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  • 1.
    Aineskog, Helena
    et al.
    Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Uppsala, Sweden.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    A case report of a complete degloving injury of the penile skin2016In: International journal of surgery case reports, ISSN 2210-2612, E-ISSN 2210-2612, Vol. 29, p. 1-3Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Male genital degloving injuries are unusual and rarely caused by animal bite. Usually patients attend health care immediately if bitten in the genital area. Prophylactic antibiotics is routinely used (Gomes et al., 2000). A penile degloving usually begins just proximal of the coronal line and progress down to the base of the shaft. Deep erectile tissue and the spermatic cord are seldom damaged and the endogenous skin of glans usually survives (Brown and Fryer, 1957; Morey et al., 2004; Finical and Arnold, 1999).

    PRESENTATION OF CASE: A heavily smoking man with a previous history of bladder cancer presented himself to the emergency department 24h after a dog bite degloved his penis. The avulsed skin was necrotic and subsequently excised. Antibiotic treatment was started. A bacterial swab was found positive for canine oral flora. The skin defect was closed using a 1:1 meshed split thickness skin graft from the inner thigh. Smoking cessation was encouraged. At the three month follow up the patient expressed satisfaction with both cosmetic and functional result and was now non-smoking.

    DISCUSSION: Several approaches to reconstruct penile skin exist. Split thickness skin graft has been lifted as a preferable alternative (Brown and Fryer, 1957; Finical and Arnold, 1999; Paraskevas et al., 2003) [5]. In this case, the avulsed skin was necrotic and could not be used. A 1:1 meshed split-thickness graft was chosen with excellent results.

    CONCLUSION: 1:1mesh of the graft can be recommended for easy attachment with a good functional and esthetical result. The potential risk of losing intimacy appearance or having to go through repeated procedures in the genital area motivated smoking cessation for this patient.

  • 2.
    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 1987-2004.2007In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 33, no 1, p. 31-6Article in journal (Refereed)
    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.

  • 3. Azzena, B
    et al.
    Tocco-Tussardi, I
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Pontini, A
    Presman, B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Late complications of high-voltage electrical injury might involve multiple systems and be related to current path2016In: Annals of Burns and Fire Disasters, ISSN 1121-1539, E-ISSN 1592-9558, Vol. 29, no 3, p. 192-194Article in journal (Refereed)
    Abstract [en]

    SUMMARY

    Delayed complications of electrical burns are mostly unexpected, and the link between the injury and the symptoms oftengoes unrecognized. A possible relation between source-ground sites and late clinical manifestations was recently emphasized. We report aunique case of combined intestinal-spinal delayed complications following a high-voltage electrical injury, a possible explanation being agreater current flow through the right hemisoma. The potential for late complications is an additional feature that physicians must considerin managing electrical injuries. Manifestations are variable and presentation is confounding, but current flow path can constitute a precioussource of information to predict complications in the late phase of management.

  • 4. Bergquist, M
    et al.
    Sveen, Josefin
    Huss, Fredrik
    Sjöberg, Folke
    Willebrand, Mimmie
    Psychological health andappearance after burns in children and adolescents aged 5-182010Conference paper (Refereed)
  • 5. Bergquist, Maria
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Fredén, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Hedenstierna, Göran
    Hästbacka, Johanna
    Rockwood, Alan
    Kushnir, Mark
    Bergquist, Jonas
    Altered adrenal and gonadal steroids biosynthesis in patients with burn injury2015Conference paper (Refereed)
  • 6.
    Bergquist, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Hästbacka, Johanna
    Lindholm, Catharina
    Martijn, Cecile
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC.
    Rylander, Christian
    Hedenstierna, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Fredén, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Glucocorticoid receptor expression and binding capacity in patients with burn injury2016In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 60, no 2, p. 213-221Article in journal (Refereed)
    Abstract [en]

    Background

    Burn injuries are associated with strong inflammation and risk of secondary sepsis which both may affect the function of the glucocorticoid receptor (GR). The aim of this study was to determine GR expression and binding capacity in leucocytes from patients admitted to a tertiary burn center.

    Methods

    Blood was sampled from 13 patients on admission and days 7, 14 and 21, and once from 16 healthy subjects. Patients were grouped according to the extent of burn and to any sepsis on day 7. Expression and binding capacity of GR were determined as arbitrary units using flow cytometry.

    Results

    GR expression and binding capacity were increased compared to healthy subjects in most circulating leucocyte subsets on admission irrespective of burn size. Patients with sepsis on day 7 displayed increased GR expression in T lymphocytes (51.8%, < 0.01) compared to admission. There was a negative correlation between GR binding capacity in neutrophils and burn size after 14 days (< 0.05).

    Conclusions

    GR expression and binding capacity are increased in most types of circulating leucocytes of severely burned patients on their admission to specialized burn care. If sepsis is present after 1 week, it is associated with higher GR expression in T lymphocytes and NK cells.

  • 7. Bodin, Maja
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Svåra skador och dödsfall till följd av brand: En genomgång av brandskadade i Sverige 20102012Other (Other academic)
    Abstract [sv]

    En genomgång av brandskadade i Sverige 2010. Den epidemiologiska kunskapen om, och omfattningen av, personskador orsakade av eld och rök (såväl lindriga som svåra och dödliga) är otillräcklig. Målet med denna studie, som genomförts av Institutionen för Kirurgiska vetenskaper vid Uppsala universitet i samverkan med MSB, har varit att sammanställa tillgänglig data över skador som kan kopplas till en brand under 2010 och lyfta fram särskilt utsatta grupper. Detta för att skapa en epidemiologisk kunskapsbas som kan ligga till grund för preventionsarbete och vidare forskning.

  • 8. Boissin, C
    et al.
    Fransén, J
    Laflamme, L
    Allorto, N
    Wallis, L
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Lundin, J
    Deep learning for image-based diagnostic support: initial development of a system for acute burns: Constance Boissin2017In: Central European Journal of Public Health, ISSN 1210-7778, E-ISSN 1803-1048, Vol. 27, no suppl. 3, p. 436-Article in journal (Other academic)
  • 9. Danielsson, Par A
    et al.
    Fredriksson, Camilla
    Huss, Fredrik
    A Novel Concept for Treating Large Necrotizing Fasciitis Wounds With Bilayer Dermal Matrix, Split-thickness Skin Grafts, and Negative Pressure Wound Therapy.2009In: Wounds (King of Prussia, Pa.), ISSN 1044-7946, E-ISSN 1943-2704, Vol. 21, no 8Article in journal (Refereed)
    Abstract [en]

    Treatment of necrotizing fasciitis (NF) includes radical surgical debridement often resulting in large wounds that need to be closed with methods including split-thickness skin grafts (STSG), local flaps, or guided tissue regeneration procedures. In this case report, a 45 year-old Caucasian male was surgically treated for a benign left groin hernia, developed NF, and was transferred to the authors' burn unit. The wound was treated initially with wide debridement and with a brief delay before finally closing the wound. A collagen matrix such as Integra® Dermal Regeneration Template (Integra LifeSciences, Plainsboro, NJ) in combination with STSG and negative pressure wound treatment, can provide fast recovery resulting in pliable, functional skin..

  • 10.
    Erlandsson, Ulf
    et al.
    Räddningsverket.
    Huss, Fredrik
    Inst för Experimentell och Klinisk medicin, Linköping.
    [Highly important during Christmas holidays. Elderly persons are overrepresented when it comes to candle light fires].2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, no 50, p. 3897-8Article in journal (Refereed)
  • 11.
    Fransén, Jian
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Bastami, Salumeh
    Sjöberg, Folke
    Uppugunduri, Srinivas
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Evaluating topical opioid gel on donor site pain: A small randomised double blind controlled trial2016In: International Journal of Surgery Open, ISSN 2405-8572, Vol. 4, p. 5-9Article in journal (Refereed)
    Abstract [en]

    Background

    Autologous donor skin harvested for transplantation is a common procedure in patients with burns, and patients often feel more pain at the donor site than is justified by the extent of trauma. Topical morphine gels have been thought to have an effect on peripheral opioid receptors by creating antinociceptive and anti-inflammatory effects, which could potentially reduce the systemic use of morphine-like substances and their adverse effects.

    Methods

    We therefore did a paired, randomised, double-blind placebo study to investigate the effect of morphine gel and placebo on dual donor sites that had been harvested in 13 patients. Pain was measured on a visual analogue scale (VAS) 15 times in a total of 5 days.

    Results

    The mean (SD) VAS was 1.6 (2.3) for all sites, 1.5 (2.2) for morphine, and 2.0 (2.5) for placebo. The pain relieving effects of morphine gel were not significantly better than placebo.

    Conclusion

    The assessment of pain at donor sites is subjective, and more systematic and objective studies are needed.

  • 12.
    Fransén, Jian
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Nilsson, L
    Sjöberg, Folke
    Hanberger, Håkan
    Sustained Low Frequency ofAntibiotic-Resistant Pathogens on a Swedish Burn Unit 1994-20122017In: Burns, ISSN 0305-4179, E-ISSN 1879-1409Article in journal (Refereed)
  • 13. Fredriksson, C.
    et al.
    Kratz, G.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Transplantation of cultured human keratinocytes: A comparative in vitro study of different application techniques2007Conference paper (Refereed)
  • 14. Fredriksson, Camilla
    et al.
    Hedhammar, My
    Feinstein, Ricardo
    Nordling, Kerstin
    Kratz, Gunnar
    Johansson, Jan
    Huss, Fredrik
    Rising, Anna
    Tissue Response to Subcutaneously Implanted Recombinant Spider Silk: An in Vivo Study2009In: Materials, ISSN 1996-1944, Vol. 2, no 4, p. 1908-1922Article in journal (Refereed)
    Abstract [en]

    Spider silk is an interesting biomaterial for medical applications. Recently, a method for production of recombinant spider silk protein (4RepCT) that forms macroscopic fibres in physiological solution was developed. Herein, 4RepCT and MersilkTM (control) fibres were implanted subcutaneously in rats for seven days, without any negative systemic or local reactions. The tissue response, characterised by infiltration of macrophages and multinucleated cells, was similar with both fibres, while only the 4RepCT-fibres supported ingrowth of fibroblasts and newly formed capillaries. This in vivo study indicates that 4RepCT-fibres are well tolerated and could be used for medical applications, e.g., tissue engineering.

  • 15. Fredriksson, Camilla
    et al.
    Kratz, Gunnar
    Huss, Fredrik
    Accumulation of Silver and Delayed Re-epithelialization in Normal Human Skin: An ex-vivo Study of Different Silver Dressings.2009In: Wounds (King of Prussia, Pa.), ISSN 1044-7946, E-ISSN 1943-2704, Vol. 21, no 5Article in journal (Refereed)
    Abstract [en]

    Silver is commonly used in wound dressings and topical formulations to assist in the management of wounds that are infected or at risk of becoming infected. They provide potent broad-spectrum antimicrobial activity, but should not cause sustained staining of the skin, dermal or systemic accumulation of silver, or discomfort to the patient. However, clinicians and healthcare personnel have been concerned about topical staining of the skin and complaints of additional pain from patients treated with certain silver dressings. Some delay in re-epithelialization has also been noticed and reported. The reasons for this are not clear, and the authors believed further study regarding the possible effects of silver accumulation and silver dressings' effect on re-epithelialization was required. The authors studied possible silver accumulation and re-epithelialization in normal human dermal skin. The results showed that most of the dressings or treatments discolored the wound surface and that there was a dermal accumulation of what were assumed to be silver particles. Varying grades of accumulation were found in deep dermal tissue, particularly around blood vessels, depending on the dressing used. The results also indicated that all of the tested products delayed re-epithelialization in this model. .

  • 16.
    Garvin, Stina
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Nilsson, Ulrika W
    Inst för Experimentell och Klinisk medicin, Linköping.
    Huss, Fredrik R M
    Inst för Experimentell och Klinisk medicin, Linköping.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Dabrosin, Charlotta
    Inst för Experimentell och Klinisk medicin, Linköping.
    Estradiol increases VEGF in human breast studied by whole-tissue culture.2006In: Cell and Tissue Research, ISSN 0302-766X, E-ISSN 1432-0878, Vol. 325, no 2, p. 245-51Article in journal (Refereed)
    Abstract [en]

    Sex steroid exposure constitutes a risk factor for breast cancer, but little is known about the effects of sex steroids on the normal breast, largely because of the lack of convenient models. We have developed a method of culturing normal breast tissue ex vivo. We have applied this method to investigate the effects of estradiol and progesterone on the key angiogenic mediator, vascular endothelial growth factor (VEGF), in the breast. Whole breast tissue was obtained from routine reduction mammoplasty. Tissue biopsies were cultured in vitro for 1-3 weeks, and the expression of luminal cytokeratin 18 was determined by immunohistochemistry. As an application, tissue biopsies were treated in vitro for 1 week with or without estradiol or estradiol and progesterone. Estrogen receptor, progesterone receptor, and Ki-67 were analyzed, and VEGF levels were examined by quantitative immunoassay and immunohistochemistry. Whole breast tissue was cultured ex vivo for 1 week with preserved morphology. Increased detachment of the luminal epithelium was observed after 2 weeks. Estradiol increased extracellular levels of VEGF in normal breast tissue biopsy medium. The addition of progesterone had neither stimulatory nor inhibitory effects on secreted VEGF. The method of whole breast tissue culturing thus provide a means by which to explore the biology of normal breast tissue. Our results suggest that estradiol exerts pro-angiogenic effects in normal breast by increasing levels of biologically active VEGF.

  • 17.
    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.2007In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 33, no 6, p. 726-35Article in journal (Refereed)
    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.

  • 18. Hastbacka, Johanna
    et al.
    Fredén, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Hult, Maarit
    Bergquist, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Wilkman, Erika
    Vuola, Jyrki
    Sorsa, Timo
    Tervahartiala, Taina
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Matrix Metalloproteinases-8 and-9 and Tissue Inhibitor of Metalloproteinase-1 in Burn Patients. A Prospective Observational Study2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 5, article id e0125918Article in journal (Refereed)
    Abstract [en]

    Introduction Matrix metalloproteinases (MMPs) -8 and -9 are released from neutrophils in acute inflammation and may contribute to permeability changes in burn injury. In retrospective studies on sepsis, levels of MMP-8, MMP-9, and tissue inhibitor of metalloproteinase-1 (TIMP-1) differed from those of healthy controls, and TIMP-1 showed an association with outcome. Our objective was to investigate the relationship between these proteins and disease severity and outcome in burn patients. Methods In this prospective, observational, two-center study, we collected plasma samples from admission to day 21 post-burn, and burn blister fluid samples on admission. We compared MMP-8, -9, and TIMP-1 levels between TBSA<20% (N = 19) and TBSA>20% (N = 30) injured patients and healthy controls, and between 90-day survivors and non-survivors. MMP-8, -9, and TIMP-1 levels at 24-48 hours from injury, their maximal levels, and their time-adjusted means were compared between groups. Correlations with clinical parameters and the extent of burn were analyzed. MMP-8, -9, and TIMP-1 levels in burn blister fluids were also studied. Results Plasma MMP-8 and -9 were higher in patients than in healthy controls (P<0.001 and P = 0.016), but only MMP-8 differed between the TBSA<20% and TBSA>20% groups. MMP-8 and -9 were not associated with clinical severity or outcome measures. TIMP-1 differed significantly between patients and controls (P<0.001) and between TBSA<20% and TBSA>20% groups (P<0.002). TIMP-1 was associated with 90-day mortality and correlated with the extent of injury and clinical measures of disease severity. TIMP-1 may serve as a new biomarker in outcome prognostication of burn patients.

  • 19. Horna Strand, Angelica
    et al.
    Rubertsson, Sten
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Mani, Maria
    EPIDERMAL EXFOLIATION OF OVER 95 % AFTER A BURN IN AN 18-MONTH-OLD BOY - A CASE REPORT AND A LITERATURE REVIEW2015In: Annals of Burns and Fire Disasters - vol. XXVIII – Supplement EBA - September 2015, 2015, Vol. 28Conference paper (Refereed)
  • 20.
    Horna Strand, Angelica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Rubertsson, Sten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Mani, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Epidermal exfoliation of over 95% after a burn in an 18-month-old boy: Case report and review of the literature2016In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 2, p. E18-E23Article, review/survey (Refereed)
    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.

  • 21. Huss, Fredrik
    Brännskadornas incidens och prevalens2002In: Brännskador / [ed] Folke Sjöberg / Leif Östrup, Stokholm: Liber, 2002, 1, p. 17-21Chapter in book (Other academic)
  • 22. Huss, Fredrik
    Challenges following the implementation of European Directive2004/23/EC regarding human tissues and cells in burn treatment2010Conference paper (Refereed)
  • 23. Huss, Fredrik
    In vitro and in vivo studies of tissue engineering in reconstructive plastic surgery2005Doctoral thesis, comprehensive summary (Other academic)
    List of papers
    1. Mammary epithelial cell and adipocyte co-culture in a 3-D matrix: the first step towards tissue-engineered human breast tissue.
    Open this publication in new window or tab >>Mammary epithelial cell and adipocyte co-culture in a 3-D matrix: the first step towards tissue-engineered human breast tissue.
    2001 (English)In: Cells Tissues Organs, ISSN 1422-6405, E-ISSN 1422-6421, Vol. 169, no 4Article in journal (Refereed) Published
    Abstract [en]

    Reconstruction of the female breast after cancer surgery is a demanding task where the methods used today suffer from several disadvantages. In the present study we have investigated the possibility to use tissue engineering methods to regenerate human autologous breast tissue. Human mammary epithelial cells and preadipocytes were derived from breast tissue biopsies from healthy women undergoing reduction mammoplasty, and the two celltypes were co-cultured with conventional cell culture methods as well as in 3-D matrices. The study shows that it is possible to harvest both human mammary epithelial cells and preadipocytes in a single session, propagate several subcultures, and that the cells maintain a normal intercellular distribution and growth-pattern when co-cultured in a 3-D collagen gel. We propose that growth and formation of a tissue closely resembling normal human breast tissue be readily obtained in the described in vitro cell culture set-up using basic tissue engineering principles. This concept may be of great importance in the development of new methods for reconstruction of the human breast.

    National Category
    Surgery
    Research subject
    Plastic Surgery
    Identifiers
    urn:nbn:se:uu:diva-286418 (URN)47903 (DOI)11490115 (PubMedID)
    Available from: 2016-04-20 Created: 2016-04-20 Last updated: 2017-11-30
    2. Adipose tissue processed for lipoinjection shows increased cellular survival in vitro when tissue engineering principles are applied.
    Open this publication in new window or tab >>Adipose tissue processed for lipoinjection shows increased cellular survival in vitro when tissue engineering principles are applied.
    2002 (English)In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 36, no 3, p. 166-71Article in journal (Refereed) Published
    Abstract [en]

    Correcting soft tissue defects by autologous fat grafting is a routine procedure in plastic surgery. Its efficacy and safety has been discussed extensively and several techniques of lipoinjection have been developed. However, one is bound to overcorrect by 30%-70% or need to repeat the procedure because of resorption of the transplant. The reasons are that many of the transplanted cells are already differentiated, and also that there is no nutritional support to the inner cell layers when they are transplanted as fragments. By culturing autologous adipocytes one can ensure that only non-differentiated, but committed, preadipocytes are transplanted and the procedure can be done in a way that ensures optimal nutritional support for the cells. In the present study we have compared our cell culture technique with two common clinical ways of processing liposuction material and found that (pre)adipocytes survive and proliferate significantly better in cell culture.

    National Category
    Surgery Cell and Molecular Biology
    Identifiers
    urn:nbn:se:uu:diva-162784 (URN)12141205 (PubMedID)
    Available from: 2011-12-06 Created: 2011-12-05 Last updated: 2018-01-12
    3. Characterization of a new degradable polymer scaffold for regeneration of the dermis: In vitro and in vivo human studies.
    Open this publication in new window or tab >>Characterization of a new degradable polymer scaffold for regeneration of the dermis: In vitro and in vivo human studies.
    Show others...
    2008 (English)In: Organogenesis, ISSN 1547-6278, Vol. 4, no 3, p. 195-200Article in journal (Refereed) Published
    Abstract [en]

    Full thickness skin wounds in humans heal with scars, but without regeneration of the dermis. A degradable poly(urethane urea) scaffold (PUUR), Artelon(R) is already used to reinforce soft tissues in orthopaedics, and for treatment of osteoarthritis of the hand, wrist and foot. In this paper we have done in vitro experiments followed by in vivo studies to find out whether the PUUR is biocompatible and usable as a template for dermal regeneration. Human dermal fibroblasts were cultured on discs of PUUR, with different macrostructures (fibrous and porous). They adhered to and migrated into the scaffolds, and produced collagen. The porous scaffold was judged more suitable for clinical applications and 4 mm Ø, 2 mm-thick discs of porous scaffold (12% w/w or 9% w/w polymer solution) were inserted intradermally in four healthy human volunteers. The implants were well tolerated and increasing ingrowth of fibroblasts was seen over time in all subjects. The fibroblasts stained immunohistochemically for procollagen and von Willebrand factor, indicating neocollagenesis and angiogenesis within the scaffolds. The PUUR scaffold may be a suitable material to use as a template for dermal regeneration.

    National Category
    Cell and Molecular Biology Surgery
    Identifiers
    urn:nbn:se:uu:diva-162772 (URN)19279733 (PubMedID)
    Available from: 2011-12-06 Created: 2011-12-05 Last updated: 2018-01-12
    4. Macroporous gelatine spheres as culture substrate, transplantation vehicle, and biodegradable scaffold for guided regeneration of soft tissues. In vivo study in nude mice.
    Open this publication in new window or tab >>Macroporous gelatine spheres as culture substrate, transplantation vehicle, and biodegradable scaffold for guided regeneration of soft tissues. In vivo study in nude mice.
    2007 (English)In: Journal of Plastic, Reconstructive & Aesthetic Surgery, ISSN 1748-6815, E-ISSN 1532-1959, Vol. 60, no 5, p. 543-55Article in journal (Refereed) Published
    Abstract [en]

    In the course of development of a new type of filler for the correction of small defects in soft tissues we studied macroporous gelatine spheres as culture substrate, transplantation vehicle, and biodegradable scaffold for guided regeneration of soft tissues in vivo. We injected intradermally in nude mice gelatine spheres that had either been preseeded with human fibroblasts or preadipocytes, or left unseeded. We compared the extent of regenerated tissue with that found after injections of saline or single-cell suspensions of human fibroblasts or preadipocytes. Routine histological examinations and immunohistochemical staining for von Willebrand factor (indicating neoangiogenesis) were made after 7, 21, and 56 days. Injected saline or single-cell suspensions had no effect. However, a quick and thorough tissue regeneration with developing neoangiogenesis was elicited by the gelatine spheres and the effect of spheres preseeded with preadipocytes surpassed the effect of spheres preseeded with fibroblasts, which in turn surpassed the effect of unseeded gelatine spheres. We suggest that minor soft tissue defects such as wrinkles or creases can be corrected by injection of naked macroporous gelatine spheres, whereas larger defects are best corrected by injection of macroporous gelatine spheres preseeded with fibroblasts, or preadipocytes, or both.

    National Category
    Cell and Molecular Biology Surgery
    Identifiers
    urn:nbn:se:uu:diva-162776 (URN)10.1016/j.bjps.2005.10.031 (DOI)17399665 (PubMedID)
    Available from: 2011-12-06 Created: 2011-12-05 Last updated: 2018-01-12
    5. Use of macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration of healthy dermis in humans: an in vivo study.
    Open this publication in new window or tab >>Use of macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration of healthy dermis in humans: an in vivo study.
    2010 (English)In: Journal of plastic, reconstructive & aesthetic surgery : JPRAS, ISSN 1878-0539, Vol. 63, no 5, p. 848-57Article in journal (Refereed) Published
    Abstract [en]

    If a biodegradable scaffold is applied, the dermis can be regenerated by guided tissue regeneration. Scaffolds can stimulate in-growth of cells from the surroundings that migrate into them and start to produce autologous extracellular matrix as the scaffold is degraded. Several materials are available, but most of them are in the form of sheets and need to be laid on an open wound surface. A number of injectable fillers have been developed to correct soft-tissue defects. However, none of these has been used for guided tissue regeneration. We present a new technique that could possibly be used to correct dermal defects by using macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration. In eight healthy volunteers, intradermal injections of macroporous gelatine spheres were compared with injections of saline and hyaluronic acid (Restylane). Full-thickness skin biopsy specimens of the implants and surrounding tissue were removed 2, 8, 12 and 26 weeks after injection, and the (immuno)histological results were analysed. The Restylane merely occupied space. It shattered the dermal tissue and compressed collagen fibres and cells at the interface between the implant and the dermis. No regeneration of tissue was found with this material at any time. The macroporous gelatine spheres were populated with fibroblasts already after 2 weeks. After 8 weeks the spheres were completely populated by fibroblasts producing dermal tissue. After 12 and 26 weeks, the gelatine spheres had been more or less completely resorbed and replaced by vascularised neodermis. There were no signs of capsular formation, rejection or adverse events in any subject. Further in vivo studies in humans are needed to evaluate the effect of the macroporous spheres fully as a matrix for guided tissue regeneration with and without cellular pre-seeding. However, the results of this study indicate the possibility of using macroporous gelatine spheres as an injectable, three-dimensional, degradable matrix for guided tissue regeneration.

    National Category
    Cell and Molecular Biology Surgery
    Identifiers
    urn:nbn:se:uu:diva-162770 (URN)10.1016/j.bjps.2009.01.068 (DOI)19443282 (PubMedID)
    Available from: 2011-12-06 Created: 2011-12-05 Last updated: 2018-01-12
  • 24.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    The result after use of autologous and allogenic skin on patients with massive skin loss2014Conference paper (Other academic)
  • 25.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Where’s the cultured skin?2016In: European Cells and Materials, ISSN 1473-2262, E-ISSN 1473-2262, Vol. 31, no Suppl. 1, p. 254-254Article in journal (Other academic)
  • 26. Huss, Fredrik
    et al.
    Bak, Zoltan
    Nettelblad, Hans
    10% BSA concentrated formic acid burn to 1-year old child2010Conference paper (Refereed)
  • 27.
    Huss, Fredrik
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Erlandsson, Ulf
    Räddningsverket.
    Cooray, Vernon
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Electricity.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Sjöberg, Folke
    Inst för Experimentell och Klinisk medicin, Linköping.
    [Lightning injuries--a mixture of electrical, thermal and multiple trauma].2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, no 28-29, p. 2328-31Article in journal (Refereed)
    Abstract [sv]

    There are several misconceptions even among hospital personnel regarding damages and injuries caused by lightning. Few health care providers have experience from lightning injuries as they are rare and different (DC) from the more common high-voltage (AC) injuries. Furthermore, fatalities are uncommon. Burns do occur but are usually minor. Most lightning injuries occur in the summer season during outdoor leisure activities and in the vicinity of a tree or other large structures. In Sweden, on average, approximately seventeen persons per year are hospitalised and 0.2-0.8 persons per million inhabitants and year die due to lightning injuries. The primary treatment follows the general guidelines for other trauma, electrical, and burn injuries, i.e. as is described in the standardised ATLS, ABLS, or A-HLR programmes. However, there are some minor points that are different and may be stressed for a favourable outcome. In this paper these are addressed together with the epidemiology, effects and treatment of lightning injuries that are specific for Sweden. Unfortunately, little is known, apart from what is described in smaller case series, of the long time sequelae experienced by this patient population and further research is therefore particularly warranted in this respect.

  • 28.
    Huss, Fredrik
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Erlandsson, Ulf
    Räddningsverket.
    Sjöberg, Folke
    Inst för Experimentell och Klinisk medicin, Linköping.
    [Deaths related to fires--protection of risk groups can be improved. Participation of health care personnel in the preventive work is important].2003In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 100, no 13, p. 1137-9Article in journal (Refereed)
  • 29. Huss, Fredrik
    et al.
    G, Kratz
    Surgical treatment of sores with difficult healing2005In: Nordisk Geriatrik, ISSN 1403-2082, Vol. 8, no 1, p. 30-5Article in journal (Refereed)
  • 30. Huss, Fredrik
    et al.
    Kratz, G
    Mammary epithelial cell and adipocyte co-culture in a 3-D matrix: the first step towards tissue-engineered human breast tissue.2001In: Cells Tissues Organs, ISSN 1422-6405, E-ISSN 1422-6421, Vol. 169, no 4Article in journal (Refereed)
    Abstract [en]

    Reconstruction of the female breast after cancer surgery is a demanding task where the methods used today suffer from several disadvantages. In the present study we have investigated the possibility to use tissue engineering methods to regenerate human autologous breast tissue. Human mammary epithelial cells and preadipocytes were derived from breast tissue biopsies from healthy women undergoing reduction mammoplasty, and the two celltypes were co-cultured with conventional cell culture methods as well as in 3-D matrices. The study shows that it is possible to harvest both human mammary epithelial cells and preadipocytes in a single session, propagate several subcultures, and that the cells maintain a normal intercellular distribution and growth-pattern when co-cultured in a 3-D collagen gel. We propose that growth and formation of a tissue closely resembling normal human breast tissue be readily obtained in the described in vitro cell culture set-up using basic tissue engineering principles. This concept may be of great importance in the development of new methods for reconstruction of the human breast.

  • 31.
    Huss, Fredrik R M
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Erlandsson, U
    Räddningsverket.
    Sjöberg, F
    Inst för Experimentell och Klinisk medicin, Linköping.
    Buses as fire hazards: a Swedish problem only? Suggestions for fire-prevention measures.2004In: Journal of Burn Care and Rehabilitation, ISSN 0273-8481, E-ISSN 1534-5939, Vol. 25, no 4, p. 377-80; discussion 372Article in journal (Refereed)
    Abstract [en]

    In Sweden, approximately 6% of all human transportation is made via buses. The Swedish Board of Accident Investigation and the Swedish Rescue Services Agency have pointed out repeatedly that buses are potential fire and burn hazards, not only when involved in collisions but also in other circumstances. The number of fire incidents is increasing, especially in newer buses. In conjunction with the Swedish Rescue Services Agency, we examined some of the recent bus fires in Sweden. We did not find any casualties, but the results of our study suggest that casualties as a result of bus fires are imminent unless preventive measures are taken. We also studied experiences from previous bus fires and suggest preventive measures.

  • 32.
    Huss, Fredrik R M
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Junker, Johan P E
    Inst för Experimentell och Klinisk medicin, Linköping.
    Johnson, Hans
    Inst för Experimentell och Klinisk medicin, Linköping.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Macroporous gelatine spheres as culture substrate, transplantation vehicle, and biodegradable scaffold for guided regeneration of soft tissues. In vivo study in nude mice.2007In: Journal of Plastic, Reconstructive & Aesthetic Surgery, ISSN 1748-6815, E-ISSN 1532-1959, Vol. 60, no 5, p. 543-55Article in journal (Refereed)
    Abstract [en]

    In the course of development of a new type of filler for the correction of small defects in soft tissues we studied macroporous gelatine spheres as culture substrate, transplantation vehicle, and biodegradable scaffold for guided regeneration of soft tissues in vivo. We injected intradermally in nude mice gelatine spheres that had either been preseeded with human fibroblasts or preadipocytes, or left unseeded. We compared the extent of regenerated tissue with that found after injections of saline or single-cell suspensions of human fibroblasts or preadipocytes. Routine histological examinations and immunohistochemical staining for von Willebrand factor (indicating neoangiogenesis) were made after 7, 21, and 56 days. Injected saline or single-cell suspensions had no effect. However, a quick and thorough tissue regeneration with developing neoangiogenesis was elicited by the gelatine spheres and the effect of spheres preseeded with preadipocytes surpassed the effect of spheres preseeded with fibroblasts, which in turn surpassed the effect of unseeded gelatine spheres. We suggest that minor soft tissue defects such as wrinkles or creases can be corrected by injection of naked macroporous gelatine spheres, whereas larger defects are best corrected by injection of macroporous gelatine spheres preseeded with fibroblasts, or preadipocytes, or both.

  • 33.
    Huss, Fredrik R M
    et al.
    Kirurgiska vetenskaper, KI.
    Kratz, Gunnar
    Kirurgiska vetenskaper, KI.
    Adipose tissue processed for lipoinjection shows increased cellular survival in vitro when tissue engineering principles are applied.2002In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 36, no 3, p. 166-71Article in journal (Refereed)
    Abstract [en]

    Correcting soft tissue defects by autologous fat grafting is a routine procedure in plastic surgery. Its efficacy and safety has been discussed extensively and several techniques of lipoinjection have been developed. However, one is bound to overcorrect by 30%-70% or need to repeat the procedure because of resorption of the transplant. The reasons are that many of the transplanted cells are already differentiated, and also that there is no nutritional support to the inner cell layers when they are transplanted as fragments. By culturing autologous adipocytes one can ensure that only non-differentiated, but committed, preadipocytes are transplanted and the procedure can be done in a way that ensures optimal nutritional support for the cells. In the present study we have compared our cell culture technique with two common clinical ways of processing liposuction material and found that (pre)adipocytes survive and proliferate significantly better in cell culture.

  • 34.
    Huss, Fredrik R M
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Nyman, Erika
    Inst för Experimentell och Klinisk medicin, Linköping.
    Bolin, Johanna S C
    Inst för Experimentell och Klinisk medicin, Linköping.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Use of macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration of healthy dermis in humans: an in vivo study.2010In: Journal of plastic, reconstructive & aesthetic surgery : JPRAS, ISSN 1878-0539, Vol. 63, no 5, p. 848-57Article in journal (Refereed)
    Abstract [en]

    If a biodegradable scaffold is applied, the dermis can be regenerated by guided tissue regeneration. Scaffolds can stimulate in-growth of cells from the surroundings that migrate into them and start to produce autologous extracellular matrix as the scaffold is degraded. Several materials are available, but most of them are in the form of sheets and need to be laid on an open wound surface. A number of injectable fillers have been developed to correct soft-tissue defects. However, none of these has been used for guided tissue regeneration. We present a new technique that could possibly be used to correct dermal defects by using macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration. In eight healthy volunteers, intradermal injections of macroporous gelatine spheres were compared with injections of saline and hyaluronic acid (Restylane). Full-thickness skin biopsy specimens of the implants and surrounding tissue were removed 2, 8, 12 and 26 weeks after injection, and the (immuno)histological results were analysed. The Restylane merely occupied space. It shattered the dermal tissue and compressed collagen fibres and cells at the interface between the implant and the dermis. No regeneration of tissue was found with this material at any time. The macroporous gelatine spheres were populated with fibroblasts already after 2 weeks. After 8 weeks the spheres were completely populated by fibroblasts producing dermal tissue. After 12 and 26 weeks, the gelatine spheres had been more or less completely resorbed and replaced by vascularised neodermis. There were no signs of capsular formation, rejection or adverse events in any subject. Further in vivo studies in humans are needed to evaluate the effect of the macroporous spheres fully as a matrix for guided tissue regeneration with and without cellular pre-seeding. However, the results of this study indicate the possibility of using macroporous gelatine spheres as an injectable, three-dimensional, degradable matrix for guided tissue regeneration.

  • 35.
    Huss, Fredrik Rm
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Nyman, Erika
    Inst för Experimentell och Klinisk medicin, Linköping.
    Gustafson, Carl-Johan
    Kirurgiska vetenskaper, KI.
    Gisselfält, Katrin
    Artimplant AB.
    Liljensten, Elisabeth
    Artimplant AB.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Characterization of a new degradable polymer scaffold for regeneration of the dermis: In vitro and in vivo human studies.2008In: Organogenesis, ISSN 1547-6278, Vol. 4, no 3, p. 195-200Article in journal (Refereed)
    Abstract [en]

    Full thickness skin wounds in humans heal with scars, but without regeneration of the dermis. A degradable poly(urethane urea) scaffold (PUUR), Artelon(R) is already used to reinforce soft tissues in orthopaedics, and for treatment of osteoarthritis of the hand, wrist and foot. In this paper we have done in vitro experiments followed by in vivo studies to find out whether the PUUR is biocompatible and usable as a template for dermal regeneration. Human dermal fibroblasts were cultured on discs of PUUR, with different macrostructures (fibrous and porous). They adhered to and migrated into the scaffolds, and produced collagen. The porous scaffold was judged more suitable for clinical applications and 4 mm Ø, 2 mm-thick discs of porous scaffold (12% w/w or 9% w/w polymer solution) were inserted intradermally in four healthy human volunteers. The implants were well tolerated and increasing ingrowth of fibroblasts was seen over time in all subjects. The fibroblasts stained immunohistochemically for procollagen and von Willebrand factor, indicating neocollagenesis and angiogenesis within the scaffolds. The PUUR scaffold may be a suitable material to use as a template for dermal regeneration.

  • 36.
    Huss, Fredrik
    et al.
    Hand- och plastikkirurgiska kliniken, Universitetssjukhuset i Linköping.
    Sjöberg, Folke
    Hand- och plastikkirurgiska kliniken, Universitetssjukhuset i Linköpin.
    Brännskador2010In: Akut Pediatrik / [ed] S. Norgren, J.F. Ludvigsson, M. Norman, Stockholm: Liber, 2010, 7, p. 138-146Chapter in book (Other academic)
  • 37.
    Huss, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Sleem, Ziad
    Engblom, Karin
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    A SWEDISH EXPERIENCE OF INTRODUCING NEXOBRID TO THE CLINIC2015In: Annals of Burns and Fire Disasters, 2015, Vol. 28Conference paper (Refereed)
  • 38. Huss, Fredrik
    et al.
    Steinvall, I
    Inst för Experimentell och Klinisk medicin, Linköping.
    Sjöberg, F
    Inst för Experimentell och Klinisk medicin, Linköping.
    [Burn injuries in Sweden 1987-1996. The number of hospitalized patients has been reduced and the mortality lowered by 70 per cent].2001In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 98, no 18, p. 2184-8Article in journal (Refereed)
    Abstract [sv]

    Continuous improvement in burn trauma care has led to decreasing mortality, morbidity, and length of hospital stay. Current data from the Swedish population is lacking, which was the reason for this investigation. Data was gathered from the Swedish database for medical care (based on ICD-9). All Swedish care providers are enrolled and assumed to report data. Hence, the quality of the database is considered reasonably good, although data from individual patients may be incorrectly recorded due to clerical errors. Available data indicate that the number of burn victims seeking medical care has decreased by 16% during the past decade, whereas mortality has decreased by 70%! The demographic data is otherwise similar to what has previously been reported in the international literature.

  • 39. Jonsson, Anders
    et al.
    Bonander, Carl
    Nilson, Finn
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    The state of the residential fire fatality problem in Sweden: Epidemiology, risk factors, and event typologies.2017In: Journal of Safety Research, ISSN 0022-4375, E-ISSN 1879-1247, Vol. 62, p. 89-100Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Residential fires represent the largest category of fatal fires in Sweden. The purpose of this study was to describe the epidemiology of fatal residential fires in Sweden and to identify clusters of events.

    METHOD: Data was collected from a database that combines information on fatal fires with data from forensic examinations and the Swedish Cause of Death-register. Mortality rates were calculated for different strata using population statistics and rescue service turnout reports. Cluster analysis was performed using multiple correspondence analysis with agglomerative hierarchical clustering.

    RESULTS: Male sex, old age, smoking, and alcohol were identified as risk factors, and the most common primary injury diagnosis was exposure to toxic gases. Compared to non-fatal fires, fatal residential fires more often originated in the bedroom, were more often caused by smoking, and were more likely to occur at night. Six clusters were identified. The first two clusters were both smoking-related, but were separated into (1) fatalities that often involved elderly people, usually female, whose clothes were ignited (17% of the sample), (2) middle-aged (45-64years old), (often) intoxicated men, where the fire usually originated in furniture (30%). Other clusters that were identified in the analysis were related to (3) fires caused by technical fault, started in electrical installations in single houses (13%), (4) cooking appliances left on (8%), (5) events with unknown cause, room and object of origin (25%), and (6) deliberately set fires (7%).

    CONCLUSIONS: Fatal residential fires were unevenly distributed in the Swedish population. To further reduce the incidence of fire mortality, specialized prevention efforts that focus on the different needs of each cluster are required.

    PRACTICAL APPLICATIONS: Cooperation between various societal functions, e.g. rescue services, elderly care, psychiatric clinics and other social services, with an application of both human and technological interventions, should reduce residential fire mortality in Sweden.

  • 40. Jonsson, Anders
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Svee, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Sjöberg, Folke
    BURNS IN SWEDEN: TEMPORAL TRENDS 1987-20102015In: Annals of Fire and Burns Disasters, 2015, Vol. 28Conference paper (Refereed)
  • 41. Karström, Alexandra
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Banking of autologous skin according to the EU regulations at Uppsala University Hospital2014Conference paper (Refereed)
  • 42.
    Karström, Alexandra
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Keratinocytes2015In: Guide to the quality and safety of tissues and cells for human application / [ed] S. Keitel, Strasbourg: Council of Europe Publishing, 2015, 2, p. 471-477Chapter in book (Other academic)
  • 43.
    Karström, Alexandra
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Westlund, Emelie
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Karström A, Westlund E, Huss F. Donor skin banking at Uppsala University Hospital –build-up and management2014Conference paper (Refereed)
  • 44.
    Kjellman, Britt-Marie
    et al.
    Inst för klinisk och experimentell medicin.
    Mats, Fredriksson
    Inst för klinisk och experimentell medicin.
    Glad Mattson, Gunilla
    Inst för klinisk och experimentell medicin.
    Sjöberg, Folke
    Inst för klinisk och experimentell medicin.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Comparing ambient, air-convection, and fluid-convection heating techniques in treating hypothermic burn patients, a clinical RCT2011In: Annals of Surgical Innovation and Research, ISSN 1750-1164, Vol. 5, no 1, p. 4-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Hypothermia in burns is common and increases morbidity and mortality. Several methods are available to reach and maintain normal core body temperature, but have not yet been evaluated in critical care for burned patients. Our unit's ordinary technique for controlling body temperature (Bair Hugger®+ radiator ceiling + bed warmer + Hotline®) has many drawbacks e.g.; slow and the working environment is hampered.The aim of this study was to compare our ordinary heating technique with newly-developed methods: the Allon™2001 Thermowrap (a temperature regulating water-mattress), and Warmcloud (a temperature regulating air-mattress).

    METHODS:

    Ten consecutive burned patients (> 20% total burned surface area and a core temperature < 36.0°C) were included in this prospective, randomised, comparative study. Patients were randomly exposed to 3 heating methods. Each treatment/measuring-cycle lasted for 6 hours. Each heating method was assessed for 2 hours according to a randomised timetable. Core temperature was measured using an indwelling (bladder) thermistor. Paired t-tests were used to assess the significance of differences between the treatments within the patients. ANOVA was used to assess the differences in temperature from the first to the last measurement among all treatments. Three-way ANOVA with the Tukey HSD post hoc test and a repeated measures ANOVA was used in the same manner, but included information about patients and treatment/measuring-cycles to control for potential confounding. Data are presented as mean (SD) and (range). Probabilities of less than 0.05 were accepted as significant.

    RESULTS:

    The mean increase, 1.4 (SD 0.6°C; range 0.6-2.6°C) in core temperature/treatment/measuring-cycle highly significantly favoured the Allon™2001 Thermowrap in contrast to the conventional method 0.2 (0.6)°C (range -1.2 to 1.5°C) and the Warmcloud 0.3 (0.4)°C (range -0.4 to 0.9°C). The procedures for using the Allon™2001 Thermowrap were experienced to be more comfortable and straightforward than the conventional method or the Warmcloud.

    CONCLUSIONS:

    The Allon™2001 Thermowrap was more effective than the Warmcloud or the conventional method in controlling patients' temperatures.

  • 45.
    Kratz, G
    et al.
    Kirurgiska vetenskaper, KI.
    Gustafson, C J
    Kirurgiska vetenskaper, KI.
    Huss, F
    Kirurgiska vetenskaper, KI.
    Neovius, E
    Kirurgiska vetenskaper, KI.
    [Recreation of tissue--the plastic surgeon's spring-board in to the 21st century].: Nybildning av vävnad - plastikkirurgens språngbräda in i 2000-talet1999In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 96, no 44, p. 4780-6Article in journal (Refereed)
    Abstract [sv]

    During recent years, a new field has appeared, in which the principles of life sciences and engineering are applied to the development of methods of regenerating human tissue and organs. Since the emergence of this interdisciplinary field, plastic surgeons have been deeply involved in its development, both in the early stages and in introducing the methods into clinical practice. The article consists in discussion of the possibilities these methods offer and the impact they may have on the field of plastic and reconstructive surgery.

  • 46.
    Kratz, G
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Huss, F
    Inst för Experimentell och Klinisk medicin, Linköping.
    Tissue engineering--body parts from the Petri dish.2003In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 92, no 4, p. 241-7Article in journal (Refereed)
    Abstract [en]

    The development of methods to regenerate human tissues and organs by tissue engineering (TE), will have a dramatic influence on many medical specialities in the future. The essence of plastic surgery is to reconstruct disrupted and damaged tissues by the use of a plethora of techniques spanning from small local skin flaps to highly advanced microsurgery and free composite grafts. However, these methods only focus on moving tissue from one part of the patient to another without actual regeneration. To be able to take the next step in development of the speciality it is of necessity to address this issue. Hence it follows naturally that plastic surgeons lead and represent the driving force of the development within the research of tissue engineering. In this paper we would like to present active research and also give an overview of areas in tissue engineering that are of special interest to the plastic surgeon.

  • 47. Nilsson, Helene
    et al.
    Jonsson, C-O
    Vikström, Tore
    Bengtsson, Eva
    Thorfinn, Johan
    Huss, Fredrik
    Kildal, Morten
    Sjöberg, Folke
    Burn disaster planning in Sweden2012Conference paper (Refereed)
  • 48. Nilsson, Heléne
    et al.
    Jonson, Carl-Oscar
    Vikström, Tore
    Bengtsson, Eva
    Thorfinn, Johan
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Sjöberg, Folke
    Simulation-assisted burn disaster planning2013In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 39, no 6, p. 1122-1130Article in journal (Refereed)
    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.

  • 49. Nyman, Erika
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Nyman, Torbjorn
    Junker, Johan
    Kratz, Gunnar
    Hyaluronic acid, an important factor in the wound healing properties of amniotic fluid: In vitro studies of re-epithelialisation in human skin wounds2013In: Journal of Plastic Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 47, no 2, p. 89-92Article in journal (Refereed)
    Abstract [en]

    Foetal wounds are unique in their ability to heal rapidly without forming scars. The amniotic fluid, rich in nutrients, growth factors, and hyaluronic acid, surrounds the foetus and is essential to foetal wound healing. The wound healing properties of foetal wounds may be the result of high concentrations of hyaluronic acid. This study aimed to verify that amniotic fluid induces re-epithelialisation in human skin wounds in vitro and to study whether this ability is dependent on hyaluronic acid. Standard deep dermal wounds were produced in vitro in human skin. The skin samples, with a central wound, were incubated in different culture media. Varying concentrations of amniotic fluid and amniotic fluid with added hyaluronidase were tested, and re-epithelialisation was assessed at 3, 7, and 12 days using light microscopy, after staining with haematoxylin and eosin. Amniotic fluid 50% resulted in a significantly higher (p < 0.05) grade of re-epithelialisation than Dulbecco's modified Eagle's medium and 10% amniotic fluid at all time points. When 50% amniotic fluid was compared with 10% foetal calf serum, no significant difference was found in grades of re-epithelialisation on days 3 and 12 and significantly higher grades of re-epithelialisation on day 7 (p < 0.05). Degradation of hyaluronic acid in the medium that contained 50% amniotic fluid gave significantly impaired re-epithelialisation (p < 0.05) on culture days 3 and 7. In conclusion, amniotic fluid promotes accelerated re-epithelialisation and hyaluronic acid is an important ingredient.

  • 50. Orwelius, Lottie
    et al.
    Huss, Fredrik
    Willebrand, Mimmie
    Gerdin, Bengt
    Sjöberg, Folke
    Health related quality of life isless of a problem for burn injured compared to other ICU patients2010Conference paper (Refereed)
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