The 3rd Educational Course of the European Burns Association (EBA).

Abstracts of the plenary sessions, workshops, and poster presentations of the 3rd EBA Educational Course in Porto, Portugal, 17-18 October 2024.

A Platform for Testing the Biocompatibility of Implants: Silicone Induces a Proinflammatory Response in a 3D Skin Equivalent.

Biocompatibility testing of materials is carried out in 2D cell cultures or animal models despite serious limitations. 3D skin equivalents are advanced in vitro models for human skin. Silicone has been shown to be noncytotoxic but capable of eliciting an immune response.

Differences in learning characteristics between support vector machine and random forest models for compound classification revealed by Shapley value analysis.

The random forest (RF) and support vector machine (SVM) methods are mainstays in molecular machine learning (ML) and compound property prediction. We have explored in detail how binary classification models derived using these algorithms arrive at their predictions. To these ends, approaches from explainable artificial intelligence (XAI) are applicable such as the Shapley value concept originating from game theory that we adapted and further extended for our analysis.

[Registry Research Funding of the German Society of Plastic, Reconstructive and Aesthetic Surgery (DGPRÄC) and Research Funding Report 2021/2022].

Background: Research is an integral part of academic medicine. In plastic surgery, it sets the course for innovations in the specialty. The purpose of this study is to present the research performance of plastic surgeons in Germany for the period 2021/2022 and to compare it with previous periods.

Development of a 3D-immunofluorescence analysis for sensory nerve endings in human ligaments.

Background: The analysis of ligamentous mechanoreceptors is difficult due to a high amount of unclassifiable mechanoreceptors, which result from incomplete visualization through limited microscopic techniques.

New Method: The method was developed using dorsal intercarpal ligaments and dorsal regions of the scapholunate interosseous ligament from human cadaver wrists. Consecutive 70 µm thick cryosections were stained with immunofluorescence markers for protein S100B, neurotrophin receptor p75 (p75), protein gene product 9.

Immunofluorescence analysis of sensory nerve endings in the periarticular tissue of the human elbow joint.

Introduction: To investigate the dynamic aspects of elbow stability, we aimed to analyze sensory nerve endings in the ligaments and the capsule of elbow joints.

Materials And Methods: The capsule with its anterior (AJC) and posterior (PJC) parts, the radial collateral ligament (RCL), the annular ligament (AL), and the ulnar collateral ligament with its posterior (PUCL), transverse (TUCL) and anterior parts (AUCL) were dissected from eleven human cadaver elbow joints. Sensory nerve endings were analyzed in two levels per specimen as total cell amount/ cm after immunofluorescence staining with low-affinity neurotrophin receptor p75, protein gene product 9.

Closing the Gap: Bridging Peripheral Sensory Nerve Defects with a Chitosan-Based Conduit a Randomized Prospective Clinical Trial.

Introduction: If tensionless nerve coaptation is not possible, bridging the resulting peripheral nerve defect with an autologous nerve graft is still the current gold standard. The concept of conduits as an alternative with different materials and architectures, such as autologous vein conduits or bioartificial nerve conduits, could not replace the nerve graft until today. Chitosan, as a relatively new biomaterial, has recently demonstrated exceptional biocompatibility and material stability with neural lineage cells.

Comparative histomorphological analysis of elbow ligaments and capsule.

This study aimed to compare the histomorphology of the elbow capsule and its ligaments to gain a better understanding of the clinically relevant biomechanical stabilization. Eleven human elbows were dissected including the joint capsule with its anterior (AJC) and posterior (PJC) parts, the annular ligament (AL), the radial collateral ligament (RCL) and the ulnar collateral ligament with its anterior (AUCL), posterior (PUCL) and transverse (TUCL) parts. Hematoxylin-Eosin and Elastica van Gieson as conventional histology stainings were applied to determine collagenous and elastic fiber arrangements in transmission and polarization light microscopy.

[Establishing a standardized diagnostic Procedure for sonographic Imaging and Evaluation of the scapholunate Ligament].

Background: Ultrasound has not yet been established in the diagnostic workup of scapholunate ligament lesions. We aimed to develop a standardised examination procedure to visualise and evaluate the SL ligament.

Patients And Methods: Forty patients (70 hands) were examined prospectively with ultrasonography and the results were compared with arthroscopy and MRI findings.

[Accident-related and workplace-related vascular disorders of the hand].

Background: Limited hand function as the result of occupational exposure or accidental injury could primarily be of vascular origin. Since it is quite rarely seen in the course of routine traumatology, special awareness of this is needed.

Aim Of The Paper: The occupational diseases hypothenar/thenar hammer syndrome (occupational disease 2114) and vibration-induced vasospastic syndrome (occupational disease 2104) are presented on the basis of their etiological and pathogenetic characteristics, taking aspects of occupational medicine and expert opinion into consideration.

Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis.

Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe skin and mucosal reactions that are associated with high mortality. Despite the severity, an evidence-based treatment protocol for SJS/TEN is still lacking.

Method: In this systematic review and meta-analysis, the PubMed database was searched using the following terms: [Stevens-Johnson syndrome] OR [toxic epidermal necrolysis] AND [therapy] OR [treatment] over a 20-year period (1999-2019) in the German and English language.

Burn depth assessment using hyperspectral imaging in a prospective single center study.

Background: The assessment of thermal burn depth remains challenging. Over the last decades, several optical systems were developed to determine burn depth. So far, only laser doppler imaging (LDI) has been shown to be reliable while others such as infrared thermography or spectrophotometric intracutaneous analysis have been less accurate.

Stevens-Johnson syndrome and toxic epidermal necrolysis: a 10-year experience in a burns unit.

Objective: Stevens-Johnson syndrome (SJS) and its more severe counterpart, toxic epidermal necrolysis (TEN), are skin hypersensitivity reactions defined by epidermal blistering and necrosis. The exact pathophysiology of SJS/TEN is yet to be deciphered, but a number of risk factors have been identified including adverse drug reactions. The diagnosis of SJS/TEN is made on a clinical basis, and treatment consists of supportive care and occasionally immunosuppressants, such as cyclosporin, high-dose intravenous immunoglobulins and/or corticosteroids.

3D-perfusion analysis of burn wounds using hyperspectral imaging.

Background: Determination of the depth of burn wounds is still a challenge in clinical practise and fundamental for an optimal treatment. Hyperspectral imaging (HSI) has a high potential to be established as a new contact-free measuring method in medicine. From hyperspectral spectra 3D-perfusion parameters can be estimated and the microcirculatory of burn wounds over the first 72h after thermal injury can be objectively described.

[Registry Research Funding of the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC) and Research Funding Report 2019/2020].

Background:  Since 2015/16 the DGPRÄC collects, evaluates and publishes the research activities of academic sections, departments and clinics for plastic surgery at university hospitals in Germany, in order to raise the awareness of plastic surgical research performance.

Materials And Methods:  The directors of plastic surgical academic institutions were contacted via the DGPRÄC and asked to report any requested/approved and rejected research applications to public, non-public and industrial funding organizations. Data was collected in our previously established online database: https://docs.

[Hyperspectral imaging for postoperative flap monitoring of pedicled flaps].

Background: Since pedicle flaps were first described by the Indian physician Sushruta Samhita in the 6th century B. C., they have become an integral part of reconstructive surgery.

Structural topography of the interosseous membrane of the human forearm.

The aim of this study was to evaluate the morphology of the six different parts of the interosseous membrane (IOM) in 11 human cadaver forearms, including the distal oblique bundle (DOB), the distal accessory band (DAB), the central band (CB), the proximal accessory band (PAB), the dorsal oblique accessory cord (DOAC), and the proximal oblique cord (POC). Hematoxylin-eosin and Elastica van Gieson stained slices were used to investigate the tissue morphology. The DOB and DOAC were absent in one IOM and the POB in two IOMs, respectively.

Molecular Mechanisms of Hair Growth and Regeneration: Current Understanding and Novel Paradigms.

Hair is a defining feature of mammals and has critical functions, including protection, production of sebum, apocrine sweat and pheromones, social and sexual interactions, thermoregulation, and provision of stem cells for skin homeostasis, regeneration, and repair. The hair follicle (HF) is considered a "mini-organ," consisting of intricate and well-organized structures which originate from HF stem and progenitor cells. Dermal papilla cells are the main components of the mesenchymal compartments in the hair bulb and are instrumental in generating signals to regulate the behavior of neighboring epithelial cells during the hair cycle.

Burns: modified metabolism and the nuances of nutrition therapy.

Objective: To review the effects of burn injury on nutritional requirements and how this can best be supported in a healthcare setting.

Method: A literature search for articles discussing nutrition and/or metabolism following burn injury was carried out. PubMed, Embase and Web of Science databases were searched using the key search terms 'nutrition' OR 'metabolism' AND 'burn injury' OR 'burns'.

Mechanical ventilation as a surrogate for diagnosing the onset of abdominal compartment syndrome (ACS) in severely burned patients (TIRIFIC-study Part II).

Intra-abdominal compartment syndrome (ACS) is a devastating complication in burn patients with a high mortality. Apart from high-volume resuscitation as known risk factor, also mechanical ventilation seems to influence the development of ACS. The TIRIFIC trial is a retrospective, matched-pair analysis.

Evaluation of proprioception in denervated and healthy wrist joints.

We recruited 25 patients after complete wrist denervation and 60 healthy adults to investigate conscious and unconscious proprioception of the wrist. Ipsi- and contralateral joint-position sense, force sense, and wrist reflexes were measured. The latter were triggered by a trapdoor, recording electromyographic signals from the extensor carpi radialis brevis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris muscles.

Immunofluorescence analysis of sensory nerve endings in the interosseous membrane of the forearm.

The human interosseous membrane (IOM) is a fundamental stabilizer during forearm rotation. To investigate the dynamic aspects of forearm stability, we analyzed sensory nerve endings in the IOM. The distal oblique bundle (DOB), the distal accessory band (DAB), the central band (CB), the proximal accessory band (PAB), the dorsal oblique accessory cord (DOAC) and the proximal oblique cord (POC) were dissected from 11 human cadaver forearms.