AUCTORES
Globalize your Research
Chat with us
Research Article | DOI: https://doi.org/10.31579/2690-1919/213
* Plastic surgery Department Baby Memorial Hospital I G Road, Arayidathupalam Kozhikode Kerala-673004, India.
*Corresponding Author: Subin Joseph, Plastic surgery Department Baby Memorial Hospital I G Road, Arayidathupalam Kozhikode Kerala-673004, India.
Citation: Subin Joseph. (2022). The Effective Management and Outcome of Hand Burns. J Clinical Research and Reports, 10(1); DOI:10.31579/2690-1919/213
Copyright: © 2022, Subin Joseph. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 02 November 2021 | Accepted: 21 December 2021 | Published: 03 January 2022
Keywords: hand burn; public health; injuries; patients; tertiary hospital; silver sulfadiazine ointment; burn wound excision; proforma; anesthesia
Burns is a common public health problem and these injuries can be accidental, suicidal or even homicidal in nature. Hands being the most active part of the body, are often involved in burns. Hand burns represent three percent of body surface area, and are involved in more than 80% of all severe burns. Hand burns predominantly affect young adults and therefore have serious social and financial implications. The hand is one of the most frequent sites of burns scar contracture deformity. The deformities and contractures result in lifelong physical problems and affects the normal functioning of the person.
Burns is a common public health problem and these injuries can be accidental, suicidal or even homicidal in nature. Hands being the most active part of the body, are often involved in burns. Hand burns represent three percent of body surface area, and are involved in more than 80% of all severe burns [1]. Hand burns predominantly affect young adults and therefore have serious social and financial implications. The hand is one of the most frequent sites of burns scar contracture deformity [2]. The deformities and contractures result in lifelong physical problems and affects the normal functioning of the person.
A prospective observational study of 74 patients with hand burns attending in a tertiary hospital burns unit within 2015 to 2018 was carried out.
Aim: To study the hand function outcome following the management of hand burns.
Objectives:
Inclusion criteria:
Exclusion criteria:
All patients were treated with standard resuscitative measures. Fluid resuscitation by Parkland formula and high calorie and high protein diet was initiated. After stabilization of the general condition, decision about conservative or operative treatment was taken. Wounds were assessed by me along with senior consultant for depth. Wounds were again reassessed after 24 hours to decide on treatment. It was decided to manage conservatively all the superficial partial thickness burns. All standard treatment options of conservative management like dressing with silver sulfadiazine ointment, amniotic membrane or collagen dressing for superficial partial thickness burns were explained to patient and bystanders and a collective decision was taken. They were advised to do all active movements and night splinting from day one onwards.
Early burn wound excision and skin grafting was planned in case of second degree deep and third degree burns. Surgical management of removal of eschar, early burn wound excision and skin grafting and flap coverage were carried out as indicated. Hands were splinted in the position of immobilization with wrist in 20 degrees extension, fingers in 70 degrees flexion of metacarpophalangeal joints and interphalangeal joints in extension and with the thumb in palmar abduction at CMC joint and IPJ at 5 degree flexion for 5 days.
Patients on silver sulfadiazine ointment dressing were reviewed every 5 days, after discharge from hospital. Patients with amniotic membrane dressings were reviewed on every 5 days after discharge or earlier if patient develops fever, redness around wound or increased wound discharge. Physiotherapy was started on the same day with the help of therapist. Splinting was advised at night. Postoperative care included frequent dressing change at fourth and sixth day in case of skin grafting and every third day in case of flaps and care of donor site. Once the graft settles, after 2 weeks, patients were started on active physiotherapy for hands and ADL as per the protocols followed by the Department of Physical medicine and rehabilitation at this hospital. Patients were advised to wear the splint when not exercising and at night.
Patients were on regular follow up after discharge for a period of at least 6 months (once weekly for one month, twice weekly for two months, once a month for three months). They were observed for any complications like hypopigmented or hyperpigmented patches, contractures, hypertrophic scar or keloid, joint stiffness, clawing and mallet deformity at each visit and documented. Scar massage and compression garments were advised for six months in all patients. Photographic record of patient at presentation, during surgery, immediate postop, at discharge and during each subsequent follow-up was maintained. Details of every patient was recorded by a questionnaire proforma.
The compiled data was analyzed for the following study variables,
The hand function outcome was assessed following each treatment modality using a hand function score.
Outcome of management of hand burns was measured by assessing the extrinsic feature, range of motion, return to work and scars. Patients were assessed by a hand function scoring system at the end of six months as given in (table 1) [3,4]. With Score 1 indicating excellent hand function and Score 4 indicating bad hand function outcome.
Score | Extrinsic feature | Range of motion | Return to work |
1 | Symptomatic tightness | >80% of normal | Resume to normal work |
2 | Minimal scarring with no architectural distortion | >50%-80% of normal | Resume to suitable work (no heavy manual work) |
3 | Early scarring with mild residual architectural distortion | >30%-50% of normal | Limited to essential daily activities |
4 | Significant scarring & architectural distortion | < 30> | Significant loss of hand function |
Table 1: Scoring system for hand function
The collected data was entered into Microsoft excel. Statistical analysis was done using statistical package and social science (SPSS) software version 16. Quantitative variables were summarized using Mean. Qualitative variables were summarized using Proportions and Percentages. Pearson Chi-square test was used for correlation.
Statistical significance of p value was taken as p <0>
All the results were shown in (tables 2-8)
Degree of burns | Number of patients |
Second Degree burns | 63 (85.1%) |
Third Degree Burns | 9 |
Fourth Degree Burns | 2 |
Table 2: Degree of Burns
Etiology | No. of Patients |
Scald burns | 35 (47.2%) |
Flame burns | 25 |
Cracker blast burns | 9 |
Electrical burns | 5 |
Total | 74 |
Table 3: Etiology
Treatment modality | No. of patients | Mean Recovery Time (Days) |
Daily dressing with Silver sulfadiazine ointment + Physiotherapy + Night splintage | 1 | 12 |
Amniotic membrane application + Physiotherapy + Night splintage | 50 (67.5%) | 25 |
Early Tangential Excision and Skin Grafing + Physiotherapy + Night splintage | 22 | 30 |
Flap cover + Physiotherapy + Night splintage | 2 | 45 |
Table 4: Management Principles Applied and Mean Recovery Time
Complications | No. of Patients |
Hyperpigmented Patches | 23 (31%) |
Hypopigmented Patches | 16 (21.6%) |
Contractures | 2 |
Keloid | 2 |
Hypertrophic Scar | 2 |
Joint Stiffness | 1 |
Mallet deformity | 1 |
Table 5: Complications
Score | Extrinsic feature | Range of motion | Return to work | No. of Patients |
1 | Symptomatic tightness | >80% of normal | Resume to normal work | 69 (93.2%) |
2 | Minimal scarring with no architectural distortion | >50%-80% of normal | Resume to suitable work (no heavy manual work) | 4 |
3 | Early scarring with mild residual architectural distortion | >30%-50% of normal | Limited to essential daily activities | 1 |
4 | Significant scarring & architectural distortion | < 30> | Significant loss of hand function | 0 |
Table 6: Outcome Analysis of Study Population
Treatment modality | No. of patients | Scores | |||
1 | 2 | 3 | 4 | ||
Dressing with Silver sulfadiazine | 1 | 1 | 0 | 0 | 0 |
Amniotic membrane application | 50 | 49 | 1 | 0 | 0 |
Excision and Skin Grafting | 22 | 19 | 2 | 1 | 0 |
Flap cover | 1 | 0 | 1 | 0 | 0 |
Score 1 obtained in 98% of patients who underwent amniotic membrane application.
Table 7: Outcome of various treatment modalities
SCORE | Total | |||||
| 1 | 2 | 3 | ||||
| Degree | 2nd | Count | 60 | 0 | 1 | 61 |
| % within Degree | 98.4% | 0.0% | 1.6% | 100.0% | ||
| 3rd | Count | 9 | 2 | 0 | 11 | |
| % within Degree | 81.8% | 18.2% | 0.0% | 100.0% | ||
| 4th | Count | 0 | 2 | 0 | 2 | |
| % within Degree | 0.0% | 100.0% | 0.0% | 100.0% | ||
| Total | Count | 69 | 4 | 1 | 74 | |
| % within Degree | 93.2% | 5.4% | 1.4% | 100.0% | ||
P value- <0>
Table 8: Degree of burns and Hand function score
Majority of the adult patients (53.4%) had sustained accidental flame burns. Similar results have been reported from India [5,6,7] and other countries [8,9]. Cracker blast burns contribute to 12% of the etiology and most of them happened in males. 6.7% of patients sustained burns from electrical appliances.
85.1% of patient population sustained second-degree burns, 12.1% of patients sustained third-degree burns and 2.7% of the patients had sustained fourth-degree burns. All the patients were treated with standard protocol mentioned earlier.
Daily dressing with silver sulfadiazine ointment was done for one-second degree superficial burns. This patient returned to his work by 12 days.
We routinely use amniotic membrane preserved in 85% glycerol [10] and gentamycin in sterile containers for temporary burn wound coverage. Once applied and dried, it seals the wound surface and acts as a good bacterial barrier and minimizes loss of fluid and electrolyte. This reduces the need for frequent dressing changes, skin grafting, decreases pain and lowers infection rates and reduces hospital stay. So it is a cheap alternative which is adherent and forms an impenetrable layer over burn wound [11,12].
After debridement of the blisters in the burn wounds, the amniotic membrane is applied and dried. This is a painful procedure and the choice of anesthesia is decided based on the size and patient comfort and ranges from tumescent or local anesthesia to sedation or general anesthesia (especially preferred in children). No prophylaxis antibiotic protocol is followed and appropriate antibiotics are used when there is an associated URTI or patient develops signs of infection like fever, tachycardia or leukocytosis. Fifty patients underwent amniotic membrane application soon after injury which includes second degree superficial burns. All patients underwent physiotherapy and night splintage. The mean recovery time was 25 days.
Twenty-two patients underwent burn wound excision and skin grafting for second degree deep, third and fourth degree burns. Harrison D.H and Park House had also found these advantages of early excision and grafting in their study [13]. We used meshed split thickness skin grafting and appropriate splintage was given. Dressing changes were done on the fourth and sixth postoperative days. The splint was removed after ten days. The mean recovery time was 30 days. All patients underwent physiotherapy after 2 weeks and night splintage following that.
Flap coverage was done for a patient, who had electrical burn involving the right index and middle finger with tissue loss in the adjoining surfaces and second webspace, who underwent abdominal flap cover.
Out of the second degree hand burns, one patient who underwent silver sulphadiazine dressing developed keloid and was excised later. One patient each among 50 patients who underwent amniotic membrane application developed hyperpigmentation, contracture and keloid. Two out of fifty patients developed hypertrophic scarring. Twelve out of fifty patients (24%) developed hypopigmentation. The patients who underwent excision and skin grafting developed hyperpigmentation in 95% of patients, hypopigmentation in 13% patients, joint stiffness, mallet deformity and contractures in one patient each as complications during six months follow up.
In my study population, skin contracture developed as complication in 2.7% patients and these patients were found to have been reluctant to do physiotherapy regularly. There were skin contractures in only two patients (2.7%) out of a total of 74 patients. These patients underwent flap cover after 6 months. One patient was a 4 yr old child who had sustained deep flame burn involving dorsum of hand and child was initially skin grafted, subsequently underwent contracture release and groin flap cover. Other patient had deep flame burns involving volar aspect of index and middle finger, and underwent contracture release and multiple Z-plasties. Kraemer et al [14] noted only a 3.7% rate of reconstructive procedures 9 years after burn scar release in a population of 839 adults and children with burn injury. Pegg et al [15] found about 7.8% incidence of contractures in about a total of 411 patients. Hypertrophic scar and keloid developed in two patients (2.7%) each. Both had deep burns and developed wound infection. Both are initially managed by massage and compression garments. Keloid excision was done for one patient. Joint stiffness and mallet deformity developed in one patient each. Joint stiffness developed because of poor compliance with physiotherapy. Loss of extensor tendon by deep burns resulted in mallet deformity of the index finger of one patient, which was managed conservatively. Both patients managed to do suitable work.
In the outcome analysis of these treated burns patients, the majority had recovered normal hand function. These patients include both second and third-degree burns. They were on regular follow up and had regular supervised physiotherapy for hand movements. All patients were counseled, educated and motivated.
Four patients (5.4%) had minimal scarring, but no architectural distortion (Score 2) (Table 8). Range of motion was around 80%. They all returned to previous jobs.
One female patient (1.3%) with third-degree flame burn had early scarring and mild residual architectural distortion (Score 3). Contracture developed on both hands. Her activities were limited to the essential daily routine. None of our patients had score 4 as outcome.
One patient who underwent silver sulphadiazine dressing had score 1 outcome (100%). Out of the 21 patients who underwent Excision and skin grafting, 19 patients had score 1 (90.4%) and two patients had score 2 (9.5%) outcome. One patient who underwent flap cover had score 2 (100%) outcome.
Statistical analysis showed 98.4% of patients with second-degree hand burns and 88.1% of patients with third-degree hand burns obtained a score of 1 (more than 80% normal range of motion). Score 2 was obtained in 18.2% of patients with second degree burns and 100% of patients with fourth degree burns. That means there was a significant correlation (P value <0>
Time is precious and is the key to functional recovery. Early intervention like excision and skin grafting decreases the mean recovery time and thus improves the hand function. Hand must figure higher in the priority list while addressing burn contractures.
Even though the mean recovery time was more in the group of patients who underwent early excision and grafting, it resulted in early burn wound coverage, minimal scar contractures and better hand function scores in deep burns. Physiotherapy, splintage and scar management in post-operative period is highly essential to prevent contracture and stiffness. Compression stockings and silicone gel sheets are useful to prevent hypertrophic scar. Thus by following the standard guidelines in the management of acute hand burns, the deformities can be minimized and can enable us to achieve the goal of an optimum hand function which is of paramount importance.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
