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  1. Article ; Online: Management of necrotising fasciitis within a burns centre: do outcomes differ?

    Ward, Joseph A / Gibson, John A G / Nguyen, Dai Q

    Scars, burns & healing

    2020  Volume 6, Page(s) 2059513120924749

    Abstract: Introduction: Many similarities exist between the care of necrotising fasciitis (NF) and burn injury patients. Each group represents a small but complex cohort requiring multiple theatre trips, specialist reconstruction, meticulous wound care and ... ...

    Abstract Introduction: Many similarities exist between the care of necrotising fasciitis (NF) and burn injury patients. Each group represents a small but complex cohort requiring multiple theatre trips, specialist reconstruction, meticulous wound care and multidisciplinary management. Over a six-year period, we sought to examine the clinical outcomes of NF patients managed within a burns centre against those managed by a plastic surgery service.
    Methods: A retrospective case-note review was performed for all identifiable patients referred to our institution's designated burns centre or plastic surgery service between 2008-2014. Patient characteristics, length of stay, wound-related and clinical outcomes were extracted and descriptively presented with statistical analysis performed for survival and length of stay.
    Results: Twenty-nine patients were included in the study (burns centre [B]: 17 patients; plastic surgery service [P]: 12 patients). Median total length of stay (B: 37 vs. P: 50 days,
    Conclusion: Caring for NF patients within a burns centre facilitated easier access to specialist reconstructive expertise and multidisciplinary care but did not lead to statistically significant differences in length of stay or survival. The management of NF within a burns centre facilitated provision of high-quality care to a highly challenging patient group.
    Language English
    Publishing date 2020-06-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2837910-X
    ISSN 2059-5131 ; 2059-5131
    ISSN (online) 2059-5131
    ISSN 2059-5131
    DOI 10.1177/2059513120924749
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  2. Article ; Online: Fellowship review: Allergan breast reconstruction fellowship in Vancouver, British Columbia.

    Nguyen, Dai Q A

    Annals of plastic surgery

    2011  Volume 66, Issue 4, Page(s) 326–327

    MeSH term(s) Breast Neoplasms/surgery ; British Columbia ; Clinical Competence ; Fellowships and Scholarships/organization & administration ; Female ; Humans ; Mammaplasty/statistics & numerical data ; Practice Patterns, Physicians'/organization & administration ; Surgery, Plastic/organization & administration
    Language English
    Publishing date 2011-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 423835-7
    ISSN 1536-3708 ; 0148-7043
    ISSN (online) 1536-3708
    ISSN 0148-7043
    DOI 10.1097/SAP.0b013e3181f8cb1c
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  3. Article ; Online: Evaluating an outreach service for paediatric burns follow up.

    Cubitt, Jonathan J / Chesney, Amy / Brown, Liz / Nguyen, Dai Q

    Burns : journal of the International Society for Burn Injuries

    2015  Volume 41, Issue 6, Page(s) 1193–1198

    Abstract: Complications following paediatric burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of ...

    Abstract Complications following paediatric burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of burns services in the UK means that patients and their parents may have to travel significant distances to receive this follow up care. To optimise our burns service we have introduced a burns outreach service to enable the patients to be treated closer to home. The aim of this study is to investigate the impact of the introduction of the burns outreach service and within this environment define the optimum length of time needed to follow up these patients. A retrospective analysis was carried out of 100 consecutive paediatric burns patients who underwent surgical management of their burn. During the follow up period there were 43 complications in 32 patients (32%). These included adverse scarring (either hypertrophic or keloid), delayed healing (taking >1 month to heal) and contractures (utilising either splinting or surgical correction). Fifty-nine percent of these complications occurred within 6 months of injury and all occurred within 18 months. Size of burn was directly correlated to the risk of developing a complication. The outreach service reduced the distance the patient needs to travel for follow up by more than 50%. There was also a significant financial benefit for the service as the follow up clinics were on average 50% cheaper with burns outreach than burns physician. Burns outreach is a feasible service that not only benefits the patients but also is cheaper for the burns service. The optimum length of follow up for paediatric burns in 18 months, after which if there have not been any complications they can be discharged.
    MeSH term(s) Adolescent ; Aftercare/economics ; Aftercare/organization & administration ; Burns/surgery ; Child ; Child, Preschool ; Cicatrix, Hypertrophic/diagnosis ; Cicatrix, Hypertrophic/therapy ; Contracture/diagnosis ; Contracture/therapy ; Cost-Benefit Analysis ; Feasibility Studies ; Female ; Health Services Accessibility ; Humans ; Infant ; Keloid/diagnosis ; Keloid/therapy ; Male ; Postoperative Complications/diagnosis ; Postoperative Complications/therapy ; Retrospective Studies ; State Medicine/economics ; State Medicine/organization & administration ; Travel ; Wales ; Wound Healing
    Language English
    Publishing date 2015-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 197308-3
    ISSN 1879-1409 ; 0305-4179
    ISSN (online) 1879-1409
    ISSN 0305-4179
    DOI 10.1016/j.burns.2015.02.004
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  4. Article ; Online: A UK consensus statement on thromboprophylaxis for autologous breast reconstruction.

    Savage, Jessica A / Hunt, Beverley J / Stansby, Gerard / Dickson, John K / Henton, John M D / Hunter, Judith / Ramsey, Kelvin / Fung, Victoria / Holt, Rachel / Hussain, Amer / Kalu, Peter / Kotwal, Ashutosh / Majdak-Paredes, Ewa / McGoldrick, Ciara / Morgan, Mary / Nguyen, Dai Q A / Waters, Ruth / Wilson, Sherif / Mackey, Simon

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS

    2023  Volume 81, Page(s) 138–148

    Abstract: Microsurgical breast reconstruction accounts for 22% of breast reconstructions in the UK. Despite thromboprophylaxis, venous thromboembolism (VTE) occurs in up to 4% of cases. Using a Delphi process, this study established a UK consensus on VTE ... ...

    Abstract Microsurgical breast reconstruction accounts for 22% of breast reconstructions in the UK. Despite thromboprophylaxis, venous thromboembolism (VTE) occurs in up to 4% of cases. Using a Delphi process, this study established a UK consensus on VTE prophylaxis strategy, for patients undergoing autologous breast reconstruction using free-tissue transfer. It captured geographically divergent views, producing a guide that reflected the peer opinion and current evidence base.
    Methods: Consensus was ascertained using a structured Delphi process. A specialist from each of the UK's 12 regions was invited to the expert panel. Commitment to three to four rounds of questions was sought at enrollment. Surveys were distributed electronically. An initial qualitative free-text survey was distributed to identify likely lines of consensus and dissensus. Each panelist was provided with full-text versions of key papers on the topic. Initial free-text responses were analyzed to develop a set of structured quantitative statements, which were refined via a second survey as a consensus was approached.
    Results: The panel comprised 18 specialists: plastic surgeons and thrombosis experts from across the UK. Each specialist completed three rounds of surveys. Together, these plastic surgeons reported having performed more than 570 microsurgical breast reconstructions in the UK in 2019. A consensus was reached on 27 statements, detailing the assessment and delivery of VTE prophylaxis.
    Conclusion: To our knowledge, this is the first study to collate current practice, expert opinion from across the UK, and a literature review. The output was a practical guide for VTE prophylaxis for microsurgical breast reconstruction in any UK microsurgical breast reconstruction unit.
    MeSH term(s) Humans ; Anticoagulants/therapeutic use ; Venous Thromboembolism/prevention & control ; Mammaplasty ; Surveys and Questionnaires ; United Kingdom
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2023-02-07
    Publishing country Netherlands
    Document type Review ; Journal Article
    ZDB-ID 2217750-4
    ISSN 1878-0539 ; 1748-6815 ; 0007-1226
    ISSN (online) 1878-0539
    ISSN 1748-6815 ; 0007-1226
    DOI 10.1016/j.bjps.2023.01.020
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  5. Article ; Online: An objective long-term evaluation of Integra (a dermal skin substitute) and split thickness skin grafts, in acute burns and reconstructive surgery.

    Nguyen, Dai Q A / Potokar, Tom S / Price, Patricia

    Burns : journal of the International Society for Burn Injuries

    2010  Volume 36, Issue 1, Page(s) 23–28

    Abstract: Introduction: The field of wound healing and tissue repair has advanced rapidly in the last decade, with this there is an increasing emphasis on the importance of the functional and cosmetic outcomes following injury. Integra artificial skin is the most ...

    Abstract Introduction: The field of wound healing and tissue repair has advanced rapidly in the last decade, with this there is an increasing emphasis on the importance of the functional and cosmetic outcomes following injury. Integra artificial skin is the most widely used synthetic skin substitute and is reported to have better outcomes in relation to the appearance and elasticity when compared to split thickness skin grafting (SSG). A review of the literature reveals very few trials that are based on an objective evaluation of Integra treated scars as compared to SSGs. This research aimed to provide objective data on the long-term outcome of Integra.
    Method: All adult patients from the Welsh Burns Centre who had been successfully treated with Integra+/-SSG were invited to attend a clinic for a follow up provided they had been healed for greater than one year. The hypothesis that Integra scars are more pliable than skin grafts was tested objectively using the Cutometer, a suction device which measures skin elasticity.
    Results: Of the 13 patients eligible, six were available for assessment. The results of this study suggest that Integra treated sites correlate well with normal skin as measured by the Cutometer. This was statistically significant for the parameters Ur/Ue (elastic function) and Ur/Uf (gross elasticity). On the other hand there was no correlation seen between the patients SSG sites and the patient's normal skin.
    Conclusion: With advances in medicine we are increasingly able to modulate wound healing and the resultant scars. In order to assess new and often costly treatments the need for objective scar measurement tools have become apparent. Integra has been advocated to improve scarring from injury. However, there have been few studies to evaluate the long-term outcome of Integra as compared to traditional methods such as SSG. In the past scar evaluation has been based on subjective scores by patients and clinicians. Now the mechanical properties of the skin can be evaluated using simple bioengineering methods such as the Cutometer Suction Device. Using this device our study has objectively demonstrated that the elastic properties of areas treated with Integra is comparable to normal skin.
    MeSH term(s) Adult ; Burns/surgery ; Burns/therapy ; Chondroitin Sulfates/therapeutic use ; Collagen/therapeutic use ; Elasticity ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Skin/physiopathology ; Skin Transplantation/methods ; Skin, Artificial ; Treatment Outcome ; Wound Healing/physiology ; Young Adult
    Chemical Substances integra artificial skin ; Chondroitin Sulfates (9007-28-7) ; Collagen (9007-34-5)
    Language English
    Publishing date 2010-02
    Publishing country Netherlands
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 197308-3
    ISSN 1879-1409 ; 0305-4179
    ISSN (online) 1879-1409
    ISSN 0305-4179
    DOI 10.1016/j.burns.2009.07.011
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  6. Article ; Online: Intensive care unit-acquired weakness in the burn population.

    Cubitt, Jonathan J / Davies, Menna / Lye, George / Evans, Janine / Combellack, Tom / Dickson, William / Nguyen, Dai Q

    Journal of plastic, reconstructive & aesthetic surgery : JPRAS

    2016  Volume 69, Issue 5, Page(s) e105–9

    Abstract: Intensive care unit-acquired weakness is an evolving problem in the burn population. As patients are surviving injuries that previously would have been fatal, the focus of treatment is shifting from survival to long-term outcome. The rehabilitation of ... ...

    Abstract Intensive care unit-acquired weakness is an evolving problem in the burn population. As patients are surviving injuries that previously would have been fatal, the focus of treatment is shifting from survival to long-term outcome. The rehabilitation of burn patients can be challenging; however, a certain subgroup of patients have worse outcomes than others. These patients may suffer from intensive care unit-acquired weakness, and their treatment, physiotherapy and expectations need to be adjusted accordingly. This study investigates the condition of intensive care unit-acquired weakness in our burn centre. We conducted a retrospective analysis of all the admissions to our burn centre between 2008 and 2012 and identified 22 patients who suffered from intensive care unit-acquired weakness. These patients were significantly younger with significantly larger burns than those without intensive care unit-acquired weakness. The known risk factors for intensive care unit-acquired weakness are commonplace in the burn population. The recovery of these patients is significantly affected by their weakness.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Aged ; Burns/complications ; Burns/rehabilitation ; Case-Control Studies ; Female ; Humans ; Intensive Care Units ; Lower Extremity ; Male ; Middle Aged ; Muscle Weakness/etiology ; Physical Therapy Modalities ; Respiration, Artificial/statistics & numerical data ; Resuscitation ; Retrospective Studies ; Risk Factors ; Sepsis/complications ; Upper Extremity
    Language English
    Publishing date 2016-05
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2217750-4
    ISSN 1878-0539 ; 1748-6815 ; 0007-1226
    ISSN (online) 1878-0539
    ISSN 1748-6815 ; 0007-1226
    DOI 10.1016/j.bjps.2016.01.033
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  7. Article: Infants under 1 year of age have a significant risk of burn injury.

    Nguyen, Dai Q A / Tobin, Sean / Dickson, William A / Potokar, Tom S

    Burns : journal of the International Society for Burn Injuries

    2008  Volume 34, Issue 6, Page(s) 863–867

    Abstract: A wealth of data exists concerning paediatric burn epidemiology in general, but very little exists specifically in infants under 1 year of age, a special group in which mobility begins to develop. A retrospective study of all burn admissions of infants ... ...

    Abstract A wealth of data exists concerning paediatric burn epidemiology in general, but very little exists specifically in infants under 1 year of age, a special group in which mobility begins to develop. A retrospective study of all burn admissions of infants under 1 year old to The Welsh Centre for Burns from January 2003 to January 2006 was performed. During the 3-year period there were 104 new burns cases identified which represents 11.8% of all paediatric admissions. 63.5% (66) were treated as inpatients and 36.5% (38) treated as out-patients. Burns increased in frequency with increasing age and occurred mainly in the home. Scalds were the commonest type of burn in 65% (68) whilst the second most common was contact burns which accounted for 30% (31). The most common source of scald was from cups containing hot drinks (39%) and the most common source of contact burn was radiators/hot water pipes (30%). The mean TBSA was 2.3%, (range 0.5-38%). The frequency of burns in the under 1 year old population highlights a need for emphasis of burn prevention directed to this group. Special attention is needed to look at the specific aetiology of these burns. Starting points for prevention should address the number of burns surrounding hot drinks and bottle warming practices in the case of scalds and the dangers of household radiators and hot water pipes in the case of contact burns.
    MeSH term(s) Accidents, Home/statistics & numerical data ; Body Surface Area ; Burns/epidemiology ; Burns/etiology ; Female ; Humans ; Incidence ; Infant ; Injury Severity Score ; Male ; Retrospective Studies ; Risk Assessment ; Sex Distribution ; Social Class ; Wales/epidemiology
    Language English
    Publishing date 2008-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 197308-3
    ISSN 1879-1409 ; 0305-4179
    ISSN (online) 1879-1409
    ISSN 0305-4179
    DOI 10.1016/j.burns.2007.11.011
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  8. Article ; Online: Tympanoplasty in chronic otitis media patients with an intact, but severely retracted malleus: a treatment challenge.

    Hol, Myrthe K S / Nguyen, Dai Q / Schlegel-Wagner, Christoph / Pabst, Gunther / Linder, Thomas E

    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

    2010  Volume 31, Issue 9, Page(s) 1412–1416

    Abstract: Objective: To analyze the outcome of patients with chronic otitis media (COM) with an intact, but markedly medialized ossicular chain, treated by removing the malleus head and interposing an autologous incus and then an underlay myringoplasty.: Study ... ...

    Abstract Objective: To analyze the outcome of patients with chronic otitis media (COM) with an intact, but markedly medialized ossicular chain, treated by removing the malleus head and interposing an autologous incus and then an underlay myringoplasty.
    Study design: Retrospective clinical study.
    Setting: Tertiary referral center.
    Patients: The search criteria within the prospective surgical database was COM with a central perforation (without cholesteatoma) with a markedly medialized malleus handle (the umbo adherent to the promontory) with an intact ossicular chain (study, n = 15) or an incus necrosis at the lenticular process (incus, n = 23). Only primary surgeries performed at our otorhinolaryngology department were included.
    Intervention: All patients underwent the same surgical procedure consisting of an autologous incus interposition and underlay myringoplasty with temporalis fascia.
    Main outcome measure: The patients' audiological and follow-up data were retrieved from the database. The postoperative audiogram (0.5-3 kHz) with the longest follow-up was used.
    Results: The preoperative air-conduction thresholds were less impaired in the study group than in the incus group. After their surgery, all, except 3 patients, improved their hearing, and 97% had an intact tympanic membrane at a mean follow-up of 2 years. The air-bone gap was closed within 20 dB in 80% (study) and in 87% (incus), in one third of all patients even within 10 dB. Although the largest improvement was seen in the lower frequencies, closure of the air-bone gap at 4 kHz was difficult to achieve.
    Conclusion: Patients presenting with COM, a (central) perforation, a medially rotated malleus and intact ossicular chain are a treatment challenge. Lateralizing the malleus handle may require disconnection of the ossicular chain and an autologous incus interposition to bring back the reconstructed tympanic membrane in its original position and improve the hearing.
    MeSH term(s) Audiology ; Auditory Threshold ; Chronic Disease ; Ear Ossicles/pathology ; Follow-Up Studies ; Humans ; Incus/pathology ; Malleus/pathology ; Myringoplasty ; Necrosis ; Otitis Media/pathology ; Otitis Media/surgery ; Otologic Surgical Procedures/methods ; Retrospective Studies ; Tympanoplasty/methods
    Language English
    Publishing date 2010-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2036790-9
    ISSN 1537-4505 ; 1531-7129
    ISSN (online) 1537-4505
    ISSN 1531-7129
    DOI 10.1097/MAO.0b013e3181f0c67d
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  9. Article ; Online: Synthesis and antibacterial activity of the C-7 side chain of 3-aminoquinazolinediones.

    Hutchings, Kim M / Tran, Tuan P / Ellsworth, Edmund L / Watson, Brian M / Sanchez, Joseph P / Showalter, H D / Stier, Michael A / Shapiro, Martin / Themis Joannides, E / Huband, Michael / Nguyen, Dai Q / Maiti, Samarendra / Li, Tingsheng / Tailor, Jyoti / Thomas, George / Ha, Chan / Singh, Rajeshwar

    Bioorganic & medicinal chemistry letters

    2008  Volume 18, Issue 18, Page(s) 5087–5090

    Abstract: A novel series of bacterial topoisomerase (3-aminoquinazolinediones) inhibitors are described. The side-chain SAR against Gram-positive and Gram-negative organisms as well as DNA gyrase activity is reported. ...

    Abstract A novel series of bacterial topoisomerase (3-aminoquinazolinediones) inhibitors are described. The side-chain SAR against Gram-positive and Gram-negative organisms as well as DNA gyrase activity is reported.
    MeSH term(s) Anti-Bacterial Agents/chemical synthesis ; Anti-Bacterial Agents/chemistry ; Anti-Bacterial Agents/pharmacology ; Combinatorial Chemistry Techniques ; Fluoroquinolones/chemical synthesis ; Fluoroquinolones/chemistry ; Fluoroquinolones/pharmacology ; Gram-Negative Bacteria/drug effects ; Gram-Negative Bacteria/enzymology ; Gram-Positive Bacteria/drug effects ; Gram-Positive Bacteria/enzymology ; Microbial Sensitivity Tests ; Molecular Structure ; Quinazolinones/chemical synthesis ; Quinazolinones/chemistry ; Quinazolinones/pharmacology ; Structure-Activity Relationship ; Topoisomerase II Inhibitors
    Chemical Substances Anti-Bacterial Agents ; Fluoroquinolones ; Quinazolinones ; Topoisomerase II Inhibitors
    Language English
    Publishing date 2008-09-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 1063195-1
    ISSN 1464-3405 ; 0960-894X
    ISSN (online) 1464-3405
    ISSN 0960-894X
    DOI 10.1016/j.bmcl.2008.07.117
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  10. Article: Structure-activity relationships of 3-aminoquinazolinediones, a new class of bacterial type-2 topoisomerase (DNA gyrase and topo IV) inhibitors.

    Tran, Tuan P / Ellsworth, Edmund L / Sanchez, Joseph P / Watson, Brian M / Stier, Michael A / Showalter, H D Hollis / Domagala, John M / Shapiro, Martin A / Joannides, E Themis / Gracheck, Stephen J / Nguyen, Dai Q / Bird, Paul / Yip, Judy / Sharadendu, Anurag / Ha, Chan / Ramezani, Saeed / Wu, Xiujuan / Singh, Rajeshwar

    Bioorganic & medicinal chemistry letters

    2007  Volume 17, Issue 5, Page(s) 1312–1320

    Abstract: A series of 3-aminoquinazolinediones was synthesized and evaluated for its antibacterial and DNA gyrase activity. The SAR around the quinazolinedione core was explored and the optimal substitutions were combined to give two compounds, 2r and 2s, with ... ...

    Abstract A series of 3-aminoquinazolinediones was synthesized and evaluated for its antibacterial and DNA gyrase activity. The SAR around the quinazolinedione core was explored and the optimal substitutions were combined to give two compounds, 2r and 2s, with exceptional enzyme potency (IC50 = 0.2 microM) and activity against gram-positive organisms (MIC's = 0.015-0.06 microg/mL).
    MeSH term(s) Amines/chemistry ; Amines/pharmacology ; Anti-Bacterial Agents/chemical synthesis ; Anti-Bacterial Agents/chemistry ; DNA Gyrase ; Gram-Positive Bacteria/drug effects ; Inhibitory Concentration 50 ; Quinazolinones/chemical synthesis ; Quinazolinones/chemistry ; Quinazolinones/pharmacology ; Structure-Activity Relationship ; Topoisomerase II Inhibitors
    Chemical Substances Amines ; Anti-Bacterial Agents ; Quinazolinones ; Topoisomerase II Inhibitors ; DNA Gyrase (EC 5.99.1.3)
    Language English
    Publishing date 2007-03-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 1063195-1
    ISSN 1464-3405 ; 0960-894X
    ISSN (online) 1464-3405
    ISSN 0960-894X
    DOI 10.1016/j.bmcl.2006.12.005
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