The female red Duroc pig has been found to be a promising model of hypertrophic scarring. The female Yorkshire pig has been demonstrated to heal in a very different manner, more resembling human normotrophic scarring. Given these observations, we studied microvessel density, an important aspect of wound healing, in human hypertrophic scars and the scars of the female Duroc and Yorkshire pigs. We studied microvessel density in uninjured skin; hypertrophic scars at 6 months or less, 7 to 12, and longer than 12 months; female Duroc tissues at 3 weeks and 3 and 5 months; and similar Yorkshire tissue, including uninjured skin and shallow and deep wounds. Antifactor VIII-related antigen was used to mark the endothelial cells. Computed assessment of microvessel density was used to quantify the microvasculature. In human hypertrophic scars, the microvessels were increased dramatically, and microvessel density and area were significantly elevated. We found similar results in the Duroc tissues at 5 months after deep wounding. In contrast, we found far less microvasculature and, at 5 months, the values had returned to normal in the Yorkshire tissues. This quantitative study of microvessel density further validates the female Duroc pig as an animal model of hypertrophic scarring and the female Yorkshire pig as a control.

Amputations following a burn injury, although infrequent, may impact community re-integration and create a barrier to returning to work. The objective of this study was to compare patient and injury characteristics, quality of life, and employment status for those with and without amputation using a national longitudinal database of people with burn injuries. In this retrospective review of prospectively collected data group differences were examined using descriptive statistics. We used linear and logistic regression models to identify factors significantly associated with amputation, factors associated with return to work rates, and SF-12 Physical (PCS) and Mental (MCS) Component Summary scores over time. Of 2,682 records, 180 individuals underwent at least one amputation (6.7%). Amputations were associated with two injury etiologies: electrical injuries (OR 8.71, 95% CI 5.5-13.7), and contact with hot object (OR 5.57, 95% CI 3.1-10.1). Employment at 12-months post-burn was associated with working before injury (OR 11.4, 95% CI 8.1-15.3). People with amputations were more likely to be unemployed 12-months post-burn than those without amputations (OR 4.95, 95% CI 2.8-8.7). Amputation was a statistically significant predictor of SF-12 scores at 6-months for both PCS (β .10, p=0.003) and MCS (β -.07, p=0.04) scores. Amputations are relatively rare following burn injury and are more often associated with electrical and contact injuries. Whereas, people with amputations were less likely to be employed at 12-months post-burn, those who were employed prior to the injury were more likely to return to work regardless of amputation status.

Objective: The aim of this study was to address the limited understanding of neuropathic pain (NP) among burn survivors by comprehensively examining its prevalence and related factors on a national scale using the Burn Model System (BMS) National Database. Background: NP is a common but underexplored complaint among burn survivors, greatly affecting their quality of life and functionality well beyond the initial injury. Existing data on NP and its consequences in burn survivors are limited to select single-institution studies, lacking a comprehensive national perspective. Methods: The BMS National Database was queried to identify burn patients responding to NP-related questions at enrollment, 6 months, 12 months, 2 years, and 5 years postinjury. Descriptive statistics and regression analyses were used to explore associations between demographic/clinical characteristics and self-reported NP at different time points. Results: There were 915 patients included for analysis. At discharge, 66.5% of patients experienced NP in their burn scars. Those with NP had significantly higher Patient-Reported Outcomes Measurement Information System 29 (PROMIS-29) pain inference, itch, anxiety, depression, and sleep disturbance scores and were less able to partake in social roles. Multiple logistic regression revealed male sex, % total body surface area, and moderate-to-severe pain as predictors of NP at 6 months. At 12 months, % total body surface area and moderate-to-severe pain remained significant predictors, while ethnicity and employment status emerged as significant predictors at 24 months. Conclusions: This study highlights the significant prevalence of NP in burn patients and its adverse impacts on their physical, psychological, and social well-being. The findings underscore the necessity of a comprehensive approach to NP treatment, addressing both physical symptoms and psychosocial factors.