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  • 1.
    Aineskog, Helena
    et al.
    Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Uppsala, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    A case report of a complete degloving injury of the penile skin2016Ingår i: International Journal of Surgery Case Reports, E-ISSN 2210-2612, Vol. 29, s. 1-3Artikel i tidskrift (Refereegranskat)
    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.

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  • 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 1987-2004.2007Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 33, nr 1, s. 31-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 3.
    Asswad, Amjad Ghazal
    et al.
    Newcastle Upon Tyne Hosp NHS Fdn Trust, Freeman Hosp, Cardiol Dept, Freeman Rd, Newcastle Upon Tyne NE7 7DN, Tyne & Wear, England..
    Holm, Sebastian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Department of Plastic and Maxillofacial Surgery, Burn Centre, Uppsala University Hospital, 751 85, Uppsala, Sweden.
    Engström, Olof
    Department of Plastic and Maxillofacial Surgery, Burn Centre, Uppsala University Hospital, 751 85, Uppsala, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Department of Plastic and Maxillofacial Surgery, Burn Centre, Uppsala University Hospital, 751 85, Uppsala, Sweden.
    Lipcsey, Miklós
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård, Hedenstiernalaboratoriet.
    Rudolph, Andre
    Karolinska Univ Hosp, Pediat Heart Ctr Stockholm Uppsala, Stockholm, Sweden.;Karolinska Univ Hosp, Karolinska Inst, Dept Med, Stockholm, Sweden..
    Delayed, Unprovoked, Hemodynamic Collapse with Following Asystole in a Pediatric Patient Following a High-Voltage Injury: A Case Report and Literature Review2022Ingår i: Pediatric Cardiology, ISSN 0172-0643, E-ISSN 1432-1971, Vol. 43, nr 5, s. 1163-1168Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Electrical incidents are common and mostly uneventful, though can be severe and sometimes lethal. Aside from skin, muscle and soft tissue damage, electrical injuries can cause cardiac arrhythmias, the most common cardiac complication. The case of a 14-year-old girl who sustained 48.5% TBSA burns following a high-voltage electrical injury is described. She suffered five episodes of asystole 78 h following the injury, requiring extracorporeal membrane oxygenation. The cause of the delayed asystole was investigated and a PubMed literature search was conducted to explore late presenting cardiac sequelae following electrical injuries. This yielded fifteen studies, identified as relevant, of high quality and in the English language. These studies included a total of 1411 patients of whom only 3 were found to have had late potentially lethal arrhythmias, all manifesting within the first 24 h after the injury. Of these patients, 32 suffered cardiac arrests shortly after the electrical injury, 11 of which were documented as asystolic arrests though these were all from a single study with the rural locale and prolonged delay in arrival to the hospital setting contributing to this finding. To our knowledge, this is the only pediatric cardiac arrest developing in a stable patient over 72 h following the initial electrical injury. No other patient has suffered any significant cardiac complications first presenting outside the initial 24-h period following the electrical injury. Guidelines and recommendations on post electrical injury observation of patient vary and further research into this field is required to allow for guidance unification.

  • 4. Azzena, B
    et al.
    Tocco-Tussardi, I
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Pontini, A
    Presman, B
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Late complications of high-voltage electrical injury might involve multiple systems and be related to current path2016Ingår i: Annals of Burns and Fire Disasters, ISSN 1121-1539, E-ISSN 1592-9558, Vol. 29, nr 3, s. 192-194Artikel i tidskrift (Refereegranskat)
    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.

  • 5. Bergquist, M
    et al.
    Sveen, Josefin
    Huss, Fredrik
    Sjöberg, Folke
    Willebrand, Mimmie
    Psychological health andappearance after burns in children and adolescents aged 5-182010Konferensbidrag (Refereegranskat)
  • 6.
    Bergquist, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi. Univ Gothenburg, Sahlgrenska Acad, Dept Rheumatol & Inflammat Res, Gothenburg, Sweden.
    Hastbacka, Johanna
    Univ Helsinki, Intens Care Med, Dept Anesthesiol Intens Care Med & Pain Med, Helsinki, Finland;Helsinki Univ Hosp, Helsinki, Finland.
    Glaumann, Christian
    Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, Uppsala, Sweden.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, Uppsala, Sweden.
    Lipcsey, Miklós
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    The time-course of the inflammatory response to major burn injury and its relation to organ failure and outcome2019Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, nr 2, s. 354-363Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 7. Bergquist, Maria
    et al.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Hedenstierna, Göran
    Hästbacka, Johanna
    Rockwood, Alan
    Kushnir, Mark
    Bergquist, Jonas
    Altered adrenal and gonadal steroids biosynthesis in patients with burn injury2015Konferensbidrag (Refereegranskat)
  • 8.
    Bergquist, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Burn Center, Uppsala University Hospital, Uppsala, Sweden.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala Burn Center, Uppsala University Hospital, Uppsala, Sweden.
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Hedenstiernalaboratoriet.
    Hästbacka, Johanna
    Intensive Care Medicine Department of Perioperative, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Finland.
    Rockwood, Alan L.
    ARUP Institute for Clinical & Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108-1221, USA;Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA.
    Kushnir, Mark M.
    ARUP Institute for Clinical & Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108-1221, USA;Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA.
    Bergquist, Jonas
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för kemi - BMC, Analytisk kemi. Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA.
    Altered adrenal and gonadal steroids biosynthesis in patients with burn injury2016Ingår i: Clinical Mass Spectrometry, ISSN 2213-8005, E-ISSN 2376-9998, Vol. 1, s. 19-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Burn injury inevitably leads to changes in the endogenous production of cytokines, as well as adrenal and gonadal steroids. Previous studies have reported gender-related differences in outcome following burn injury, which suggests that gonadal steroids may play a role. The aim of this study was to assess alterations in concentration of endogenous steroids in patients with burn injury.

    Methods: For this single-center, prospective descriptive study, high-sensitivity liquid chromatography tandem mass spectrometry (LC-MS/MS)-based steroid quantification was used to determine longitudinal profiles of the concentrations of endogenous steroids in plasma from sixteen adult male patients with burn injury (14.5-72% of total body surface area). Steroids were extracted from plasma samples and analyzed using multiple reaction monitoring acquisition, with electrospray ionization on a triple quadruple mass spectrometer. Total protein concentration was measured in the samples using spectrophotometry.

    Results: Steroid and total protein concentration distributions were compared to reference intervals characteristic of healthy adult men. Concentrations of the following steroids in plasma of burn injured patients were found to correlate positively to the area of the burn injury: cortisol (r = 0.84), corticosterone (r = 0.73), 11-deoxycortisol (r = 0.72), androstenedione (r = 0.72), 17OH-progesterone (r = 0.68), 17OH-pregnenolone (r = 0.64) and pregnenolone (r = 0.77). Concentrations of testosterone decreased during the acute phase and were up to ten-times lower than reference values for healthy adult men, while concentrations of estrone were elevated. By day 21 after injury, testosterone concentrations were increased in younger, but not older, patients. The highest concentrations of estrone were observed on day 3 after the injury and then declined by day 21 to concentrations comparable to those observed on the day of the injury.

    Conclusion: Burn injury alters endogenous steroid biosynthesis, with decreased testosterone concentrations and elevated estrone concentrations, during the first 21 days after the injury. Concentrations of glucocorticoids, progestagens and androgen precursors correlated positively with the area of burn injury. The finding of increased estrone following burn injury needs to be confirmed in a larger hypothesis driven study.

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  • 9.
    Bergquist, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Hästbacka, Johanna
    Lindholm, Catharina
    Martijn, Cecile
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Kemiska sektionen, Institutionen för kemi - BMC.
    Rylander, Christian
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Glucocorticoid receptor expression and binding capacity in patients with burn injury2016Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 60, nr 2, s. 213-221Artikel i tidskrift (Refereegranskat)
    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.

  • 10. Bodin, Maja
    et al.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Svåra skador och dödsfall till följd av brand: En genomgång av brandskadade i Sverige 20102012Övrigt (Övrigt vetenskapligt)
    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.

  • 11. Boissin, C
    et al.
    Fransén, J
    Laflamme, L
    Allorto, N
    Wallis, L
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Lundin, J
    Deep learning for image-based diagnostic support: initial development of a system for acute burns: Constance Boissin2017Ingår i: Central European Journal of Public Health, ISSN 1210-7778, E-ISSN 1803-1048, Vol. 27, nr suppl. 3, s. 436-Artikel i tidskrift (Övrigt vetenskapligt)
  • 12.
    Boissin, Constance
    et al.
    Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden.;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Laflamme, Lucie
    Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden.;Univ South Afr, Inst Social & Hlth Sci, Johannesburg, South Africa..
    Fransén, Jian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Department of Plastic and Maxillofacial Surgery, Burn Center, Uppsala University Hospital.
    Lundin, Mikael
    Univ Helsinki, Inst Mol Med Finland FIMM, Helsinki Inst Life Sci HiLIFE, Helsinki, Finland..
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Department of Plastic and Maxillofacial Surgery, Burn Center, Uppsala University Hospital.
    Wallis, Lee
    Stellenbosch Univ, Fac Med & Hlth Sci, Div Emergency Med, Bellville, South Africa.;Univ Cape Town, Div Emergency Med, Cape Town, South Africa..
    Allorto, Nikki
    Univ KwaZulu Natal, Dept Gen Surg, Pietermaritzburg Burn Serv, Pietermaritzburg, South Africa..
    Lundin, Johan
    Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden.;Univ Helsinki, Inst Mol Med Finland FIMM, Helsinki Inst Life Sci HiLIFE, Helsinki, Finland..
    Development and evaluation of deep learning algorithms for assessment of acute burns and the need for surgery2023Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 13, nr 1, artikel-id 1794Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Assessment of burn extent and depth are critical and require very specialized diagnosis. Automated image-based algorithms could assist in performing wound detection and classification. We aimed to develop two deep-learning algorithms that respectively identify burns, and classify whether they require surgery. An additional aim assessed the performances in different Fitzpatrick skin types. Annotated burn (n = 1105) and background (n = 536) images were collected. Using a commercially available platform for deep learning algorithms, two models were trained and validated on 70% of the images and tested on the remaining 30%. Accuracy was measured for each image using the percentage of wound area correctly identified and F1 scores for the wound identifier; and area under the receiver operating characteristic (AUC) curve, sensitivity, and specificity for the wound classifier. The wound identifier algorithm detected an average of 87.2% of the wound areas accurately in the test set. For the wound classifier algorithm, the AUC was 0.885. The wound identifier algorithm was more accurate in patients with darker skin types; the wound classifier was more accurate in patients with lighter skin types. To conclude, image-based algorithms can support the assessment of acute burns with relatively good accuracy although larger and different datasets are needed.

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  • 13. 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.2009Ingår i: Wounds (King of Prussia, Pa.), ISSN 1044-7946, E-ISSN 1943-2704, Vol. 21, nr 8Artikel i tidskrift (Refereegranskat)
    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..

  • 14.
    Dimander, Josefin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Andersson, Agneta
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Lindqvist, Catarina
    Department of Medicine Huddinge, Karolinska Institutet, 141 52, Stockholm, Sweden.
    Miclescu, Adriana
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Klinisk smärtforskning.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Documented nutritional therapy in relation to nutritional guidelines post burn injury: a retrospective observational study2023Ingår i: Clinical Nutrition ESPEN, E-ISSN 2405-4577, Vol. 56, s. 222-229Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background & aims: Intensive nutritional therapy is an essential component of burn care. Regardingpost-minor burn injuries, the literature is lacking. The aim of this study was to evaluate documentednutritional therapy in relation to international guidelines after both minor and major burn injuries. The secondary aim of this study was to evaluate the adequacy of energy and protein intake compared toindividual nutritional goals post-burn injury.

    Methods: A retrospective observational single-centre study including patients admitted between 2017and 2019 at a burn centre in Sweden was performed. The patients included in the study were >18 years old and in need of hospital care for > 72 h post-burn injury. Information about patients' demographics,nutritional therapy, and clinical characteristics of burn injury was collected. The patients were dividedaccording to total body surface area burnt (TBSA %) into minor burn injuries (TBSA <20%) and major burninjuries (TBSA >20%). Descriptive statistics were used to analyse data. Adherence to guidelines wasestablished by comparing 24 nutritional therapy recommendations to documented treatment. If documented nutritional treatment were in accordance with guidelines, adherence was considered high(>80%), moderate (60-79.9%) or low (<59.9%).

    Results: One hundred thirty-four patients were included, 90 patients with minor burn injuries and 44patients with major burn injuries. Documented adherence to the nutritional guideline was overall low.After minor burn injury, 8% (2/24) of nutritional therapy recommendations had a high adherence (fatintake <35% of total energy intake and enteral nutrition as prioritized feeding route), 17% (4/24) amoderate adherence, and 75% (18/24) a low adherence. In patients treated after a major burn injury,there were two recommendations with documented high adherence (Vitamin C and Zinc); 25% (6/24)had moderate adherence, and 67% (16/24) had low adherence. In addition, quite a large amount ofmissing data was found.Adequacy of documented nutritional intake, compared to the individual documented goal, was 78%(±23%) for energy and 66% (±22%) for protein after minor burn injury. After major burn injury, the adequacy was 89% (±21%) for energy and 78% (±19%) for protein, respectively.

    Conclusions: This study revealed low adherence to nutritional guidelines in patients treated for minorand major burn injuries. Compared to major burn injuries, lower documented adequacy for both energyand proteins was found in minor burn injuries. Given the disparity between guidelines and documentednutritional therapy, and the lack of specific guidelines for minor burn injuries, there could be aconsiderable risk of inadequate nutritional therapy post-burn injury.

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  • 15.
    Dimander, Josefin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Burn Centre, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital.
    Andersson, Agneta
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Miclescu, Adriana
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Klinisk smärtforskning.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Burn Centre, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital.
    Two Modified Questionnaires for the Assessment of Nutrition Impact Symptoms in the Rehabilitation Phase after Burn Injury: A Content Validation Study2022Ingår i: European Burn Journal, E-ISSN 2673-1991, Vol. 3, nr 1, s. 156-164Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Disease Related Appetite Questionnaire (DRAQ) and Eating Symptom Questionnaire(ESQ) are used to assess nutrition impact symptoms, which are symptoms that can negatively affectthe patients’ food intake. However, these questionnaires have not yet been adapted to the needsof patients recovering from burn injuries. Our aim was therefore to develop DRAQ and ESQ forassessments of nutrition impact symptoms after burn injury. A content validation index (I-CVI) foritems included in DRAQ and ESQ, regarding their relevance for possible nutrition impact symptomsin a burn-injured patient (Likert scale 1–4), was performed by an expert review group. A clarityvalidation by expert and non-expert reviewers was carried out. Two of the eleven questions inDRAQ and eight of the fourteen questions in ESQ were not considered relevant and were thereforeremoved from the questionnaires. Five additional questions were added to DRAQ and two to ESQ.A high degree of consensus on relevance (scale-content validity index average, S-CVI/Ave, 0.86 forDRAQ-burn and 0.83 for ESQ-burn) was reached in the expert group. To conclude, it is suggestedthat we use developed forms of DRAQ and ESQ (DRAQ-burn and ESQ-burn) for the assessment ofnutrition impact symptoms, specifically during the rehabilitation phase of burn-injured patients.

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  • 16. Edlund, C
    et al.
    Karström, A
    Fransén, Jian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Optimization of storage conditions when banking autologous split-thickness skin grafts.2017Ingår i: Annals of Burns and Fire Disasters, ISSN 1121-1539, E-ISSN 1592-9558, Vol. 15Artikel i tidskrift (Refereegranskat)
  • 17. Enblom, Sara
    et al.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Fatigue after burn – Is it common? A preliminary survey2021Ingår i: Burns Open, Vol. 5, nr 3, s. 134-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Physical function and daily activities are often affected after burn injury. Fatigue is a condition that is rarely assessed. Being a well-known sequela after traumatic brain-injury or diseases of the nervous system, fatigue has also been described among the burn population with a negative impact on daily activities and reduced capacity for work.

    The aim of this study was to examine if, and to what extent, fatigue is a problem among our burn victims.

    Twenty consecutive patients scheduled for follow-up at the Burn center’s outpatient clinic in Uppsala, were asked to fill out the Fatigue Severity Scale (FSS). A healthy reference group without a burn injury, gender and age matched, were asked to fill out the same questionnaire.

    The results show that the patient group has a statistically significant higher score of fatigue compared to the reference group (p = 0.004). However, the results must be interpreted with caution considering the relatively small sample size. In future research it is also important to investigate the relationship between fatigue and daily activities, depression, return to work, and quality of life.

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  • 18.
    Enblom, Sara
    et al.
    Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden.
    Sundin, Elin
    Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden.
    Guné, Gerd Edvinsson
    Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden.
    Aspling, Nona
    Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden.
    The Relationship between Health-Related Quality of Life, Subjective Scar Estimation, and Activity Performance in Adult Burn Patients 6 and 12 Months after Injury2022Ingår i: European Burn Journal, E-ISSN 2673-1991, Vol. 3, nr 4, s. 486-492Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A burn injury affects a person’s health-related quality of life (HRQoL) in different ways and might influence their daily life for months and years afterward. The aim of this study was to examine how activity performance and subjective scar estimation relate to self-rated health and whether this changes in the first year post-burn. Fifty consecutive patients who were scheduled for follow-up at the Burn Center’s outpatient clinic in Uppsala were included. Assessments of HRQoL (EQ-5D), activity performance (DASH), and subjective scar evaluation (POSAS) were conducted at 6 and 12 months post-burn. The results show a statistically significant correlation between self-rated HRQoL and activity performance (p = 0.001) and between self-rated HRQoL and subjective scar estimation (p = 0.000) at 6 but not at 12 months post-burn. A possible explanation of the lack of correlation at one year post-burn might be the patient´s expectations of his or her recovery. In future research, it would be interesting to investigate the long-term correlations between quality of life and activity performance.

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  • 19.
    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].2005Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, nr 50, s. 3897-8Artikel i tidskrift (Refereegranskat)
  • 20.
    Fransén, Jian
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Bastami, Salumeh
    Department of Medical and Health Sciences, Division of Drug Research, Linköping University, Linköping, Sweden.
    Sjöberg, Folke
    Department of Hand-, Plastic-, and Burn Surgery, University Hospital of Linköping, Linköping, Sweden.
    Uppugunduri, Srinivas
    Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Burn Center, Dept of Plastic- and Maxillofacial Surgery, Uppsala University hospital, Uppsala, Sweden.
    Evaluating topical opioid gel on donor site pain: A small randomised double blind controlled trial2016Ingår i: International Journal of Surgery Open, ISSN 2405-8572, Vol. 4, s. 5-9Artikel i tidskrift (Refereegranskat)
    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.

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  • 21.
    Fransén, Jian
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Lundin, Johan
    Karolinska Institute Department of Global Public Health, Stockholm, Sweden;FIMM, Institute for Molecular Medicine, Helsinki, Finland.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Department of Plastic- and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
    A proof-of-concept study on mortality prediction with machine learning algorithms using burn intensive care data2022Ingår i: Scars, Burns & Healing, ISSN 2059-5131Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction

    Burn injuries are a common traumatic injury. Large burns have high mortality requiring intensive care and accurate mortality predictions. To assess if machine learning (ML) could improve predictions, ML algorithms were tested and compared with the original and revised Baux score.

    Methods

    Admission data and mortality outcomes were collected from patients at Uppsala University Hospital Burn Centre from 2002 to 2019. Prognostic variables were selected, ML algorithms trained and predictions assessed by analysis of the area under the receiver operating characteristic curve (AUC). Comparison was made with Baux scores using DeLong test.

    Results

    A total of 17 prognostic variables were selected from 92 patients. AUCs in leave-one-out cross-validation for a decision tree model, an extreme boosting model, a random forest model, a support-vector machine (SVM) model and a generalised linear regression model (GLM) were 0.83 (95% confidence interval [CI] = 0.72–0.94), 0.92 (95% CI = 0.84–1), 0.92 (95% CI = 0.84–1), 0.92 (95% CI = 0.84–1) and 0.84 (95% CI = 0.74–0.94), respectively. AUCs for the Baux score and revised Baux score were 0.85 (95% CI = 0.75–0.95) and 0.84 (95% CI = 0.74–0.94). No significant differences were observed when comparing ML algorithms with Baux score and revised Baux score. Secondary variable selection was made to analyse model performance.

    Conclusion

    This proof-of-concept study showed initial credibility in using ML algorithms to predict mortality in burn patients. The sample size was small and future studies are needed with larger sample sizes, further variable selections and prospective testing of the algorithms.

  • 22. Fredriksson, C.
    et al.
    Kratz, G.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Transplantation of cultured human keratinocytes: A comparative in vitro study of different application techniques2007Konferensbidrag (Refereegranskat)
  • 23. 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 Study2009Ingår i: Materials, E-ISSN 1996-1944, Vol. 2, nr 4, s. 1908-1922Artikel i tidskrift (Refereegranskat)
    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.

  • 24. 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.2009Ingår i: Wounds (King of Prussia, Pa.), ISSN 1044-7946, E-ISSN 1943-2704, Vol. 21, nr 5Artikel i tidskrift (Refereegranskat)
    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. .

  • 25.
    Frestadius, Andrea
    et al.
    Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Burn Ctr, S-75185 Uppsala, Sweden.
    Grehn, Filip
    Vrinnevi Cty Hosp, S-60182 Norrköping, Sweden.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Burn Ctr, S-75185 Uppsala, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Burn Ctr, S-75185 Uppsala, Sweden.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden.
    Intranasal dexmedetomidine and rectal ketamine for young children undergoing burn wound procedures2022Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 48, nr 6, s. 1445-1451Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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  • 26.
    Frew, Quentin
    et al.
    Mid Essex Hosp Trust, Broomfield Hosp, St Andrews Ctr Plast Surg & Burns, Chelmsford, Essex, England.
    Rennekampff, Hans-Oliver
    Rhein Maas Klinikum, Dept Plast Aesthet & Burn Surg, Wurselen, Germany.
    Dziewulski, Peter
    Mid Essex Hosp Trust, Broomfield Hosp, St Andrews Ctr Plast Surg & Burns, Chelmsford, Essex, England.
    Moiem, Naiem
    Univ Hosp Birmingham NHS Fdn Trust Queen Elisabet, Burns & Plast, Birmingham, W Midlands, England.
    Zahn, Tobias
    Birken AG, Niefern Oschelbronn, Germany;3R Pharma Consulting GmbH, Dobel, Germany.
    Hartmann, Bernd
    Unfallkrankenhaus Berlin, Burn Ctr Plast Surg, Berlin, Germany.
    Siemers, Frank
    BG Kliniken Bergmannstrost, Klin Plast & Handchirurg Brandverletzten Zentrum, Halle, Germany.
    Mailander, Peter
    Univ Lubeck, Klin Plast Chirurg Handchirurg, Intens Inheit Schwerbrandverletzte, Lubeck, Germany.
    Lehnhardt, Marcus
    BG Univ Klin Bergmannsheil, Klin Plast Chirurg & Schwerbrandverletzte, Bochum, Germany.
    Thorfinn, Johan
    Linkoping Univ Hosp, Dept Hand & Plast Surg & Intens Care, Burn Ctr, Linkoping, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Pietramaggiori, Sandra Scherer
    CHU Vaudois, Chirurg Plast & Reconstruct, Lausanne, Switzerland.
    Dheansa, Baljit
    Queen Victoria Hosp NHS, Burn Ctr, E Grinstead, England.
    Metelmann, Hans-Robert
    Univ Med Greifswald, Klin & Poliklin Mund Kiefer Gesichtschirurg Plast, Greifswald, Germany.
    Schumann, Hauke
    Kathol Hsch Freiburg, Freiburg, Germany.
    Betulin wound gel accelerated healing of superficial partial thickness burns: Results of a randomized, intra-individually controlled, phase III trial with 12-months follow-up2019Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, nr 4, s. 876-890Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 27.
    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.2006Ingår i: Cell and Tissue Research, ISSN 0302-766X, E-ISSN 1432-0878, Vol. 325, nr 2, s. 245-51Artikel i tidskrift (Refereegranskat)
    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.

  • 28.
    Glas, Gerie J.
    et al.
    Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands..
    Horn, Janneke
    Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands..
    Hollmann, Markus W.
    Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands..
    Preckel, Benedikt
    Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands..
    Colpaert, Kirsten
    Med Univ Lublin, Dept Anaesthesia & Intens Therapy, Aleje Racklawickie 1, PL-20059 Lublin, Poland..
    Malbrain, Manu
    Med Univ Lublin, Dept Anaesthesia & Intens Therapy, Aleje Racklawickie 1, PL-20059 Lublin, Poland.;AZ JAN PALFIJN GENT, Watersportlaan 5, B-9000 Ghent, Belgium..
    Neto, Ary Serpa
    ABC Med Sch, BR-5001 Bangu, SP, Brazil.;Monash Univ, Australian & New Zealand Intens Care Res Ctr, Melbourne, Vic 3004, Australia.;GH St Louis Lariboisiere, AP HP, F-75010 Paris, France..
    Asehnoune, Karim
    Serv Anesthesie Reanimat Chirurg, F-44093 Nantes, France..
    de Abreu, Marcello Gamma
    Univ Hosp Carl Gustav Carus, D-01307 Dresden, Germany..
    Martin-Loeches, Ignacio
    St James Univ Hosp, Dublin D08 NHY1, Ireland..
    Pelosi, Paolo
    Univ Genoa, I-16128 Genoa, GE, Italy..
    Sjoberg, Folke
    Linköping Univ Hosp, S-58185 Linköping, Sweden..
    Binnekade, Jan M.
    Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands..
    Cleffken, Berry
    Maasstad Hosp, NL-3079 DZ Rotterdam, Netherlands..
    Juffermans, Nicole P.
    Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands..
    Knape, Paul
    Red Cross Hosp, NL-1942 LE Beverwijk, Netherlands..
    Loef, Bert G.
    Martini Hosp, NL-9728 NT Groningen, Netherlands..
    Mackie, David P.
    Red Cross Hosp, NL-1942 LE Beverwijk, Netherlands..
    Enkhbaatar, Perenlei
    Univ Texas Med Branch, Galveston, TX 77555 USA..
    Depetris, Nadia
    Turin CTO Burn Ctr, I-10126 Turin, TO, Italy..
    Perner, Anders
    Rigshosp, DK-2100 Copenhagen, Denmark..
    Herrero, Eva
    La Paz Univ Hosp, Madrid 28046, Spain..
    Cachafeiro, Lucia
    La Paz Univ Hosp, Madrid 28046, Spain..
    Jeschke, Marc
    Sunnybrook Hlth Sci Ctr, Ross Tilley Burn Ctr, Toronto, ON M4N 3M5, Canada..
    Lipman, Jeffrey
    Queensland Univ, Royal Brisbane & Womens Hosp, Herston, Qld 4029, Australia. Hosp Israelita Albert Einstein, Dept Crit Care Med, BR-05652900 Sao Paulo, Brazil..
    Legrand, Matthieu
    GH St Louis Lariboisiere, AP HP, F-75010 Paris, France.;St Louis Hosp, F-75010 Paris, France..
    Horter, Johannes
    BG Klin Ludwigshafen, D-67071 Ludwigshafen, Germany..
    Lavrentieva, Athina
    Papanikoalou Hosp, Thessaloniki 54621, Greece..
    Kazemi, Alex
    Middlemore Hosp, Auckland 2025, New Zealand..
    Guttormsen, Anne Berit
    Haukeland Hosp, N-5021 Bergen, Norway..
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, S-75185 Uppsala, Sweden..
    Kol, Mark
    Univ Sydney, Concord Repatriat Gen Hosp NSW, Concord 2139, Australia. Ziekenhuis Netwerk Antwerpen Stuivenberg, B-2060 Antwerp, Belgium..
    Wong, Helen
    Univ Sydney, Concord Repatriat Gen Hosp NSW, Concord 2139, Australia. Ziekenhuis Netwerk Antwerpen Stuivenberg, B-2060 Antwerp, Belgium..
    Starr, Therese
    Queensland Univ, Royal Brisbane & Womens Hosp, Herston, Qld 4029, Australia. Hosp Israelita Albert Einstein, Dept Crit Care Med, BR-05652900 Sao Paulo, Brazil..
    De Crop, Luc
    Med Univ Lublin, Dept Anaesthesia & Intens Therapy, Aleje Racklawickie 1, PL-20059 Lublin, Poland..
    de Oliveira Filho, Wilson
    Med Univ Lublin, Dept Anaesthesia & Intens Therapy, Aleje Racklawickie 1, PL-20059 Lublin, Poland..
    Silva Junior, Joao Manoel
    Univ Sao Paulo, BR-01246903 Sao Paulo, Brazil..
    Grion, Cintia M. C.
    Univ Estadual Londrina, BR-86057970 Londrina, Parana, Brazil..
    Burnett, Marjorie
    Sunnybrook Hlth Sci Ctr, Toronto, ON M4N 3M5, Canada..
    Mondrup, Frederik
    Rigshosp, DK-2100 Copenhagen, Denmark..
    Ravat, Francois
    CHU Lyon St Luc, F-69007 Lyon, France..
    Fontaine, Mathieu
    CHU Lyon St Luc, F-69007 Lyon, France..
    Le Floch, Renan
    CHU Nantes, Serv Anesthesie Reanimat Chirug, F-44093 Nantes, France..
    Jeanne, Mathieu
    CHRU Lille, Hop Roger Salengro, F-59037 Lille, France..
    Bacus, Morgane
    CHRU Lille, Hop Roger Salengro, F-59037 Lille, France..
    Chaussard, Maite
    St Louis Hosp, F-75010 Paris, France..
    Lehnhardt, Marcus
    BG Univ Hosp Bergmannsheil, D-44789 Bochum, Germany..
    Mikhail, Bassem Daniel
    BG Univ Hosp Bergmannsheil, D-44789 Bochum, Germany..
    Gille, Jochen
    St George Leipzig, D-04129 Leipzig, Germany..
    Sharkey, Aidan
    St James Univ Hosp, Dublin D08 NHY1, Ireland..
    Trommel, Nicole
    Maasstad Hosp, NL-3079 DZ Rotterdam, Netherlands..
    Reidinga, Auke C.
    Martini Hosp, NL-9728 NT Groningen, Netherlands..
    Vieleers, Nadine
    Red Cross Hosp, NL-1942 LE Beverwijk, Netherlands..
    Tilsley, Anna
    Middlemore Hosp, Auckland 2025, New Zealand..
    Onarheim, Henning
    Haukeland Hosp, N-5021 Bergen, Norway..
    Teresa Bouza, Maria
    Complexo Hosp Univ A Coruna, La Coruna 15006, Spain..
    Agrifoglio, Alexander
    La Paz Univ Hosp, Madrid 28046, Spain..
    Freden, Filip
    Uppsala Univ Hosp, S-75185 Uppsala, Sweden..
    Palmieri, Tina
    Univ Calif Davis, Sacramento, CA 95817 USA..
    Painting, Lynda E.
    Univ Calif Davis, Sacramento, CA 95817 USA..
    Schultz, Marcus J.
    Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands..
    Ventilation practices in burn patients-an international prospective observational cohort study2021Ingår i: BURNS & TRAUMA, ISSN 2321-3868, Vol. 9, artikel-id tkab034Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: It is unknown whether lung-protective ventilation is applied in burn patients and whether they benefit from it. This study aimed to determine ventilation practices in burn intensive care units (ICUs) and investigate the association between lung-protective ventilation and the number of ventilator-free days and alive at day 28 (VFD-28). Methods: This is an international prospective observational cohort study including adult burn patients requiring mechanical ventilation. Low tidal volume (V-T) was defined as V-T <= 8 mL/kg predicted body weight (PBW). Levels of positive end-expiratory pressure (PEEP) and maximum airway pressures were collected. The association between V-T and VFD-28 was analyzed using a competing risk model. Ventilation settings were presented for all patients, focusing on the first day of ventilation. We also compared ventilation settings between patients with and without inhalation trauma. Results: A total of 160 patients from 28 ICUs in 16 countries were included. Low V-T was used in 74% of patients, median V-T size was 7.3 [interquartile range (IQR) 6.2-8.3] mL/kg PBW and did not differ between patients with and without inhalation trauma (p= 0.58). Median VFD-28 was 17 (IQR 0-26), without a difference between ventilation with low or high V-T (p= 0.98). All patients were ventilated with PEEP levels >= 5 cmH(2)O; 80% of patients had maximum airway pressures <30 cmH(2)O. Conclusion: In this international cohort study we found that lung-protective ventilation is used in the majority of burn patients, irrespective of the presence of inhalation trauma. Use of low V-T was not associated with a reduction in VFD-28.

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  • 29.
    Glaumann, Christian
    et al.
    Akademiska sjukhuset, Uppsala.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Brännskador2018Ingår i: Svensk Kirurgi, ISSN 0346-847X, Vol. 76, nr 6, s. 314-317Artikel i tidskrift (Refereegranskat)
  • 30. Gonzalez, V
    et al.
    Lindblad, Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Renlund, M
    Rangsten, P
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    A first clinical verification of a radio frequency-based spectroscopy sensor intended for glucose detection in interstitial fluid.2017Ingår i: Diabetes Technology & Therapeutics, ISSN 1520-9156, E-ISSN 1557-8593, Vol. 19, nr S1Artikel i tidskrift (Refereegranskat)
  • 31.
    Greenhalgh, David G.
    et al.
    Shriners Childrens Northern Calif, Dept Burns, Sacramento, CA USA.;Univ Calif Davis, Dept Surg, Sacramento, CA USA.;Shriners Childrens Northern Calif, 2425 Stockton Blvd, Sacramento, CA 95817 USA..
    Hill, David M.
    Univ Tennessee, Hlth Sci Ctr, Coll Pharm, Dept Clin Pharm & Translat Scre, Memphis, TN USA..
    Burmeister, David M.
    Uniformed Serv Univ Hlth Sci, Dept Med, Bethesda, MD USA..
    Gus, Eduardo I.
    Hosp Sick Children, Div Plast & Reconstruct Surg, Toronto, ON, Canada.;Univ Toronto, Dept Surg, Toronto, ON, Canada..
    Cleland, Heather
    Monash Univ, Dept Surg, Melbourne, Vic 3181, Australia.;Alfred Hosp, Melbourne, Australia..
    Padiglione, Alex
    Monash Univ, Dept Surg, Melbourne, Vic 3181, Australia.;Alfred Hosp, Melbourne, Australia..
    Holden, Dane
    Monash Univ, Dept Surg, Melbourne, Vic 3181, Australia.;Alfred Hosp, Melbourne, Australia..
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, Uppsala, Sweden..
    Chew, Michelle S.
    Linköping Univ, Dept Anaesthesia & Intens Care, Biomed & Clin Sci, Linköping, Sweden..
    Kubasiak, John C.
    Loyola Univ, Dept Surg, Med Ctr, Maywood, IL USA..
    Burrell, Aidan
    Monash Univ, Dept Epidemiol & Preventat Med, Melbourne, Australia.;Alfred Hosp, Intens Care Res Ctr ANZIC RC, Melbourne, Australia..
    Manzanares, William
    Univ Republ UdelaR, Dept Crit Care Med, Montevideo, Uruguay..
    Gomez, Maria Chacon
    LGII, Natl Rehabil Inst, Ctr Nacl Invest & Atenc Quemados CENIAQ, Div Intens Care & Crit Med, Mexico City, Mexico..
    Yoshimura, Yuya
    Hachinohe Municipal Hosp, Dept Emergency & Crit Care Med, Hachinohe, Japan..
    Sjoberg, Folke
    Linköping Univ, Dept Anaesthesia & Intens Care, Biomed & Clin Sci, Linköping, Sweden..
    Xie, Wei-Guo
    Wuhan Univ, Wuhan Hosp 3, Tongren Hosp, Inst Burns, Wuhan, Peoples R China..
    Egipto, Paula
    Ctr Hosp & Univ Sao Joao, Burn Unit, Porto, Portugal..
    Lavrentieva, Athina
    Papanikolaou Hosp, Burn ICU, A ICU, Thessaloniki, Greece..
    Jain, Arpana
    Arizona Burn Ctr, Phoenix, AZ USA..
    Miranda-Altamirano, Ariel
    Hosp Civil Guadalajara, Guadalajara, Mexico..
    Raby, Ed
    Fiona Stanley Hosp, Infect Dis Dept, Murdoch, WA, Australia..
    Aramendi, Ignacio
    Ctr Nacl Quemados, Montevideo, Uruguay..
    Sen, Soman
    Shriners Childrens Northern Calif, Dept Burns, Sacramento, CA USA.;Univ Calif Davis, Dept Surg, Sacramento, CA USA..
    Chung, Kevin K.
    Uniformed Serv Univ Hlth Sci, Dept Med, Bethesda, MD USA..
    Alvarez, Renata Jennifer Quintana
    Pediat Burn Ctr, Santiago, Dominican Rep..
    Han, Chunmao
    Zhejiang Univ, Affiliated Hosp 2, Dept Burn & Wound Repair, Sch Med, Hangzhou, Peoples R China..
    Matsushima, Asako
    Nagoya City Univ, Grad Sch Med Sci, Dept Emergency Crit Care, Nagoya, Japan..
    Elmasry, Moustafa
    Linköping Univ, Dept Hand Plast Surg & Burns, Linköping, Sweden..
    Liu, Yan
    Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Burn, Shanghai, Peoples R China..
    Donoso, Carlos Segovia
    Mutual Secur Clin Hosp, Intens Care Unit Major Burns, Santiago, Chile..
    Bolgiani, Alberto
    Deutsch Hosp, Dept Surg, Buenos Aires, Argentina..
    Johnson, Laura S.
    Emory Univ, Sch Med, Dept Surg, Atlanta, GA USA.;Grady Hlth Syst, Atlanta, GA USA..
    Vana, Luiz Philipe Molina
    Univ Fed Sao Paulo, Escola Paulista Med, Disciplina Cirurgia Plast, Sao Paulo, Brazil..
    de Romero, Rosario Valdez Duval
    Pearl F Ort Burn Unit, Infect Dis Dept, Santo Domingo, Dominican Rep..
    Allorto, Nikki
    Univ KwaZulu Natal, Greys Hosp Pietermaritzburg, Metropolitan Burn Serv, Pietermaritzburg, South Africa..
    Abesamis, Gerald
    Univ Philippines Manila, Philippine Gen Hosp, Alfredo T Ramirez Burn Ctr, Dept Surg,Div Burns, Manila, Philippines..
    Luna, Virginia Nunez
    Secretaria Salud Ciudad Mexico, Unidad Michou & Mau Xochimilco Burnt Children, Mexico City, Mexico..
    Gragnani, Alfredo
    Fdn Santa Fe Bogota, Dept Pediat & Intens Care, Clin Studies & Clin Epidemiol Div, Pediat Burn Unit, Bogota, Colombia..
    Gonzalez, Carolina Bonilla
    Pediat Hosp Prof Dr Juan P Garrahan, Intens Care Area Burn Unit, Buenos Aires, Argentina..
    Basilico, Hugo
    Fiona Stanley Hosp, Dept Surg, Murdoch, WA, Australia..
    Wood, Fiona
    Univ Calif Irvine, Dept Surg, Irvine, CA USA..
    Jeng, James
    UCL, Dept Intens Care Med, London, England..
    Li, Andrew
    Monash Univ, Dept Surg, Melbourne, Vic 3181, Australia.;Alfred Hosp, Melbourne, Australia..
    Singer, Mervyn
    Army Third Mil Med Univ, Southwest Hosp, Inst Burn Res, Chongqing, Peoples R China..
    Luo, Gaoxing
    Med Univ South Carolina, South Carolina Burn Ctr, Dept Surg, Charleston, SC USA..
    Palmieri, Tina
    Shriners Childrens Northern Calif, Dept Burns, Sacramento, CA USA.;Univ Calif Davis, Dept Surg, Sacramento, CA USA..
    Kahn, Steven
    Sunnybrook Med Ctr, Dept Surg, Toronto, ON, Canada..
    Joe, Victor
    UCL, Dept Intens Care Med, London, England..
    Cartotto, Robert
    Sunnybrook Med Ctr, Dept Surg, Toronto, ON, Canada..
    Surviving Sepsis After Burn Campaign2023Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 49, nr 7, s. 1487-1524Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 32.
    Gustafson, Carl-Johan
    et al.
    Kirurgiska vetenskaper, KI.
    Birgisson, Agust
    Inst för Experimentell och Klinisk medicin, Linköping.
    Junker, Johan
    Inst för Experimentell och Klinisk medicin, Linköping.
    Huss, Fredrik
    Salemark, Lars
    Johnson, Hans
    Inst för Experimentell och Klinisk medicin, Linköping.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Employing human keratinocytes cultured on macroporous gelatin spheres to treat full thickness-wounds: an in vivo study on athymic rats.2007Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 33, nr 6, s. 726-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 33. Hastbacka, Johanna
    et al.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Hult, Maarit
    Bergquist, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Wilkman, Erika
    Vuola, Jyrki
    Sorsa, Timo
    Tervahartiala, Taina
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Matrix Metalloproteinases-8 and-9 and Tissue Inhibitor of Metalloproteinase-1 in Burn Patients. A Prospective Observational Study2015Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 10, nr 5, artikel-id e0125918Artikel i tidskrift (Refereegranskat)
    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.

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  • 34. Heyland, Daren K.
    et al.
    Wibbenmeyer, Lucy
    Pollack, Jonathan A.
    Friedman, Bruce
    Turgeon, Alexis F.
    Eshraghi, Niknam
    Jeschke, Marc G.
    Bélisle, Sylvain
    Grau, Daisy
    Mandell, Samuel
    Velamuri, Sai R.
    Hundeshagen, Gabriel
    Moiemen, Naiem
    Shokrollahi, Kayvan
    Foster, Kevin
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
    Collins, Declan
    Savetamal, Alisa
    Gurney, Jennifer M.
    Depetris, Nadia
    Stoppe, Christian
    Ortiz-Reyes, Luis
    Garrel, Dominique
    Day, Andrew G.
    A Randomized Trial of Enteral Glutamine for Treatment of Burn Injuries2022Ingår i: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 387, nr 11, s. 1001-1010Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND

    Glutamine is thought to have beneficial effects on the metabolic and stress response to severe injury. Clinical trials involving patients with burns and other critically ill patients have shown conflicting results regarding the benefits and risks of glutamine supplementation.

    METHODS

    In a double-blind, randomized, placebo-controlled trial, we assigned patients with deep second-or third-degree burns (affecting >= 10% to >= 20% of total body-surface area, depending on age) within 72 hours after hospital admission to receive 0.5 g per kilogram of body weight per day of enterally delivered glutamine or placebo. Trial agents were given every 4 hours through a feeding tube or three or four times a day by mouth until 7 days after the last skin grafting procedure, discharge from the acute care unit, or 3 months after admission, whichever came first. The primary outcome was the time to discharge alive from the hospital, with data censored at 90 days. We calculated subdistribution hazard ratios for discharge alive, which took into account death as a competing risk.

    RESULTS A total of 1209 patients with severe burns (mean burn size, 33% of total body-surface area) underwent randomization, and 1200 were included in the analysis (596 patients in the glutamine group and 604 in the placebo group). The median time to discharge alive from the hospital was 40 days (interquartile range, 24 to 87) in the glutamine group and 38 days (interquartile range, 22 to 75) in the placebo group (subdistribution hazard ratio for discharge alive, 0.91; 95% confidence interval [CI], 0.80 to 1.04; P = 0.17). Mortality at 6 months was 17.2% in the glutamine group and 16.2% in the placebo group (hazard ratio for death, 1.06; 95% CI, 0.80 to 1.41). No substantial between-group differences in serious adverse events were observed.

    CONCLUSIONS

    In patients with severe burns, supplemental glutamine did not reduce the time to discharge alive from the hospital.

  • 35.
    Holm, Sebastian
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Burn Centre, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85, Uppsala, Sweden.
    Engström, Olof
    Burn Centre, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85, Uppsala, Sweden.
    Melander, Marielle
    Division for Forensic Medicine in Uppsala, National Board of Forensic Medicine, Uppsala, Sweden.
    Horvath, Monika C.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin. Division for Forensic Medicine in Uppsala, National Board of Forensic Medicine, Uppsala, Sweden.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Department of Anesthesia and Intensive Care, Uppsala University Hospital, Uppsala, Sweden.
    Lipcsey, Miklós
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Department of Anesthesia and Intensive Care, Uppsala University Hospital, Uppsala, Sweden.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Burn Centre, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, 751 85, Uppsala, Sweden.
    Cutaneous steam burns and steam inhalation injuries: a literature review and a case presentation2022Ingår i: European journal of plastic surgery, ISSN 0930-343X, E-ISSN 1435-0130, Vol. 45, nr 6, s. 881-896Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Scald is one type of burn that s often mentioned alone and occurs mostly in the paediatric population. Inhaled steam is mostly cooled off in the airways, why thermal damage is rarely seen. A sudden exposure to hot steam/inhalation can cause a thermal inhalation injury. A scoping review was performed, with the aim to summarize all published papers in English, about steam-related injuries. The search was conducted using the PubMed (R) and Cochrane libraries on 19th of May 2021, without a set time period. Out of a total of 1186 identified records, 31 were chosen for review. Burns related to the contact with steam are generally rare and can be both minor and severe. The more severe cases related to steam exposure are mostly workplace accidents and the minor injuries reported in the literature are often related to steam inhalation therapy, especially in the paediatric population. This review describes the challenges that can be found dealing with patients suffering from cutaneous steam burns and/or steam inhalation injuries. A steam injury to the airways or the skin can be directly life-threatening and should be treated with caution. This type of injury can lead to acute respiratory insufficiency and sometimes death. A case of a male patient with extensive cutaneous steam burns and a steam inhalation injury who passed away after 11 days of treatment is also presented to illustrate this review. Level of evidence: Level V, Therapeutic; Risk/Prognostic Study.

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  • 36. Holm, Sebastian
    et al.
    Engström, Olof
    Petäjä, Ida
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Does the estimation of burn extent at admission differ from the assessment at discharge?2021Ingår i: Scars, burns & healing, ISSN 2059-5131, Vol. 7, artikel-id 20595131211019403Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Estimation of total body surface area (TBSA) burnt and burn depth are among the most central parts of acute burn assessment/treatment as they determine the level and type of care needed. Traditional methods for determining burn extent on admission often lead to inaccurate estimations, especially in paediatric or overweight patients.

    Aim: To compare %TBSA at admission with validated %TBSA at discharge in different patient populations to investigate if significant over- or underestimation occurs.

    Method: This retrospective observational study is based on a patient registry of all the patients (n = 863) treated at the Uppsala University Hospital's Burn Centre between 2010 and 2018. The patients were divided into subgroups based on age, gender, body mass index (BMI) and validated burn extent. The %TBSA estimated at admission was compared to the validated %TBSA in all groups separately.

    Results: As has been published before, we also found that the %TBSA in paediatric patients was more often overestimated as were the smaller injuries, whereas larger injuries were often underestimated. BMI did not clearly affect the estimations and there was no clear difference between the genders in estimated %TBSA.

    Conclusion: Inaccurate estimations of %TBSA are common, particularly for paediatric patients and small or large injuries. We recommend a careful accurate approach when calculating %TBSA in the paediatric population to avoid over- and under-resuscitation. Increased education and training are recommended to improve accurate estimation in the future.

    Lay Summary: The correct estimation of both extent and depth of burn is very important. This assessment guides the lever of care needed, the necessary amount of fluid resuscitation, the predicted outcome and more. It has been proven notably difficult to correct assess, especially the extent of a burn. Despite different tools as the "Rule of Nine" (body area divided into multiples of 9% body surfaces), the "Rule of Palm" (Patient's palm, fingers included, approximates 1% of body surfaces), the Lund & Browder chart (detailed, age-specific body areas) and different more technical solutions. Often inaccurate estimations are done which thus affect the treatment. This depth and extent estimation is usually performed when the patient is admitted. However, it is known that burns change appearance during the first few days of care. In our Burn Center we have also performed this estimation when the patient is discharged. At this point it is known the true extent and depth of the initial burn. In this retrospective observational study, we compared the burn extent estimated on admission with the one on discharge to investigate whether the initial assessment is accurate. This study highlights the issue of frequent inaccurate burn extent estimations, especially in subgroups as overweight patient or pediatric patients.

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  • 37.
    Holm, Sebastian
    et al.
    Uppsala Univ Hosp, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden..
    Tell, Katinka
    Uppsala Univ Hosp, Dept Emergency Care & Internal Med, Uppsala, Sweden..
    Karlsson, Matilda
    Linköping Univ, Dept Hand Surg Plast Surg & Burns, Linköping, Sweden..
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden..
    Pompermaier, Laura
    Linköping Univ, Dept Hand Surg Plast Surg & Burns, Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden..
    Elmasry, Moustafa
    Linköping Univ, Dept Hand Surg Plast Surg & Burns, Linköping, Sweden..
    Löfgren, Jenny
    Karolinska Inst, Dept Mol Med & Surg, Solna, Sweden.;Karolinska Univ Hosp, Dept Reconstruct Surg, Solna, Sweden..
    Sociodemographic Patterns of Pediatric Patients in Specialized Burn Care in Sweden2022Ingår i: Plastic and Reconstructive Surgery - Global Open, E-ISSN 2169-7574, Vol. 10, nr 4, artikel-id e4246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Trauma is a leading cause of mortality in children. Burns affect children disproportionally. Although burn incidence and mortality are decreasing, differences in the risk depend on socioeconomic status. The present study aimed to investigate the sociodemographic patterns of pediatric patients (0-17 years) managed at the two burn centers in Sweden. Uppsala, and Linkoping, between 2010 and 2020.

    Method: This retrospective register-based study used hospital records from the two burn centers combined with information front Statistics Sweden plus data regarding number of asylum seekers from the Swedish Migrations Agency. Choropleth maps representing the patients' geographical distribution were created. Information about income levels per geographic area was added. A Wilcoxon signed-rank test was performed to investigate differences in median income levels between the areas where the patients lived, related to Sweden's median income.

    Results: The study included 2455 patients. Most of the children aged below 5 years (76%) and were boys (60%). The mean percentage of total skin area was 4.2%. There was no significant increment or decrease in the incidence of pediatric burns during the study. Most patients with recorded zip codes lived in areas with an income level below the national median (n = 1974, 83%). Children with asylum status were over-represented compared with residents and/or Swedish citizens.

    Conclusions: In Sweden, most pediatric burns occur in families that live in areas with low-income levels. Pediatric burns affect children with asylum status disproportionally compared with those who are residents in and/or citizens of Sweden. Prevention strategies should be designed and implemented to alleviate this health inequity.

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  • 38.
    Holm, Sebastian
    et al.
    Uppsala Univ Hosp, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden..
    Thurfjell, Viktoria
    Uppsala Univ Hosp, Dept Clin Pathol & Cytol, Uppsala, Sweden..
    Lara-Valencia, Paola
    Uppsala Univ Hosp, Dept Clin Pathol & Cytol, Uppsala, Sweden..
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi. Uppsala Univ Hosp, Dept Plast & Maxillofacial Surg, Burn Ctr, Uppsala, Sweden..
    Purpura fulminans, TEN, and disseminated herpes simplex: An unexpected combination2022Ingår i: Clinical Case Reports, E-ISSN 2050-0904, Vol. 10, nr 4, artikel-id e05784Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and purpura fulminans (PF) are all rare conditions. A combination of these 3 conditions together with a viral infection is very rare. A 52-year-old, previously healthy woman which developed SJS, potentially due to a reaction to CT contrast, although this is still unknown. This developed into TEN on day 10 of the initial admission, the patient scored 3 points on SCORTEN. On day 12 from initial admission, she developed unexpected multiorgan failure and PF. The patient passed away 2 days later, the autopsy demonstrates herpes simplex virus in the bladder and lungs on immunohistological staining. Our clinical case encountered the challenge of differentiating TEN and PF. The microscopic and immunochemical examination confirmed the clinical suspicion of PF but also a disseminated herpes simplex infection. We speculate the clinical route of this case started SJS and TEN, leading to superimposed infection with three different types of bacteria, confirmed in blood cultures, and a disseminated viral infection. The combination of all these diagnoses are very rare, no similar case has been described in adults to the authors' knowledge. We recommend a prompt diagnosis and early recognition of both bacterial and viral infections to prevent the development of PF.

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  • 39. Horna Strand, A
    et al.
    Rubertsson, Sten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Mani, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Epidermal exfoliation of over 95 % after a burn in an 18-month-old boy: a case report and a literature review.2015Ingår i: Annals of Burns and Fire Disasters, ISSN 1121-1539, E-ISSN 1592-9558, Vol. 28Artikel i tidskrift (Refereegranskat)
  • 40. Horna Strand, Angelica
    et al.
    Rubertsson, Sten
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Mani, Maria
    EPIDERMAL EXFOLIATION OF OVER 95 % AFTER A BURN IN AN 18-MONTH-OLD BOY - A CASE REPORT AND A LITERATURE REVIEW2015Ingår i: Annals of Burns and Fire Disasters - vol. XXVIII – Supplement EBA - September 2015, 2015, Vol. 28Konferensbidrag (Refereegranskat)
  • 41.
    Horna Strand, Angelica
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Rubertsson, Sten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Mani, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Epidermal exfoliation of over 95% after a burn in an 18-month-old boy: Case report and review of the literature2016Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, nr 2, s. E18-E23Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

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

  • 42. Huss, Fredrik
    Brännskadornas incidens och prevalens2002Ingår i: Brännskador / [ed] Folke Sjöberg / Leif Östrup, Stokholm: Liber, 2002, 1, s. 17-21Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 43. Huss, Fredrik
    Challenges following the implementation of European Directive2004/23/EC regarding human tissues and cells in burn treatment2010Konferensbidrag (Refereegranskat)
  • 44.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Fire-Related Injury Mechanisms2023Ingår i: Residential Fire Safety: An Interdisciplinary Approach / [ed] Marcus Runefors, Ragnar Andersson, Mattias Delin, Thomas Gell, Springer Nature, 2023, s. 45-66Kapitel i bok, del av antologi (Refereegranskat)
  • 45. Huss, Fredrik
    In vitro and in vivo studies of tissue engineering in reconstructive plastic surgery2005Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Delarbeten
    1. Mammary epithelial cell and adipocyte co-culture in a 3-D matrix: the first step towards tissue-engineered human breast tissue.
    Öppna denna publikation i ny flik eller fönster >>Mammary epithelial cell and adipocyte co-culture in a 3-D matrix: the first step towards tissue-engineered human breast tissue.
    2001 (Engelska)Ingår i: Cells Tissues Organs, ISSN 1422-6405, E-ISSN 1422-6421, Vol. 169, nr 4Artikel i tidskrift (Refereegranskat) 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.

    Nationell ämneskategori
    Kirurgi
    Forskningsämne
    Plastikkirurgi
    Identifikatorer
    urn:nbn:se:uu:diva-286418 (URN)47903 (DOI)11490115 (PubMedID)
    Tillgänglig från: 2016-04-20 Skapad: 2016-04-20 Senast uppdaterad: 2017-11-30
    2. Adipose tissue processed for lipoinjection shows increased cellular survival in vitro when tissue engineering principles are applied.
    Öppna denna publikation i ny flik eller fönster >>Adipose tissue processed for lipoinjection shows increased cellular survival in vitro when tissue engineering principles are applied.
    2002 (Engelska)Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 0284-4311, E-ISSN 1651-2073, Vol. 36, nr 3, s. 166-71Artikel i tidskrift (Refereegranskat) 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.

    Nationell ämneskategori
    Kirurgi Cell- och molekylärbiologi
    Identifikatorer
    urn:nbn:se:uu:diva-162784 (URN)12141205 (PubMedID)
    Tillgänglig från: 2011-12-06 Skapad: 2011-12-05 Senast uppdaterad: 2022-06-29
    3. Characterization of a new degradable polymer scaffold for regeneration of the dermis: In vitro and in vivo human studies.
    Öppna denna publikation i ny flik eller fönster >>Characterization of a new degradable polymer scaffold for regeneration of the dermis: In vitro and in vivo human studies.
    Visa övriga...
    2008 (Engelska)Ingår i: Organogenesis, ISSN 1547-6278, Vol. 4, nr 3, s. 195-200Artikel i tidskrift (Refereegranskat) 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.

    Nationell ämneskategori
    Cell- och molekylärbiologi Kirurgi
    Identifikatorer
    urn:nbn:se:uu:diva-162772 (URN)19279733 (PubMedID)
    Tillgänglig från: 2011-12-06 Skapad: 2011-12-05 Senast uppdaterad: 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.
    Öppna denna publikation i ny flik eller fönster >>Macroporous gelatine spheres as culture substrate, transplantation vehicle, and biodegradable scaffold for guided regeneration of soft tissues. In vivo study in nude mice.
    2007 (Engelska)Ingår i: Journal of Plastic, Reconstructive & Aesthetic Surgery, ISSN 1748-6815, E-ISSN 1878-0539, Vol. 60, nr 5, s. 543-55Artikel i tidskrift (Refereegranskat) 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.

    Nationell ämneskategori
    Cell- och molekylärbiologi Kirurgi
    Identifikatorer
    urn:nbn:se:uu:diva-162776 (URN)10.1016/j.bjps.2005.10.031 (DOI)17399665 (PubMedID)
    Tillgänglig från: 2011-12-06 Skapad: 2011-12-05 Senast uppdaterad: 2022-05-02
    5. Use of macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration of healthy dermis in humans: an in vivo study.
    Öppna denna publikation i ny flik eller fönster >>Use of macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration of healthy dermis in humans: an in vivo study.
    2010 (Engelska)Ingår i: Journal of plastic, reconstructive & aesthetic surgery : JPRAS, ISSN 1878-0539, Vol. 63, nr 5, s. 848-57Artikel i tidskrift (Refereegranskat) 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.

    Nationell ämneskategori
    Cell- och molekylärbiologi Kirurgi
    Identifikatorer
    urn:nbn:se:uu:diva-162770 (URN)10.1016/j.bjps.2009.01.068 (DOI)19443282 (PubMedID)
    Tillgänglig från: 2011-12-06 Skapad: 2011-12-05 Senast uppdaterad: 2018-01-12
  • 46.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    The result after use of autologous and allogenic skin on patients with massive skin loss2014Konferensbidrag (Övrigt vetenskapligt)
  • 47.
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Where’s the cultured skin?2016Ingår i: European Cells and Materials, ISSN 1473-2262, E-ISSN 1473-2262, Vol. 31, nr Suppl. 1, s. 254-254Artikel i tidskrift (Övrigt vetenskapligt)
  • 48. Huss, Fredrik
    et al.
    Bak, Zoltan
    Nettelblad, Hans
    10% BSA concentrated formic acid burn to 1-year old child2010Konferensbidrag (Refereegranskat)
  • 49.
    Huss, Fredrik
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Erlandsson, Ulf
    Räddningsverket.
    Cooray, Vernon
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Tekniska sektionen, Institutionen för teknikvetenskaper, Elektricitetslära.
    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].2004Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, nr 28-29, s. 2328-31Artikel i tidskrift (Refereegranskat)
    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.

  • 50.
    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].2003Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 100, nr 13, s. 1137-9Artikel i tidskrift (Refereegranskat)
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