Thermal Injury

Many patients suffer from traumatic burns, and current treatments mainly focus on infection prevention and fluid management without improving the skin's ability to regenerate. This research aims to evaluate the role of 4-aminopyridine (4-AP), a promising agent with a good safety profile, in accelerating burn wound healing in patients with second-degree burns. The study addresses the need for new regenerative treatments that can speed up recovery while allowing existing protocols to continue. Participants will be randomly assigned to receive either 4-aminopyridine capsules (10 mg every 12 hours) or a placebo capsule on the same schedule. This phase 2 study will compare these two groups over a 12-month period to assess the treatment's effect on the healing process. The study uses triple masking to ensure unbiased results. During the study, participants will be monitored for healing rate, skin graft requirements, scar formation, and scar sensitivity over 12 months. They will provide informed consent and attend scheduled follow-up visits where researchers will evaluate wound healing through sensory and motor assessments and calibrated wound photographs. Safety and adherence will be closely tracked to evaluate the treatment's impact and patient outcomes throughout the study period.

Burn injuries can cause long-lasting physical and mental effects due to scarring and painful dressings. The usual treatment involves antibiotic topical dressings while waiting to determine the depth of the burn, followed by surgery for deeper burns. Assessing burn depth is difficult, and surgical removal of damaged tissue may remove some healthy tissue. New methods like hydro-dissection devices and enzymatic treatments like Bromolein have been explored but lack clear proof of benefit and may sometimes cause harm. This research compares PluroGel®, a special gel that helps soften and remove dead tissue while keeping the wound moist, to the standard antibiotic ointment and gauze dressings. PluroGel® is applied in a 0.5 cm layer with moist gauze twice daily, alongside the standard dressing applied three times a week. The study will assess if PluroGel® improves wound healing and reduces the need for surgery. Participants will receive either the standard dressing or PluroGel® treatment and will be followed for up to 14 days. Researchers will monitor wound healing, pain levels, satisfaction of patients and caregivers, and whether surgery is needed. The study uses a randomized, double-blind design and aims to provide evidence on the effectiveness of PluroGel® in burn care.

This research aims to evaluate interventions to support family members who act as surrogate decision makers for critically ill patients in Intensive Care Units (ICUs). These surrogates often face intense grief and stress that can affect their mental health and the quality of decisions made for their loved ones near end-of-life. The study focuses on reducing symptoms of prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), and related emotional challenges through a psychological intervention called EMPOWER. The study compares two approaches: the EMPOWER intervention, which is a brief, cognitive-behavioral and acceptance-based treatment delivered by trained mental health professionals, and a Supportive Conversation (SC) that provides empathetic support without specific skill-building. EMPOWER includes six 15-minute modules and two booster phone sessions, totaling about 90 minutes plus follow-ups, while the Supportive Conversation matches this time with supportive interaction and follow-up calls. Participants are assessed up to four times before and after the intervention within three months. Participants, who are surrogate decision makers of ICU patients near end-of-life, will complete assessments on grief, PTSD, depression, regret, anxiety, and distress before the intervention, immediately after, and at 3 and 12 months follow-up. The study also includes interviews with some participants to better understand the intervention's effects and contextual factors during the COVID-19 pandemic. The primary outcomes focus on changes in grief and PTSD symptoms over twelve months, with safety and mental health monitored throughout the study period.

Researchers are evaluating the use of disposable nitrous oxide canisters to provide better pain control during burn dressing changes. Despite advances in burn care, managing pain during routine wound care remains challenging due to the high doses of narcotics required and their potential side effects. This pilot randomized controlled crossover trial aims to test if nitrous oxide, a rapidly acting analgesic, can improve pain relief compared to placebo in adult burn patients. Participants will receive nitrous oxide inhalant or placebo canisters during burn dressing changes. Nitrous oxide acts within seconds and provides pain relief lasting minutes, making it potentially suitable for short but intense pain episodes like dressing changes. The study compares pain and anxiety levels when using nitrous oxide versus placebo, with treatments administered in a double-blinded and randomized manner. Participants will be assessed for pain and anxiety using the Burn Specific Pain Anxiety Scale and Visual Analogue Scales before, during, and after dressing changes. Researchers will also monitor the use of additional anxiolytics at these time points. The study enrolls adult burn patients with 5-20% body surface area burns and excludes those with serious respiratory or cardiovascular conditions or those unable to use the inhalant. The trial is led by the University of Manitoba and started in 2019, continuing until 2029.

Burn injuries can cause long-lasting physical and mental challenges due to scarring and painful dressings. The usual treatment involves antibiotic topical dressings while waiting to determine the burn depth, followed by surgery for deeper burns. Assessing burn depth is complex and can take weeks, with surgical removal of tissue often removing some healthy tissue. New methods like hydro-dissection devices and enzymatic debridement have been explored but lack definitive proof of benefit and may sometimes cause harm. This trial is studying PluroGel®, a gel that helps clean burn wounds by loosening and removing dead tissue while keeping the wound moist. Participants will receive either the standard antibiotic ointment and gauze dressing or PluroGel® plus the standard dressing with moist gauze. Dressings are applied every Monday, Wednesday, and Friday, with moist gauze kept wet twice daily in the PluroGel® group. This is a randomized, double-blind study comparing these two approaches. Participants will be monitored to see how much of the burn heals within 14 days and whether surgery is needed during this time. The study includes regular dressing changes and wound evaluations. The trial aims to gather evidence on the healing effects of PluroGel® compared to standard care over this two-week period. Participation lasts at least 14 days, with close follow-up to assess wound healing and treatment safety.

Partial thickness burns are the most common type of burn injury, typically treated with two weeks of topical therapy and wound care. If the burn wound does not heal within this period, surgical excision and skin grafting may be required. Researchers are exploring the use of Modulated Imaging and Laser Speckle Imaging as additional tools to assess burn wound severity and healing potential alongside standard clinical evaluation. This study uses two noninvasive imaging methods: Modulated Imaging, which measures the metabolic functions of the burn wound, and Laser Speckle Imaging, which measures blood flow in the wound. These imaging techniques are compared with the current standard of care and clinical exams to gather information on wound healing time and treatment outcomes. Participants with burn wounds will undergo imaging with these devices to assess their wounds. Researchers will measure burn wound severity noninvasively within one day. The study involves both inpatients and outpatients, and researchers will collect data on healing progress to evaluate the usefulness of these imaging technologies in managing burn wounds. The study may continue until February 2030.

Researchers are evaluating the accuracy of the New Injury Severity Score (NISS) in predicting mortality and other outcomes in patients with blunt trauma admitted to the Emergency Department of Kadhimiya Educational Hospital in Iraq. This prospective observational study aims to understand how well NISS predicts death, the need for intensive care, and the length of hospital stay among trauma patients, addressing a research gap in resource-limited healthcare settings. Participants admitted with blunt trauma will be assessed using the NISS score within the first six hours of arrival to the emergency department to ensure accurate trauma evaluation. Their clinical progress, including mortality, need for intensive care, hospital stay duration, and surgical interventions, will be monitored throughout hospitalization, averaging six days. During the study, patients' anatomical injuries and physiological parameters will be documented to calculate the NISS. Researchers will track outcomes such as in-hospital mortality and length of hospitalization, with follow-ups at days 7 and 30 after discharge. This study will provide valuable information on the usefulness of NISS in managing blunt trauma in Iraq and contribute to improving trauma care protocols.

Researchers are collecting and analyzing data from patients with Acute Subdural Hematoma to better understand the effects of different surgical treatments. This observational study focuses on comparing standard surgical options such as burr hole trephination, craniotomy, decompressive craniectomy, and a newer technique called Middle Meningeal Artery embolization. The goal is to evaluate how these procedures impact survival outcomes in trauma patients. The study gathers information retrospectively from the Methodist Dallas Medical Center Trauma Registry. Data collected includes patient demographics, diagnosis codes, injury details, surgical procedures, complications, laboratory results, and outcomes such as discharge status and mortality. This comprehensive data collection allows researchers to observe real-world treatment effects without altering patient care. Participants are trauma patients aged 18 years or older who have an acute subdural hematoma diagnosed by brain CT or MRI within 72 hours of injury. Researchers will review medical records and imaging to collect relevant information. The primary measurement is the total number of study sites and subjects over five years. There is no active treatment or intervention; instead, the study monitors and analyzes existing clinical data to improve understanding of surgical options and patient outcomes.

The trial investigates how the drugs propranolol and metoprolol affect core body temperature in older adults during extreme heat exposure. It aims to understand why adults over 65 have higher rates of heat-related illness and death, especially since beta blockers are commonly prescribed for cardiovascular conditions in this age group. This is important because previous studies in younger people showed beta blockers affect sweating and blood flow, but their impact on older adults in heat is unknown. Participants will experience 3 hours of heat exposure in a chamber set to 41°C with 40% humidity. They will receive different sequences of propranolol, metoprolol, and placebo in a randomized, double-blind manner to compare effects on their body temperature and sweat rate. The study involves multiple treatment arms rotating these drugs to assess their influence during simulated heat waves. During the study, researchers will continuously measure internal body temperature, heart rate, and blood pressure while also tracking whole body sweat rate before and after heat exposure by measuring body mass. The trial focuses on healthy adults aged 65 and older who meet specific health criteria. The total observation lasts through the 3-hour heat exposure, with close monitoring of cardiovascular and thermoregulatory responses to understand drug effects in aging individuals.

Researchers are studying the outcomes of adults with severe burns covering more than 30% of their total body surface area. The study focuses on how albumin administration during the first 24 hours of burn resuscitation may impact prognosis, including risks like organ failure and mortality. This observational study aims to collect detailed data on patient outcomes to help design future interventional trials evaluating albumin's role in burn care. Participants are adults aged 18 to 80 years admitted to intensive care units within 12 hours of severe burns. The study observes current management practices, including how albumin is given, such as dose, duration, and method of administration. The research follows patients for 90 days after admission to track their health and treatments. During the study, researchers will monitor combined outcomes of death, severe acute kidney failure, and serious respiratory distress within 28 days after the burn injury. They will also assess rates of kidney failure, respiratory distress, abdominal complications, sepsis, and organ function scores up to 90 days post-injury. This thorough follow-up helps understand how albumin use relates to recovery and complications in severe burn patients.