Jan Dokter - Academia.edu (original) (raw)
Papers by Jan Dokter
Archives of Public Health
Background A comprehensive overview of the burden of disease of burns for the full spectrum of ca... more Background A comprehensive overview of the burden of disease of burns for the full spectrum of care is not available. Therefore, we estimated the burden of disease of burns for the full spectrum in the Netherlands in 2018, and explored whether the burden of disease changed over the past 5 years (2014-2018). Methods Data were collected at four levels: general practice, emergency department, hospital, and mortality data. For each level, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life-years (DALY) were estimated using a tailored methodology. Results Burns resulted in a total of 9278 DALYs in the Netherlands in 2018, comprising of 7385 YLDs (80%) and 1892 YLLs (20%). Burn patients who visited the general practice contributed most DALYs (64%), followed by deceased burn patients (20%), burn patients admitted to hospital (14%) and those treated at the emergency department (2%). The burden of disease was comparable in both sexes (4734 DALYs (51%) fo...
Burns, 2011
skin, more than twofold changes were observed in a total of 383 genes at the acute stage, 2014 ge... more skin, more than twofold changes were observed in a total of 383 genes at the acute stage, 2014 genes at the 3rd POD, and 1617 genes at 7th POD. Overall, the most induced gene was S100 calcium binding protein A7A with a fold-change of 246 at the 7th day, while the most down-regulated gene was keratin 2 at day 3 with a fold-change of 940 as compared to the intact skin. Conclusion: Our results reveal novel genes and gene expression profiles associated with the process of epidermal healing. They also provide a fundamental basis for the translational interpretation of data acquired from experimental models. O0.4 Improved scar elasticity after dermal substitution and topical negative pressure: a multicentre controlled trial in burns
Burns, 2006
We conducted a Medline search (1966-11/2003) on empirical studies into the consequences of burns.... more We conducted a Medline search (1966-11/2003) on empirical studies into the consequences of burns. The International Classification of Functioning, disabilities and health (ICF) was used to classify dimensions of functional outcome. We included 50 studies, reporting a wide spectrum of ICF-dimensions. The current state of knowledge on the functional outcome after burns was hard to summarise, due to the wide variety in study designs and outcome assessment methods. Some indications on the major functional problems after burns were gained. Problems in mental function were described in subgroups of patients, both in children/adolescents and adults. Restrictions in range of motion were observed in about one-fifth of burn patients, even 5 years after injury. Problems with appearance were reported often (up to 43%), even in patients with minor burns (14%). Problems with work were reported in 21-50% of the adult patients, with permanent incapacity for work in 1-5%. None of the publications gave sufficient information to fully estimate the functional consequences of burns. We recommend the development of a standard core set for measurement and reporting of functional outcome after burns.
Burns, 2019
OBJECTIVE Multiple studies have been published on toxic epidermal necrolysis (TEN) and Stevens-Jo... more OBJECTIVE Multiple studies have been published on toxic epidermal necrolysis (TEN) and Stevens-Johnsen syndrome (SJS). Nursing care is an important part of the treatment of TEN patients. Unfortunately, limited information on nursing in TEN/SJS patients has been published in the current literature. Nursing research is needed to improve the complex nursing care required for these rare patients. Therefore, the objective was to assess nursing problems in TEN patients in a burn centre setting over a 30-year period. METHODS The data for this study were gathered retrospectively from nursing records of all patients with TEN/SJS admitted to Burn Centre Rotterdam between January 1987 and December 2016. Dutch burn centres were recently accepted as expertise centres for TEN patients. Nursing problems were classified using the classification of nursing problems of the Dutch Nursing Society. RESULTS A total of 69 patients were admitted with SJS/TEN. Fifty-nine patient files were available. The most frequently reported nursing problems (>20% of the patients) were wounds, threatened or disrupted vital functions, dehydration or fluid imbalance, pain, secretion problems and fever. Furthermore, TEN-specific nursing problems were documented, including oral mucosal lesions and ocular problems. The highest number of concomitant nursing problems occurred during the period between days three and 20 after onset of the disease and varied by nursing problem. CONCLUSIONS The most frequently reported nursing problems involved physical functions, especially on days three to 20 after onset of the disease. With this knowledge, we can start nursing interventions early in the treatment, address problems at the first sign and inform patients and their families or relatives of these issues early in the disease process. A next step to improve nursing care for TEN patients is to acquire knowledge on the optimal interventions for nursing problems.
The Journal of Hand Surgery, 2017
k{# and the Dutch Burn Repository R3 Group Purpose The objective of this study was to analyze the... more k{# and the Dutch Burn Repository R3 Group Purpose The objective of this study was to analyze the prevalence, indications, and type of reconstructive surgery and predictors of the outcomes of reconstructive surgery after hand burns. Methods A retrospective cohort study was conducted that included all patients admitted with acute hand burns in the Dutch burn centers from January 1998 through December 2002. The details of reconstruction including frequency, timing, indication, and techniques were collected over a 10-year follow-up period. Results Hand burns were seen in 42% (n ¼ 562 of 1,334) of all patients admitted with acute burns. Reconstructive surgery during the 10-year follow-up period was required in 15%. Contractures, especially of the first web space and little finger, were the most frequent indications for reconstructive surgery. Web spaces 1 to 3 and the little finger were the location most frequently operated on. The most frequently performed surgical technique was release of the contractures and the use of a random flap. Eighty percent of the reconstructive surgery patients required more than 1 reconstructive procedure, most often within 2 years of the initial injury. Secondary operations at the same location were required in 12%. In 40% of the patients, the first reconstructive surgery was performed within the first postburn year. Significant independent factors related to the need for reconstructive hand surgery were a larger area of full-thickness burns and surgical treatment of the hand during the acute phase. Conclusions Reconstructive surgery was required in 15% of patients who sustained hand burns. The majority of the patients requiring reconstructive surgery of the hand needed 2 or more operations to correct the contractures of the hand. Contractures of the little finger and first web space were the locations most frequently operated on. Patients with more extensive burns and who required hand surgery during the acute phase were more likely to need reconstructive surgery.
Journal of Burn Care & Research, 2006
Burns, 2006
The Health Outcomes Burn Questionnaire (HOBQ) is a self-administered questionnaire to monitor out... more The Health Outcomes Burn Questionnaire (HOBQ) is a self-administered questionnaire to monitor outcome after burns in young children. This study aimed to assess feasibility, reliability and validity of the Dutch version of the HOBQ. The HOBQ was adapted into Dutch and tested in a population of children aged 0-4 years with a primary admission to a Dutch burn centre in March 2001-February 2004. Parents of 413 children were sent a questionnaire. To assess validity, a generic outcome instrument was included, the Infant Toddler Quality of Life Questionnaire (ITQOL). The response rate was 50.0% (n=196). Mean self-reported completion time was 16.7 min. The internal consistency of all the HOBQ-scales was good (Cronbach's alpha's>0.69). Test-retest results showed no differences in 7 out of 10 scales. High correlations between HOBQ-scales and conceptually equivalent ITQOL and scales were found in 5 out of 7 comparisons. The majority of the HOBQ-scales (7 out of 10) showed significant differences in the expected direction between children with a long versus short length of stay. Our data support the reliability and validity of the Dutch HOBQ. The HOBQ can be used as a research tool, to monitor functional outcome after burns in young children. Further research in other samples is recommend to fully establish the reliability and validity of the HOBQ.
Burns, 2013
The aim of this study was to compare clinical outcome of children with scald burns treated with a... more The aim of this study was to compare clinical outcome of children with scald burns treated with a hydrofiber dressing (Aquacel(®), Convatec Inc.) with the former standard of care with silver sulfadiazine (Flammazine(®); Solvay Pharmaceuticals), considering surgical intervention and length of stay (LOS). A retrospective study of all consecutive children from zero to four years with primary scald burns up to 10% admitted to the Burn Centre of the Maasstad Hospital Rotterdam between January 1987 and January 2010 were reviewed. For data collection a prospective computerized database was used. For comparison the study period was divided into two periods representing the period before and after the introduction of the hydrofiber dressing (HFD), respectively 1987-1999 (period 1) and 1999-2010 (period 2). Over the whole study period 27.3% of 502 patients treated with silver sulfadiazine (Ag-SD) underwent surgery, while before the introduction of HFD 30.5% of 338 Ag-SD treated patients were operated upon. After the introduction of the HFD 20.7% of 164 patients treated with Ag-SD eventually underwent skin grafting, a significant difference with the 11.6% of 302 patients whose wounds were dressed with HFD (p<0.01). Compared to silver sulfadiazine treatment a reduced number of surgical interventions was observed in mixed partial thickness scald burns up to 10% TBSA burned in children aged 0-4 years after the introduction of hydrofiber dressings. The mode of treatment with this wound dressing also limited hospital length of stay.
Burns, 2011
S15 ables. A step by step logistic regression was performed to determine predictive factors of mo... more S15 ables. A step by step logistic regression was performed to determine predictive factors of mortality. Results: Number of admissions after burn injury was 1559: 1397 thermal injuries (89.6%), 119 electrical (7.6%), 34 chemical (2.2%), 2 radiological (0.1%) and 7 other mechanisms (0.4%). The male to female ratio was 2.46. The mean age was 39.2 (±19.3) years. The mean total body surface area (TBSA) was 23.4% (±21.5) and the full total body surface area (FTBSA) 13.8% (±20.2). The length of stay was 29.6 (±32.9) days, the length of ventilation (n=605) was 29.5 (±34) days. Inhalation injury was present in 360 (23.1%) cases, intoxication (CO, cyanide) in 71 (4.6%) cases and associated traumatism in 68 (4.4%) cases.
Search strategy. (DOCX 24 kb)
Voor het instellen van de optimale therapie van brandwonden is een vroege, accurate bepaling van ... more Voor het instellen van de optimale therapie van brandwonden is een vroege, accurate bepaling van brandwondendiepte belangrijk. De meest gebruikte techniek om brandwondendiepte te bepalen is de klinische inschatting. Dit is een goedkope techniek, maar niet de meest accurate. ‘Laser-doppler-imaging’ is een techniek waarmee, door van het meten van de dermale perfusie, een meer accurate (> 95%) inschatting van brandwondendiepte kan worden gemaakt. De hypothese is dat de introductie van ‘laser-doppler-imaging’ zal leiden tot een snellere keuze voor het wel of niet verrichten van een operatie, met mogelijk een kortere ligduur en lagere kosten als gevolg. Om deze hypothese te testen, loopt er momenteel een gerandomiseerd gecontroleerd onderzoek in de Nederlandse brandwondencentra.
Nederlands tijdschrift voor geneeskunde, 2012
Early accurate determination of burn depth is important to determine the optimal treatment of bur... more Early accurate determination of burn depth is important to determine the optimal treatment of burns. The method most used to determine burn depth is clinical assessment. This is a cheap method, but not the most accurate. Laser Doppler imaging (LDI) is a technique with which a more accurate (>95%) estimate of burn depth can be made by measuring the dermal perfusion. It is hypothesised that the introduction of LDI will lead to quicker decisions as to whether or not to operate, possibly leading to a shorter length of hospital stay and lower medical costs. To test this hypothesis, a multicentre randomized controlled trial is presently being conducted in the Dutch burn centres.
Vaak wordt bij de eerste traumaopvang van iemand met ernstige brandwonden de aandacht afgeleid om... more Vaak wordt bij de eerste traumaopvang van iemand met ernstige brandwonden de aandacht afgeleid omdat soms ook behandelaars schrikken van het uiterlijk van de patiënt. Daarnaast heeft de patiënt meestal veel pijn, is hij angstig en is er de stress van de patiënt en de familie over het gebeurde. Later komen daar ook het verlies van inkomen en de onzekerheid
Burns & Trauma
Background In modern-day burn care, advanced age remains an important predictor for mortality amo... more Background In modern-day burn care, advanced age remains an important predictor for mortality among burn victims. In this study, we compared the complete treatment trajectory (including pre-hospital and surgical treatment) and the outcomes between an elderly burn population and a younger adult burn population. Methods In this nationwide study, data from the Dutch Burn Repository were used. This is a uniform national registration for Dutch specialized burn care. All adult patients that were admitted to one of the three Dutch burn centres from the period 2009 to 2015 were included in the analysis. Burn patients were considered as elderly when ≥65 years of age, and were then further subdivided into three age categories: 65–74, 75–85 and 85+ years. Younger adults in the age category 18–64 years were used as the reference group. Surgical management was studied comprehensively and included timing of surgery, the number of procedures and details on the surgical technique, especially the te...
Archives of Public Health
Background A comprehensive overview of the burden of disease of burns for the full spectrum of ca... more Background A comprehensive overview of the burden of disease of burns for the full spectrum of care is not available. Therefore, we estimated the burden of disease of burns for the full spectrum in the Netherlands in 2018, and explored whether the burden of disease changed over the past 5 years (2014-2018). Methods Data were collected at four levels: general practice, emergency department, hospital, and mortality data. For each level, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life-years (DALY) were estimated using a tailored methodology. Results Burns resulted in a total of 9278 DALYs in the Netherlands in 2018, comprising of 7385 YLDs (80%) and 1892 YLLs (20%). Burn patients who visited the general practice contributed most DALYs (64%), followed by deceased burn patients (20%), burn patients admitted to hospital (14%) and those treated at the emergency department (2%). The burden of disease was comparable in both sexes (4734 DALYs (51%) fo...
Burns, 2011
skin, more than twofold changes were observed in a total of 383 genes at the acute stage, 2014 ge... more skin, more than twofold changes were observed in a total of 383 genes at the acute stage, 2014 genes at the 3rd POD, and 1617 genes at 7th POD. Overall, the most induced gene was S100 calcium binding protein A7A with a fold-change of 246 at the 7th day, while the most down-regulated gene was keratin 2 at day 3 with a fold-change of 940 as compared to the intact skin. Conclusion: Our results reveal novel genes and gene expression profiles associated with the process of epidermal healing. They also provide a fundamental basis for the translational interpretation of data acquired from experimental models. O0.4 Improved scar elasticity after dermal substitution and topical negative pressure: a multicentre controlled trial in burns
Burns, 2006
We conducted a Medline search (1966-11/2003) on empirical studies into the consequences of burns.... more We conducted a Medline search (1966-11/2003) on empirical studies into the consequences of burns. The International Classification of Functioning, disabilities and health (ICF) was used to classify dimensions of functional outcome. We included 50 studies, reporting a wide spectrum of ICF-dimensions. The current state of knowledge on the functional outcome after burns was hard to summarise, due to the wide variety in study designs and outcome assessment methods. Some indications on the major functional problems after burns were gained. Problems in mental function were described in subgroups of patients, both in children/adolescents and adults. Restrictions in range of motion were observed in about one-fifth of burn patients, even 5 years after injury. Problems with appearance were reported often (up to 43%), even in patients with minor burns (14%). Problems with work were reported in 21-50% of the adult patients, with permanent incapacity for work in 1-5%. None of the publications gave sufficient information to fully estimate the functional consequences of burns. We recommend the development of a standard core set for measurement and reporting of functional outcome after burns.
Burns, 2019
OBJECTIVE Multiple studies have been published on toxic epidermal necrolysis (TEN) and Stevens-Jo... more OBJECTIVE Multiple studies have been published on toxic epidermal necrolysis (TEN) and Stevens-Johnsen syndrome (SJS). Nursing care is an important part of the treatment of TEN patients. Unfortunately, limited information on nursing in TEN/SJS patients has been published in the current literature. Nursing research is needed to improve the complex nursing care required for these rare patients. Therefore, the objective was to assess nursing problems in TEN patients in a burn centre setting over a 30-year period. METHODS The data for this study were gathered retrospectively from nursing records of all patients with TEN/SJS admitted to Burn Centre Rotterdam between January 1987 and December 2016. Dutch burn centres were recently accepted as expertise centres for TEN patients. Nursing problems were classified using the classification of nursing problems of the Dutch Nursing Society. RESULTS A total of 69 patients were admitted with SJS/TEN. Fifty-nine patient files were available. The most frequently reported nursing problems (>20% of the patients) were wounds, threatened or disrupted vital functions, dehydration or fluid imbalance, pain, secretion problems and fever. Furthermore, TEN-specific nursing problems were documented, including oral mucosal lesions and ocular problems. The highest number of concomitant nursing problems occurred during the period between days three and 20 after onset of the disease and varied by nursing problem. CONCLUSIONS The most frequently reported nursing problems involved physical functions, especially on days three to 20 after onset of the disease. With this knowledge, we can start nursing interventions early in the treatment, address problems at the first sign and inform patients and their families or relatives of these issues early in the disease process. A next step to improve nursing care for TEN patients is to acquire knowledge on the optimal interventions for nursing problems.
The Journal of Hand Surgery, 2017
k{# and the Dutch Burn Repository R3 Group Purpose The objective of this study was to analyze the... more k{# and the Dutch Burn Repository R3 Group Purpose The objective of this study was to analyze the prevalence, indications, and type of reconstructive surgery and predictors of the outcomes of reconstructive surgery after hand burns. Methods A retrospective cohort study was conducted that included all patients admitted with acute hand burns in the Dutch burn centers from January 1998 through December 2002. The details of reconstruction including frequency, timing, indication, and techniques were collected over a 10-year follow-up period. Results Hand burns were seen in 42% (n ¼ 562 of 1,334) of all patients admitted with acute burns. Reconstructive surgery during the 10-year follow-up period was required in 15%. Contractures, especially of the first web space and little finger, were the most frequent indications for reconstructive surgery. Web spaces 1 to 3 and the little finger were the location most frequently operated on. The most frequently performed surgical technique was release of the contractures and the use of a random flap. Eighty percent of the reconstructive surgery patients required more than 1 reconstructive procedure, most often within 2 years of the initial injury. Secondary operations at the same location were required in 12%. In 40% of the patients, the first reconstructive surgery was performed within the first postburn year. Significant independent factors related to the need for reconstructive hand surgery were a larger area of full-thickness burns and surgical treatment of the hand during the acute phase. Conclusions Reconstructive surgery was required in 15% of patients who sustained hand burns. The majority of the patients requiring reconstructive surgery of the hand needed 2 or more operations to correct the contractures of the hand. Contractures of the little finger and first web space were the locations most frequently operated on. Patients with more extensive burns and who required hand surgery during the acute phase were more likely to need reconstructive surgery.
Journal of Burn Care & Research, 2006
Burns, 2006
The Health Outcomes Burn Questionnaire (HOBQ) is a self-administered questionnaire to monitor out... more The Health Outcomes Burn Questionnaire (HOBQ) is a self-administered questionnaire to monitor outcome after burns in young children. This study aimed to assess feasibility, reliability and validity of the Dutch version of the HOBQ. The HOBQ was adapted into Dutch and tested in a population of children aged 0-4 years with a primary admission to a Dutch burn centre in March 2001-February 2004. Parents of 413 children were sent a questionnaire. To assess validity, a generic outcome instrument was included, the Infant Toddler Quality of Life Questionnaire (ITQOL). The response rate was 50.0% (n=196). Mean self-reported completion time was 16.7 min. The internal consistency of all the HOBQ-scales was good (Cronbach's alpha's>0.69). Test-retest results showed no differences in 7 out of 10 scales. High correlations between HOBQ-scales and conceptually equivalent ITQOL and scales were found in 5 out of 7 comparisons. The majority of the HOBQ-scales (7 out of 10) showed significant differences in the expected direction between children with a long versus short length of stay. Our data support the reliability and validity of the Dutch HOBQ. The HOBQ can be used as a research tool, to monitor functional outcome after burns in young children. Further research in other samples is recommend to fully establish the reliability and validity of the HOBQ.
Burns, 2013
The aim of this study was to compare clinical outcome of children with scald burns treated with a... more The aim of this study was to compare clinical outcome of children with scald burns treated with a hydrofiber dressing (Aquacel(®), Convatec Inc.) with the former standard of care with silver sulfadiazine (Flammazine(®); Solvay Pharmaceuticals), considering surgical intervention and length of stay (LOS). A retrospective study of all consecutive children from zero to four years with primary scald burns up to 10% admitted to the Burn Centre of the Maasstad Hospital Rotterdam between January 1987 and January 2010 were reviewed. For data collection a prospective computerized database was used. For comparison the study period was divided into two periods representing the period before and after the introduction of the hydrofiber dressing (HFD), respectively 1987-1999 (period 1) and 1999-2010 (period 2). Over the whole study period 27.3% of 502 patients treated with silver sulfadiazine (Ag-SD) underwent surgery, while before the introduction of HFD 30.5% of 338 Ag-SD treated patients were operated upon. After the introduction of the HFD 20.7% of 164 patients treated with Ag-SD eventually underwent skin grafting, a significant difference with the 11.6% of 302 patients whose wounds were dressed with HFD (p<0.01). Compared to silver sulfadiazine treatment a reduced number of surgical interventions was observed in mixed partial thickness scald burns up to 10% TBSA burned in children aged 0-4 years after the introduction of hydrofiber dressings. The mode of treatment with this wound dressing also limited hospital length of stay.
Burns, 2011
S15 ables. A step by step logistic regression was performed to determine predictive factors of mo... more S15 ables. A step by step logistic regression was performed to determine predictive factors of mortality. Results: Number of admissions after burn injury was 1559: 1397 thermal injuries (89.6%), 119 electrical (7.6%), 34 chemical (2.2%), 2 radiological (0.1%) and 7 other mechanisms (0.4%). The male to female ratio was 2.46. The mean age was 39.2 (±19.3) years. The mean total body surface area (TBSA) was 23.4% (±21.5) and the full total body surface area (FTBSA) 13.8% (±20.2). The length of stay was 29.6 (±32.9) days, the length of ventilation (n=605) was 29.5 (±34) days. Inhalation injury was present in 360 (23.1%) cases, intoxication (CO, cyanide) in 71 (4.6%) cases and associated traumatism in 68 (4.4%) cases.
Search strategy. (DOCX 24 kb)
Voor het instellen van de optimale therapie van brandwonden is een vroege, accurate bepaling van ... more Voor het instellen van de optimale therapie van brandwonden is een vroege, accurate bepaling van brandwondendiepte belangrijk. De meest gebruikte techniek om brandwondendiepte te bepalen is de klinische inschatting. Dit is een goedkope techniek, maar niet de meest accurate. ‘Laser-doppler-imaging’ is een techniek waarmee, door van het meten van de dermale perfusie, een meer accurate (> 95%) inschatting van brandwondendiepte kan worden gemaakt. De hypothese is dat de introductie van ‘laser-doppler-imaging’ zal leiden tot een snellere keuze voor het wel of niet verrichten van een operatie, met mogelijk een kortere ligduur en lagere kosten als gevolg. Om deze hypothese te testen, loopt er momenteel een gerandomiseerd gecontroleerd onderzoek in de Nederlandse brandwondencentra.
Nederlands tijdschrift voor geneeskunde, 2012
Early accurate determination of burn depth is important to determine the optimal treatment of bur... more Early accurate determination of burn depth is important to determine the optimal treatment of burns. The method most used to determine burn depth is clinical assessment. This is a cheap method, but not the most accurate. Laser Doppler imaging (LDI) is a technique with which a more accurate (>95%) estimate of burn depth can be made by measuring the dermal perfusion. It is hypothesised that the introduction of LDI will lead to quicker decisions as to whether or not to operate, possibly leading to a shorter length of hospital stay and lower medical costs. To test this hypothesis, a multicentre randomized controlled trial is presently being conducted in the Dutch burn centres.
Vaak wordt bij de eerste traumaopvang van iemand met ernstige brandwonden de aandacht afgeleid om... more Vaak wordt bij de eerste traumaopvang van iemand met ernstige brandwonden de aandacht afgeleid omdat soms ook behandelaars schrikken van het uiterlijk van de patiënt. Daarnaast heeft de patiënt meestal veel pijn, is hij angstig en is er de stress van de patiënt en de familie over het gebeurde. Later komen daar ook het verlies van inkomen en de onzekerheid
Burns & Trauma
Background In modern-day burn care, advanced age remains an important predictor for mortality amo... more Background In modern-day burn care, advanced age remains an important predictor for mortality among burn victims. In this study, we compared the complete treatment trajectory (including pre-hospital and surgical treatment) and the outcomes between an elderly burn population and a younger adult burn population. Methods In this nationwide study, data from the Dutch Burn Repository were used. This is a uniform national registration for Dutch specialized burn care. All adult patients that were admitted to one of the three Dutch burn centres from the period 2009 to 2015 were included in the analysis. Burn patients were considered as elderly when ≥65 years of age, and were then further subdivided into three age categories: 65–74, 75–85 and 85+ years. Younger adults in the age category 18–64 years were used as the reference group. Surgical management was studied comprehensively and included timing of surgery, the number of procedures and details on the surgical technique, especially the te...