scholarly journals Preliminary Assessment of Burn Depth by Paper-Based ELISA for the Detection of Angiogenin in Burn Blister Fluid—A Proof of Concept

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 127
Author(s):  
Shin-Chen Pan ◽  
Yao-Hung Tsai ◽  
Chin-Chuan Chuang ◽  
Chao-Min Cheng
Keyword(s):  
Rapid Assessment ◽  
Healing Time ◽  
Wound Management ◽  
Blister Fluid ◽  
Serum Samples ◽  
Burn Wound ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Conventional Elisa ◽  
Burn Depth

Rapid assessment of burn depth is important for burn wound management. Superficial partial-thickness burn (SPTB) wounds heal without scars, but deep partial-thickness burn (DPTB) wounds require a longer healing time and have a higher risk of scar formation. We previously found that DPTB blister fluid displayed a higher angiogenin level than SPTB blister fluid by conventional ELISA. In this study, we developed a paper-based ELISA (P-ELISA) technique for rapid assessment of angiogenin concentration in burn blister fluid. We collected six samples of SPTB blister fluid, six samples of DPTB blister fluid, and seven normal healthy serum samples for analysis. We again chose ELISA to measure and compare angiogenin levels across all of our samples, but we developed a P-ELISA tool and compared sample results from that tool to the results from conventional ELISA. As with conventional ELISA, DPTB blister fluid displayed higher angiogenin levels than SPTB in P-ELISA. Furthermore, our P-ELISA results showed a moderate correlation with conventional ELISA results. This new diagnostic technique facilitates rapid and convenient assessment of burn depth by evaluating a key molecule in burn blister fluid. It presents a novel and easy-to-learn approach that may be suitable for clinically determining burn depth with diagnostic precision.

734 A Comparison of Burn Depth Assessment Between Clinical Diagnosis and Laser Doppler Imaging

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S199-S199
Author(s):  
Suzanne Mitchell ◽  
Dhaval Bhavsar ◽  
Jessica Reynolds ◽  
Jessica Jones ◽  
Julia M Pena
Keyword(s):  
Wound Healing ◽  
Clinical Diagnosis ◽  
Laser Doppler ◽  
Burn Injuries ◽  
Burn Wound ◽  
Burn Wound Healing ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Doppler Image ◽  
Burn Depth

Abstract Introduction Accurate burn assessment is crucial to prescribing appropriate treatment and is dependent upon the experience of the provider and the timing of diagnosis relative to the burn injury evaluation. Differentiating between a deep partial thickness and full thickness burn may not be easily discernible. To augment the clinical diagnosis of burn depth, a laser doppler image measures the microvascular blood flow of injured tissue to predict burn wound healing. The aim of this study is to evaluate the clinical assessment of burn wounds by experienced burn providers compared to the laser doppler image assessment in predicting which burn wounds should heal spontaneously in 3 weeks. Methods A retrospective chart review from 2012–2016, included 54 subjects. The clinical assessment included a description of burn variables relevant to the determination of spontaneous burn wound healing (burn depth, total body surface area, mechanism of injury, anatomical location, clinical burn depth diagnosis, and laser doppler image). A chi-square analysis compared the clinical diagnosis and the laser doppler assessment of burn wound depth, as well as the correlation between clinical diagnosis versus laser doppler image in predicting spontaneous burn wound healing. Results Comparing partial thickness burn injuries, there were 38 clinically diagnosed partial thickness injuries (by experienced burn providers) and 38 partial thickness burn injures diagnosed via LDI. Deep partial thickness burn injuries were diagnosed clinically in 9 subjects, compared to 10 via LDI. Full thickness burn injuries were diagnosed clinically in 7 subjects and 6 via LDI. A chi-square test was performed to examine the relationship between clinical diagnosis of burn depth and laser doppler image. The relation between these variables was significant,X2= 26.884, p< .000. Comparing clinically diagnosed burn depth to LDI, each approach (clinical or LDI) diagnosed 42 subjects with partial thickness or deep partial thickness burn injuries and all healed spontaneously. Two of the clinically diagnosed full thickness burn injuries required skin grafting. Six patients were lost to follow-up (X2= 17.745, p < .001). Conclusions This study confirms there is no difference between an experienced burn provider’s clinical diagnosis of burn wound depth and prognosis for spontaneous healing compared to a laser doppler image prognosis of burn wound healing. Applicability of Research to Practice In an era of advanced technologies, expert clinical bedside assessment is the standard of care.

Deep partial thickness burn blister fluid promotes neovascularization in the early stage of burn wound healing

2010 ◽  
Vol 18 (3) ◽  
pp. 311-318 ◽  
Author(s):  
Shin-Chen Pan ◽  
Li-Wha Wu ◽  
Chung-Lin Chen ◽  
Shyh-Jou Shieh ◽  
Haw-Yen Chiu
Keyword(s):  
Wound Healing ◽  
Early Stage ◽  
Blister Fluid ◽  
Burn Wound ◽  
Burn Wound Healing ◽  
Partial Thickness ◽  
Partial Thickness Burn

726 The Use of Xeroform Dressings for Partial Thickness Scald Burn Injuries in a Verified Pediatric Burn Center

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S194-S195
Author(s):  
Lisa C Vitale ◽  
Jennifer Livingston ◽  
Erica Curtis ◽  
Katherine Oag ◽  
Christina M Shanti ◽  
...  
Keyword(s):  
Burn Injury ◽  
Wound Care ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Wound Complications ◽  
Burn Wound ◽  
Burn Center ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
At Home

Abstract Introduction For children who have suffered a burn injury one of the greatest challenges is managing pain with an adequate yet practical burn wound dressing that will ultimately be managed at home. Medical product companies have created a variety of wound care products available on the market. These products are advertised to be more superior over one another in categories such as decrease in wound infections, minimization of pain, ease of dressing application, increased dressing wear time, and better wound healing. With all the options for burn wound care there are many factors to consider when choosing a burn dressing such as cost, ease of dressing for families at home, comfort, and efficacy. At our ten year verified pediatric burn center we have tried many different burn wound care products, however we have found Xeroform and bacitracin to be the most practical and easy to use for our patient population. Methods A retrospective chart review was performed from 2016–2018 of all cascading scald injuries to children 0–5 years of age treated at our verified pediatric burn center. 179 patients were included in this review. Of those patients a total of 52 patients were excluded, 28 patients had no follow up, 21 patients received alternate dressings, and 3 patients had full thickness injuries requiring a split thickness skin graft (STSG). Charts were reviewed for total body surface area (TBSA), length of stay (LOS), discharge dressing type, complications, and time to healing. All patients included routinely received consistent application of the Xeroform and bacitracin. Results 127 patients discharged with Xeroform dressings were included in this study with an average age of 1.4 years old (range 0–5 years) and average TBSA of 2.5% (range 0.25–13%). The average LOS was 1.6 days (range 1–10 days). In this sample 32 (25%) patients were healed within 7 days. 77 (61%) patients were healed within 7–14 days. 11 (9%) patients were healed within 14–21 days. 7 (5%) patients were healed in greater than 21 days. There were no wound complications identified within this study group. Conclusions Using Xeroform as our standard of practice has streamlined the care provided to our patients. We have demonstrated consistent effective re-epithelization, protection from infection, and ease of dressings for families and burn providers. In our experience Xeroform has provided a versatile way to care for partial thickness burn injuries. Applicability of Research to Practice We suggest Xeroform and bacitracin dressings be used for partial thickness burn injuries in patients under 5 years of age. This dressing may be superior to other products because it allows for bathing while providing good wound epithelization and is easy to use.

535 Porcine Infected Partial-Thickness Burn Wound Model

2018 ◽  
Vol 39 (suppl_1) ◽  
pp. S241-S241
Author(s):  
F M Egro ◽  
M Schusterman ◽  
D Kim ◽  
D Grybowski ◽  
I James ◽  
...  
Keyword(s):  
Burn Wound ◽  
Wound Model ◽  
Partial Thickness ◽  
Partial Thickness Burn

54 Validation of Infrared Thermography for Prediction of 21-day Burn Wound Healing

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S35-S36
Author(s):  
Michael P Peterson ◽  
Matthew A Firpo ◽  
Irma D Fleming ◽  
Clement Vachet ◽  
Zachary T Huston ◽  
...  
Keyword(s):  
Infrared Thermography ◽  
Animal Studies ◽  
Demographic Data ◽  
Doppler Imaging ◽  
P Value ◽  
Burn Wound ◽  
Absolute Increase ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Significant Difference

Abstract Introduction Although trained specialists easily identify most full and superficial partial thickness burn injuries, deep partial-thickness injuries present a true challenge to the clinician. Various imaging modalities to assess perfusion and determine healing potential include skin biopsy with histology, laser doppler imaging, active dynamic and static infrared thermography, vital dyes, indocyanine green video angiography and others. Prior studies indicate, with small clinical and animal studies, forward looking infrared is a valid tool to assess healing potential and 21-day healing within the first 48 hrs after presentation. The aim of our study is to determine if an absolute increase or decrease in temperature (°C) measurements across a burn wound in a large clinical cohort correlates with 21-day healing after 48 hrs from time of injury. Methods After informed photo consent was obtained, thermographic images were captured at presentation, 24hrs, and 48hrs from patients admitted to our center between October 2018 and August 2019. Thermographic images were reviewed and temp measurements obtained using a linear vector through the wound. Next we determined if patients healed within 21 days. Data collected includes demographic data, burn characteristics, injury site (based on Lund Browder segmentation) and wound temp (average, minimum, maximum). Data was analyzed using Wilcoxon rank sum test with continuity correction. Results We reviewed images for 159 burn sites from 29 patients, the largest image set to be reviewed to date. The cases were 84% male, the mean and range was 33.1 years (1.7 – 70) for age and 25% (2 – 54.5) for TBSA. We found an average temp difference between 24 hrs – 48 hrs (p-value= 0.007) was significant, and no significant difference in average temp change when evaluating admit – 24 hrs (p-value=0.053) and admit – 48 hrs (p-value=0.316), consistent with predictions of prior studies. Average temp from admit – 24 hrs decreased by 0.86°C in healed (n=48) vs non-healed (n=91); increased on average by 1.25°C in healed (n=39) vs non-healed (n=74) from 24 hrs – 48 hrs; and showed a modest decrease by 0.3°C in healed (n=50) vs non-healed (n=82) when comparing admit 48 hr temp. Conclusions These data demonstrate that burn wound temperature difference between 24 and 48 hours after admittance as measured by infrared thermography correlates with clinical outcomes and 21 day healing. Applicability of Research to Practice Infrared thermography is a validated tool to assess burn depth after 48 hrs. In the future, this modality may impact triage in the military, rural, accidental and non-accidental disasters.

The wound management of patients with partial thickness burn injuries

1995 ◽  
Vol 4 (6) ◽  
pp. 256-258 ◽  
Author(s):  
B. Sperring ◽  
F. Wood ◽  
A Crocker
Keyword(s):  
Burn Injuries ◽  
Wound Management ◽  
Partial Thickness ◽  
Partial Thickness Burn

scholarly journals Comparison of the outcome of amnion versus conventional (Vaseline-impregnated gauze) dressing in superficial partial thickness burn patients in terms of healing time and mean pain.

2021 ◽  
Vol 28 (09) ◽  
pp. 1262-1268
Author(s):  
Abdul Malik Mujahid ◽  
Husnain Khan ◽  
Usman Ishhaque ◽  
Sania Ahmad ◽  
Kashif Mehmood ◽  
...  
Keyword(s):  
Pain Score ◽  
Healing Time ◽  
P Value ◽  
Burn Patients ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Group A ◽  
Gauze Dressing ◽  
Group B ◽  
Dressing Change

Objectives: To compare the healing time and mean pain score of Amnion versus Conventional (Vaseline-impregnated gauze) dressing in superficial partial thickness burn patients. Study Design: Randomized controlled study. Settings: Plastic & Reconstructive Surgery Department, Jinnah Hospital & Burn Center, Lahore. Period: January 2018 to January 2019. Material & Methods: A total of 60 patients with superficial second degree burns full filling the inclusion criteria were recruited for the study. Subjects were divided into two groups randomly. All patients were followed up regularly and dressing was changed on alternate days in Group B (Vaseline-impregnated gauze) and only secondary dressing was changed in Group A (amnion) until the auto sloughage (self-removal) of amnion. Outcome variables i.e. pain during first dressing change and healing time were noted. Statistical analysis of data was done using SPSS version 22. Quantitative variables i.e. age, duration of burn, total body surface area, pain during dressing and healing time were presented as mean and standard deviation. Frequency and percentage was calculated for qualitative variables like gender. The pain during dressing change and healing time of both groups were compared for difference. Student’t’ test was applied to compare the outcome and p-value ≤0.05 was considered as significant. Results: Out of sixty cases, 18 (30.0%) were females and 42 (70.0%) were males, with female to male ratio of 1:2.3. Mean age of patients in group A was 33.0 ± 10.19 years and in group B was 33.73 ± 9.55 years. The mean pain score in group A (amnion group) was 1.93 ± 0.91 and in group B (Vaseline-impregnated gauze) was 3.33 ± 1.56 with p-value of 0.0001. The mean healing time in group A (amnion group) was 15.73 ± 2.79 days and in group B (Vaseline-impregnated gauze) was 22.80 ± 4.44 days with p-value of 0.0001. Conclusion: Amnion dressing in superficial partial thickness burn patients is more effective in terms of mean pain score and healing time as compared to conventional (Vaseline-impregnated gauze) dressing.

scholarly journals Coming to Consensus: What Defines Deep Partial Thickness Burn Injuries in Porcine Models?

2020 ◽  
Author(s):  
Angela L F Gibson ◽  
Bonnie C Carney ◽  
Leila Cuttle ◽  
Christine J Andrews ◽  
Christine J Kowalczewski ◽  
...  
Keyword(s):  
Animal Models ◽  
Burn Injury ◽  
Burn Injuries ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Consensus Statements ◽  
Partial Thickness Burns ◽  
Burn Depth ◽  
Histological Staining ◽  
Educational Component

Abstract Deep partial thickness burns are clinically prevalent and difficult to diagnose. In order to develop methods to assess burn depth and therapies to treat deep partial thickness burns, reliable, accurate animal models are needed. The variety of animal models in the literature and the lack of precise details reported for the experimental procedures make comparison of research between investigators challenging and ultimately affect translation to patients. They sought to compare deep partial thickness porcine burn models from five well-established laboratories. In doing so, they uncovered a lack of consistency in approaches to the evaluation of burn injury depth that was present within and among various models. They then used an iterative process to develop a scoring rubric with an educational component to facilitate burn injury depth evaluation that improved reliability of the scoring. Using the developed rubric to re-score the five burn models, they found that all models created a deep partial thickness injury and that agreement about specific characteristics identified on histological staining was improved. Finally, they present consensus statements on the evaluation and interpretation of the microanatomy of deep partial thickness burns in pigs.

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