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1. KECORT Study: An International e-Delphi Study on the Treatment of KEloids Using Intralesional CORTicosteroids in Clinical Practice

Author

Yin, Qi, Wolkerstorfer, Albert, Lapid, Oren, Qayumi, Khatera, Alam, Murad, Al-Niaimi, Firas, Artzi, Ofir, van Doorn, Martijn B. A., Goutos, Ioannis, Haedersdal, Merete, Hsu, Chao-Kai, Manuskiatti, Woraphong, Monstrey, Stan, Mustoe, Thomas A., Ogawa, Rei, Ozog, David, Park, Tae Hwan, Pötschke, Julian, Rossi, Anthony, Tan, Swee T., Téot, Luc, Wood, Fiona M., Yu, Nanze, Gibbs, Susan, Niessen, Frank B., and van Zuijlen, Paul P. M.

Published
2024
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6. IDENTIFICATION OF POTENTIALLY MODIFIABLE FACTORS TO IMPROVE RECOGNITION AND OUTCOME OF NECROTIZING SOFT-TISSUE INFECTIONS

Author

Suijker, Jaco, Pijpe, Anouk, Hoogerbrug, Denise, Heymans, Martijn W., van Zuijlen, Paul P.M., Halm, Jens A., Meij-de Vries, Annebeth, Bonjer, Jaap, Bloemers, Frank, Terra, Maartje, van der Vlies, Cornelis H., Nieuwenhuis, Marianne, Krijnen, Pieta, Van Lieshout, Esther M.M., Ponsen, Kees J., Sosef, Nico, Winkelhagen, Jasper, de Castro, Steve, Twigt, Bas, and Wurfbain, Lisca

Published
2024
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7. A one-dimensional morphoelastic model for burn injuries: stability analysis, numerical validation and biological interpretation

Author

Egberts, Ginger, Vermolen, Fred, and van Zuijlen, Paul

Subjects
Mathematics - Numerical Analysis, Physics - Biological Physics, Quantitative Biology - Tissues and Organs, 35B20, 35B35, 35G20, 35L65, 35M10, 35Q74, 35Q80, 35Q92, 35R37, 65C05, 65C20, 65M12, 65M60, 65N12, 65N30, 74-10, 74L15, 92-10, 92C10, 92C17, 92C45
Abstract

To deal with permanent deformations and residual stresses, we consider a morphoelastic model for the scar formation as the result of wound healing after a skin trauma. Next to the mechanical components such as strain and displacements, the model accounts for biological constituents such as the concentration of signaling molecules, the cellular densities of fibroblasts and myofibroblasts, and the density of collagen. Here we present stability constraints for the one-dimensional counterpart of this morphoelastic model, for both the continuous and (semi-) discrete problem. We show that the truncation error between these eigenvalues associated with the continuous and semi-discrete problem is of order $\mathcal{O}(h^2)$. Next, we perform numerical validation to these constraints and provide a biological interpretation of the (in)stability. For the mechanical part of the model, the results show the components reach equilibria in a (non) monotonic way, depending on the value of the viscosity. The results show that the parameters of the chemical part of the model need to meet the stability constraint, depending on the decay rate of the signaling molecules, to avoid unrealistic results., Comment: 38 pages, 5 figures

Published
2020
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8. A one-dimensional morphoelastic model for burn injuries: sensitivity analysis and a feasibility study

Author

Egberts, Ginger, Vermolen, Fred, and van Zuijlen, Paul

Subjects
Mathematics - Numerical Analysis, Physics - Biological Physics, Quantitative Biology - Tissues and Organs
Abstract

We consider a one-dimensional morphoelastic model describing post-burn scar contraction. This model describes the displacement of the dermal layer of the skin and the development of the effective Eulerian strain in the tissue. Besides these components, the model also contains components that play a major role in skin repair after trauma. These components are signaling molecules, fibroblasts, myofibroblasts, and collagen. We perform a sensitivity analysis for many parameters of the model and use the results for a feasibility study. In this study, we test whether the model is suitable for predicting the extent of contraction in different age groups. To this end, we conduct an extensive literature review to find parameter values. From the sensitivity analysis, we conclude that the most sensitive parameters are the equilibrium collagen concentration in the dermal layer, the apoptosis rate of fibroblasts and myofibroblasts, and the secretion rate of signaling molecules. Further, although we can use the model to simulate distinct contraction densities in different age groups, our results differ from what is seen in the clinic.

Published
2020
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17. Characteristics, treatments and outcomes in patients with severe burn wounds; a 10 year cohort study on acute and reconstructive treatment.

Author

Smit, Lucindi, Pijpe, Anouk, Nguyen, Cindy, Hartsuiker, Tara, Stoop, Matthea, van Heel, Anouk, Bosma, Eelke, van der Vlies, Cornelis H., van Zuijlen, Paul P. M., van Baar, Margriet E., and Middelkoop, Esther

Subjects
BODY surface area, MEDICAL care use, BURN patients, PLASTIC surgery, TREATMENT effectiveness
Abstract

Reports on treatment characteristics and long term outcomes for severe burns are scarce, while the need to compare outcomes of novel treatment modalities to standard of care is increasing. Our national database on burn treatment enabled analysis of patient as well as treatment characteristics during acute treatment and following reconstructive procedures. Furthermore, outcome data of longitudinal scar assessments were analysed from a single burn centre database. Acute and reconstructive data were analysed for patients admitted to the three Dutch burn centres with total body surface area burned of ≥ 20% TBSA. Long term outcome was analysed from a single centre scar database, both for a period of 2009–2019. Treatment characteristics from 396 surviving acute burn patients were analysed. Surgical treatment was required in 89.6% of these patients and 110 patients (27.8%) needed reconstructive surgery in the years after the burn incident, with a mean of 4.4 reconstructive procedures per patient. Main indications were contractures (70.5%) and arms (45.0%) and head and neck region (41.2%) were most frequently affected. Techniques used for reconstructive corrections were predominantly excision, release and flaps (54.7%), followed by skin transplants (32.4%). Scar quality was significantly worse in patients with more severe burns compared to those with TBSA < 20% during prolonged times. These data provide insight into health care utilization, treatment characteristics and outcomes in severely burned patients. These real-world data can guide future development of improved treatment strategies for at risk patients as well as anatomical locations. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Outcomes of dermal substitutes in burns and burn scar reconstruction: A systematic review and meta‐analysis.

Author

van den Bosch, Anna S., Verwilligen, Robin A. F., Pijpe, Anouk, Bosma, Eelke, van der Vlies, Cees H., Lucas, Ymke, Burchell, George L., van Zuijlen, Paul P. M., Middelkoop, Esther, van Baar, M.E., Baran, K.C., Blok, S., van Dammen, L., van Eck, M.E., Geelen, S.J.G., van Gemert, R., Nieuwenhuis, M.K., Salemans, R.F.C., van Schie, C.M.H., and Scholten‐Jaegers, S.M.H.J.

Subjects
WOUND healing, HEALTH literacy, SKIN grafting, BURNS & scalds, RESEARCH funding, TISSUE engineering, TREATMENT effectiveness, META-analysis, DESCRIPTIVE statistics, ARTIFICIAL skin, SYSTEMATIC reviews, BURN patients, PLASTIC surgery, WOUND care, CONFIDENCE intervals, COLLAGEN
Abstract

Dermal substitutes have been introduced in burn care to improve wound healing outcomes; however, their use remains limited in standard treatments. This systematic review and meta‐analysis aimed to evaluate the outcomes of dermal substitutes in patients with burns and patients requiring burn scar reconstruction and subsequently contribute to optimising the integration of dermal substitutes into clinical practice and reducing the knowledge gap. A comprehensive search across various databases included human studies from peer‐reviewed journals on dermal substitutes for deep dermal and full‐thickness burns, and scar reconstruction across all ages. Data from comparative trials were extracted, focusing on patient and wound characteristics, treatment specifics, and outcomes related to wound healing and scar quality. Meta‐analysis was performed on trials reporting similar post‐burn measures, with statistical heterogeneity assessed. Outcomes were presented using mean differences or odds ratios with 95% confidence intervals. A total of 31 comparative trials were included. The overall quality of the studies was considered moderate. The meta‐analysis indicated delayed re‐epithelialization 4–7 days after treatment with a collagen‐elastin matrix compared to split‐thickness skin graft in acute burns (−7.30%, p = 0.02). Significant improvement in subjective scar quality was observed with acellular dermal matrix compared to split‐thickness skin graft in acute burn wounds 6 months post‐operative (−1.95, p <0.01). While acknowledging the initially delayed wound healing, incorporating dermal substitutes into the surgical treatment of burn patients holds promise for enhancing scar quality. However, future research must prioritise outcome measure uniformity, address variations in dermal substitute application, and standardise indications for consistent and effective practices. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Some Mathematical Properties of Morphoelasticity

Author

Egberts, Ginger, Smits, Daan, Vermolen, Fred, Zuijlen, Paul van, Barth, Timothy J., Series Editor, Griebel, Michael, Series Editor, Keyes, David E., Series Editor, Nieminen, Risto M., Series Editor, Roose, Dirk, Series Editor, Schlick, Tamar, Series Editor, Vermolen, Fred J., editor, and Vuik, Cornelis, editor

Published
2021
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22. Intraluminal release of citrullinated histone 3 from various cellular origins coincides with microvascular thrombosis in burn wounds

Author

van der Leeden, Britt, primary, Korkmaz, H. Ibrahim, additional, Vlig, Marcel, additional, Waas, Ingeborg S.E., additional, Boekema, Bouke K.H.L., additional, Hassan, Chopie, additional, van Zuijlen, Paul P.M., additional, Niessen, Hans W.M., additional, Gibbs, Susan, additional, and Krijnen, Paul A.J., additional

Published
2024
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26. Scar Assessment Scales

Author

Carrière, Michelle E., van de Kar, Annekatrien L., van Zuijlen, Paul P. M., Téot, Luc, editor, Mustoe, Thomas A., editor, Middelkoop, Esther, editor, and Gauglitz, Gerd G., editor

Published
2020
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27. Scar Symptoms: Pigmentation Disorders

Author

Pijpe, A., Gardien, K. L. M., van Meijeren-Hoogendoorn, R. E., Middelkoop, E., van Zuijlen, Paul P. M., Téot, Luc, editor, Mustoe, Thomas A., editor, Middelkoop, Esther, editor, and Gauglitz, Gerd G., editor

Published
2020
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29. Scar Assessment

Author

Verhaegen, Pauline D. H. M., van der Wal, Martijn B. A., Middelkoop, Esther, van Zuijlen, Paul P. M., Kamolz, Lars-Peter, editor, Jeschke, Marc G., editor, Horch, Raymund E., editor, Küntscher, Markus, editor, and Brychta, Pavel, editor

Published
2020
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34. The efficacy of therapeutic interventions on paediatric burn patients’ height, weight, body composition, and muscle strength:A systematic review and meta-analysis

Author

Cuijpers, Maxime D., Baartmans, Martin G.A., Joosten, Koen F.M., Dulfer, Karolijn, van Zuijlen, Paul P.M., Ket, Johannes C.F., Pijpe, Anouk, Cuijpers, Maxime D., Baartmans, Martin G.A., Joosten, Koen F.M., Dulfer, Karolijn, van Zuijlen, Paul P.M., Ket, Johannes C.F., and Pijpe, Anouk

Abstract

Objective: To evaluate the efficacy of therapeutic interventions on pediatric burn patients’ height, weight, body composition, and muscle strength. Methods: A systematic literature search was conducted in PubMed, Embase, and Web of Science up to March 2021. Eligible interventional studies reported metrics on the height, weight, body composition, or muscle strength of pediatric burn patients in a peer-reviewed journal. Meta-analyses were performed if ≥ 2 trials of clinical homogeneity reported on an outcome measure at the same time point post-burn. Results: Twenty-six interventional studies were identified, including twenty-two randomised controlled trials and four non-randomised trials. Most studies were conducted by a single institution. On average, the burn covered 45.3% ( ± 9.9) of the total body surface area. Three categories of interventions could be distinguished: rehabilitative exercise programs, pharmacologic agents, and nutrition support. Conclusions: Each of the interventions had a positive effect on height, weight, body composition, or muscle strength. The decision to initiate an intervention should be made on a case-by-case basis following careful consideration of the benefits and risks. In future research, it is important to evaluate the heterogeneity of intervention effects and whether participation in an intervention allowed pediatric burn patients to reach the physical and functional status of healthy peers.

Published
2024

35. Timing of surgery in acute deep partialthickness burns:A study protocol

Author

Salemans, Roos F.C., Van Uden, Denise, Van Baar, Margriet E., Haanstra, Tjitske M., Van Schie, Carine H.M., Van Zuijlen, Paul P.M., Lucas, Ymke, Scholten-Jaegers, Sonja M.H.J., Meij-De Vries, Annebeth, Wood, Fiona M., Edgar, Dale W., Spronk, Inge, Van Der Vlies, Cornelis H., Van Der Vlegel, Marjolein, Salemans, Roos F.C., Van Uden, Denise, Van Baar, Margriet E., Haanstra, Tjitske M., Van Schie, Carine H.M., Van Zuijlen, Paul P.M., Lucas, Ymke, Scholten-Jaegers, Sonja M.H.J., Meij-De Vries, Annebeth, Wood, Fiona M., Edgar, Dale W., Spronk, Inge, Van Der Vlies, Cornelis H., and Van Der Vlegel, Marjolein

Abstract

For deep partial-thickness burns no consensus on the optimal treatment has been reached due to conflicting study outcomes with low quality evidence. Treatment options in high- and middle-income countries include conservative treatment with delayed excision and grafting if needed; and early excision and grafting. The majority of timing of surgery studies focus on survival rather than on quality of life. This study protocol describes a study that aims to compare long-term scar quality, clinical outcomes, and patient-reported outcomes between the treatment options. A multicentre prospective study will be conducted in the three Dutch burn centres (Rotterdam, Beverwijk, and Groningen). All adult patients with acute deep-partial thickness burns, based on healing potential with Laser Doppler Imaging, are eligible for inclusion. During a nine-month baseline period, standard practice will be monitored. This includes conservative treatment with dressings and topical agents, and excision and grafting of residual defects if needed 14-21 days post-burn. The subsequent nine months, early surgery is advocated, involving excision and grafting in the first week to ten days post-burn. The primary outcome compared between the two groups is long-term scar quality assessed by the Patient and Observer Scar Assessment Scale 3.0 twelve months after discharge. Secondary outcomes include clinical outcomes and patient-reported outcomes like quality of life and return to work. The aim of the study is to assess long-term scar quality in deep partial-thickness burns after conservative treatment with delayed excision and grafting if needed, compared to early excision and grafting. Adding to the ongoing debate on the optimal treatment of these burns. The broad range of studied outcomes will be used for the development of a decision aid for deep partial-thickness burns, to fully inform patients at the point of consent to surgery and support optimal person-centred care.

Published
2024

37. Application of dermal substitutes in the surgical treatment of full‐thickness wounds: Outcomes of an international survey.

Author

van den Bosch, Anna S., Verwilligen, Robin A. F., Pijpe, Anouk, Bosma, Eelke, Lucas, Ymke, van Zuijlen, Paul P. M., Middelkoop, Esther, van Baar, M. E., van Dammen, L., Geelen, S. J. G., Haanstra, T. M., Hulleman, D. N., van Gemert, R., Lansdorp, C. A., Vries, A. Meij‐de, Nieuwenhuis, M. K., Salemans, R. F. C., van Schie, C. M. H., Scholten‐Jaegers, S. M. H. J., and Spronk, I.

Subjects
TRAUMA surgery, SKIN grafting, WOUND healing, CONTRACTURE (Pathology), RESEARCH funding, QUESTIONNAIRES, TISSUE engineering, TREATMENT effectiveness, SCARS, ARTIFICIAL skin, SKIN, PHYSICIAN practice patterns, PLASTIC surgery, MEDICAL equipment contamination, MEDICAL care costs
Abstract

Dermal substitutes have been introduced to improve the outcome of wound healing. Despite proven efficacy in trials, these skin constructs do not have a firm footing in treatment protocols. This survey aimed to gain insight into the international perspective on dermal substitutes. An open, voluntary and anonymous internet‐based international survey was conducted. Eligible to complete the survey were professionals involved in the surgical treatment of patients with wounds. Information was collected on participant demographics, appointed facilitators, barriers, indications and contraindications related to the use of dermal substitutes, as well as participants' perceptions on the current available evidence and treatment protocols. A total of 148 professionals from 30 countries completed the survey. The majority of participants were male (57%), with 60% being plastic surgeons. Eighty‐three percent of the professionals had experience in using dermal substitutes. The primary facilitators were 'increased scar elasticity' and 'reduction of contractures', while primary barriers included 'costs' and 'contamination risk'. Sixty‐two percent of the professionals acknowledged the efficacy of dermal substitutes; however, the majority emphasised the absence of clear indications and treatment protocols. This study emphasises the acknowledged efficacy of dermal substitutes while highlighting the need for clearer indications and treatment protocols. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Efficacy of Alkaline Phosphatase in Critically Ill Patients with COVID-19: A Multicentre Investigator-Initiated Double-Blind Randomised Placebo-Controlled Trial

Author

Pijpe, Anouk, primary, Papendorp, Stephan G., additional, van der Heijden, Joost W., additional, Vermin, Ben, additional, Ertugrul, Iris, additional, Ritt, Michael W. J., additional, Stessel, Björn, additional, Callebaut, Ina, additional, Beishuizen, Albertus, additional, Vlig, Marcel, additional, Jimmink, Joost, additional, Huijgen, Henk J., additional, van Zuijlen, Paul P. M., additional, Middelkoop, Esther, additional, and de Jong, Evelien, additional

Published
2024
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44. Improving patient care by virtual case discussion between plastic surgeons and residents of Uganda and the Netherlands

Author

Opegu, Titus M., primary, Smit, Johannes A., additional, Lachkar, Nadia, additional, Kalanzi, Edris W., additional, Hop, M. Jenda, additional, Driessen, Caroline, additional, Botman, Matthijs, additional, van Zuijlen, Paul P.M., additional, Lapid, Oren, additional, van der Sluis, Wouter B., additional, Alenyo, Rose, additional, Wandabwa, Joel, additional, Mghase, Adelaide E., additional, Teklu, Zenebe, additional, Kazibwe, Simon, additional, and Breugem, Corstiaan C., additional

Published
2023
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46. ISBI Practice Guidelines for Burn Care, Part 2

Author

Allorto, Nikki, Atieh, Bechara, Bolgiani, Alberto, Chatterjee, Pallab, Cioffi, William, Dziewulski, Peter, de Jong, Alette, Gibran, Nicole, Guerrero, Linda, Hanumadass, Marella, Hofland, Helma, Icaza, Ivette, Koogewerf, Kees, Li-Tsang, Cecilia, Mackie, David, Nnabuko, Richard, Oen, Irma, Peck, Michael, Puri, Vinita, Putu Riasa, Nyoman, Sjoberg, Folke, van Schie, Carine, Wilson, Yvonne, Wolf, Steve, Ahuja, Rajeev B., Carrougher, Gretchen, Cartotto, Robert, Cleland, Heather, Greenhalgh, David, Herndon, David, Jeng, James, Malic, Claudia, Moghazy, Amr, Moiemen, Naiem, Palmieri, Tina, Parry, Ingrid, Sheridan, Robert, Singer, Yvonne, van Zuijlen, Paul, Weber, Joan, and Wiechman, Shelly

Published
2018
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50. 20th Congress of the European Burns Association (EBA)

Author

Depetris, Nadia, primary, De Jong, Alette, additional, Schiestl, Clemens, additional, Duteille, Franck, additional, Meirte, Jill, additional, Barret-Nerin, Joan P., additional, Van Zuijlen, Paul, additional, Vuola, Jyrki, additional, and Almeland, Stian, additional

Published
2023
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