Association of Dutch Burn Centres

Beverwijk, Netherlands

Association of Dutch Burn Centres

Beverwijk, Netherlands
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Bakker A.,Association of Dutch Burn Centres | Maertens K.J.P.,Scar After Care and Research | Maertens K.J.P.,Vrije Universiteit Brussel | Van Son M.J.M.,University Utrecht | And 2 more authors.
Clinical Psychology Review | Year: 2013

In order to inform clinical practice, we reviewed the empirical literature on emotional, behavioral and social outcomes in children with burns and their families published between 1989 and 2011. A systematic search of the literature yielded 75 articles. Qualitative synthesis of the results showed that child anxiety, traumatic stress reactions, and behavioral problems were considerably prevalent in the first months after the burn event. Among parents, high rates of posttraumatic stress, depressive symptoms, and guilt feelings were found. Cross-sectional studies, often performed many years after the injury, suggest that some children experience long-term psychological problems, such as anxiety, depression, and difficulties with social functioning. However, there was little evidence that behavior in general, self-esteem, or body image were impaired in the total population of children with a history of burns. Long-term family outcome studies suggest that psychological problems persist in a substantial subgroup of parents. Child peritraumatic factors anxiety and pain, parental posttrauma psychological reactions, and family functioning were the most consistently reported factors associated with child outcome. More recent studies have demonstrated that burn severity may have an indirect effect on child postburn psychosocial outcome. Clinical implications, methodological strengths and limitations of the reviewed studies, and directions for future research are discussed. © 2013 Elsevier Ltd.


Marck R.E.,Red Cross | Middelkoop E.,Association of Dutch Burn Centres | Middelkoop E.,VU University Amsterdam | Breederveld R.S.,Red Cross | Breederveld R.S.,Leiden University
Journal of Burn Care and Research | Year: 2014

Platelet-rich plasma (PRP) is a fraction of blood plasma with a platelet concentration above baseline. After activation of the platelets, growth factors are released, which are involved in wound-healing processes. Application of a multitude of growth factors seems to boost the healing process. In this review the authors provide a comprehensive overview of the many different aspects of PRP; this is followed by a short outline of the evidence for a wide range of applications and finally narrowing down to a more in-depth analysis of the literature on the potential use of PRP in burn treatment. The authors performed an extensive search on PRP and the different biological, as well as practical aspects for the different applications. Furthermore, we performed a systematic search on PRP in the treatment of burn wounds. A high variety exists in PRP products, procedures, and content. This makes interpretation and comparison of the evidence difficult. PRP has been reported to have beneficial effects on wound healing in different fields of surgery and in the treatment of acute, chronic, and diabetic wounds. Literature on the use of PRP in burns is scarce. Separate growth factors have shown beneficial results in the treatment of burns. Furthermore, an animal study and several case reports showed improved burn wound-healing time after the application of PRP. A deep dermal burn could benefit from PRP through its hemostatic antimicrobial abilities and the positive effects seen in wound healing. However, burn patients have an altered physiological state and it is unknown how this may affect platelet function and quality. Furthermore, the effect of PRP on scarring has not been evaluated properly. Future research is needed to elucidate the role of PRP in the treatment of burns. Copyright © 2014 by the American Burn Association.


Van Gils C.A.J.,TU Eindhoven | Hofmann S.,TU Eindhoven | Boekema B.K.H.L.,Association of Dutch Burn Centres | Brandenburg R.,TU Eindhoven | And 2 more authors.
Journal of Physics D: Applied Physics | Year: 2013

A radio-frequency atmospheric pressure argon plasma jet is used for the inactivation of bacteria (Pseudomonas aeruginosa) in solutions. The source is characterized by measurements of power dissipation, gas temperature, absolute UV irradiance as well as mass spectrometry measurements of emitted ions. The plasma-induced liquid chemistry is studied by performing liquid ion chromatography and hydrogen peroxide concentration measurements on treated distilled water samples. Additionally, a quantitative estimation of an extensive liquid chemistry induced by the plasma is made by solution kinetics calculations. The role of the different active components of the plasma is evaluated based on either measurements, as mentioned above, or estimations based on published data of measurements of those components. For the experimental conditions being considered in this work, it is shown that the bactericidal effect can be solely ascribed to plasma-induced liquid chemistry, leading to the production of stable and transient chemical species. It is shown that HNO 2, ONOO- and H2O2 are present in the liquid phase in similar quantities to concentrations which are reported in the literature to cause bacterial inactivation. The importance of plasma-induced chemistry at the gas-liquid interface is illustrated and discussed in detail. © 2013 IOP Publishing Ltd.


Ter Smitten M.H.,Association of Dutch Burn Centres | De Graaf R.,Netherlands Institute of Mental Health and Addiction | Van Loey N.E.,Association of Dutch Burn Centres
Burns | Year: 2011

Objective: Currently, little is known about psychiatric disorders in the period following on the first year after burn. We examined the prevalence of DSM-IV Axis I disorders in burn patients 1-4 years after burn, using a standardized structured clinical interview and comparing findings with a representative general population sample. Methods: Ninety patients admitted to five burn centres were assessed with the 12-month Composite International Diagnostic Interview. Results were compared to an age and gender matched nation based norm group. Results: Twelve-month prevalence for any DSM-IV study disorder was 39%. Prevalence for any after burn onset disorder was 28%. Most prevailing were major depression (10%), generalized anxiety disorder (10%), and PTSD (7%). The comorbidity-proportions for PTSD and generalized anxiety disorder where the highest. Fifty-seven percent of all burn onset disorders started within 1 year after the trauma and 21% within the next year. Burn patients had significantly higher prevalence rates for DSM-IV disorders than people from the general population sample. Conclusion: Psychiatric morbidity among burn patients, 1-4 years after burn, is considerable and higher than what may be expected in the general population. A 2-year follow-up for anxiety and depression disorder is warranted. © 2011 Elsevier Ltd and ISBI. All rights reserved.


Bakker A.,Association of Dutch Burn Centres | Van Der Heijden P.G.M.,University Utrecht | Van Son M.J.M.,University Utrecht | Van Loey N.E.E.,University Utrecht
Health Psychology | Year: 2013

Objective: This study examines traumatic stress reactions in couples that were followed prospectively for 18 months after a burn event to their child. Method: The participants included 186 mothers and 159 fathers of 198 preschool children. Parents' self-reported traumatic stress reactions were measured with the Impact of Event Scale (IES). Predictors included parental emotions and the perceived life-threatening character of the child's injury. Results: Rates for clinically significant symptoms (IES ≥ 26) decreased from 50% within the first month to 18% at 18 months postburn for mothers and from 27% to 6% for fathers. The decline in symptoms was not entirely linear. Mothers had higher scores than fathers, but the discrepancy in intrusion symptoms among couples diminished over the course of time. Early appraisal of life threat and emotions about the burn event were significant predictors. Conclusions: Both mothers and fathers are seriously affected by a burn event of their young child. Despite a general decrease over time, a subgroup of parents is at risk for chronic symptoms. The results call for the integration of prolonged parent support in family centered pediatric burn aftercare programs. © 2013 American Psychological Association.


Bakker A.,Association of Dutch Burn Centres | Van Loey N.E.E.,Association of Dutch Burn Centres | Van Der Heijden P.G.M.,University Utrecht | Van Son M.J.M.,University Utrecht
Journal of Pediatric Psychology | Year: 2012

ObjectiveThis multicenter study examines acute stress reactions in couples following a burn event to their preschool child.MethodsParticipants were 182 mothers and 154 fathers, including 143 couples, of 193 children (0-4 years) with acute burns. Parents' self-reported acute stress reactions and emotions regarding the burn event were measured within the first month postburn.ResultsMore mothers than fathers reported clinically significant acute stress reactions. Multilevel analysis revealed that individual parent reactions were associated with parent gender and negative emotions about the burn event. Interestingly, avoidance symptoms overlapped to an important extent within couples, whereas intrusion symptoms were mainly intra-individual. Burn characteristics, such as burn size, contributed to acute stress within couples.ConclusionsMothers and fathers are seriously affected by their child's burn trauma and share a part of their acute stress reactions. These results emphasize the importance of a family-based approach to support adjustment after pediatric medical trauma. © 2012 The Author 2012. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.


Coolen N.A.,Association of Dutch Burn Centres | Coolen N.A.,VU University Amsterdam | Schouten K.C.W.M.,Association of Dutch Burn Centres | Middelkoop E.,Association of Dutch Burn Centres | And 3 more authors.
Archives of Dermatological Research | Year: 2010

Healing of early-gestation fetal wounds results in scarless healing. Since the capacity for regeneration is probably inherent to the fetal skin itself, knowledge of the fetal skin composition may contribute to the understanding of fetal wound healing. The aim of this study was to analyze the expression profiles of different epidermal and dermal components in the human fetal and adult skin. In the human fetal skin (ranging from 13 to 22 weeks' gestation) and adult skin biopsies, the expression patterns of several epidermal proteins (K10, K14, K16, K17, SKALP, involucrin), basement membrane proteins, Ki-67, blood vessels and extracellular matrix proteins (fibronectin, chondroitin sulfate, elastin) were determined using immunohistochemistry. The expression profiles of K17, involucrin, dermal Ki-67, fibronectin and chondroitin sulfate were higher in the fetal skin than in adult skin. In the fetal skin, elastin was not present in the dermis, but it was found in the adult skin. The expression patterns of basement membrane proteins, blood vessels, K10, K14, K16 and epidermal Ki-67 were similar in human fetal skin and adult skin. In this systematic overview, most of the differences between fetal and adult skin were found at the level of dermal extracellular matrix molecules expression. This study suggests that, especially, dermal components are important in fetal scarless healing.


Boekema B.K.H.L.,Association of Dutch Burn Centres | Pool L.,Association of Dutch Burn Centres | Ulrich M.M.W.,Association of Dutch Burn Centres
Burns | Year: 2013

Bacterial contamination remains a constant threat in burn wound care. Topical treatments to combat contaminations have good bactericidal effects but can have detrimental effects for the healing process. Treatments with for example silver can increase healing times. Honey based products can be a good alternative as it is antibacterial and patient-friendly. We evaluated the bactericidal and cytotoxic effects of a honey based gel and silver sulphadiazine in a human burn wound model with Pseudomonas aeruginosa. After adding 10 5 colony forming units of P. aeruginosa, topical treatments were applied on the burn wound models. After 2, 12, 24, 28 and 70 h, bacteria were dislodged and counted by plating dilutions. Cytotoxic effects were evaluated histologically in samples of burn wound models treated topically for 3 weeks, without bacteria. l-Mesitran Soft significantly reduced the bacterial load (5-log reduction) up to 24 h but did not completely eliminate bacteria from the burn wounds. After Flammazine® treatment, only a few colony forming units were observed at all time points. In contrast, re-epithelialization was significantly reduced after application of Flammazine® compared to l-Mesitran Soft or control. This in vitro model of burn wound infection can be used to evaluate topical treatments. l-Mesitran Soft is a good alternative for treating burn wounds but the slightly lower bactericidal activity in the burn wound model warrants a higher frequency of application. © 2012 Elsevier Ltd and ISBI.


Bakker A.,Association of Dutch Burn Centres
Journal of pediatric psychology | Year: 2010

OBJECTIVE: This prospective longitudinal study examines the course of posttraumatic stress symptoms (PTSS) in mothers of children with burns between 1 and 11 years after the burn event and the role of burn severity and feelings of guilt on this course. METHOD: Self-reported PTSS of 48 mothers were measured with the Impact of Event Scale. Guilt feelings were assessed during an in-depth interview 2 years after the burn event. Eleven years after the burn event, mothers marked their child's scars at the present time on a drawing. RESULTS: Over a period of 10 years, maternal PTSS decreased. Multiple regression analysis showed that the interaction between guilt and burn severity predicted the course of PTSS. CONCLUSIONS: Although PTSS substantially decreases through the years, a subset of mothers, in particular mothers who feel guilty about the burn event and whose children have more extensive permanent scarring seem at risk for longer term PTSS.


Ter Smitten M.H.,Association of Dutch Burn Centres
Burns : journal of the International Society for Burn Injuries | Year: 2011

Currently, little is known about psychiatric disorders in the period following on the first year after burn. We examined the prevalence of DSM-IV Axis I disorders in burn patients 1-4 years after burn, using a standardized structured clinical interview and comparing findings with a representative general population sample. Ninety patients admitted to five burn centres were assessed with the 12-month Composite International Diagnostic Interview. Results were compared to an age and gender matched nation based norm group. Twelve-month prevalence for any DSM-IV study disorder was 39%. Prevalence for any after burn onset disorder was 28%. Most prevailing were major depression (10%), generalized anxiety disorder (10%), and PTSD (7%). The comorbidity-proportions for PTSD and generalized anxiety disorder where the highest. Fifty-seven percent of all burn onset disorders started within 1 year after the trauma and 21% within the next year. Burn patients had significantly higher prevalence rates for DSM-IV disorders than people from the general population sample. Psychiatric morbidity among burn patients, 1-4 years after burn, is considerable and higher than what may be expected in the general population. A 2-year follow-up for anxiety and depression disorder is warranted. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

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