Publications by authors named "Sebastian Vrouwe"

Comprehensive studies on the incidence, risk factors, and prophylactic measures related to venous thromboembolism (VTE) are lacking in burn care. This study characterizes VTE risk and existing prevention measures to improve and inform overall patient care in the field of burn care on a national scale. The US National Trauma Data Bank (NTDB) was queried from 2007 to 2021 to identify burn-injured patients.

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Article Synopsis
  • The article focuses on the essential roles of plastic surgeons in managing burn injuries, highlighting the need for improved acute burn care practices due to workforce shortages.
  • It covers important learning objectives, including understanding the current epidemiology, pathophysiology, and emergency management of burns, as well as techniques for wound assessment and care.
  • The piece also discusses advancements in surgical methods, fluid resuscitation guidelines, and both traditional and innovative approaches for closing burn wounds using autografts and skin substitutes.
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Older adults with burn injuries have a high risk of readmission after the initial burn admission. Frailty is associated with poor outcomes from the initial burn injury, however, it remains unknown if frailty impacts readmission in older adults after the initial index burn admission. Our study aims to examine patient, frailty, burn, surgical, and hospital factors that contribute to 90-day readmissions in older adults with an acute burn.

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Burn prevention information may be inadequate or inaccessible to communities with non-English language preference. Our objective was to systematically analyze the content accuracy, website quality, and readability of online Spanish information for burn prevention in the home and compare it to English websites. We collected the top ten burn prevention results from a search on Google, Bing, and Yahoo using a list of Spanish key terms.

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Mortality following a severe burn is influenced by both patient- and injury-factors, and a number of predictive models have been developed or applied. As there is no consensus on the optimal formula to use, we aimed to investigate the predictive value of the revised Baux score in comparison to other models when determining mortality risk in patients with burn injuries. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

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Introduction: Scalds are the most common mechanism of burn injury in pediatric populations and scald burns sustained during bathing present a unique opportunity for injury prevention. Evidence-based infant bathing educational resources recommend checking water temperature and having a caregiver present for the duration of the bath, but do not explicitly recommend avoiding running water or explain the associated risks. This study seeks to determine the incidence and role of running water in bathing scald burns at our institution.

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Introduction: Children are particularly vulnerable to scald injuries, and hot beverages/foods are often implicated in this subset of pediatric burns. Burns from instant noodles are common and thus an attractive target for burn prevention. The purpose of this study is to characterize the frequency, demographics, outcomes, and circumstances of pediatric instant noodle burns to guide future educational and prevention efforts.

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Staphylococcal toxic shock syndrome (TSS) is a severe systemic disease characterized by fever, hypotension, desquamating rash, and multiorgan dysfunction. Attributed to bacterial exotoxins, TSS has been a known, though rare, complication in the field of pediatric burns for decades. The adoption of new antimicrobial burn dressings has allowed for the management of small to medium sized burns with minimal discomfort or inconvenience to the patient.

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Acute burn surgery has long been associated with significant intra-operative bleeding. Several techniques were introduced to limit hemorrhage, including tourniquets, tumescent infiltration, and topical agents. To date, no study has comprehensively investigated the available data regarding topical hemostatic agents in burn surgery.

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Older adults with an acute burn experience a high frequency of in-hospital mortality. However, traditional burn mortality prediction models are less accurate for older adults likely because they do not account for geriatric specific factors, such as frailty. This study aims to investigate the impact of frailty on in-hospital mortality in older adult burn patients.

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Fireworks injuries can result in devastating cutaneous burns and may be further complicated in the head and neck region by the presence of specialized deeper structures. In the United States, the head and neck remain the most commonly injured sites, with the majority of these injuries constituting burns. We present an adult patient who suffered an accidental right cheek burn injury and went on to experience a complex pattern of findings including pneumomediastinum, facial nerve palsy, and sialocele formation.

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Tangential excision and grafting of burn wounds result in significant intraoperative blood loss, and infiltration of a dilute epinephrine solution (tumescence) is routinely performed to reduce such bleeding. Tumescent infiltration has been described using both a manual technique (syringe) and a pump device. The purpose of this study is to compare the efficiency of these two methods in terms of time and economy of motion.

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Hair braiding that incorporates synthetic extensions has increased in popularity across all age groups. As part of the styling process, the ends of the braid are commonly dipped in scalding water; an increasing number of patients have presented to our center after containers of recently boiled water are accidentally tipped over and spilled onto patients. A retrospective chart review was performed of all patients who sustained burn injuries related to at-home hair braiding presenting to an ABA-verified burn center between January 1, 2006 and July 31, 2020.

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Introduction: Burn care is a relatively small, mutidisciplinary field with variability in practices between centers. Given these factors, survey studies are frequently used to better understand practice variations, establish guidelines, and direct future research. If survey research is poorly designed or reported, it limits the ability to form meaningful conclusions.

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Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are life-threatening conditions best approached with multidisciplinary burn-equivalent care. There is a lack of consensus on wound management, in particular, whether to debride detached epidermis. Our center instituted "antishear" wound therapy 35 years ago, where detached skin is left in situ as a biologic dressing and a standardized protocol avoids shear forces to prevent further desquamation.

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Hypoglycemic episodes are associated with worse hospital outcomes. All adult patients admitted to our burn center from 2015 to 2019 were retrospectively reviewed. Patient demographics and burn characteristics were recorded.

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Orbital compartment syndrome (OCS) is a rare but devastating complication of over-resuscitation in burn patients that may lead to permanent visual loss. The purpose of this study was to 1) present a series of burn patients with OCS and 2) survey practice patterns of monitoring intra-ocular pressure (IOP) during burn resuscitation. Cases of OCS at two American Burn Association (ABA)-verified burn centers were retrospectively reviewed.

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The United States is facing a growing homelessness crisis. We characterize the demographics and outcomes of homeless patients who sustain burn injury and compare them to a cohort of domiciled patients. A retrospective cohort study was performed at the Los Angeles County + University of Southern California Regional Burn Center for consecutive acute burn admissions in adults from June 1, 2015, to December 31, 2018.

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Stimulant (cocaine, methamphetamine, and amphetamine) abuse compromises the peripheral vasculature through endothelial injury. In combination with the physiologic derangements seen in burn injuries, patients abusing stimulants may have additional impairments in wound healing. A retrospective review from July 1, 2015 to July 1, 2018 was performed at an American Burn Association-verified burn center.

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Major burn injuries incite a hypermetabolic response, and the initiation of early enteral nutrition is the standard of care in patients with large burns and contributes to improved outcomes. Perioperative fasting is a common cause of caloric deficits in burn patients and can be obviated with intraoperative enteral nutrition. However, the risks and benefits of this practice are unknown, and there is a concern for aspiration.

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Introduction: There is an ongoing shortage of burn specialists, and workforce reports suggest possible hurdles attracting plastic surgeons into burn care. The purpose of this study was to (1) determine the state of burn care in plastic surgery residency and (2) identify what barriers might exist for plastic surgeons pursuing a practice that involves burn care.

Methods: Surveys were distributed to North American plastic surgery program directors and residents, respectively, during the 2018-2019 academic year.

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Introduction: Patient positioning in the operating room remains a challenge for burn surgeons; burn surgery involves critically ill patients who require close monitoring, difficult exposures, and careful handling of grafted areas. Various techniques to optimize intraoperative positioning during burn surgery have been described in the literature. The aim of this review was to outline these positioning techniques and report on their complications.

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In contrast to the well-established association between ultraviolet radiation (UVR) exposure and skin cancers, the relationship between UVR and uveal malignant melanoma (UM) remains controversial. To address this controversy, we evaluated the incidence rates of cutaneous malignancies in the eyelids as a proxy for UVR exposure in the ocular region using a population-based cancer registry. Overall, 74,053 cases of eyelid basal cell carcinoma (BCC) and 7890 cases of melanoma over a 26-year period (1982-2007) were analyzed.

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