Sara Sheikh-Oleslami

Acute burn care is heavily resource-dependent and thus was significantly impacted by the COVID-19 pandemic. This study sought to examine the relationship between COVID-19 and the length of stay (LOS) in hospital following burn injury, as prolonged admissions have implications on both individuals and healthcare systems. Additionally, this study explored how COVID-19 affected the homeless burn population, as homelessness has been associated with longer hospital admissions due to limited post-discharge resources. Single-center, retrospective cohort study using data from the Burn Registry and medical chart review with inclusion of all adult burn patients admitted to a quaternary provincial burn unit from April 1, 2016, to March 31, 2023. Patients admitted prior to April 1, 2020, were considered the pre-COVID cohort. Key variables included demographic characteristics and LOS, with homelessness defined as a lack of a fixed address. Of 498 included patients, 301 and 197 were in the pre-COVID and COVID cohorts, respectively. While both cohorts had similar age and gender distributions, a significant difference was noted in LOS between cohorts, with COVID cohort patients staying in hospital for 22 (24) days compared to 20 (29) days in the pre-COVID cohort. More notably, a 58% increase in homeless patients was seen during COVID, with 17% (50/301) of admitted patients being homeless pre-COVID compared to 26% (52/197) during COVID (P < .05). The COVID-19 pandemic resulted in a slightly increased LOS in burn patients, with homeless patients disproportionately affected. This has important implications for both patient outcomes and healthcare resource allocation.

Purpose The demographic proportions of plastic surgery trials approximating real-world disease have not well been studied. Judicious trial representation is essential in evaluation of treatments across diverse patient populations. Herein, we investigate sex, racial, and ethnic disparities in patient enrollment across burn trials. Methods Cross-sectional analysis of participants enrolled in high-quality, with reduced risk of bias, randomized controlled trials (RCT) on burns registered on clinicaltrials.gov under the query “burn.” Completed RCTs reporting at least two demographic groups, employing double masking or greater, and with results accessible through the registry or publications were included. Trial characteristics (sponsor country, site location, initiation year, study phase, masking) and demographic data (sex, race, ethnicity per US reporting guidelines) were collected. The Global Burden of Disease database provided sex-based burn disease burdens. The primary outcome was the population-to-prevalence ratio of enrolled female participants. Secondary outcomes included representation of racial and ethnic populations as related to study blinding, phase, and study/sponsor locations. Results Of 546 records, 39 trials met the inclusion criteria (2919 participants). All trials reported sex demographics, with females comprising 37.02% of all participants (PPR = 0.71, 95% CI [0.59, 0.82], likely indicating underrepresentation against their empiric disease burden). Only 7 and 9 trials reported ethnicity and race, respectively, although not comprehensively. Among trials reporting race or ethnicity, Caucasians and Black persons comprised 57.52% and 21.80% of participants, respectively, while only 9.80% had Hispanic/Latino ethnicity. Severe underreporting of race and ethnicity precluded much of secondary significance testing across study variables. Conclusions Females are likely underrepresented in high-quality, US-registered burn trials, unreflective of their real-world disease burden. Further, severe underreporting of race and ethnicity was noted. Future trials should enroll diverse demographics and equitable populations for promotion of study generalizability.

Social media platforms can serve as a readily accessible tool for burn education, potentially reducing the incidence and severity of burn injuries. Previous studies have investigated the quality of online burn education videos on platforms such as YouTube. Here, we review the quality of such videos on TikTok, a newer and rapidly growing platform. TikTok was searched for English videos using 29 keywords (hashtags) such as #burn, #education, #prevention, and #management. The first 30 videos per hashtag were screened. Videos were categorized by content and creator. Two independent reviewers assessed the quality of the included videos using the Global Quality Scale (GQS). Metrics such as views, commentary, and likes were also examined. Of 535 screened videos, 72 met inclusion criteria. 47% (n = 34) were on management, 33% (n = 31) education, and 10% (n = 7) prevention. Only 6% (n = 4) cited sources. The median GQS score was 3.0 (IQR: 2.0–3.0, max 4.0). 50% (n = 36) were made by healthcare professionals with a median GQS score of 3.0 (IQR: 2.0–3.0, max 4.0) compared to 2.0 (IQR: 2.0–3.0, max 4.0) in nonhealthcare professionals (n = 36). Viewership varied from 41 to 4.2 million views. Overall, there is a lack of high-quality educational information on TikTok. This rapidly expanding and dynamic platform may provide an opportunity to direct individuals to higher quality resources.

An evolving field, nanotechnology has made its mark in the fields of nanoscience, nanoparticles, nanomaterials, and nanomedicine. Specifically, metal nanoparticles have garnered attention for their diverse use and applicability to dressings for wound healing due to their antimicrobial properties. Given their convenient integration into wound dressings, there has been increasing focus dedicated to investigating the physical, mechanical, and biological characteristics of these nanoparticles as well as their incorporation into biocomposite materials, such as hydrogel scaffolds for use in lieu of antibiotics as well as to accelerate and ameliorate healing. Though rigorously tested and applied in both medical and non-medical applications, further investigations have not been carried out to bring metal nanoparticle–hydrogel composites into clinical practice. In this review, we provide an up-to-date, comprehensive review of advancements in the field, with emphasis on implications on wound healing in in vivo experiments.

In full-thickness wounds, inflammation, lack of matrix deposition, and paucity of progenitor cells delay healing. As commercially available solid (sheet) scaffolds are unable to conform to wounds of varying shapes and sizes, we previously generated a nutritious, injectable, liquid skin substitute that can conform to wound topography. In combination with adipose micro-fragments as a viable source of progenitor cells, a composite, in situ forming skin substitute was tested for the treatment of silicon ring splinted full-thickness wounds in rats. The in vitro survivability and migratory capacity of adipocytes derived from rat micro-fragmented fat cultured in our scaffold was examined with a Live/Dead assay, showing viability and migration after 7 and 14 days. In vivo, the efficacy of our scaffold alone (LDS) or with adipose micro-fragments (LDS+A) was compared to a standard dressing protocol (NT). LDS and LDS+A showed ameliorated wound healing, including complete epithelialization and less immune cell infiltration, compared to the NT control. Our findings demonstrate that a 3D liquid skin scaffold is a rich environment for adipocyte viability and migration, and that the addition of adipose micro-fragments to this scaffold can be used as a rich source of cells for treating full-thickness wounds.

It is well-understood that wound care poses a significant burden on the healthcare system and patient well-being. As such, it is imperative to develop efficient methods that facilitate tissue repair. Our group previously developed a nutritional gel scaffold, proven to accelerate wound repair. Due to its gel-like properties, this scaffold requires a time-consuming reconstitution, and is optimized for cavernous wounds. This pilot study examined the feasibility of a powdered form of this scaffold to accelerate healing of full-thickness wounds, thus broadening the range of applications, while providing a practical product. Splinted full-thickness wounds were generated on the backs of 6 mice, and treated with either powder, the original gel scaffold, or no treatment. Feasibility and efficacy of the powder was assessed through comparison of clinical wound measurements and histological assessments. There was a significant effect of treatment on rate of epithelialization [H(3) = 8.346, p = 0.0024] and on days to epithelial closure [H(3) = 8.482, p = 0.0061]. Post hoc analysis revealed that while requiring no reconstitution and simple to apply, the powder was sufficient to accelerate epithelialization compared to untreated wounds (p < 0.05). Furthermore, our results suggest that application of this powder did not alter certain processes associated with healing progress, such as epidermal thickness and collagen deposition. As such, this powder may provide a novel alternative to our previously developed gel scaffold by accelerating epithelialization, while providing a practical product. Future studies necessitate further evaluation of healing measures with a larger sample size.