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

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.