scholarly journals Activity Impairment, Work Status, and Work Productivity Loss in Adults 5–7 Years After Burn Injuries

2021 ◽  
Author(s):  
Inge Spronk ◽  
Nancy EE Van Loey ◽  
Cornelis H van der Vlies ◽  
Juanita A Haagsma ◽  
Suzanne Polinder ◽  
...  
Keyword(s):  
Productivity Loss ◽  
Total Body Surface Area ◽  
Work Productivity ◽  
Burn Injuries ◽  
Work Status ◽  
Burn Patients ◽  
Work Situation ◽  
Activity Impairment ◽  
Severe Burns ◽  
Specific Health

Abstract An important aspect of the rehabilitation of burn patients is social participation, including daily activities and work. Detailed information on long-term activity impairment and employment is scarce. Therefore, we investigated activity impairment, work status, and work productivity loss in adults 5–7 years following burn injuries, and investigated associations with burn-specific health-related quality of life (HRQL) domains. Adult participants completed the Work Productivity and Activity Impairment General Health questionnaire and the Burn Specific Health Scale-brief (BSHS-B) 5–7 years post-burn. Outcomes were compared between participants with mild/intermediate and severe burns (>20% total body surface area burned). Seventy-six (36%) of the 213 participants experienced some degree of activity impairment due to burn-related problems 5–7 years post-burn. Seventy percent of the population was employed; 12% of them experienced work productivity loss due to burn-related problems. Nineteen percent reported changes in their work situation (partly) because of the burn injury. A higher proportion of participants with severe burns had activity impairments (56% vs 29%; P = .001) and work productivity loss (26% vs 8%; P < .001) compared to participants with mild/intermediate burns. Activity impairment and work productivity loss were both associated with burn-related work problems and lower mood, measured with the BSHS-B. In conclusion, a substantial part of the study population experienced activity impairment and work productivity loss, was unemployed, and/or reported changes in their work situation due to their injury. Particularly patients with severe burns reported productivity loss and had lower employment rates. This subscribes the importance of addressing work-related functioning in the rehabilitation of burn patients.

31 A phase 3 open-label, controlled, randomized trial evaluating the efficacy and safety of a bioengineered allogeneic cellularized construct in patients with deep partial-thickness thermal burns

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S25-S26
Author(s):  
Angela L F Gibson ◽  
James H Holmes ◽  
Jeffrey W Shupp ◽  
David Smith ◽  
Victor Joe ◽  
...  
Keyword(s):  
Donor Site ◽  
Efficacy And Safety ◽  
Phase 3 ◽  
Thermal Burns ◽  
Treatment Site ◽  
Severe Burns ◽  
Donor Site Pain ◽  
The Difference ◽  
Percent Area ◽  
Site Pain

Abstract Introduction Autograft (AG) is the standard of care for treatment of severe burns. While AG provides effective wound closure (WC), the procedure creates a donor site wound prone to pain and scarring. In a phase 1b trial, no deep partial-thickness (DPT) wound treated with a bioengineered allogeneic cellularized construct (BACC) required AG by Day 28 and WC at the BACC site was achieved in 93% of patients by Month (M) 3. This phase 3 study (NCT03005106) evaluated the efficacy and safety of this BACC in patients with DPT burns. Methods Enrolled patients were aged ≥18 years with 3–49% TBSA thermal burns on the torso or extremities. In each patient, two DPT areas (≤2,000 cm2 total) deemed comparable following excision were randomized to treatment with either cryopreserved BACC or AG. Coprimary endpoints were 1) the difference in percent area of BACC treatment site and AG treatment site autografted at M3 and 2) the proportion of patients achieving durable WC of the BACC treatment site without AG at M3. Ranked secondary endpoints were: 1) the difference between BACC and AG donor sites in average donor site pain intensity through Day 14; 2) the difference between BACC and AG donor site cosmesis at M3; and 3) the difference between BACC and AG treatment site cosmesis at M12. Safety assessments were performed in all patients through M12. Results Seventy-one patients were enrolled. By M3, there was a 96% reduction in mean percent area of BACC treatment sites that required AG, compared with AG treatment sites (4.3% vs 102.1%, respectively; P<.0001). BACC treatment resulted in durable WC at M3 without AG in 92% (95% CI: 85.6, 98.8; 59/64) of patients for whom data was available. By M3, mean donor site Patient and Observer Scar Assessment Scale (POSAS) observer total score (±SD) was significantly lower (more like normal skin) for BACC donor sites compared with AG donor sites (6.3 ± 1.71 vs 16.3 ± 7.71; P<.0001). At M12, mean POSAS observer total score (±SD) was 15.6 (± 8.34) for BACC treatment sites compared with 16.3 (± 9.41) for AG treatment sites (P=.4268). The most common BACC-related adverse event (AE) was pruritus, which occurred in 11 (15%) patients. All BACC-related AEs were mild or moderate in severity. Conclusions This phase 3 study achieved both coprimary endpoints, including significant autograft sparing and durable WC in DPT burns. Both donor site pain and donor site cosmesis were favorable outcomes of significantly reduced use of AG in BACC-treated patients. M12 POSAS for BACC did not differ significantly from AG. This BACC may offer a new treatment for severe burns to reduce or eliminate the need for AG. Applicability of Research to Practice This BACC has shown clinical benefit in patients with DPT thermal burns, potentially mitigating donor site morbidity. External Funding Stratatech, a Mallinckrodt Company; Funding and technical support for the Phase 3 clinical study were provided by the Biomedical Advanced Research and Development Authority (BARDA), under the Assistant Secretary for Preparedness and Response, within the U.S. Department of Health and Human Services, under Project BioShield Contract No. HHSO100201500027C.

Prevention of stress ulcer bleeding with cimetidine in severe burns

Burns ◽  
1983 ◽  
Vol 9 (5) ◽  
pp. 327-329 ◽  
Author(s):  
Liu Yao-Liang ◽  
Yuan Ke-Jian
Keyword(s):  
Stress Ulcer ◽  
Ulcer Bleeding ◽  
Severe Burns ◽  
Stress Ulcer Bleeding

Critical care management of hydrofluoric acid burns with a negative outcome

2021 ◽  
Vol 14 (6) ◽  
pp. e242187
Author(s):  
Aalekh Prasad ◽  
Heba Ibrahim ◽  
Katherine Mortimore ◽  
Rohan Vandabona
Keyword(s):  
Hydrofluoric Acid ◽  
Care Management ◽  
Vital Role ◽  
Severe Metabolic Acidosis ◽  
Fluoride Ions ◽  
Subcutaneous Injections ◽  
Electrolyte Disturbances ◽  
Severe Burns ◽  
Systemic Reactions ◽  
Critical Care Management

Hydrofluoric acid is a highly corrosive acid widely used in various industries. When in contact with skin it causes local and systemic reactions due to the generation of fluoride ions. Severe burns are associated with high mortality rates, approaching 100%. We present a 21-year-old man with 15% full thickness burns, severe metabolic acidosis, hypoxia and electrolyte disturbances. The burns were treated with topical and subcutaneous injections of calcium gluconate, and the patient was given intravenous fluid, calcium chloride, magnesium and insulin-glucose infusions. Continuous renal replacement therapy was initiated due to the severity of the systemic toxicity. Extracorporeal membrane oxygenation was considered as it plays a vital role when conventional therapies fail. Our patient suffered multiple cardiac arrests and cardiopulmonary resuscitation was conducted several times but despite extensive efforts, he did not survive.

scholarly journals The Influence of Obesity on Treatment and Outcome of Severely Burned Patients

2019 ◽  
Vol 40 (6) ◽  
pp. 996-1008 ◽  
Author(s):  
Christian Tapking ◽  
Khosrow S Houschyar ◽  
Victoria G Rontoyanni ◽  
Gabriel Hundeshagen ◽  
Karl-Friedrich Kowalewski ◽  
...  
Keyword(s):  
Fluid Resuscitation ◽  
Chronic Conditions ◽  
Perioperative Management ◽  
Normal Weight ◽  
Burn Patients ◽  
Obese Patients ◽  
Nonalcoholic Fatty Liver ◽  
Wound Coverage ◽  
Severe Burns ◽  
Early Wound

Abstract Obesity and the related medical, social, and economic impacts are relevant multifactorial and chronic conditions that also have a meaningful impact on outcomes following a severe injury, including burns. In addition to burn-specific difficulties, such as adequate hypermetabolic response, fluid resuscitation, and early wound coverage, obese patients also present with common comorbidities, such as arterial hypertension, diabetes mellitus, or nonalcoholic fatty liver disease. In addition, the pathophysiologic response to severe burns can be enhanced. Besides the increased morbidity and mortality compared to burn patients with normal weight, obese patients present a challenge in fluid resuscitation, perioperative management, and difficulties in wound healing. The present work is an in-depth review of the current understanding of the influence of obesity on the management and outcome of severe burns.

Sign in / Sign up

Export Citation Format

Share Document