• Journal of the Korean Burn Society
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• v.22 no.2
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• pp.53-57
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• 2019

Dichloromethane is widely used as a solvent in paint removers. Unlike inhalation injury, contact injury caused by dichloromethane is not well known. Two patients who had undergone skin grafting to treat chemical burn of the hand caused by dichloromethane exposure were evaluated, and a literature review was done. Two healthy men aged 37 and 40 years visited our hospital with chief complaints of pain on the hands due to dichloromethane exposure. The patients had not worn protective clothing. Multiple bullae were initially noted. On the next day, fluctuation in bullae and purulent discharge were observed, and central eschar change was noted. On the 18th day after the burn, escharectomy and full-thickness skin graft were performed. Therefore, workers who use dichloromethane should wear protective clothing at workplaces. If exposed to the chemical, the worker should be instructed to do a quick wash and visit the hospital.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.67-70
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• 2005

Recently, the usage of an exercising treadmill has increased in Korean homes. Along with increasing utilization of these machines, injuries relating to the inadvertent usage of the machine have gradually increased for the last several years. The purpose of this study is to identify the feature of this type of injury, thereby to help prevent and to raise an awareness of the potential injury. 25 patients who had been admitted to Hangang Sacred Heart Hospital from January 2002 through March 2004 were investigated retrospectively. Age, sex, place of injury, the area and the extent of injury, treatment and prognosis were analyzed for each case. All injuries involved in the children with an average age of 3.5 years. This new type of injury was at least a deep second-degree burn of the friction-burn type in all cases. Most of them primarily involved hands. Inattention of the guardian was the main cause of such injuries. 68% of the cases needed an operation such as a split-thickness skin graft or a full-thickness skin graft. In this study, authors reached a conclusion that such injuries may be prevented by an education of the potential risks of using a treadmill and by developing additional safety devices.

• Journal of Veterinary Clinics
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• v.35 no.5
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• pp.229-232
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• 2018

A 9-year-old intact female Poodle (weighing 3.6 kg) was presented for the treatment of a partial and full thickness burn that covering 45% of body including bilateral thigh and sacrolumbar region. Autologous platelet-rich plasma (PRP) stimulates angiogenesis, promoting vascular in-growth and fibroblast proliferation. On the unrecovered right thigh of the dog, autologous PRP was injected into the lesion after application of micro-needles. For macroscopic evaluation digital, photographs were taken from wounds at days 0, 3, 5, 13, 21, and 28. On the $3^{rd}$ day after PRP application, epithelialization was accelerated. Application of autologous PRP accelerated wound-healing rate and healing time in full thickness burns as well as secondary complications originating from unrecovered wounds. The delayed lesion was completely healed on the $28^{th}$ day by autologous PRP treatment. In human, PRP was increasingly used in the treatment of a variety of soft tissue in the management of chronic non-healing wounds. This study has shown that PRP treatment can be a valuable and effective aid on intractable wound healing in the dog with burns.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.451-457
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• 2011

Purpose: As a central feature of the face, the nose has considerable significance in appearance and expression. Reconstruction of full thickness defects of the nasal ala has always been a challenge because of the 3-dimensional structure. For reconstruction of post burn defects of ala, skin graft, local or pedicled flap and composite graft are optionally available. We have reconstructed the ala defects using adiposocutaneous graft and observed the outcome. Methods: From March 2003 to December 2010, 19 cases in 11 patients with scar contracture and defect on ala portion were performed operation using adiposocutaneous graft. As a donor site, we used the inguinal crease and posterior auricular area and the donor site was primarily closed. We made incision through the superior rim of ala and released fully. A graft is applied to recipient site with larger size than recipient volume. Results: The mean age of the patient was 38.6 years (16~51), males are seven patients and females are four patients. The operation was performed bilaterally in 5 patients and unilaterally in 6 patients. Composite grafts were harvested from inguinal area in 13 cases and posterior auricular area in 6 cases. In one case, we did 4 times of operation to get enough volume. All the grafts were well taken. The mean size of the graft was 3.63 $cm^2$. Conclusion: For reconstruction of post burn defects of ala, it's not easy to use local flap or pedicled flap because of hardness and fibrosis of surrounding tissue. So, we choose adiposocutaneous graft for ala deformity reconstruction, got satisfactory outcome in color matching and texture.

• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.80-87
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• 2000

Acute high speed accidents that results in full thickness skin defect and exposure of tendon, nerve, vessel and periosteum over denuded bone demands soft tissue coverage. Exposed bone often ensues chronic infection and requires free flap transplantation which surely covers defects in one stage operation and enhances transport of oxygen-rich blood and converts a non-osteogenic or partially osteogenic site into a highly osteogenic site, but exposed bone which had performed free flap transplantation sometimes necroses and needs secondary bone procedure. Scar contracture limits joint motion should be excised and covered with normal soft tissue to restore normal range of motion. Authors have performed the large latissimus dorsi myocutaneous free flap in 8 cases of extensive soft tissue defect and exposed bone lesion in the leg and 1 case of the flap was failed. The secondary ilizarov bone procedure was performed in 3 of 8 cases. 2 cases of large burn scar contracture and 1 case of posttraumatic scar contracture in lower extremity were restored with the large latissimus dorsi myocutaneous free flap. Authors concluded that large latissimus dorsi myocutaneous free flap is the most acceptable microvascular procedure in large soft tissue defect combined with exposed periosteum and bone requiring secondary bone procedure and in large burn scar contracture limiting knee joint motion.

• Archives of Plastic Surgery
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• v.39 no.5
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• pp.483-488
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• 2012

Background Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies. Methods From January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed. Results The mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months. Conclusions In the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.521-526
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• 2008

Purpose: Most burn scar contractures are curable with skin grafts, but free flaps may be needed in some cases. Due to the adjacent tissue scarring, local flap is rarely used, and thus we may consider free flap which gives us more options than local flap. However, inappropriate performance of free flap may lead to unsatisfactory results despite technical complexity and enormous amount of effort. The author will discuss the points we should consider when using free flaps in treating burn scar contractures Methods: We surveyed patients who underwent free flaps to correct burn scar contractures from 2000 to 2007. We divided patients into two groups. The first group was those in which free flaps were inevitable due to exposure of deep structures such as bones and tendons. The second group was those in which free flap was used to minimize scar contracture and to achieve aesthetic result. Results: We performed 44 free flap on 42 patients. All of the flaps were taken well except one case of partial necrosis and wound dehiscence. Forearm free flap was the most common with 21 cases. Most of the cases(28 cases) in which free flaps were inevitable were on the wrist and lower limbs. These were cases of soft tissue defect due to wide and extensive burns. Free flaps were done in 16 cases to minimize scar contracture and to obtain aesthetic outcome, recipient sites were mostly face and upper extremities. Conclusion: When using free flaps for correction of burn scar contractures, proper release and full resurfacing of the contracture should be carried out in advance. If inadequate free flap is performed, secondary correction is more challenging than in skin grafts. In order to optimize the result of reconstruction, flap thickness, size and scar of the recipient site should be considered, then we can achieve natural shape, and minimize additional correction.

• Journal of the Korean Burn Society
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• v.23 no.2
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• pp.54-59
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• 2020

Purpose: A fourth degree burn is a full-thickness burn of the skin usually accompanied by damage to deep structures and commonly results in extensive damage to surrounding tissues which makes the treatment of the wound difficult. Coverage of these wound using free flap is known to effective but not commonly used. The purpose of our study is to review our experience and suggest early application of free flap surgery. Methods: A retrospective review was performed from 2010 to 2019, on a total of 34 fourth degree burn patients undergone free flap surgery as primary treatment in our hospital. We reviewed the location of the injury, etiology, TBSA (%), Presence of osteomyelitis, flap choice, complications, period of injury to surgery and healing. Results: Using free flap as a primary reconstrcuction, the outcome is satisfactory. The treatment period was shortened, and there was less loss of function due to complications. Also the incidence of osteomyelitis and amputation was significantly low. Conclusion: Applying free flap surgery as soon as possible in fourth degree burns is effective, such as reducing complications such as infection, reducing amputation, shortening treatment period, and preventing severe sequelae.

• Medical Lasers
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• v.9 no.1
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• pp.51-57
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• 2020

Background and Objectives For experiments on simulated burn, the preparation of an animal model is a very important step. The purpose of the current experiment is to design a simple and controllable method for the preparation of third-degree scald in a mouse model using the boiling water method. Materials and Methods A total of 18 Swiss mice were used. After the anesthetization, the mice were scalded by boiling water (100℃) using a mold with a 1 cm² circle area on the dorsum at contact times of 3s, 5s, and 8s. After confirming that 8 seconds of scald can cause a third-degree scald, the skin samples were collected at day 2, 4, 6, 8, 10, and 12, and analyzed by histopathological examinations. The wound retraction index (WRI) was also measured. Results Third-degree scald involving full-thickness skin was observed in the 8-second scald group, while a 3-second scald caused a superficial second-degree scald and a 5-second scald caused a deep second-degree scald. After third-degree scald, the burn wound continued to contract until day 14. Conclusion The scalding model of mice can be successfully established by the boiling water method. This method is easy to operate, it has a low cost, and it can control the scald depth by controlling the scald time. This is adequate to study skin thermal injury in the future. The scald model established by this method can last for 14 days.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.220-226
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• 2010

Purpose: Many topical agents had been used for burn or wound treatment. An awareness of topical agents on various aspects of wound healing permits the clinician to choose the most appropriate material to advantageously control the wound process and final results. Although polydeoxyribonucleotide (PDRN) was used as a tissue repair stimulating agent in a number of human diseases, such as ulcers and burns, its wound healing effects were largely unreported. We aimed to compare the woundhealing effects of PDRN and common dressing materials on full-thickness skin defect in the mouse. Methods: Full-thickness skin defects were made on the back of mice (N=60). The mice were divided into the following 4 groups according to the dressing used for the wounds: group O (Polydeoxyribonucleotide cream), group I (Polydeoxyribonucleotide solution), group M (Medifoam$^{(R)}$), and group G (dry gauze, control group). We analyzed the gross findings, wound sizes and histological findings for the groups. Results: The rate of wound size was decreased in order of group I, group O, group M and group G. The histological findings revealed that the I group showed more reepithelialization and granulation tissue formation and less inflammatory cell infiltration than the other materials. The grade score of wound healing was increased in order of group I, group O, group M and group G. Conclusion: PDRN applicated wound dressings can be used for treating a full-thickness skin defect wounds. Considering its superior efficacy in comparison to the efficacies of other wound dressings, PDRN soaked gauze dressing should be preferentially used for the treatment of fullthickness skin wounds.