Eur. Burn J., Volume 2, Issue 1 (March 2021) – 3 articles

The aim of this study was to provide insight into the admission rate, treatment, and healthcare costs of patients with fireworks-related burns admitted to a Dutch burn center in the past 10 years. We hypothesized that, like the nationwide number of injuries, the number of patients admitted to a burn center with fireworks-related burn injuries would have decreased during the study period. In this retrospective multicenter cohort study, all patients with fireworks-related burns admitted to a Dutch burn center between 2009 and 2019 were eligible. Patients were identified from a national database and data were obtained regarding admission details, patient and injury characteristics, treatment, and healthcare costs. A total of 133 patients were included. On average, 12 patients were admitted per year. No increase or decrease was observed during the study period. The median total body surface area burned was 1% (P₂₅–P₇₅ 0.5–2.5) and 75% of the burns were of partial thickness. Thirteen (10%) patients were admitted to the ICU and 66 (50%) underwent surgical treatment. The mean total healthcare costs across all 133 patients were estimated at €9040 (95% CI €5830 to €12,260) per patient. In contrast to the hypothesis, no increase or decrease was observed in burn center admissions over the past 10 years. Most burns were of small size, but nevertheless, all patients were admitted to a burn center and half of them underwent surgical treatment. Full article

Second-degree burns result in the loss of the epidermal barrier and could lead to delayed complications during the healing process. Currently, therapeutic options to treat severe burns are limited. Thus, this work aims to evaluate the effect of NaHS, a hydrogen sulfide (H₂S) donor, in poloxamer hydrogel in topical application and the potentiating effect of injected encapsulated adipose-derived stem cells (ASCs) compared to monolayer ASCs using our previous second-degree burn model on human skin explants. Indeed, our model allows testing treatments in conditions similar to a clinical application. The observed benefits of NaHS may include an antioxidant role, which might be beneficial in the case of burns. Concerning ASCs, their interest in wound healing is more than well documented. In order to evaluate the efficiency of our treatments, we analyzed the kinetics of wound closure, keratinocyte proliferation, and dermal remodeling. The effect of NaHS led to a delay in re-epithelialization, with a decrease in the number of proliferating cells and a decrease in the synthesis of procollagen III. On the contrary, intradermal injection of ASCs, encapsulated or not, improves wound healing by accelerating re-epithelialization and collagen I synthesis; however, only encapsulated ASCs accelerate keratinocyte migration and increase the rate of procollagen III and collagen III. In conclusion, NaHS treatment did not improve burn healing. However, the injection of ASCs stimulated wound healing, which is encouraging for their therapeutical use in burn treatment. Full article

Background: Burn patients are susceptible to healthcare-associated infections. Contaminated surfaces play a role in microbial transmission. This study aimed to quantify the degree of contamination of burns theatre fomites during routine clinical use. Methods: The Patslide Patient Transfer Board (PAT slide) and operating table were investigated using two methods—bacterial swabs to culture viable organisms and adenosine triphosphate (ATP) swabs to measure biological material. Both items were sampled four times a day: before the first case, immediately after a case, immediately before the next case after cleaning and after the terminal clean. Results: Among 82 bacterial samples, four organisms were isolated, including Staphylococcus aureus, Enterobacter cloacae (E. cloacae) x2 and Pseudomonas aeruginosa (P. aeruginosa), all from the PAT slide. The E. cloacae persisted after cleaning. In 9/82 swabs, the ATP count was >10 relative light units (RLU). In all cases where an organism was identified, the ATP count was >10 RLU. Hence the sensitivity and specificity of ATP > 10 RLU in detecting an organism were 100% and 94% respectively. Conclusions: Within burns theatres, there are instances of bacterial contamination on surfaces that persist despite cleaning. ATP luminometers as a point-of-care device may have a role in determining the cleanliness of surfaces, potentially minimizing onwards-bacterial transmission. Full article