201
|
A Randomized Controlled Pilot Study on Ablative Fractional CO2 Laser for Consecutive Patients Presenting With Various Scar Types. Dermatol Surg 2015; 41:371-7. [DOI: 10.1097/dss.0000000000000306] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
202
|
Personality as a predictor of depression symptoms in burn patients: A follow-up study. Burns 2015; 41:25-32. [DOI: 10.1016/j.burns.2014.07.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 07/15/2014] [Accepted: 07/30/2014] [Indexed: 11/19/2022]
|
203
|
Gardien KLM, Middelkoop E, Ulrich MMW. Progress towards cell-based burn wound treatments. Regen Med 2015; 9:201-18. [PMID: 24750061 DOI: 10.2217/rme.13.97] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cell therapy as part of the concept of regenerative medicine represents an upcoming platform technology. Although cultured epidermal cells have been used in burn treatment for decades, new developments have renewed the interest in this type of treatment. Whereas early results were hampered by long culture times in order to produce confluent sheets of keratinocytes, undifferentiated proliferating cells can nowadays be applied on burns with different application techniques. The application of cells on carriers has improved early as well as long-term results in experimental settings. The results of several commercially available epidermal substitutes for burn wound treatment are reviewed in this article. These data clearly demonstrate a lack of randomized comparative trials and application of measurable outcome parameters. Experimental research in culture systems and animal models has demonstrated new developments and proof of concepts of further improvements in epidermal coverage. These include combinations of epidermal cells and mesenchymal stem cells, and the guidance of both material and cell interactions towards regeneration of skin appendages as well as vascular and nerve structures.
Collapse
Affiliation(s)
- Kim L M Gardien
- Department of Plastic Reconstructive & Hand Surgery, MOVE Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | | | | |
Collapse
|
204
|
van de Schoot R, Broere JJ, Perryck KH, Zondervan-Zwijnenburg M, van Loey NE. Analyzing small data sets using Bayesian estimation: the case of posttraumatic stress symptoms following mechanical ventilation in burn survivors. Eur J Psychotraumatol 2015; 6:25216. [PMID: 25765534 PMCID: PMC4357639 DOI: 10.3402/ejpt.v6.25216] [Citation(s) in RCA: 136] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 02/17/2015] [Accepted: 02/20/2015] [Indexed: 12/03/2022] Open
Abstract
Background : The analysis of small data sets in longitudinal studies can lead to power issues and often suffers from biased parameter values. These issues can be solved by using Bayesian estimation in conjunction with informative prior distributions. By means of a simulation study and an empirical example concerning posttraumatic stress symptoms (PTSS) following mechanical ventilation in burn survivors, we demonstrate the advantages and potential pitfalls of using Bayesian estimation. Methods : First, we show how to specify prior distributions and by means of a sensitivity analysis we demonstrate how to check the exact influence of the prior (mis-) specification. Thereafter, we show by means of a simulation the situations in which the Bayesian approach outperforms the default, maximum likelihood and approach. Finally, we re-analyze empirical data on burn survivors which provided preliminary evidence of an aversive influence of a period of mechanical ventilation on the course of PTSS following burns. Results : Not suprisingly, maximum likelihood estimation showed insufficient coverage as well as power with very small samples. Only when Bayesian analysis, in conjunction with informative priors, was used power increased to acceptable levels. As expected, we showed that the smaller the sample size the more the results rely on the prior specification. Conclusion : We show that two issues often encountered during analysis of small samples, power and biased parameters, can be solved by including prior information into Bayesian analysis. We argue that the use of informative priors should always be reported together with a sensitivity analysis.
Collapse
Affiliation(s)
- Rens van de Schoot
- Department of Methods and Statistics, Utrecht University, Utrecht, The Netherlands.,Optentia Research Program, Faculty of Humanities, North-West University, Vanderbijlpark, South Africa;
| | - Joris J Broere
- Department of Methods and Statistics, Utrecht University, Utrecht, The Netherlands
| | - Koen H Perryck
- Department of Methods and Statistics, Utrecht University, Utrecht, The Netherlands
| | | | - Nancy E van Loey
- Department of Clinical & Health Psychology, Utrecht University, Utrecht, The Netherlands.,Department Behavioural Research, Association of Dutch Burn Centres, Beverwijk, The Netherlands
| |
Collapse
|
205
|
Zamanzadeh V, Valizadeh L, Lotfi M, Salehi F. Burn Survivors' Experience of Core Outcomes during Return to Life: a Qualitative Study. J Caring Sci 2014; 3:227-37. [PMID: 25717453 DOI: 10.5681/jcs.2014.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 09/02/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Burn is one of the main and common health problems that face the victims with significant challenges in their lives. The main purpose of caring and rehabilitating these people is returning them to their previous life situation. Thus, the present study was conducted with the purpose of determining the experience of burn survivors with regard to returning to life in order to be able to obtain new concepts of acceptable implications in the present cultural and religious context. METHODS The present study is a qualitative study that was conducted using qualitative content analysis and in-depth unstructured interviews with 15 burn survivors in 2012 and 2013 in Tabriz. RESULTS During the process of qualitative analysis, the content of the category "balance", as the core essence of the experience of participants, was extracted according to three sub-categories: a- the physical integration (physiological stability, saving the affected limb), b-connecting to the life stream (self-care, getting accustomed, normalization), and c- return to the existence (sense of inner satisfaction and excellence). CONCLUSION The results of this study confirmed the physical, psychological and social scales introduced by other studies. Also proposed the concept "return to the existence", that can be measured by the emergence of a sense of inner satisfaction and excellence in the individual, as one of the key and determinant scales in returning the victims of burn to life.
Collapse
Affiliation(s)
- Vahid Zamanzadeh
- Department of Medical Surgical Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Valizadeh
- Department of Pediatrics Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Lotfi
- Department of Medical Surgical Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Feridoon Salehi
- Department of Surgury, Medicine Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
206
|
Shapiro F. The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. Perm J 2014; 18:71-7. [PMID: 24626074 DOI: 10.7812/tpp/13-098] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND A substantial body of research shows that adverse life experiences contribute to both psychological and biomedical pathology. Eye movement desensitization and reprocessing (EMDR) therapy is an empirically validated treatment for trauma, including such negative life experiences as commonly present in medical practice. The positive therapeutic outcomes rapidly achieved without homework or detailed description of the disturbing event offer the medical community an efficient treatment approach with a wide range of applications. METHODS All randomized studies and significant clinical reports related to EMDR therapy for treating the experiential basis of both psychological and somatic disorders are reviewed. Also reviewed are the recent studies evaluating the eye movement component of the therapy, which has been posited to contribute to the rapid improvement attributable to EMDR treatment. RESULTS Twenty-four randomized controlled trials support the positive effects of EMDR therapy in the treatment of emotional trauma and other adverse life experiences relevant to clinical practice. Seven of 10 studies reported EMDR therapy to be more rapid and/or more effective than trauma-focused cognitive behavioral therapy. Twelve randomized studies of the eye movement component noted rapid decreases in negative emotions and/or vividness of disturbing images, with an additional 8 reporting a variety of other memory effects. Numerous other evaluations document that EMDR therapy provides relief from a variety of somatic complaints. CONCLUSION EMDR therapy provides physicians and other clinicians with an efficient approach to address psychological and physiologic symptoms stemming from adverse life experiences. Clinicians should therefore evaluate patients for experiential contributors to clinical manifestations.
Collapse
Affiliation(s)
- Francine Shapiro
- Senior Research Fellow Emeritus at the Mental Research Institute, the Creator of EMDR Therapy, the Executive Director of the EMDR Institute, and the Founder of the nonprofit EMDR Humanitarian Assistance Programs in Hamden, CT.
| |
Collapse
|
207
|
Oster C, Sveen J. The psychiatric sequelae of burn injury. Gen Hosp Psychiatry 2014; 36:516-22. [PMID: 24953259 DOI: 10.1016/j.genhosppsych.2014.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/24/2014] [Accepted: 05/08/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine factors predicting psychiatric morbidity, taking into account the full range of psychiatric disorders before and after burn injury. METHODS A cohort of 107 patients consecutively admitted to a Swedish national burn center was examined for lifetime psychiatric morbidity, as well as 94 patients at 1 year postinjury. Sixty-seven individuals, some from that same cohort, were interviewed at 2 to 7years postinjury. The predictive effects of psychiatric history, personality and other risk factors for psychiatric morbidity following burn were evaluated with multiple regression analyses. RESULTS The prevalence of having a psychiatric disorder preburn was 57%. One year postinjury 19% had minor or major depression and 23% had subsyndromal or full posttraumatic stress disorder. At 2 to 7years, 31% fulfilled the criteria for a psychiatric disorder. The strongest contributing factors were a history of psychiatric morbidity and neuroticism. CONCLUSIONS Two-thirds of the patients had a lifetime psychiatric disorder, and one-third had a psychiatric diagnosis 2 to 7years postburn. Mental health problems can have a major impact on daily life and functional abilities. Thus, identification and treatment of a range of psychiatric disorders, taking into account preburn psychiatric disorders and personality, is important for optimal adjustment after burn.
Collapse
Affiliation(s)
- Caisa Oster
- Department of Neuroscience Psychiatry, Uppsala University, SE-751 85 Uppsala, Sweden
| | - Josefin Sveen
- Department of Neuroscience Psychiatry, Uppsala University, SE-751 85 Uppsala, Sweden.
| |
Collapse
|
208
|
Studying the complex expression dependences between sets of coexpressed genes. BIOMED RESEARCH INTERNATIONAL 2014; 2014:940821. [PMID: 25147825 PMCID: PMC4132326 DOI: 10.1155/2014/940821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/13/2014] [Accepted: 07/06/2014] [Indexed: 11/18/2022]
Abstract
Organisms simplify the orchestration of gene expression by coregulating genes whose products function together in the cell. The use of clustering methods to obtain sets of coexpressed genes from expression arrays is very common; nevertheless there are no appropriate tools to study the expression networks among these sets of coexpressed genes. The aim of the developed tools is to allow studying the complex expression dependences that exist between sets of coexpressed genes. For this purpose, we start detecting the nonlinear expression relationships between pairs of genes, plus the coexpressed genes. Next, we form networks among sets of coexpressed genes that maintain nonlinear expression dependences between all of them. The expression relationship between the sets of coexpressed genes is defined by the expression relationship between the skeletons of these sets, where this skeleton represents the coexpressed genes with a well-defined nonlinear expression relationship with the skeleton of the other sets. As a result, we can study the nonlinear expression relationships between a target gene and other sets of coexpressed genes, or start the study from the skeleton of the sets, to study the complex relationships of activation and deactivation between the sets of coexpressed genes that carry out the different cellular processes present in the expression experiments.
Collapse
|
209
|
He F, Zhou Q, Zhao Z, Zhang Y, Guan H. Effect of perceived social support and dispositional optimism on the depression of burn patients. J Health Psychol 2014; 21:1119-25. [PMID: 25161173 DOI: 10.1177/1359105314546776] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Burn wounds have a significant impact on the mental health of patients. This study aimed to investigate the impact of perceived social support and dispositional optimism on depression of burn patients. A total of 246 burn patients accomplished the Multidimensional Scale of Perceived Social Support, the Revised Life Orientation Test, and Depression Scale. The results revealed that both perceived social support and optimism were significantly correlated with depression. Structural equation modeling indicated that optimism partially mediated the relationship between perceived social support and depression. Implications for prevention of depression in burn patients were discussed.
Collapse
Affiliation(s)
- Fei He
- Northwest University, China
| | | | | | | | | |
Collapse
|
210
|
Brewin M, Lister T. Prevention or treatment of hypertrophic burn scarring: A review of when and how to treat with the Pulsed Dye Laser. Burns 2014; 40:797-804. [DOI: 10.1016/j.burns.2013.12.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 11/25/2013] [Accepted: 12/17/2013] [Indexed: 11/29/2022]
|
211
|
Stavrou D, Weissman O, Tessone A, Zilinsky I, Holloway S, Boyd J, Haik J. Health Related Quality of Life in burn patients – A review of the literature. Burns 2014; 40:788-96. [DOI: 10.1016/j.burns.2013.11.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 11/12/2013] [Accepted: 11/22/2013] [Indexed: 12/01/2022]
|
212
|
Wasiak J, Lee S, Paul E, Mahar P, Pfitzer B, Spinks A, Cleland H, Gabbe B. Predictors of health status and health-related quality of life 12 months after severe burn. Burns 2014; 40:568-74. [DOI: 10.1016/j.burns.2014.01.021] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 12/26/2013] [Accepted: 01/22/2014] [Indexed: 11/29/2022]
|
213
|
Goodhew F, Van Hooff M, Sparnon A, Roberts R, Baur J, Saccone EJ, McFarlane A. Psychiatric outcomes amongst adult survivors of childhood burns. Burns 2014; 40:1079-88. [PMID: 24857829 DOI: 10.1016/j.burns.2014.04.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 04/24/2014] [Accepted: 04/24/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Research on the adult psychiatric outcomes of childhood burns is limited. AIMS To examine the rates of DSM-IV psychiatric disorder amongst adult survivors of paediatric burns, and to explore factors likely to contribute to variation in outcomes. In line with Meyer and colleagues [1], it was expected that high levels of psychopathology would be found. METHOD Participants were 272 adults hospitalised for burns during childhood between the years 1980 and 1990. Structured interviews and self-report questionnaires were used to assess psychiatric symptoms. RESULTS Lifetime prevalence of any DSM-IV disorder was 42%, 30% for depressive disorders, and 28% for anxiety disorders. Eleven percent had made a suicide attempt. Female gender, single relationship status, higher level of disfigurement, longer hospital stays and higher number of burn-related surgeries were associated with adverse psychiatric outcomes. CONCLUSIONS High rates of suicidality and depression were concerning in adults with a history of childhood burns. Factors found to predict psychiatric outcomes could be used to direct interventions and further research is needed to establish how this could best be done.
Collapse
Affiliation(s)
- Freya Goodhew
- The Centre for Traumatic Stress Studies and the School of Psychology, University of Adelaide, South Australia, Australia.
| | - Miranda Van Hooff
- The Centre for Traumatic Stress Studies, University of Adelaide, South Australia, Australia
| | - Anthony Sparnon
- The Burns Unit, Adelaide Women's and Children's Hospital, South Australia, Australia
| | - Rachel Roberts
- School of Psychology, University of Adelaide, South Australia, Australia
| | - Jenelle Baur
- The Centre for Traumatic Stress Studies, University of Adelaide, South Australia, Australia
| | - Elizabeth J Saccone
- The Centre for Traumatic Stress Studies, University of Adelaide, South Australia, Australia
| | - Alexander McFarlane
- The Centre for Traumatic Stress Studies, University of Adelaide, South Australia, Australia
| |
Collapse
|
214
|
Hoogewerf CJ, van Baar ME, Middelkoop E, van Loey NE. Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity. Gen Hosp Psychiatry 2014; 36:271-6. [PMID: 24417954 DOI: 10.1016/j.genhosppsych.2013.12.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/29/2013] [Accepted: 12/03/2013] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with facial burns. Patients completed the Patient and Observer Scar Assessment Scale, the Rosenberg Self-esteem Scale and the Hospital Anxiety and Depression Scale. Structural Equation Modeling was used to assess the relations between depressive symptoms, self-esteem and scar severity. RESULTS The model showed that patient-rated facial scar severity was not predictive for self-esteem and depressive symptoms six months post-burn. There was, however, a significant relationship between early depressive symptoms and both patient-rated facial scar severity and subsequent self-esteem. The variables in the model accounted for 37% of the variance in depressive symptoms six months post-burn and the model provided a moderately well-fitting representation of the data. CONCLUSION The study suggests that self-esteem and depressive symptoms were not affected by self-reported facial scar severity but that earlier depressive symptoms were indicative for a more severe self-reported facial scar rating. Therefore, routine psychological screening during hospitalisation is recommended in order to identify patients at risk and to optimise their treatment.
Collapse
Affiliation(s)
- Cornelis Johannes Hoogewerf
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands; Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Centre, Amsterdam, the Netherlands.
| | - Margriet Elisabeth van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands; Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Esther Middelkoop
- Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Centre, Amsterdam, the Netherlands; Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, the Netherlands
| | - Nancy Elisa van Loey
- Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, the Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands
| |
Collapse
|
215
|
Dowda DJ, Li F. Major concerns and issues in burn survivors in Australia. BURNS & TRAUMA 2014; 2:84-7. [PMID: 27602366 PMCID: PMC5012066 DOI: 10.4103/2321-3868.130192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 03/18/2014] [Indexed: 12/03/2022]
Abstract
Burn injury significantly impacts the victim’s long-term quality of life, both physically and psychosocially. This prospective, observational study aimed to assess the physical and psychological health status in adult burn survivors in Sydney Australia using the Burns Specific Health Scale-Brief Version (BSHS-B) questionnaire, together with analysis of the baseline demographic data collected from medical records. A total of 24 adult acute burn victims admitted consecutively to the Burns Unit at Concord Repatriation General Hospital, Sydney, Australia between March 2007 and February 2009 fulfilled the inclusion criteria and participated in the study. The BSHS-B questionnaire (which includes nine domains or subscales) was administered to all 24 participants in person at time of discharge and by mail 6, 12, and 24 months post discharge. By 12 months, 11 participants dropped out and the final analysis was performed on the remaining 13 participants. The analyzed results showed that: 1) Perceived return to work was the only variable that continued to change with time at 12 months after discharge (P < 0.01); 2) At 12 months; return to work was significantly correlated with simple functional ability (P < 0.05), heat sensitivity (P < 0.01), and treatment regimes (P < 0.05), but no longer with affect and body image as demonstrated at 6 months. In summary, our findings have shown that the perception of returning to work changes significantly with time post discharge and this perception is affected by certain subscales of the BSHS-B. Given that return to work is one of the most important outcome concerns and issues of recovery for adult burn injury victims and families, it is essential that therapists be aware of the factors influencing return to work and address these factors through a comprehensive rehabilitation program.
Collapse
Affiliation(s)
- Deborah J Dowda
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia
| | - Frank Li
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia
| |
Collapse
|
216
|
Gankande TU, Duke JM, Danielsen PL, DeJong HM, Wood FM, Wallace HJ. Reliability of scar assessments performed with an integrated skin testing device - the DermaLab Combo(®). Burns 2014; 40:1521-9. [PMID: 24630817 DOI: 10.1016/j.burns.2014.01.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 01/13/2014] [Accepted: 01/31/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND The DermaLab Combo(®) is a device with potential to make objective measurements of key scar components - pigmentation, vascularity, pliability and thickness. This study assessed the inter-rater and test-retest reliability of these measurements. METHOD Three raters performed scar assessments on thirty patients with burn scars using the DermaLab Combo(®). Measurements of pigmentation, vascularity, pliability and thickness were made and intra-class correlation coefficients (ICC) were derived for inter-rater and test-retest reliability. RESULTS Inter-rater reliability was found to be "excellent" in the 'best' and 'worst' areas of the index scar and normal skin for pigmentation (ICC: 0.94-0.98) and thickness (ICC: 0.86-0.96). Test-retest reliability was also "excellent" for pigmentation (ICC: 0.87-0.89) and thickness (ICC: 0.92-0.97) in all areas. Vascularity showed "good" to "excellent" inter-rater reliability (ICC: 0.66-0.84) in all areas however test-retest reliability was "low" (ICC: 0.29-0.42). Test-retest reliability was "excellent" for pliability (ICC: 0.76-0.91). Technical limitations were encountered making measurements in some scars for thickness, and in particular, pliability. CONCLUSION The DermaLab Combo(®) measured pigmentation, thickness and pliability with "excellent" reliability. If future studies provide protocols to improve test-retest reliability of vascularity measurements and obtain pliability measurements more successfully, the DermaLab Combo(®) will be valuable device for scar assessment.
Collapse
Affiliation(s)
- T U Gankande
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia.
| | - J M Duke
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia
| | - P L Danielsen
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia; Department of Dermatology, Bispebjerg University Hospital, Denmark
| | - H M DeJong
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia; Burn Outcomes Centre, Royal Perth Hospital, Australia
| | - F M Wood
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia; Burn Outcomes Centre, Royal Perth Hospital, Australia
| | - H J Wallace
- Burn Injury Research Unit, School of Surgery, The University of Western Australia, Australia
| |
Collapse
|
217
|
Differential item functioning in the Observer Scale of the POSAS for different scar types. Qual Life Res 2014; 23:2037-45. [DOI: 10.1007/s11136-014-0637-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2014] [Indexed: 11/25/2022]
|
218
|
Increased risk for stroke in burn patients: A population-based one-year follow-up study. Burns 2014; 40:54-60. [DOI: 10.1016/j.burns.2013.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 05/23/2013] [Accepted: 05/25/2013] [Indexed: 11/23/2022]
|
219
|
Supp DM. Skin substitutes for burn wound healing: current and future approaches. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.10.73] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
220
|
|
221
|
12-month generic health status and psychological distress outcomes following an Australian natural disaster experience: 2009 Black Saturday Wildfires. Injury 2013; 44:1443-7. [PMID: 23021367 DOI: 10.1016/j.injury.2012.08.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Accepted: 08/29/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the generic health status, health-related quality of life and psychological distress over a 12-month period of burns patients affected by the 2009 Black Saturday Wildfires. DESIGN SETTING AND PARTICIPANTS Cohort study with retrospective assessment of pre-injury status and prospective assessment of physical and psychosocial functioning in the Black Saturday Wildfires burns patients across time. Generic health status and burn specific quality of life using the 36-item Short Form Health Survey (SF-36) and Burn Specific Health Scale (BSHS) were collected at three, six and twelve months post-burn injury. In addition, similar time points were used to measure level of psychological distress and the presence of pain using the Kessler-10 questionnaire (K-10) and the McGill Pain Questionnaire. RESULTS At 12 months post-injury, patients reported a mean 16.4 (standard error, SE: 3.2) reduction in physical health and a 5.3 (SE 2.5) reduction in mental health scores of the SF-36 as compared to their pre-injury scores, with significant decreases observed in the "bodily pain", "physical functioning", "role physical" and "vitality" subscales. High levels of psychological distress and persistent pain were experienced, with no significant changes during the study period to the overall burns specific quality of life. CONCLUSIONS Even 12 months post-burn injury, patients affected by the 2009 Victorian Wildfires still experienced a significant reduction in generic health, increased psychological distress and persistent pain. The need for early and ongoing identification of physical and psychosocial impairments during hospital admission and upon discharge could be helpful to establish systematic interdisciplinary goals for long-term rehabilitation after severe burn injury.
Collapse
|
222
|
Farroha A, McGregor J, Paget T, John A, Lloyd K. Using anonymized, routinely collected health data in Wales to estimate the incidence of depression after burn injury. J Burn Care Res 2013; 34:644-8. [PMID: 23511283 DOI: 10.1097/bcr.0b013e31827e6363] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Burn injuries are associated with depression. Patients show variable incidence of postburn depression. The purpose of this study was to use anonymized, routinely collected health-related data in Wales (United Kingdom) to estimate the incidence of depression postburns. The incidence of postburn depression was estimated using routinely collected health data of complete years (1999-2007) from all general practitioner surgeries in Swansea and all National Health Service hospitals in Wales. This had been collected, double encrypted, and stored at the Secure Anonymised Information Linkage databank of the Health Information Research Unit for Wales at College of Medicine, Swansea University. The incidence of depression within 5 years after the burn injury was 5.9% in patients registered with general practitioner surgeries in Swansea. The incidence was 7.4% in female patients and 4.3% in male patients. The incidence of depression within 5 years after the burn was 3.2% in patients admitted to National Health Service hospitals in Wales. The incidence was 4.5% in female patients and 2.6% in male patients. The advantages of using the anonymized, routinely collected data were avoiding bias, protecting patients' confidentiality, including all patients thus minimizing attrition and greatly reduced costs. It is concluded that anonymized, routinely collected, health-related data may have value in monitoring postburn depression in Wales.
Collapse
Affiliation(s)
- Azzam Farroha
- From the *Locum Consultant Burns, Queen Elizabeth Hospital, Birmingham, United Kingdom; †College of Medicine, Swansea University, United Kingdom; and ‡School of Health Science, Swansea University, United Kingdom
| | | | | | | | | |
Collapse
|
223
|
Van Loey NE, Oggel A, Goemanne AS, Braem L, Vanbrabant L, Geenen R. Cognitive emotion regulation strategies and neuroticism in relation to depressive symptoms following burn injury: a longitudinal study with a 2-year follow-up. J Behav Med 2013; 37:839-48. [DOI: 10.1007/s10865-013-9545-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 10/07/2013] [Indexed: 11/30/2022]
|
224
|
Renneberg B, Ripper S, Schulze J, Seehausen A, Weiler M, Wind G, Hartmann B, Germann G, Liedl A. Quality of life and predictors of long-term outcome after severe burn injury. J Behav Med 2013; 37:967-76. [DOI: 10.1007/s10865-013-9541-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 09/17/2013] [Indexed: 10/26/2022]
|
225
|
Burns to the head and neck: Epidemiology and predictors of surgery. Burns 2013; 39:1184-92. [DOI: 10.1016/j.burns.2013.03.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 03/14/2013] [Accepted: 03/15/2013] [Indexed: 11/22/2022]
|
226
|
Piccolo MS, Gragnani A, Daher RP, de Tubino Scanavino M, de Brito MJ, Ferreira LM. Burn Sexuality Questionnaire: Brazilian translation, validation and cultural adaptation. Burns 2013. [DOI: 10.1016/j.burns.2012.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
227
|
Smith KB, Wang DL, Plotkin SR, Park ER. Appearance concerns among women with neurofibromatosis: examining sexual/bodily and social self-consciousness. Psychooncology 2013; 22:2711-9. [DOI: 10.1002/pon.3350] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 05/31/2013] [Accepted: 06/17/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Kelly B. Smith
- Department of Obstetrics & Gynaecology; University of British Columbia; BC Canada
| | - Daphne L. Wang
- Department of Neurology and Cancer Center; Massachusetts General Hospital/Harvard Medical School; MA USA
| | - Scott R. Plotkin
- Department of Neurology and Cancer Center; Massachusetts General Hospital/Harvard Medical School; MA USA
| | - Elyse R. Park
- Department of Psychiatry; Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital/Harvard Medical School; MA USA
| |
Collapse
|
228
|
Öster C, Willebrand M, Ekselius L. Burn-specific health 2 years to 7 years after burn injury. J Trauma Acute Care Surg 2013; 74:1119-24; discussion 1124. [PMID: 23511154 DOI: 10.1097/ta.0b013e318283cca0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Knowledge concerning the pattern of recovery and predictors of burn-specific health years after burn injury is limited, and these factors were therefore assessed with a disease-specific instrument, the Burn Specific Health Scale-Brief. METHODS Consecutive adult burn patients were prospectively included during hospitalization and assessed at 3, 6, and 12 months as well as at 2 years to 7 years (4.6 years on average) after burn. Data concerning injury characteristics, sociodemographic variables, psychiatric disorders, and burn-specific health were obtained. RESULTS Burn-specific health improved over time, from 6 months to the final assessment after burn. At 2 years to 7 years after burn, most problems were reported in the subscales heat sensitivity, body image, and work. The regression analyses revealed that length of stay, any preburn psychiatric disorder, major depression, and posttraumatic stress disorder 12 months after burn were predictors of long-term burn-specific health in the affect and relations domain, whereas time since injury, length of stay, and major depression 12 months after burn predicted outcome in the skin involvement domain. Predictors for the subscale work were length of stay, working at the time of injury, and posttraumatic stress disorder at 12 months. CONCLUSION This study underscores that significant improvement in postburn health can be expected even later than 2 years after injury. Furthermore, the results imply that both preburn factors and factors identified 1 year after burn have impact on burn-specific health after several years. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Caisa Öster
- Department of Neuroscience Psychiatry, Uppsala University, Uppsala, Sweden.
| | | | | |
Collapse
|
229
|
Sareen J, Erickson J, Medved MI, Asmundson GJG, Enns MW, Stein M, Leslie W, Doupe M, Logsetty S. Risk factors for post-injury mental health problems. Depress Anxiety 2013; 30:321-7. [PMID: 23408506 DOI: 10.1002/da.22077] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 01/04/2013] [Accepted: 01/18/2013] [Indexed: 11/09/2022] Open
Abstract
Serious nonfatal physical injuries and burns are common occurrences that can have substantial implications for personal, social, and occupational functioning. Such injuries are frequently associated with significant mental health issues, and compromised quality of life and well-being. The purpose of this review is to summarize the current literature on physical, psychological, and social risk factors for mental health issues post-injury and to contextualize findings using Engel's biopsychosocial framework. We distinguish between pre-injury, injury-related, and post-injury risk factors for mental health problems. Female sex, history of mental health problems or trauma, type of injury, and level of pain are among the strong risk factors for mental health problems post-injury. We highlight inconsistent findings in the literature, identify directions for future research, and explore the implications of the risk factors identified for treatment and prevention.
Collapse
Affiliation(s)
- Jitender Sareen
- Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
| | | | | | | | | | | | | | | | | |
Collapse
|
230
|
Ahrari F, Salehi SH, Fatemi MJ, Soltani M, Taghavi S, Samimi R. Severity of symptoms of depression among burned patients one week after injury, using Beck Depression Inventory-II (BDI-II). Burns 2013; 39:285-90. [DOI: 10.1016/j.burns.2012.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 06/21/2012] [Accepted: 07/12/2012] [Indexed: 11/25/2022]
|
231
|
van der Wal MBA, Vloemans JFPM, Tuinebreijer WE, van de Ven P, van Unen E, van Zuijlen PPM, Middelkoop E. Outcome after burns: an observational study on burn scar maturation and predictors for severe scarring. Wound Repair Regen 2013; 20:676-87. [PMID: 22985039 DOI: 10.1111/j.1524-475x.2012.00820.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in relation to the depth, etiology of the burn wound and age of the patient. Burn scars of 474 patients were subjected to a scar assessment protocol 3, 6, and 12 months postburn. Three different age groups were defined (≤5, 5-18, and ≥18 years). The observer part of the patient and observer scar assessment scale revealed a significant (p < 0.001) improvement in scar quality at 12 months compared with the 3- and 6-month data. Predictors for severe scarring are depth of the wound (p < 0.001) and total body surface area burned (p < 0.001). Etiology (p = 0.753) and age (p > 0.230) have no significant influence on scar quality when corrected for sex, total body surface area burned, time, and age or etiology, respectively.
Collapse
|
232
|
HELLGREN EM, LAGERGREN P, LARSSON AC, SCHANDL AR, SACKEY PV. Body image and psychological outcome after severe skin and soft tissue infection requiring intensive care. Acta Anaesthesiol Scand 2013; 57:220-8. [PMID: 23167497 DOI: 10.1111/aas.12015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND Patients with severe skin and soft tissue infection (SSTI) requiring intensive care unit (ICU) stay are commonly treated with antibiotics, surgery and in some centers also with hyperbaric oxygen therapy. Long-term follow-up of body image and psychological outcome has not been described despite extensive surgery, potentially altered body image and subsequent psychological problems. The aim was to describe perceived body image and its relation to anxiety, depression and post-traumatic stress disorder (PTSD)-related symptoms in patients with severe SSTI 1 year after ICU stay. Specifically, we aimed to assess potential differences related to gender and anatomic site of infection. METHODS Fifty patients treated for severe SSTI in the General ICU, Karolinska University Hospital 2008-2010 received the body image scale (BIS), impact of event scale (IES), and hospital anxiety and depression scale (HADS) 1 year after ICU discharge. RESULTS Abdominoperineal SSTI was associated with more body image problems than other anatomic sites of infection in both men and women. Generally, women reported higher BIS scores than men (median 9.5 vs. 3.0 of total 30, P < 0.03) indicating more negative body image. A substantial number of patients reported scar dissatisfaction (63.9%), body dissatisfaction (51.1%) and body feeling less whole (51.0%). BIS scores correlated with HADS anxiety (r = 0.59, P < 0.01), depression (r = 0.60, P < 0.01) and IES (r = 0.61, P < 0.01) scores. CONCLUSION One year after severe SSTI requiring intensive care, women and patients with abdominoperineal SSTI reported significantly more body image problems. Negative body image was associated with anxiety, depression and PTSD-related symptoms. Specific follow-up for SSTI patients is warranted.
Collapse
Affiliation(s)
| | - P. LAGERGREN
- Unit of Upper Gastrointestinal Research (UGIR); Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm; Sweden
| | | | | | | |
Collapse
|
233
|
Hoogewerf CJ, Van Baar ME, Hop MJ, Nieuwenhuis MK, Oen IMMH, Middelkoop E. Topical treatment for facial burns. Cochrane Database Syst Rev 2013:CD008058. [PMID: 23440823 DOI: 10.1002/14651858.cd008058.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Burn injuries are an important health problem. They occur frequently in the head and neck region - the area central to a person's identity, that provides our most expressive means of communication. Topical interventions are currently the cornerstone of treatment of partial-thickness burns to the face. OBJECTIVES To assess the effects of topical interventions on wound healing in people with facial burns of any depth. SEARCH METHODS We searched the Cochrane Wounds Group Specialised Register (searched 12 November 2012); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 10); Ovid MEDLINE (1950 to November Week 1 2012); Ovid MEDLINE - In-process & Other Non-Indexed Citations (searched November 12, 2012); Ovid EMBASE (1980 to 2012 Week 45); and EBSCO CINAHL (1982 to 9 November 2012) for relevant trials. We did not apply date or language restrictions. SELECTION CRITERIA Randomised controlled trials (RCTs) that evaluated the effects of topical treatment for facial burns were eligible for inclusion in this review. DATA COLLECTION AND ANALYSIS Two review authors independently assessed and included the references identified by the search strategy. Included trials were assessed using a risk of bias form, and data were extracted using a standardised data extraction sheet. For dichotomous and continuous outcomes, we calculated risk ratios and mean differences, respectively, both with 95% confidence intervals (CI). MAIN RESULTS We included five RCTs, comprising a total of 119 participants. Two studies compared two different antimicrobial agents and three compared a biological or bioengineered skin substitute with an antimicrobial agent. All studies had small sample sizes and were at high risk of bias. Heterogeneity of interventions and outcomes prevented pooling of data. In three studies time to complete wound healing was significantly shorter for those using a skin substitute than for those using an antibacterial agent, but the quality of the evidence was low. Pain was significantly reduced with the use of skin substitutes in both studies that reported this outcome in all groups, range mean differences -2.00 (95% CI -3.82 to -0.18) to -4.00 (95% CI -5.05 to -2.95) on a 10-point scale. AUTHORS' CONCLUSIONS There is insufficient high quality research and evidence to enable conclusions to be drawn about the effects of topical interventions on wound healing in people with facial burns.
Collapse
Affiliation(s)
- Cornelis J Hoogewerf
- Burn Centre, Maasstad Hospital, Association of Dutch Burn Centres, Rotterdam, Netherlands
| | | | | | | | | | | |
Collapse
|
234
|
Clouatre E, Gomez M, Banfield JM, Jeschke MG. Work-related burn injuries in Ontario, Canada: A follow-up 10-year retrospective study. Burns 2013; 39:1091-5. [PMID: 23352030 DOI: 10.1016/j.burns.2012.12.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 12/24/2012] [Accepted: 12/28/2012] [Indexed: 10/27/2022]
Abstract
Work-related burn injuries contribute to a quarter of all burns in the USA. In 2009, the provincial Workplace Safety and Insurance Board reported 64,824 work-related injuries that resulted in time lost, 1188 injuries (2%) were a result of burns. There were two previous studies performed at a regional burn centre (1984-1990 and 1998-2000) that examined incidence and characteristics of work-related burns. There was no significant change between these two groups. The purpose of this study was to identify the recent pattern of work-related burns from 2001 to 2010 and to compare it to the previous studies. During the study period, 1427 patients were admitted for an acute injury to the regional burn centre. Of these, 330 were due to a work-related incident (23%). The mean age of patients was 40.5±11.9 years, 95% were male. The mean total body surface area burn was 11.9±16.2%. The most common mechanism of injury was flame (32.7%) followed by electrical (27%) and scald (19.7%), inhalation injury was present in 4.8% of patients and the mortality was 1.8%. Our study shows a significant decrease in the incidence in work-related burns treated at the regional burn centre (23.1% vs. 28.2% vs. 30.2%, p<0.01), flame burns have now become the leading cause of injury, there was a significant reduction in inhalation injury (4.8% vs. 23% vs. 14.8%, p<0.00001), and mortality over time (1.8% vs. 4% vs. 6.7% p=0.02). These findings strongly suggest a change in the cause of work-related burns, improvement in burn care, and that prevention strategies may have been more effective.
Collapse
Affiliation(s)
- Elsa Clouatre
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | | | | |
Collapse
|
235
|
Koljonen V, Laitila M, Sintonen H, Roine RP. Health-related quality of life of hospitalized patients with burns-comparison with general population and a 2-year follow-up. Burns 2013; 39:451-7. [PMID: 23313018 DOI: 10.1016/j.burns.2012.07.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 07/28/2012] [Accepted: 07/31/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Health-related quality of life (HRQoL) has gained increasing interest as an important indicator of adaptation after a burn injury. Our objective was to compare HRQoL of medium severity hospitalized burn victims with no need for intensive care treatment with that of the general population. METHODS The 15D HRQoL questionnaire at discharge, and 6, 12 and 24 months thereafter. RESULTS 44 patients filled in the baseline questionnaire between June 2007 and December 2009. At discharge the mean (SD) HRQoL score (on a scale of 0-1) of the patients was worse in comparison with that of the general population (0.839 (0.125) vs. 0.936 (0.071)), p<0.001. The most striking differences (p<0.001) were seen on the dimensions of sleeping, usual activities, discomfort and symptoms, and sexual activity. At the 2-year follow-up the mean HRQoL score had increased from 0.835 (0.121) to 0.856 (0.149), but the difference was not statistically significant. Of the dimensions, moving and usual activities improved statistically significantly. CONCLUSIONS HRQoL of patients hospitalized for treatment of burns is, at discharge, compromised compared with that of the general population. During follow-up HRQoL showed slight improvement but remained at a clearly lower level.
Collapse
Affiliation(s)
- Virve Koljonen
- Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki Finland, P.O. Box 266, 00029 HUS, Finland.
| | | | | | | |
Collapse
|
236
|
Xiamenmycin attenuates hypertrophic scars by suppressing local inflammation and the effects of mechanical stress. J Invest Dermatol 2013; 133:1351-60. [PMID: 23303451 DOI: 10.1038/jid.2012.486] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Hypertrophic scarring is a common disease affecting millions of people around the world, but there are currently no satisfactory drugs to treat the disease. Exaggerated inflammation and mechanical stress have been shown to be two main mechanisms of excessive fibrotic diseases. Here we found that a benzopyran natural product, xiamenmycin, could significantly attenuate hypertrophic scar formation in a mechanical stretch-induced mouse model. The compound suppressed local inflammation by reducing CD4+ lymphocyte and monocyte/macrophage retention in fibrotic foci and blocked fibroblast adhesion with monocytes. Both in vivo and in vitro studies found that the compound inhibited the mechanical stress-induced profibrotic effects by suppressing proliferation, activation, fibroblast contraction, and inactivating FAK, p38, and Rho guanosine triphosphatase signaling. Taken together, the compound could simultaneously suppress both the inflammatory and mechanical stress responses, which are the two pivotal pathological processes in hypertrophic scar formation, thus suggesting that xiamenmycin can serve as a potential agent for treating hypertrophic scar formation and other excessive fibrotic diseases.
Collapse
|
237
|
Treatment of Patients With Severe Burns—Costs and Health-Related Quality of Life Outcome. J Burn Care Res 2013; 34:e318-25. [DOI: 10.1097/bcr.0b013e3182779c90] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
238
|
Disseldorp LM, Niemeijer AS, Van Baar ME, Reinders-Messelink HA, Mouton LJ, Nieuwenhuis MK. How disabling are pediatric burns? Functional independence in Dutch pediatric patients with burns. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:29-39. [PMID: 22940156 DOI: 10.1016/j.ridd.2012.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 07/12/2012] [Accepted: 07/16/2012] [Indexed: 06/01/2023]
Abstract
Although the attention for functional outcomes after burn injury has grown over the past decades, little is known about functional independence in performing activities of daily living in children after burn injury. Therefore, in this prospective cohort study functional independence was measured by burn care professionals with the WeeFIM(®) instrument in 119 pediatric patients with burns (age: 6 months-16 years; 58.8% boys) in the Netherlands. In order to identify whether functional independence was affected, participants' total scores on the WeeFIM(®) instrument were compared to American norm values. Of the participants assessed at 2 weeks post burn (n = 117), 3 months post burn (n = 68) and/or 6 months post burn (n = 38), 22, 9 and 9 participants showed affected performance, respectively. Improvements in WeeFIM(®) total scores for the total study population between 2 weeks and 6 months post burn were significant (Wilcoxon T = 2.5; p<.001, effect size = -0.59). Individual improvements were found to be significant for 30.3% of the assessed participants between 2 weeks and 3 months post burn, and for 12.1% between 3 and 6 months post burn. This study is unique in providing data on functional independence for this large and special population. However, a proportion of participants were lost to follow-up and the use of the WeeFIM(®) instrument in this specific population and setting has its limitations. To conclude, burn injury impacts functional independence in children, yet the vast majority of Dutch pediatric patients with burns returns to functional independence typical for age within 6 months post burn.
Collapse
Affiliation(s)
- Laurien M Disseldorp
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | | | | | | | | | | |
Collapse
|
239
|
Disseldorp LM, Mouton LJ, Takken T, Van Brussel M, Beerthuizen GI, Van der Woude LH, Nieuwenhuis MK. Design of a cross-sectional study on physical fitness and physical activity in children and adolescents after burn injury. BMC Pediatr 2012; 12:195. [PMID: 23253263 PMCID: PMC3575222 DOI: 10.1186/1471-2431-12-195] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 12/07/2012] [Indexed: 11/24/2022] Open
Abstract
Background Burn injuries have a major impact on the patient’s physical and psychological functioning. The consequences can, especially in pediatric burns, persist long after the injury. A decrease in physical fitness seems logical as people survive burn injuries after an often extensive period of decreased activity and an increased demand of proteins leading to catabolism, especially of muscle mass. However, knowledge on the possibly affected levels of physical fitness in children and adolescents after burn injury is limited and pertains only to children with major burns. The current multidimensional study aims to determine the level of physical fitness, the level of physical activity, health-related quality of life and perceived fatigue in children after a burn injury. Furthermore, interrelations between those levels will be explored, as well as associations with burn characteristics. Methods/design Children and adolescents in the age range of 6 up to and including 18 years are invited to participate in this cross-sectional descriptive study if they have been admitted to one of the three Dutch burn centers between 6 months and 5 years ago with a burn injury involving at least 10% of the total body surface area and/or were hospitalized ≥ 6 weeks. Physical fitness assessments will take place in a mobile exercise lab. Quantitative measures of cardiorespiratory endurance, muscular strength, body composition and flexibility will be obtained. Outcomes will be compared with Dutch reference values. Physical activity, health-related quality of life and fatigue will be assessed using accelerometry and age-specific questionnaires. Discussion The findings of the current study will contribute to a better understanding of the long-term consequences of burn injury in children and adolescents after burns. The results can guide rehabilitation to facilitate a timely and optimal physical recovery. Trial registration The study is registered in the National Academic Research and Collaborations Information System of the Netherlands (OND1348800).
Collapse
Affiliation(s)
- Laurien M Disseldorp
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, PO Box 196, 9700 AD, Groningen, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
240
|
Seehausen A, Renneberg B. Ein Gruppenbehandlungsprogramm zur Bewältigung von schweren Brandverletzungen. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2012. [DOI: 10.1026/1616-3443/a000153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Theoretischer Hintergrund: Schwere Verbrennungen verursachen häufig bleibende körperliche Einschränkungen und Entstellungen. Viele Betroffene fühlen sich beim Bewältigungsprozess der Unfallfolgen überfordert. Das deutschlandweit erste verhaltenstherapeutische Gruppenbehandlungsprogramm speziell für Brandverletzte wurde entwickelt, um Betroffene bei der Bewältigung der längerfristigen Folgen des Unfalls und der Rückkehr in den Alltag zu unterstützen. Fragestellung: Ziel der Arbeit ist die Beschreibung des Programms und der Implementierung sowie die Darstellung der Ergebnisse zur Zufriedenheit der Teilnehmer (n = 86). Methode: Mit Hilfe eines Evaluationsbogens bewerteten die Gruppenteilnehmer, wie hilfreich und interessant sie die einzelnen Sitzungen fanden. Antworten auf die Frage: „Was könnte an der Sitzung verbessert werden?” wurden qualitativ ausgewertet. Ergebnisse: Die Zufriedenheit der Patienten mit dem Gruppenprogramm war hoch. 89,3 % beurteilten es als „gut oder sehr gut” und 80,4 % der Teilnehmer empfanden es als „sehr hilfreich oder hilfreich”. Als besonders wichtig wurde in den Rückmeldungen der Austausch mit anderen Betroffenen hervorgehoben. Schlussfolgerung: Das neu entwickelte Gruppenbehandlungsprogramm für Brandverletzte wurde von den Betroffenen gut angenommen und als hilfreich für die Bewältigung der Unfallfolgen beurteilt.
Collapse
Affiliation(s)
- Annika Seehausen
- Unfallkrankenhaus Berlin, Zentrum für Schwerbrandverletzte mit plastischer Chirurgie
| | | |
Collapse
|
241
|
Berchialla P, Gangemi EN, Foltran F, Haxhiaj A, Buja A, Lazzarato F, Stella M, Gregori D. Predicting severity of pathological scarring due to burn injuries: a clinical decision making tool using Bayesian networks. Int Wound J 2012; 11:246-52. [PMID: 22958613 DOI: 10.1111/j.1742-481x.2012.01080.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
It is important for clinicians to understand which are the clinical signs, the patient characteristics and the procedures that are related with the occurrence of hypertrophic burn scars in order to carry out a possible prognostic assessment. Providing clinicians with an easy-to- use tool for predicting the risk of pathological scars. A total of 703 patients with 2440 anatomical burn sites who were admitted to the Department of Plastic and Reconstructive Surgery, Burn Center of the Traumatological Hospital in Torino between January 1994 and May 2006 were included in the analysis. A Bayesian network (BN) model was implemented. The probability of developing a hypertrophic scar was evaluated on a number of scenarios. The error rate of the BN model was assessed internally and it was equal to 24·83%. While classical statistical method as logistic models can infer only which variables are related to the final outcome, the BN approach displays a set of relationships between the final outcome (scar type) and the explanatory covariates (patient's age and gender, burn surface area, full-thickness burn surface area, burn anatomical area and wound-healing time; burn treatment options such as advanced dressings, type of surgical approach, number of surgical procedures, type of skin graft, excision and coverage timing). A web-based interface to handle the BN model was developed on the website www.pubchild.org (burns header). Clinicians who registered at the website could submit their data in order to get from the BN model the predicted probability of observing a pathological scar type.
Collapse
Affiliation(s)
- Paola Berchialla
- Department of Public Health and Microbiology, University of Torino, Torino, ItalyDepartment of Plastic and Reconstructive Surgery, Burn Center, Trauma Center, Torino, ItalyUnit of Biostatistics, Epidemiology and Public Health, Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padova, ItalyProchild ONLUS, Trieste, ItalyUnit of Cancer Epidemiology, CPO Piemonte, University of Torino, Torino, Italy
| | | | | | | | | | | | | | | |
Collapse
|
242
|
Van Loey NE, van de Schoot R, Faber AW. Posttraumatic stress symptoms after exposure to two fire disasters: comparative study. PLoS One 2012; 7:e41532. [PMID: 22911810 PMCID: PMC3404048 DOI: 10.1371/journal.pone.0041532] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 06/24/2012] [Indexed: 02/07/2023] Open
Abstract
This study investigated traumatic stress symptoms in severely burned survivors of two fire disasters and two comparison groups of patients with "non-disaster" burn injuries, as well as risk factors associated with acute and chronic stress symptoms. Patients were admitted to one out of eight burn centers in The Netherlands or Belgium. The Impact of Event Scale (IES) was administered to 61 and 33 survivors respectively of two fire disasters and 54 and 57 patients with "non-disaster" burn etiologies at 2 weeks, 3, 6, 12 and 24 months after the event. We used latent growth modeling (LGM) analyses to investigate the stress trajectories and predictors in the two disaster and two comparison groups. The results showed that initial traumatic stress reactions in disaster survivors with severe burns are more intense and prolonged during several months relative to survivors of "non-disaster" burn injuries. Excluding the industrial fire group, all participants' symptoms on average decreased over the two year period. Burn severity, peritraumatic anxiety and dissociation predicted the long-term negative outcomes only in the industrial fire group. In conclusion, fire disaster survivors appear to experience higher levels of traumatic stress symptoms on the short term, but the long-term outcome appears dependent on factors different from the first response. Likely, the younger age, and several beneficial post-disaster factors such as psychosocial aftercare and social support, along with swift judicial procedures, contributed to the positive outcome in one disaster cohort.
Collapse
Affiliation(s)
- Nancy E Van Loey
- Department of Psychosocial and Behavioural Research, Association of Dutch Burns Centres, Beverwijk, The Netherlands.
| | | | | |
Collapse
|
243
|
Supp DM, Hahn JM, Glaser K, McFarland KL, Boyce ST. Deep and Superficial Keloid Fibroblasts Contribute Differentially to Tissue Phenotype in a Novel In Vivo Model of Keloid Scar. Plast Reconstr Surg 2012; 129:1259-1271. [DOI: 10.1097/prs.0b013e31824ecaa9] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
244
|
Roh YS, Chung HS, Kwon B, Kim G. Association between depression, patient scar assessment and burn-specific health in hospitalized burn patients. Burns 2012; 38:506-12. [DOI: 10.1016/j.burns.2011.12.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 11/11/2011] [Accepted: 12/21/2011] [Indexed: 10/28/2022]
|
245
|
Health-related quality of life after burns: a prospective multicenter cohort study with 18 months follow-up. J Trauma Acute Care Surg 2012; 72:513-20. [PMID: 22439227 DOI: 10.1097/ta.0b013e3182199072] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is an important parameter after medical treatments. Knowledge of (predictors of) diminished quality of life can help improve medical outcome. The aim of this study was to quantify health loss in patients with burns and to assess the contribution of injury extent, age, gender, and psychologic factors to HRQOL and speed of recovery. A multicenter prospective cohort design was used to address these aims. METHODS Data were obtained from 260 adults with burns. Patients completed the EQ-5D at 3 weeks, 3, 6, 9, and 18 months after burn and psychologic questionnaires during hospitalization. Patients' scores were compared with an age- and gender-weighted normpopulation. RESULTS Patients suffered from substantial health losses at short term, but after 18 months the majority reached a HRQOL comparable with the norm population with the exception of patients requiring two or more surgeries. The best predictor of long-term HRQOL and the speed of recovery was the number of surgeries, followed by psychologic problems. Both predicted baseline and trajectories of improvement. Symptoms of traumatic stress were most debilitating over time. CONCLUSIONS Both injury severity and psychologic problems play a pivotal role in reduced HRQOL and the speed of recovery. The number of surgeries seems to give a practically useful indication of the expected recovery speed that could aid in decision making and provides adequate information for patients in the aftermath of their initial surgical treatment. Screening for traumatic stress is recommended.
Collapse
|
246
|
XU F, WANG PF, LIN M, LU TJ, NG EYK. QUANTIFICATION AND THE UNDERLYING MECHANISM OF SKIN THERMAL DAMAGE: A REVIEW. J MECH MED BIOL 2012. [DOI: 10.1142/s0219519410003459] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Skin thermal damage is the most common thermal trauma in civilian and military communities. Besides, advances in laser, microwave, and similar technologies have led to recent developments of thermal treatments for diseases involving skin tissue aiming at inducing damage precisely within targeted tissue structures without affecting the surrounding healthy tissue. Pain sensation accompanying thermal damage is also a serious problem for burn patients. Therefore, it is of great importance to quantify the thermal damage in skin tissue. In this review, we detail the progress of the state-of-the-art mathematical models and experimental methods for the quantification of thermal damage (both heat damage and cold damage) and the general development of thermal treatments in tissue engineering. This could enable better understanding of the underlying mechanisms of skin thermal damage and the optimization of clinical thermal therapies.
Collapse
Affiliation(s)
- F. XU
- Biomedical Engineering and Biomechanics Center, School of Aerospace, Xi'an Jiaotong University, Xi'an 710049, P. R. China
- HST-Center for Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA 02129, USA
| | - P. F. WANG
- Biomedical Engineering and Biomechanics Center, School of Aerospace, Xi'an Jiaotong University, Xi'an 710049, P. R. China
| | - M. LIN
- Biomedical Engineering and Biomechanics Center, School of Aerospace, Xi'an Jiaotong University, Xi'an 710049, P. R. China
| | - T. J. LU
- Biomedical Engineering and Biomechanics Center, School of Aerospace, Xi'an Jiaotong University, Xi'an 710049, P. R. China
| | - E. Y. K. NG
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore
| |
Collapse
|
247
|
Bäckström J, Ekselius L, Gerdin B, Willebrand M. Prediction of psychological symptoms in family members of patients with burns 1 year after injury. J Adv Nurs 2012; 69:384-93. [DOI: 10.1111/j.1365-2648.2012.06017.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
248
|
Gardner PJ, Knittel-Keren D, Gomez M. The Posttraumatic Stress Disorder Checklist as a Screening Measure for Posttraumatic Stress Disorder in Rehabilitation After Burn Injuries. Arch Phys Med Rehabil 2012; 93:623-8. [DOI: 10.1016/j.apmr.2011.11.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 11/11/2011] [Accepted: 11/14/2011] [Indexed: 10/28/2022]
|
249
|
Low AJF, Dyster-Aas J, Willebrand M, Ekselius L, Gerdin B. Psychiatric morbidity predicts perceived burn-specific health 1 year after a burn. Gen Hosp Psychiatry 2012; 34:146-52. [PMID: 22266132 DOI: 10.1016/j.genhosppsych.2011.12.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 12/08/2011] [Accepted: 12/12/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Individual factors such as gender, age, coping and personality traits and injury-related factors such as injury severity have been implicated as risk factors for poor perceived health after burns. As psychiatric morbidity is common in individuals who sustain burns, the aim of this study was to examine the effect of preinjury psychiatric problems on perceived health after injury. METHOD A total of 85 consecutive patients treated at a national burn center were prospectively assessed: the patients were interviewed during acute care with the Structured Clinical Interview for DSM-IV Axis I Disorders. One year after injury, perceived health was assessed with the Burn-Specific Health Scale-Brief (BSHS-B). Multiple regression analyses were used to evaluate the predictive effect of preinjury psychiatric history on perceived postinjury health. RESULTS Psychiatric morbidity, especially mood disorders, affected outcome for six of the nine BSHS-B subscales, with the covariates mainly being the length of hospital stay and total burn size. CONCLUSION The results show that a history of preinjury psychiatric disorders, especially during the year before the burn, affects perceived outcome regarding both physical and psychological aspects of health 1 year after injury and that it is a risk factor for worse perceived outcome.
Collapse
Affiliation(s)
- Aili J F Low
- Department of Surgical Sciences, Plastic and Maxillofacial Surgery, Burn Center, Uppsala University Hospital, 75185 Uppsala, Sweden.
| | | | | | | | | |
Collapse
|
250
|
A prospective longitudinal study of posttraumatic stress disorder symptom trajectories after burn injury. ACTA ACUST UNITED AC 2012; 71:1808-15. [PMID: 21841510 DOI: 10.1097/ta.0b013e31822a30b8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Psychologic problems are common after burns, and symptoms of posttraumatic stress disorder (PTSD) are some of the most prevalent. Risk factors for PTSD have been identified, but little is known about the onset and course of these symptoms. The objective was to investigate whether there are different PTSD symptom trajectories after burns. METHODS Ninety-five adults with burns were enrolled in a prospective study from in-hospital treatment until 12 months after burn. Symptoms of PTSD were assessed with the Impact of Event Scale-Revised and scores at 3, 6, and 12 months after the burn were used in a cluster analysis to detect trajectories. The trajectories were compared regarding known risk factors for PTSD using non-parametric analysis of variance. RESULTS Four clusters were identified: (1) resilient, with low levels of PTSD symptoms that decreased over time; (2) recovery, with high levels of symptoms that gradually decreased; (3) delayed, with moderate symptoms that increased over time; and (4) chronic, with high levels of symptoms over time. The trajectories differed regarding several risk factors for PTSD including life events, premorbid psychiatric morbidity, personality traits, avoidant coping, in-hospital psychologic symptoms, and social support. The resilient trajectory consistently had fewer of the risk factors and differed the most from the chronic trajectory. CONCLUSIONS There are subgroups among patients with burns that have different patterns of PTSD symptom development. These findings may have implications for clinical practice, such as the timing of assessment and the management of patients who present with these symptoms.
Collapse
|