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  • 1.
    Akerlund, Emma
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Huss, Fredrik R M
    Inst för Experimentell och Klinisk medicin, Linköping.
    Sjöberg, Folke
    Inst för Experimentell och Klinisk medicin, Linköping.
    Burns in Sweden: an analysis of 24,538 cases during the period 1987-2004.2007Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 33, nr 1, s. 31-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Burn care is always progressing, but there is little epidemiological information giving a clear picture of the current number of treated burns in Sweden. This study was conducted to provide an update of patients admitted to hospital with burns in Sweden. Data were obtained for all patients who were admitted to hospitals with a primary or secondary diagnosis of burns (ICD-9/10 codes) from 1 January 1987 to 31 December 2004; 24,538 patients were found. Most of the patients were male (69%), giving a male:female ratio of 2.23:1. Children in the age-group 0-4 years old predominated, and accounted for 27% of the study material. The median length of stay was 3 days. Throughout the period 740 patients (3%) died of their burns. Significant reductions in mortality, incidence, and length of stay were seen during the study, which correlates well with other studies. However, most of the reductions were in the younger age-groups. Men accounted for the improved mortality, as female mortality did not change significantly. We think that the improvement in results among patients admitted to hospital after burns is a combination of preventive measures, improved treatment protocols, and an expanding strategy by which burned patients are treated as outpatients.

  • 2.
    Andersson, Gerhard
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Sandberg, Susanne
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Rydell, Ann Margret
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Gerdin, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Social competence and behaviour problems in burned children2003Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 29, nr 1, s. 25-30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to collect follow-up data on social competence and behavioural problems in a sample of Swedish burned children and to compare the results with normative data from a reference group of children comparable in age, socio-economic status and gender. Parents of 44 children (55% response rate) aged 7-12 years were asked to complete a questionnaire booklet including the Children's Behaviour Questionnaire (CBQ) and the Social Competence Inventory (SCI). Data from the children's teachers were also collected for 20 children using the same booklet. In addition, data on TBSA, localisation of injury, and other background factors were collected. Results showed that the burned children were rated by their parents as showing lesser degrees of social initiative and more externalising problems and concentration problems compared with the control group. Teachers rated the burn injured children as having less prosocial orientation, more externalising problems, and more concentration problems. No clear effects were found for gender and characteristics of the burn injury. Results on the Social Competence Inventory were associated with scores on the Children's Behaviour Questionnaire.The findings are consistent with previous research in that the differences found were relatively small. However, they do call for attention to the possible adverse effects of growing up with a burn injury, but also to the possible pre-morbid characteristics that may be related to the injury.

  • 3.
    Bergquist, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi. Univ Gothenburg, Sahlgrenska Acad, Dept Rheumatol & Inflammat Res, Gothenburg, Sweden.
    Hastbacka, Johanna
    Univ Helsinki, Intens Care Med, Dept Anesthesiol Intens Care Med & Pain Med, Helsinki, Finland;Helsinki Univ Hosp, Helsinki, Finland.
    Glaumann, Christian
    Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, Uppsala, Sweden.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, Uppsala, Sweden.
    Lipcsey, Miklós
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    The time-course of the inflammatory response to major burn injury and its relation to organ failure and outcome2019Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, nr 2, s. 354-363Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Burn injury causes major inflammatory activation and cytokine release, however, the temporal resolution of the acute and sub-acute inflammatory response has not yet been fully delineated. To this end, we have quantified 20 inflammatory mediators in plasma from 44 adult patients 0-21 days after burn injury and related the time course of these mediators to % total body surface area (TBSA) burned, clinical parameters, organ failure and outcome. Of the cytokines analyzed in these patients, interleukin 6 (IL-6), IL-8, IL-10 and monocyte chemoattractant protein 1 (MCP-1) correlated to the size of the injury at 24-48h after burn injury. In our study, the concentration of IL-10 had prognostic value in patients with burn injury both measured at admission and at 24-48h after injury. However, simple demographic data such as age, % burned TBSA, inhalation injury and their combination, the Baux score and modified Baux score, outperform most of the cytokines, with the exception of IL-8 and MCP1 levels on admission, in predicting death.

  • 4.
    Fransen, Jian
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Huss, Fredrik R. M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Uppsala, Sweden..
    Nilsson, Lennart E.
    Linkoping Univ, Dept Clin & Expt Med, Clin Microbiol, Linkoping, Sweden..
    Rydell, Ulf
    Linkoping Univ, Inst Clin & Expt Med, Infect Dis, Linkoping, Sweden..
    Sjöberg, Folke
    Linkoping Univ, Inst Clin & Expt Med, Linkoping, Sweden..
    Hanberger, Håkan
    Linkoping Univ, Inst Clin & Expt Med, Infect Dis, Linkoping, Sweden..
    Surveillance of antibiotic susceptibility in a Swedish Burn Center 1994-20122016Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, nr 6, s. 1295-1303Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Patients with burn trauma are at risk for infections caused by antibiotic resistant bacteria (ABR) with subsequent increase in morbidity and mortality. As part of the Swedish strategic program against antibiotic resistance in intensive care (ICU-Strama), we have surveyed the distribution of species and ABR in isolates from patients admitted to a Swedish burn center at Linkoping University Hospital from 1994 through 2012. In an international comparison Strama has been successful in reducing the antibiotic consumption among animals and humans in primary care. The aim of this study was to investigate the antibiotic consumption pressure and resistance rates in a Swedish burn unit. Methods: Microbiology data, total body surface area (TBSA), patient days, and mortality were collected from a hospital database for all patients admitted to the Burn Center at the University Hospital of Linkoping from April 1994 through December 2012. Results: A total of 1570 patients were admitted with a mean annual admission rate of 83 patients (range: 57-152). 15,006 microbiology cultures (approximately 10 per patient) were collected during the study period and of these 4531 were positive (approximately 3 per patient). The annual mean total body surface area (TBSA) was 13.4% (range 9.5-18.5) with an annual mortality rate of 5.4% (range 1-8%). The MRSA incidence was 1.7% (15/866) which corresponds to an MRSA incidence of 0.34/1000 admission days (TAD). Corresponding figures were for Escherichia coli resistant to 3rd generation cephalosporins (ESBL phenotype) 8% (13/170) and 0.3/TAD, Klebsiella spp. ESBL phenotype 5% (6/134) and 0.14/TAD, carbapenem resistant Pseudomonas aeruginosa 26% (56/209) and 1.28/TAD, and carbapenem resistant Acinetobacter spp. 3% (2/64) and 0.04/TAD. Conclusions: Our results show a sustained low risk for MRSA and high, although not increasing, risk for carbapenem resistant P. aeruginosa.

  • 5.
    Fredriksson, Camilla
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Huss, Fredrik
    Inst för Experimentell och Klinisk medicin, Linköping.
    Transplantation of cultured human keratinocytes in single cell suspension: a comparative in vitro study of different application techniques.2008Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 34, nr 2, s. 212-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Transplantation of autologous cultured keratinocytes in single cell suspension is useful in the treatment of burns. The reduced time needed for culture, and the fact that keratinocytes in suspension can be transported from the laboratory to the patient in small vials, thus reducing the costs involved and be stored (frozen) in the clinic for transplantation when the wound surfaces are ready, makes it appealing. We found few published data in the literature about actual cell survival after transplantation of keratinocytes in single cell suspension and so did a comparative in vitro study, considering commonly used application techniques. Human primary keratinocytes were transplanted in vitro in a standard manner using different techniques. Keratinocytes were counted before and after transplantation, were subsequently allowed to proliferate, and counted again on days 4, 8, and 14 by vital staining. Cell survival varied, ranging from 47 to >90%, depending on the technique. However, the proliferation assays showed that the differences in numbers diminished after 8 days of culture. Our findings indicate that a great number of cells die during transplantation but that this effect is diminished if cells are allowed to proliferate in an optimal milieu. A burned patient's wounds cannot be regarded as the optimal milieu, and using less harsh methods of transplantation may increase the take rate and wound closing properties of autologous keratinocytes transplanted in a single cell suspension.

  • 6.
    Frestadius, Andrea
    et al.
    Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Burn Ctr, S-75185 Uppsala, Sweden.
    Grehn, Filip
    Vrinnevi Cty Hosp, S-60182 Norrköping, Sweden.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Burn Ctr, S-75185 Uppsala, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Burn Ctr, S-75185 Uppsala, Sweden.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden.
    Intranasal dexmedetomidine and rectal ketamine for young children undergoing burn wound procedures2022Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 48, nr 6, s. 1445-1451Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Safe and effective methods for sedation and analgesia in pediatric burn patients are strongly warranted. This retrospective study of electronic health care records aims to evaluate the safety and efficacy of intranasal dexmedetomidine combined with rectal ketamine as procedural sedation for young children undergoing dressing changes and debridement of burn wounds.

    Methods: Documentation was analyzed from 90 procedures in 58 pediatric patients aged <5 years. Safety and efficacy of the method were assessed based on documentation for complications, adverse effects, pain level, level of sedation and preoperative and recovery time.

    Results: All 90 sedations were completed without significant adverse events with acute airway management or medical intervention. The combination of dexmedetomidine-ketamine produced acceptable analgesia during the procedure and effectively relieved postoperative pain. However, the approach was insufficient for 7/58 patients (7.8%); these patients were converted from the dexmedetomidine-ketamine combination to intravenous anesthesia. In 23% of the cases an extra dose of either ketamine of dexmedetomidine was administered. Moreover, there were two cases of delayed awakening with recovery time >120 min.

    Conclusion: The drug combination intranasal dexmedetomidine and rectal ketamine is a safe and reliable approach for procedural sedation and analgesia in pediatric patients undergoing burn wound procedures, producing a clinically stable sedative condition requiring only basic monitoring.

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  • 7.
    Frew, Quentin
    et al.
    Mid Essex Hosp Trust, Broomfield Hosp, St Andrews Ctr Plast Surg & Burns, Chelmsford, Essex, England.
    Rennekampff, Hans-Oliver
    Rhein Maas Klinikum, Dept Plast Aesthet & Burn Surg, Wurselen, Germany.
    Dziewulski, Peter
    Mid Essex Hosp Trust, Broomfield Hosp, St Andrews Ctr Plast Surg & Burns, Chelmsford, Essex, England.
    Moiem, Naiem
    Univ Hosp Birmingham NHS Fdn Trust Queen Elisabet, Burns & Plast, Birmingham, W Midlands, England.
    Zahn, Tobias
    Birken AG, Niefern Oschelbronn, Germany;3R Pharma Consulting GmbH, Dobel, Germany.
    Hartmann, Bernd
    Unfallkrankenhaus Berlin, Burn Ctr Plast Surg, Berlin, Germany.
    Siemers, Frank
    BG Kliniken Bergmannstrost, Klin Plast & Handchirurg Brandverletzten Zentrum, Halle, Germany.
    Mailander, Peter
    Univ Lubeck, Klin Plast Chirurg Handchirurg, Intens Inheit Schwerbrandverletzte, Lubeck, Germany.
    Lehnhardt, Marcus
    BG Univ Klin Bergmannsheil, Klin Plast Chirurg & Schwerbrandverletzte, Bochum, Germany.
    Thorfinn, Johan
    Linkoping Univ Hosp, Dept Hand & Plast Surg & Intens Care, Burn Ctr, Linkoping, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Pietramaggiori, Sandra Scherer
    CHU Vaudois, Chirurg Plast & Reconstruct, Lausanne, Switzerland.
    Dheansa, Baljit
    Queen Victoria Hosp NHS, Burn Ctr, E Grinstead, England.
    Metelmann, Hans-Robert
    Univ Med Greifswald, Klin & Poliklin Mund Kiefer Gesichtschirurg Plast, Greifswald, Germany.
    Schumann, Hauke
    Kathol Hsch Freiburg, Freiburg, Germany.
    Betulin wound gel accelerated healing of superficial partial thickness burns: Results of a randomized, intra-individually controlled, phase III trial with 12-months follow-up2019Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, nr 4, s. 876-890Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Acceleration of wound healing promises advantages for patients and caregivers in reducing the burden of disease, avoiding complications such as wound infections, and improving the long-term outcome. However, medicines that can accelerate wound healing are lacking. The objective of this open, blindly evaluated, randomized, multicenter phase III study was to compare intra-individually the efficacy and tolerability of Oleogel-S10 with fatty gauze dressing versus Octenilin (R) wound gel with fatty gauze dressing in accelerating the healing of superficial partial thickness burn wounds. Methods: Acute superficial partial thickness burn wounds in adults caused by fire, heat burn or scalding were divided into 2 halves and randomly assigned to treatment with Oleogel-S10 or Octenilin (R) wound gel. Photos for observer-blinded analysis of wound healing were taken at each wound dressing change. Percentages of reepithelialization were assessed at defined intervals. Efficacy and tolerability were evaluated based on a 5-point Likert scale. Results: Of 61 patients that were enrolled, 57 received the allocated intervention and 48 completed treatment. The percentage of patients with earlier wound healing was significantly higher for Oleogel-S10 (85.7%, n=30) compared to Octenilin (R) wound gel (14.3%, n= 5, p <0.0001). The mean intra-individual difference in time to wound closure was -1.0 day in favour of Oleogel-S10 (-1.4, -0.6; 95% CI, p <0.0001). Most investigators (87.0%) and patients (84.8%) evaluated the efficacy of Oleogel-S10 to be 'better' or 'much better' than that of Octenilin (R) wound gel. Long-term outcome 3 months and 12 months post injury was improved in some patients. Conclusions: Oleogel-S10 (Episalvan) significantly accelerated the healing of superficial partial thickness burn wounds. It was safe and well tolerated. (C) 2018 Elsevier Ltd and ISBI. All rights reserved.

  • 8. García Barreiro, J
    et al.
    Rodriguez Lorenzo, Andres
    Cal, M
    Alvarez, A
    Martelo Villar, F
    Treatment of postoperative pain for burn patients with intravenous analgesia in continuous perfusion using elastomeric infusors2005Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 31, nr 1, s. 67-71Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Postoperative pain after surgery with patients suffering from burns tends to be moderate or severe, and its treatment requires a combination of high-strength analgesics (opioids) with others having different action mechanisms according to the concept of multimodal analgesia.

    AIMS: In this article we propose the use of continuous intravenous analgesia with morphine using elastomeric infusors at fixed dose for the treatment of this kind of pain. An evaluation is made of its analgesic efficacy, side effects and level of satisfaction.

    MATERIAL AND METHODS: A study was made of 17 burn patients operated on in our unit who received continuous intravenous analgesia during the postoperative period, with morphine at 1mg/h, using elastomeric infusors for a period of 24h. Its analgesic efficacy was analysed using the visual analogical scale (VAS) at different moments; side effects and the level of acceptance by the patient was also evaluated.

    RESULTS: The results confirm a good analgesic effect after 2h from starting perfusion (VAS < 3). The side effects reveal a similar or lesser incidence to the use of morphine in bolus or using the PCA system, and in no cases did they require treatment to be halted. The level of acceptance of the procedure by patients was good.

    CONCLUSION: This method reveals a high level of analgesic efficacy in the postoperative period with burn patients in this study. However, it is important to note the lower results obtained in the first hours of perfusion, and proposing a heavy initial dose of analgesics when starting perfusion. This is presented as an efficient analgesic method that is easy to apply, has a low cost, and the possibility of extending its indications to ambulatory treatment.

  • 9.
    Gauffin, Emelie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Öster, Caisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Patient perception of long-term burn-specific health and congruence with the Burn Specific Health Scale-Brief2019Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, nr 8, s. 1833-1840Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: This qualitative study aims to explore former burn patients’ perception of burn-specific health and investigate how these experiences correspond to the subscales in the Burn Specific Health Scale-Brief (BSHS-B).

    Method: Respondents were former burn patients, admitted to the Uppsala Burn Centre between 2000 and 2007. A total of 20 respondents with a Total Body Surface Area (TBSA) of 20% or larger, were approached at 10 to 17 years post-burn and interviewed using a semi-structured guide. Data was analyzed using thematic analysis.

    Results: Despite extensive burn injuries, respondents said they led a close-to-normal life. Their descriptions validated the significance of the existing themes of BSHS-B. Additional themes of importance for post-burn health were skin related problems, morphine de-escalation, the importance of work, stress and avoidance, mentality and the healthcare system.

    Conclusion: The BSHS-B alone may not be sufficient in providing a comprehensive picture of former burn patients’ self-perceived health in the long-term perspective. Investigating supplementary areas reflecting former patients’ sociocultural and attitudinal environment, as well as personal factors, may be of great importance. 

  • 10.
    Gauffin, Emelie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Linkoping Univ, Burn Ctr, Dept Hand Plast & Intens, S-58185 Linkoping, Sweden..
    Öster, Caisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sjöberg, Folke
    Linkoping Univ, Burn Ctr, Dept Hand Plast & Intens, S-58185 Linkoping, Sweden..
    Gerdin, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Health-related quality of life (EQ-5D) early after injury predicts long-term pain after burn2016Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, nr 8, s. 1781-1788Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Chronic pain after burn can have severe physical and psychological effects on former patients years after the initial injury. Although the issue of pain after burn has gained increased attention over the past years, prospective, longitudinal studies are scarce. Our aim was to prospectively investigate consecutive burn patients for pain severity over time and to evaluate the prevalence and characteristics of post-burn pain to 2-7 years after the burn. As an additional aim, the effects of burn and individual-related factors, especially health related Quality of Life (HRQoL), were investigated.

    Method: Sixty-seven consecutive burn patients were assessed during acute care at 3, 6, 12 and 24 months, as well as at 2-7 years post-burn. HRQoL, symptoms of post-traumatic stress disorder (PTSD) and other psychiatric disorders were investigated. During the interviews that took place 2-7 years after the injury (mean 4.6 1.9 years), current chronic post-burn pain was assessed using the Brief Pain Inventory-Short Form (BPI-SF).

    Results: One-third of the patients still reported pain 2-7 years after the injury. Pain severity and interference with daily life were mainly mild to moderate though they were found to be associated with significantly lower HRQoL. Chronic pain after bum was associated with both burn- and individual-related factors. In logistic regression analysis HRQoL at 3 and 12 months and symptoms of PTSD at 12 months were independent factors in predicting chronic pain after burn.

    Conclusion: Pain after burn becomes a chronic burden for many former burn patients and decreases HRQoL. A novel finding in this study was that HRQoL assessed early after burn was a predictor for the development of chronic pain. This finding may help to predict future pain problems and serve as an indicator for pain preventive measures.

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  • 11. Gerdin, Bengt
    et al.
    Sjoberg, Folke
    Professor Gosta Arturson (1927-2013)2013Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 39, nr 8, s. 1654-1655Artikel i tidskrift (Refereegranskat)
  • 12.
    Greenhalgh, David G.
    et al.
    Shriners Childrens Northern Calif, Dept Burns, Sacramento, CA USA.;Univ Calif Davis, Dept Surg, Sacramento, CA USA.;Shriners Childrens Northern Calif, 2425 Stockton Blvd, Sacramento, CA 95817 USA..
    Hill, David M.
    Univ Tennessee, Hlth Sci Ctr, Coll Pharm, Dept Clin Pharm & Translat Scre, Memphis, TN USA..
    Burmeister, David M.
    Uniformed Serv Univ Hlth Sci, Dept Med, Bethesda, MD USA..
    Gus, Eduardo I.
    Hosp Sick Children, Div Plast & Reconstruct Surg, Toronto, ON, Canada.;Univ Toronto, Dept Surg, Toronto, ON, Canada..
    Cleland, Heather
    Monash Univ, Dept Surg, Melbourne, Vic 3181, Australia.;Alfred Hosp, Melbourne, Australia..
    Padiglione, Alex
    Monash Univ, Dept Surg, Melbourne, Vic 3181, Australia.;Alfred Hosp, Melbourne, Australia..
    Holden, Dane
    Monash Univ, Dept Surg, Melbourne, Vic 3181, Australia.;Alfred Hosp, Melbourne, Australia..
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, Uppsala, Sweden..
    Chew, Michelle S.
    Linköping Univ, Dept Anaesthesia & Intens Care, Biomed & Clin Sci, Linköping, Sweden..
    Kubasiak, John C.
    Loyola Univ, Dept Surg, Med Ctr, Maywood, IL USA..
    Burrell, Aidan
    Monash Univ, Dept Epidemiol & Preventat Med, Melbourne, Australia.;Alfred Hosp, Intens Care Res Ctr ANZIC RC, Melbourne, Australia..
    Manzanares, William
    Univ Republ UdelaR, Dept Crit Care Med, Montevideo, Uruguay..
    Gomez, Maria Chacon
    LGII, Natl Rehabil Inst, Ctr Nacl Invest & Atenc Quemados CENIAQ, Div Intens Care & Crit Med, Mexico City, Mexico..
    Yoshimura, Yuya
    Hachinohe Municipal Hosp, Dept Emergency & Crit Care Med, Hachinohe, Japan..
    Sjoberg, Folke
    Linköping Univ, Dept Anaesthesia & Intens Care, Biomed & Clin Sci, Linköping, Sweden..
    Xie, Wei-Guo
    Wuhan Univ, Wuhan Hosp 3, Tongren Hosp, Inst Burns, Wuhan, Peoples R China..
    Egipto, Paula
    Ctr Hosp & Univ Sao Joao, Burn Unit, Porto, Portugal..
    Lavrentieva, Athina
    Papanikolaou Hosp, Burn ICU, A ICU, Thessaloniki, Greece..
    Jain, Arpana
    Arizona Burn Ctr, Phoenix, AZ USA..
    Miranda-Altamirano, Ariel
    Hosp Civil Guadalajara, Guadalajara, Mexico..
    Raby, Ed
    Fiona Stanley Hosp, Infect Dis Dept, Murdoch, WA, Australia..
    Aramendi, Ignacio
    Ctr Nacl Quemados, Montevideo, Uruguay..
    Sen, Soman
    Shriners Childrens Northern Calif, Dept Burns, Sacramento, CA USA.;Univ Calif Davis, Dept Surg, Sacramento, CA USA..
    Chung, Kevin K.
    Uniformed Serv Univ Hlth Sci, Dept Med, Bethesda, MD USA..
    Alvarez, Renata Jennifer Quintana
    Pediat Burn Ctr, Santiago, Dominican Rep..
    Han, Chunmao
    Zhejiang Univ, Affiliated Hosp 2, Dept Burn & Wound Repair, Sch Med, Hangzhou, Peoples R China..
    Matsushima, Asako
    Nagoya City Univ, Grad Sch Med Sci, Dept Emergency Crit Care, Nagoya, Japan..
    Elmasry, Moustafa
    Linköping Univ, Dept Hand Plast Surg & Burns, Linköping, Sweden..
    Liu, Yan
    Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Burn, Shanghai, Peoples R China..
    Donoso, Carlos Segovia
    Mutual Secur Clin Hosp, Intens Care Unit Major Burns, Santiago, Chile..
    Bolgiani, Alberto
    Deutsch Hosp, Dept Surg, Buenos Aires, Argentina..
    Johnson, Laura S.
    Emory Univ, Sch Med, Dept Surg, Atlanta, GA USA.;Grady Hlth Syst, Atlanta, GA USA..
    Vana, Luiz Philipe Molina
    Univ Fed Sao Paulo, Escola Paulista Med, Disciplina Cirurgia Plast, Sao Paulo, Brazil..
    de Romero, Rosario Valdez Duval
    Pearl F Ort Burn Unit, Infect Dis Dept, Santo Domingo, Dominican Rep..
    Allorto, Nikki
    Univ KwaZulu Natal, Greys Hosp Pietermaritzburg, Metropolitan Burn Serv, Pietermaritzburg, South Africa..
    Abesamis, Gerald
    Univ Philippines Manila, Philippine Gen Hosp, Alfredo T Ramirez Burn Ctr, Dept Surg,Div Burns, Manila, Philippines..
    Luna, Virginia Nunez
    Secretaria Salud Ciudad Mexico, Unidad Michou & Mau Xochimilco Burnt Children, Mexico City, Mexico..
    Gragnani, Alfredo
    Fdn Santa Fe Bogota, Dept Pediat & Intens Care, Clin Studies & Clin Epidemiol Div, Pediat Burn Unit, Bogota, Colombia..
    Gonzalez, Carolina Bonilla
    Pediat Hosp Prof Dr Juan P Garrahan, Intens Care Area Burn Unit, Buenos Aires, Argentina..
    Basilico, Hugo
    Fiona Stanley Hosp, Dept Surg, Murdoch, WA, Australia..
    Wood, Fiona
    Univ Calif Irvine, Dept Surg, Irvine, CA USA..
    Jeng, James
    UCL, Dept Intens Care Med, London, England..
    Li, Andrew
    Monash Univ, Dept Surg, Melbourne, Vic 3181, Australia.;Alfred Hosp, Melbourne, Australia..
    Singer, Mervyn
    Army Third Mil Med Univ, Southwest Hosp, Inst Burn Res, Chongqing, Peoples R China..
    Luo, Gaoxing
    Med Univ South Carolina, South Carolina Burn Ctr, Dept Surg, Charleston, SC USA..
    Palmieri, Tina
    Shriners Childrens Northern Calif, Dept Burns, Sacramento, CA USA.;Univ Calif Davis, Dept Surg, Sacramento, CA USA..
    Kahn, Steven
    Sunnybrook Med Ctr, Dept Surg, Toronto, ON, Canada..
    Joe, Victor
    UCL, Dept Intens Care Med, London, England..
    Cartotto, Robert
    Sunnybrook Med Ctr, Dept Surg, Toronto, ON, Canada..
    Surviving Sepsis After Burn Campaign2023Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 49, nr 7, s. 1487-1524Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: The Surviving Sepsis Campaign was developed to improve outcomes for all patients with sepsis. Despite sepsis being the primary cause of death after thermal injury, burns have always been excluded from the Surviving Sepsis efforts. To improve sepsis outcomes in burn patients, an international group of burn experts developed the Surviving Sepsis After Burn Campaign (SSABC) as a testable guideline to improve burn sepsis outcomes. Methods: The International Society for Burn Injuries (ISBI) reached out to regional or na-tional burn organizations to recommend members to participate in the program. Two members of the ISBI developed specific "patient/population, intervention, comparison and out-come" (PICO) questions that paralleled the 2021 Surviving Sepsis Campaign [1]. SSABC parti-cipants were asked to search the current literature and rate its quality for each topic. At the Congress of the ISBI, in Guadalajara, Mexico, August 28, 2022, a majority of the participants met to create "statements" based on the literature. The "summary statements" were then sent to all members for comment with the hope of developing an 80% consensus. After four reviews, a consensus statement for each topic was created or "no consensus" was reported. Results: The committee developed sixty statements within fourteen topics that provide guidance for the early treatment of sepsis in burn patients. These statements should be used to improve the care of sepsis in burn patients. The statements should not be considered as "static" comments but should rather be used as guidelines for future testing of the best treatments for in burn should be on a basis. Conclusion: Members of the burn community from the around the world have developed the Surviving Sepsis After Burn Campaign guidelines with the goal of improving the outcome of sepsis in burn patients. (c) 2023 Elsevier Ltd and ISBI. All rights reserved.

  • 13.
    Gustafson, Carl-Johan
    et al.
    Kirurgiska vetenskaper, KI.
    Birgisson, Agust
    Inst för Experimentell och Klinisk medicin, Linköping.
    Junker, Johan
    Inst för Experimentell och Klinisk medicin, Linköping.
    Huss, Fredrik
    Salemark, Lars
    Johnson, Hans
    Inst för Experimentell och Klinisk medicin, Linköping.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Employing human keratinocytes cultured on macroporous gelatin spheres to treat full thickness-wounds: an in vivo study on athymic rats.2007Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 33, nr 6, s. 726-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Providing cutaneous wounds with sufficient epidermis to prevent infections and fluid loss is one of the most challenging tasks associated with surgical treatment of burns. Recently, application of cultured keratinocytes in this context has allowed this challenge to be met without several of the limitations connected with the use of split-thickness skin grafts. The continuous development of this novel approach has now revealed that transplantation of cultured autologous keratinocytes as single-cell suspensions exhibits several advantages over the use of cultured epidermal grafts. However, a number of methodological problems remain to be solved, primarily with regards to the complexity of culturing these cells; loss of viability and other negative effects during their preparation and transportation; the relatively long period of time required following transplantation to obtain a sufficiently protective epidermis. In the present investigation we attempted to eliminate these limitations by culturing the keratinocytes on macroporous gelatin spheres. Accordingly, the efficacies of normal human keratinocytes in single-cell suspension or growing on macroporous gelatin spheres, as well as of split-thickness skin grafts in healing wounds on athymic rats were compared. Human keratinocytes were found to adhere and proliferate efficiently both on the surface and within the pores of such spheres. Transplantation of such cells adherent to the spheres resulted in significantly more rapid formation of a stratified epidermis than did transplantation of single-cell suspensions or spheres alone. Twenty-three days after transplantation, the epidermis formed from the cells bound to the spheres was not as thick as the epidermis on wounds covered with split-thickness skin grafts, but significantly thicker than on wounds to which single-cell suspensions, spheres alone or no transplant at all was applied. Furthermore, fluorescence in situ hybridisation revealed that the transplanted keratinocytes, both those adherent to gelatin spheres and those in single-cell suspension, were components of the newly formed epidermis. These findings indicate that application of biodegradable macroporous spheres may prove to be of considerable value in designing cell-based therapies for the treatment of acute and persistent wounds.

  • 14.
    Horna Strand, Angelica
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Rubertsson, Sten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Mani, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Epidermal exfoliation of over 95% after a burn in an 18-month-old boy: Case report and review of the literature2016Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, nr 2, s. E18-E23Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    This report concerns an 18-month-old boy who presented with a 6% total body surface area scald. The subject of this report is unique in that he developed the largest exfoliation described in literature. After 3 days an epidermal exfoliation with the appearance of a deliberately inflicted scald developed. As the exfoliation progressed to over 95% total body surface area the suspicion of child abuse or neglect could be abandoned. The diagnosis Staphylococcal scalded skin syndrome was set, due to the finding of Staphylococcus aureus on swabs, the lack of mucosal engagement, and the patient's age. The boy's skin healed within 3 weeks. The few reports published are all case reports and most frequently described visually infected burns with smaller epidermal exfoliations, and clinically based exfoliation diagnosis. S. aureus often cause burn wound infections that can lead to complications caused by cross-infection. It is important for burn surgeons and intensive care specialists to be aware of the increased possibility of Staphylococcal scalded skin syndrome occurring in patients who have a reduced barrier to infection such as burn patients and also, that the diagnosis can be difficult to make.

  • 15. Karlsson, Matilda
    et al.
    Elmasry, Moustafa
    Steinvall, Ingrid
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Olofsson, Pia
    Elawa, Sherif
    Larsson, Alexander
    Sjöberg, Folke
    Biosynthetic cellulose compared to porcine xenograft in the treatment of partial-thickness burns: A randomised clinical trial.2022Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 48, nr 5, s. 1236-1245, artikel-id S0305-4179(21)00264-3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: The aim was to compare two dressing treatments for partial-thickness burns: biosynthetic cellulose dressing (BsC) (Epiprotect® S2Medical AB, Linköping, Sweden) and porcine xenograft (EZ Derm®, Mölnlycke Health Care, Gothenburg, Sweden).

    METHODS: Twenty-four adults with partial-thickness burns were included in this randomized clinical trial conducted at The Burn Centers in Linköping and Uppsala, Sweden between June 2016 and November 2018. Time to healing was the primary outcome. Secondary outcomes were wound infection, pain, impact on everyday life, length of hospital stay, cost, and burn scar outcome (evaluated with POSAS).

    RESULTS: We found no significant differences between the two dressing groups regarding time to healing, wound infection, pain, impact on everyday life, duration of hospital stay, cost, or burn scar outcome at the first follow up. Burn scar outcome at the 12-month follow up showed that the porcine xenograft group patients scored their scars higher on the POSAS items thickness (p = 0.048) and relief (p = 0.050). This difference was, however, not confirmed by the observer.

    CONCLUSIONS: The results showed the dressings performed similarly when used in adults with burns evaluated as partial thickness.

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  • 16.
    Lindblad, Marie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Burn center Department of plastic and maxillofacial surgery, Uppsala University Hospital..
    Sütterlin, Susanne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell barnhälsa och nutrition.
    Tano, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Burn center Department of plastic and maxillofacial surgery, Uppsala University Hospital..
    Lytsy, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi.
    Infection control measures to stop the spread of sequence type 15 OXA-23-producing Acinetobacter baumannii in a Swedish Burn Center2022Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 48, nr 8, s. 1940-1949Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe the course of the outbreak and infection control measures to stop the spread of sequence type 15 OXA-23-producing Acinetobacter baumannii in the Burn Center of Uppsala University Hospital, between November 2014 and the end of April 2015.

    METHODS: Compliance with hand hygiene, dress code, and cleaning routines were reviewed, the ward's environment was systematically investigated to identify potential environmental sources. Sampling routines for A. baumannii, from patients and environment, were established, and the epidemiological relationship was analysed for all carbapenem-resistant A. baumannii isolates using arbitrarily primed polymerase chain reaction (AP-PCR) and pulsed-field gel electrophoresis (PFGE).

    RESULTS: A total of 54 patients were treated at the burn intensive care unit during the studied, approximately five months period, and an OXA-23-producing A. baumannii was isolated from nine patients (9/54, 17%), whereof two died (2/9, 22.2%). All isolates shared identical PFGE-genotype patterns and belonged to sequence type 15; AP-PCR was eligible for prompt epidemiological investigations.

    CONCLUSIONS: Higher awareness and increased compliance with hand hygiene and dress code as well as intensified cleaning protocols of the environment and equipment were successfully established and likely to have led to stop the spread of sequence type 15 OXA-23-producing Acinetobacter baumannii.

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  • 17.
    Lindblad, Marie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden..
    Tano, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionsmedicin.
    Lindahl, Claes
    Intellego Technol AB, Gothenburg, Sweden..
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden.
    Ultraviolet-C decontamination of a hospital room: Amount of UV light needed2020Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 46, nr 4, s. 842-849Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Our primary aim was to investigate, using a commercial radiometer, the ultraviolet C (UVC) dose received in different areas in a burn ICU ward room after an automated UVC decontamination. The secondary aim was to validate a disposable UVC-dose indicator with the radiometer readings. Methods: Disposable indicators and an electronic radiometer were positioned in ten different positions in a burn ICU room. The room was decontaminated using the Tru-D (TM)-UVC device. Colour changes of the disposable indicators and radiometer readings were noted and compared. Experiment was repeated 10 times. Findings: The UVC radiation received in different areas varied between 15.9 mJ/cm(2) and 1068 mJ/cm(2) (median 266 mJ/cm(2)). Surfaces, at shorter distances and in the direct line of sight of the UVC device showed statistically significant higher UVC doses than surfaces in the shadow of equipment (p=0.019). The UVC-dose indicator's colour change corresponded with the commercially radiometer readings. Conclusions: The amount of UVC radiation that is received in surfaces depends on their locations in the room (ie distance from the UVC emitter) and whether any objects shadow the light. In this study we suggest that quality controls should be used to assure that enough UVC radiation reaches all surfaces. (C) 2019 The Authors. Published by Elsevier Ltd.

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  • 18.
    Nilsson, Andreas
    et al.
    Linkoping Univ, Fac Med & Hlth Sci, Dept Med & Hlth Sci, Linkoping, Sweden;Reg Ostergotland, Dept Anesthesia & Intens Care, Linkoping, Sweden.
    Orwelius, Lotti
    Reg Ostergotland, Dept Anesthesia & Intens Care, Linkoping, Sweden;Linkoping Univ, Fac Med & Hlth Sci, Dept Clin & Expt Med, Linkoping, Sweden.
    Sveen, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Ekselius: Psykiatri.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Gerdin, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Sjoberg, Folke
    Reg Ostergotland, Dept Anesthesia & Intens Care, Linkoping, Sweden;Linkoping Univ, Fac Med & Hlth Sci, Dept Clin & Expt Med, Linkoping, Sweden;Burn Ctr Linkoping, Dept Hand, Linkoping, Sweden;Burn Ctr Linkoping, Dept Plast Surg, Linkoping, Sweden.
    Anxiety and depression after burn, not as bad as we think-A nationwide study2019Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, nr 6, s. 1367-1374Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: A history of psychiatric disorders is more common among patients who have had burns than in the general population. To try and find out the scale of the problem we have assessed self-reported symptoms of anxiety and depression after a burn. Methods: Consecutive patients with burns measuring more than 10% total body surface area or duration of stay in hospital of seven days or more were included. Personal and clinical details about the patients were extracted from the database at each center. Data were collected from the Hospital Anxiety and Depression Scale, as well as Health-Related Quality of Life (HRQoL; Short Form-36, SF-36) and questionnaires about socioeconomic factors. All results were obtained 12 and 24 months after the burn, and compared with those from a reference group. Results: A total of 156 patients responded to the questionnaires. Mean (SD) age and TBSA (%) were 46 (16.4) years and 23.6 (19.2) %, respectively. There were no differences in incidence between the burn and reference groups in anxiety or depression either 12 or 24 months after the burn. Those who reported higher anxiety and depression scores also had consistently poorer HRQoL as assessed by the SF-36. Conclusion: Seen as a group, people who have had burns report anxiety and depression the same range as a reference group. Some patients, however, express more anxiety and depression, and concomitantly poorer HRQoL. These patients should be identified, and offered additional support. (C) 2019 Elsevier Ltd and ISBI. All rights reserved.

  • 19. Nilsson, Heléne
    et al.
    Jonson, Carl-Oscar
    Vikström, Tore
    Bengtsson, Eva
    Thorfinn, Johan
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Sjöberg, Folke
    Simulation-assisted burn disaster planning2013Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 39, nr 6, s. 1122-1130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to evaluate the Swedish medical systems response to a mass casualty burn incident in a rural area with a focus on national coordination of burn care. Data were collected from two simulations of a mass casualty incident with burns in a rural area in the mid portion of Sweden close to the Norwegian border, based on a large inventory of emergency resources available in this area as well as regional hospitals, university hospitals and burn centres in Sweden and abroad. The simulation system Emergo Train System® (ETS) was used and risk for preventable death and complications were used as outcome measures: simulation I, 18.5% (n = 13) preventable deaths and 15.5% (n = 11) preventable complications; simulation II, 11.4% (n = 8) preventable deaths and 11.4% (n = 8) preventable complications. The last T1 patient was evacuated after 7 h in simulation I, compared with 5 h in simulation II. Better national coordination of burn care and more timely distribution based on the experience from the first simulation, and possibly a learning effect, led to a better patient outcome in simulation II. The experience using a system that combines both process and outcome indicators can create important results that may support disaster planning.

  • 20. Orwelius, L.
    et al.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Gerdin, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Fredrikson, M.
    Sjoberg, F.
    Long term health-related quality of life after burns is strongly dependent on pre-existing disease and psychosocial issues and less due to the burn itself2013Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 39, nr 2, s. 229-235Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Health-related quality of life (HRQoL) is reduced after a burn, and is affected by coexisting conditions. The aims of the investigation were to examine and describe effects of coexisting disease on HRQoL, and to quantify the proportion of burned people whose HRQoL was below that of a reference group matched for age, gender, and coexisting conditions. Method: A nationwide study covering 9 years and examined HRQoL 12 and 24 months after the burn with the SF-36 questionnaire. The reference group was from the referral area of one of the hospitals. Results: The HRQoL of the burned patients was below that of the reference group mainly in the. mental dimensions, and only single patients were affected in the physical dimensions. The factor that significantly affected most HRQoL dimensions (n = 6) after the burn was unemployment, whereas only smaller effects could be attributed directly to the burn. Conclusion: Poor HRQoL was recorded for only a small number of patients, and the decline were mostly in the mental dimensions when compared with a group adjusted for age, gender, and coexisting conditions. Factors other than the burn itself, such as mainly unemployment and pre-existing disease, were most important for the long term HRQoL experience in these patients.

  • 21. Smolle, Christian
    et al.
    Cambiaso-Daniel, Janos
    Forbes, Abigail A
    Wurzer, Paul
    Hundeshagen, Gabriel
    Branski, Ludwik K
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Kamolz, Lars-Peter
    Recent trends in burn epidemiology worldwide: A systematic review2017Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 43, nr 2, s. 249-257Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Burns have been more prevalent among low socioeconomic populations and in less developed regions. Incredible advances in burn care and social development over the recent decades, however, should have placed the incidence and severity of burns in a downwards trend. The aim of this review was to give an overview on current trends in burn epidemiology across the world. Also the socioeconomic development in countries that have published epidemiological data used in this study has been taken into account when comparing the results. There was a worldwide downwards trend of burn incidence, burn severity, length of hospital stay, and mortality rate. These findings were particularly pronounced in very highly developed countries. Data from highly and medium developed countries were more heterogeneous. No studies could be obtained from low and middle income countries. Comparisons between the different studies were compromised by the fact that studies emerged from specialized facilities on one hand and general hospitals on the other. Analyzed studies were also frequently focusing on limited patient populations such as "children" or "elderly". Our findings indicate the need for an international burn database with a minimal data-set in order to obtain objective and comparable results in respect of burn epidemiology.

  • 22.
    Sveen, Josefin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Andersson, Gerhard
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Buhrman, Bo
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden..
    Sjöberg, Folke
    Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden..
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Internet-based information and support program for parents of children with burns: A randomized controlled trial2017Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 43, nr 3, s. 583-591Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim of the study was to evaluate the feasibility and effects of an intemet-based information and self-help program with therapist contact for parents of children and adolescents with burns. The program aimed to reduce parents' symptoms of general and posttraumatic stress.

    Methods: Participants were parents of children treated for burns between 2009-2013 at either of the two specialized Swedish Burn centers. Sixty-two parents were included in a two-armed, randomized controlled trial with a six-week intervention group and a wait list control group, including a pre and post-assessment, as well as a 3 and 12-month follow-up. The intervention contained psychoeducation, exercises and homework assignments, and the intervention group received weekly written feedback from a therapist. The main outcome was stress (post-traumatic stress, general stress and parental stress).

    Results: The program had a beneficial effect on posttraumatic stress in the short term, but did not affect general stress or parental stress. The parents rated the program as being informative and meaningful, but some of them thought it was time-consuming.

    Conclusion: The program has the potential to support parents of children with burns. The intervention is easily accessible, cost-effective and could be implemented in bum care rehabilitation.

  • 23.
    Sveen, Josefin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sjöberg, F
    Öster, Caisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Health-related quality of life in Swedish pediatric burn patients and associations with burn and family characteristics2014Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 40, nr 5, s. 987-994Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Although many children with burns recover well and have a satisfying quality of life after the burn, some children do not adjust as well. Health-related quality of life (HRQoL) focuses on the impact health status has on quality of life. The aim of this study was to assess HRQoL with the American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire (BOQ) in a nationwide Swedish sample of children with burns 0.3-9.0 years after injury. Participants were parents (n=109) of children aged up to 18 years at the time of investigation who were treated at the Linköping or Uppsala Burn Center between 2000 and 2008. The majority of children did not have limitations in physical function and they did not seem to experience much pain. However, there were indications of psychosocial problems. Parents of preschool children reported most problems with the children's behavior and family disruption, whereas parents of children aged 5-18 years reported most problems with appearance and emotional health. There were mainly burn-related variables associated with suboptimal HRQoL in children aged 5-18 years, while family-related variables did not contribute as much.

  • 24.
    Sveen, Josefin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sjöberg, F
    Öster, Caisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Response to Letter to the Editor: 'Sleep quality implicates in life quality: an analysis about children who suffered burns'2014Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 40, nr 4, s. 775-776Artikel i tidskrift (Övrigt vetenskapligt)
  • 25.
    Sveen, Josefin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Feelings of guilt and embitterment in parents of children with burns and its associations with depression2018Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 44, nr 5, s. 1135-1140Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The aim was to examine guilt and embitterment in mothers and fathers of children with burns and its associations with depression and burn severity. Methods: Parents (N=61, mothers n=41, fathers n=20) completed self-report questionnaires on guilt and embitterment, 0.8-5.6 years after their child's burn. Burn severity and sociodemographic variables were obtained from medical records and symptoms of depression were assessed with the Montgomery-Asberg Depression Rating Scale (MADRS). Results: The parents reported low levels of guilt, embitterment and depression. Burn-specific and general guilt were higher in mothers than fathers, but there were no differences in embitterment or symptoms of depression. General guilt was associated with depression, whereas burn-specific guilt and embitterment were not. Conclusions: Parents with general guilt may suffer from symptoms of depression. An implication is that clinicians should address guilt feelings among parents in order to alleviate distress and to identify any need for further counseling.

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  • 26.
    Wikehult, Björn
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Gerdin, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Prediction of patient satisfaction with care one year after burn2009Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 35, nr 2, s. 194-200Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this prospective study was to find predictors of patient satisfaction with burn care. Sixty-nine consecutive adult patients undergoing acute treatment in a Burn Unit completed the following questionnaires: the Swedish universities Scales of Personality, the Impact of Event Scale-Revised, and the Hospital Anxiety and Depression Scale. Socio-demographic data and burn severity were registered. One year later they completed the Patient Satisfaction-Results and Quality (PS-RESKVA) questionnaire containing four subscales: quality of contact with nursing staff (QCN), quality of contact with medical staff (QCM), adequate treatment information (INF), and global satisfaction with treatment (GS). Each subscale was treated as a dependent variable in separate multiple regression models. Overall, the explained variance was low to moderate (range adjusted R2 = 0.06-0.19). Variables remaining in the models were: intrusive symptoms, and the personality trait stress susceptibility for QCN; age, education, and symptoms of hyperarousal for QCM; trait irritability for INF; and age and the personality traits detachment and social desirability for GS. In conclusion, psychological and socio-demographic variables predicted satisfaction to some degree, whereas injury severity did not. The low amount of explained variance suggests that other factors, hypothetically related to care itself, determine patient satisfaction as assessed by the PS-RESKVA.

  • 27.
    Wikehult, Björn
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Patient satisfaction with burn care 1-6 years after injury2008Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 34, nr 6, s. 783-790Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Patient satisfaction is an important outcome in health care but has not been studied in relation to burn care. The aim was to explore factors related to satisfaction with care 1-6 years after a burn. Participants were 86 adult burn patients, injured on average 3.6 years previously. The Patient Satisfaction-Results and Quality (PS-RESKVA) was used to assess satisfaction. It has four subscales: Quality of contact with the nursing staff (QCN), Quality of contact with the medical staff (QCM), Adequate treatment information (INF) and Global satisfaction with treatment (GS). Further, data were gathered regarding personality traits and health. Average scores for QCN were significantly higher than scores for the other subscales, and INF received the lowest mean score. In multiple regressions, the PS-RESKVA subscales were associated with better interpersonal relationships (all PS-RESKVA subscales), more sensation seeking (QCM, INF, and GS) and less aggressiveness (QCM and GS). Other variables contributed to a lesser degree. Total amount of explained variance ranged between 18% and 25% for the PS-RESKVA subscales. In summary, satisfaction with burn care was only moderately explained by health and personality characteristics. Further, former patients rated satisfaction with nursing staff higher than other aspects of care, especially information routines.

  • 28.
    Willebrand, Mimmie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Norlund, Fredrika
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Gerdin, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Andersson, Gerhard
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Cognitive distortions in recovered burn patients: the emotional Stroop task and autobiographical memory test2002Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 28, nr 5, s. 465-471Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to explore cognitive distortions in recovered burn patients. Previous studies in trauma patients have shown trauma-specific attentional bias, long response latencies, and deficits in memory specificity. Eighteen former patients, burn injured 5-19 years ago and 18 matched controls performed the emotional Stroop task, including burn and general trauma-related words, and the autobiographical memory test (AMT). In addition, verbal fluency, life events, and current mood were assessed. Regarding the Stroop task, the recovered patients had longer response latencies to burn words than to neutral and trauma words, a difference not seen in the control subjects. Regarding the AMT, the memory specificity did not differ between the groups. Overall, the former patients had longer latencies than the controls and poorer verbal fluency. The present study showed that recovered burn patients display a moderate Stroop effect, i.e. an attentional bias, in spite of the fact that the injury occurred several years before the testing. This may imply that the recovered burn patients consider the burn an important issue in life. The post-burn patients also presented signs of a slight cognitive slowness as compared to the controls. This finding deserves further attention in the rehabilitation of burn patients.

  • 29.
    Willebrand, Mimmie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sveen, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Injury-related fear-avoidance and symptoms of posttraumatic stress in parents of children with burns2016Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, nr 2, s. 414-420Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Parents of children with burns experience a range of psychological reactions and symptoms, and parents’ health is known to impact children's health. So far, there is little research into potential mechanisms that maintain parents’ symptoms. The aim was to investigate parental injury-related fear-avoidance, and its associations with injury severity and health measures. Parents (n = 107) of children aged 0.4–18 years that sustained burns 0.1–9.0 years previously completed questionnaires on fear-avoidance, posttraumatic stress, and health of the child. Analyses showed that the average level of fear-avoidance was low and positively associated with measures of injury severity and parents’ symptoms of posttraumatic stress, and negatively associated with parents’ ratings of their child's health. In two separate multiple regressions with parents’ symptoms of PTSD and the child's health as dependent variables, fear-avoidance made the largest contribution in both models while injury severity was non-significant. Results were not related to comorbid conditions of the child, scarring, or parent-related socio-demographic variables. In summary, injury-related fear-avoidance is more likely among parents whose children sustain more severe burns. In turn, fear-avoidance contributes significantly to parents’ symptoms of PTSD and to poorer health ratings regarding the child, irrespective of injury severity or child comorbidity.

  • 30.
    Willebrand, Mimmie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sveen, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ramklint, Mia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Bergquist, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Sjöberg, Folke
    Psychological problems in children with burns: Parents' reports on the Strengths and Difficulties Questionnaire2011Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 37, nr 8, s. 1309-1316Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Burns may have a devastating effect on psychological health among children, although previous studies report difficulties as well as positive findings. The aims were to describe the rate of psychological problems in children with burns using a standardised instrument and to explore statistical predictors of these problems. Parents (n = 94) of children aged 3-18 years who sustained burns 0.3-9.0 years previously answered the Strengths and Difficulties Questionnaire (SDQ) covering Emotional symptoms, Conduct problems, Hyperactivity/Inattention, Peer relationship problems, Prosocial behaviour, and a Total difficulties score. Questions regarding parental psychological health and family situation were also included. The results for three of the SDQ subscales were close to the norm (10%) regarding the rate of cases where clinical problems were indicated, while the rate of cases indicated for Conduct, Peer problems and Total difficulties was 18-20%. Statistical predictors of the SDQ subscales were mainly parents' psychological symptoms, father's education, and changes in living arrangements. Visible scars were relevant for the Total difficulties score and Hyperactivity/Inattention. In summary, a slightly larger proportion of children with burns had psychological problems than is the case among children in general, and family variables exerted the most influence on parental reports of children's psychological problems.

  • 31.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Return to work after burn: a prospective study2011Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 37, nr 7, s. 1117-1124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Return to work (RTW) is one of the most important objectives to strive for in burn rehabilitation. Most individuals do return to work after burn but there is a subgroup that does not. Prospective long-time follow-up studies focusing on RTW after burn are scarce. Consecutive adult burn patients employed before injury (n = 58) were included in the present study during hospitalization and subsequently followed up for 12 months. In addition, a structured interview was performed at 2-7 years after burn. At that time; mean 4.5 years (SD 2.0) after burn; 67% of the participants had returned to their work. Predictive variables for time to RTW were length of stay (LOS) at the burn center and fulfilling criteria for Any personality disorder. No RTW was predicted by LOS and having Any anxiety disorder or Any substance use disorder prior to the burn. The non-working group reported lower generic (EQ-5D) and burn-specific (BSHS-B) HRQoL than the working group at every time point. Identification of risk factors associated with difficulties in RTW is required in order to execute individualized vocational rehabilitation.

  • 32.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Dyster-Aas, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Validation of the EQ-5D questionnaire in burn injured adults2009Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 35, nr 5, s. 723-732Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Health-related quality of life (HRQoL) is an important aspect of adaptation after burn. The EQ-5D is a standardized generic instrument for assessing HRQoL. Its psychometric properties in a group of burn injured individuals are, however, not known.

    METHODS: Seventy-eight consecutive patients admitted to a burn unit were included in a prospective longitudinal study. The participants completed the EQ-5D during acute care, and at 3, 6, and 12 months after the burn. At 6 and 12 months after the burn they also completed the Short-Form 36 Health Survey (SF-36) and the Burn Specific Health Scale-Brief (BSHS-B).

    RESULTS: High feasibility of the EQ-5D was demonstrated through a high response rate and a low proportion of missing or invalid answers. The floor and ceiling effects were small. Construct validity was demonstrated through good differentiation between health states and good discrimination of health states over time. The EQ-5D was associated with burn severity and discriminated between clinical subgroups in an expected manner. Criterion validity was demonstrated through significant correlations between the EQ-5D and subscales of the SF-36 and the BSHS-B.

    CONCLUSIONS: The EQ-5D has good psychometric properties, it is short and easy to administer and thus useful in assessment of HRQoL after burn.

  • 33.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sveen, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Is sexuality a problem?: A follow-up of patients with severe burns 6 months to 7 years after injury2015Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 41, nr 7, s. 1572-1578Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE AND AIMS:

    This is the first study investigating sexuality from 6 months up to 7 years after burn. The aim was to examine sexuality in females and males by using the BSHS-B sexuality subscale and to examine possible contributing factors with regard to sociodemographics, burn characteristics, personality traits, and previous psychiatric disorders.

    METHODS:

    A cohort of 107 patients consecutively admitted to a Swedish national burn center was followed up at 6, 12, and 24 months after burn, and 67 individuals were followed up at 2-7 years after burn. The present study utilized the BSHS-B sexuality subscale, and multiple regression analyses were used to examine possible contributing factors.

    RESULTS:

    Women were less satisfied than men, and sexuality mean scores improved over time, even up to 7 years after-burn, in both men and women. The strongest contributing factors for worse outcome regarding sexuality were a history of psychiatric morbidity, neuroticism and burn severity.

    CONCLUSIONS:

    As some patients experience sexual problems after burns, even many years later, it is important to identify these individuals. The BSHS-B sexuality subscale may be used as a screening tool, but more in-depth assessment might be needed to address all aspects of sexuality.

  • 34.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Dyster-Aas, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Health-related quality of life after a severe burn: a prospective study2009Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 35, nr Suppl 1, s. S27-S27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale:

    Health related quality of life (HRQoL) is defined as the impact an injury or illness has on quality of life, including the individual's perception of his or her injury or illness. The aim of this study was to investigate changes over time in HRQoL in burn-injured adults using the EQ-5D instrument.

    Methods:

    Participants were 88 consecutively included burn patients treated at the Uppsala University Hospital Burn Center. Their mean age was 43.3 (SD 15.5), total body surface area burned 24.4 (SD 19.8) and full-thickness burn 10.7 (SD 14.5). The participants completed the EQ-5D during hospitalisation, and at 3, 6, 12 and 24 months after injury. The EQ-5D includes five dimensions: Mobility, Self-care, Usual activities, Pain/Discomfort and Anxiety/Depression. Within each dimension there are three severity levels: no problems, moderate problems or severe problems. In addition the participants rate their health state on a VAS scale from 0 to 100. In a follow-up study the participants completed the EQ-5D in average 4.5 years after burn, with a range of 2–7 years. Pre- and post-burn psychiatric morbidity were assessed as well as burn characteristics.

    Results:

    The mean EQ utility index score improved on a group level from 0.15 at baseline to 0.72 at 24 months after the burn. In average 4.5 years after the burn the index score was 0.79. All scores were below the population norm. The VAS score improved from 48.3 at baseline to 72.5 at 24 months after burn. In spite of the fact that utility scores and VAS scores have improved more than half of the participants reported problems in the dimension Pain/Discomfort and one fifth reported problems in Usual Activities, in average 4.5 years after burn. Psychiatric morbidity pre- and post-burn as well as burn characteristics will be discussed.

    Conclusion:

    Burn injured adults have evident impairments in HRQoL even many years after burn. Most pronounced are problems in Pain/Discomfort and Usual Activities.

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