• Archives of Plastic Surgery
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• v.38 no.5
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• pp.649-654
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• 2011

Purpose: Split-or full-thickness skin grafts are used to reconstruct palmar skin and soft tissue defects after trauma or to release burn scar contracture on the hand. Glabrous skin defects should be substituted with similar skin to preserve function and aesthetics. The authors report their experiences with a technique that uses a full-thickness graft taken from glabrous skin on the ulnar edge of the palm for the reconstruction of soft tissue defects of the hand. Methods: During a three-year period from 2007 to 2010, 22 patients with burn scar contracture and 12 patients with post-traumatic skin defects on their hands were treated with full-thickness skin graft operations. The palmar skin and soft tissue defects after release of burn scar contracture or debridement of post-traumatic wounds were reconstructed with full-thickness skin grafts harvested from the ulnar border of their palms. All donor-site wounds were primarily closed. Results: The followup periods ranged from 3 to 25 months. Contractures of the hand were corrected without recurrence, and the grafts showed relatively good contour and color match to the adjacent fields. There were no reported complications such as significant color change or hypertrophic scarring. The grafted skin showed an average 5.9 mm static two-point discrimination obtained in fingertip reconstruction cases, indicating satisfactory reinnervation. Conclusion: Glabrous full-thickness grafts harvested from the palmar ulnar border is a very useful way of reconstructing soft tissue defects on hands, including fingertips, for function restoration, favorable aesthetic results, and low donor-site morbidity.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.415-420
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• 2010

Purpose: Heterotopic calcification is a pathological event in which deposits of calcium salts build up, usually in the joint area or soft tissues. It can occur under many conditions and in some rare cases may develop in burn scars. In particular, ulcerations in burn scars accompanied by heterotopic calcification are difficult to treat through conservative treatment. This study reports methods for accurate diagnosis and adequate treatment of ulceration in burn scars accompanied by heterotopic calcification. Methods: Fourteen patients who visited our hospital from March 2008 to January 2010 were subjected to this study. Their sex, age, modes of burn, degree, TBSA (%), ulcerated area, the time of occurrence of the ulcerations in the burn scars were investigated. In addition, radiological examination and biopsy was performed to diagnose heterotopic calcification. Results: Among the 14 cases, 6 were male and 8 were female. The average age of the patients was 48.2 (27 - 69 yrs). As for the mode of burn, 11 were flame burns and 3 were scalding burns. The average time of occurrence of the ulcerations in the burn scars was 4.5 months. The ulcerated areas were situated in the legs in 12 cases, arms in 1 case, and torso in 1 case. The diagnosis was confirmed through X-ray and biopsy, and skin graft was performed after wide excision. Conclusion: Diagnosis of the ulceration in burn scars accompanied by heterotopic calcification is possible through radiological and pathologic studies. Surgical treatment is the most reliable method of treatment, and we chose to perform skin graft after wide excision. Also, we learned that the complete removal of the calcified tissue and the inflammatory fibrotic tissues is crucial in preventing recurrence. Also, in contrast to Marjolin's ulcer, heterotopic calcification had a small size, little or no granulation tissue, and lacked fungating type ulceration. Therefore, favorable prognosis could be achieved through adequate treatment.

• Journal of the Korean Burn Society
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• v.22 no.2
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• pp.30-33
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• 2019

Purpose: Wound healing and scar management of donor site after skin graft should not be overlooked. Patients continue to complain of dryness, itching sensation. Such discomfort can cause irritation to the patients and lead to delayed healing or secondary infection. Thus, the author predicted Eucalyptus Oil, which acts on Transient Receptor Potential Melastatin 8 would be effective in regulating scar by reducing itching sensation in donor site when combining conventional silicone materials. Methods: The study was performed on 30 patients who underwent split thickness skin graft with lateral thigh as donor site between January 2017 and August 2018. First, primary evaluation of fully epithelized donor site scar three weeks after surgery was conducted. Control group (n=15) applied silicone gel (Kelo-cote, USA) solely two times a day. study group (n=15) applied Eucalyptus oil, combined with silicone gel. After 3 months of follow up, donor scar was evaluated using Vancouver scar scale and VAS scores of subjective patient reports regarding pain and itching sensation. Results: It was confirmed that both groups showed stable scar improvement comparing scar quality for 3 months. After 3 months, scar quality in study group showed superiority in pigmentation, pliability and pruritus compared to control group. Conclusion: Application of Eucalyptus Oil combined with conventional silicone gel is favorable to scar management and may give additional benefit of alleviating pruritis symptoms.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.358-365
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• 1996

Deep burns of the face & lips often lead to scarring and contraction of the circum-oral tissues with a marked reduction in the size of the oral aperture. Such burns most commonly caused by electrical contact, for example, children sucking electric plugs, or as a result of chemical burns and the exposture to flame. Once having burns, burned tissue may contract and reduce considerably the size and mobility of the mouth ; therefore bring up the resultant functional disturbance, verbal difficulty, even digestive difficulty, and poor appearance, which fall into difficulty in social acceptability, caused by burns. In our department, 2 patients who were complain of functional limitations and esthetic problem owing to scar contracture, were visited, and we treated this microstomia with scar excision, graft and flap technique, and postoperative intensive physical therapy. We obtained relatively favorable results, thus report this cases with literature review.

• Women's Health Nursing
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• v.18 no.4
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• pp.257-267
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• 2012

Purpose: This study was conducted to identify the caring experience of the mothers of childhood burn patients. Methods: Data were collected from 28 mothers of childhood burn patients, through semi-structured in-depth interviews. Data were categorized and coded by using content analysis. Results: 27 categories and 102 statements were drawn from 4 domains. The analyzed domains were psychological sufferings, confronted harsh reality, coping method, and future concerns. Psychological sufferings were categorized heartache, sense of guilt, confusion, regret, depression, sorriness, getting hurt, frustration and upset feeling. Confronted harsh nature were categorized economic difficulty, physical burn-out, lack of caring other children and family troubles. Coping method were categorized positive thinking, having hope, ventilating feelings, accepting the situations, demanding help from family members, changing patterns of the burned child rearing, collecting information for burn treatment, refusing accept the condition of burned child, avoiding personal and social relationship, and reliance on religion. Concerns were categorized concerns of growth and adaptation of the burned child, anxiety for scar, concerns of adapting school life and vague future concerns. Conclusion: The nursing interventions for early assessing psychological problems and providing social supports for caring both burn patients and other siblings should be provided to the mothers of childhood burn patients.

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.194-197
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• 2020

Anterior neck burns represent a major reconstructive challenge due to severe sequalae including restriction in movement and poor aesthetic outcomes. Common treatment options include skin grafting with/without dermal matrices, and loco-regional and distant free flap transfers with/without prior tissue expansion. Such variation in technique is largely influenced by the extent of burn injury requiring resurfacing. In order to optimize like-for-like reconstruction of the anterior neck, use of wide, thin and long flaps such as the anterolateral thigh (ALT) perforator flap have been reported with promising results. Of note, some patients have a tendency towards severe scar contractures, which may be contributed by the greater extent of inflammation during wound healing. We report our experience at 4 years' followup after secondary reconstruction of severe, anterior neck burn contractures in two patients by harvesting the ALT flap with a butterfly design. This technique provides adequate wound resurfacing of the burned neck and surrounding areas, and provides good neck extensibility by addressing both anterior and lateral aspects of the scar defect simultaneously. Such a flap design reduces tension on wound edges and thus, the risk of contracture recurrence in what remains a particularly challenging type of burn reconstruction.

• Journal of Korean Academy of Nursing
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• v.37 no.2
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• pp.221-226
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• 2007

Purpose. Hypertrophic scarring and depression are the principal problems of bum rehabilitation. This study was done to verify the effects of skin rehabilitation massage therapy (SRMT) on pruritus, skin status, and depression for Korean bum survivors. Methods. A pretest - posttest design using a nonequivalent control group was applied to examine the effects of SRMT for 3 months in a group of 18 bum survivors. The major dependent variables - including pruritus, objective and subjective scar status, and depression - were measured at the beginning and at the end of the therapy to examine the effects of SRMT. Results. Bum survivors receiving SRMT showed reduced pruritus, improved skin status, and depression. The remaining scar also showed improvement in skin pigmentation, pliability, vascularity, and height (compared to the surrounding skin) as measured on the Vancouver Scar Scale (VSS). Conclusions. The findings demonstrate that SRMT for bum survivors may improve their scars both objectively and subjectively, and also reduce pruritus and depression.

• Archives of Plastic Surgery
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• v.35 no.6
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• pp.748-750
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• 2008

Purpose: Chemical burn accounts for a small proportion of burns in burn patient population. However, chemical injuries own importance to their deep tissue destruction which continues long after the initial exposure. $YUHANROX^{(R)}$ is a domestic bleach which has been widely used in Korea. Chemical burn by the domestic bleach is an unusual case. Methods: A 70 yrs old female soiled with stool, her husband wiped the mess with $YUHANROX^{(R)}$. Skin edema, erythematous lesion was developed the second day, and she was admitted to our hospital via emergency department. Results: Complete epithelization was done after 3 times STSG but, severe scar was formed. Conclusion: We report this case to warn about the dangers of domestic bleaches chemical substances and to emphasize that they should be used with caution. Public relation of the primary care of the chemical burn injury is needed.

• Korean Journal of Remote Sensing
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• v.24 no.2
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• pp.195-203
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• 2008

Burn severity is an important role for rehabilitation of burned forest area. This factor led to the pilot study to determine if high resolution IKONOS images could be used to classify and delinenate the bum severity over burned areas of Samchock Fire and Cheongyang-Yesan Fire. The results of this study can be summarized as follows: 1. The modified Normalized Bum Ratio (NBR) for IKONOS imagery can be evaluated using burn severity mapping. 2. IKONOS-derived NBR imagery could provide fire scar and detail mapping of burned areas at Samchock fire and Cheongyang-Yesan Burns.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.1
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• pp.81-88
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• 1999

A fibrin adhesive have been widely used in oral and maxillofacial surgery for microvascular anastomosis, autogenous chip bone grafts, many kinds of soft tissue surgery (vestibuloplasty, bleeding control after extraction, primary healing by covering of suture of a gum after the extirpation of large cysts). There are two principal components in adhesive systems biologically: lyophilized human fibrinogen and bovine thrombin. The fibrinogen component contains coagulation factor XIII and enhance the initial wound healing, which polymerizes soluble fibrin monomers into an insoluble clot. The thrombin is dissolved in a solution of calcium chloride to provide the second component. We applied fibrin adhesive, Beriplast (Behring, Behringwerke AG, D-3350, Marburg, FRD), to 4 patients for fixation of free skin grafting donors who had facial scar around eye, nose, mouth corner which received from accidents, or burn. We have experienced initial accelerated graft fixation between donor and recipient sites with no additional fixation. And It's made easy bleeding control and easy manipulation during operation. But two cases showed partial hypertrophic scar engrowth in above 3 months follow up, but no significant. Histopathological reviews in general were showed similar scar findings such as abundant collagen bundles in H&E, M/T stain, but slight positive signs in elastic and collagen antibody immunopathologic findings in hypertrophic scar cases.