Papers by Roelf Breederveld
Burns, 2019
Please check your proof carefully and mark all corrections at the appropriate place in the proof ... more Please check your proof carefully and mark all corrections at the appropriate place in the proof (e.g., by using on-screen annotation in the PDF file) or compile them in a separate list. Note: if you opt to annotate the file with software other than Adobe Reader then please also highlight the appropriate place in the PDF file. To ensure fast publication of your paper please return your corrections within 48 hours.
The open orthopaedics journal, Jan 17, 2010
Repair of full thickness defects of articular cartilage in the knee is difficult but important to... more Repair of full thickness defects of articular cartilage in the knee is difficult but important to prevent progression to osteoarthritis. The purpose of this retrospective study was to evaluate the clinical results of Osteochondral Autograft Transplant System (OATS) treatment for articular defects of the knee.Between 1999 and 2005, 15 knees (14 patients) were treated by the OATS technique. Age ranged from 27 to 52 years. Cartilage defects were up to 3.75 cm2. The mean follow-up was 42 months. Knee function was assessed by the Lysholmscore and International Knee Documentation Committee (IKDC) Subjective Knee Form. Six patients scored good or excellent. No patient had knee instability. Twelve of 13 patients returned to sports at an intermediate or high level. The subjective assessment score (0-10) changed from 4.7 before operation to 7.2 afterward (P=0.007). The OATS-technique resulted in a decrease in symptoms in patients with localized articular cartilage defects. We consider the OAT...
The Journal of Trauma: Injury, Infection, and Critical Care, 2004
Background: Rapid diagnosis of scaphoid bone fracture in the wrist is important so that appropria... more Background: Rapid diagnosis of scaphoid bone fracture in the wrist is important so that appropriate treatment can be started. If a fracture is clinically suspected without being visible on radiography, further investigation has to be conducted to reveal a fracture or to rule it out. The objective of this study was to investigate the validity of computed tomographic (CT) scanning and bone scintigraphy compared with the clinical fracture rate during follow-up of 1 year for examining patients with a suspected scaphoid fracture. Methods: Bone scintigraphy and CT scanning were performed in 29 patients with persistent clinical suspicion of a scaphoid bone fracture 5 to 10 days after trauma. Results: The sensitivity, specificity, and positive and negative predictive values of the CT scan were 100%. The sensitivity, specificity, and positive and negative predictive values of bone scintigraphy were 78%, 90%, 78%, and 90%, respectively. Seven patients showed a fracture on both CT scanning and bone scintigra-phy. Eighteen patients showed no fracture on both CT scanning and bone scintigraphy. A false-positive bone scintigram showed up in two patients and a falsenegative bone scintigram in another two patients. Conclusion: CT scanning is a rapid, simple, valid method for demonstrating or ruling out a scaphoid fracture and is superior to bone scintigraphy.
BMC Musculoskeletal Disorders, 2010
Background Elbow dislocations can be classified as simple or complex. Simple dislocations are cha... more Background Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures. After reduction of a simple dislocation, treatment options include immobilization in a static plaster for different periods of time or so-called functional treatment. Functional treatment is characterized by early active motion within the limits of pain with or without the use of a sling or hinged brace. Theoretically, functional treatment should prevent stiffness without introducing increased joint instability. The primary aim of this randomized controlled trial is to compare early functional treatment versus plaster immobilization following simple dislocations of the elbow. Methods/Design The design of the study will be a multicenter randomized controlled trial of 100 patients who have sustained a simple elbow dislocation. After reduction of the dislocation, patients are randomized between...
BMC Musculoskeletal Disorders, 2010
Background Fractures of the proximal humerus are associated with a profound temporary and sometim... more Background Fractures of the proximal humerus are associated with a profound temporary and sometimes permanent, impairment of function and quality of life. The treatment of comminuted fractures of the proximal humerus like selected three-or four-part fractures and split fractures of the humeral head is a demanding and unresolved problem, especially in the elderly. Locking plates appear to offer improved fixation; however, screw cut-out rates ranges due to fracture collapse are high. As this may lead to higher rates of revision surgery, it may be preferable to treat comminuted fractures in the elderly primarily with a prosthesis or non-operatively. Results from case series and a small-sample randomized controlled trial (RCT) suggest improved function and less pain after primary hemiarthroplasty (HA); however these studies had some limitations and a RCT is needed. The primary aim of this study is to compare the Constant scores (reflecting functional outcome and pain) at one year after ...
Burns & Trauma, 2015
Background Although the feet involve a small percentage of the total body surface area, they can ... more Background Although the feet involve a small percentage of the total body surface area, they can have major effects in daily life, caused by prolonged bed rest, hospitalization and high risk of both early and late complications. The aim of this study was to define the aetiology, treatment and outcomes of foot burns, with special interest in paediatric patients, patients with diabetic disease and burns acquired at the workplace. Methods This is a retrospective cohort study of 82 patients who were admitted to one of the three burn centres in the Netherlands during the period 2004 to 2013. The patients had a median age of 43.5 years (range 0.01–85.9), and included 14 children and 8 diabetics. Data were collected from the hospital records. Results Scalding was the most common cause of the injury. Almost all patients required surgical management. It is notable that most of hospitalized patients (82 %) were not admitted on the day of injury. Children had a significantly shorter length of ...
The evaluation of nasal mupirocin to prevent Staphylococcus aureus burn wound colonization in routine clinical practice
Burns, 2014
Staphylococcus aureus wound colonization frequently occurs in patients with burns and can cause i... more Staphylococcus aureus wound colonization frequently occurs in patients with burns and can cause impaired wound healing. Nasal mupirocin application may contribute to the reduction of burn wound colonization of endogenous origin, whereas colonization by the exogenous route can be reduced by blocking cross-infection from other sources. In this study we evaluated whether the implementation of routine treatment of patients and burn center personnel using nasal mupirocin ointment reduces S. aureus burn wound colonization. We composed three study groups, consisting of a control period (Control), a mupirocin period (MUP), in which patients with burns were all receiving nasal mupirocin at admission, and a mupirocin+personnel period (MUP+P), in which we also screened the burn center personnel and decolonized S. aureus carriers by nasal mupirocin. The patients who carried S. aureus in their nose and did not have S. aureus burn wound colonization at admission were considered as patients susceptible for the use of nasal mupirocin. In these patients, the S. aureus burn wound colonization rate was the same in all study groups. S. aureus nasal carriage was a significant independent risk factor for burn wound colonization (OR: 3.3; 95% CI: 1.4-7.6) when analyzed within the three study groups. Although S. aureus carriage is a significant risk factor for developing burn wound colonization, the routine use of nasal mupirocin did not contribute to a reduction of burn wound colonization.
Phage therapy 2.0: where do we stand?
P.E. Zollinger, W.E. Tuinebreijer, R.S. Breederveld, and R.W. Kreis reply
We read the letter of our colleague, Dr. Frolke, with great interest. First, on the basis of our ... more We read the letter of our colleague, Dr. Frolke, with great interest. First, on the basis of our study, we believe that vitamin C does prevent complex regional pain syndrome. Unfortunately, most of Dr. Frolke's comments do not apply to our study. The number of enrolled patients in our study in relation to the number of eligible patients was mentioned in the Discussion of our article. The quality of reduction was studied in this paper and in our paper in Lancet 1 as well. In both studies, there was no relationship between the occurrence of complex regional pain syndrome and the need to undergo fracture reduction. Moreover, the quality of reduction did not influence the chance of complex regional pain syndrome developing. We performed the current study because, to our knowledge, there have been no published …
Comparing doxepin cream to oral antihistamines for the treatment of itch in burn patients: a multi-center triple-blind randomized controlled trial
Burns Open
International Journal of Molecular Sciences
Platelet rich plasma (PRP) is blood plasma with a platelet concentration above baseline. When act... more Platelet rich plasma (PRP) is blood plasma with a platelet concentration above baseline. When activated, PRP releases growth factors involved in all stages of wound healing, potentially boosting the healing process. To expand our knowledge of the effectiveness of PRP, it is crucial to know the content and composition of PRP products. In this study, growth factor quantification measurements of PRP from burn patients and gender- and age-matched controls were performed. The PRP of burn patients showed levels of growth factors comparable to those of the PRP of healthy volunteers. Considerable intra-individual variation in growth factor content was found. However, a correlation was found between the platelet count of the PRP and most of the growth factors measured.
Injury, 2017
Background The immobilisation of the lower leg is associated with deep vein thrombosis (DVT). How... more Background The immobilisation of the lower leg is associated with deep vein thrombosis (DVT). However, thromboprophylaxis in patients with a below-knee plaster cast remains controversial. We examined the efficacy and safety of nadroparin and fondaparinux to ascertain the need for thromboprophylaxis in these patients. Methods PROTECT was a randomised, controlled, single-blind, multicentre study that enrolled adults with an ankle or foot fracture who required immobilisation for a minimum of four weeks. The patients were randomly assigned (1:1:1) to a control group (no thromboprophylaxis) or to one of the intervention groups: daily subcutaneous self-injection of either nadroparin (2850 IE anti-Xa = 0•3 ml) or fondaparinux (2•5 mg = 0•5 ml). A venous duplex sonography was performed after the removal of the cast or earlier if thrombosis was suspected. The primary outcome was the relative risk of developing DVT in the control group compared with that in both intervention groups. This trial is registered at ClinicalTrials.gov, number NCT00881088. Results Between April 2009 and December 2015, 467 patients were enrolled and assigned to either the nadroparin group (n=154), the fondaparinux group (n=157), or the control group (n=156). A total of 273 patients (92, 92, and 94 patients, respectively) were analysed. The incidence of DVT in the nadroparin group was 2/92 (2•2%) compared with 11/94 (11•7%) in the control group, with a relative risk of 5.4 (95% CI 1•2-23•6; p = 0•011). The incidence of DVT in the fondaparinux group was 1/92 (1•1%), yielding a relative risk of 10• 8 (95% CI 1•4-80•7; p = 0•003) compared with that in the control group. No major complications occurred in any group. Conclusion Thromboprophylaxis with nadroparin or fondaparinux significantly reduces the risk of DVT in patients with an ankle or foot fracture who were treated in a below-knee cast without any major adverse events.
World journal of orthopedics, Jan 18, 2016
To analyze all windsurfing and kitesurfing (kiteboarding) injuries presented at our coastal hospi... more To analyze all windsurfing and kitesurfing (kiteboarding) injuries presented at our coastal hospital over a 2-year period. Twenty-five windsurfers (21 male; aged 31 ± 8 years) and 32 kitesurfers (23 male; aged 29 ± 11 years) presented at our hospital during the 2-year study period. Various injury data were recorded, including transport to hospital and treatment. After a median follow-up of 16 mo (range, 7-33 mo), 18 windsurfers (72%) and 26 kitesurfers (81%) completed questionnaires on the trauma mechanisms, the use of protective gear, time spent on windsurfing or kitesurfing, time to return to sports, additional injuries, and chronic disability. Most patients sustained minor injuries but severe injuries also occurred, including vertebral and tibial plateau fractures. The lower extremities were affected the most, followed by the head and cervical spine, the upper extremities, and the trunk. The injury rates were 5.2 per 1000 h of windsurfing and 7.0 per 1000 h of kitesurfing (P = 0....
Increase in Early Mechanical Ventilation of Burn Patients: An Effect of Current Emergency Trauma Management?
The Journal of Trauma Injury Infection and Critical Care, Mar 1, 2011
Data relating to patients admitted with extensive burn injuries in the Netherlands have revealed ... more Data relating to patients admitted with extensive burn injuries in the Netherlands have revealed a marked increase in patients whose initial care included mechanical ventilation (MV). The increase was abrupt, dating from 1997, and has been sustained since. The aim of this study is to quantify this observation and to discuss possible causes. The study included 258 consecutive patients with burns >30% total body surface area admitted to the Beverwijk burns center. Patients were divided into two groups based on admission date: group 1 from 1987 to 1996 (n=135) and group 2 from 1997 to 2006 (n=123). Data were analyzed using χ or analysis of variance. There were no differences between groups in demographics, facial burns, inhalation injury, and % total body surface area. However, the number of patients subjected to MV at admission increased from 38% to 76% (group 1 vs. 2; p<0.001). In 57% of patients who were intubated based on the suspicion of inhalation injury, this condition could not be confirmed (p<0.05 vs. 9% [1987-1996]). This study has confirmed that a higher proportion of patients were treated with MV since 1997, whereas the severity of burn injury remained unchanged throughout the study period. In the absence of a clinical explanation, we surmise that there has been a change within Dutch casualty departments in the initial management of major burn injury. The change coincides with the implementation of the Advanced Life Trauma Support training course as the accepted standard of trauma care in Dutch hospitals.
Nederlands Tijdschrift Voor Traumatologie, Feb 1, 2009
Nederlands Tijdschrift Voor Geneeskunde, 2010
Burns & Trauma, 2016
Background Split skin grafting (SSG) is the cornerstone in the treatment of deep burns and large ... more Background Split skin grafting (SSG) is the cornerstone in the treatment of deep burns and large skin defects. Frequently used donor sites are the thigh, abdomen and buttocks. The scalp is less common while considered as a reliable donor site. Advantages are a large surface area, rapid wound healing, cosmetically favourable results and multiple harvests from the same donor site. Complications include scab formation, chronic folliculitis and alopecia but have been recorded sporadically in previous studies. This article evaluates the complication rate of the scalp donor site in the treatment of deep burns in the Beverwijk Burn Centre. Methods A retrospective study was performed of all patients who received a skin graft from the scalp at the Beverwijk Burn Centre between January 2004 and December 2012. Data were collected from medical files of included patients, including gender, age, type of burn (scald, flame, other) and total body surface area (TBSA) burned at the time of first surg...
Trials, Jan 5, 2016
Partial thickness burns are painful, difficult to manage and can have a negative effect on qualit... more Partial thickness burns are painful, difficult to manage and can have a negative effect on quality of life through scarring, permanent disfigurement and loss of function. The aim of burn treatment in partial thickness burns is to save lives, stimulate wound healing by creating an optimumly moist wound environment, to have debriding and analgesic effects, protect the wound from infection and be convenient for the patient and caregivers. However, there is no consensus on the optimal treatment of partial thickness wounds. Flaminal® and Flamazine® are two standard treatment options that provide the above mentioned properties in burn treatment. Nevertheless, no randomized controlled study has yet compared these two common treatment modalities in partial thickness burns. Thus, the aim of this study is to evaluate the clinical effectiveness, quality of life and cost-effectiveness of Flaminal® versus Flamazine® in the treatment of partial thickness burns. In this two-arm open multi-center r...
K.J. Hartemink, AIOS Chirurgie, R.S. Breederveld, Chirurg-traumatoloog, Rode Kruis Ziekenhuis, Beverwijk
Nederlands Tijdschrift Voor Traumatologie, 2008
The treatment of hand burns: Timing of debridement and grafting
Burns, 2010
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Papers by Roelf Breederveld