Synopsis of the 2013 Annual Report of the National Burn Repository

Bessey, Palmer Q.; Phillips, Bart D; Lentz, Christopher W.; Edelman, Linda S.; Faraklas, Iris; Finocchiaro, Margaret A.; Kemalyan, Nathan; Klein, Matthew B.; Miller, Sidney F.; Mosier, Michael J.; Potenza, Bruce; Reigart, Cynthia L.; Browning, Susan; Kiley, M.; Krichbaum, John A.

doi:10.1097/bcr.0000000000000080

Cited by 51 publications

(28 citation statements)

References 2 publications

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“…Outcomes after burn injuries vary; data from the National Burn Repository (NBR) shows high variability in mortality rates (2% to 12% hospital mortality) in high-volume centers, even after adjustment for burn severity 5 . This variability remains mostly unexplained, but is likely related to factors such as distribution of comorbidities including substance abuse, and infection rates.…”

Section: Introductionmentioning

confidence: 99%

Timeline of health care–associated infections and pathogens after burn injuries

Duin

Strassle

DiBiase

et al. 2016

American Journal of Infection Control

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Background Infections are an important cause of morbidity and mortality after burn injuries. Here, we describe the timeline of infections and pathogens after burns. Methods A retrospective study was performed in a large tertiary care burn center from 2004 through 2013. Analyses were performed on healthcare-associated infections (HAI) meeting Centers for Disease Control and Prevention criteria and on all positive cultures. Incidence rates (IR) per 1,000 days were calculated for specific HAI categories and pathogens, and across hospitalization time (week 1, 2–3 and 4+). Results Among 5,524 patients the median burn size was 4% of total body surface area (interquartile range, 2–10%). 7% of patients developed an HAI, of whom 33% had more than one HAI episode. Gram-positive bacteria were isolated earlier and Gram-negative later during hospitalization. Of 1,788 bacterial isolates, 44% met criteria for multi-drug resistance and 23% for extensive drug resistance. Bacteria tended to become increasingly resistant to antibiotics as time from admission increased. Conclusions We observed differences in infection type, pathogen and antibiotic resistant bacterium risk across time of hospitalization. These results may guide infection prevention in various stages of the post-burn admission.

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Section: Introductionmentioning

confidence: 99%

Timeline of health care–associated infections and pathogens after burn injuries

Duin

Strassle

DiBiase

et al. 2016

American Journal of Infection Control

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“…Although European Americans had lower aggregate mental health functioning (assessed via the SF-12) prior to MThBI, adjusting for this did not significantly influence the results that Aftrican American’s experience greater pain and itch severity following MThBI. These study results are important, given that African Americans are at 50% higher risk of sustaining a burn injury based on estimated from the National Burn Registry and US Census data [2; 8]. …”

Section: Discussionmentioning

confidence: 99%

“…primary biliary cirrhosis[46], eczema[52]). If confirmed by future studies, an increased burden of pain and itch experienced by African American MThBI survivors is of particular importance as African Americans are at higher risk of MThBI [2]. …”

Section: Discussionmentioning

confidence: 99%

“…There was no patient in the sample who self reported a mast cell disorder. Individuals with <30% total body surface area burn were enrolled because such individuals constitute the great majority of burns that present to a burn center [2] and are able to provide pain scores (e.g., are not intubated). Other exclusion criteria were chosen to remove heterogeneous populations (e.g., children, electrical burns, individuals presenting long after injury).…”

Section: Methodsmentioning

confidence: 99%

“…Based on data from the National Burn Registry and the US Census data, African Americans are 1.5 times as likely to experience burn injury compared to European Americans [2; 8], and in other clinical settings African Americans have been shown to experience a greater burden of pain and itch relative to European Americans [14; 17; 50; 56]. Some of this disparity in pain and itch outcomes is likely due to the markedly greater socioeconomic disadvantage experienced by African Americans [25; 41; 64]; however, evidence from other health conditions characterized by chronic pain and/or itch suggests that differences in health outcomes between African Americans and European Americans may not be due to socioeconomic differences alone [46; 52; 56; 64].…”

Section: Introductionmentioning

confidence: 99%

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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

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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.

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A Battery Powered, Portable, and Self-Contained Non-Thermal Helium Plasma Jet Device for Point-of-Injury Burn Wound Treatment

Parkey

Cross

Hayes

et al. 2015

Plasma Process. Polym.

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Non-thermal plasmas (NTP) have been shown to be promising for disinfection, blood coagulation, and cutaneous wound healing applications. Unfortunately, most existing NTP technologies rely on bulky and specialized instrumentation which limits their utility for pointof-injury wound treatment. Here we discuss the fabrication of an inexpensive, compact, lightweight, battery powered, portable, and self-contained helium NTP jet device for potential applicability in burn wound treatment directly at the point-of-injury or during transport of the burn casualty to a medical facility. Using the NTP jet we demonstrate rapid inactivation of three bacterial species, two of which are implicated in causing burn wound infection. We also demonstrate that application of the NTP jet improves the rate of closure of deep partial thickness thermal burn wounds compared to untreated wounds in vitro (EpiDermFT).

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Synopsis of the 2013 Annual Report of the National Burn Repository

Cited by 51 publications

References 2 publications

Timeline of health care–associated infections and pathogens after burn injuries

Timeline of health care–associated infections and pathogens after burn injuries

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

A Battery Powered, Portable, and Self-Contained Non-Thermal Helium Plasma Jet Device for Point-of-Injury Burn Wound Treatment

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