• Journal of the Korean Burn Society
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• v.24 no.2
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• pp.43-45
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• 2021

Magnetic Resonance Image (MRI) has been used as a safe, conventional and harmless diagnostic tool. However, thermal injuries have frequently been reported during MRI scanning due to the heat generated by the reaction with the magnetic field. It is recommended that metal-containing monitoring devices such as pulse oximetry and ECG monitoring leads should be removed prior to the start of the MRI scan, but these monitoring devices are inevitably placed in children or patients in the intensive care unit who have low compliance with the scan. Since the interaction between the metal probe or wire loop of pulse oximetry and the magnetic field can result in high thermal conduction, full-thickness burn can occur over the entire body surface during the MRI examination. Several cases of thermal burns from pulse oximetry on the fingers have been reported. However, we present a case of a full-thickness burn arising left earlobe in a 2-month-old child caused by the high conduction heat from pulse oximetry metal probe.

• 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.35 no.6
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• pp.716-722
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• 2008

Purpose: Split or full thickness skin graft is generally used to reconstruct the palmar skin and soft tissue defect after release of burn scar flexion contracture of hand. As a way to overcome and improve aesthetic and functional problems, the authors used the preserved superficial fat skin(PSFS) composite graft for correction of burn scar contracture of hand. Methods: From December of 2001 to July of 2007, thirty patients with burn scar contracture of hand were corrected. The palmar skin and soft tissue defect after release of burn scar contracture was reconstructed with the PSFS composite graft harvested from medial foot or below lateral and medial malleolus, with a preserved superficial fat layer. To promote take of the PSFS composite graft, a foam and polyurethane film dressing was used to maintain the moisture environment and Kirschner wire was inserted for immobilization. Before and after the surgery, a range of motion was measured by graduator. Using a chromameter, skin color difference between the PSFS composite graft and surrounding normal skin was measured and compared with full thickness skin graft from groin. Results: In all cases, the PSFS composite graft was well taken without necrosis, although the graft was as big as $330mm^2$(mean $150mm^2$). Contracture of hand was completely corrected without recurrence. The PSFS composite graft showed more correlations and harmonies with surrounding normal skin and less pigmentation than full thickness skin graft. Donor site scar was also obscure. Conclusion: The PSFS composite graft should be considered as a useful option for correction of burn scar flexion contracture of hand.

• Archives of Plastic Surgery
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• v.35 no.4
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• pp.373-378
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• 2008

Purpose: In full thickness burn, the depth of burn is known to increase until around 1-3 days after the burn. However, no study on how the depth increase during the first 24 hours has been conducted. Therefore, the authors investigated how the depth of burn changes within the first 24 hours after the burn by using the standardized burn model. Methods: A total of four experiments on pigs were carried out for this study. Experiment 1 was performed to examine how temperature affects the depth of burn. The digitally controlled aluminum thermal block was set at different temperatures-80, 90 and 100 degrees in Celsius, respectively. Then the pig was exposed to the block for 15 seconds each time. The time exposed to heat was set as a variable for the Experiment 2. The temperature was maintained at 80 degrees Celsius, and the pig was contacted with the thermal block for 5, 10 and 20 seconds, respectively. The biopsy of the tissues were performed in one hour, 6 hours, 24 hours, and 7 days after the burn. After hematoxylin and eosin staining a percentage of the depth from a basement membrane of epidermis to the deepest tissue damaged by the burn against total dermal thickness was measured. Results: In Experiment 1, the depth of burn increased considerably as time passed by. At all three temperatures, differences in depths measured in 6 and 24 hours, and in 1 hour and 7 days were both significant. In addition, the depth deepened as the temperature went higher. In the case of Experiment 2, the depth of burn also increased significantly as time passed by. At all three times, differences in depth measured in 6 and 24 hours, and in 1 hour and 7 days were also significant. Moreover, the depth extended with longer contact time when it was compared according to the time. Conclusion: Full thickness burn progressed rapidly from 6 to 24 hours after the burn and the depth of burn was almost decided within the first 24 hours after the burn. On the other hand, partial thickness burn also advanced from 6 to 24 hours after the burn but the depth deepened at slower level.

• Archives of Reconstructive Microsurgery
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• v.25 no.1
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• pp.15-18
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• 2016

Any types of burn injury that involve more than deep dermis often require reconstructive treatment. In gluteal region, V-Y fasciocutaneous advancement flap is frequently used to cover the defect. However, in case of large burn wounds, this kind of flap cannot provide adequate coverage because of the lack of normal surrounding tissues. We suggest V-Y adipofascial flap using the surrounding superficially damaged tissue. We present the case of a patient who was referred for full-thickness burn on gluteal region. We performed serial debridement and applied vacuum-assisted closure device to defective area as wound preparation for coverage. When healthy granulation tissue grew adequately, we covered the defect with surrounding V-Y adipofascial flap and the raw surface of the flap was then covered with split-thickness skin graft. We think the use of subcutaneous fat as an adipofascial flap to cover the deeper defect adjacent to the flap is an excellent alternative especially in huge defect with uneven depth varying from subcutaneous fat to bone exposure in terms of minimal donor site morbidity and reliability of the flap. Even if the flap was not intact, it was reuse of the adjacent tissue of the injured area, so it is relatively safe and applicable.

• Journal of the Korean Burn Society
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• v.24 no.2
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• pp.60-63
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• 2021

In the face, the nose plays an important role in both function and appearance. Among the subunits on the nose, the alar is a critical nasal structure of high aesthetic value. Previously, many surgeons have insisted that structural support should be added to the reconstruction of alar and particularly so in the case of a full-thickness defect. In a 58-year-old male patient who had a third-degree burn injury and full-thickness defect in most of the left nasal alar, forehead flap surgery alone was successfully performed without structural support.

• Journal of Korean Foot and Ankle Society
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• v.16 no.3
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• pp.190-192
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• 2012

In the extremity surgery, pneumatic tourniquet and povidone-iodine solution are commonly used to provide an aseptic, bloodless field, and their complication rate has remained low. However, chemical burn under tourniquet has been rarely reported. Patients sustained burn injuries over the dependent, weight-bearing regions such as posterior neck, back, buttocks and posterior thighs. This rare adverse complication occurred in a 22-year-old man who underwent modified Brostrom operation with arthroscopic os trigonum excision. 10% povidone-iodine was used as topical antiseptic, and full thickness burn occurred underneath the area of tourniquet application. Main causes of povidone-iodine related chemical burn are considered maceration, irritation of the skin, long term use of the tourniquet and pressure. To reduce the complications like chemical burn, awareness of the risk and the possible pathogenesis as well as the preventive measures is important in surgical practice.

• Archives of Plastic Surgery
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• v.46 no.2
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• pp.167-170
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• 2019

Full-thickness scalp burns secondary to hair coloring are rare; however, such defects can be large and complex reconstruction of hair-bearing tissue may be necessary. Many skin-stretching devices that use gradual traction have been applied to take advantage of the viscoelastic properties of the skin. A 21-year-old female patient was seen with a burn defect on her occipital scalp leading to exposed subcutaneous tissue after chemical application of hair coloring in a salon. The dimensions of the wound were $10cm{\times}5cm$, and a skin graft or flap would have been necessary to close the defect. Two long transfixing K-wires (1.4 mm) and paired 3-wire threads (23 gauge), which are readily available in most hospitals, were applied over a period of 12 days for trichophytic closure of the defect. The remaining scalp scars after primary trichophytic closure with this skin-stretching method were refined with hair follicle transplantation. This skin-stretching method is simple to apply and valuable for helping to close problematic areas of skin shortage that would otherwise require more complicated procedures. This case shows a relatively unknown complication of hair coloring and its treatment.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.607-612
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• 2005

A traditional tie-over dressing may be applied to support the take of a skin graft. Although there are many advantage of this method, it has significant disadvantages, including time-consuming application. Furthermore, when the dressing is changed, the gauze becomes hard and can be stuck to the graft, causing damage and pain upon removal. The purpose of our study is to evaluate the effect of semi-occlusive dressing using polyurethane foam and film dressing($Allevyn^{(R)}$, $Opsite^{(R)}$) after full thickness skin graft. The authors treated 45 cases including burn scar contracture(n=38), syndactyly (n=1), absence of nipple-areolar complex(n=4), traumatic skin defect(n=1) and contact burn(n=1) with authors' method and 39 patients including burn scar contracture (n=39) with the tie-over dressing between 2000 and 2004. The patients in polyurethane foam and film dressing group ranged from 1 to 62 years of age (mean age, 15.1 years) and the patients in tie-over dressing group ranged from 2 to 60 years of age(mean age, 21.3 years). The postoperative results were analyzed according to the following measures: (1) the duration of graft-taking, (2) the admission period, (3) complications. Compared with the traditional tie-over dressing, polyurethane foam and film dressing was shown to be more successful in a reduced duration of graft-taking, in which was similar to the former in the rate of graft-taking, a reduced admission period and patient's discomfort. We concluded that semi-occlusive dressing using $Allevyn^{(R)}$ and $Opsite^{(R)}$ was an effective method after full thickness skin graft, which was easy to shape to difficult body locations, such as web spaces, fingers and maintains a moist environment for wound healing and does not stick to the wound.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.6
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• pp.280-284
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• 2014

Purpose: This study evaluated woven silk textile for burn wound dressing materials in an animal model. Methods: Ten rats were used in this experiment. Full-thickness $2{\times}2cm$ burn wounds were created on the back of the rats under anesthesia. In the experimental group, the wounds were treated with three different dressing materials from woven silk textile. In the control group, natural healing without any dressing material was set as control. The wound surface area was measured at five days, seven days, and 14 days. Wound healing was evaluated by histologic analysis. Results: There were no statistically significant differences among groups at five days post injury. The mean defect size at seven days was largest in Group 3 ($462.87mm^2$), and smallest in Group 1 ($410.89mm^2$), not a significant difference (P=0.341). The mean defect size at 14 days was smallest at the Group 3 ($308.28mm^2$) and largest in the control group ($388.18mm^2$), not a significant difference (P=0.190). The denuded area was smaller in Group 1 ($84.57mm^2$) and Group 2 ($82.50mm^2$) compared with the control group ($195.93mm^2$), not statistically significant differences (P=0.066, 0.062). The difference between Group 3 and control was also not statistically significant (P=0.136). In histologic analysis, the experimental groups re-epithelialized more than control groups. No evidence was found of severe inflammation. Conclusion: The healing of burn wounds was faster with silk weave textile more than the control group. There was no atypical inflammation with silk dressing materials. In conclusion, silk dressing materials could be used to treat burn wounds.