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Human herpes viruses in burn patients: A systematic review.

Authors
  • Wurzer, Paul1
  • Guillory, Ashley2
  • Parvizi, Daryousch3
  • Clayton, Robert P4
  • Branski, Ludwik K5
  • Kamolz, Lars-P3
  • Finnerty, Celeste C4
  • Herndon, David N2
  • Lee, Jong O2
  • 1 Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. Electronic address: [email protected] , (Austria)
  • 2 Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA.
  • 3 Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. , (Austria)
  • 4 Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA; Sealy Center for Molecular Medicine and the Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX, USA.
  • 5 Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA; Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. , (Austria)
Type
Published Article
Journal
Burns : journal of the International Society for Burn Injuries
Publication Date
Feb 01, 2017
Volume
43
Issue
1
Pages
25–33
Identifiers
DOI: 10.1016/j.burns.2016.02.003
PMID: 27515422
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The contribution of human herpes viruses, including herpes simplex virus (HSV), cytomegalovirus (CMV), and varicella zoster virus (VZV) to morbidity and mortality after burns remains controversial. This systematic review was undertaken to assess evidence of herpes virus-related morbidity and mortality in burns. PubMed, Ovid, and Web of Science were searched to identify studies of HSV, CMV, or VZV infections in burn patients. Exclusion criteria included: A level of evidence (LoE) of IV or V; nonhuman in vivo studies; and non-English articles. There was no limitation by publication date. Fifty articles were subjected to full-text analysis. Of these, 18 had LoE between I-III and were included in the final review (2 LoE I, 16 LoE II-III). Eight had a prospective study design, 9 had a retrospective study design, and 1 included both. No direct evidence linked CMV and HSV infection with increased morbidity and mortality in burns. Following burn, CMV reactivation was more common than a primary CMV infection. Active HSV infection impaired wound healing but was not directly correlated to mortality. Infections with VZV are rare after burns but when they occur, VZV infections were associated with severe complications including mortality. The therapeutic effect of antiviral agents administered after burns warrants investigation via prospective randomized controlled trials. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

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