Dr Dulan Gunawardena^1,2, Dr  Edward Stanley¹, Dr Andrea Issler-Fisher^1,2

¹Concord Repatriation General Hospital, Sydney, Australia, ²Concord Clinical School, University of Sydney, Sydney, Australia

Abstract:

Background:

Pruritis and neuropathic pain are common symptoms of burn-related tissue injury. It can be disabling for the burn-injured patient, often presenting within several days of the initial injury.(GOUTOS; CLARKE; UPSON; RICHARDSON et al., 2010) Burn-related pruritus significantly affects the quality of life of these patients through negative impacts on well-being, sleep and activities of daily living.(CHUNG; KIM; JUNG; KANG et al., 2020) Such impacts are primarily the result of the sensory discomfort these patients experience; these include numbness, prickling, stinging and burning sensations. Despite advances in the neurophysiological understanding of pruritis, there remains a paucity of literature examining neural factors implicated in burn-related pruritus and neuropathic pain.(TWYCROSS; GREAVES; HANDWERKER; JONES et al., 2003) We review the current literature regarding neural factors that contribute to burn-related pruritus and neuropathic pain.

Methods:

A literature review was performed through the Embase and MEDLINE databases. The medical subject heading (MeSH) Terms used included: pruritus, neuropathic pain, burn, burn-related tissue injury. Articles were excluded if single case-reports, no results or non-peer reviewed. A total of 47 articles were included for review.

Discussion:

There are four key pathogenic mechanisms that have been purported for pruritus: these include neuropathic (affecting the afferent neurological pathway), neurogenic (centrally focussed only), pruritogenic (a result of skin inflammation) and psychogenic.(TWYCROSS; GREAVES; HANDWERKER; JONES et al., 2003) There is consensus within the literature that pruritus and neuropathic pain is likely a consequence of all four mechanisms, nevertheless, a paucity of literature exists that examines the neural mediators that serve as inducing stimuli.

Biography:

Dr Dulan Gunawardena is currently a junior medical officer at Concord Repatriation Hospital. He has a keen interest in Burns and Plastic Reconstructive surgery. He was formerly the medical director at HealthMatch, Australia’s most well-funded healthtech start-up.