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Social media offers a readily available, cost-effective way for medical experts to disseminate knowledge and shape public health outcomes but also allows for the spread of misinformation. This study aims to analyze burn-related material on social media by creator, content type, and engagement. Facebook, TikTok, and X (formerly Twitter) were queried with the following search terms: "burn," "burn injury," "burn recovery," and "burn treatment." Identified accounts were then manually screened for relevance. Year of creation and engagement metrics were collected. Accounts were categorized by content and creator type. Data were reported using descriptive statistics and visualized graphically to explore trends. Our search yielded 434 profiles, 234 of which met the inclusion criteria. TikTok had the most engagement at a median of 43,500 followers per account, with 38.3% of accounts focusing on individual experiences of burn survivors primarily on personal accounts (48.3%). In contrast, content on Facebook was related to the promotion of medical services (36.9%), whereas the most represented creator type was medical centers (33.6%). Nonprofits made up 40.4% of accounts on Twitter/X and more than a third of the content focused on patient advocacy, support, or burn prevention (36.5%). Important topics like burn education, prevention, and social support are lacking on major social media platforms. Engagement from burn care organizations and burn experts on social media is necessary. The findings of this study may guide advocates in the burn community on where and how to disseminate information on social media., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Despite the growing incidence of burn injuries globally and the advancements in physical recovery, the psychological aspect of burn trauma recovery remains inadequately addressed. This review aims to consolidate existing literature on posttraumatic stress disorder (PTSD) and depression in adult burn survivors, recognizing the need for a holistic approach to burn recovery that encompasses both physical and mental health. The comprehensive analysis of 156 studies revealed significant variations in methodological approaches, leading to challenges in creating standardized protocols for mental health assessment in burn care. Key findings include the identification of a wide range of psychological assessment tools and a substantial research gap in low- and middle-income countries, where the majority of burn injuries occur. Only 7.0% of the studies assessed interventions for PTSD or depression, indicating a lack of focus on treatment modalities. The studies identified demographic factors, patient history, psychosocial factors, burn injury characteristics, and treatment course as risk factors for PTSD and depression postburn injury. The review highlights the need for early screening, intervention, and attention to subjective experiences related to burn injury, as these are strong predictors of long-term psychological distress. It also emphasizes the complexity of addressing psychological distress in burn survivors and the need for more standardized practices in assessing PTSD and depression specific to this population., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Self-inflicted burns (SIBs) represent a distinct entity in burn care often associated with an underlying psychiatric etiology. In this review, we summarize the existing evidence on SIBs in North America to inform targeted prevention and interventions for patients afflicted with SIBs. The following databases were queried to identify relevant articles used for literature review: PubMed, Embase, and Scopus. The main outcome measures were burn characteristics and risk factors of SIBs in the American population. A total of 14,189 patients were included across 13 included studies. The percent of total body surface area burned ranged from less than one to 100%, with a mean of 29.6 +/- 20.7%. Depressive disorders were the most reported overall; however, among mood disorders, bipolar disorder was also reported frequently, while anxiety was reported least. Motives for self-inflicting burn injury included premeditated self-injury as a coping mechanism, escape or response to delusions, impulsive self-injury, and most commonly, suicidal intention. The majority of the studies reported that pre-admission drug and alcohol abuse were associated with the occurrence of SIBs. Other identified risk factors for SIB injury included female sex, younger age, unemployment, and unmarried status. From this, it is imperative that targeted interventions are developed to address the complex interplay of psychiatric disorders, drug use, and other demographic risk factors among the American population. It is crucial for initiatives to emphasize early identification of individuals at-risk of self-harm, better access to mental health services, and stronger drug abuse programs to target SIB occurrence in the U.S.., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Glucagon-like peptide-1 (GLP-1) agonists mimic the action of GLP-1, a hormone that regulates blood glucose levels via stimulation of insulin release and inhibition of glucagon secretion. After burn, the current literature suggests that the use of GLP-1 agonists results in less insulin dependence with similar glucose control and hypoglycemic events to patients receiving a basal-bolus insulin regimen. GLP-1 agonists may also promote wound healing through various mechanisms including angiogenesis and improved keratinocyte migration. Despite the potential benefits, GLP-1 agonists reduce gastrointestinal motility which impacts their widespread adoption in burn care. This dysmotility can result in inadequate nutrition delivery, unintentional weight loss, and is a potential aspiration risk. The net impact of these medications on burn patients is unclear. Given their potential to demonstrate the safety, efficacy, and optimal dosing of various GLP-1 agonists in acute burn management., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

There is no consensus on the optimal management of diabetic foot burn injuries. Here, we systematically identify studies reporting on diabetic foot burns and evaluate outcomes among patients managed operatively vs nonoperatively. PubMed, Embase, and Web of Science were searched. Screening was performed by independent reviewers. Primary research studies with English full texts published between 1980 and 2023 that discussed outcomes of foot burns in adults with diabetes were included and critically appraised using validated tools. Results are presented using descriptive statistics of aggregated data. The search yielded 2402 nonduplicate papers, of which 35 met the inclusion criteria. Nine papers were included for meta-analysis, including 7 retrospective comparative analyses, 1 cross-sectional study, and 1 retrospective chart review. There were 1798 diabetic foot burn patients. The mean age was 58.2 years (SD 4.12), and 73.1% (n = 1314) were male. A total of 15.7% (n = 283) of patients were surgically managed, including debridement (3.7%, n = 66), grafting (8.2%, n = 147), flap (0.2%, n = 3), and primary amputation (7.1%, n = 127). The secondary amputation rate, defined as amputation following initial surgery, was 4.9% (n = 14). The overall amputation rate was 7.8% (n = 141). Other complications included infection (4.0%, n = 72), osteomyelitis (1.9%, n = 34), and graft failure (8.2%, n = 12). One study reported functional status at the last visit. Diabetic foot burns are highly morbid. The surgical management of these complex injuries is high risk, as amputation results in poorer quality of life and functional outcomes., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Despite the growing recognition of self-harm as a pressing public health issue, demographic risk factors of self-inflicted burn (SIB) injuries in the U.S. have not been extensively described. In this retrospective study, we seek to identify demographic risk factors and patterns associated with SIB injuries at an urban burn center. Charts were reviewed of patients admitted to a single American Burn Association (ABA)-verified burn unit between 2015 and 2023 with a history of SIB injury, identified with ICD10 code X76.XXXA. Descriptive statistics, Welch's t-test of unequal variances, and Chi-Squared-analysis were performed. A total of 3,212 patients were admitted to our institution for management of acute burn injury, with 94 (2.9%) patients who presented with SIB injury. SIB patients were more likely than the control cohort to be male (p = 0.035), single (p=0.008), unhoused (p < 0.001), live alone (p < 0.001), and have documented psychiatric diagnoses (72.3% vs. 2.1%, p < 0.001). They had larger %TBSA affected (p < 0.001) and higher rates of inhalation injury (p < 0.001). The SIB cohort also showed significantly higher rates of positive urine toxicology results, primarily for stimulants and opiates (p < 0.001). Patients with SIBs had longer hospital stays (21.7 ± 2.6 days vs. 12.0 ± 22.1 days, p = 0.006), higher rates of ICU admission (p < 0.001), and mechanical ventilation requirement (p < 0.001). Mental health support services, substance abuse rehabilitation programs, and community outreach need to be prioritized, especially targeting vulnerable populations such as the unhoused., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

The percent total body surface area burned is a critical determinant of the required level of care, initial management, and prognosis in burn patients. The current gold standard for estimating this measurement, the Lund-Browder chart, requires familiarity with its construction and may not be practical for use by first responders in the field. In this study, we present a novel burn surface area calculator mobile application developed for first responders and validate its accuracy. Infant, pediatric, and adult manikins were fabricated with eight simulated burns of varying sizes and distributions. 42 pre-clinical medical students and firefighters were tasked with estimating the total body surface area of each burn using both the FireSync-EMS app and Lund-Browder chart. Univariate analysis and mixed-effects linear regression modeling were performed to compare the accuracy of both methods in relation to user experience, manikin size, and burn size. FireSync-EMS significantly reduced overestimation bias (0.11%, SD 2.33 versus 0.91%, SD 4.12, p = 0.002), particularly for burns on child-size manikins (p < 0.001) and burns involving <10% (p = 0.005) and >20% (p = 0.030) total body surface area. Multivariable modeling revealed that the Lund-Browder chart was an independent determinant of the magnitude of estimation error, with a 1.19 times multiplicative effect relative to FireSyncEMS (p < 0.001). Participants overwhelmingly found FireSync-EMS easier, more intuitive, faster, and preferable (p < 0.001 for all). FireSync-EMS may be an easier, faster, and more accurate alternative to the Lund-Browder chart for estimation of the total body surface area burned., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

While patient education materials (PEMs) across various specialties have been reported as being too difficult to read, the quality and understandability of PEMs related to scar management have not been assessed. In this study, we report the breadth of scar management interventions and readability of online PEMs authored by academic societies and university hospitals. Websites of academic medical societies and university hospitals with scar revision PEMs were assessed for relevance. PEM readability was assessed via Flesch Reading Ease, Flesch-Kincaid Grade Level, and Gunning-Fox Index scores. Understandability and actionability were evaluated using the Patient Education Material Assessment Tool (PEMAT). A total of 26 scar revision PEMs met the inclusion criteria. The most commonly mentioned scar management interventions were scar revision surgery (73%) and laser scar revision (70%), with minimal emphasis on non-invasive methods like scar massage or sun protection. Readability analysis yielded a mean Flesch reading level of 8.8. Overall PEMAT understandability of online scar treatment PEMs was moderate, with a median of 76.0% (IQR 71.5 - 80.5%). PEMs from all specialties and institution types were lacking in actionability, with median actionability of 40.8% (IQR 38.1-60.0%). Online scar revision PEMs included a wide breadth of scar management interventions, however the least costly interventions of sun protection and scar massage were not commonly included. PEMs for scar management could be improved by simplifying language, including visual aids, and including checklists or specific steps patients can take to take action on scar management interventions., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)