The phases of burn care include initial resuscitation, definitive wound management, and reha- bilitation of physical and psychological injuries. In severe burns, this response lasts for the first two to three days post-burn and burns larger than 15% of total body surface area lead to the initiation of systemic inflammatory response syndrome. Neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker that can indicate systemic inflammation. NLR is defined by the absolute number of neutrophils divided by the absolute number of lymphocytes. Many studies have been done in severe burn patients because they reflect changes in the sys temic inflammatory response. This study aimed to investigate the prognostic value of NLR values in patients with severe burns and provide clinical guidance for sepsis and mortality. This was a retrospective cohort study conducted in the Service of Burns of the University Hospital Centre “Mother Teresa” in Tirana (UHCT), Albania. We compared NLR levels in burn patients with sepsis and without sepsis. Our data showed a significantly higher level of NLR in burn patients with sepsis, while the values of NLR on the 3rd day (NLR 3) have statistical significance. From the logistic regression analysis, we found that only NLR 3 can predict mortality, whose cut-off (4.59) was determined with the help of ROC curve analysis and was accurately presented with the help of Kaplan-Meier curves with statistical significance. From multiple regression, we understand that mortality can be predicted based on TBSA%, age, presence of inhalatory burn, and NLR 3 together.

Burn injury is trauma that has a negative impact on physical and psychosocial function and affects quality of life in post-burn patients. This study aimed to measure quality of life and analyze factors that affect quality of life, including psychological aspects in post-burn patients. This was an analytic observational study with a cross-sectional design. The study was conducted at the plastic surgery outpatient unit of Dr. Soetomo from May to August 2024 among post-burn patients who met the inclusion criteria. Quality of life was measured using the Burn Specific Health Scale Brief (BSHS-B) questionnaire, and measurement of patient depression levels uses the PHQ-9 questionnaire. Binary logistic regression was used to analyze the factors that affect quality of life. One hundred and thirteen patients were included in this study, with the majority being male. Overall, the patients’ quality of life was classified as good, with an average score of 99.71 ± 30.75. Based on the PHQ-9 score, the post-burn patients were classified as mildly depressed. For female patients, the burn area, frequency of debridement, comorbid diseases and PHQ-9 score affected their quality of life. This study concluded that post-burn patients had a good quality of life. Interventions need to be carried out by the burn care team to improve quality of life, especially for patients with risk factors.

Burns are among the most serious injuries worldwide, ranking fifth in terms of non-fatal injuries in children. Scald injuries represent a significant global burden, especially in children. Scalds result from exposure to boiling liquids or steam and cause varying degrees of skin injury depending on the temperature and duration of contact. They typically occur either through immersion or spillover incidents. The study aimed to compare immersion and spillover burns in children to improve prevention strategies, treatment approaches, and overall outcomes for young burn victims. An analytical cross-sectional study was conducted at the Burn Care Center of the Pakistan Institute of Medical Sciences, Islamabad by reviewing data on scald cases admitted during 2022-2023 with a study duration of 12 months. Data from 266 scald cases were analyzed, including 148 male and 118 female patients. Of these cases, 156 were spillover burns and 110 were immersion burns. Spillover burns (24.1%) affected a slightly smaller area of the body compared to immersion burns (26.5%) which was statistically significant (p=0.004). Number of fasciotomies and mortality rate was higher in immersion burns (28.1% and 68.4% respectively) than spillover burns (2.56% and 31.5%). Overall, spillover burns were more common, but immersion burns were more severe and fatal. Scald burns in children, though preventable, remain a major concern. Immersions, despite being less common, result in higher mortality and severe outcomes. Effective prevention strategies, including improved parental supervision and widespread public awareness through social media and communication channels, are essential to reduce the incidence and severity of scald burns.

Le syndrome de détresse respiratoire aiguë (SDRA) est une pathologie fréquente en réanimation, associée à une mortalité élevée. Nous avons mené une étude rétrospective descriptive monocentrique, dans le service de réanimation des brûlés, sur 4 ans (Janvier 2018-Décembre 2021), incluant les patients ayant présenté un SDRA, retenu selon la définition de Berlin de 2012. Mille cent cinquante patients ont été admis dans le service, 360 ont été intubés (31%) dont 100 ont présenté un SDRA (28%). L’âge moyen était de 40±13 ans avec un genre- ratio M/F de 1,8. L’IGS II et L’APACHE II moyens étaient respectivement de 34 (29-42) et 18 (15-21). La surface cutanée brûlée (SCB) moyenne était de 46±18%, le score ABSI moyen était de 7,6±2,5. Le SDRA était sévère dans 60% des cas et modéré dans 40% des cas. Le délai moyen de diagnostic par rapport aux brûlures était de 5,8±4 jours. Le SDRA était secondaire à une pneumonie nosocomiale dans 56% des cas, aux atteintes pulmonaires initiales dans 22% des cas et mixte dans 22% des cas. La durée moyenne de ventilation mécanique était de 12,6±5,3 jours et la durée moyenne de séjour était de 13,7±5 jours. La mortalité était de 61%. En analyse multivariée, les facteurs indépendants de mortalité étaient une SCB supérieure à 39% (p=0,02), un IGS II supérieur à 27, un APACHE II supérieur à 14,5, la présence de lésions pulmonaires initialeset la survenue d’un état de choc.

This is a longitudinal study of 40 firefighters, in which the effects of firefighting on saliva were investigated using firefighting simulators. Salivary concentrations of TNF-α, IL-6, IL-10, lactoferrin and lysozyme were measured using the ELISA method, and salivary volume and pH were measured before and after firefighting exposure. The concentrations of TNF-α, IL-6, lactoferrin and lysozyme showed no significant changes, in contrast there was a decrease in the concentrations of IL-10 in pH and saliva production of firefighters after acute exposure to firefighting. We conclude that firefighting alters the composition of saliva.

Denatured alcohol, bioethanol and the many forms of devices that use these flammable liquids rep- resent a significant risk for severe burn injury. The experiences and perspectives of former victims of accidents with these accelerants and fuels have scarcely been reported. The objective of this qualitative semi-structured interview study was to describe former burn patients’ experience of their accidents using flammable liquids, as well as their perspective on future prevention. Three themes were identified: “to be shocked”; “to be vigilant”; and “to use what was learnt”. This meant that for all participants, the totally unexpected explosive character of the accident and the severe consequences for those burned had made them rethink earlier beliefs and adapt behaviour, as well as engage and come up with suggestions for future preventive measures. Hence, burn accidents caused by denatured alcohol or bioethanol resulted in an unanticipated and shocking experience with large injuries and longterm physical and psychological consequences, including increased vigilance and altered behaviour. The former burn victims suggested strong and combined preventive actions involving information, education for use, improved design of devices, as well as restrictions and regulations involving stakeholders, authorities and users.

Renal failure frequently occurs as the primary organ failure in patients with severe burns, but accurately defining acute kidney injury and renal failure remains complex. This study aims to explore the relationship between these commonly measured renal biomarkers, diuresis and clinical outcomes in burn patients. The purpose of this study was to investigate the relationship between serum creatinine and urea levels, and the clinical outcomes in burn patients. By analyzing this relationship, the study aims to enhance the understanding of renal function and its impact on prognosis in patients with severe burns, thereby improving the management and treatment strategies for this vulnerable patient population. This was a retrospective cohort study that examined patients from the Department of Burns and Plastic Surgery at “Mother Teresa” University Hospital Center in Tirana, Albania. Data were collected from the burn registry and Medical Records from January 2023 to April 2024. Elevated creatinine levels upon admission are linked with a higher risk of morbidity and mortality. Similarly, increased urea levels and low diuresis are also associated with poor prognosis in burn patients. We propose that both admission creatinine and urea levels, along with diuresis measurements, can serve as “warning signs” to identify patients at higher risk for adverse outcomes.

The study investigates the potential of Karsen leaves (Muntingia calabura L.) extract in spray gel form to aid the healing of second-degree burns. This experimental research assesses the effects of the extract on key inflammatory and proliferative indicators: wound temperature, erythema, skin moisture and wound contraction. Rats with induced burns were treated with varying concentrations (12.5%, 15% and 17.5%) of the extract over 14 days. Results demonstrated that the 15% concentration effectively managed wound base temperature and enhanced wound contraction, while the 17.5% concentration significantly reduced erythema and retained skin moisture in the proliferative phase. These findings suggest that Karsen leaves extract in spray gel form has promising therapeutic benefits for burn wound healing. Further research could enhance formulation efficacy and expand its clinical applications.

La chronic critical illness (CCI) caractérise les patients admis en réanimation, qui, au décours d’une affection aigue, restent dépendants des soins. N’ayant pas trouvé sa traduction française dans la littérature, nous la dénommerons « défaillance grave chronique » (DGC). Son incidence varie de 5 à 55% selon la population étudiée. Cette étude rétrospective, cas-témoin, menée sur une période d’une année dans le service de réanimation des brûlés de Tunis a inclus tous les patients âgés de plus de 16 ans ayant été hospitalisés pour brûlure sur une durée excédant les 8 jours. La DGC a été définie selon les critères du Research Triangle Institute à savoir une durée de séjour de plus de 8 jours et un critère parmi les suivants : sepsis, ventilation mécanique invasive de plus de 96 heures, lésion sévère, traumatisme crânien ou accident vasculaire cérébral et trachéotomie. Parmi les 272 brûlés adultes, 103 patients ont été inclus, 85 ont développé une DGC soit une incidence de 31,2%. Les critères diagnostiques identifiés étaient un sepsis dans 42,4% des cas (n=36) et la ventilation invasive dans 38,8% des cas (n=33). L’âge moyen était de 41,5 ± 16,9 ans avec une prédominance masculine (n=53 ; 62,4%). La SCB moyenne était de 29 ± 16%. Les facteurs de risque de DGC en analyse multivariée étaient : une SCB >21,5%, le recours à la transfusion, la survenue d’anémie, de thrombopénie, d’hypophosphorémie, d’insuffisance rénale aiguë et d’acidose métabolique. La durée médiane de séjour était de 12 jours [8-128]. La mortalité des patients souffrant de DGC était de 55,3%.

Burns are among the most severe and painful injuries, affecting individuals of all ages, including children, adults and the elderly. The gold standard for burn wound coverage is autologous split-thickness skin grafts (STSGs) harvested from an uninjured donor site. These grafts can be expanded through meshing to ensure complete wound coverage. This study aims to present data on applying meshed grafts as a surgical treatment for severe burn patients hospitalized in the Intensive Care Unit (ICU) of the Burn Service at the University Hospital Center “Mother Teresa” in Tirana, Albania. Additionally, it describes our surgical methods for treating severe burns and assesses the limits of survival in critically ill patients within our service. Patients who underwent meshed graft surgery accounted for 20% of all surgical interventions performed on individuals with burns, burn sequelae and trauma. Key factors influencing the decision for meshed graft application included age, total body surface area burned (TBSA%), sepsis, and full-thickness burns. Sepsis and full-thickness burns were significant determinants in the surgical approach. Our surgical protocol involved selective procedures, including multiple escharotomies and delayed escharectomy, typically performed between the 2nd and 3rd week post-injury. Skin grafting, either with full-thickness or meshed partial-thickness grafts, was subsequently applied to achieve complete wound closure. Multiple escharotomies facilitated wound management, while delayed escharectomy proved to be a safe and effective technique. Our findings suggest that survival is possible in patients with burns covering up to 60% TBSA, with 30-40% classified as full-thickness burns.

The gold standard burn dressing silver sulfadiazine (SSD) is widely used, but many disadvantages have been reported. An alternative is 1% feracrylum (1FA), a hemostatic agent that provides antibacterial activity, and wound improvement has been clinically proven. This study aimed to investigate the effect of 1FA in reepithelization in burn wound management. This experimental study used 27 healthy male Wistar rats. All received inhalation anesthesia, then were prepared for deep burn injury using a metal plate. The animals were treated with either 1FA, SSD, or moist saline gauze (control group). The wound was measured with a two-ruler method on days 0, 5, 10 and 14. On day 14, quantitative and qualitative assessments of re-epithelialization were made. The percentage of wound healing was significantly better in the 1FA group compared to the control and SSD groups . The histopathology evaluation revealed that the epithelial thickness was significantly greater in the 1FA group compared to the control and SSD groups. The granulation tissue thickness was greater in the SSD group compared to the control and 1FA groups. The neovascularization in the 1FA group was more mature compared to the control and SSD groups. In this animal study, 1FA administration showed improved wound healing and re-epithelialization of the skin after deep dermal burns. These findings may lead to a new therapeutic approach for burn wound healing.