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Sjöberg, F., Elmasry, M., Abdelrahman, I., Nyberg, G., T-Elserafi, A., Ursing, E. & Steinvall, I. (2024). The impact and validity of the Berlin criteria on burn-induced ARDS: Examining mortality rates, and inhalation injury influences. A single center observational cohort study.. Burns, Article ID S0305-4179(24)00149-9.
Åpne denne publikasjonen i ny fane eller vindu >>The impact and validity of the Berlin criteria on burn-induced ARDS: Examining mortality rates, and inhalation injury influences. A single center observational cohort study.
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2024 (engelsk)Inngår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, artikkel-id S0305-4179(24)00149-9Artikkel i tidsskrift (Fagfellevurdert) Epub ahead of print
Abstract [en]

BACKGROUND: As several recent studies have shown low mortality rates in burn injury induced ARDS early (≤7 days) after the burn, the Berlin criteria for the ARDS diagnosis in this setting may be disputed. Related to this issue, the present study investigated the incidence, trajectory and risk factors of early Acute Respiratory Distress Syndrome (ARDS) and outcome in burn patients, as per the Berlin criteria, along with the concurrent prevalence and influence of inhalation injury, and ventilator-acquired pneumonia (VAP).

METHODS: Over a 2.5-year period, burn patients with Total Burn Surface Area (TBSA) exceeding 10% admitted to a national burn center were included. The subgroup of interest comprised patients with more than 48 h of ventilatory support. This group was assessed for ARDS, inhalation injury, and VAP.

RESULTS: Out of 292 admissions, 62 sustained burns > 10% TBSA. Of these, 28 (45%) underwent ventilatory support for over 48 h, almost all, 24 out of 28, meeting the criteria for ARDS early, within 7 days post-injury and with a PaO2/FiO2 (PF) ratio nadir at day 5. The mortality rate for this early ARDS group was under 10%, regardless of PF ratios (mean TBSA% 34,8%). Patients with concurrent inhalation injury and early ARDS showed significantly lower PF ratios (p < 0.001), and higher SOFA scores (p = 0.004) but without impact on mortality. Organ failure, indicated by SOFA scores, peaked early (day 3) and declined in the first week, mirroring PF ratio trends (p < 0.001).

CONCLUSIONS: The low mortality associated with early ARDS in burn patients in this study challenges the Berlin criteria's for the early ARDS diagnosis, which for its validity relies on that higher mortality is linked to worsening PF ratios. The finding suggests alternative mechanisms, leading to the early ARDS diagnosis, such as the significant impact of inhalation injury on early PF ratios and organ failure, as seen in this study. The concurrence of early organ failure with declining PF ratios, supports, as expected, the hypothesis of trauma-induced inflammation/multi-organ failure mechanisms contributing to early ARDS. The study highlights the complexity in differentiating between the contributions of inhalation injury to early ARDS and the related organ dysfunction early in the burn care trajectory. The Berlin criteria for the ARDS diagnosis may not be fully applicable in the burn care setting, where the low mortality significantly deviates from that described in the original Berlin ARDS criteria publication but is as expected when considering the actual not very extensive burn injury sizes/Baux scores as in the present study.

sted, utgiver, år, opplag, sider
Elsevier, 2024
Emneord
ARDS, Burns, Inhalation injury, Mortality ventilatory acquired pneumonia
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-203817 (URN)10.1016/j.burns.2024.05.005 (DOI)38777667 (PubMedID)
Merknad

Funding agencies: The Carnegie Foundation, Stockholm, Sweden. King Gustaf the Vth and Queen Victoria Foundation, Stockholm and King Gustaf foundation, “Frimurarestiftelsen” Stockholm Sweden. Linköping University Hospital and Linköping University, Linköping Sweden.

Tilgjengelig fra: 2024-05-27 Laget: 2024-05-27 Sist oppdatert: 2024-05-28
Parker, V. E. R., Robertson, D., Erazo-Tapia, E., Havekes, B., Phielix, E., de Ligt, M., . . . Schrauwen, P. (2023). Cotadutide promotes glycogenolysis in people with overweight or obesity diagnosed with type 2 diabetes. Nature Metabolism, 5, 2086-2093
Åpne denne publikasjonen i ny fane eller vindu >>Cotadutide promotes glycogenolysis in people with overweight or obesity diagnosed with type 2 diabetes
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2023 (engelsk)Inngår i: Nature Metabolism, E-ISSN 2522-5812, Vol. 5, s. 2086-2093Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Cotadutide is a dual glucagon-like peptide 1 and glucagon receptor agonist under development for the treatment of non-alcoholic steatohepatitis and type 2 diabetes mellitus (T2DM) and chronic kidney disease. Non-alcoholic steatohepatitis is a complex disease with no approved pharmacotherapies, arising from an underlying state of systemic metabolic dysfunction in association with T2DM and obesity. Cotadutide has been shown to improve glycaemic control, body weight, lipids, liver fat, inflammation and fibrosis. We conducted a two-part, randomized phase 2a trial in men and women with overweight or obesity diagnosed with T2DM to evaluate the efficacy and safety of cotadutide compared with placebo and liraglutide. The primary endpoints were change from baseline to day 28 of treatment in postprandial hepatic glycogen (part A) and to day 35 of treatment in fasting hepatic glycogen (part B) with cotadutide versus placebo. Secondary endpoints in part B were changes in fasting hepatic glycogen with cotadutide versus the mono glucagon-like peptide 1 receptor agonist, liraglutide, and change in hepatic fat fraction. The trial met its primary endpoint. We showed that cotadutide promotes greater reductions in liver glycogen and fat compared with placebo and liraglutide. Safety and tolerability findings with cotadutide were comparable to those of previous reports. Thus, this work provides evidence of additional benefits of cotadutide that could be attributed to glucagon receptor engagement. Our results suggest that cotadutide acts on the glucagon receptor in the human liver to promote glycogenolysis and improve the metabolic health of the liver. ClinicalTrials.gov registration: NCT03555994. In a two-part randomized phase 2a trial in men and women with overweight or obesity and type 2 diabetes mellitus, cotadutide promoted greater reductions in liver glycogen and fat than placebo and liraglutide.

sted, utgiver, år, opplag, sider
NATURE PORTFOLIO, 2023
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-200002 (URN)10.1038/s42255-023-00938-0 (DOI)001117026600001 ()38066113 (PubMedID)
Merknad

Funding Agencies|AstraZeneca

Tilgjengelig fra: 2024-01-11 Laget: 2024-01-11 Sist oppdatert: 2024-05-03
Elewa, A. M., Faisal, M., Sjöberg, F. & Abuelnaga, M. E. (2023). Erector spinae plane block versus paravertebral block in analgesic outcomes following breast surgery [Letter to the editor]. BMC Anesthesiology, 23(1), Article ID 19.
Åpne denne publikasjonen i ny fane eller vindu >>Erector spinae plane block versus paravertebral block in analgesic outcomes following breast surgery
2023 (engelsk)Inngår i: BMC Anesthesiology, E-ISSN 1471-2253, Vol. 23, nr 1, artikkel-id 19Artikkel i tidsskrift, Letter (Annet vitenskapelig) Published
Abstract [en]

This article represents the response to the inquiries adopted by Dr. Raghuraman M Sethuraman, M.D., regarding our recently published study which compared the erector spinae plane block (ESPB) versus paravertebral block (PVB) regarding postoperative analgesic consumption following breast surgeries (Elewa et al, BMC Anesthesiol 22: 1-9, 2022). We would like to introduce our appreciation and gratitude to the author for his interest in our work, despite being inaccurate in some of his comments.

sted, utgiver, år, opplag, sider
BMC, 2023
Emneord
Erector spinae plane block; Modified radical mastectomy; Paravertebral block
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-191854 (URN)10.1186/s12871-022-01950-9 (DOI)000912356500001 ()36631777 (PubMedID)
Tilgjengelig fra: 2023-02-21 Laget: 2023-02-21 Sist oppdatert: 2024-05-03
Leclerc, T., Sjöberg, F., Jennes, S., Mendez, J. R., van der Vlies, C. H., Battistutta, A., . . . Almeland, S. K. (2023). European Burns Association guidelines for the management of burn mass casualty incidents within a European response plan. Burns, 49(2), 275-303
Åpne denne publikasjonen i ny fane eller vindu >>European Burns Association guidelines for the management of burn mass casualty incidents within a European response plan
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2023 (engelsk)Inngår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 49, nr 2, s. 275-303Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: A European response plan to burn mass casualty incidents has been jointly developed by the European Commission and the European Burn Association. Upon request for assistance by an affected country, the plan outlines a mechanism for coordinated international assistance, aiming to alleviate the burden of care in the affected country and to offer adequate specialized care to all patients who can benefit from it. To that aim, Burn Assessment Teams are deployed to assess and triage patients. Their transportation priority recommendations are used to distribute outnumbering burn casualties to foreign burn centers. Following an appropriate medical evacuation, these casualties receive specialized care in those facilities. Methods: The European Burns Associations disaster committee developed medical-organizational guidelines to support this European plan. The experts identified fields of interest, defined questions to be addressed, performed relevant literature searches, and added their expertise in burn disaster preparedness and response. Due to the lack of highlevel evidence in the available literature, recommendations and specially designed implementation tools were provided from expert opinion. The European Burns Association officially endorsed the draft recommendations in 2019, and the final full text was approved by the EBA executive committee in 2022. Recommendations: The resulting 46 recommendations address four fields. Field 1 underlines the need for national preparedness plans and the necessary core items within such plans, including coordination and integration with an international response. Field 2 describes Burn Assessment Teams roles, composition, training requirements, and reporting goals. Field 3 addresses the goals of specialized in-hospital triage, appropriate severity criteria, and their effects on priorities and triage. Finally, field 4 covers medical evacuations, including their timing and organization, the composition of evacuation teams and their assets, preparation, and the principles of en route care. (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

sted, utgiver, år, opplag, sider
ELSEVIER SCI LTD, 2023
Emneord
Burns; Mass casualty incidents; Disaster planning; Burn assessment teams; Triage; Patients transportation
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-193408 (URN)10.1016/j.burns.2022.12.011 (DOI)000957684500001 ()36702682 (PubMedID)
Merknad

Funding Agencies|European Commission, Directorate-General for European Civil Protection and Humanitarian Aid Operations (ECHO); European Commission, Directorate-General for European Civil Protection and Humanitarian Aid Operations (ECHO) [ECHOB1-NP-2019-05]

Tilgjengelig fra: 2023-05-05 Laget: 2023-05-05 Sist oppdatert: 2024-05-03
Dogan, S., Elmasry, M., Elserafy, A. T., Sjöberg, F., Vuola, J., Kankuri, E., . . . Lindford, A. (2022). A prospective dual-centre intra-individual controlled study for the treatment of burns comparing dermis graft with split-thickness skin auto-graft. Scientific Reports, 12(1), Article ID 21666.
Åpne denne publikasjonen i ny fane eller vindu >>A prospective dual-centre intra-individual controlled study for the treatment of burns comparing dermis graft with split-thickness skin auto-graft
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2022 (engelsk)Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 12, nr 1, artikkel-id 21666Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

To investigate if donor and recipient site morbidity (healing time and cosmesis) could be reduced by a novel, modified split-thickness skin grafting (STSG) technique using a dermal component in the STSG procedure (DG). The STSG technique has been used for 150 years in surgery with limited improvements. Its drawbacks are well known and relate to donor site morbidity and recipient site cosmetic shortcomings (especially mesh patterns, wound contracture, and scarring). The Dermal graft technique (DG) has emerged as an interesting alternative, which reduces donor site morbidity, increases graft yield, and has the potential to avoid the mesh procedure in the STSG procedure due to its elastic properties. A prospective, dual-centre, intra-individual controlled comparison study. Twenty-one patients received both an unmeshed dermis graft and a regular 1:1.5 meshed STSG. Aesthetic and scar assessments were done using The Patient and Observer Scar Assessment Scale (POSAS) and a Cutometer Dual MPA 580 on both donor and recipient sites. These were also examined histologically for remodelling and scar formation. Dermal graft donor sites and the STSG donor sites healed in 8 and 14 days, respectively (p < 0.005). Patient-reported POSAS showed better values for colour for all three measurements, i.e., 3, 6, and 12 months, and the observers rated both vascularity and pigmentation better on these occasions (p < 0.01). At the recipient site, (n = 21) the mesh patterns were avoided as the DG covered the donor site due to its elastic properties and rendered the meshing procedure unnecessary. Scar formation was seen at the dermal donor and recipient sites after 6 months as in the standard scar healing process. The dermis graft technique, besides potentially rendering a larger graft yield, reduced donor site morbidity, as it healed faster than the standard STSG. Due to its elastic properties, the DG procedure eliminated the meshing requirement (when compared to a 1:1.5 meshed STSG). This promising outcome presented for the DG technique needs to be further explored, especially regarding the elasticity of the dermal graft and its ability to reduce mesh patterns. Trial registration: ClinicalTrials.gov Identifier (NCT05189743) 12/01/2022. © 2022, The Author(s).

Emneord
burns, cicatrix, dermis, humans, prospective studies, skin transplantation
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-190855 (URN)10.1038/s41598-022-25346-4 (DOI)001015461100020 ()36522434 (PubMedID)2-s2.0-85144147270 (Scopus ID)
Merknad

Funding: Linkoping University; Department of Plastic and Hand Surgery Linkoping University Hospital; Department of Biomedical and Clinical Sciences, Linkoping University, Linkoping

Tilgjengelig fra: 2023-01-03 Laget: 2023-01-03 Sist oppdatert: 2024-01-10
Steinvall, I., Elmasry, M., Abdelrahman, I., El-Serafi, A. T., Fredrikson, M. & Sjöberg, F. (2022). ABO blood group and effects on ventilatory time, length of stay and mortality in major burns a retrospective observational outcome study. Burns, 48(4), 785-790
Åpne denne publikasjonen i ny fane eller vindu >>ABO blood group and effects on ventilatory time, length of stay and mortality in major burns a retrospective observational outcome study
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2022 (engelsk)Inngår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 48, nr 4, s. 785-790Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Blood group has been found to be important in the development of many diseases and the outcome of several disease processes, especially cardiovascular morbidity and mortality, such as caused by trauma and sepsis. The main reason is claimed to be related to glycobiology and effects mediated through the endothelium. This study investigated the possible effect of blood group (ABO) on burn care outcome. Burn outcome prediction models are extremely accurate and as such can be used to identify outcome effects even in single centre settings. In this retrospective risk adjusted observational study, we investigated the effect of ABO blood group on ventilatory time, length of hospital stay (LOS), and 90 day mortality among patients with burns. RESULTS: A total of 225 patients were included (2008-2019) with median TBSA of 26%; interquartile range (IQR) of 20-37%; median age 45 years (IQR 22-65 years); median Baux score (age + TBSA%); 76 (IQR 53- 97); 168 (75%) were male; median duration of hospital stay was 31 days (IQR 19-56); a total of 138 (61%) received treatment with mechanical ventilation; and 29 (13%) died. In a multivariable regression model, we were unable to isolate any significant effect of any blood group (O, A, B, AB) on the outcome measures studied (ventilatory time, LOS, and mortality). IN SUMMARY: contrary to many other major areas of disease in which ABO blood groups affect outcome, we were unable to find any such effect on patients with burns. Given the precision of the outcome models presented (AUC 0.93) any such an effect, if missed due to the limited study cohort, may be considered limited and to have only a minor clinical impact.

sted, utgiver, år, opplag, sider
Oxford, United Kingdom: Elsevier, 2022
Emneord
ICU; Large burns; Mortality prediction; Survival; Total Body Surface area burned (TBSA %)
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-183534 (URN)10.1016/j.burns.2022.02.001 (DOI)000833489400007 ()35227532 (PubMedID)2-s2.0-85125505549 (Scopus ID)
Merknad

Funding agencies: Carnegie foundation (Stockholm, Sweden); Queen Victoria Foundation (Stockholm, Sweden); Department of Hand Surgery, Plastic Surgery and Burns, Linkoping University Hospital; Linkoping University Linkoping, Sweden

Tilgjengelig fra: 2022-03-17 Laget: 2022-03-17 Sist oppdatert: 2024-01-10bibliografisk kontrollert
Ellabban, M. A., Elmasry, M., Abdelrahman, I., Abdel Kader, G., Steinvall, I., Sjöberg, F., . . . Abdel Fattah, I. O. (2022). Experimental study of the effects of nitroglycerin, botulinum toxin A, and clopidogrel on bipedicled superficial inferior epigastric artery flap survival.. Scientific Reports, 12(1), Article ID 20891.
Åpne denne publikasjonen i ny fane eller vindu >>Experimental study of the effects of nitroglycerin, botulinum toxin A, and clopidogrel on bipedicled superficial inferior epigastric artery flap survival.
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2022 (engelsk)Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 12, nr 1, artikkel-id 20891Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Beneficial effects could be achieved by various agents such as nitroglycerin, botulinum toxin A (BoTA), and clopidogrel to improve skin flap ischaemia and venous congestion injuries. Eighty rats were subjected to either arterial ischaemia or venous congestion and applied to a bipedicled U-shaped superficial inferior epigastric artery (SIEA) flap with the administration of nitroglycerin, BoTA, or clopidogrel treatments. After 7 days, all rats were sacrificed for flap evaluation. Necrotic area percentage was significantly minimized in flaps treated with clopidogrel (24.49%) versus the ischemic flaps (34.78%); while nitroglycerin (19.22%) versus flaps with venous congestion (43.26%). With ischemia, light and electron microscopic assessments revealed that nitroglycerin produced degeneration of keratinocytes and disorganization of collagen fibers. At the same time, with clopidogrel administration, there was an improvement in the integrity of these structures. With venous congestion, nitroglycerin and BoTA treatments mitigated the epidermal and dermal injury; and clopidogrel caused coagulative necrosis. There was a significant increase in tissue gene expression and serum levels of vascular endothelial growth factor (VEGF) in ischemic flaps with BoTA and clopidogrel, nitroglycerin, and BoTA clopidogrel in flaps with venous congestion. With the 3 treatment agents, gene expression levels of tumor necrosis factor-α (TNF-α) were up-regulated in the flaps with ischemia and venous congestion. With all treatment modalities, its serum levels were significantly increased in flaps with venous congestion and significantly decreased in ischemic flaps. Our analyses suggest that the best treatment option for ischemic flaps is clopidogrel, while for flaps with venous congestion are nitroglycerin and BoTA.

sted, utgiver, år, opplag, sider
Nature Publishing Group, 2022
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-192151 (URN)10.1038/s41598-022-24898-9 (DOI)000969757300018 ()36463303 (PubMedID)
Tilgjengelig fra: 2023-03-06 Laget: 2023-03-06 Sist oppdatert: 2024-01-10bibliografisk kontrollert
Henricson, J., Sjöberg, F., Iredahl, F., Strömberg, T. & Björk Wilhelms, D. (2022). In vivo dose-response analysis to acetylcholine: pharmacodynamic assessment by polarized reflectance spectroscopy. Scientific Reports, 12(1), Article ID 6594.
Åpne denne publikasjonen i ny fane eller vindu >>In vivo dose-response analysis to acetylcholine: pharmacodynamic assessment by polarized reflectance spectroscopy
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2022 (engelsk)Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 12, nr 1, artikkel-id 6594Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Transdermal iontophoresis offers an in vivo alternative to the strain-gauge model for measurement of vascular function but is limited due to lack of technical solutions for outcome assessment. The aims of this study were to, after measurement by polarized reflectance spectroscopy (PRS), use pharmacodynamic dose-response analysis on responses to different concentrations of acetylcholine (ACh); and to examine the effect of three consecutively administered iontophoretic current pulses. The vascular responses in 15 healthy volunteers to iontophorised ACh (5 concentrations, range 0.0001% to 1%, three consecutive pulses of 0.02 mA for 10 min each) were recorded using PRS. Data were fitted to a four-parameter logistic dose response model and compared. Vascular responses were quantifiable by PRS. Similar pharmacodynamic dose response curves could be generated irrespectively of the ACh concentration. Linearly increasing maximum vasodilatory responses were registered with increasing concentration of ACh. A limited linear dose effect of the concentration of ACh was seen between pulses. Polarized reflectance spectroscopy is well suited for measuring vascular responses to iontophoretically administrated ACh. The results of this study support further development of iontophoresis as a method to study vascular function and pharmacological responses in vivo.

sted, utgiver, år, opplag, sider
London, United Kingdom: Nature Publishing Group, 2022
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-185028 (URN)10.1038/s41598-022-10617-x (DOI)000784878300039 ()35449189 (PubMedID)2-s2.0-85128631757 (Scopus ID)
Merknad

Funding Agencies: Linköping University; ALF grants; Region Östergotland, Linköping, Sweden [RO-726731]

Tilgjengelig fra: 2022-05-18 Laget: 2022-05-18 Sist oppdatert: 2022-09-15bibliografisk kontrollert
Pompermaier, L., Drake Af Hagelsrum, E., Ydenius, V., Sjöberg, F., Steinvall, I. & Elmasry, M. (2022). Patient Reported Experiences at a Swedish National Burn Centre. Journal of Burn Care & Research, 43(1), 249-254
Åpne denne publikasjonen i ny fane eller vindu >>Patient Reported Experiences at a Swedish National Burn Centre
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2022 (engelsk)Inngår i: Journal of Burn Care & Research, ISSN 1559-047X, E-ISSN 1559-0488, Vol. 43, nr 1, s. 249-254Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Previous studies have shown that burn patients were satisfied with the received care. Satisfaction was not strongly associated to burns or to psycho-social characteristics, suggesting that other factors, related to burn care specific aspects, may be important. The aim of this study was to analyze the independent effect of provided workload on the general satisfaction in adult patients at a Swedish national Burn Centre. The study population (n = 122) included patients ≥18 years, treated at the Linköping Burn Centre between 2016 and 2017. Experienced burn care was evaluated with the PS-RESKA survey (score range: 0-4), and provided workload was scored with the Burn Scoring System (BSC). Groups were compared with χ 2 test, MW test, or Fisher´s exact test. Multivariable logistic regression analyzed the independent effect of BSC on the outcome High Satisfaction (= score ≥3 to the survey-question: "How would you score your global experience at the Burn Centre?"). In-patients (n = 60) had more often larger burns and required more workload than out-patients (median[IQR]: TBSA% = 6.3 [3-12.3] % vs. 0.7 [0.3-2] %, p < .001; BSC = 65 [25.5-135.5] vs. 6 [4-9], p < .001). Both groups were highly satisfied with the experienced care (mean score [SD] = 3.68 [0.57] vs. 3.41 [0.77], p = .03). Neither characteristics of the patients (age, sex), nor TBSA% nor provided workload (BSC) were independently associated with High Satisfaction. Regardless of burn severity, demographics and provided workload, adult patients with burns were highly satisfied with the experienced burn care. This finding suggested that the reason of the satisfaction was multifactorial.

sted, utgiver, år, opplag, sider
Oxford University Press, 2022
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-178803 (URN)10.1093/jbcr/irab091 (DOI)000744007600034 ()34131732 (PubMedID)
Merknad

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

Tilgjengelig fra: 2021-08-30 Laget: 2021-08-30 Sist oppdatert: 2022-05-19bibliografisk kontrollert
Abdelrahman, I., Steinvall, I., Sjöberg, F., Ellabban, M. A., Zdolsek, J. & Elmasry, M. (2022). Pros and Cons of Early and Late Skin Grafting in Children with Burns—Evaluation of Common Concepts. European Burn Journal, 3(1), 180-187
Åpne denne publikasjonen i ny fane eller vindu >>Pros and Cons of Early and Late Skin Grafting in Children with Burns—Evaluation of Common Concepts
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2022 (engelsk)Inngår i: European Burn Journal, E-ISSN 2673-1991, Vol. 3, nr 1, s. 180-187Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: There is no consensus regarding the timing of surgery in children with smallerburn size, specifically in deep dermal burns. Delayed surgery has risks in terms of infection anddelayed wound healing. Early surgery also risks the removal of potentially viable tissue. Our aim wasto investigate the effect of the timing of surgical intervention on the size of the area operated on andthe time to wound healing. Methods: A retrospective analysis for all children (<18 years) with burnsize <20% body surface area (BSA%) during 2009–2020 who were operated on with a split-thicknessskin graft. The patients were grouped by the timing of the first skin graft operation: early = operatedon within 14 days of injury; delayed = operated on more than two weeks after injury. Results: A totalof 84 patients were included in the study, 43 who had an early operation and 41 who had a delayedoperation. There were no differences between the groups regarding burn size, or whether the burnswere superficial or deep. The mean duration of healing time was seven days longer in the group withdelayed operation (p = 0.001). The area operated on was somewhat larger (not significantly so) in thegroup who had early operation. Nine children had two skin graft operations, eight in the early groupand one in the delayed group (p = 0.03). Conclusion: The patients who were operated on early hadthe advantage of a shorter healing time, but there was a higher rate of complementary operationsand a tendency towards a larger burn excision.

sted, utgiver, år, opplag, sider
MDPI, 2022
Emneord
burns; children; healing time; burn surgery; skin graft
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-183535 (URN)10.3390/ebj3010015 (DOI)
Tilgjengelig fra: 2022-03-17 Laget: 2022-03-17 Sist oppdatert: 2024-06-24bibliografisk kontrollert
Organisasjoner
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-5903-2918