The role of multiplatform messaging applications in burns care and rehabilitation: A systematic review.

BACKGROUND: Multiplatform messaging applications also referred to as cross-platform instant messaging play an important role in delivery of healthcare and education with its low cost, ease of use and accessibility. AIM: To evaluate the existing evidence regarding the use of multiplatform messaging applications in facilitating consultations and decision-making processes in the context of burns care, as well as to assess the impact of such applications on burns care and rehabilitation. METHOD: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and PROSPERO protocol CRD42021265203. The CASP and JBI tools were used to evaluate the quality of the studies. Eight hundred fifty-three papers were retrieved from PubMed, CINAHL, Scopus, EMBASE and LILACS published up to July 2022 (updated August 2023) with no time restrictions applied. RESULTS: An analysis of the seven studies included in this review, inclusive of 16 Multiplatform messaging applications, revealed six themes. These encompassed the utilization of social media for directing and managing clinical practice, as a mode of communication, for evaluating the quality-of-care provision, for investigating available platforms and their technological features, measuring quality of life and for examining issues related to confidentiality. CONCLUSION: Multiplatform messaging applications offer a solution for individuals with burn injuries to stay in direct contact with burn specialist clinicians for their follow-up and subsequent rehabilitation phase of recovery.

Efficacy of transfer form implementation for adult burn patients between institutions to the Israeli National Burn Center.

Burns are serious injuries associated with significant morbidity and mortality. In Israel, burn patients are often transferred between facilities. However, unstructured and non-standardized transfer processes can compromise the quality of patient care and outcomes. In this retrospective study, we assessed the impact of implementing a transfer form for burn management, comparing two populations: those transferred before and after the transfer form implementation. This study included 47 adult patients; 21 were transferred before and 26 after implementing the transfer form. We observed a statistically significant improvement in reporting rates of crucial information obtained by Emergency Room clinicians and inpatient management indicators. Introducing a standardized transfer form for burn patients resulted in improved communication and enhanced primary management, transfer processes, and emergency room preparation. The burns transfer form facilitated accurate and comprehensive information exchange between clinicians, potentially improving patient outcomes. These findings highlight the importance of structured transfer processes in burn patient care and emphasize the benefits of implementing a transfer form to streamline communication and optimize burn management during transfers to specialized burn centers.

Spincare® System Demonstrates Safety and Efficacy in Treating Partial Thickness Burns.

Partial-thickness burns are the most common form of burns, affecting the dermis and possibly resulting in scarring and infection. The Spincare® System is a new device that uses electrospinning technology to create a temporary skin-like matrix that can be applied to wounds. This study evaluated the performance, safety, and efficacy of Spincare in treating superficial to partial-thickness burns not considered for surgery. A prospective single-arm, open-label, multicenter study was conducted in three adult burn units across Israel. Forty-four patients with superficial to intermediate burns of up to 10% of total body surface area (TBSA) were enrolled. Spincare was applied to the wounds, and follow-up visits were performed on days 7, 14, and 21 and months 3 and 6 post-treatment. Thirty-one patients with 36 wounds completed the day 21 visit. The mean wound healing area on day 21 was 97.26± 9.41%, and the mean healing time was 12.8±4.3 days. Only one moderate adverse event was observed concerning the treatment, and it is important to acknowledge the potential progression of this hypertrophic scar into a keloid. This study demonstrated that Spincare is a safe and effective device for treating superficial to intermediate partial-thickness burns. Spincare achieved rapid and complete wound healing with a low incidence of adverse events.

["PLASTICS" DURING THE WAR OF "IRON SWORDS" - THE ROLE OF A SPECIALIST IN PLASTIC AESTHETIC AND RECONSTRUCTIVE SURGERY].

INTRODUCTION: A war usually requires a new or adjusted set up and needs of all caregivers according to the "new" status. The current war in Israel began on the 7.10.2023. The Israeli Ministries of Defense and Health were in a new status in which they had to complete new requirements according to the use of new weapons, and in numbers and types of injuries that overwhelmed the system from the day the war began. In the past, we published evidence that in times of terror, as in times of war, epidemiology of injuries changes and requires adjustments in human resources, surgical tools and consumables in the Israeli health and defense systems. This article aims to describe the role of specialists in plastic, aesthetic and reconstructive surgery and the first response according to the existing system divided into prevention, preparedness, response and rehabilitation. In the long term rapid response, recruitment of human resources, abilities and flexibility of the system enables overcoming a sudden "new" status as in war, terror and mass casualty events.

The Implications of a Dermatopathologist's Report on Melanoma Diagnosis and Treatment.

An accurate and comprehensive histopathology report is essential for cutaneous melanoma management, providing critical information for accurate staging and risk estimation and determining the optimal surgical approach. In many institutions, a review of melanoma biopsy specimens by expert dermatopathologists is considered a necessary step. This study examined these reviews to determine the critical primary histopathology Breslow score in which a histopathology review would be most beneficial. Histopathology reports of patients referred to our institute between January 2011 and September 2019 were compared with our in-house review conducted by an expert dermatopathologist. The review focused on assessing fundamental histologic and clinical prognostic features. A total of 177 specimens underwent histopathology review. Significant changes in the Breslow index were identified in 103 cases (58.2%). Notably, in many of these cases (73.2%), the revised Breslow was higher than the initially reported score. Consequently, the T-stage was modified in 51 lesions (28.8%). Substantial discordance rates were observed in Tis (57%), T1b (59%), T3a (67%) and T4a (50%) classifications. The revised histopathology reports resulted in alterations to the surgical plan in 15.3% of the cases. These findings emphasize the importance of having all routine pathologies of pigmented lesions referred to a dedicated cancer center and reviewed by an experienced dermatopathologist. This recommendation is particularly crucial in instances where the histopathology review can potentially alter the diagnosis and treatment plan, such as in melanoma in situ and thinner melanomas measuring 0.6-2.2 mm in thickness. Our study highlights the significant impact of histopathology reviews in cutaneous melanoma cases. The observed changes in Breslow scores and subsequent modifications in T-stage classification underline the need for thorough evaluation by an expert dermatopathologist, especially in cases of melanoma in situ and thin melanomas. Incorporating such reviews into routine practice within dedicated cancer centers can improve diagnostic accuracy and guide appropriate treatment decisions, ultimately leading to better patient outcomes.

Personalised burn treatment: bedside electrospun nanofibre scaffold with cultured autologous keratinocytes: a case study.

Nearly four decades after cultured epidermal autografts (CEA) were first used for the treatment of extensive burn wounds, the current gold standard treatment remains grafting healthy autologous skin from a donor site to the damaged areas, with current skin substitutes limited in their clinical use. We propose a novel treatment approach, using an electrospun polymer nanofibrous matrix (EPNM) applied on-site directly on the CEA-grafted areas. In addition, we propose a personalised treatment on hard-to-heal areas, in which we spray suspended autologous keratinocytes integrated with 3D EPNM applied on-site, directly onto the wound bed. This method enables the coverage of larger wound areas than possible with CEA. We present the case of a 26-year-old male patient with full-thickness burns covering 98% of his total body surface area (TBSA). We were able to show that this treatment approach resulted in good re-epithelialisation, seen as early as seven days post CEA grafting, with complete wound closure within three weeks, and to a lesser extent in areas treated with cell spraying. Moreover, in vitro experiments confirmed the feasibility of using keratinocytes embedded within the EPNM: cell and culture viability, identity, purity and potency were determined. These experiments show that the skin cells are viable and can proliferate within the EPNM. The results presented are of a promising novel strategy for the development of personalised wound treatment, integrating on-the-spot 'printed' EPNM with autologous skin cells, which will be applied at the bedside, over deep dermal wounds, to accelerate healing time and wound closure.

Using Virtual Reality for Deep Inferior Epigastric Perforator Flap Preoperative Planning.

This study was designed to compare VR stereoscopical three-dimensional (3D) imaging with two-dimensional computed tomography angiography (CTA) images for evaluating the abdominal vascular anatomy before autologous breast reconstruction. Methods: This prospective case series feasibility study was conducted in two tertiary medical centers. Participants were women slated to undergo free transverse rectus abdominis muscle, unilateral or bilateral deep inferior epigastric perforator flap immediate breast reconstruction. Based on a routine CTA, a 3D VR model was generated. Before each procedure, the surgeons examined the CTA and then the VR model. Any new information provided by the VR imaging was submitted to a radiologist for confirmation before surgery. Following each procedure, the surgeons completed a questionnaire comparing the two methods. Results: Thirty women between 34 and 68 years of age were included in the study; except for one, all breast reconstructions were successful. The surgeons ranked VR higher than CTA in terms of better anatomical understanding and operative anatomical findings. In 72.4% of cases, VR models were rated having maximum similarity to reality, with no significant difference between the type of perforator anatomical course or complexity. In more than 70% of the cases, VR was considered to have contributed to determining the surgical approach. In four cases, VR imaging modified the surgical strategy, without any complications. Conclusions: VR imaging was well-accepted by the surgeons who commented on its importance and ease compared with the standard CTA presentation. Further studies are needed to determine whether VR should become an integral part of preoperative deep inferior epigastric perforator surgery planning.

Comparison of stationary and dynamic fractional CO2 laser modalities of large burns treatment: Experimental laboratory model.

OBJECTIVES: To experimentally compare two fractional ablative CO2 laser handpieces intended for the treatment of large area burn scars. Each handpiece coverage rate, depth of penetration and application time were measured and compared in a simulation model of large area burns scars using a dynamic/roller handpiece (small footprint) and a stationary/stamping handpiece (large footprint). METHODS: A 30 W fractional ablative CO2 laser was applied using 2 different handpieces and footprints on a A4 size paper stack. The handpieces were a stationary (stamping) handpiece with 7 × 7 (49 pixels/square shape) and dynamic (roller) handpiece with 7 × 1 (7 pixels/single row shape). For both handpieces the laser settings were fixed at "High" power (30 W), providing an energy level of 100 mJ/pixel. Both handpieces were applied perpendicular to the surface, with the process repeated for the dynamic handpiece with an angled operation. The depth of laser penetration was assessed by the number of pages of paper having visible holes and burn area coverage time measured under each handpiece/condition. RESULTS: The application time was faster and the penetration deeper for the dynamic handpiece compared to the stationary handpiece in both the perpendicular and angled conditions. This study has practical implications for lasers operators to improve time efficacy in large area scars with improved clinical endpoints. CONCLUSION: The fractional ablative dynamic handpiece demonstrated superior application efficiency compared to the stationary handpiece in the simulated treatment of large surface area burn scars, reducing treatment time with improved depth of penetration.

An automated high-throughput platform for experimental study of burn injuries - in vitro and ex vivo.

The use of in-vitro and ex-vivo models for the study of burn wound injuries is encouraged to reduce the animal burden in experimental burn research. However, few existing platforms enable the production of reproducible, locally confined thermal injuries at short durations in a high-throughput manner for both in-vitro and ex-vivo models. To address this gap, we established an automated high-throughput burn platform (HTBP) that provided accurate control over burn temperature, exposure time, and pressure application. This platform was built by fabricating an aluminum heat block with 96 pins and positioning a high-resolution actuator below the block. By activating the actuator, 96-well cell culture plates and skin samples were pressed against the heat block's pins. We demonstrated the applicability of the HTBP for studying in-vitro burn injuries by investigating the effects of burn temperature and contact duration on cell viability and migration in human umbilical vein endothelial cells and NIH-3T3 fibroblasts. We showed that higher temperatures and a longer contact duration decreased cellular viability and increased the area of the burn. Moreover, we found that even a short exposure time of 200 msec caused a severe burn wound at 75 °C in a cell monolayer. In addition, we used the HTBP to generate burn injuries at different burn durations in ex-vivo porcine skin and showed that dermis discoloration was present in histologic sections after exposure to 100 °C for a short duration of 500 msec. Our work demonstrates that the HTBP can constitute an important tool for both in-vitro and ex-vivo research of mild and severe burn injuries in a tightly controlled setting and high-throughput manner.

Burns in Israel: Etiologic, Demographic, and Clinical trends-A 9-Year Updated Comprehensive Study, 2004-2010 versus 2011-2019.

Based on the Israeli National Trauma Registry (INTR) data, this study reports etiological, demographic, and clinical trends and includes all admissions to burn and trauma centers across Israel from 2011 to 2019 and compares these with 2004 to 2010 rates. From 2011 to 2019, 5,710 patients were admitted to burn centers across Israel. Children aged 0 to 1 years (25.9%), non-Jews (40.7%), and males (67.2%) remain the main groups of the burn casualties. Most of the casualties sustained 1 to 9% total body surface area (TBSA) burns with various depths. Scalds were less fatal than fire/flame-related casualties (<1 vs. 11.5%). Fewer surgical procedures were conducted for burns under 9% TBSA compared with greater TBSA. The percentage of TBSA and burn depth were found to be the most significant predictor of mortality among all age groups (>200 times increased risk with full-thickness burns >30% TBSA burn) and correlated with prolonged length of stay (>7 days).

Soft tissue-related injuries sustained following volcanic eruptions: An integrative review.

BACKGROUND: The contribution of various volcanic phenomena to immediate soft tissue injury types has received limited attention challenging emergency management planning. This integrative review sought to investigate the immediate types of soft tissue-related injury sustained following volcanic eruptions. METHODS: A systematic search was conducted in January 2020 across EMBASE, PubMed, and Scopus databases. 718 articles were retrieved, and 15 studies met the final inclusion criteria. RESULTS: Injuries acquired, and health impacts were categorized by onset-direct/indirect or immediate/delayed. Health concerns following an eruption were categorised: (1) respiratory; (2) ocular; and (3) skin, including deep tissues. Respiratory concerns were attributed to ashfall, volcanic gases and pyroclastic density currents; most ocular injuries to ashfall; and skin/deep tissues to pyroclastic density currents and mudflows. CONCLUSIONS: Volcanic eruptions simultaneously present multiple hazards with immediate/short term health consequences across three major levels (i.e., respiratory, ocular, and skin, including deep tissues). Hazard(s) differ by time of onset and associated mostly with the eruptive phenomena. Understanding local volcanic phenomenon is essential to assisting health personnel provide informed and timely care.

Advances in the Use of Electrospun Nanofibrous Polymeric Matrix for Dermal Healing at the Donor Site After the Split-Thickness Skin Graft Excision: A Prospective, Randomized, Controlled, Open-Label, Multicenter Study.

Dressings used to manage donor site wounds (DSWs) have up to 40% of patients experiencing complications that may cause suboptimal scarring. We evaluated the efficacy and safety of a portable electrospun nanofibrous matrix that provides contactless management of DSWs compared with standard dressing techniques. This study included adult patients who underwent an excised split-thickness skin graft (STSG) with a DSW area of 10 to 200 cm2. Patients were allocated into two groups; ie, the nanofiber group managed with a nanofibrous polymer-based matrix, and the control group managed using the standard of care such as Jelonet® or Biatain® Ibu dressing. Primary outcomes were postoperative dermal healing efficacy assessed by Draize scores. The time to complete re-epithelialization was also recorded. Secondary outcomes included postoperative adverse events, pain, and infections during the first 21 days and extended 12-month follow-up. The itching and scarring were recorded during the extended follow-up (months 1, 3, 6, 9, and 12) using Numerical-Analogue-Score and Vancouver scores, respectively. The nanofiber and control groups included 21 and 20 patients, respectively. The Draize dermal irritation scores were significantly lower in the nanofiber vs control group (Z = -2.509; P = .028) on the first postoperative day but became similar afterward (Z ≥ -1.62; P ≥ .198). In addition, the average time to re-epithelialization was similar in the nanofiber (17.9 ± 4.4 days) and control group (18.3 ± 4.5 days; Z = -0.299; P = .764), so were postoperative adverse events, pain, and infection incidence, itching and scarring. The safety and efficacy of electrospun nanofibrous matrix are similar to standard wound care allowing its use as an alternative donor site dressing following the STSG excision.

Pain management during a bromelain-based selective enzymatic debridement in paediatric and adult burn patients.

BACKGROUND: Pain associated with surgical or enzymatic burn wound debridement prevents many burn centres from working outside an operating theatre, creating a burden. Alternatives for general anaesthesia to manage pain in burn patients treated with enzymatic debridements, such as regional anaesthesia, have not been studied in detail. This study explores the different possibilities for pain management during a bedside NexoBrid™ procedure. MATERIAL AND METHODS: We performed a single-centre retrospective study that included 82 paediatric, adolescent, and adult patients with deep dermal and full-thickness burns treated bedside with NexoBrid™ under regional or general anaesthesia. Outcome measures were pain during the NexoBrid™ procedure, the safety of the anaesthesia and the NexoBrid™ procedure, logistics of the bedside NexoBrid™ procedure, and time to wound closure. RESULTS: Forty-three patients in the adult group (43/67, 64%) only presented with burn wounds on one upper or the one or two lower extremities. In 29 of them (29/43, 67%), a NexoBrid™ procedure was performed under regional anaesthesia, which resulted in low pain levels without any adverse events. All seven patients in the paediatric group, where only one upper or one or two lower limbs were involved (7/15, 47%), underwent a NexoBrid™ procedure performed under regional anaesthesia where no adverse events were reported. In these children, the use of regional anaesthesia was associated with a significant decrease in time to wound closure (average treatment effect on the treated = -22.5 days, p = 0.021). CONCLUSION: This study highlights that regional anaesthesia administered at the bedside should be the method of choice for pain management during NexoBrid™ procedures because often, it can be adequately and safely performed in all age groups. This approach will reduce the burden on operating theatres. A flow chart has been developed to guide pain management during a NexoBrid™ procedure.

The Hidden Danger of Lithium Battery-Powered Electric Bicycles and Scooters: A Case Series of the Israeli National Burn Center Experience.

Electric-powered bicycles and scooters that use rechargeable lithium batteries are an urban transportation alternative and have become increasingly popular. However, in recent years, there has been an increase in patient admissions to the Israeli National Burn Center with burns associated with their use. In this case series of all patients (n = 9) referred to the Emergency Department (February 2016-October 2020) with lithium-related battery burns from electric-powered bicycles and scooters, we present burn depth, size, treatment, inhalation injuries, and hospitalization. All patients were admitted to the Israeli National Burn Center for treatment. The average TBSA was 27.5% (range 3%-57%). All but one patient had a combination of partial to full-thickness burns affecting the upper and lower limbs. Three patients sustained inhalation injuries and a total of four patients required intubation. Seven patients required surgery that included debridement and, in most cases, skin grafting. The availability and increase in the use of battery-powered bicycles and scooters may lead to an increase in injuries and death if consumers are not aware of the potential dangers related to the safe use of lithium batteries.

Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial.

Chronic wounds are estimated to affect over 6 million people annually in the United States with an estimated annual cost of $25 billion. Debridement represents a key step in their management and is considered a basic necessity to induce the functional process of tissue repair. However, there is an unmet need for an efficient rapid acting non-surgical debridement agent. Bromelain-based enzymatic debridement has been proven to provide an effective, selective and safe non-surgical debridement in deep burns. EscharEx (MediWound Ltd, Yavne, Israel), is a bromelain-based enzymatic debridement agent currently in development for chronic wounds. The aim of this study was to assess its safety and efficacy in chronic wounds. Seventy-three patients suffering from a lower extremity ulcer of diabetic/venous insufficiency/post-surgical/traumatic aetiology were enrolled in a multicentre, assessor blinded, randomized controlled trial. Patients were randomized to topical treatment by either EscharEx or its gel vehicle for up to 10 daily 4 hour applications, and then continued follow-up for up to 6 months. The EscharEx arm achieved a significantly higher incidence of complete debridement compared to the gel vehicle arm; 55 versus 29% (p = .047), thus meeting the primary endpoint of this study. The EscharEx and gel vehicle arms achieved similar reductions in wound area, non-viable tissue area and wound healing scores during the debridement period. There were no significant differences between the arms in the incidence of complete wound closure (41% in the EsxcharEx arm vs. 53% in the gel vehicle arm) and in the mean time to complete wound closure (70.0 ± 32.8 days in the EsxcharEx arm vs. 65.7 ± 38.4 days in gel vehicle arm). There were no significant safety issues and EscharEx demonstrated a favourable benefit to risk profile.

Conceptual Paper: Abdominoplasty and Liposuction in Systemic Sclerosis.

BACKGROUND: Surgical interventions in patients with systemic sclerosis (SSc), in particular plastic procedures, might cause undesired consequences. Notably, liposuction seems to possess greater risk as adipose tissue has been shown to play an important role in treating wounds and ulcers in patients with SSc. While anticentromere antibodies were found to be correlated with vasculopathy in SSc, patients with SSc and anticentromere antibodies might be more vulnerable to surgical wound complications following liposuction. A 46-year-old female patient, who had been diagnosed with SSc at the age of 31 years, had antinuclear as well as anticentromere antibodies. She underwent abdominoplasty with liposuction and developed severe skin necrosis of the abdomen following the procedure and at the site of liposuction. The correlation with anticentromere and the role of liposuction in skin necrosis in SSc are presented.

Autoimmune dysautonomia in women with silicone breast implants.

IMPORTANCE AND OBJECTIVES: There is unmet medical need to understand the pathogenic mechanism of the panoply of clinical manifestations associated with silicone breast implants (SBIs) such as severe fatigue, widespread pain, palpitations, dry mouth and eyes, depression, hearing loss etc. We aimed to determine whether autoantibodies against the autonomic nervous system receptors can explain the enigmatic and subjective clinical manifestation reported by women with SBIs. RESULTS: Circulating level of autoantibodies against G protein-coupled receptors (GPCRs) of the autonomic nervous system (adrenergic, muscarinic, endothelin and angiotensin receptors) have been evaluated in symptomatic women with SBIs using an ELISA method. These women with SBIs addressed our clinic due to various subjective and autonomic-related manifestations such as chronic severe fatigue, cognitive impairment, widespread pain, memory loss, sleep disorders, palpitations, depression, hearing abnormalities etc. We report for the first time, a significant reduction in the sera level of anti-ß1 adrenergic receptor (p < 0.001), anti-angiotensin II type 1 receptor (p < 0.001) and anti-endothelin receptor type A (p = 0.001) autoantibodies in women with SBIs (n = 93) as compared with aged matched healthy women (n = 36). Importantly, anti-ß1 adrenergic receptor autoantibody was found to significantly correlate with autonomic-related manifestations such as: sleep disorders and depression in women with SBIs. CONCLUSIONS: Chronic immune stimulation by silicone material may lead to an autoimmune dysautonomia in a subgroup of potentially genetically susceptible women with SBIs. The appearance of autoantibodies against GPCRs of the autonomic nervous system serve as an explanation for the subjective autonomic-related manifestations reported in women with SBIs.

A simplified fluid resuscitation formula for burns in mass casualty scenarios: Analysis of the consensus recommendation from the WHO Emergency Medical Teams Technical Working Group on Burns.

BACKGROUND: Burn fluid resuscitation guidelines have not specifically addressed mass casualty with resource limited situations, except for oral rehydration for burns below 40% total body surface area (TBSA). The World Health Organization Technical Working Group on Burns (TWGB) recommends an initial fluid rate of 100 mL/kg/24 h, either orally or intravenously, beyond 20% TBSA burned. We aimed to compare this formula with current guidelines. METHODS: The TWGB formula was numerically compared with 2-4 mL/kg/%TBSA for adults and the Galveston formula for children. RESULTS: In adults, the TWGB formula estimated fluid volumes within the range of current guidelines for burns between 25 and 50% TBSA, and a maximal 20 mL/kg/24 h difference in the 20-25% and the 50-60% TBSA ranges. In children, estimated resuscitation volumes between 20 and 60% TBSA approximated estimations by the Galveston formula, but only partially compensated for maintenance fluids. Beyond 60% TBSA, the TWGB formula underestimated fluid to be given in all age groups. CONCLUSION: The TWGB formula for mass burn casualties may enable appropriate fluid resuscitation for most salvageable burned patients in disasters. This simple formula is easy to implement. It should simplify patient management including transfers, reduce the risk of early complications, and thereby optimize disaster response, provided that tailored resuscitation is given whenever specialized care becomes available.

Standardization of Burn Patients Transfer: Implementation of a Transfer Request Form to Israel's National Burn Center.

BACKGROUND: Burn injuries are an extreme form of traumatic injury and are a global health issue. The Israeli National Burn Unit at the Sheba Medical Center, a tertiary level 1 trauma center and hence the national referral center, treats burn patients admitted both directly and referred from other medical centers. The transfer and handover of patients is a critical step in patient care. In Israel, to date, there is no standardized and accepted transfer request form for burn patients from one medical facility to another. OBJECTIVES: To construct a transfer request form to be used in all future burn patient referrals. METHODS: After reviewing publicly available international transfer forms and comparing them to the admission checklist used at our unit, a structured transfer request form was constructed. RESULTS: After a pilot study period, testing the form in various scenarios and adapting it, the first standardized transfer form for burn patients in Israel in both English and Hebrew was implemented beginning May 2020. CONCLUSIONS: Implementation of a standardized transfer process will improve communication between healthcare professionals to help maintain a continuum of care. We believe that implementation of a burn transfer form in all future referrals can standardize and assure better care for burn patients, thus improving overall patient care.