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  • 1. Adolfsson, L.E.
    et al.
    Nettelblad, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Radial nerve entrapment in the upper arm as a cause of lateral arm pain: A report of four cases2001In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 35, no 2, p. 217-220Article in journal (Refereed)
    Abstract [en]

    Four patients with no history of trauma presented with lateral arm pain, local tenderness, and a tingling sensation at the distal end of the arm when the radial nerve was percussed in the mid-third of the upper arm (Tinel's sign), but no clinical or subjective signs of muscular weakness. They were treated by decompression of the radial nerve in the fibrous canal proximal to the lateral intermuscular septum. Three of the patients had a complete or pronounced reduction in pain, while the fourth had only a slight improvement. Non-traumatic radial nerve entrapment in the upper arm may be the cause of lateral arm pain without clinical signs of muscular weakness.

  • 2.
    Berggren, Magnus
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Joost-Davidsson, A
    Lindstrand, J
    Nylander, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Povlsen, B
    Reduction in the need for operation after conservative treatment of osteoarthritis of the first carpometacarpal joint: a seven year prospective study.2001In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 35, p. 415-417Article in journal (Refereed)
  • 3. Clarkson, James
    et al.
    Probst, Fey
    Niranjan, Niri
    Meuli, Claudia
    Vogt, Paul
    Lidman, Disa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Andersson, Lena
    Our experience using the vertical rectus abdominis muscle flap for reconstruction in 12 patients with dehiscence of a median sternotomy wound and mediastinitis2003In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 37, no 5, p. 266-271Article in journal (Refereed)
    Abstract [en]

    The vertical rectus abdominis (VRAM) flap has been used for reconstruction of sternal defects, particularly in the interior third, since it was first described 20 years ago. We describe 12 patients with mediastinitis or chronic sternal osteomyelitis after sternotomy treated between 1994 and 1997, nine performed at the Royal Hospitals Trust, London. Sternal osteomyelitis and mediastinitis after median sternotomy is an uncommon (0.4%-8.4%) but often fatal condition. Vascularised pedicles are the treatment of choice, and VRAM flaps were used in all cases. We report good long-term outcome with a follow up of 2-5 years, and no long-term morbidity relating to the VRAM reconstruction. We had only one partial failure of a flap. The operations were largely done in hospitals away from the plastic surgical unit in extremely sick patients, which illustrates the importance of multidisciplinary management to reduce hospital stay, mortality, and morbidity. We argue that early involvement of plastic surgical specialists in the treatment of sternal dehiscence is essential to ensure a successful outcome.

  • 4.
    Danielsson, Pär
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Adolfsson, Lars
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Dahlin, Lars B
    Different effect on axonal outgrowth of application of non-absorbable or absorbable tubes around a nerve repair2001In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 35, no 4, p. 347-353Article in journal (Refereed)
    Abstract [en]

    We studied regeneration distance of rat sciatic nerve, with the sensory pinch reflex test and immunocytochemical staining for neurofilaments, four to 21 days after transsection, repair, and enclosure of the repair site in either a non-absorbable silicone tube or an absorbable polyglycolic acid (PGA) tube. The size of both tube-types was carefully selected so that they did not compress the repaired nerve. The opposite nerve was repaired and not inserted in a tube (control). The regeneration distances in repaired nerves enclosed in silicone tube were significantly longer than the control side at all time points, a result not seen when PGA tube was used. The number of proliferating non-neuronal cells (incorporation of 5-bromodeoxyuridine (BrdU)) was studied just proximal to the site of nerve repair after six days. Numerous stained cells were seen, but there where no significant differences between the groups. We conclude that outgrowth of sensory axons after transsection and repair of rat sciatic nerve with sutures can be increased by enclosing the site of repair in a silicone tube but not in a PGA tube. The effect is probably not related to the number of proliferative non-neuronal cells.

  • 5. Fossum, Magdalena
    et al.
    Gustafson, Carl-Johan
    Nordenskjöld, Agneta
    Kratz, Gunnar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Isolation and in vitro cultivation of human urothelial cells from bladder washings of adult patients and children2003In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 37, p. 41-45Article in journal (Refereed)
  • 6.
    Haapaniemi, Tomas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Nishiura, Yasumasa
    Dahlin, Lars B
    Effects of hyperbaric oxygen treatment on axonal outgrowth in sciatic nerve grafts in rats2001In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 35, no 1Article in journal (Refereed)
    Abstract [en]

    We studied the effect of hyperbaric oxygen treatment on axonal outgrowth in grafts of sciatic nerves in 40 rats. The sciatic nerve was transsected and a 10 mm long segment from the opposite side was immediately sutured in as a nerve graft. Postoperatively 17 animals were treated with 100% oxygen at 3.2 atmospheres absolute pressure for 45 minutes and the treatment was repeated at four and eight hours postoperatively and then every eight hours until evaluation. At seven days the axonal outgrowth was evaluated by immunohistochemical staining of neuro-filaments in the nerve grafts. The axonal outgrowth was significantly longer in animals treated with hyperbaric oxygen. We conclude that hyperbaric oxygen can improve nerve regeneration in sciatic nerve grafts in rats.

  • 7.
    Hansson, Emma
    et al.
    Gothenburg Univ, Sweden; Lund Univ, Sweden.
    Elander, Anna
    Gothenburg Univ, Sweden.
    Hallberg, Hakan
    Gothenburg Univ, Sweden.
    Sandman, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. Vastra Gotaland Reg, Sweden; Boras Univ, Sweden.
    Should immediate breast reconstruction be performed in the setting of radiotherapy? An ethical analysis2019In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764Article in journal (Refereed)
    Abstract [en]

    Immediate breast reconstruction (IBR) combined with post-mastectomy radiotherapy (PMRT) is associated with an increased risk for complications. Here, we analyse whether IBR combined with PMRT is ethically acceptable. We employ normative analysis following reflective equilibrium and the principles of Beauchamp and Childress: non-maleficence, beneficence, autonomy, and justice. From the perspective of beneficence and non-maleficence, we can choose either IBR or PMRT according to documented risks and complications, delayed autologous breast reconstruction with corresponding benefits but less risk for complications, or even no reconstruction, which for some women, might be equally beneficial. In such a situation, given the level of severity associated with lacking a breast after mastectomy, IBR violates the principles of beneficence and non-maleficence. To deny an IBR in the context of PMRT does not violate the principle of autonomy as it is normally interpreted in the healthcare system, not even when patient-centred care is taken into consideration. Moreover, there is a risk that the decision of the patient will be affected by heuristics, optimism bias, and surgeon bias. IBR in the context of PMRT could be in conflict with the principle of justice, as it could lead to displacement of care for other patient groups. Furthermore, an acceptable level of cost effectiveness should be low, given that living without a breast is a condition of moderate severity. In conclusion, given the current knowledgebase and established ethical norms within the healthcare system, we find strong ethical reasons not to offer IBR when PMRT is expected.

  • 8.
    Hansson, Thomas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Povlsen, Bo
    Functional evaluation of regenerated and misrouted low threshold mechanoreceptors and polymodal nociceptors in the skin of rat hindfeet after crush lesions to the sciatic nerve2005In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 39, no 5, p. 261-267Article in journal (Refereed)
    Abstract [en]

    Tracer studies on motor axons after nerve crush injuries have indicated that misrouting may occur even when the endoneurium is intact. Misrouting of regenerated polymodal nociceptive C-fibres and low threshold mechanoreceptive axons have been studied functionally in 50 rats three months after unilateral crush lesions to the sciatic nerve. Two weeks before evaluation the tibial fascicle (or the peroneal fascicle) above the lesion was cut and tied off. In this way only functional regeneration of misrouted axons was tested. Misrouted low threshold mechanoreceptive axons and polymodal nociceptor C-fibres were found after regeneration in both glabrous and hairy skin. We conclude that functional misdirection of both myelinated and unmyelinated sensory axons innervating either glabrous or hairy skin can occur after a crush lesion to a peripheral nerve in rats. © 2005 Taylor & Francis.

  • 9.
    Hansson, Thomas
    et al.
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Povlsen, Bo
    Department of Plastic Surgery, Hand Surgery and Burns, University Hospital, Linköping, Sweden and Department of Orthopaedics, St Thomas's Hospital, London, England.
    Functional Regeneration of C-Fibries Inside a Silicone Tube After Sciatic Neurotomy in Rats1997In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 31, no 1, p. 7-11Article in journal (Refereed)
    Abstract [en]

    Peripheral nerve lesions are often complicated by difficulties in approximating the nerve tumps without tension. The aim of the present study was to evaluate C-fïbre function after nerve regeneration in rats in which the nerve had been lengthened by leaving a 5 mm gap inside a silicone tube (n = 5). The outcome was compared with nerve regeneration after epineural end-to-end suture (n = 5). The innervated skin territory was defined by Evans blue extravasation after antidromic nerve stimulation. Five rats acted as controls. After three months, there was similar functional reinnervation in both experimental groups, which indicates that silicone tubes may reduce tension over a nerve repair with no adverse effects.

  • 10. Henriksson, Tor-Göran
    et al.
    Nettelblad, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Technical refinements in the Washio tempororetroauricular flap in reconstruction of the nasal wing2005In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 39, no 5, p. 295-298Article in journal (Refereed)
    Abstract [en]

    Retroauricular tissue for reconstruction of external nasal defects was described by Washio. We describe our recent experiences in elderly patients, in whom the risk of reconstruction after excision of a malignant growth is high. We present seven reconstructions, six after excision of malignant disease, together with our ideas about how to maximise its possibilities. © 2005 Taylor & Francis.

  • 11.
    Holmgren, Rafael
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine.
    Tarpila, Erkki
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Intermittent injection of bupivacaine into the margin or the cavity after reduction mammaplasty2005In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 39, no 4, p. 218-221Article in journal (Refereed)
    Abstract [en]

    Twenty-seven operated women had postoperative intermittent injections of bupivacaine or saline for 24 hours after reduction mammaplasty. The injections were given five-hourly either subcutaneously along the submammary incision or deep into the wound. The patients were randomised into three groups of nine each: 5 ml bupivacaine 0.25% into the margin, 5 ml bupivacaine 0.25% into the cavity, and 5 ml physiological saline into the cavity. Postoperatively all patients received oral paracetamol and dextropropoxyphene. If additional analgesia was needed morphine was given intravenously. Total morphine consumption was significantly (p <0.03) lower in patients given bupivacaine into the margin (2.0 (0.9) mg) or into the cavity (2.4 (0.8) mg) compared with controls (6.9 (1.5) mg). VAS pain scores and vomiting did not differ among the three groups. Postoperative intermittent infusion of bupivacaine lowered morphine consumption after reduction mammaplasty, and the analgesic effect seemed to be independent of where the infusion was given. © 2005 Taylor & Francis.

  • 12.
    Lidman, Disa
    et al.
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Danielsson, Pär
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Abdiu, Avni
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Fåhraeus, Bengt
    Linköping University, Department of Biomedicine and Surgery, Urology. Linköping University, Faculty of Health Sciences.
    The functional result two years after a microsurgical penile replantation1999In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 33, no 3, p. 325-328Article in journal (Refereed)
    Abstract [en]

    We describe the technique of microsurgical penile replantation and a case followed up after two years. The patient was a young man with decompensated schizophrenia who emasculated himself with a kitchen knife. A particularly good functional result was achieved including restoration of sensation in the penile shaft and in the glans, and return of erectile capacity.

  • 13.
    Lidman, Disa
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Niklasson, Magnus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Survival and function in patients with tumours of the head and neck operated on and reconstructed with free flaps2008In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 42, no 2, p. 77-85Article in journal (Refereed)
    Abstract [en]

    From 1983 to 2003, 131 patients were operated on in the head and neck region with 139 free flaps. They were operated on using a team approach of ear, nose, and throat surgeons and plastic surgeons, and sometimes maxillofacial surgeons. The tumours were squamous cell carcinoma (SCC) 104 (80%), salivary gland cancer 13 (10%), sarcoma 5 (4%), basal cell carcinoma 4 (3%), and others 4 (3%). The staging of the primary intraoral SCC tumours (n=79) was 42% in stage II, 28% in stage III, and 30% in stage IV. The survival of patients with primary oral SCC was compared with a previously treated previous series that gave an increase in tumour-related five-year survival from 48% to 58%. Most flaps were radial forearm flaps (73%). Fifteen percent were vascularised bone transfers. A questionnaire was sent to patients who had had oral/oropharyngeal tumours to measure function and satisfaction, to which 47/49 responded. The results including ability to chew and swallow, speech was good, with a median score of 0.78 (range 1-0).

  • 14. Lundborg, Göran
    et al.
    Björkman, Anders
    Hansson, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Nylander, Lotta
    Nyman, Torbjörn
    Rosén, Birgitta
    Artificial sensibility of the hand based on cortical audiotactile interaction: A study using functional magnetic resonance imaging2005In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 39, no 6, p. 370-372Article in journal (Refereed)
    Abstract [en]

    The capacity of the central nervous system for plastic alterations is the base for our ability to adapt to environmental needs. The crossmodal capacity of the brain makes interaction between senses possible, and deprivation of one sense leads to compensatory changes in other senses. We have recently shown how hearing can substitute for sensation in a transplanted insensitive hand by using a sensor glove equipped with small microphones that pick up the sound of friction, which is elicited by active touch. Here we have used functional magnetic resonance imaging (fMRI) in healthy people to illustrate their capacity for cortical audiotactile interaction with activation of the somatosensory cortex induced by auditory stimuli. The phenomenon occurred only in subjects trained to substitute sensibility by hearing, and no audiotactile interaction was found in untrained subjects. © 2005 Taylor & Francis.

  • 15.
    Lutz, Barbara
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns.
    Wieslander, Jan B
    Reconstruction with microvascular free flaps by visiting microsurgeons2003In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 37, p. 140-144Article in journal (Refereed)
  • 16.
    Marcusson, Agneta
    et al.
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL. Östergötlands Läns Landsting, Sinnescentrum.
    List, Thomas
    Östergötlands Läns Landsting.
    Paulin, Gunnar
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL. Östergötlands Läns Landsting, Sinnescentrum.
    Åkerlind, Ingemar
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Reliability of a multidimensional questionnaire for adults with treated complete cleft lip and palate2001In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 35, no 3, p. 271-278Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate the reliability of a multidimensional questionnaire for Swedish adults with treated complete unilateral or bilateral cleft lip and palate (CLP). The questionnaire was designed to be used in the evaluation of adults with treated CLP after treatment. Before any conclusions were drawn from the results of the study we assessed the test-retest reliability of the questionnaire. The questionnaire included 168 questions and assessed the following domains: aesthetics, functions associated with CLP, satisfaction with treatment and perceived need for treatment, quality of life, depression and non-specific physical symptoms, body image, and jaw function. The subjects answered the questionnaire twice at a 2-3-week interval. Sixty-one adults (38 men, 23 women) mean age 24 years (range 20-29) participated in the study. The response rate for the questionnaire was acceptable at 75%. The test-retest reliability varied among the different domains. The reliability of questions regarding aesthetics, functions associated with CLP, and treatment satisfaction was good to excellent (intraclass correlation coefficient (ICC) = 0.51 to 0.89). Good to excellent (ICC = 0.61 to 1.0) reliability was also found for the quality of life in various life domains and the wellbeing scales. The reliability of the body image scale was moderate (kappa = 0.43-0.60) for most items and lower than that of other scales used in this study. The reliability of the mean depression symptom score (ICC = 0.93) and the mean non-specific physical symptoms score (ICC = 0.85) were excellent. The reliability of the mandibular function impairment was good (ICC = 0.67). The conclusion of the study is that an overall reliability was good for the multidimensional questionnaire.

  • 17.
    Marcusson, Agneta
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Linköping University, Faculty of Health Sciences.
    Paulin, Gunnar
    Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Linköping University, Faculty of Health Sciences.
    Östrup, Leif
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Facial appearance in adults who had cleft lip and palate treated in childhood2002In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 36, no 1, p. 16-23Article in journal (Refereed)
    Abstract [en]

    Sixty-eight adults (44 men and 24 women) with treated total cleft lip and palate were compared with a group of 66 adults (49 men and 17 women) without clefts, matched by sex and age. The outcome measures included a self-report questionnaire about body image, quality of life in general, health-related quality of life, somatisation, and depression. The group with clefts were also asked if they had further need of treatment. They reported significantly more dissatisfaction with their facial appearance (nose, lips, mouth, profile, and overall facial appearance) than the group without clefts. Satisfaction with facial appearance was significantly correlated with a better quality of life in both groups, and significantly correlated with a better health-related quality of life and a lower grade of somatisation in the group with clefts. Dissatisfaction with facial appearance was the most significant predictor of depression in both groups. A panel of four professionals from a cleft lip and palate treatment team judged the outcome of treatment in 64 of the subjects on colour slides. The professionals and the subjects with clefts were generally not very satisfied with the results of the surgical outcome. Thirty of the subjects with clefts (47%) wished to have more operations. The professional group recommended further operations in 38 of the cases (59%), in particular, rhinoplasties. We conclude that the subjects with treated clefts were not satisfied with their facial appearance, although they seem to be psychosocially well-adjusted to their disability.

  • 18.
    Moloney, Maria
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Farnebo, Simon
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Adolfsson, Lars
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    20-Year outcome of TFCC repairs2018In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 52, no 3, p. 193-197Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to investigate the functional result and rate of osteoarthritis 15-25 years after a TFCC-repair. Forty-seven patients completed the questionnaire Patient Rated Wrist Evaluation (PRWE), and 43 had new X-rays. Fifty-seven percent had a simultaneous arthroscopy. Sixteen patients had later additional surgery to the wrist, of these eight had a reoperation of the TFCC-injury due to recurrent instability. Radiographs showed that 17.5% had developed radiocarpal osteoarthritis and 34% osteoarthritis in the distal radioulnar joint. The median PRWE result was 22.5. Patients with radiocarpal osteoarthritis and patients who had additional surgery had significantly worse scores. Patients who had undergone arthroscopy significantly less often had developed radiocarpal osteoarthritis. The result is acceptable but not impressive and efforts should be made to diagnose these injuries early and also diagnose associated injuries, advisably by arthroscopy.

  • 19.
    Nyman, Erika
    et al.
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Linköping University, Department of Clinical and Experimental Medicine, Burn Center.
    Huss, Fredrik
    Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Nyman, Torbjörn
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Junker, Johan
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Kratz, Gunnar
    Linköping University, Department of Clinical and Experimental Medicine, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Hyaluronic acid, an important factor in the wound healing properties of amniotic fluid: In vitro studies of re-epithelialisation in human skin wounds2013In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 47, no 2, p. 89-92Article in journal (Refereed)
    Abstract [en]

    Foetal wounds are unique in their ability to heal rapidly without forming scars. The amniotic fluid, rich in nutrients, growth factors, and hyaluronic acid, surrounds the foetus and is essential to foetal wound healing. The wound healing properties of foetal wounds may be the result of high concentrations of hyaluronic acid. This study aimed to verify that amniotic fluid induces re-epithelialisation in human skin wounds in vitro and to study whether this ability is dependent on hyaluronic acid. Standard deep dermal wounds were produced in vitro in human skin. The skin samples, with a central wound, were incubated in different culture media. Varying concentrations of amniotic fluid and amniotic fluid with added hyaluronidase were tested, and re-epithelialisation was assessed at 3, 7, and 12 days using light microscopy, after staining with haematoxylin and eosin. Amniotic fluid 50% resulted in a significantly higher (p andlt; 0.05) grade of re-epithelialisation than Dulbeccos modified Eagles medium and 10% amniotic fluid at all time points. When 50% amniotic fluid was compared with 10% foetal calf serum, no significant difference was found in grades of re-epithelialisation on days 3 and 12 and significantly higher grades of re-epithelialisation on day 7 (p andlt; 0.05). Degradation of hyaluronic acid in the medium that contained 50% amniotic fluid gave significantly impaired re-epithelialisation (p andlt; 0.05) on culture days 3 and 7. In conclusion, amniotic fluid promotes accelerated re-epithelialisation and hyaluronic acid is an important ingredient.

  • 20.
    Sommar, Pehr
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Junker, Johan
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Strandenes, Eivind
    Haukeland Hospital, Norway .
    Ness, Charlotte
    Haukeland Hospital, Norway .
    Hansson, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
    Johnson, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
    Kratz, Gunnar
    Linköping University, Department of Clinical and Experimental Medicine, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
    Osteogenically-induced human dermal fibroblasts as a tool to regenerate bone2013In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 47, no 1, p. 8-13Article in journal (Refereed)
    Abstract [en]

    Engineering of bone tissue could help to overcome the need for extensive reconstruction and associated donor site morbidity, and it has been proposed that osteogenic biomaterials, which are scaffolds that contain osteocompetent cells, could be used to fill large bone defects. This study investigated the potential of osteogenically-induced human dermal fibroblasts cultured on gelatin microcarriers combined with platelet-rich plasma in a model of a femoral defect in athymic rats. Defects were transplanted with one of the following six combinations: 1 = sodium chloride, 2 = platelet-rich plasma, 3 = microcarriers + platelet-rich plasma, 4 = human dermal fibroblasts on microcarriers + platelet-rich plasma, 5 = human osteoblasts on microcarriers + platelet-rich plasma, and 6 = osteogenically induced human dermal fibroblasts on microcarriers + platelet-rich plasma. The femoral defects were assessed 4 weeks postoperatively with computed tomography (CT), routine histological staining, fluorescence in situ hybridisation, and polyclonal antibodies directed towards osteocalcin and osteonectin. Radiographs of all groups taken 4 weeks postoperatively showed unhealed defects. Femoral defects transplanted with osteogenically-induced human dermal fibroblasts on microcarriers (group 6) contained dense clusters of cells with large quantities of extracellular matrix. These clusters were exclusive to this group and stained strongly for osteocalcin and osteonectin. Fluorescence in situ hybridisation showed viable human cells in femoral defects that had been transplanted with microcarriers seeded with cells, which confirmed the survival of implanted cells. In conclusion, osteogenically-induced human dermal fibroblasts survived in this new niche, and bone-like structures were apparent in the defects.

  • 21.
    Svernlöv, Birgitta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Adolfsson, Lars
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Outcome of release of the lateral extensor muscle origin for epicondylitis2006In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 40, no 3, p. 161-165Article in journal (Refereed)
    Abstract [en]

    Fifty-five elbows in 53 patients affected by lateral epicondylitis for more than a year were operated on with lateral extensor release. Fifty-one patients (53 elbows) were followed-up 90 months postoperatively by two independent observers using Verhaar's score and the subjective grading scheme described by Svernlöv and Adolfsson. According to Verhaar's score 26 (49%) were excellent or good and 27 (51%) fair or poor. Women had significantly worse results than men (p

  • 22.
    Thorfinn, Johan
    et al.
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Faculty of Health Sciences.
    Lidman, Disa
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Perfusion of buttock skin in healthy volunteers after long and short repetitive loading evaluated by laser Doppler perfusion imager2007In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 41, no 6, p. 297-302Article in journal (Refereed)
    Abstract [en]

    Frequent unloading is vital to avoid pressure ulcers of the seat area in patients with injuries to the spinal cord. The duration of unloading is probably as important as that of the sitting period in the prophylaxis of pressure ulcers. The aim of this study was to investigate the microcirculatory reactions after occlusion of the buttock skin after repeated ischaemic provocation. The perfusion of buttock skin was studied with a laser Doppler perfusion imager (LDPI) in healthy people after short and long periods of sitting (repeated four times). The perfusion increased significantly during the consecutive loadings compared with the first loading, and this effect was more profound after the long load. Repeated periods of ischaemia of the buttock skin without allowing the tissues to recover resulted in increasing reactive hyperaemia, and are therefore probably more damaging than single loadings. This is important when establishing clinical guidelines for the prophylaxis of pressure ulcers in patients with spinal cord injuries.

  • 23.
    Thorfinn, Johan
    et al.
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Faculty of Health Sciences.
    Lidman, Disa
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Sitting can cause ischaemia in the subcutaneous tissue of the buttocks, which implicates multilayer tissue damage in the development of pressure ulcers2009In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 43, no 2, p. 82-89Article in journal (Refereed)
    Abstract [en]

    A better understanding of how pressure ulcers develop in the buttocks will improve prophylactic measures. Our aim was to investigate signs of reduced perfusion and ischaemia in the subcutaneous fat in the buttocks during sitting. A microelectrode was used to quantify oxygen (pO2). Metabolites that indicate aerobic or anaerobic metabolism (glucose, lactate, pyruvate, and glycerol) were quantified using microdialysis. Sixteen healthy people were studied while they sat on a wheel chair cushion, and a hard surface. Sitting pressures were mapped, and the thickness of the subcutaneous fatty layer was measured. The results showed that pO2 and glucose were significantly reduced during sitting, and for pO2 the effect is significantly more profound during sitting on a hard surface. After loading, both glucose and pO2 increased significantly. We conclude that the subcutaneous adipose tissue covering the ischial tuberosities becomes ischaemic during sitting. This finding supports the theory that not only is the skin involved in early development of pressure ulcers, but also the deeper tissues.

  • 24.
    Thorfinn, Johan
    et al.
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Faculty of Health Sciences.
    Lidman, Disa
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Sitting pressure and perfusion of buttock skin in paraplegic and tetraplegic patients, and in healthy subjects: a comparative study2002In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 36, no 5, p. 279-283Article in journal (Refereed)
    Abstract [en]

    The distribution of sitting pressure and ability to respond with reactive hyperaemia were studied in a group of paraplegic and tetraplegic patients (n = 8) with spinal cord lesions and healthy controls (n = 10) using a pressure sensitive plate and laser Doppler perfusion imager. The results show that the mean sitting pressure of the patients was 9.9 N/cm2 (left) and 11.7 N/cm2 (right) compared with 3.5 N/cm2 (left) and 3.6 N/cm2 (right) in controls. The differences were significant on both the left (p < 0.01) and right (p < 0.05) sides. The maximum pressure in patients was 42.9 N/cm2 (left) and 48.7 N/cm2 (right), and in controls 12.0 N/cm2 (left) and 12.9 (right) (p < 0.01). Both groups showed a reduction in skin perfusion in the seat area during sitting compared with unloaded resting, and in the controls it was significantly increased (p < 0.001 on both sides) during the reactive hyperaemic phase immediately after sitting. Compared with the preload values, the patients showed a similar but slightly weaker picture significant on the right side (p < 0.05), but not on the left. The hyperaemia was not uniformly distributed, but occurred where the pressure was greater than 2 N/cm2. There was no correlation between the amount of reactive hyperaemia and absolute values of sitting pressures. We conclude that tetraplegic and paraplegic patients have significantly higher sitting pressures than normal controls, and that the hyperaemic response in the buttock region in the upright position after pressure load is slightly weaker in the patients, which could be of importance for the development of decubitus ulcers.

  • 25.
    Thorfinn, Johan
    et al.
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Faculty of Health Sciences.
    Sjöstrand, Lotta
    Linköping University, Faculty of Health Sciences.
    Lidman, Disa
    Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
    Perfusion of the skin of the buttocks in paraplegic and tetraplegic patients, and in healthy subjects after a short and long load2006In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 40, no 3, p. 153-160Article in journal (Refereed)
    Abstract [en]

    In patients with spinal cord injuries (n=8) and healthy controls (n=8) the hyperaemic response in the buttock skin after sitting on a hard surface was studied using a laser Doppler perfusion imager. They sat for three minutes (short load), or 15 minutes (long load). An exponential mathematical function was used to compare the mean perfusion during the observed interval. The results showed that preloading perfusion is significantly higher among patients than healthy subjects. In both groups, the microcirculation of the skin increased significantly after loading, and peak perfusion was significantly lower after the short load. The mean perfusion was higher among the patients after both loadings, which suggests that there was stronger ischaemic provocation. The main outcome was that there was a dose-response relation between duration of loading and intensity of reactive hyperaemia, and that patients with spinal cord injuries have greater perfusion before and after loading than healthy controls.

  • 26. Turczynski, R
    et al.
    Tarpila, Erkki
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Treatment of leg ulcers with split skin graft.Short-time and late results.1999In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 33, p. 301-305Article in journal (Refereed)
  • 27.
    Zdolsek, Johann
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology.
    Droog, Erik
    Thorfinn, Johan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Lidman, Disa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Laser Doppler perfusion imaging of the radial forearm flap: A clinical study2006In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 40, no 2, p. 101-105Article in journal (Refereed)
    Abstract [en]

    Laser Doppler perfusion imaging (LDPI) allows non-invasive assessment of blood flow in a predefined area of skin rather than at one single point. We have used LDPI to study the pattern of skin blood flow in the radial forearm flap before and after the flap has been raised. The data were collected from a consecutive series of 11 patients with cancer of the oral cavity or oropharynx in whom the radial forearm flap had been used during the reconstructive procedure. Reperfusion leads to an immediate hyperaemic response both in the flap and the surrounding skin. This hyperaemia remains for at least the first 30 minutes after reperfusion. The perfusion of the radial side of the forearm skin distal to the flap is significantly lower than that on the ulnar side after the skin island has been raised and the distal artery divided. We suggest that LDPI is useful for monitoring the perfusion of free skin flaps. © 2006 Taylor & Francis.

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