Integrative medicine in burn care: A conceptual framework and study protocol for a multimodal non-pharmacological intervention programme

Advances in Integrative Medicine, vol. 13, pp. 100645

Abstract

Severe burn injuries cause lasting physical and psychosocial sequelae. Integrative medicine (IM) combines guideline-based burn care with evidence-informed non-pharmacological interventions (NPIs) but is rarely implemented in a structured manner in burn units. Recent evidence supports selected non-pharmacological adjuncts for symptom control and highlights the need for systematic evaluation of multimodal integrative programmes. Adding a modular IM-NPI programme to standard burn care improves patient-centred outcomes, including symptom burden, psychological well-being and functional recovery. Controlled therapeutic hyperthermia is positioned as a mechanistic co-candidate to influence perfusion and tissue viability. Pragmatic randomised controlled pilot feasibility trial in adult burn inpatients following the CONSORT 2010 extension for pilot trials. Standard care will be compared with standard care plus a multimodal IM-NPI bundle. Primary outcomes assess feasibility (recruitment, adherence, retention). Exploratory clinical outcomes include validated patient-reported measures (BPI, HADS, PROMIS). Secondary outcomes include time to 95% re-epithelialisation (separately defined for partial-thickness wounds, grafted sites and donor sites), perfusion (LDI), need for grafting, functional recovery, scar quality, analgesic use, length of stay, readmission and safety. Early-initiated, individually titrated modular programme. Core acute-phase interventions include psychoeducation, breathing therapy and physiotherapy; optional rehabilitation-phase components include movement-based, manual, artistic and thermotherapeutic modalities. First structured adult inpatient pilot integrating controlled hyperthermia within a burn-specific IM framework with explicit progression criteria. This pilot will determine feasibility, safety and preliminary signals to inform a definitive trial.

Authors 6

1. Ibrahim Güler corresponding

   Friedrich-Alexander-Universität Erlangen-Nürnberg · Gemeinschaftskrankenhaus Havelhöhe

   Affiliation as printed

   Department of Plastic Surgery and Hand Surgery, Gemeinschaftskrankenhaus Havelhoehe, Kladower Damm 221, 14089 Berlin, Germany

   Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany

2. Jacqueline Bastiaanse

   Gemeinschaftskrankenhaus Havelhöhe

   Affiliation as printed

   Department of Plastic Surgery and Hand Surgery, Gemeinschaftskrankenhaus Havelhoehe, Kladower Damm 221, 14089 Berlin, Germany

3. Andreas Zoric

   University Hospital Magdeburg

   Affiliation as printed

   Department of Plastic, Aesthetic and Hand Surgery, University Hospital Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany

4. Carlos Rodrigo Munoz Salazar

   Diakonie-Klinikum Stuttgart

   Affiliation as printed

   Department of Plastic, Aesthetic and Hand Surgery Diakonie Klinikum Stuttgart, Rosenbergstraße 38, 70176 Stuttgart, Germany

5. Henrik Stelling

   Friedrich-Alexander-Universität Erlangen-Nürnberg · Klinikum Ernst von Bergmann

   Affiliation as printed

   Department of Nuclear Medicine, Klinikum Ernst von Bergmann, Charlottenstrasse 72, 14467 Potsdam, Germany

   Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany

6. Gerrit Grieb Aachen Medical Faculty Department of Plastic Surgery and Hand Surgery Burn Center

   RWTH Aachen University · Gemeinschaftskrankenhaus Havelhöhe

   Affiliation as printed

   Department of Plastic Surgery and Hand Surgery, Burn Center, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany

   Department of Plastic Surgery and Hand Surgery, Gemeinschaftskrankenhaus Havelhoehe, Kladower Damm 221, 14089 Berlin, Germany