liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Olofsson, Pia
Alternative names
Publications (10 of 14) Show all publications
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
Show others...
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)000435188200008 ()29561343 (PubMedID)
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2019-04-11Bibliographically approved
Abdelrahman, I., Elmasry, M., Steinvall, I., Olofsson, P., Nettelblad, H. & Zdolsek, J. (2018). Versatility of the Extensor Digitorum Brevis Muscle Flap in Lower Limb Reconstruction. Plastic and Reconstructive Surgery – Global Open, 6(12), Article ID e2071.
Open this publication in new window or tab >>Versatility of the Extensor Digitorum Brevis Muscle Flap in Lower Limb Reconstruction
Show others...
2018 (English)In: Plastic and Reconstructive Surgery – Global Open, E-ISSN 2169-7574, Vol. 6, no 12, article id e2071Article in journal (Refereed) Published
Abstract [en]

Background: Reconstruction of complex defects in the lower leg is a challenge. Although microvascular free tissue transfer is a popular technique, experience and available resources limit its use. Furthermore, free tissue transfer is not always required in the reconstruction of small lower leg defects, as many of them can be reconstructed with local alternatives such as an extensor digitorum brevis flap (EDB). Our aim was to describe our experience of the last 20 years with the EDB as a local muscle flap to cover small complex lower leg defects to establish its clinical feasibility and to document its associated complications. Methods: All adult patients who were operated with EDB flap reconstruction of the lower limb during 1997–2017 at the Department of Hand and Plastic Surgery, Linköping University Hospital, were included in this retrospective study. Results: Of 64 patients operated, only 7 had total flap failure, and the rate of complete success was 73% (47/64). Most of the skin defects were associated with fractures or complications thereof and were located in the ankle region, the dorsum of the foot, and the distal third of tibia or even the proximal tibia. Defects in the malleolar region and coexisting cardiovascular condition were factors associated with flap loss (either partial or total). Conclusion: The pedicled EDB-flap has, in our hands, proved to be a versatile and safe reconstructive option in the reconstruction of small defects in the lower leg and foot. Long-time follow-up is, however, recommended. 

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-153635 (URN)10.1097/GOX.0000000000002071 (DOI)
Available from: 2019-01-06 Created: 2019-01-06 Last updated: 2019-04-12
Zötterman, J., Elmasry, M. & Olofsson, P. (2017). Braskaminer kan orsaka svåra brännskador hos små barn. Läkartidningen, 2017(19), 873-873
Open this publication in new window or tab >>Braskaminer kan orsaka svåra brännskador hos små barn
2017 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 2017, no 19, p. 873-873Article in journal, Editorial material (Other academic) Published
Abstract [en]

[No abstract available]

Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag AB, 2017
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-147504 (URN)28485762 (PubMedID)2-s2.0-85019171501 (Scopus ID)
Available from: 2018-05-01 Created: 2018-05-01 Last updated: 2018-05-04Bibliographically 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.
Show others...
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
Elmasry, M., Steinvall, I., Thorfinn, J., Abdelrahman, I., Olofsson, P. & Sjöberg, F. (2017). Staged excisions of moderate-sized burns compared with total excision with immediate autograft: an evaluation of two strategies.. International journal of burns and trauma, 7(1), 6-11
Open this publication in new window or tab >>Staged excisions of moderate-sized burns compared with total excision with immediate autograft: an evaluation of two strategies.
Show others...
2017 (English)In: International journal of burns and trauma, ISSN 2160-2026, Vol. 7, no 1, p. 6-11Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Different surgical techniques have evolved since excision and autografting became the treatment of choice for deep burns in the 1970s. The treatment plan at the Burn Center, Linköping University Hospital, Sweden, has shifted from single-stage excision and immediate autografting to staged excisions and temporary cover with xenografts before autografting. The aim of this study was to find out if the change in policy resulted in extended duration of hospital stay/total body surface area burned (LOS/TBSA%).

METHODS: Retrospective clinical cohort including surgically-managed patients with burns of 15%-60% TBSA% within each treatment group. The first had early full excisions of deep dermal and full thickness burns and immediate autografts (1997-98), excision and immediate autograft group) and the second had staged excisions before final autografts using xenografts for temporary cover (2010-11, staged excision group).

RESULTS: The study included 57 patients with deep dermal and full-thickness burns, 28 of whom had excision and immediate autografting, and 29 of whom had staged excisions with xenografting before final autografting. Adjusted (LOS/TBSA%) was close to 1, and did not differ between groups. Mean operating time for the staged excision group was shorter and the excised area/operation was smaller. The total operating time/TBSA% did not differ between groups.

CONCLUSION: Staged excisions with temporary cover did not affect adjusted LOS/TBSA% or total operating time. Staged excisions may be thought to be more expensive because of the cost of covering the wound between stages, but this needs to be further investigated as do the factors that predict long term outcome.

Place, publisher, year, edition, pages
E-Century Publishing Corporation, 2017
Keywords
Burn surgery, moderate sized burns, xenografts
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-135745 (URN)28123862 (PubMedID)
Available from: 2017-03-20 Created: 2017-03-20 Last updated: 2018-05-03Bibliographically approved
Elmasry, M., Steinvall, I., Thorfinn, J., Olofsson, P., Abbas, A., Abdelrahman, I., . . . Sjöberg, F. (2016). Temporary coverage of burns with a xenograft and sequential excision, compared with total early excision and autograft. Annals of burns and fire disasters, 29(3), 196-201
Open this publication in new window or tab >>Temporary coverage of burns with a xenograft and sequential excision, compared with total early excision and autograft
Show others...
2016 (English)In: Annals of burns and fire disasters, ISSN 1592-9558, Vol. 29, no 3, p. 196-201Article in journal (Refereed) Published
Abstract [en]

During the 80s and 90s, early and total excision of full thickness burns followed by immediate autograft was the most common treatment, with repeated excision and grafting, mostly for failed grafts. It was hypothesized, therefore, that delayed coverage with an autograft preceded by a temporary xenograft after early and sequential smaller excisions would lead to a better wound bed with fewer failed grafts, a smaller donor site, and possibly also a shorter duration of stay in hospital. We carried out a case control study with retrospective analysis from our National Burn Centre registry for the period 1997-2011. Patients who had been managed with early total excision and autograft were compared with those who had had sequential smaller excisions covered with temporary xenografts until the burn was ready for the final autograft. The sequential excision and xenograft group (n=42) required one-third fewer autografts than patients in the total excision and autograft group (n=45), who needed more than one operation (p<0.001). We could not detect any differences in duration of stay in hospital / total body surface area burned% (duration of stay/TBSA%) (2.0 and 1.8) (p=0.83). The two groups showed no major differences in terms of adjusted duration of stay, but our findings suggest that doing early, smaller, sequential excisions using a xenograft for temporary cover can result in shorter operating times, saving us the trouble of making big excisions. However, costs tended to be higher when the burns were > 25% TBSA.

Place, publisher, year, edition, pages
Mediterranean Council for Burns and Fire Disasters, 2016
Keywords
autograft, burn surgery, sequential excision, total early excision, xenograft
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-137912 (URN)28149249 (PubMedID)
Available from: 2017-06-01 Created: 2017-06-01 Last updated: 2018-07-03
Gimm, O., Arnesson, L.-G., Olofsson, P., Morales, O. & Juhlin, C. (2012). Super-selective venous sampling in conjunction with quickPTH for patients with persistent primary hyperparathyroidism: report of five cases. Surgery today (Print), 42(6), 570-576
Open this publication in new window or tab >>Super-selective venous sampling in conjunction with quickPTH for patients with persistent primary hyperparathyroidism: report of five cases
Show others...
2012 (English)In: Surgery today (Print), ISSN 0941-1291, E-ISSN 1436-2813, Vol. 42, no 6, p. 570-576Article in journal (Refereed) Published
Abstract [en]

Selective venous sampling (SVS) helps to interpret imaging results in patients with persistent primary hyperparathyroidism (pHPT). However, one of the drawbacks of conventional SVS may be low "spatial resolution", depending on the sample size. We modified SVS in the following way: first, patients underwent conventional SVS with up to 11 parathyroid hormone (PTH) samples taken. The quickPTH assay was used to measure PTH levels. The patients subsequently underwent super-selective venous sampling (super-SVS) in the region with the highest quickPTH level in the same session. The subjects were five consecutive patients with persistent pHPT investigated by various imaging techniques, none of which was considered conclusive. Therefore, all five patients underwent super-SVS, which was done successfully in four. Re-evaluation of the imaging results of these four patients resulted in localization of the parathyroid adenoma. Curative surgery was performed successfully in all four patients during the study period. Super-SVS increases the "spatial resolution" of conventional SVS and may have advantages when imaging results of patients with persistent pHPT are interpreted. Its true value must be analyzed in larger studies.

Place, publisher, year, edition, pages
Springer Verlag (Germany), 2012
Keywords
Primary hyperparathyroidism, Selective venous sampling, QuickPTH
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-78807 (URN)10.1007/s00595-012-0119-7 (DOI)000304509100010 ()
Available from: 2012-06-21 Created: 2012-06-21 Last updated: 2018-04-25
Olofsson, P., Berg, S., Casimir Ahn, H., Brudin, L., Wikström, T. & Johansson, K. J. (2009). Gastrointestinal microcirculation and cardiopulmonary function during experimentally increased intra-abdominal pressure. Critical Care Medicine, 37(1), 230-239
Open this publication in new window or tab >>Gastrointestinal microcirculation and cardiopulmonary function during experimentally increased intra-abdominal pressure
Show others...
2009 (English)In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 37, no 1, p. 230-239Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to assess gastric, intestinal, and renal cortex microcirculation parallel with central hemodynamics and respiratory function during stepwise increase of intra-abdominal pressure (IAP).

Design: Prospective, controlled animal study.

Setting: Research laboratory, University Hospital.

Subjects: Twenty-six anesthetized and mechanically ventilated pigs.

Interventions: Following baseline registrations, CO2 peritoneum was inflated (n = 20) and IAP increased stepwise by 10 mm Hg at 10 mins intervals up to 50 mm Hg and subsequently exsufflated. Control animals (n = 6) were not insufflated with CO2.

Measurements and Main Results: The microcirculation of gastric mucosa, small bowel mucosa, small bowel seromuscular layer, colon mucosa, colon seromuscular layer, and renal cortex were selectively studied at all pressure levels and after exsufflation using a four-channel laser Doppler flowmeter (Periflex 5000, Perimed). Central hemodynamic and respiratory function data were registered at each level and after exsufflation. Cardiac output decreased significantly at IAP levels above 10 mm Hg. The microcirculation of gastric mucosa, renal cortex and the seromuscular layer of small bowel and colon was significantly reduced with each increase of IAP. The microcirculation of the small bowel mucosa and colon mucosa was significantly less affected compared with the serosa (p < 0.01).

Conclusions: Our animal model of low and high IAP by intraperitoneal CO2-insufflation worked well for studies of microcirculation, hemodynamics, and pulmonary function. During stepwise increases of pressure there were marked effects on global hemodynamics, respiratory function, and microcirculation. The results indicate that intestinal mucosal flow, especially small bowel mucosal flow, although reduced, seems better preserved in response to intra-abdominal hypertension caused by CO2-insufflation than other intra-abdominal microvascular beds.

Keywords
intra-abdominal hypertension, gastrointestinal microcirculation, cardiopulmonary function
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16533 (URN)10.1097/CCM.0b013e318192ff51 (DOI)
Available from: 2009-01-30 Created: 2009-01-30 Last updated: 2017-12-14Bibliographically approved
Johansson, K., Bjorck, M. & Olofsson, P. (2009). HAVE ROUTINES FOR RECORDING IAP AND AWARENESS IF IAH IMPROVED IN SWEDEN BETWEEN 2006 AND 2008?. In: in ACTA CLINICA BELGICA, vol 64, no 3 (pp. 261-261). , 64(3)
Open this publication in new window or tab >>HAVE ROUTINES FOR RECORDING IAP AND AWARENESS IF IAH IMPROVED IN SWEDEN BETWEEN 2006 AND 2008?
2009 (English)In: in ACTA CLINICA BELGICA, vol 64, no 3, 2009, Vol. 64, no 3, p. 261-261Conference paper, Published paper (Refereed)
Abstract [en]

n/a

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-20200 (URN)
Available from: 2009-09-02 Created: 2009-08-31 Last updated: 2009-09-02
Olofsson, P. H., Mellblom, L., Berg, S., Ahn, H. C., Wikström, T., Johansson, K. J. M. & Söderholm, J. D. (2009). Increased transmucosal uptake of E. coli K12 in porcine small bowel following experimental short term abdominal compartment syndrome.
Open this publication in new window or tab >>Increased transmucosal uptake of E. coli K12 in porcine small bowel following experimental short term abdominal compartment syndrome
Show others...
2009 (English)Article in journal (Other academic) Submitted
Abstract [en]

Background: Abdominal compartment syndrome (ACS) may lead to bacterial translocation and possibly be of importance for development of multiorgan failure. However, the underlying mechanisms have not been fully elucidated. In a porcine model we recently demonstrated preserved intestinal mucosal blood flow during experimental short duration ACS. In the present study we used the same model to determine mucosal barrier function and morphology in the small bowel and colon of pigs before and after short term ACS.

Methods: The study comprised 12 anaesthetized pigs exposed to experimental ACS and 6 control animals. Via laparotomy, samples of small bowel and colon were taken out for studies before short term ACS, where the abdomen was inflated with CO2 and IAP was increased stepwise by 10 mm Hg at 10-minute intervals up to 50 mm Hg, and again 10 minutes after exsufflation. Mucosal microcirculation was measured by laser Doppler flowmetry, and mucosal tissues were mounted in modified Ussing chambers for assessment of barrier function (E. coli K12 uptake and 51Cr-EDTA permeability). Specimens were also fixed in formaldehyde, stained with eosin-hematoxylin and evaluated blindly using an 8-grade scale for assessment of mucosal damage.

Results: Transmucosal passage of E. coli was three-fold increased in the small bowel after ACS (22.6 [18.2 – 54.4] units) vs. baseline (8.1 [2.0 – 13.9]; P< 0.050) with a significant correlation to alterations of mucosal microcirculation. In the colon bacterial passage was unchanged, whereas 51Cr-EDTA permeability after ACS increased to 181% of baseline (P<0.05) and was correlated to significant mucosal histopathological changes (P<0.03).

Conclusion: Short term ACS with reperfusion induced significant dysfunction of the intestinal mucosal barrier. The response patterns concerning barrier dysfunction differed between small bowel and colonic mucosa, with increased bacterial passage and paracellular permeability, respectively.

Keywords
Short term ACS, intestinal barrier function, animal model, Ussing chamber
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-17795 (URN)
Available from: 2009-04-21 Created: 2009-04-21 Last updated: 2010-04-23Bibliographically approved
Organisations

Search in DiVA

Show all publications