Hypertrophic scarring: the greatest unmet challenge after burn injury

Finnerty, Celeste C.; Jeschke, Marc G.; Branski, Ludwik K.; Barret, Juan P.; Dziewulski, Peter; Herndon, David N.

doi:10.1016/s0140-6736(16)31406-4

Cited by 479 publications

(397 citation statements)

References 113 publications

(116 reference statements)

Supporting

Mentioning

356

Contrasting

Unclassified

Order By: Relevance

“…Hypertrophic scars develop in more than half of deep partialthickness burn wounds, typically after prolonged inflammation, and once formed, treatments are only minimally effective. 6 Therefore, treatments are needed that promote regenerative healing before these scars form. TLR signaling pathways are among the candidate molecular targets for such treatments.…”

Section: Discussionmentioning

confidence: 99%

Toll-Like Receptor Signaling in Burn Wound Healing and Scarring

D’Arpa

Leung

2017

Advances in Wound Care

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Toll-Like Receptor Signaling in Burn Wound Healing and Scarring

D’Arpa

Leung

2017

Advances in Wound Care

View full text Add to dashboard Cite

“…Therefore a linear mixed model was fit in which acute pain (≤ 6 weeks, corresponding to the inflammatory and proliferative phase of wound healing [11; 54]) and persistent pain (> 6 weeks, corresponding to the maturation phase of wound healing [11; 18]) were represented by separate linear components conjoined at a node 6 weeks after injury (Figure 2a).…”

Section: Resultsmentioning

confidence: 99%

Pain and itch outcome trajectories differ among European American and African American survivors of major thermal burn injury

Mauck

Smith

Shupp

et al. 2017

PAIN

View full text Add to dashboard Cite

Over half of individuals experiencing major thermal burn injury (MThBI) receive an autologous skin graft (autograft), in which skin is removed from a healthy “donor” site and transplanted to the burn site. Persistent pain/itch at the graft site are major causes of suffering and disability in MThBI survivors. African Americans have a higher risk of MThBI, and in other clinical settings African Americans experience a greater burden of pain and itch relative to European Americans. However, to our knowledge, ethnic differences in skin graft site pain/itch outcomes after MThBI have not been assessed. We evaluated skin graft site pain and itch severity (0–10 numeric rating scale (NRS)) over 1 year in a prospective multicenter cohort sample of African Americans and European Americans. In adjusted linear mixed models African Americans experienced a slower rate of pain resolution in the acute phase of recovery (β=−0.05 versus −0.08 NRS points per day, p<0.001), which resulted in a higher pain severity in the persistent phase of recovery (NRS mean difference=1.21, 95% CI [0.12, 2.29]), although not statistically significant after correction for multiple comparisons. African Americans also experience greater itch severity in the 6 weeks to 12 months after burn injury compared to European Americans (NRS mean difference=1.86 [0.80–2.93]), which results from a faster rate of itch development in African Americans in the acute recovery phase after burn injury. Future studies may improve outcomes in African Americans and lead to new pathogenic insights that benefit all burn injury survivors.

show abstract

“…Deep partial thickness wounds requiring ≥three weeks to heal will likely leave hypertrophic scars and disfiguring contractures (15). For large burns, allograft is applied to burned regions until sufficient donor-site grafts can be harvested or cultured epidermal autografts created (16).…”

Section: Early Excision and Grafting Of The Burn Woundmentioning

confidence: 99%

The P50 Research Center in Perioperative Sciences

Finnerty

Čapek

Voigt

et al. 2017

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

Since the inception of the P50 Research Center in Peri-Operative Sciences (RCIPS) funding mechanism, the National Institute for General Medical Sciences has supported a team approach to science. Many advances in critical care, particularly burns, have been driven by RCIPS teams. In fact, burns that were fatal in the early 1970s, prior to the inception of the P50 RCIPS program, are now routinely survived as a result of the P50-funded research. The advances in clinical care that led to the reduction in post-burn death were made by optimizing resuscitation, incorporating early excision and grafting, bolstering acute care including support for inhalation injury, modulating the hypermetabolic response, augmenting the immune response, incorporating aerobic exercise, and developing anti-scarring strategies. The work of the Burn RCIPS programs advanced our understanding of the pathophysiological response to burn injury. As a result, the effects of a large burn on all organ systems have been studied, leading to the discovery of persistent dysfunction, elucidation of the underlying molecular mechanisms, and identification of potential therapeutic targets. Survival and subsequent patient satisfaction with quality of life have increased. In this review article, we describe the contributions of the Galveston P50 RCIPS that have changed post-burn care and have considerably reduced post-burn mortality.

show abstract

Hypertrophic scarring: the greatest unmet challenge after burn injury

Cited by 479 publications

References 113 publications

Toll-Like Receptor Signaling in Burn Wound Healing and Scarring

Toll-Like Receptor Signaling in Burn Wound Healing and Scarring

Pain and itch outcome trajectories differ among European American and African American survivors of major thermal burn injury

The P50 Research Center in Perioperative Sciences

Contact Info

Product

Resources

About