FLIR imaging is a fast and simple tool that has been shown to predict burn wound outcome in a porcine vertical injury progression model. Data showed that more severe burn wounds get cooler between 1 and 2 days after burn. We found four analytic methods of FLIR images that were predictive of burn progression at 1 and 2 days after burn; however, temperature minima 2 days after burn appeared to be the best predictive test for injury progression to a full-thickness burn. Although these results must be validated in clinical studies, FLIR imaging has the potential to aid clinicians in assessing burn severity and thereby assisting in burn wound management.

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Burn injuries are generally considered to be among the most painful. However, there is little evidence to support this. It is also unknown if pain management in burn patients differs from patients with other sources of pain. We compared pain severity among patients presenting to emergency departments (EDs) across the United States with burn and nonburn injuries using data generated from the National Hospital Ambulatory Care Survey. Multivariate analyses was performed to determine the association between predictor variables and pain severity as well as pain management in the ED. Of the estimated 527 million ED visits between 2010 and 2013, 2.1 million were due to burns and 128 million were due to nonburn trauma. Mean (SE) initial pain scores by patient group were burns 6.3 (0.27), nonburn trauma 5.4 (0.04), and nontrauma 4.8 (0.04), P < .001. Mean (95% confidence interval) pain scores by specific type of injury were burns 6.4 (5.9-6.9), fractures 6.7 (6.6-6.9), dislocations 6.7(6.3-7.1), and sprains/strains 6.8 (6.7-6.9), P < .001. Pain scores were higher for males and increased with age. Adjusted for age and gender, burns had the smallest effect of all types of injuries on pain score except for open wounds, contusions, and crush injuries. Patients with fractures and dislocations were more likely to receive an opioid than burn patients after adjusting for pain severity. We conclude that pain severity due to burns is no greater than due to dislocations, fractures, and sprains/strains and that burn patients are less likely to receive opioid and nonopioid analgesics than fractures and dislocations.

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Fibronectin (FN) is a multimodular glycoprotein that is a critical component of the extracellular matrix (ECM) anlage during embryogenesis, morphogenesis, and wound repair. Our laboratory has previously described a family of FN‐derived peptides collectively called “epiviosamines” that enhance platelet‐derived growth factor‐BB (PDGF‐BB)‐driven tissue cell survival, speed burn healing, and reduce scarring. In this study, we used an agarose drop outmigration assay to report that epiviosamines can enhance PDGF‐BB‐stimulated adult human dermal fibroblast (AHDF) outmigration in a dose‐dependent manner. Furthermore, these peptides can, when delivered topically, stimulate granulation tissue formation in vivo. A thiol‐derivatized hyaluronan hydrogel cross‐linked with polyethyleneglycol diacrylate (PEGDA) was used to topically deliver a cyclized epiviosamine: cP12 and a cyclized engineered variant of cP12 termed cNP8 to porcine, full‐thickness, excisional wounds. Both cP12 and cNP8 exhibited dose‐dependent increases in granulation tissue formation at day 4, with 600 μM cNP8 significantly enhancing new granulation tissue compared to vehicle alone. In contrast to previous studies, this study suggests that epiviosamines can be used to increase granulation tissue formation without an exogenous supply of PDGF‐BB or any cell‐binding peptides. Thus, epiviosamine may be useful topically to increase granulation tissue formation in acute wounds.