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Steinvall, Ingrid
Publications (10 of 33) Show all publications
Pompermaier, L., Steinvall, I., Elmasry, M., Thorfinn, J. & Sjöberg, F. (2018). Burned patients who die from causes other than the burn affect the model used to predict mortality: a national exploratory study. Burns, 44(2), 280-287
Open this publication in new window or tab >>Burned patients who die from causes other than the burn affect the model used to predict mortality: a national exploratory study
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2018 (English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 44, no 2, p. 280-287Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The Baux score - the sum of age and total body surface area burned (TBSA %) - is a good predictor of mortality has a high specificity but low sensitivity. Our aim was to examine the causes of death in patients who die with Baux scores of <100, which may explain the lower sensitivity and possibly affect the prediction of mortality.

METHODS: All patients admitted to our centre for burn care from 1993 to 2015 (n=1946) were included in this retrospective, descriptive, exploratory study. The study group comprised those patients who died with Baux scores of <100 (n=23), and their medical charts were examined for the cause of death and for coexisting diseases.

RESULTS: Crude mortality was 5% (93/1946) for the overall cohort, and a quarter of the patients who died (23/93) had Baux scores of less than 100 (range 64-99). In this latter group, flame burns were the most common (18/23), the median (10th-90th centile) age was 70 (46-86) years and for TBSA 21 (5.0-40.5) %, of which 7 (0-27.0) % of the area was full thickness. The main causes of death in 17 of the 23 were classified as "other than burn", being cerebral disease (n=9), cardiovascular disease (n=6), and respiratory failure (n=2). Among the remaining six (burn-related) deaths, multiple organ failure (predominantly renal failure) was responsible. When we excluded the cases in which the cause of death was not related to the burn, the Baux mortality prediction value improved (receiver operating characteristics area under the curve, AUC) from 0.9733 (95% CI 0.9633-0.9834) to 0.9888 (95% CI 0.9839-0.9936) and the sensitivity estimate increased from 45.2% to 53.9%.

CONCLUSION: Patients with burns who died with a Baux score <100 were a quarter of all the patients who died. An important finding is that most of these deaths were caused by reasons other than the burn, usually cerebrovascular disease. This may be the explanation why the sensitivity of the Baux score is low, as factors other than age and TBSA % explain the fatal outcome.

Place, publisher, year, edition, pages
Elsevier, 2018
Keyword
Baux score, Burns, Cause of death, Mortality
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-142898 (URN)10.1016/j.burns.2017.07.014 (DOI)000427535000006 ()28830698 (PubMedID)2-s2.0-85027674409 (Scopus ID)
Note

Funding agencies: Burn Centre, Department of Plastic Surgery, Hand Surgery, and Burns, Region Ostergotland; Linkoping University, Linkoping, Sweden

Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2018-04-12Bibliographically approved
Steinvall, I., Karlsson, M. & Elmasry, M. (2018). C-reactive protein response patterns after antibiotic treatment among children with scalds. Burns, 44, 718-723
Open this publication in new window or tab >>C-reactive protein response patterns after antibiotic treatment among children with scalds
2018 (English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 44, p. 718-723Article in journal (Refereed) Published
Abstract [en]

Background

Scalds are the most common cause of burns in children, yet there is little information available about the inflammatory response. The aim of the study was to investigate the response to treatment with antibiotics among scalded children by following the C-reactive protein (CRP) concentration, procalcitonin (PCT) concentration, and white blood cell count (WCC) during the first two weeks after injury.

Methods

All children with scalds who presented to the Burn Centre during 2010–2016 were included in this retrospective study. All measurements of CRP, PCT, and WCC from the first 14 days after injury were recorded, and each patient’s maximum values during days 0–2, 3–7, and 8–14 were used for calculations. Multivariable regression for panel data was used to study the inflammatory response after antibiotic treatment.

Results

A total of 216 children were included. C-reactive protein was 45 mg/L (p < 0.001) higher in the group treated with antibiotics, and decreased with 8.8 mg/L per day over the studied time in this group, which was more than twice as fast as among the children who were not given antibiotics.

Conclusion

The CRP response, among children with minor scalds treated with antibiotics, shows an appreciable rise during the first week of injury that subsided rapidly during the second week.

Place, publisher, year, edition, pages
Pergamon Press, 2018
Keyword
Burns, C-reactive protein, Inflammatory response, Procalcitonin, White blood cell count, Antibiotics
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-147069 (URN)10.1016/j.burns.2017.10.023 (DOI)29571718 (PubMedID)2-s2.0-85044143191 (Scopus ID)
Available from: 2018-04-11 Created: 2018-04-11 Last updated: 2018-04-20
Larsen, R., Bäckström, D., Fredrikson, M., Steinvall, I., Gedeborg, R. & Sjöberg, F. (2018). Decreased risk adjusted 30-day mortality for hospital admitted injuries: a multi-centre longitudinal study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 26(1), Article ID 24.
Open this publication in new window or tab >>Decreased risk adjusted 30-day mortality for hospital admitted injuries: a multi-centre longitudinal study
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2018 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 26, no 1, article id 24Article in journal (Refereed) Published
Abstract [en]

Background: The interpretation of changes in injury-related mortality over time requires an understanding of changes in the incidence of the various types of injury, and adjustment for their severity. Our aim was to investigate changes over time in incidence of hospital admission for injuries caused by falls, traffic incidents, or assaults, and to assess the risk-adjusted short-term mortality for these patients.less thanbr /greater thanMethods: All patients admitted to hospital with injuries caused by falls, traffic incidents, or assaults during the years 2001-11 in Sweden were identified from the nationwide population-based Patient Registry. The trend in mortality over time for each cause of injury was adjusted for age, sex, comorbidity and severity of injury as classified from the International Classification of diseases, version 10 Injury Severity Score (ICISS).less thanbr /greater thanResults: Both the incidence of fall (689 to 636/100000 inhabitants: p = 0.047, coefficient - 4.71) and traffic related injuries (169 to 123/100000 inhabitants: p less than 0.0001, coefficient - 5.37) decreased over time while incidence of assault related injuries remained essentially unchanged during the study period. There was an overall decrease in risk-adjusted 30-day mortality in all three groups (OR 1.00; CI95% 0.99-1.00). Decreases in traffic (OR 0.95; 95% CI 0.93 to 0.97) and assault (OR 0.93; 95% CI 0.87 to 0.99) related injuries was significant whereas falls were not during this 11-year period.less thanbr /greater thanDiscussion: Risk-adjustment is a good way to use big materials to find epidemiological changes. However after adjusting for age, year, sex and risk we find that a possible factor is left in the pre- and/or in-hospital care.less thanbr /greater thanConclusions: The decrease in risk-adjusted mortality may suggest changes over time in pre- and/or in-hospital care. A non-significantdecrease in risk-adjusted mortality was registered for falls, which may indicate that low-energy trauma has not benefited for the increased survivability as much as high-energy trauma, ie traffic- and assault related injuries.

National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-146965 (URN)10.1186/s13049-018-0485-2 (DOI)29615089 (PubMedID)
Available from: 2018-04-09 Created: 2018-04-09 Last updated: 2018-04-25
Abdelrahman, I., Steinvall, I., Mossaad, B., Sjöberg, F. & Elmasry, M. (2018). Evaluation of Glandular Liposculpture as a Single Treatment for Grades I and II Gynaecomastia. Aesthetic Plastic Surgery, 1-9
Open this publication in new window or tab >>Evaluation of Glandular Liposculpture as a Single Treatment for Grades I and II Gynaecomastia
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2018 (English)In: Aesthetic Plastic Surgery, ISSN 0364-216X, E-ISSN 1432-5241, p. 1-9Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background

Gynaecomastia is a benign enlargement of the male breast, of which the psychological burden on the patient can be considerable, with the increased risk of disorders such as depression, anxiety, and social phobia. Minimal scarring can be achieved by liposuction alone, though it is known to have a limited effect on the dense glandular and fibroconnective tissues. We know of few studies published on “liposuction alone”, so we designed this study to evaluate the outcome of combining liposuction with glandular liposculpturing through two axillary incisions as a single treatment for the management of grades I and II gynaecomastia.

Methods

We made a retrospective analysis of 18 patients with grade I or II gynaecomastia who were operated on by combined liposuction and glandular liposculpturing using a fat disruptor cannula, without glandular excision, during the period 2014–2016. Patient satisfaction was assessed using the Breast Evaluation Questionnaire (BEQ), which is a 5-point Likert scale (1 = very dissatisfied; 2 = dissatisfied; 3 = neither; 4 = satisfied; 5 = very satisfied). The post-operative aesthetic appearance of the chest was evaluated by five independent observers on a scale from 1 to 5 (5 = considerable improvement).

Results

The patient mean (SD) overall satisfaction score was 4.7 (0.7), in which 92% of the responders were “satisfied” to “very satisfied”. The mean (SD) BEQ for all questions answered increased from 2.1 (0.2) “dissatisfied” preoperatively to 4.1 (0.2) “satisfied” post-operatively. The observers’ mean (SD) rate for the improvement in the shape of the front chest wall was 4.1 (0.7). No haematomas were recorded, one patient developed a wound infection, and two patients complained of remnants of tissue. The median (IQR) body mass index was 27.4 (26.7–29.4), 11 patients had gynaecomastia grade I, and 7 patients grade II. The median (IQR) volume of aspirated fat was 700 ml (650–800), operating time was 67 (65–75) minutes, 14 patients had general anaesthesia, and hospital charges were US$ 538 (481–594).

Conclusions

Combined liposuction and liposculpturing using the fat disruptor cannula resulted in satisfied patients and acceptable outcomes according to the observers’ ratings. It could be a useful alternative with an outcome that corresponds to that of more expensive methods.

Place, publisher, year, edition, pages
Springer, 2018
Keyword
Gynaecomastia, Liposculpture, Liposuction, Patient satisfaction
National Category
Surgery Gastroenterology and Hepatology Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-146046 (URN)10.1007/s00266-018-1118-x (DOI)29549405 (PubMedID)
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2018-04-13Bibliographically approved
Karlsson, M., Elmasry, M., Steinvall, I., Sjöberg, F., Olofsson, P. & Thorfinn, J. (2018). Scarring At Donor Sites After Split-Thickness Skin Graft: A Prospective, Longitudinal, Randomized Trial. Advances in Skin & Wound Care, 3(4), 183-188
Open this publication in new window or tab >>Scarring At Donor Sites After Split-Thickness Skin Graft: A Prospective, Longitudinal, Randomized Trial
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2018 (English)In: Advances in Skin & Wound Care, ISSN 1527-7941, E-ISSN 1538-8654, Vol. 3, no 4, p. 183-188Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim of this study was to evaluate scarring at split-thickness skin graft donor sites 8 years after surgery.

METHODS: At surgery, 67 patients were randomized to hydrofiber, polyurethane foam, or porcine xenograft treatment. Scars were evaluated with the Patient and Observer Scar Assessment Scale.

RESULTS: Results showed significant differences in observed scar outcomes at donor sites, leaving the polyurethane foam–treated and the porcine xenograft–treated patients with the least satisfying scars. Multivariable regression analysis showed that the group treated with the xenografts had worse scores for overall opinion of the scar than did the other groups (P = .03), the most important factor being pigmentation. There was no correlation between duration of healing time and quality of the scar.

CONCLUSIONS: There were significant differences among the groups, with the hydrofiber group being the most satisfied with the appearance of their scar.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
National Category
Surgery Otorhinolaryngology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-146085 (URN)10.1097/01.ASW.0000530684.31491.5f (DOI)29561343 (PubMedID)
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-04-11Bibliographically approved
Abdelrahman, I., Elmasry, M., Fredrikson, M. & Steinvall, I. (2018). Validation of the burn intervention score in a National Burn Centre. Burns
Open this publication in new window or tab >>Validation of the burn intervention score in a National Burn Centre
2018 (English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409Article in journal (Refereed) In press
Abstract [en]

The Linköping burn score has been used for two decades to calculate the cost to the hospital of each burned patient. Our aim was to validate the Burn Score in a dedicated Burn Centre by analysing the associations with burn-specific factors: percentage of total body surface area burned (TBSA%), cause of injury, patients referred from other (non-specialist) centres, and survival, to find out which of these factors resulted in higher scores. Our second aim was to analyse the variation in scores of each category of care (surveillance, respiration, circulation, wound care, mobilisation, laboratory tests, infusions, and operation).

We made a retrospective analysis of all burned patients admitted during the period 2000–15. Multivariable regression models were used to analyse predictive factors for an increased daily burn score, the cumulative burn score (the sum of the daily burn scores for each patient) and the total burn score (total sum of burn scores for the whole group throughout the study period) in addition to sub-analysis of the different categories of care that make up the burn score.

We retrieved 22 301 daily recordings for inpatients. Mobilisation and care of the wound accounted for more than half of the total burn score during the study. Increased TBSA% and age over 45 years were associated with increased cumulative (model R2 0.43, p < 0.001) and daily (model R2 0.61, p < 0.001) burn scores. Patients who died had higher daily burn scores, while the cumulative burn score decreased with shorter duration of hospital stay (p < 0.001).

To our knowledge this is the first long term analysis and validation of a system for scoring burn interventions in patients with burns that explores its association with the factors important for outcome. Calculations of costs are based on the score, and it provides an indicator of the nurses’ workload. It also gives important information about the different dimensions of the care provided from thorough investigation of the scores for each category.

Place, publisher, year, edition, pages
Elsevier, 2018
Keyword
Burn intervention score; Validation; Workload
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-145311 (URN)10.1016/j.burns.2018.02.001 (DOI)29475745 (PubMedID)2-s2.0-85042192631 (Scopus ID)
Available from: 2018-02-22 Created: 2018-02-22 Last updated: 2018-02-28Bibliographically approved
Bäckström, D., Steinvall, I. & Sjöberg, F. (2017). Change in child mortality patterns after injuries in Sweden: a nationwide 14-year study.. European Journal of Trauma and Emergency Surgery, 43(3), 343-349
Open this publication in new window or tab >>Change in child mortality patterns after injuries in Sweden: a nationwide 14-year study.
2017 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 43, no 3, p. 343-349Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Sweden has one of the world's lowest child injury mortality rates, but injuries are still the leading cause of death among children. Child injury mortality in the country has been declining, but this decline seems to decrease recently. Our objective was therefore to further examine changes in the mortality of children's death from injury over time and to assess the contribution of various effects on mortality. The underlying hypothesis for this investigation is that the incidence of lethal injuries in children, still is decreasing and that this may be sex specific.

PATIENTS AND METHODS: We studied all deaths from injury in Sweden under-18-year-olds during the 14 years 1999-2012. We identified those aged under 18 whose underlying cause of death was recorded as International Classification of Diseases, 10th Revision (ICD-10) diagnosis from V01 to X39 in the Swedish cause of death, where all dead citizens are registered.

RESULTS: From the 1 January 1999 to 31 December 2012, 1213 children under the age of 18 died of injuries in Sweden. The incidence declined during this period (r = -0.606, p = 0.02) to 3.3 deaths/100,000 children-years (95 % CI 2.6-4.2). Death from unintentional injury was more common than that after intentional injury (p < 0.0001). There was a reduction in the incidence of unintentional injuries during the study period (r = -0.757, p = 0.03). The most common causes of death were injury to the brain (n = 337, 41 %), followed by drowning (n = 109, 13 %). The number of deaths after intentional injury increased (r = 0.585, p = 0.03) and at the end of the period was 1.5 deaths/100,000 children-years. The most common causes of death after intentional injuries were asphyxia (n = 177, 45 %), followed by injury to the brain (n = 76, 19 %).

DISCUSSION: Mortality patterns in injured children in Sweden have changed from being dominated by unintentional injuries to a more equal distribution between unintentional and intentional injuries as well as between sexes and the overall rate has declined further. These findings are important as they might contribute to the preventive work that is being done to further reduce mortality in injured children.

Place, publisher, year, edition, pages
Springer, 2017
Keyword
Children, Injury, Mortality, Scandinavia, Trauma
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-135548 (URN)10.1007/s00068-016-0660-y (DOI)000402789500010 ()27084542 (PubMedID)
Note

Funding agencies: Swedish Carnegie Hero Fund

Available from: 2017-03-16 Created: 2017-03-16 Last updated: 2017-11-02Bibliographically approved
Bäckström, D., Larsen, R., Steinvall, I., Fredrikson, M., Gedeborg, R. & Sjöberg, F. (2017). Deaths caused by injury among people of working age (18-64) are decreasing, while those among older people (64+) are increasing. European Journal of Trauma and Emergency Surgery
Open this publication in new window or tab >>Deaths caused by injury among people of working age (18-64) are decreasing, while those among older people (64+) are increasing
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2017 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Injury is an important cause of death in all age groups worldwide, and contributes to many losses of human and economic resources. Currently, we know a few data about mortality from injury, particularly among the working population. The aim of the present study was to examine death from injury over a period of 14 years (1999-2012) using the Swedish Cause of Death Registry (CDR) and the National Patient Registry, which have complete national coverage.

METHOD: CDR was used to identify injury-related deaths among adults (18 years or over) during the years 1999-2012. ICD-10 diagnoses from V01 to X39 were included. The significance of changes over time was analyzed by linear regression.

RESULTS: The incidence of prehospital death decreased significantly (coefficient -0.22, r (2) = 0.30; p = 0.041) during the study period, while that of deaths in hospital increased significantly (coefficient 0.20, r (2) = 0.75; p < 0.001). Mortality/100,000 person-years in the working age group (18-64 years) decreased significantly (coefficient -0.40, r (2) = 0.37; p = 0.020), mainly as a result of decrease in traffic-related deaths (coefficient -0.34, r (2) = 0.85; p < 0.001). The incidence of deaths from injury among elderly (65 years and older) patients increased because of the increase in falls (coefficient 1.71, r (2) = 0.84; p < 0.001) and poisoning (coefficient 0.13, r (2) = 0.69; p < 0.001).

CONCLUSION: The epidemiology of injury in Sweden has changed during recent years in that mortality from injury has declined in the working age group and increased among those people 64 years old and over.

Place, publisher, year, edition, pages
Springer, 2017
Keyword
Elderly, Injury, Mortality, Prehospital, Trauma, Working age
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-142763 (URN)10.1007/s00068-017-0827-1 (DOI)28825159 (PubMedID)2-s2.0-85027836250 (Scopus ID)
Available from: 2017-11-02 Created: 2017-11-02 Last updated: 2018-03-08Bibliographically approved
Abdelrahman, I., Elmasry, M., Olofsson, P., Steinvall, I., Fredrikson, M. & Sjöberg, F. (2017). Division of overall duration of stay into operative stay and postoperative stay improves the overall estimate as a measure of quality of outcome in burn care.. PLoS ONE, 12(3), Article ID e0174579.
Open this publication in new window or tab >>Division of overall duration of stay into operative stay and postoperative stay improves the overall estimate as a measure of quality of outcome in burn care.
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 3, article id e0174579Article in journal (Refereed) Published
Abstract [en]

Patients and Methods: Surgically managed burn patients admitted between 2010-14 were included. Operative stay was defined as the time from admission until the last operation, postoperative stay as the time from the last operation until discharge. The difference in variation was analysed with F-test. A retrospective review of medical records was done to explore reasons for extended postoperative stay. Multivariable regression was used to assess factors associated with operative stay and postoperative stay.less thanbr /greater thanResults: Operative stay/TBSA% showed less variation than total duration/TBSA% (F test = 2.38, pless than0.01). The size of the burn, and the number of operations, were the independent factors that influenced operative stay (R2 0.65). Except for the size of the burn other factors were associated with duration of postoperative stay: wound related, psychological and other medical causes, advanced medical support, and accommodation arrangements before discharge, of which the two last were the most important with an increase of (mean) 12 and 17 days (pless than0.001, R2 0.51).less thanbr /greater thanConclusion: Adjusted operative stay showed less variation than total hospital stay and thus can be considered a more accurate outcome measure for surgically managed burns. The size of burn and number of operations are the factors affecting this outcome measure.

Place, publisher, year, edition, pages
Public Library of Science, 2017
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-136275 (URN)10.1371/journal.pone.0174579 (DOI)000399175000022 ()
Note

Funding agencies: Burn Centre, Department of Plastic Surgery, Hand Surgery, and Burns; Linkoping University, Linkoping, Sweden

Available from: 2017-04-05 Created: 2017-04-05 Last updated: 2017-11-29
Abdelrahman, I., Elmasry, M., Steinvall, I., Fredrikson, M. & Sjöberg, F. (2017). Improvement in mortality at a National Burn Centre since 2000: Was it the result of increased resources?. Medicine (Baltimore, Md.), 96(25), Article ID e6727.
Open this publication in new window or tab >>Improvement in mortality at a National Burn Centre since 2000: Was it the result of increased resources?
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2017 (English)In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 96, no 25, article id e6727Article in journal (Refereed) Published
Abstract [en]

Abstract The aim of this study was to find out whether the charging costs (calculated using interventional burn score) increased as mortality decreased. During the last 2 decades, mortality has declined significantly in the Linköping Burn Centre. The burn score that we use has been validated as a measure of workload and is used to calculate the charging costs of each burned patient. We compared the charging costs and mortality in 2 time periods (2000–2007 and 2008–2015). A total of 1363 admissions were included. We investigated the change in the burn score, as a surrogate for total costs per patient. Multivariable regression was used to analyze risk-adjusted mortality and burn score. The median total body surface area % (TBSA%) was 6.5% (10–90 centile 1.0–31.0), age 33 years (1.3–72.2), duration of stay/ TBSA% was 1.4 days (0.3–5.3), and 960 (70%) were males. Crude mortality declined from 7.5% in 2000–2007 to 3.4% in 2008–2015, whereas the cumulative burn score was not increased (P=.08). Regression analysis showed that risk-adjusted mortality decreased (odds ratio 0.42, P=.02), whereas the adjusted burn score did not change (P=.14, model R2 0.86). Mortality decreased but there was no increase in the daily use of resources as measured by the interventional burn score. The data suggest that the improvements in quality obtained have been achieved within present routines for care of patients (multidisciplinary/ orientated to patients’ safety).

Abbreviation: TBSA% = total body surface area %.

Place, publisher, year, edition, pages
Wolters Kluwer, 2017
Keyword
burn, cost, hospital billing charge, interventional score, mortality, resources, survival
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-138833 (URN)10.1097/md.0000000000006727 (DOI)000404116900001 ()28640072 (PubMedID)
Note

Funding agencies: Department of Plastic and Hand Surgery Linkoping University Hospital; Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden

Available from: 2017-06-26 Created: 2017-06-26 Last updated: 2018-03-27
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