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  • 1.
    Arvidson, Johan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Linde, Torbjörn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Gedeborg, Rolf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Toxic epidermal necrolysis and hemolytic uremic syndrome after allogeneic stem-cell transplantation2007Ingår i: Pediatric Transplantation, ISSN 1397-3142, E-ISSN 1399-3046, Vol. 11, nr 6, s. 689-693Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    TEN and HUS are challenging complications with excessive mortality after HSCT. We report the development of these two conditions in combination in a nine-yr-old boy after HSCT from an unrelated donor. TEN with skin detachment of more than 90% of body surface area developed after initial treatment for GvHD. Within a few days of admission to the burns unit, the patient developed severe hemolysis, hypertension, thrombocytopenia, and acute renal failure consistent with HUS, apparently caused by CSA. The management included intensive care in a burns unit, accelerated drug removal using plasmapheresis, and a dedicated multi-disciplinary team approach to balance immunosuppression and infections management in a situation with extensive skin detachment. The patient survived and recovered renal function but requires continued treatment for severe GvHD. Suspecting and identifying causative drugs together with meticulous supportive care in the burns unit is essential in the management of these patients and long-term survival is possible.

  • 2. Audolfsson, Thorir
    et al.
    Rodríguez-Lorenzo, Andrés
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Wong, Corrine
    Cheng, Angela
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Nowinski, Daniel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Rozen, Shai
    Nerve Transfers for Facial Transplantation: a cadaveric study for motor and sensory restoration2013Ingår i: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 131, nr 6, s. 1231-1240Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND

    Restoration of facial animation and sensation are highly important for the outcome after facial allotransplantation. The identification of healthy nerves for neurotization, through recipient to donor nerve coaptation, is of particular importance for successful nerve regeneration within the allograft. However, due to the severity of the initial injury and resultant scar formation, a lack of healthy nerve stumps in the recipient is a commonly encountered problem. In this study, we evaluate the technical feasibility of performing nerve transfers in facial transplantation for both sensory and motor neurotization.

    METHODS

    Fifteen fresh cadaver heads were used in this study. The study was divided in two parts. First, the technical feasibility of nerve transfer from the cervical plexus (CP) to the mental nerve (MN) and the masseter nerve (MaN) to the buccal branches of the facial nerve (BBFN) was assessed. Next, we performed nerve transfers in simulated face transplants to describe the surgical technique focusing on sensory restoration of the midface and upper lip by neurotization of the infraorbital nerve (ION), sensory restoration of the lower lip by neurotization of the MN, and smile reanimation by neurotization of the BBFN.

    RESULTS

    In all specimens coaptation of at least one of branches of the CP to the mental nerve was possible as well as between the masseter nerve to the buccal branch of the facial nerve. In simulated face transplant procedures nerve transfers of the supraorbital nerve (SON) to the infraorbital nerve (ION), cervical plexus branches to the mental nerve, and masseter nerve to facial nerve are all technically possible.

    CONCLUSION

    Nerve transfers are a technically feasible option that could theoretically be used in face transplantation either as a primary nerve reconstruction when there are no available healthy nerves, or as a secondary procedure for enhancement of functional outcomes. The supraorbital nerve, branches of the cervical plexus and the masseter nerve are nerves usually located out of the zone of injury and can be selected as neurotizers for the infraorbital nerve, mental nerve and buccal branch of the facial nerve respectively.

  • 3.
    Blomstrand, Lena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Käkkirurgi.
    Sand, Lars P
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Käkkirurgi.
    Gullbrandsson, Lotta
    Eklund, Benny
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Hirsch, Jan-Michael
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Käkkirurgi.
    Telemedicine: a complement to traditional referrals in oral medicine2012Ingår i: Telemedicine journal and e-health, ISSN 1530-5627, E-ISSN 1556-3669, Vol. 18, nr 7, s. 549-553Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction:

    Introducing telemedicine into clinical practice has not been without difficulties. Within the framework of the European Union project "Health Optimum," telemedicine consultations with specialists at the Department of Oral & Maxillofacial Surgery at Uppsala University Hospital (Uppsala, Sweden) have been offered to dentists in the public dental health service. The aim is to streamline the consultation process, improve/develop the skills of the participating dentists and dental hygienists, and save time and money for patients, healthcare authorities, and society.

    Subjects and Methods:

    Patient records are collected in a database for demonstration and discussion, and the system is also available for referrals. Both medical and dental photographs and x-rays are digitized in the same system. These can be viewed during telemedicine rounds and by the consultants at the hospital prior to a consultation. Secure, interactive conferencing software is used, which provides a quick, easy, and effective way to share video and data over the Internet. Both parties can demonstrate different parts of an image using a pointer or a drawing system. Conference phones are presently used for verbal communication.

    Results:

    Ten patients were discussed during telemedicine rounds (3 males and 7 females), all of whom would normally have been referred to a specialist. As a result of the telemedicine round, 2 were referred to a specialist, whereas diagnoses were made for the other 8, and treatment was suggested. The dental health clinic could thus provide treatment without the need for referral to a consultant.

    Conclusions:

    The telemedicine system described here allows patient care to be provided rapidly and more economically. Future plans include "live" rounds using a videocamera, providing the possibility to relay real-time information about the intraoral situation. A camera is being developed and should preferably be permanently installed chair side.

  • 4. Chang, Yang-Ming
    et al.
    Tsai, Chi-Ying
    Kildal, Morten
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper. Plastic Surgery.
    Wei, Fu-Chan
    Importance of coronoidotomy and masticatory muscle myotomy in surgical release of trismus caused by submucous fibrosis.2004Ingår i: Plast Reconstr Surg, ISSN 0032-1052, Vol. 113, nr 7, s. 1949-54Artikel i tidskrift (Övrigt vetenskapligt)
  • 5.
    Dyster-Aas, Johan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    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.
    Return to work and health-related quality of life after burn injury2007Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 1, s. 49-55Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Although severe burn injury is associated with long-term rehabilitation and disability, research on returning to work in burn patients is limited. The aims of this study were: (i) to explore injury- and personality-related predictors of returning to work, and (ii) to compare health-related quality of life and health outcome in working versus non-working individuals.Design: Cross-sectional study.Subjects: Forty-eight former patients with pre-burn employment were evaluated on average 3.8 years after the burn.Methods: Data were collected from medical records and by a questionnaire in which the patients were asked about their main activity status described in the terms: work, studies, pension, disability pension, sick leave or unemployment. It also contained the Swedish universities Scales of Personality, SF-36, Burn Specific Health Scale-Brief, items assessing fear-avoidance, Impact of Event Scale-Revised and Hospital Anxiety and Depression Scale.Results: Thirty-one percent had not returned to work. In logistic regression, returning to work was associated with time since injury, the extent of full-thickness injuries, and the personality trait embitterment. Those who did not work had lower health-related quality of life, poorer burn-specific health, more fear-avoidance and more symptoms of post-traumatic stress disorder, but they did not differ from those who were working regarding general mood.Conclusion: Returning to work was explained by both injury severity and personality characteristics. Those who did not work were characterized by low health-related quality of life and poorer trauma-related physical and psychological health.

  • 6.
    Dyster-Aas, Johan
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Kildal, Morten
    Institutionen för kirurgiska vetenskaper. Plastikkirurgi.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Gerdin, Bengt
    Institutionen för kirurgiska vetenskaper. Plastikkirurgi.
    Ekselius, Lisa
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Work status and burn specific health after work-related burn injury.2004Ingår i: Burns, ISSN 0305-4179, Vol. 30, nr 8, s. 839-42Artikel i tidskrift (Refereegranskat)
  • 7.
    Kildal, Morten
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper. Plastic Surgery.
    Andersson, Gerhard
    Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Gerdin, Bengt
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper. Plastic Surgery.
    Health status in Swedish burn patients. Assessment utilising three variants of the Burn Specific Health Scale.2002Ingår i: Burns, ISSN 0305-4179, Vol. 28, nr 7, s. 639-45Artikel i tidskrift (Övrigt vetenskapligt)
  • 8.
    Kildal, Morten
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper. plastikkirurgi.
    Willebrand, Mimmie
    Institutionen för neurovetenskap. psykiatri, UAS.
    Andersson, Gerhard
    Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Gerdin, Bengt
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper. plastikkirurgi.
    Ekselius, Lisa
    Institutionen för neurovetenskap. psykiatri, UAS.
    Coping strategies, injury characteristics and long-term outcome after burn injury.2005Ingår i: Injury, Int. J. Care Injured, Vol. 36, s. 511-518Artikel i tidskrift (Refereegranskat)
  • 9.
    Low, Aili
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Dyster Aas, Johan
    Institutionen för neurovetenskap.
    Willebrand, Mimmie
    Institutionen för neurovetenskap.
    Kildal, Morten
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper. plastikkirurgi.
    Gerdin, Bengt
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper. plastikkirurgi.
    Ekselius, Lisa
    Institutionen för neurovetenskap.
    Chronic nightmares after severe burns; risk factors and implications for treatment.2003Ingår i: J Burn Care Rehabil, Vol. 24, s. 260-Artikel i tidskrift (Refereegranskat)
  • 10.
    Low, Aili Janina
    et al.
    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.
    Kildal, Morten
    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.
    The presence of nightmares as a screening tool for symptoms of posttraumatic stress disorder in burn survivors2006Ingår i: Journal of Burn Care and Research, ISSN 1559-047X, Vol. 27, nr 5, s. 727-733Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Recurrent nightmares can be a symptom of posttraumatic stress disorder (PTSD). This study evaluated the method of asking burn survivors about nightmares as a screening tool for the presence of PTSD symptomatology. The presence of nightmares in 85 individuals treated at the Burn Center in Uppsala, Sweden, between 1996 and 2000 (23 women, 62 men, average age 47 years, average burn size 17% TBSA, average time after burn 3.6 years) was evaluated by one question from the Burn Specific Health Scale (BSHS) and by using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for nightmares. PTSD symptomatology was assessed with the Impact of Event Scale-Revised. Sensitivity, Specificity, Discriminant Ability, and Likelihood Ratios for a positive and a negative result were calculated to evaluate the screening questions. As many as 46% of the burn survivors reported nightmares of some frequency in the BSHS and as many as 28% when using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. Both approaches were useful tools for detecting or ruling out PTSD symptoms. The best Discriminant Ability was achieved with a screening test using the BSHS item "I have nightmares." Screening questions for presence of nightmares after burns can be useful in detecting PTSD symptomatology.

  • 11. 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.

  • 12.
    Rodriguez Lorenzo, Andres
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Audolfsson, Thorir
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Rozen, Shai Michael
    University of Texas Southwestern Medical Center, US.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Nowinski, Daniel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Supraorbitary to infraorbitary nerve transfer for restoration of midface sensation in face transplantation: cadaver feasibility study2012Ingår i: Microsurgery, ISSN 0738-1085, E-ISSN 1098-2752, Vol. 32, nr 4, s. 309-313Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    The collected experience from facial allotransplantations has shown that the recovery of sensory function of the face graft is unpredictable. Unavailability of healthy donor nerves, especially in central face defects may contribute to this fact. Herein, the technical feasibility of transferring the supraorbitary nerve (SO) to the infraorbitary nerve (IO) in a model of central facial transplantation was investigated.

    Methods:

    Five heads from fresh cadavers were dissected with the aid of 3× loupe magnification. Measurements of the maximum length of dissection of the SO nerve through a supraciliary incision and the IO nerve from the skin of the facial flap to the infraorbital foramen were performed. The distance between supraorbital and infraorbital foramens and the calibers of both nerves were also measured. In all dissections, we simulated a central allotransplantation procedure and assessed the feasibility of directly transferring the SO to the IO nerve.

    Results:

    The average maximum length of dissection for the IO and SO nerve was 1.4 ± 0.3 cm and 4.5 ± 1.0 cm, respectively. The average distance between the infraorbital and supraorbital foramina was 4.6 ± 0.3 cm. The average calibers of the nerves were of 1.1 ± 0.2 mm for the SO nerve and 2.9 ± 0.4 mm for the IO nerve. We were able to perform tension-free SO to IO nerve coaptations in all specimens.

    Conclusion:

    SO to IO nerve transfer is an anatomically feasible procedure in central facial allotransplantation. This technique could be used to improve the restoration of midfacial sensation by the use of a healthy recipient nerve in case of the recipient IO nerves are not available secondary to high-energy trauma.

  • 13.
    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.

  • 14.
    Wikehult, Björn
    et al.
    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 psykiatri, Akademiska sjukhuset.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Lannerstam, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Fugl-Meyer, Axel R
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för psykiatri, Akademiska sjukhuset.
    Gerdin, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Use of healthcare a long time after severe burn injury: relation to perceived health and personality characteristics2005Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Disability and Rehabilitation, ISSN 0963-8288, Vol. 27, nr 15, s. 863-870Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose. The aim of the study was to evaluate which factors are associated with the use of healthcare a long time after severe burn injury.

    Method. After a review process based on clinical reasoning, 69 former burn patients out of a consecutive group treated at the Uppsala Burn Unit from 1980 – 1995 were visited in their homes and their use of care and support was assessed in a semi-structured interview. Post-burn health was assessed with the Burn-Specific Health Scale-Brief (BSHS-B) and personality was assessed with the Swedish universities Scales of Personality (SSP).

    Results.  The participants were injured on average eight years previously. Thirty-four had current contact with healthcare due to their burn injury and had significantly lower scores on three BSHS-B-domains: Simple Abilities, Work and Hand function, and significantly higher scores for the SSP-domain Neuroticism and the SSP-scales Stress Susceptibility, Lack of Assertiveness, and lower scores for Social Desirability. There was no relation to age, gender, time since injury, length of stay, or to the surface area burned.

    Conclusions. A routine screening of personality traits as a supplement to long-term follow-ups may help in identifying the patient's need for care.

  • 15.
    Willebrand, M
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap. psykiatri UAS.
    Andersson, G
    Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Kildal, M
    Institutionen för kirurgiska vetenskaper. plastic surgery.
    Ekselius, L
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap. psykiatri UAS.
    Exploration of coping patterns in burned adults: cluster analysis of the coping with burns questionnaire (CBQ).2002Ingår i: Burns, ISSN 0305-4179, Vol. 28, nr 6, s. 549-54Artikel i tidskrift (Övrigt vetenskapligt)
  • 16.
    Willebrand, M
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Andersson, G
    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, L
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap. psykiatri UAS.
    Injury-related fear-avoidance, neuroticism and burn-specific health.2006Ingår i: Burns, ISSN 0305-4179, Vol. 32, nr 4, s. 408-15Artikel i tidskrift (Refereegranskat)
  • 17.
    Willebrand, Mimmie
    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, Plastikkirurgi.
    A simplified domain structure of the Burn-Specific Health Scale-Brief (BSHS-B): A tool to improve its value in routine clinical work2008Ingår i: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 64, nr 6, s. 1581-1586Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Injury-specific instruments with good psychometric properties are valuable in the assessment of health status after trauma. Previous studies of burn-specific health have attempted to create broad domains such as physical and psychological health, but these domains have not been validated. In this study, burn-specific health domains were explored and validated by a factor analytic approach.

    Methods:

    Participants were 334 former burn patients injured between 1980 and 2000. Data were collected from medical charts and by a postal questionnaire, the Burn Specific Health Scale-Brief (BSHS-B). The nine subscales of the BSHS-B were subjected to second-order factor analysis. The sample was split into two subsamples that were equal with respect to burn severity.

    Results:

    The factor structure was well replicated in each of the subsamples and in the total sample. Three internally consistent and well separated domains were derived: affect and relations (BSHS-B subscales interpersonal relationships, affect, sexuality), function (simple abilities, hand function), and skin involvement (heat sensitivity, treatment regimens, body image). The work subscale of the BSHS-B was excluded from the analysis because of consistent double loadings. The three domains had intelligible associations with injury-specific and sociodemographic variables.

    Conclusion:

    The underlying structure of the BSHS-B comprises three clinically meaningful health domains. The work subscale is not part of these domains and can be considered a separate outcome domain. The domain scores increase the understanding of outcome after burn injury and could prove useful in clinical use of the BSHS-B.

  • 18.
    Willebrand, Mimmie
    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, Plastikkirurgi.
    Burn Specific Health up to 24 Months After the Burn: A Prospective Validation of the Simplified Model of the Burn Specific Health Scale-Brief2011Ingår i: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 71, nr 1, s. 78-84Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Outcome after burn injury is a multidimensional concept, but few multidimensional, injury-specific outcome measures have been psychometrically evaluated. A recent cross-sectional study using the Burn Specific Health Scale-Brief (BSHS-B) found three psychometrically sound health domains: function, skin involvement, and affect and relations. The aim of this study was to reexamine the psychometric properties of the BSHS-B using a prospective study design. Methods: Ninety-four consecutive adult patients with burns were included and asked to fill in questionnaires, the BSHS-B, the Hospital Anxiety and Depression Scale, and the short-form 36 (SF-36), at 6 months, 12 months, and 24 months postburn. Results: The factor structure was replicated and the three domains, function, skin involvement, and affect and relations, had excellent internal consistency. Over time the scores of function and skin involvement increased, indicating health improvement, whereas the domain affect and relations did not change over time. At 6 months and 12 months postburn, all domains were associated with burn severity. The function domain was highly associated with the SF-36 subscales physical functioning and role-physical, the affect and relations domain was highly associated with the Hospital Anxiety and Depression Scale and the SF-36 subscales denoting psychological health, and the domain skin involvement was highly associated with subscales indicating role-concerns, social functioning, vitality, and mental health. Conclusion: The psychometric properties of the BSHS-B domains were excellent and they had intelligible concurrent associations with other measures. Thus, the simplified model of the BSHS-B is a reliable, valid, and useful tool in describing postburn health over time.

  • 19.
    Willebrand, Mimmie
    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, Plastikkirurgi.
    Andersson, Gerhard
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Long-term assessment of personality after burn trauma in adults2002Ingår i: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 190, nr 1, s. 53-56Artikel i tidskrift (Refereegranskat)
  • 20.
    Willebrand, Mimmie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Low, Aili
    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.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Andersson, Gerhard
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    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.
    Pruritus, personality traits and coping in long-term follow-up of burn-injured patients2004Ingår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 84, nr 5, s. 375-80Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Pruritus is a major problem after burn injury; however, prevalence and predictors of prolonged pruritus are not known. The aims were to assess frequency of pruritus and the role of personality traits and coping in prolonged pruritus. The participants were burn patients injured 1-18 years earlier (n=248). Pruritus was assessed with an item from the Abbreviated Burn Specific Health Scale, personality was assessed with the Swedish universities Scales of Personality, and coping with the Coping with Burns Questionnaire. In all, 60% of the participants had pruritus at follow-up, however as the time after injury increased, the number of patients with persistent itch decreased. In logistic regression, 39% of the likelihood of having persistent pruritus was explained by greater extent of burn, less time after injury, and psychological features (being less assertive, and using more instrumental but less emotional support). In summary, chronic burn-related pruritus is rather common and psychological factors such as anxiety-related traits and coping are significantly associated with its presence.

  • 21.
    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.

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