Lars P Kamolz

• M.D., Ph.D., M.Sc.
• Head of Department at Medical University of Graz

Background: Defects of the foot and ankle area pose a significant challenge for both patients and surgeons. While the primary objective of microvascular free flap reconstructions of lower leg defects is limb preservation, there should be an effort to obtain the best functional and aesthetic results possible and to restore the patient’s quality of l...

Background: Non-healing soft tissue defects pose challenges to treating physicians. Microsurgical reconstruction is a treatment option for achieving wound closure and limb salvage. These free tissue transfers are often challenging due to associated risk factors. This study aimed to evaluate microsurgical reconstruction using specialized microsurgic...

Objective: Managing flexor tendon injuries surgically remains challenging due to the ongoing debate over the most effective suture technique and materials. An optimal repair must be technically feasible while providing enough strength to allow for early active mobilization during the post-operative phase. This study aimed to assess the biomechanica...

Aim: In the field of burns and soft tissue reconstruction, skin substitutes have been successfully used for various indications. They allow for conservative treatment as well as temporal coverage through the improvement of wound bed conditions, pathogen control, and the formation of new tissue. Fish skin grafts (FSGs) have gained rising attention a...

Background: Microvascular thrombosis following free tissue transfer presents a complex challenge for surgeons and carries the potential risk of flap failure. The application of fibrinolytic agents represents a robust therapeutic option. The aim of this systematic review is to provide a comprehensive overview of the clinical use of fibrinolytic drug...

Background: Hand burns are involved in 80–90% of severe burn injuries. Even though hands correspond to a small total burn surface area (TBSA) of less than 5%, the loss of their functionality has a significant impact on the patient’s life. Studies that provide long-term results regarding hand functionality after hand burns are scarce. Therefore, thi...

A new ceramic dressing, free from active antimicrobial or pharmaceutical agents, uses physical binding mechanisms for its absorption capacities and bacterial-binding properties. The purpose of this study was to evaluate wound healing, bacterial-related retention, and diagnostic properties of ceramic dressings in patients with stagnated chronic woun...

Introduction Acellular fish skin grafts (FSG) have proven to be effective in acute and chronic wound healing, as well as in burns. However, the underlying mechanisms promoting healing are still unknown. The aim of this preclincal study was to investigate the effects of fish skin grafts on wound healing properties under standardized conditions in a...

Bei ausbleibendem Goldstandard für die Behandlung von chronischen Wunden können neue innovative (additive) Therapiemöglichkeiten sozioökonomisch sowie für betroffene Patient:innen einen nicht zu unterschätzenden Vorteil mit sich bringen. Additive Anwendungen von intelligenten Verbänden, Hautersatzmaterialien oder physikalischen Methoden wie der Kal...

Background: Prolonged symptoms of carpal tunnel syndrome (CTS) after primary carpal tunnel release (CTR) can reduce the quality of life and lead to multiple referrals across specialties. The following study aimed to identify differences in symptoms, signs, and intraoperative findings between recurrent and persistent CTS cases to avoid undesired ou...

Background and Objectives: Essential oils are a complementary treatment and can play an important role in scar care. The aim of this study was to evaluate and compare the efficacy of a new essential oil (regeneration oil) with a control group on scar quality in healed split-thickness skin graft donor sites. Materials and Methods: A single-center bl...

Breast-Implant-Associated Anaplastic Large-Cell Lymphoma (BIA-ALCL) is a rare low-incidence type of T-cell non-Hodgkin lymphoma, arising in the capsule around breast implants, and predominantly associated with the use of macro-textured breast implants. The purpose of this study was to use an evidence-based approach to systematically identify clinic...

Hintergrund: Der physiologische "Säuremantel" der Haut weist abhängig von Lokalisation und Alter des Menschen pH-Werte von 4-6 auf und ist von essenzieller Bedeutung für deren vollständige, funktionale Integrität, sowie deren Resistenz gegenüber Noxen und bakterieller Kolonisation. Bei akuten Verletzungen der Haut verschiebt sich der normale pH-Wer...

Wound Healing in Burns Influence of pH and Polylactide Membrane (Suprathel) on the Healing of Burn Wounds

Burns and Wound treatment with polylactide membranes has a long history dating back to 1998. Over the years, it has shown many significant positive effects. Undisturbed wound healing and effective pain relief, dressing changes, and a reduced number of skin grafts in the case of partial-deep burns together with rapid stabilization of the patient com...

Resveratrol is a well-known polyphenol that harbors various health benefits. Besides its well-known anti-oxidative potential, resveratrol exerts anti-inflammatory, pro-angiogenic, and cell-protective effects. It seems to be a promising adjuvant for various medical indications, such as cancer, vascular, and neurodegenerative diseases. Additionally,...

Nodal clearance was recommended after positive sentinel lymph node biopsy (SLNB) despite further metastases to the regional lymph node basin being found in only 6–21% in the literature. This retrospective study was conducted to determine the role of the time interval between excision of primary melanoma and confirmed metastasis in the sentinel lymp...

Introduction Mass casualties with younger people are a rare incident, but the effects are devastating. MCs can be from a fire in leisure facilities; or from terroristic attacks, especially with radioactive materials. Coping requires not only addressing organizational needs but also treatment modalities usable in a major-event scenario under sca...

This presentation demonstrates the progress in indications of polylactides as well as from clinical research. Keratinocytes: In a retrospective quality evaluation the data of 103 non-randomized patients were evaluated in which sprayed keratinocytes were covered with Suprathel. Precultured keratinocytes were compared to non-cultured sprayed keratino...

Einleitung: Großschadensereignisse mit Brandverletzungen stellen eine ständige Bedrohung unserer Gesellschaft dar, die in den letzten Jahren durch die Möglichkeit terroristischer Anschläge zugenommen hat. Die Bewältigung solcher Ereignisse erfordert nicht nur die Befassung mit organisatorischen Erfordernissen, sondern auch die Abschätzung, welche B...

Over many decades, the treatment of Dupuytren’s disease, a fibroproliferative disease of the hand, is the centre of various studies and publications. Surgical intervention has always been the method of choice, with fasciectomy being today’s state of the art. Nevertheless, researchers also focused on conservative non-operative treatment methods of w...

Objectives: Determine whether the peripheral capillary oxygenation/ Fio2 ratio correlates with the Pao2/Fio2 ratio in burned children with smoke inhalation injury, with the goal of understanding if the peripheral capillary oxygenation/Fio2 ratio can serve as a surrogate for the Pao2/Fio2 ratio for the diagnosis of acute respiratory distress syndrom...

Background Tissue expansion is frequently used in reconstructive surgery. Although the surgical procedure is typically considered simple, reported complication rates of tissue expansions exceed 40%. There is little evidence concerning risk factors for complications in tissue expansion in body regions other than breast. The aim was to determine risk...

Currently, there are various therapeutic approaches to reduce hypertrophic scarring, however, there is no standard evidence-based treatment protocol. Hence, we performed a systematic review to obtain a summary of the latest clinical trials to evaluate evidence for the treatment of hypertrophic scars. The review protocol was registered and approved...

Amnion-derived mesenchymal stem cells (AMSC) are a promising tool in regenerative medicine. Here we evaluated the utility of Matrigel and Matriderm as carrier for the topical application of AMSC to mice skin wounds. In both application forms, AMSC promoted neovascularization of the wound area. Matrigel proved as excellent matrix for AMSC and immigr...

Burns have been more prevalent among low socioeconomic populations and in less developed regions. Incredible advances in burn care and social development over the recent decades, however, should have placed the incidence and severity of burns in a downwards trend. The aim of this review was to give an overview on current trends in burn epidemiology...

The vast majority of research on the impact of age on skin wound healing (WH) compares old animals to young ones. The middle age is often ignored in biogerontological research despite the fact that many functions that decline in an age-dependent manner have starting points in mid-life. With this in mind, we examined gene expression patterns during...

Background: Botulinum (neuro)toxin A (BoNT) is widely used in the field of plastic and reconstructive surgery. Among treatment of pain, hyperhidrosis, or aesthetic purposes, it is also used to enhance wound healing and prevent excessive scar formation. Some clinical data already exist, but only little is known on a cellular level. The aim of this s...

Background: Patient safety has become a hot topic, and there are numerous initiatives ongoing to improve patient-relevant processes. But how can both the effectiveness and sustainability of these initiatives be evaluated? The aim of the present paper was to describe the development of an instrument to assess patient safety aspects which can be use...

Background: "The Surgical Safety Checklist (SSC) is important, but we don't use it adequately" is a well-suited statement that reflects the SSC's application in hospitals. Our aim was to follow up on our initial study on compliance (2014) by analysing differences between individual perception and compliance with the SSC. Methods: We conducted a...

a b s t r a c t Objective: The aim of this study was to compare the accuracy of burn size estimation using the computer-assisted software BurnCase 3D (RISC Software GmbH, Hagenberg, Austria) with that using a 2D scan, considered to be the actual burn size. Methods: Thirty artificial burn areas were pre planned and prepared on three mannequins (one...

Einleitung: Die Bestimmung des Gesamtausmaßes einer Verbrennung stellt eine der wesentlichsten Grundlagen der Verbrennungsbehandlung dar. Seit geraumer Zeit weist die Literatur darauf hin, dass die getroffenen Einschätzungen wesentliche Fehler aufweisen, wobei als goldener Standard meist die Evaluierung des Verbrennungsausmaßes durch Experten von B...

Background: Smartphones have become an integral part of our daily lives, and numerous applications (apps) make use of the goniometer, which is comparable to a medical protractor. The aim of this study was to evaluate the availability, reliability and validity of medical apps using the goniometer function in smartphones. Methods: Sixteen goniometer-...

Background: Health care-associated infections are a major patient safety issue worldwide. Hand hygiene (HH) campaigns have started all over the world to increase awareness and decrease HH barriers. The aim of this study was to assess healthcare professionals' HH-knowledge, HH-barriers as well HH-environmental factors in general and especially in su...

Burns are common injuries that are usually covered with a layer of necrotic tissue called the eschar. Early removal of the eschar is the current standard of care, however, debridement using tangential excision is usually traumatic and may increase wound surface. In recent years a bromelain-based debriding agent called NexoBrid® that can remove the...

Objective: The aim of our internet survey was to assess the preferences of burn specialists who use skin substitutes in patients with burns covering 20% or more of their total body surface area (TBSA). Methods: An open, voluntary Internet-based cross-sectional survey was performed. Responses to 19 non-compulsory questions, and participant career an...

Background: In 2013, Angelina Jolie's double mastectomy and publication of her personal treatment choice for BRCA1 positivity generated considerable media attention. To the authors' knowledge, the current study is the first prospective survey conducted among the general public to measure a quantifiable media-related effect on public awareness. Me...

Introduction: Suprathel is a synthetic copolymer membrane mostly from polylactids used in burn treatment to provide temporary coverage of superficial and partial deep dermal burns and donor areas. warranting no biological hazards. It degrades hydrolytically to lactic acid components, such showing negative effect on bacterial growth. It usually is c...

Objective: The aim of this study was to compare the accuracy of burn size estimation using the computer-assisted software BurnCase 3D (RISC Software GmbH, Hagenberg, Austria) with that using a 2D scan, considered to be the actual burn size. Methods: Thirty artificial burn areas were pre planned and prepared on three mannequins (one child, one fe...

Introduction: The development of usable electronic burn surface area calculators shows the necessity of a generally accepted standard. There is a tendency to develop into two different directions: two dimensional or three dimensional models and systems showing clearly different results. The existing rather error prone methods for total body surface...

Introduction: An objective, comprehensible and uniform data collection is essential for executing medical multicenter trials for quality assurance benchmarking or for assessing new treatment methods or materials.

A variety of skin substitutes that restore epidermal and dermal structures are currently available on the market. However, the main focus in research and clinical application lies on dermal and epidermal substitutes whereas the development of a subcutaneous replacement (hypodermis) is often disregarded. In this study we used fibrin sealant as hydro...

BACKGROUND: In 2013, Angelina Jolie's double mastectomy and publication of her personal treatment choice for BRCA1 positivity generated considerable media attention. To the authors' knowledge, the current study is the first prospective survey conducted among the general public to measure a quantifiable media-related effect on public awareness. METH...

The aim of this study was to characterize the epidemiology of pediatric and adolescent burns admitted to the Children's Burns Unit at the Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Austria, between January 1st 1988 and December 31st 2012. This is a retrospective review over the past 25-years and describes admissio...

A surgical safety checklist (SSC) was implemented and routinely evaluated within our hospital. The purpose of this study was to analyze compliance, knowledge of and satisfaction with the SSC to determine further improvements. The implementation of the SSC was observed in a pilot unit. After roll-out into each operating theater, compliance with the...

Objective: Since the introduction of applications (apps) for smartphones, the popularity of medical apps has been rising. The aim of this review was to demonstrate the current availability of apps related to burns on Google's Android and Apple's iOS store as well as to include a review of their developers, features, and costs. Methods: A systema...

As bariatric surgery becomes ever more popular, so does body-contouring surgery to eliminate excess skin after radical weight loss. To date, the literature has described a number of risk factors affecting the postoperative outcome. Our study aimed to define those factors more closely, focusing on abdominoplasty ("tummy tuck") patients who suffered...

Hintergrund: Die Schätzung der verbrannten Körperoberfläche (VKOF) mittels gängiger Methoden (Neuner Regel, Handflächenregel, Lund and Browder Tabellen etc.) ist aufgrund ihrer Komplexität und vielfachen Einflussfaktoren (Alter, BMI, Fettverteilung etc.) auch für Spezialisten bis dato ungenau. Die Überprüfung der Genauigkeit und Reproduzierbarkeit...

Einleitung: Bei der Durchführung von medizinischen Multi-Zentren-Studien für qualitätssicherndes Benchmarking oder zur Bewertung neuer Behandlungsmethoden oder -materialien ist eine objektive, nachvollziehbare und einheitliche Datenerfassung unumgänglich. Nur durch standardisierte Datenerfassung mit niedrigem Inter-Observer-Error kann eine statisti...

In den Lehrbüchern und auch Kursen über präklinische Erstversorgung von Verbrennungsverletzungen werden oft Maßnahmen empfohlen die nicht mehr dem zeitgemäßen Standard entsprechen. Wesentliche Veränderungen der Therapie haben im Bereich der Kühlung des Patienten stattgefunden. Hier wird die Kühlung zur Aufgabe des Ersthelfers mit limitierter Dauer,...

Background: For health care systems in recent years, patient safety has increasingly become a priority issue. National and international strategies have been considered to attempt to overcome the most prominent hazards while patients are receiving health care. Thereby, clinical risk management (CRM) plays a dominant role in enabling the identifica...

Analysing the three-dimensional (3D) texture of skin substitute materials and evaluating their performance after covering skin defects is essential for improving their design and for optimising surgical procedures and post implantation wound treatment regimes. Here we explore the capacities of the recently developed High-resolution episcopic micros...

Introduction: Generation of adipose tissue for burn patients that suffer from an irreversible loss of the hypodermis is still one of the most complex challenges in tissue engineering. Electrospun materials with their micro- and nanostructures are already well established for their use as extracellular matrix substitutes. Gelatin is widely used in...

Introduction: Due to the fact that the number of breast implant surgeries for cosmetic and medical purposes is rising yearly, a discussion about the quality of service for both patients and physicians is more important than ever. To this end, we reviewed the Austrian Breast Implant Register with one specific question in mind: What are the trends?...

Despite the popularity of a simultaneous application of dermal matrices and split-thickness skin grafts, scarce evidence exists about the process of revascularizationinvolved. In this study, we aimed at analyzing the progression of revascularizationby high-resolution episcopic microscopy (HREM) in a porcine excisional wound model.Following the surg...

Over the last 50 years, the evolution of burn care has led to a significant decrease in mortality. The biggest impact on survival has been the change in the approach to burn surgery. Early excision and grafting has become a standard of care for the majority of patients with deep burns; the survival of a given patient suffering from major burns is i...

Suprathel is a synthetic copolymer membrane mostly from polylactids[1] used in burn treatment to provide temporary coverage of superficial and partial deep dermal burns and donor areas warranting no biological hazards. It degrades hydrolytically to lactic acid components, such showing negative effect on bacterial growth.[2] It usually is covered wi...

Silver-containing wound dressings are an integral part of wound therapy in adult and pediatric burn patients. The antimicrobial effect of silver is well known and has been described in numerous studies. Side effects are rarely reported from silver-containing wound care products, even though systemic absorption of silver has been demonstrated by ele...

Background: The DIEP- (Deep Inferior Epigastric Perforator) flap and the free TRAM- (Transverser Rectus Abdominis Musculocutaneous) flap are common procedures for breast reconstruction. The aim of the study was to identify a difference in the psychological and physiological patient satisfaction between DIEP- and free TRAM-flap. Material and metho...

Achilles tendon and overlying soft tissue reconstruction presents an interdisciplinary challenge. In the literature many possible procedures are described, but each reconstruction in this region has its specific demands. Single stage reconstruction is normally pursued, but it is not always the best procedure for the patient, either aesthetically or...

Unlabelled: Acellular dermal matrices (ADM) have been used frequently in therapeutic and prophylactic breast procedures. To date there have been no reports on vascularisation of ADMs and formation of tissue around them as seen with modern non-invasive imaging techniques such as contrast-enhanced ultrasound (CEUS). In this case series, we used CEUS...

No universally accepted standard for evaluation, prevention, and treatment of scars, hypertrophic scars, and keloids exists. Following development of a questionnaire, we performed a closed Web‐based survey among burn centers. Server‐based data collection was performed over 4 weeks and closed thereafter. The poll revealed emerging new treatment sche...

Estimation of the total body surface area burned (%TBSA) following a burn injury is used in determining whether to transfer the patient to a burn center and the required fluid resuscitation volumes. Unfortunately, the commonly applied methods of estimation have revealed inaccuracies, which are mostly related to human error. To calculate the %TBSA (...

The requirements for accurate documentation within the process of burn assessment have increased dramatically over the years. TBSA (total body surface area) and burn depth are commonly determined by visual inspection, especially in the emergency or acute care setting. However, inexperience often results in incorrect estimation of these factors. In...

As a result of the global demographic change, the number of elderly patients is expected to rise particularly in developed countries over the next decades. The elderly population seems to be most vulnerable to burn injuries and their clinical management is undoubtedly a challenge. A clear age range for elderly patients has not yet been defined, but...

Lipofilling with autologous fat tissue is widely used in plastic and reconstructive surgery to treat soft tissue deficiency. Unfortunately, implanted cells disappear gradually and make it difficult to predict the resorption rate. Several adjuvants are used to improve the success of fat tissue grafting. In this study, the effect of botulinum toxin (...

Introduction: In recent years a complete and accurate documentation of injuries, treatment and convalescence has become essential for many reasons such as improvement of treatment, legal requirements and many more. Publications state that surface estimations concerning the same injuries have significant variations. In order to tackle this drawback,...

Healthy aging depends on removal of damaged cellular material that is in part mediated by autophagy. The nutritional status of cells affects both aging and autophagy through as-yet-elusive metabolic circuitries. Here, we show that nucleocytosolic acetyl-coenzyme A (AcCoA) production is a metabolic repressor of autophagy during aging in yeast. Block...