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

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

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

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

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

  • 2.
    Akerlund, Emma
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Huss, Fredrik R M
    Inst för Experimentell och Klinisk medicin, Linköping.
    Sjöberg, Folke
    Inst för Experimentell och Klinisk medicin, Linköping.
    Burns in Sweden: an analysis of 24,538 cases during the period 1987-2004.2007In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 33, no 1, p. 31-6Article in journal (Refereed)
    Abstract [en]

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

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

    SUMMARY

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

  • 4. Bergquist, M
    et al.
    Sveen, Josefin
    Huss, Fredrik
    Sjöberg, Folke
    Willebrand, Mimmie
    Psychological health andappearance after burns in children and adolescents aged 5-182010Conference paper (Refereed)
  • 5.
    Bergquist, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology. 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 University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, Uppsala, Sweden.
    Lipcsey, Miklós
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Hedenstierna laboratory.
    The time-course of the inflammatory response to major burn injury and its relation to organ failure and outcome2019In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, no 2, p. 354-363Article in journal (Refereed)
    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.

  • 6. Bergquist, Maria
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Fredén, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Hedenstierna, Göran
    Hästbacka, Johanna
    Rockwood, Alan
    Kushnir, Mark
    Bergquist, Jonas
    Altered adrenal and gonadal steroids biosynthesis in patients with burn injury2015Conference paper (Refereed)
  • 7. Bergquist, Maria
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Fredén, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Hedenstierna, Göran
    Hästbacka, Johanna
    Rockwood, Alan L.
    Kushnir, Mark M.
    Bergquist, Jonas
    Altered adrenal and gonadal steroids biosynthesis in patients with burn injury2016In: Clinical Mass Spectrometry, no 1, p. 19-26Article in journal (Refereed)
  • 8.
    Bergquist, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Hästbacka, Johanna
    Lindholm, Catharina
    Martijn, Cecile
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC.
    Rylander, Christian
    Hedenstierna, Göran
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Fredén, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Glucocorticoid receptor expression and binding capacity in patients with burn injury2016In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 60, no 2, p. 213-221Article in journal (Refereed)
    Abstract [en]

    Background

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

    Methods

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

    Results

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

    Conclusions

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

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

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

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

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

  • 12. Edlund, C
    et al.
    Karström, A
    Fransén, Jian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Optimization of storage conditions when banking autologous split-thickness skin grafts.2017In: Annals of Burns and Fire Disasters, ISSN 1121-1539, E-ISSN 1592-9558, Vol. 15Article in journal (Refereed)
  • 13. Edlund, C
    et al.
    Karström, A
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Microbiological control in banked autologous skin transplants at the Burn Centre in Uppsala University Hospital.2016Conference paper (Other academic)
  • 14. Eggert, E
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Medicinsk sårbarhet vid brand.: Vad vet vi om Bostads- och dödsbränder?2016Conference paper (Other academic)
  • 15. Eggert, Erik
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Medical and biological factors affecting mortality in elderly residential fire victims: a narrative review of the literature2017In: Scars, Burns & Healing, Vol. 3Article in journal (Refereed)
    Abstract [en]

    For older people (aged over 65 years), the risk of dying in a residential fire is doubled compared to the general population. Obvious causes of death mainly include smoke inhalation and burn injuries. That older people are more fragile and have more concurrent diseases is inherent, but what is it that makes them more vulnerable? It is known that the number of elderly people is increasing globally and that the increased risk of death in fires can be explained, at least in part, by physical and/or cognitive disabilities as well as socioeconomic and behavioural factors. The possibility that medical illnesses and an aging organism/tissues might explain this increased risk has not been shown to the same extent. Therefore, this narrative literature review focuses on medical and biological explanations. An initial search using the terms ‘elderly’, ‘fatal’, ‘residential’ and ‘fire’ yielded some interesting articles. Using a broader snowball search also accepting grey literature, several additional risk factors could be identified. Cardiovascular diseases, in particular atherosclerotic heart disease, greatly increases the vulnerability to, for example, carbon monoxide and probably also other asphyxiating gases. Cardiovascular diseases and lack of physical fitness may also increase vulnerability to heat. Burned elderly patients are also at a higher risk of death than younger patients, but it is controversial whether it is age itself or the pre-existing illnesses that come with age that increase the risk. Immunosenescence, malnutrition and female gender are other risk factors for poorer outcome after burns, all of which are common among older people.

  • 16. Engblom, K
    et al.
    Carlsson, C
    Eriksson, M
    Andersson, P
    Thalén, D
    Gerhardsson, L
    Lindblad, M
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Reaction after the use of xenograft dressings in burns: infection or inflammation?2018Conference paper (Other academic)
  • 17.
    Erlandsson, Ulf
    et al.
    Räddningsverket.
    Huss, Fredrik
    Inst för Experimentell och Klinisk medicin, Linköping.
    [Highly important during Christmas holidays. Elderly persons are overrepresented when it comes to candle light fires].2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, no 50, p. 3897-8Article in journal (Refereed)
  • 18.
    Fransen, Jian
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik R. M.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery. Univ Uppsala Hosp, Dept Plast & Maxillofacial Surg, Uppsala, Sweden..
    Nilsson, Lennart E.
    Linkoping Univ, Dept Clin & Expt Med, Clin Microbiol, Linkoping, Sweden..
    Rydell, Ulf
    Linkoping Univ, Inst Clin & Expt Med, Infect Dis, Linkoping, Sweden..
    Sjöberg, Folke
    Linkoping Univ, Inst Clin & Expt Med, Linkoping, Sweden..
    Hanberger, Håkan
    Linkoping Univ, Inst Clin & Expt Med, Infect Dis, Linkoping, Sweden..
    Surveillance of antibiotic susceptibility in a Swedish Burn Center 1994-20122016In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 6, p. 1295-1303Article in journal (Refereed)
    Abstract [en]

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

  • 19. Fransén, J
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Clinical Paired Randomized Double-Blinded Placebo Study Evaluating Topical Opioid-Gel on Donor Site Pain2016Conference paper (Other academic)
  • 20.
    Fransén, Jian
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Bastami, S
    Sjöberg, F
    Uppugunduri, S
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Clinical paired randomized double-blinded placebo study evaluating topical opioidgel on donor site pain.2016Conference paper (Other academic)
  • 21.
    Fransén, Jian
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    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 University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery. 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 trial2016In: International Journal of Surgery Open, ISSN 2405-8572, Vol. 4, p. 5-9Article in journal (Refereed)
    Abstract [en]

    Background

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

    Methods

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

    Results

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

    Conclusion

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

  • 22.
    Fransén, Jian
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Surveillance of Antibiotic Susceptibility in a Swedish Burn Center 1994-20122016Conference paper (Other academic)
  • 23.
    Fransén, Jian
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Nilsson, L
    Sjöberg, Folke
    Hanberger, Håkan
    Sustained Low Frequency ofAntibiotic-Resistant Pathogens on a Swedish Burn Unit 1994-20122017In: Burns, ISSN 0305-4179, E-ISSN 1879-1409Article in journal (Refereed)
  • 24.
    Fransén, Jian
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Nilsson, L.E
    Rydell, U
    Sjöberg, F
    Hanberger, H
    Surveillance of antibiotic susceptibility in a Swedish Burn Center 1994–2012.2016Conference paper (Other (popular science, discussion, etc.))
  • 25. Fredriksson, C.
    et al.
    Kratz, G.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Transplantation of cultured human keratinocytes: A comparative in vitro study of different application techniques2007Conference paper (Refereed)
  • 26. Fredriksson, Camilla
    et al.
    Hedhammar, My
    Feinstein, Ricardo
    Nordling, Kerstin
    Kratz, Gunnar
    Johansson, Jan
    Huss, Fredrik
    Rising, Anna
    Tissue Response to Subcutaneously Implanted Recombinant Spider Silk: An in Vivo Study2009In: Materials, ISSN 1996-1944, Vol. 2, no 4, p. 1908-1922Article in journal (Refereed)
    Abstract [en]

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

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

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

  • 28.
    Fredriksson, Camilla
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Huss, Fredrik
    Inst för Experimentell och Klinisk medicin, Linköping.
    Transplantation of cultured human keratinocytes in single cell suspension: a comparative in vitro study of different application techniques.2008In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 34, no 2, p. 212-9Article in journal (Refereed)
    Abstract [en]

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

  • 29.
    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 University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    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-up2019In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, no 4, p. 876-890Article in journal (Refereed)
    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.

  • 30.
    Garvin, Stina
    et al.
    Inst för Experimentell och Klinisk medicin, Linköping.
    Nilsson, Ulrika W
    Inst för Experimentell och Klinisk medicin, Linköping.
    Huss, Fredrik R M
    Inst för Experimentell och Klinisk medicin, Linköping.
    Kratz, Gunnar
    Inst för Experimentell och Klinisk medicin, Linköping.
    Dabrosin, Charlotta
    Inst för Experimentell och Klinisk medicin, Linköping.
    Estradiol increases VEGF in human breast studied by whole-tissue culture.2006In: Cell and Tissue Research, ISSN 0302-766X, E-ISSN 1432-0878, Vol. 325, no 2, p. 245-51Article in journal (Refereed)
    Abstract [en]

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

  • 31. Gonzalez, V
    et al.
    Lindblad, Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Renlund, M
    Rangsten, P
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    A first clinical verification of a radio frequency-based spectroscopy sensor intended for glucose detection in interstitial fluid.2017In: Diabetes Technology & Therapeutics, ISSN 1520-9156, E-ISSN 1557-8593, Vol. 19, no S1Article in journal (Refereed)
  • 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.2007In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 33, no 6, p. 726-35Article in journal (Refereed)
    Abstract [en]

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

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

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

  • 34. Horna Strand, A
    et al.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Analysis of 28 consecutive cases of severe bullous skin diseases in a burn centre and a review of the literature.2016Conference paper (Other academic)
  • 35. Horna Strand, A
    et al.
    Mani, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Långtidsmortalitet hos patienter med allvarlig bullös hudsjukdom.2016Conference paper (Other academic)
  • 36. Horna Strand, A
    et al.
    Rubertsson, Sten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Mani, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Epidermal exfoliation of over 95 % after a burn in an 18-month-old boy: a case report and a literature review.2015In: Annals of Burns and Fire Disasters, ISSN 1121-1539, E-ISSN 1592-9558, Vol. 28Article in journal (Refereed)
  • 37. Horna Strand, Angelica
    et al.
    Rubertsson, Sten
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Mani, Maria
    EPIDERMAL EXFOLIATION OF OVER 95 % AFTER A BURN IN AN 18-MONTH-OLD BOY - A CASE REPORT AND A LITERATURE REVIEW2015In: Annals of Burns and Fire Disasters - vol. XXVIII – Supplement EBA - September 2015, 2015, Vol. 28Conference paper (Refereed)
  • 38.
    Horna Strand, Angelica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Rubertsson, Sten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Mani, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Epidermal exfoliation of over 95% after a burn in an 18-month-old boy: Case report and review of the literature2016In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 2, p. E18-E23Article, review/survey (Refereed)
    Abstract [en]

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

  • 39. Horna-Strand, A
    et al.
    Mani, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Analysis of 28 Consecutive Cases of Severe Bullous Skin Diseases Over a 7-Year Period in One of Sweden's Two National Burn Centers and a Review of the Literature.2016Conference paper (Other academic)
  • 40. Huss, Fredrik
    Brännskadornas incidens och prevalens2002In: Brännskador / [ed] Folke Sjöberg / Leif Östrup, Stokholm: Liber, 2002, 1, p. 17-21Chapter in book (Other academic)
  • 41.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Burns in Sweden2017Conference paper (Other academic)
  • 42.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Catastrophe planning: Lessons learned following the Romanian night club fire2017Conference paper (Other academic)
  • 43. Huss, Fredrik
    Challenges following the implementation of European Directive2004/23/EC regarding human tissues and cells in burn treatment2010Conference paper (Refereed)
  • 44.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Dermal substitute in burn patients.2018Conference paper (Other academic)
  • 45.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Follow up of patients/home integrated care.2018Conference paper (Other academic)
  • 46. Huss, Fredrik
    In vitro and in vivo studies of tissue engineering in reconstructive plastic surgery2005Doctoral thesis, comprehensive summary (Other academic)
    List of papers
    1. Mammary epithelial cell and adipocyte co-culture in a 3-D matrix: the first step towards tissue-engineered human breast tissue.
    Open this publication in new window or tab >>Mammary epithelial cell and adipocyte co-culture in a 3-D matrix: the first step towards tissue-engineered human breast tissue.
    2001 (English)In: Cells Tissues Organs, ISSN 1422-6405, E-ISSN 1422-6421, Vol. 169, no 4Article in journal (Refereed) Published
    Abstract [en]

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

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

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

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

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

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

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

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

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

    National Category
    Cell and Molecular Biology Surgery
    Identifiers
    urn:nbn:se:uu:diva-162770 (URN)10.1016/j.bjps.2009.01.068 (DOI)19443282 (PubMedID)
    Available from: 2011-12-06 Created: 2011-12-05 Last updated: 2018-01-12
  • 47.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Modern wound treatment.2018Conference paper (Other academic)
  • 48.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    NexoBrid: From unmet need to common practice2016Conference paper (Other academic)
  • 49.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    NexoBrid vs. the unmet need.: In session: Industry-sponsored Symposium.2015Conference paper (Other academic)
  • 50.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Our experiences on the use of non-surgical methods for debridement: Swedish experiences in the development and maintenance of a national tissue establishment (and the use of biological dressings (xeno- and hetero), cultured keratinocytes in single-cell suspension transplanted in tissue glue).2016Conference paper (Other academic)
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