| 1. |
- Bergquist, Maria, et al.
(författare)
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The time-course of the inflammatory response to major burn injury and its relation to organ failure and outcome
- 2019
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Ingår i: Burns. - : Elsevier BV. - 0305-4179 .- 1879-1409. ; 45:2, s. 354-363
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Tidskriftsartikel (refereegranskat)abstract
- Burn injury causes major inflammatory activation and cytokine release, however, the temporal resolution of the acute and sub-acute inflammatory response has not yet been fully delineated. To this end, we have quantified 20 inflammatory mediators in plasma from 44 adult patients 0-21 days after burn injury and related the time course of these mediators to % total body surface area (TBSA) burned, clinical parameters, organ failure and outcome. Of the cytokines analyzed in these patients, interleukin 6 (IL-6), IL-8, IL-10 and monocyte chemoattractant protein 1 (MCP-1) correlated to the size of the injury at 24-48h after burn injury. In our study, the concentration of IL-10 had prognostic value in patients with burn injury both measured at admission and at 24-48h after injury. However, simple demographic data such as age, % burned TBSA, inhalation injury and their combination, the Baux score and modified Baux score, outperform most of the cytokines, with the exception of IL-8 and MCP1 levels on admission, in predicting death.
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| 2. |
- Karlsson, Matilda, et al.
(författare)
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Biosynthetic cellulose compared to porcine xenograft in the treatment of partial-thickness burns : A randomised clinical trial.
- 2022
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Ingår i: Burns. - : Elsevier. - 0305-4179 .- 1879-1409. ; 48:5, s. 1236-1245
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim was to compare two dressing treatments for partial-thickness burns: biosynthetic cellulose dressing (BsC) (Epiprotect® S2Medical AB, Linköping, Sweden) and porcine xenograft (EZ Derm®, Mölnlycke Health Care, Gothenburg, Sweden).METHODS: Twenty-four adults with partial-thickness burns were included in this randomized clinical trial conducted at The Burn Centers in Linköping and Uppsala, Sweden between June 2016 and November 2018. Time to healing was the primary outcome. Secondary outcomes were wound infection, pain, impact on everyday life, length of hospital stay, cost, and burn scar outcome (evaluated with POSAS).RESULTS: We found no significant differences between the two dressing groups regarding time to healing, wound infection, pain, impact on everyday life, duration of hospital stay, cost, or burn scar outcome at the first follow up. Burn scar outcome at the 12-month follow up showed that the porcine xenograft group patients scored their scars higher on the POSAS items thickness (p = 0.048) and relief (p = 0.050). This difference was, however, not confirmed by the observer.CONCLUSIONS: The results showed the dressings performed similarly when used in adults with burns evaluated as partial thickness.
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| 3. |
- Bergquist, Maria, et al.
(författare)
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Altered adrenal and gonadal steroids biosynthesis in patients with burn injury
- 2016
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Ingår i: Clinical Mass Spectrometry. - : Elsevier BV. - 2213-8005 .- 2376-9998. ; 1, s. 19-26
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Burn injury inevitably leads to changes in the endogenous production of cytokines, as well as adrenal and gonadal steroids. Previous studies have reported gender-related differences in outcome following burn injury, which suggests that gonadal steroids may play a role. The aim of this study was to assess alterations in concentration of endogenous steroids in patients with burn injury.Methods: For this single-center, prospective descriptive study, high-sensitivity liquid chromatography tandem mass spectrometry (LC-MS/MS)-based steroid quantification was used to determine longitudinal profiles of the concentrations of endogenous steroids in plasma from sixteen adult male patients with burn injury (14.5-72% of total body surface area). Steroids were extracted from plasma samples and analyzed using multiple reaction monitoring acquisition, with electrospray ionization on a triple quadruple mass spectrometer. Total protein concentration was measured in the samples using spectrophotometry.Results: Steroid and total protein concentration distributions were compared to reference intervals characteristic of healthy adult men. Concentrations of the following steroids in plasma of burn injured patients were found to correlate positively to the area of the burn injury: cortisol (r = 0.84), corticosterone (r = 0.73), 11-deoxycortisol (r = 0.72), androstenedione (r = 0.72), 17OH-progesterone (r = 0.68), 17OH-pregnenolone (r = 0.64) and pregnenolone (r = 0.77). Concentrations of testosterone decreased during the acute phase and were up to ten-times lower than reference values for healthy adult men, while concentrations of estrone were elevated. By day 21 after injury, testosterone concentrations were increased in younger, but not older, patients. The highest concentrations of estrone were observed on day 3 after the injury and then declined by day 21 to concentrations comparable to those observed on the day of the injury.Conclusion: Burn injury alters endogenous steroid biosynthesis, with decreased testosterone concentrations and elevated estrone concentrations, during the first 21 days after the injury. Concentrations of glucocorticoids, progestagens and androgen precursors correlated positively with the area of burn injury. The finding of increased estrone following burn injury needs to be confirmed in a larger hypothesis driven study.
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| 4. |
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| 5. |
- Greenhalgh, David G., et al.
(författare)
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Surviving Sepsis After Burn Campaign
- 2023
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Ingår i: Burns. - : Elsevier. - 0305-4179 .- 1879-1409. ; 49:7, s. 1487-1524
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The Surviving Sepsis Campaign was developed to improve outcomes for all patients with sepsis. Despite sepsis being the primary cause of death after thermal injury, burns have always been excluded from the Surviving Sepsis efforts. To improve sepsis outcomes in burn patients, an international group of burn experts developed the Surviving Sepsis After Burn Campaign (SSABC) as a testable guideline to improve burn sepsis outcomes. Methods: The International Society for Burn Injuries (ISBI) reached out to regional or na-tional burn organizations to recommend members to participate in the program. Two members of the ISBI developed specific "patient/population, intervention, comparison and out-come" (PICO) questions that paralleled the 2021 Surviving Sepsis Campaign [1]. SSABC parti-cipants were asked to search the current literature and rate its quality for each topic. At the Congress of the ISBI, in Guadalajara, Mexico, August 28, 2022, a majority of the participants met to create "statements" based on the literature. The "summary statements" were then sent to all members for comment with the hope of developing an 80% consensus. After four reviews, a consensus statement for each topic was created or "no consensus" was reported. Results: The committee developed sixty statements within fourteen topics that provide guidance for the early treatment of sepsis in burn patients. These statements should be used to improve the care of sepsis in burn patients. The statements should not be considered as "static" comments but should rather be used as guidelines for future testing of the best treatments for in burn should be on a basis. Conclusion: Members of the burn community from the around the world have developed the Surviving Sepsis After Burn Campaign guidelines with the goal of improving the outcome of sepsis in burn patients. (c) 2023 Elsevier Ltd and ISBI. All rights reserved.
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| 6. |
- Holm, Sebastian, et al.
(författare)
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Cutaneous steam burns and steam inhalation injuries : a literature review and a case presentation
- 2022
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Ingår i: European journal of plastic surgery. - : Springer Nature. - 0930-343X .- 1435-0130. ; 45:6, s. 881-896
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Tidskriftsartikel (refereegranskat)abstract
- Scald is one type of burn that s often mentioned alone and occurs mostly in the paediatric population. Inhaled steam is mostly cooled off in the airways, why thermal damage is rarely seen. A sudden exposure to hot steam/inhalation can cause a thermal inhalation injury. A scoping review was performed, with the aim to summarize all published papers in English, about steam-related injuries. The search was conducted using the PubMed (R) and Cochrane libraries on 19th of May 2021, without a set time period. Out of a total of 1186 identified records, 31 were chosen for review. Burns related to the contact with steam are generally rare and can be both minor and severe. The more severe cases related to steam exposure are mostly workplace accidents and the minor injuries reported in the literature are often related to steam inhalation therapy, especially in the paediatric population. This review describes the challenges that can be found dealing with patients suffering from cutaneous steam burns and/or steam inhalation injuries. A steam injury to the airways or the skin can be directly life-threatening and should be treated with caution. This type of injury can lead to acute respiratory insufficiency and sometimes death. A case of a male patient with extensive cutaneous steam burns and a steam inhalation injury who passed away after 11 days of treatment is also presented to illustrate this review. Level of evidence: Level V, Therapeutic; Risk/Prognostic Study.
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| 7. |
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| 8. |
- Huss, Fredrik, 1971-, et al.
(författare)
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Buses as fire hazards : A Swedish problem only? Suggestions for fire-prevention measures
- 2004
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Ingår i: Journal of Burn Care and Rehabilitation. - 0273-8481 .- 1534-5939. ; 25:4, s. 377-380
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, approximately 6% of all human transportation is made via buses. The Swedish Board of Accident Investigation and the Swedish Rescue Services Agency have pointed out repeatedly that buses are potential fire and burn hazards, not only when involved in collisions but also in other circumstances. The number of fire incidents is increasing, especially in newer buses. In conjunction with the Swedish Rescue Services Agency, we examined some of the recent bus fires in Sweden. We did not find any casualties, but the results of our study suggest that casualties as a result of bus fires are imminent unless preventive measures are taken. We also studied experiences from previous bus fires and suggest preventive measures.
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| 9. |
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| 10. |
- Sommar, Pehr, et al.
(författare)
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[Burns].
- 2008
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 105:48-49, s. 3547-52
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Tidskriftsartikel (refereegranskat)
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