[Burns].

In the Netherlands, an average of 92,000 patients with burn injuries are seen annually by a general practitioners. A burn injury is defined as skin damage caused by heat, radiation, electricity, and/or chemical agents. It is crucial to make an accurate assessment of the severity of the burn.

[Wounds after necrotizing soft tissue infections: the treatment options].

Necrotizing soft tissue infection (NSTI) is a life-threatening illness that can seriously harm a person. Over the last years the incidence of NSTI has increased. A rapid and thorough debridement is crucial to let patients survive.

Timing of surgery in acute deep partial-thickness burns: A study protocol.

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.

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

Background : Necrotizing soft-tissue infections (NSTIs) present a surgical emergency of increasing incidence, which is often misdiagnosed and associated with substantial mortality and morbidity. A retrospective multicenter (11 hospitals) cohort study was initiated to identify the early predictors of misdiagnosis, mortality, and morbidity (skin defect size and amputation). Methods : Patients of all ages who presented with symptoms and were admitted for acute treatment of NSTIs between January 2013 and December 2017 were included.

Aetiology of bioethanol related burn accidents: A qualitative study.

Background: Since insight into the motivation of behaviour in bioethanol related burn accidents is lacking, this study aimed to qualitatively examine influencing factors in bioethanol related burn accidents. In order to identify target points for effective burn prevention.

Methods: Patients previously admitted with bioethanol related acute non-intentional burn injury to the three Dutch burn centres were eligible.

Effectiveness of prevention programmes on the rate of burn injuries in children: a systematic review.

Introduction: Burns are a frequent injury in children and can cause great physical and psychological impairment. Studies have identified positive effects of prevention measures based on increase in knowledge or reduction in hazards. The main goal of burn prevention campaigns, however, is to prevent burns.

The Role of Burn Centers in the Treatment of Necrotizing Soft-Tissue Infections: A Nationwide Dutch Study.

Patients with extensive and complex wounds due to Necrotizing Soft-Tissue Infections (NSTI) may be referred to a burn center. This study describes the characteristics, outcomes, as well as diagnostic challenges of these patients. Patients admitted to three hospitals with a burn center for the treatment of NSTI in a 5-year period were included.

The impact of necrotizing soft tissue infections on the lives of survivors: a qualitative study.

Purpose: Necrotizing soft tissue infections (NSTI) are potentially lethal infections marked by local tissue destruction and systemic sepsis, which require aggressive treatment. Survivors often face a long recovery trajectory. This study was initiated to increase understanding of the long-term impact of NSTI on health related quality of life (HRQoL), and how care may be improved.

Outcomes of Meek micrografting versus mesh grafting on deep dermal and full thickness (burn) wounds: Study protocol for an intra-patient randomized controlled trial.

Introduction: Autologous split thickness skin grafting is the standard-of-care for most deep dermal and full thickness skin defects. Historically, mesh grafting is used to expand skin grafts for smaller defects and other techniques such as Meek micrografting is used to enable expansion for larger skin defects. Yet, Meek micrografting is increasingly used for smaller skin defects as well.

Decision support system and outcome prediction in a cohort of patients with necrotizing soft-tissue infections.

Introduction: Necrotizing Soft Tissue Infections (NSTI) are severe infections with high mortality affecting a heterogeneous patient population. There is a need for a clinical decision support system which predicts outcomes and provides treatment recommendations early in the disease course.

Methods: To identify relevant clinical needs, interviews with eight medical professionals (surgeons, intensivists, general practitioner, emergency department physician) were conducted.

The Meek micrograft technique for burns; review on its outcomes: Searching for the superior skin grafting technique.

Introduction: Autologous split thickness skin grafting is the standard-of-care for the majority of deep dermal and full thickness burns: Meshed grafting is most commonly used. Patients with extensive burn injuries have limited donor site availability. Meek micrografting is a well-known technique to enable larger expansions.

Approaches to Surgical Debridement in Necrotizing Soft Tissue Infections: Outcomes of an Animated, Interactive Survey.

Background: Necrotizing soft tissue infections (NSTI) affect long-term quality of life in survivors. Different approaches to debridement may influence quality of life. The aim of this study was to assess the current practice of the debridement of NSTI in the Netherlands.

Aetiology of severe burn incidents in children under 5 years of age in the Netherlands: A prospective cohort study.

Background: Risk factors and mechanisms of injury may change over time. Since knowledge on aetiology of severe burn incidents in children under 5 years of age in the Netherlands is outdated, this study aimed to identify current risk factors and mechanisms of severe burn injury in children under 5 years of age in the Netherlands to direct future prevention campaigns.

Methods: Information on personal-, environmental- and behavioural circumstances as well as the mechanism of burn injury was prospectively collected in all burn centres during one year from patient records and structured interviews with parents.

[Iatrogenic burns in neonates].

Background: Despite the availability of different medical tools to simplify blood withdrawal, an old-fashioned method is still frequently being used in neonatal infants: the use of warm elements such as a warm washcloth or a glove filled with warm water, wrapped around an extremity. Use of these warm elements may easily cause contact burns in neonates. Unfortunately, not seldom we see and treat neonates with these burn injuries.

Child abuse and neglect in paediatric burns: The majority is caused by neglect and thus preventable.

Introduction: It is complex to distinguish negligent burns from inflicted and non-intentional burns, especially since no deliberate action caused the burn. Its recognition is important to create a safe life without (future) burns for our loved-ones who cannot take care of themselves (yet). Our aim was to investigate the incidence and associated characteristics of negligent burns are among children treated at a burn center.

The Skin-Sparing Debridement Technique in Necrotizing Soft-Tissue Infections: A Systematic Review.

Background: Skin-sparing debridement (SSd) was introduced as an alternative to en bloc debridement (EBd) to decrease morbidity caused by scars in patients surviving Necrotizing soft-tissue infections (NSTI). An overview of potential advantages and disadvantages is needed. The aim of this review was to assess (1) whether SSd is noninferior to EBd regarding general outcomes, that is, mortality, length of stay (LOS), complications, and (2) if SSd does indeed result in decreased skin defects.

Using fibrin sealant for skin graft fixation to avoid sedation in children with burns: a prospective study.

Objective: To investigate whether a fibrin sealant, Fitrix (Sanquin Blood Supply Foundation, The Netherlands), for fixation of skin grafts in children with burn wounds is less invasive and equally effective in comparison with skin staples.

Method: A single-centre prospective observational cohort study was conducted. Children requiring skin grafting after burns were included and received the fibrin sealant.

[Frostbite due to recreational nitrous oxide use].

Background: There is a new type of injury that is observed increasingly often: frostbite of the thighs that has occurred as result of holding a cylinder containing nitrous oxide in position between the legs during recreational use of said substance. Because skin symptoms are often mild in the first few days after the event, the severity of the injury is often not recognized. However, patients can suffer serious scarring from this type of injury.

Bacterial Species and Load Increase During Negative Pressure Wound Therapy: A Prospective Cohort Study.

Introduction: The course of both the bacterial species and load and the incidence of infection during negative pressure wound therapy (NPWT) are unclear, with published studies presenting contradicting results.

Objective: The aim of the study is to assess the changes in both bacterial species and load, as well as the incidence of infection, before and after NPWT in a patient population with a variety of wounds.

Methods: Surgical patients 18 years of age or older who needed NPWT were included in this multicenter, prospective cohort study.

Validity of thermography for measuring burn wound healing potential.

Accurate assessment of burn wound depth and the associated healing potential is vital in determining the need for surgical treatment in burns. Infrared thermography measures the temperature of the burn wound noninvasively, thereby providing indirect information on its blood flow. Previous research demonstrated that a small, low-priced, handheld thermal imager has an excellent reliability, but a moderate validity for measuring burn wound healing potential.

Burn wounds after electrical injury in a bathtub: a case report.

Background: Increased smartphone use among minors makes our population more prone to electrical injury. Despite regulations on electrical home safety standards, smartphones and chargers still pose a risk for severe injury among users.

Case Presentation: We present a case of a patient with low-voltage electrical burns due to smartphone use in a bathtub.

Detection of bacteria in burn wounds with a novel handheld autofluorescence wound imaging device: a pilot study.

Objective: To compare the detection of bacteria in burn wounds between an bacterial fluorescence imaging device MolecuLight i:X, (Canada), and standard microbiological swabs.

Methods: Wounds were swabbed three times on one occasion; once with a standard swab, once with a high-fluorescent area swab, indicating a bacterial load >10 colony-forming units (CFU)/gram and a finally with a non-fluorescent (nF) area swab. Proportion agreement of the microbiological results was calculated and the accuracy of the device to detect relevant bacteria was assessed.

The independent functioning of the orchidopexied congenital undescended testis as assessed by positron emission tomography/computed tomography.

Fertility after orchidopexied undescended testes (UDT) is impaired. Although fertility parameters are known to be more favorable in unilateral cases than in bilateral cases, the exact contribution of the unilateral orchidopexied UDT to fertility is unknown. We used testicular (18)F-fluoro-2-deoxyglucose ((18)F-FDG)-uptake assessed by positron emission tomography/computed tomography (PET/CT) to investigate the function of the orchidopexied unilateral congenital UDT, compared to its normally descended counterpart.

The value of ultrasonography in boys with a non-palpable testis.

Background: In patients with a non-palpable testis (NPT) on physical examination, the testis is assumed either to be situated intra-abdominally or to be hypoplastic or absent. Diagnostic laparoscopy in these boys is considered the preferable first step. In this study the diagnostic value of pre-operative ultrasound for NPT is assessed in comparison with laparoscopy.

Natural course of undescended testes after inguinoscrotal surgery.

Purpose: The purpose of the study is to study the natural course of undescended testes after inguinoscrotal surgery.

Methods: From 2003-2010, 24 boys were observed with 26 undescended testes after inguinoscrotal surgery; 12 had previously undergone inguinal hernia repair and 12 orchidopexy. Spontaneous descent was awaited and (re-)orchidopexy would only be performed in case of non-descent at puberty.