Conectar
This study aimed to systematically delineate the clinical characteristics and identify the key risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) infections in burn patients, thereby informing targeted preventive measures and therapeutic strategies. This retrospective study included 270 burn patients with Staphylococcus aureus (S. aureus) infections at a Chinese centre (2019–2022), comprising 127 MRSA and 143 methicillin-susceptible S. aureus (MSSA) cases. Clinical data were analysed to assess infection profiles, resistance patterns and MRSA risk factors. Amongst the infections, 68.1% (184/270) were caused by multi-drug resistant S. aureus, specifically 47.0% (127/270) by MRSA and 21.1% (57/270) by MSSA. The predominant resistance pattern (penicillin, oxacillin, gentamicin, clindamycin, erythromycin, ciprofloxacin, levofloxacin, tetracycline) accounted for 23.9% (44/184) of multidrug-resistant cases. The overall MRSA detection rate was 47.0% (127/270). Univariate analysis identified multiple factors significantly associated with MRSA infection (p < 0.05). Multivariate analysis identified the use of ≥ 3 types of antibiotics as an independent risk factor for MRSA infection in burn wounds. The detection rate of multi-drug resistant S. aureus (including MRSA) infections in burn wounds is relatively high. A number of variables are the influencing factors for MRSA infections. Medical personnel should adopt infection control measures to block the transmission of multi-drug resistant bacteria (including MRSA).
To evaluate the effectiveness of multidisciplinary offloading versus standard care on one-year diabetic foot ulcer recurrence, amputation, mortality, and functional recovery. In this prospective cohort study, 232 patients with healed diabetic foot ulcers were stratified into a control group (76 patients) or an intervention group (156 patients) receiving offloading modalities ranging from felt padding to custom-made therapeutic footwear. Assignment was based on shared decision-making considering biomechanical needs and economic feasibility. Primary outcomes included recurrence, amputation, and mortality. Secondary outcomes assessed quality of life, working ability, and ankle function. The intervention group demonstrated significantly lower recurrence (10.9% vs. 25.0%; p = 0.007) and mortality (3.2% vs. 14.5%; p = 0.004). Multivariable analysis identified offloading as independently protective against recurrence (odds ratio 0.35) and mortality (odds ratio 0.24). Amputation rates did not differ significantly after adjustment. Functionally, the intervention group achieved superior recovery in quality of life, working ability, and ankle scores (p < 0.001). Subgroup analysis indicated that customized therapeutic footwear yielded the lowest complication rates and highest patient satisfaction. Multidisciplinary offloading significantly reduces recurrence and mortality while restoring physical function. Although financial barriers influence device selection, customized therapeutic footwear offers the optimal balance of biomechanical protection and functional outcomes.
Globally, a lower-extremity amputation occurs every 20 s as a complication of a diabetic foot ulcer, underscoring the urgent need for effective preventive strategies. Previous studies have shown that temperature-based foot monitoring can reduce both the incidence and severity of diabetic foot ulcers. However, real-world adherence data for remote temperature monitoring remain limited, particularly in diverse or resource-constrained communities. We conducted a pilot implementation study of 20 adults with diabetes and a history of diabetic foot ulcers to assess adherence to a remote foot temperature monitoring mat within the context of receiving podiatric care. Participants are instructed to stand on the mat for 20 s daily, and data are transmitted wirelessly for remote monitoring. Adherence was defined as use of the mat at least four times a week. Participants demonstrated high adherence to the foot monitoring mat, averaging 6 scans per week, with sustained adherence over the 6-month study period. These findings suggest that high-risk patients with diabetes can reliably engage with the foot temperature monitoring technology, supporting its potential as a management tool to improve outcomes and reduce the burden of diabetic foot ulcer-related complications in high-risk, resource constrained patient populations.
Early detection of sacral pressure injuries (PIs) in immobilised polytrauma patients remains challenging. This study evaluated ultrahigh-frequency (UHF) ultrasound combining structural and haemodynamic parameters for early PI diagnosis. In a prospective cohort of 73 polytrauma patients (Injury Severity Score 16–25), daily sacrococcygeal assessments were performed over 15 days using UHF ultrasound (Mindray Resona 11; L20-5 s probe). Parameters included 2D morphology, perfusion (colour power angiography [CPA]), flow metrics (peak systolic velocity [PSV]), Braden Scale and inflammatory markers. PI incidence was 27.4% (n = 20; all stage I/II). Haemodynamic markers outperformed 2D ultrasound: CPA grade ≥ 1 (AUC = 0.858, 80.0% sensitivity) and PSV > 5.55 cm/s (AUC = 0.841, 95.0% sensitivity). Combined CPA + PSV achieved superior accuracy (AUC = 0.922). Systemic inflammation showed no intergroup differences. UHF ultrasound detects early PIs by capturing ischaemia-reperfusion changes. The CPA + PSV protocol provides nurses with a rapid (< 5 min), sensitive bedside tool to guide proactive interventions.
This study aimed to explore how persons living with a hard-to-heal wound and their family members experience care. The inclusion criteria for patients were wounds that had persisted for more than 6 weeks or hard-to-heal wounds that had recently healed. The study included 16 participants (13 patients and 3 family members) from primary healthcare services in Örebro County, Sweden. The interview data were transcribed and analysed using reflexive thematic analysis. One overarching theme was generated: Navigating an uncertain path towards healing, along with three subthemes: (1) Striving to be an active agent, (2) Being part of collaboration efforts and (3) Being a bystander in the search for the right treatment. Together, these themes illustrate how patients and family members engaged in an uncertain care process as they sought to understand the condition and manage care in everyday life. These everyday efforts reflected forms of invisible agency, as participants did not always recognise them as meaningful contributions to wound care. The findings highlight the importance of person-centred approaches that recognise and value patients' and family members' everyday contributions to wound care and support self-management through partnerships among patients, family members and HCPs.
Chronic diabetic foot ulcers and venous leg ulcers remain difficult to treat due to delayed healing and high complication rates. Biologic skin allografts derived from living or amniotic tissue provide extracellular matrix components, cytokines, growth factors and viable cells that facilitate tissue repair. This investigation systematically reviewed randomised controlled trials comparing Apligraf, Theraskin, Amnioband, Amnioexcel, EpiCord and Epifix for chronic lower extremity wounds. Searches were conducted in PubMed, Embase and Cochrane databases. Primary outcomes included complete wound closure at 12 weeks, time to healing and percent area reduction. Secondary outcomes included infection, amputation and recurrence rates. Nineteen trials with a total of 1303 participants met inclusion criteria. Analysis demonstrated statistical significance in 12-week wound closure (p = 0.0394), with Theraskin achieving the highest mean closure (84.7%) and Amnioexcel the lowest (37.5%). Epifix and Amnioband showed faster healing trends and greater closure advantages compared with standard care. Reported complications were uncommon and inconsistently defined. While no single graft demonstrated statistically superior outcomes, descriptive trends suggest Theraskin, Epifix and Amnioband may offer greater clinical benefit. These findings provide comparative insight to guide clinical selection of skin substitutes and highlight the need for large-scale head-to-head trials to establish relative efficacy.
Chronic diabetic wounds persist because of impaired angiogenesis, dysregulated transforming growth factor beta activity and delayed matrix remodelling. Non-thermal atmospheric pressure plasma therapy represents a potential non-pharmacologic approach to overcome these barriers. This study compared reactive nitrogen–dominant and reactive oxygen–dominant plasma exposures under identical apparatus conditions in a diabetic wound model. A universal plasma jet operated with nitrogen or argon gas was applied to streptozotocin-induced diabetic rats. Wound area reduction and time to 90% closure were quantified. Histological evaluation assessed re-epithelialisation and collagen deposition and immunohistochemistry measured angiogenesis using cluster of differentiation 31 staining and transforming growth factor beta expression. Nitrogen plasma treatment demonstrated sustained improvement in wound reduction relative to diabetic controls and reached 90% closure on day 19, whereas argon plasma reached this threshold on day 24 and diabetic controls exceeded 30 days. Nitrogen plasma was also associated with an earlier, self-limited angiogenic response characterised by an early cluster of differentiation 31 peak on day 6, together with patterns consistent with enhanced collagen maturation and earlier normalisation of transforming growth factor beta expression. Overall, these findings suggest mechanistic differences between reactive nitrogen–dominant and reactive oxygen–dominant plasma exposures in regulating angiogenesis and matrix remodelling during diabetic wound repair. These results indicate that plasma gas chemistry may influence wound-healing trajectories, supporting the potential of plasma therapy as a translational adjunct approach for difficult-to-heal wounds.
Pilonidal sinus disease (PSD) is associated with substantial morbidity because of wound complications and recurrence after surgery. Adjunct laser hair removal (LHR) has been incorporated into postoperative management in some settings, but real-world outcomes in cohorts treated uniformly with LHR remain incompletely described. This study aimed to characterize postoperative outcomes after PSD surgery in a large integrated healthcare system in which adjunctive LHR was standard practice and to compare outcomes by surgical approach. We performed a retrospective descriptive cohort study of patients aged 14–89 years who underwent operative treatment of PSD with adjunctive LHR at Kaiser Permanente Northern California between 2012 and 2024. Outcomes included repeat procedures, 30-day surgical site infection (SSI), and unplanned clinic visits. Outcomes were summarized as proportions overall and by surgical approach. Exploratory bivariable logistic regression examined associations between sex or body mass index (BMI) and outcomes. Multivariable modeling was not performed because of low event counts and sparse covariate distributions, which resulted in unstable models. Among 168 patients, the overall repeat procedure rate was 16.7%, the 30-day SSI rate was 14.4%, and 39.3% had at least one unplanned clinic visit. Patients treated with Bascom flap closure had fewer repeat procedures (10.4% vs. 20.8%) and fewer unplanned visits (33.8% vs. 43.6%) than those undergoing pilocystectomy, with similar SSI rates (14.9% vs. 14.0%). In exploratory analyses, sex and BMI were not significantly associated with outcomes in either surgical group. In this real-world cohort managed uniformly with adjunctive LHR, postoperative outcomes appeared to vary more by surgical approach than by sex or BMI. These findings are descriptive and do not estimate the independent effect of LHR. Controlled comparative studies are needed to determine the contribution of LHR to PSD outcomes.
Chronic non-healing wounds represent a major global public health challenge. Their persistence is frequently attributed to localized biological deficits that cause them unresponsive to conventional therapeutic modalities. While Platelet-Rich Plasma (PRP) has demonstrated promising results as an adjunctive treatment by delivering highly concentrated growth factors, its clinical application is currently impeded by a lack of clinical standardization, particularly optimal injection frequency, interval, and dosage. The aim of this study is to rigorously evaluate the efficacy and safety of a specific, non-intensive two-dose PRP injection protocol for accelerating the reduction of wound area in patients with various types of refractory chronic wounds. We conducted a prospective, single-arm, pretest-posttest study enrolling 18 patients with refractory non-healing wounds, defined as lesions persisting for a minimum period of 4 weeks which had failed to achieve definitive closure under optimized standard care. Autologous high-concentration PRP was injected intradermally around the wound margin at baseline (Day 0) and again 3 weeks later (Day 21). Wound area was digitally measured at baseline and subsequently at 7, 11 and 15 weeks. The primary outcome was the mean reduction in wound area (cm2) at the 15-week follow-up, assessed using a Paired Samples t-test. The mean patient age was 57.89 ± 15.64 years, and wounds had a mean chronicity of 15.83 ± 19.05 months. The PRP preparation achieved a mean platelet concentration 8.5 times greater than the peripheral blood threshold (first injection) and 7.0 times greater than the threshold (second injection), confirming high therapeutic quality. Analysis of the total cohort demonstrated a statistically significant reduction in mean wound area from baseline 27.41 ± 70.38 cm2 to 15 weeks 21.5 ± 68.96 cm2. Three patients (16.67%) achieved complete epithelialization. Subgroup trends suggested diabetic and venous ulcers responded more favourably than radiation-induced ulcers. The protocol was safe, with no systemic or severe localized adverse events observed among participants. The defined two-dose PRP injection protocol provides a clinically effective and safe adjunctive therapy that significantly promotes wound area reduction in challenging chronic non-healing wounds. This reproducible, low-frequency protocol offers a rationale for standardization in advanced wound care, warranting validation through future large-scale Randomized Controlled Trials (RCTs).
Debridement is widely used across various wound types, but its biological significance differs fundamentally between acute and chronic hard-to-heal wounds. In acute wounds, debridement directly triggers the initiation of regeneration; however, in chronic wounds, persistent biofilm, insufficient angiogenesis and dysregulated inflammation lead to a prolonged cycle of inflammation and proliferation, making traditional one-off debridement insufficient to change the healing trajectory. Therefore, the concept of debridement needs to evolve from an acute wound model to a sequential, biologically driven continuous management strategy. Maintenance debridement, by dynamically regulating the microenvironment, reducing pathological load and restoring a ‘healable state’, has emerged as the crucial bridge between inflammation control and regenerative therapies. This review systematically explains the theoretical basis and clinical value of maintenance debridement and explores the future direction of AI-assisted precision debridement management.
High-arched feet affect approximately 10%–15% of the general population. Although the relationship between plantar pressure and bilateral symmetry is well studied, there is limited evidence regarding the use of Symmetry Index and pressure platforms. The objective of the study is to compare dynamic foot pressures and Symmetry Index during gait between subjects with Pes Cavus and subjects with normal feet. The analysis of asymmetric pressure patterns could benefit from studies that compare dynamic foot pressures and Symmetry Index values in subjects with high-arched feet and normal feet. This analysis can promote better clinical understanding of gait alterations and help solve biomechanical problems that may lead to pathologies, as well as prevent and treat them. A descriptive case–control study was developed from October to December 2024 with 82 participants, 41 with Pes Cavus and 41 normal feet and 71 females of 25.52 ± 5.99 years through a consecutive nonrandom technique. For this study, a baropodometry platform (Neo-Plate, Herbitas) was used, which acquired dynamic gait with a 2-step protocol. The inclusion criteria regarding the selection of subjects were age 18–65 years; if both cavus feet, Navicular Drop Test (NDT) < 9 mm; neutral feet and no lower limb problem or surgery. Regarding SI use, the PC demonstrated to have large asymmetries compared to the control group. Left anterior pressure was lower (44.93% ± 4.59% vs. 48.60% ± 3.43%, p = 0.014), left posterior pressure was higher (55.07% ± 4.58% vs. 51.40% ± 3.43%, p = 0.013) and the left Initial Contact Phase (ICP) was prolonged (123.34 ± 51.75 ms vs. 91.30 ± 31.86 ms, p = 0.036); right medial pressure was higher (58.18% ± 4.08% vs. 53.77% ± 4.79%, p = 0.034). SI measurements were greater in normal foot group than in the PC group with SI 94.15% ± 5.00% versus 93.75% ± 4.59%, p = 0.001, respectively; ICP and lateral SI were both p = 0.001. Findings confirmed that subjects with cavus feet tend to present greater alterations in bilateral symmetry, specifically posteromedial pressure movements and altered gait phases, which are indicative of more probability of future injuries. For this reason, pressure platforms are excellent tools for understanding, analysing and therefore applying the correct treatment according to the SI.
To study the risk factors associated with multidrug-resistant bacteria (MDRB) infection in diabetic foot (DF) wounds and to develop a nomogram model to predict the risk of MDRB infection in patients with DF. A total of 157 patients with DF between January 2013 and December 2023 were included in this study. A retrospective analysis was conducted to examine the characteristics of MDRB infections. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with MDRB infection. Based on these risk factors, a predictive model was built using R software and a nomogram was constructed. Multivariate logistic regression analysis revealed that the wound area, previous hospitalization, prior use of antibacterial agents, lower extremity ischaemia grade, and hypoproteinaemia were independent risk factors for MDRB infection in DF wounds (p < 0.05). Construction of the nomogram model for MDRB infection in DF wounds: A nomogram model was developed using five identified risk factors—wound area, previous hospitalization, previous use of antibacterial drugs, lower extremity ischaemia grade and hypoproteinaemia—as predictors. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.863. The model has a good ability to predict MDRB infections in DF wounds. Wound area, previous hospitalization, previous use of antibacterial drugs, lower extremity ischaemia grade and hypoproteinaemia were identified as independent risk factors for MDRB infections in DF wounds. The nomogram model constructed on the basis of these five factors demonstrated good predictive performance for MDRB infection.
Acute, chronic, and hard-to-heal wounds pose a growing challenge due to reduced patient quality-of-life, higher cost and increased hospital admissions. Although there is no gold standard for wound care, there is a trend toward simple, outpatient-compatible treatment options. Acellular dermal fish skin derived from Gadus morhua (Atlantic cod) is a promising alternative. This retrospective study evaluated the surgical procedures and outcomes associated with fish-skin graft transplantation for difficult-to-treat wounds. Forty-four patients (33 male and 11 female; mean age: 72.4 years; mean wound area: 84.5 cm2) were treated with acellular fish skin graft. Wound healing was assessed by photographic documentation, confocal microscopy and clinical evaluation. Patient satisfaction was assessed using a structured questionnaire. A positive effect on wound healing, defined as a reduction in wound size, was observed in 88.6% of cases, with complete wound closure in 45.45% of cases. Most patients reported that the procedure was neither painful nor time-intensive; 95% stated that they would opt for treatment again. Fish skin grafting has also shown beneficial outcomes in complex cases, such as in wounds secondary to pyoderma gangrenosum and wounds with exposed bone. Fish skin graft transplantation represents a safe, well-tolerated and effective option for managing chronic wounds as well as challenging postoperative wounds, such as those at anatomically challenging sites.
Complex perianal fistulas are difficult to treat because of high recurrence rates and the need to preserve sphincter function. Negative pressure wound therapy (NPWT) improves healing in complex wounds, but its role in perianal fistula surgery is not well defined. This case series evaluated the feasibility, safety and early clinical outcomes of NPWT following surgical excision of complex perianal fistula tracts. A retrospective case series was conducted including eight adults with high or otherwise complex cryptoglandular perianal fistulas treated by surgical debridement followed by portable NPWT. Outcomes assessed were time to epithelialisation, symptom resolution, recurrence, complications and NPWT-related technical issues and refinements. Seven of eight patients achieved complete epithelialisation of the perianal wound after NPWT. One patient developed recurrence and required ongoing seton drainage. Over the course of the series, optimisation of sealing, sponge contouring and use of a bridge technique improved dressing reliability and wound progression. No NPWT device-related adverse events were observed. NPWT appears to be a feasible, well tolerated adjunct to surgery for complex cryptoglandular perianal fistulas, with high early healing rates and no device complications in this small series. Larger prospective studies are warranted to confirm efficacy and define optimal technical parameters.
Medical malpractice imposes a substantial clinical and economic burden worldwide. Pressure injuries (PIs) are amongst the most frequently litigated adverse events and represent a major source of preventable patient harm. To characterise the medicolegal landscape of PI-related malpractice, the Westlaw legal database was queried for cases litigated between 1990 and 2024. A total of 590 cases met inclusion criteria, with data extracted from court documents. The mean patient age was 71 years; 53.4% were female and 46.6% male. Nursing homes were the most commonly named defendants (59.8%), followed by hospitals and outpatient surgical practices (37.3%) and individual physicians (14.1%). The mean settlement was $383 099, compared with a mean jury award of $2 100 787. Adverse legal outcomes were strongly associated with allegations of inadequate care, poor clinical outcomes and gross provider negligence. When prevention and timely management fail, the consequences extend beyond patient harm to substantial legal and financial liability. Targeted interventions such as standardised risk assessment, rigorous documentation, staff education, appropriate staffing ratios and institutional accountability may mitigate both PI incidence and litigation risk. Strengthening these measures represents a critical opportunity to improve patient safety whilst reducing medicolegal exposure.
Spinal cord injury (SCI) predisposes patients to pressure injuries (PIs) often requiring surgery. Multiple factors influence postoperative complications and recurrence, though their associations remain unclear. We performed a PRISMA-guided systematic review and meta-analysis to assess predictors of acute postoperative complications and PI recurrence in SCI patients undergoing surgery. PubMed, Scopus and Embase were searched. Studies with ≥ 15 participants were eligible; 24 (n = 2566 subjects) were included, with 15 (n = 1976 subjects) quantitatively synthesized. Risk of bias was assessed with the Newcastle-Ottawa Scale. A random-effects model meta-analysis was performed, and odds ratios (OR) were pooled when > 2 studies were available; otherwise, findings were narratively synthesized. Moderate-quality evidence showed prior flap reconstruction increased complication risk (aOR = 4.98). Low-quality evidence linked diabetes (OR = 1.39) and smoking (OR = 1.35) with complications. Higher recurrence risk was associated with prior flap reconstruction (OR = 1.80) and thoracic injury (OR = 2.21), while cervical injury was protective (OR = 0.37). Prior flap reconstruction resulted as the strongest predictor of complications and significantly increased the odds of recurrence. These findings underscore the importance of a multidisciplinary approach for preventing the first occurrence of flap reconstruction and subsequent procedures.
Calciphylaxis is a rare, life-threatening disorder primarily affecting patients with end-stage renal disease (ESRD) on dialysis. Early lesions can mimic infection, leading to delays in diagnosis and wound-directed care. We describe an atypical early presentation of calciphylaxis in a patient with ESRD and sarcoidosis, initially misdiagnosed as cellulitis. Despite early sodium thiosulfate therapy and metabolic control, the patient developed progressive necrotic wounds. This case underscores that calciphylaxis can progress despite controlled mineral metabolism and standard therapy, particularly when potentiated by conditions like sarcoidosis. Early dermatologic evaluation and a high index of suspicion are critical to avoid misdiagnosis.
Pressure ulcers represent a significant healthcare challenge among respiratory patients. This study aimed to develop and validate a predictive nomogram based on machine learning algorithms to identify patients at high risk for pressure ulcer development. We conducted a retrospective analysis of 263 respiratory patients (166 with pressure ulcers). Patients were randomly divided into training and testing cohorts at a 7:3 ratio. Potential risk factors were identified through univariate logistic regression. Least absolute shrinkage and selection operator (LASSO) regression selected 17 significant predictors, from which 10 variables with optimal predictive values were incorporated into a nomogram model. Model performance was assessed using receiver operating characteristic (ROC) curves, calibration plots and decision curve analysis (DCA). The final nomogram incorporated 10 predictors: age, albumin, C-reactive protein, serum sodium, history of diabetes, chronic obstructive pulmonary disease, peripheral vascular disease, urinary incontinence, length of hospital stay and Braden sensory perception score. The model demonstrated excellent discriminative ability with AUCs of 0.865 (95% CI: 0.816–0.914) in the training cohort and 0.837 (95% CI: 0.783–0.891) in the testing cohort. Calibration curves showed good agreement between predicted and observed probabilities (Hosmer–Lemeshow test: training cohort χ 2 = 4.257, P = 0.833; testing cohort χ 2 = 12.350, P = 0.142). DCA confirmed the nomogram's superior clinical utility compared to individual predictors across a wide range of threshold probabilities. The machine learning–derived nomogram provides a practical, noninvasive tool for early identification of respiratory patients at risk for pressure ulcers. Implementation of this model could facilitate timely intervention strategies, potentially reducing the incidence of pressure ulcers and improving patient outcomes.
Chronic wounds represent a major global health and economic burden. Smart wound dressings integrate biosensing and stimuli-responsive materials to monitor and modulate biological parameters within the wound microenvironment. This scoping review maps the biological parameters monitored by smart wound dressings, an area not previously synthesized across preclinical and clinical contexts. Following Joanna Briggs Institute (JBI) and PRISMA-ScR frameworks, five databases were searched in March 2025. Studies published between 2008 and 2025 reporting biosensing or responding technologies in wound dressings were included. A total of 179 studies met the inclusion criteria, most being preclinical (in vitro or in vivo rodent models), with few human investigations. The most frequently monitored parameters were pH, temperature, oxygenation, moisture, bacterial burden, and protease activity (particularly MMP-9). Preclinical data showed enhanced collagen deposition, angiogenesis, and infection control compared with conventional dressings, whereas human studies mainly assessed feasibility and biocompatibility. Smart dressings demonstrate strong technical and biological performance, but clinical validation and standardized outcome reporting remain limited. Future interdisciplinary research should prioritize well-designed clinical trials to confirm therapeutic and economic benefits and enable translation into personalized wound care.
Burn injuries pose a significant challenge in resource-limited settings, particularly during humanitarian crises. This study examines the epidemiology, management, and outcomes of burn patients at a tertiary hospital in Damascus, Syria, from 2021 to 2024. A single-centre retrospective cohort study was conducted on 500 admitted burn patients. Data on demographics, injury characteristics, management, complications and mortality were analysed using descriptive statistics, chi-square tests, Mann–Whitney U tests and binary logistic regression. The lethal area 50% (LA50) was estimated using the logistic regression equation: LA50=−constant+∑bixibTBSA$$ LA50=-\frac{constant+\sum \left({b}_i{x}_i\right)}{b_{TBSA}} $$. The mean patient age was 20.5 ± 17.9 years, with a male predominance (55%). Flame burns (72.4%) at home (87.6%) were most common. The mean total body surface area burned was 30.99% ± 21.31%, with 68.6% being full-thickness injuries. The complication rate was 91%, with infection being most prevalent. The overall mortality rate was 39%, with sepsis (56.4%) as the leading cause. Logistic regression identified larger burn area (OR = 1.152, p < 0.001), full-thickness depth (ref. partial thickness, OR = 0.281, p < 0.001), older age and female gender as independent predictors of increased mortality. Deceased patients had significantly shorter hospital stays. LA50 was 42.63% for a 40-year-old male with a partial-thickness flame burn and a 10-day hospital stay; for a female with a full-thickness flame burn under the same conditions, it was 27.43%. This study reveals an alarmingly high burden of burn injuries in a crisis-affected setting, with extreme complication and mortality rates. The findings highlight the critical impact of extensive burns and sepsis, underscoring severe systemic constraints on care. Urgent context-specific interventions to strengthen acute burn management, infection control, and prevention strategies are imperative.
FreshRSS 