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Droog Tesselaar, ErikORCID iD iconorcid.org/0000-0002-8387-0583
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Publications (10 of 37) Show all publications
Zötterman, J., Opsomer, D., Farnebo, S., Blondeel, P., Monstrey, S. & Tesselaar, E. (2020). Intraoperative Laser Speckle Contrast Imaging in DIEP Breast Reconstruction: A Prospective Case Series Study. Plastic and reconstructive surgery. Global open, 8(1), e2529-e2529
Open this publication in new window or tab >>Intraoperative Laser Speckle Contrast Imaging in DIEP Breast Reconstruction: A Prospective Case Series Study
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2020 (English)In: Plastic and reconstructive surgery. Global open, ISSN 2169-7574, Vol. 8, no 1, p. e2529-e2529Article in journal (Refereed) Published
Abstract [en]

Laser speckle contrast imaging (LSCI) is a laser-based perfusion imaging technique that recently has been shown to predict ischemic necrosis in an experimental flap model and predicting healing time of scald burns. The aims were to investigate perfusion in relation to the selected perforator during deep inferior epigastric artery perforator (DIEP) flap surgery, and to evaluate LSCI in assisting of prediction of postoperative complications. METHODS: Twenty-three patients who underwent DIEP-procedures for breast reconstruction at 2 centers were included. Perfusion was measured in 4 zones at baseline, after raising, after anastomosis, and after shaping the flap. The perfusion in relation to the selected perforator and the accuracy of LSCI in predicting complications were analyzed. RESULTS: After raising the flap, zone I showed the highest perfusion (65 ± 10 perfusion units, PU), followed by zone II (58 ± 12 PU), zone III (53 ± 10 PU), and zone IV (45 ± 10 PU). The perfusion in zone I was higher than zone III (P = 0.002) and zone IV (P < 0.001). After anastomosis, zone IV had lower perfusion than zone I (P < 0.001), zone II (P = 0.01), and zone III (P = 0.02). Flaps with areas <30 PU after surgery had partial necrosis postoperatively (n = 4). CONCLUSIONS: Perfusion is highest in zone I. No perfusion difference was found between zones II and III. Perfusion <30 PU after surgery was correlated with partial necrosis. LSCI is a promising tool for measurement of flap perfusion and assessment of risk of postoperative ischemic complications.

Place, publisher, year, edition, pages
Wolters Kluwer, 2020
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-164324 (URN)10.1097/GOX.0000000000002529 (DOI)32095386 (PubMedID)
Note

32095386[pmid]; PMC7015619[pmcid]

Available from: 2020-03-17 Created: 2020-03-17 Last updated: 2020-03-23Bibliographically approved
Nilsson, K., Hallberg, P., Droog Tesselaar, E. & Farnebo, S. (2019). A Novel Technique to Assess Distal Radioulnar Joint Stability Using Increasing Torque. Journal of wrist surgery, 8(4), 327-334
Open this publication in new window or tab >>A Novel Technique to Assess Distal Radioulnar Joint Stability Using Increasing Torque
2019 (English)In: Journal of wrist surgery, ISSN 2163-3916, E-ISSN 2163-3924, Vol. 8, no 4, p. 327-334Article in journal (Refereed) Published
Abstract [en]

Background Previous studies on computed tomography (CT) in patients with a suspected triangular fibrocartilage complex (TFCC) injury have not been successful in assessing distal radioulnar joint (DRUJ) laxity. The aim of this study was to develop a novel servomotor-driven device for the assessment of DRUJ by applying increasing torque to the DRUJ in pronation and supination. Methods A custom-built device was designed to function during four-dimensional (4D) CT of the wrist. A torque meter, positioned between the incoming hand holder, and a direct current (DC) servomotor were used for angular positioning and for applying rotational force to the patients arm. A total of 110 healthy participants were recruited to gather reference values for the range of motion (ROM), maximum torque in neutral and supinated/pronated position, and the ability to withstand an increasing, device-generated torque in these positions. The device was also used during 4D DRUJ CT in five patients with suspected TFCC injuries. Results A gender- and age-relevant reference chart for ROM and torque was created. Men showed a tendency (ns) toward having a larger ROM and increasing strength with increasing age, whereas women showed the opposite. Also, the dominant hand showed a tendency toward having a larger ROM and being stronger than the nondominant hand (ns). A smaller cohort of patients ( n = 5) with suspected TFCC injuries showed a significantly decreased ability to withstand increasing torque in both supination (2.1 +/- 0.3 vs. 3.1 +/- 0.2 s; p amp;lt; 0.005) and pronation (2.3 +/- 0.5 vs. 3.1 +/- 0.4 s; p amp;lt; 0.0005) and also showed a clear laxity on real-time 4D CT image sequences. Decreased strength at all positions was also found (average 74% decrease compared to noninjured side). Conclusion Reference values for torque strength and ability to withstand increasing torque can be used clinically in the assessment of patients with symptoms that could represent ligamentous injuries to the TFCC. The ability to use the device during CT enables radiographic evaluation of instability during increasing torque.

Place, publisher, year, edition, pages
THIEME MEDICAL PUBL INC, 2019
Keywords
DRUJ Instability; TFCC injury; 4D CT; torque
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-164446 (URN)10.1055/s-0038-1675561 (DOI)000484312000014 ()31402996 (PubMedID)
Available from: 2020-03-28 Created: 2020-03-28 Last updated: 2020-03-28
Elmasry, M., Mirdell, R., Tesselaar, E., Farnebo, S., Sjöberg, F. & Steinvall, I. (2019). Laser speckle contrast imaging in children with scalds: Its influence on timing of intervention, duration of healing and care, and costs. Burns, 45(4), 798-804
Open this publication in new window or tab >>Laser speckle contrast imaging in children with scalds: Its influence on timing of intervention, duration of healing and care, and costs
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2019 (English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, no 4, p. 798-804Article in journal (Refereed) Published
Abstract [sv]

Background

Scalds are the most common type of burn injury in children, and the initial evaluation of burn depth is a problem. Early identification of deep dermal areas that need excision and grafting would save unnecessary visits and stays in hospital. Laser speckle contrast imaging (LSCI) shows promise for the evaluation of this type of burn. The aim of this study was to find out whether perfusion measured with LSCI has an influence on the decision for operation, duration of healing and care period, and costs, in children with scalds.

Methods

We studied a group of children with scalds whose wounds were evaluated with LSCI on day 3–4 after injury during the period 2012–2015. Regression (adjustment for percentage total body surface area burned (TBSA%), age, and sex) was used to analyse the significance of associations between degree of perfusion and clinical outcome.

Results

We studied 33 children with a mean TBSA% of 6.0 (95% CI 4.4–7.7)%. Lower perfusion values were associated with operation (area under the receiver-operating characteristic curve 0.86, 95% CI 0.73–1.00). The perfusion cut-off with 100% specificity for not undergoing an operation was ≥191 PU units (66.7% sensitivity and 72.7% accurately classified). Multivariable analyses showed that perfusion was independently associated with duration of healing and care period.

Conclusion

Lower perfusion values, as measured with LSCI, are associated with longer healing time and longer care period. By earlier identification of burns that will be operated, perfusion measurements may further decrease the duration of care of burns in children with scalds.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Laser speckle contrast imaging; Burns; Scalds; Perfusion; Outcome; Children
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-154872 (URN)10.1016/j.burns.2019.02.001 (DOI)000467914900006 ()30827850 (PubMedID)2-s2.0-85062153561 (Scopus ID)
Note

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

Available from: 2019-03-02 Created: 2019-03-02 Last updated: 2019-07-01Bibliographically approved
Mirdell, R., Lemstra-Idsardi, A. N., Farnebo, S. & Tesselaar, E. (2018). Data on microcirculatory perfusion dips in the resting nail bed. Data in Brief, 21, 1232-1235
Open this publication in new window or tab >>Data on microcirculatory perfusion dips in the resting nail bed
2018 (English)In: Data in Brief, E-ISSN 2352-3409, Vol. 21, p. 1232-1235Article in journal (Refereed) Published
Abstract [en]

This article contains the raw data from the article entitled: "The presence of synchronized perfusion dips in the microcirculation of the resting nail bed" Mirdell et al. (in press). A laser speckle contrast imager (LSCI) was used to make a total of 21 recordings of the perfusion in the resting nail bed of 10 healthy test subjects. The first 10 recordings were acquired after 5?min of acclimatization. An additional 10 recordings were acquired in the same test subjects, after 20?min of acclimatization. In the last recording, a digital nerve block was applied to the left dig III. The data show the presence of highly irregular perfusion variations, a phenomenon we like to call perfusion dips. The data also show how the perfusion dips can be abolished through a digital nerve block. An algorithm for the quantification of the perfusion dips is included in the data.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
laser speckle contrast imaging; microcirculation; nail bed; perfusion
National Category
Bioinformatics and Systems Biology
Identifiers
urn:nbn:se:liu:diva-156038 (URN)10.1016/j.dib.2018.10.077 (DOI)30456238 (PubMedID)
Available from: 2019-04-02 Created: 2019-04-02 Last updated: 2019-04-02
Tesselaar, E., Nezirevic Dernroth, D. & Farnebo, S. (2017). Acute effects of coffee on skin blood flow and microvascular function. Microvascular Research, 114, 58-64
Open this publication in new window or tab >>Acute effects of coffee on skin blood flow and microvascular function
2017 (English)In: Microvascular Research, ISSN 0026-2862, E-ISSN 1095-9319, Vol. 114, p. 58-64Article in journal (Refereed) Published
Abstract [en]

Objective

Studies on the acute effects of coffee on the microcirculation have shown contradicting results. This study aimed to investigate if intake of caffeine-containing coffee changes blood flow and microvascular reactivity in the skin.

Methods

We measured acute changes in cutaneous vascular conductance (CVC) in the forearm and the tip of the finger, the microvascular response to transdermaliontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP) and post-occlusive reactive hyperemia (PORH) in the skin, after intake of caffeinated or decaffeinated coffee.

Results

Vasodilatation during iontophoresis of ACh was significantly stronger after intake of caffeinated coffee compared to after intake of decaffeinated coffee (1.26 ± 0.20 PU/mm Hg vs. 1.13 ± 0.38 PU/mm Hg, P < 0.001). Forearm CVC before and after PORH were not affected by caffeinated and decaffeinated coffee. After intake of caffeinated coffee, a more pronounced decrease in CVC in the fingertip was observed compared to after intake of decaffeinated coffee (− 1.36 PU/mm Hg vs. − 0.52 PU/mm Hg, P = 0.002).

Conclusions

Caffeine, as ingested by drinking caffeinated coffee acutely improves endothelium-dependent microvascular responses in the forearm skin, while endothelium-independent responses to PORH and SNP iontophoresis are not affected. Blood flow in the fingertip decreases markedly during the first hour after drinking caffeinated coffee compared to decaffeinated coffee.

Place, publisher, year, edition, pages
Academic Press, 2017
Keywords
Coffee, Caffeine, Skin, Microcirculation, Laser Doppler flowmetry, Laser speckle contrast imaging
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-145382 (URN)10.1016/j.mvr.2017.06.006 (DOI)000431155100009 ()28625890 (PubMedID)2-s2.0-85020924088 (Scopus ID)
Available from: 2018-02-27 Created: 2018-02-27 Last updated: 2019-01-11Bibliographically approved
Droog Tesselaar, E., Flejmer, A. M., Farnebo, S. & Dasu, A. (2017). Changes in skin microcirculation during radiation therapy for breast cancer. Acta Oncologica, 56(8), 1072-1080
Open this publication in new window or tab >>Changes in skin microcirculation during radiation therapy for breast cancer
2017 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 56, no 8, p. 1072-1080Article in journal (Refereed) Published
Abstract [en]

Abstract:

Background: The majority of breast cancer patients who receive radiation treatment are affected by acute radiation-induced skin changes. The assessment of these changes is usually done by subjective methods, which complicates the comparison between different treatments or patient groups. This study investigates the feasibility of new robust methods for monitoring skin microcirculation to objectively assess and quantify acute skin reactions during radiation treatment.

Material and methods: Laser Doppler flowmetry, laser speckle contrast imaging, and polarized light spectroscopy imaging were used to measure radiation-induced changes in microvascular perfusion and red blood cell concentration (RBC) in the skin of 15 patients undergoing adjuvant radiation therapy for breast cancer. Measurements were made before treatment, once a week during treatment, and directly after the last fraction.

Results: In the treated breast, perfusion and RBC concentration were increased after 1–5 fractions (2.66–13.3 Gy) compared to baseline. The largest effects were seen in the areola and the medial area. No changes in perfusion and RBC concentration were seen in the untreated breast. In contrast, Radiation Therapy Oncology Group (RTOG) scores were increased only after 2 weeks of treatment, which demonstrates the potential of the proposed methods for early assessment of skin changes. Also, there was a moderate to good correlation between the perfusion (r = 0.52) and RBC concentration (r = 0.59) and the RTOG score given a week later.

Conclusion: We conclude that radiation-induced microvascular changes in the skin can be objectively measured using novel camera-based techniques before visual changes in the skin are apparent. Objective measurement of microvascular changes in the skin may be valuable in the comparison of skin reactions between different radiation treatments and possibly in predicting acute skin effects at an earlier stage.

Place, publisher, year, edition, pages
Oxfordshire: Taylor & Francis, 2017
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:liu:diva-134594 (URN)10.1080/0284186X.2017.1299220 (DOI)000402609100006 ()28281359 (PubMedID)
Available from: 2017-02-20 Created: 2017-02-20 Last updated: 2018-05-03Bibliographically approved
Bergkvist, M., Zötterman, J., Henricson, J., Iredahl, F., Tesselaar, E. & Farnebo, S. (2017). Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation.. Plastic and reconstructive surgery. Global open, 5(11), Article ID e1531.
Open this publication in new window or tab >>Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation.
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2017 (English)In: Plastic and reconstructive surgery. Global open, ISSN 2169-7574, Vol. 5, no 11, article id e1531Article in journal (Refereed) Published
Abstract [en]

Background: Venous congestion in skin flaps is difficult to detect. This study evaluated the ability of tissue viability imaging (TiVi) to measure changes in the concentration of red blood cells (CRBC), oxygenation, and heterogeneity during vascular provocations in a porcine fasciocutaneous flap model.

Methods: In 5 pigs, cranial gluteal artery perforator flaps were raised (8 flaps in 5 pigs). The arterial and venous blood flow was monitored with ultrasonic flow probes. CRBC, tissue oxygenation, and heterogeneity in the skin were monitored with TiVi during baseline, 50% and 100% venous occlusion, recovery, 100% arterial occlusion and final recovery, thereby simulating venous and arterial occlusion of a free fasciocutaneous flap. A laser Doppler probe was used as a reference for microvascular perfusion in the flap.

Results: During partial and complete venous occlusion, increases in CRBC were seen in different regions of the flap. They were more pronounced in the distal part. During complete arterial occlusion, CRBC decreased in all but the most distal parts of the flap. There were also increases in tissue oxygenation and heterogeneity during venous occlusion.

Conclusions: TiVi measures regional changes in CRBC in the skin of the flap during arterial and venous occlusion, as well as an increase in oxygenated hemoglobin during venous occlusion that may be the result of reduced metabolism and impaired delivery of oxygen to the tissue. TiVi may provide a promising method for measuring flap viability because it is hand-held, easy to-use, and provides spatial information on venous congestion.

Place, publisher, year, edition, pages
Wolters Kluwer, 2017
National Category
Radiology, Nuclear Medicine and Medical Imaging Surgery
Identifiers
urn:nbn:se:liu:diva-145391 (URN)10.1097/GOX.0000000000001531 (DOI)29263951 (PubMedID)2-s2.0-85038559789 (Scopus ID)
Available from: 2018-02-27 Created: 2018-02-27 Last updated: 2019-07-23Bibliographically approved
Tesselaar, E. & Sandborg, M. (2016). ASSESSING THE USEFULNESS OF THE QUASI-IDEAL OBSERVER FORQUALITY CONTROL IN FLUOROSCOPY. Radiation Protection Dosimetry, 169(1-4), 360-364
Open this publication in new window or tab >>ASSESSING THE USEFULNESS OF THE QUASI-IDEAL OBSERVER FORQUALITY CONTROL IN FLUOROSCOPY
2016 (English)In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 169, no 1-4, p. 360-364Article in journal (Refereed) Published
Abstract [en]

The aim of this work was to evaluate the reliability of the square of the signal-to-noise ratio rate, SNR2rate, as a precise measurement for quality control test in a digital fluoroscopy system. The quasi-ideal model observer was used to measure SNR2rate. The dose rate, pulse rate and field of view were varied, and their effect on dose efficiency, defined as SNR2rate=PKA;rate, was evaluated (where PKA;rate is the air kerma-area product rate). Measurements were repeated to assess reproducibility. The relative standard deviation in SNR2rate=PKA;rate over seven consecutive measurements was 5 %. No significant variation in SNR2rate=PKA;rate was observed across different pulse rates (10–30 pulses s-1). The low-dose-rate setting had a superior dose efficiency compared with the medium- and high-dose-rate settings. A smaller field of view resulted in higher dose efficiency. The results show that SNR2rate=PKA;rate measurements offer the high precision required in quality control constancy tests.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-123020 (URN)10.1093/rpd/ncv434 (DOI)000383492100057 ()26493947 (PubMedID)
Note

Funding agencies: ALF (Avtal om Lakarutbildning och Forskning) grants from Region Ostergotland [LIO-357651]

Available from: 2015-12-02 Created: 2015-12-02 Last updated: 2017-12-01Bibliographically approved
Tesselaar, E., Dahlström, N. & Sandborg, M. (2016). CLINICAL AUDIT OF IMAGE QUALITY IN RADIOLOGY USING VISUAL GRADING CHARACTERISTICS ANALYSIS. Radiation Protection Dosimetry, 169(1-4), 340-346
Open this publication in new window or tab >>CLINICAL AUDIT OF IMAGE QUALITY IN RADIOLOGY USING VISUAL GRADING CHARACTERISTICS ANALYSIS
2016 (English)In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 169, no 1-4, p. 340-346Article in journal (Refereed) Published
Abstract [en]

The aim of this work was to assess whether an audit of clinical image quality could be efficiently implemented within a limited time frame using visual grading characteristics (VGC) analysis. Lumbar spine radiography, bedside chest radiography and abdominal CT were selected. For each examination, images were acquired or reconstructed in two ways. Twenty images per examination were assessed by 40 radiology residents using visual grading of image criteria. The results were analysed using VGC. Inter-observer reliability was assessed. The results of the visual grading analysis were consistent with expected outcomes. The inter-observer reliability was moderate to good and correlated with perceived image quality (r2 5 0.47). The median observation time per image or image series was within 2 min. These results suggest that the use of visual grading of image criteria to assess the quality of radiographs provides a rapid method for performing an image quality audit in a clinical environment.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-123019 (URN)10.1093/rpd/ncv411 (DOI)000383492100054 ()26410763 (PubMedID)
Available from: 2015-12-02 Created: 2015-12-02 Last updated: 2017-05-03
Ericsson, E., Tesselaar, E. & Sjöberg, F. (2016). Effect of Electrode Belt and Body Positions on Regional Pulmonary Ventilation- and Perfusion-Related Impedance Changes Measured by Electric Impedance Tomography. PLoS ONE, 11(6), e0155913
Open this publication in new window or tab >>Effect of Electrode Belt and Body Positions on Regional Pulmonary Ventilation- and Perfusion-Related Impedance Changes Measured by Electric Impedance Tomography
2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 6, p. e0155913-Article in journal (Refereed) Published
Abstract [en]

Ventilator-induced or ventilator-associated lung injury (VILI/VALI) is common and there is an increasing demand for a tool that can optimize ventilator settings. Electrical impedance tomography (EIT) can detect changes in impedance caused by pulmonary ventilation and perfusion, but the effect of changes in the position of the body and in the placing of the electrode belt on the impedance signal have not to our knowledge been thoroughly evaluated. We therefore studied ventilation-related and perfusion-related changes in impedance during spontaneous breathing in 10 healthy subjects in five different body positions and with the electrode belt placed at three different thoracic positions using a 32-electrode EIT system. We found differences between regions of interest that could be attributed to changes in the position of the body, and differences in impedance amplitudes when the position of the electrode belt was changed. Ventilation-related changes in impedance could therefore be related to changes in the position of both the body and the electrode belt. Perfusion-related changes in impedance were probably related to the interference of major vessels. While these findings give us some insight into the sources of variation in impedance signals as a result of changes in the positions of both the body and the electrode belt, further studies on the origin of the perfusion-related impedance signal are needed to improve EIT further as a tool for the monitoring of pulmonary ventilation and perfusion.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2016
National Category
Physiology
Identifiers
urn:nbn:se:liu:diva-130067 (URN)10.1371/journal.pone.0155913 (DOI)000377218700010 ()27253433 (PubMedID)
Available from: 2016-07-06 Created: 2016-07-06 Last updated: 2018-03-21
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8387-0583

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