• Title/Summary/Keyword: Pediatric burn

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Usefulness of using Tissue Expander in Pediatric Patient (소아 환자에서 조직확장기 사용의 유용성)

  • Lee, Jun-Woo;Park, Chul-Gyoo;Park, Jong-Lim;Kim, Yong-Kyu
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.763-768
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    • 2010
  • Purpose: Reconstruction of soft tissue defect using tissue expander can provide better flap which is more similar to surrounding tissue in color, skin texture and hair compared to other methods. Many pediatric patients need reconstruction of soft tissue defect because of giant congenital nevi, congenital or acquired malformations and burn scars. Reconstruction using tissue expander is adequate to minimize dysmorphism in these patients. We intended to assess outcomes of using tissue expander in pediatric patients by retrospective study. Methods: Total cases were 168 of pediatric patients who received soft tissue reconstruction using tissue expander by the same surgeon from February, 1982 to May, 2009. All patients who received soft tissue reconstruction were under 10 years old. Mean age was 4.3 years old, the youngest 13 months, the oldest 8 years. Eightynine cases were male and 79 cases were female. Most common cause was giant hairy nevi (67 cases, 39.9%), secondary cause was burn scar/scar contracture (61 cases, 36.3%). Trunk (38 cases, 22.6%) was most common anatomical location. Results: Soft tissue defects were successfully covered using tissue expander in 149 cases (88.7%) without major complications. There was infection on 8 cases (4.7%) and we treated by adequate antibiotics in these cases. There were tissue expander folding or valve displacement on 5 cases (3%). Conclusion: Usage of tissue expander is useful on pediatric patients because tissue expansion is rapid on children and there are less secondary contractures on operation site than full thickness skin graft. Because of psychological stress due to tissue expander, operation should be performed before school age.

Clinical aspects of injury and acute poisoning in Korean pediatric patients (소아의 응급질환 - 우리나라 소아 및 청소년의 손상과 급성 중독을 중심으로 -)

  • Lee, Mi Jin;Park, Joon Seok
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.116-121
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    • 2008
  • Unintentional injuries are the most important cause of morbidity and mortality in the pediatric population, and the home is the most common site of injury for children in Korea. The most common cause of injury was slip down. Fall down and burn were frequent in infant/toddlers group, automobile and bicycle accident more frequent in preschool children. Findings from the survey could then be used to provide targets for direct educational efforts by medical services and to direct environmental safety modifications tailored to the unique situation of each family. Pediatric toxic ingestions are treated commonly by pediatricians and emergency physicians. Significant injury after these ingestions is infrequent, but identifying the dangerous ingestion is sometimes a difficult task. By performing a detailed history, focused physical examination, and directed laboratory evaluation, an estimation of risk can be developed. According to recent Korean poison papers, there were bimodal peak of age distribution in poisoned children patient on the whole: infant and adolescents group. Various types of materials belonged the classes of drugs, household products, and industrial solvents. Most of the poisoned children patients had been poisoned accidentally, while most cases of adolescents poisoning had been intentional. More than half of the adolescents group had a suicidal purpose in Korea, so an understanding of the demographic factors associated with self-harm poisoning may provide useful information to improve prevention and treatment strategies.

The use of negative-pressure wound therapy over a cultured epithelial autograft for full-thickness wounds secondary to purpura fulminans in an infant

  • Goh, Benjamin Kah Liang;Chua, Alvin Wen Choong;Chew, Khong Yik;Kang, Gavin Chun-Wui;Chiang, Li-Wei;Tan, Bien-Keem;Ramachandran, Savitha
    • Archives of Plastic Surgery
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    • v.48 no.3
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    • pp.338-343
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    • 2021
  • Purpura fulminans is a serious condition that can result in severe morbidity in the pediatric population. Although autologous skin grafts remain the gold standard for the coverage of partial- to full-thickness wounds, they have several limitations in pediatric patients, including the lack of planar donor sites, the risk of hemodynamic instability, and the limited graft thickness. In Singapore, an in-house skin culture laboratory has been available since 2005 for the use of cultured epithelial autografts (CEAs), especially in burn wounds. However, due to the fragility of CEAs, negative-pressure wound therapy (NPWT) dressings have been rarely used with CEAs. With several modifications, we report a successful case of NPWT applied over a CEA in an infant who sustained 30% total body surface area full-thickness wounds over the anterior abdomen, flank, and upper thigh secondary to purpura fulminans. We also describe the advantages of using NPWT dressing over a CEA, particularly in pediatric patients.

Evaluation of the Remineralization Capacity of Water-based Silver Fluoride

  • Gwangsuk Kim;Juhyun Lee;Haeni Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.51 no.1
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    • pp.80-87
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    • 2024
  • Silver diamine fluoride, which can arrest dental caries, is alkaline and may cause mild soft tissue irritation. Water-based silver fluoride has a neutral pH, which is closer to the physiological range, and is biocompatible for use in the oral environment. This study aimed to evaluate the effect of water-based silver fluoride on remineralizing early enamel lesions by comparing it with other fluoride agents through microhardness and quantitative light-induced fluorescence measurements. An in vitro study with intact bovine incisors was performed. Artificial enamel lesions were induced and subjected to microhardness and quantitative light-induced fluorescence testing. Specimens were randomly divided into 4 groups for treatment. The specimens in group I were treated with water-based silver fluoride and potassium iodide, group II with silver diamine fluoride and potassium iodide, group III with sodium fluoride varnish, and group IV with distilled water. After 8 days of pH cycling, the specimens were subjected to microhardness and quantitative light-induced fluorescence testing. Water-based silver fluoride and silver diamine fluoride showed the greatest increases in microhardness and quantitative light-induced fluorescence, with no significant differences between the two. Sodium fluoride varnish also exhibited a significant increase in microhardness and quantitative light-induced fluorescence, but the differences were smaller than those for water-based silver fluoride and silver diamine fluoride. Water-based silver fluoride is considered useful in a clinical setting for remineralizing enamel lesions, with the advantages of no risk of tissue burn and improved taste and smell.

"외대비요(外臺秘要)"의 훈법(熏法)과 방향요법(芳香療法)에 관한 연구

  • Kim, Eun-Ha;Kim, Gi-Uk;Park, Hyeon-Guk;Lee, Byeong-Uk
    • Journal of Korean Medical classics
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    • v.18 no.3 s.30
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    • pp.116-125
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    • 2005
  • 1) Objective ${\lceil}Wai-Tai-Mi-Yao{\rfloor}$ had been made by Wang-Dao(王燾) in Tang Dynasty(唐朝). It included fumigation therapy and aroma therapy. Therefore we would like to bring out use sphere and detailed method of Fumigation therapy and Aroma therapy in Tang Dynasty and before period. 2) Conclusions (1) Fumigation therapies of ${\lceil}Wai-Tai-Mi-Yao{\rfloor}$ have contained boil and burn. The effects of fumigation therapy are made by cooperation effect of medicine and heat. (2) Aroma therapies of ${\lceil}Wai-Tai-Mi-Yao{\rfloor}$ have been used to cure infectious, internal, psychologic, dental, pediatric, dermatologic and surgical diseases. Especially these therapies have a good effect on cough. (4) Aroma therapies of ${\lceil}Wai-Tai-Mi-Yao{\rfloor}$ have been used to cure infectious, internal, psychologic, dental, ophthalmic, otolaryngologic, obstetrics, gynecologic, dermatologic and surgical diseases. Expecially this therapy has an good effect on nightmare.

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Characteristics of Pediatric and Adolescent Trauma-Database Review of Single Level Trauma Center in Gangwon Province

  • Lee, Tae Han;Jung, Pil Young;Kwon, Hye Youn;Shim, Hongjin;Jang, Ji Young;Bae, Keum Seok;Kim, Seongyup
    • Journal of Trauma and Injury
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    • v.30 no.3
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    • pp.75-79
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    • 2017
  • Purpose: Although trauma is the most common cause of death under age 18, Korean national pediatric trauma data has lack of clinical data. This study is to prepare manpower resources, equipment, and make a correct policy decision on pediatric trauma victims Methods: The study enrolled 528 patients under age 16 with traumatic injury visited Wonju Severance Christian Hostpital Trauma Center, from February 12, 2015 to December 31, 2016. We analyzed the distribution of gender, age, place and time of the accident, injury mechanism, injury severity, and injured organ by medical record. Results: The major injury mechanisms were blunt injury in 485 (91.90%), penetrating injury in 27 (5.10%), burn in 13 (2.50%), near drowning in 2 (0.40%), and foreign body ingestion in 1 (0.20%). Ninety-seven (18.4%) patients were injured at home and 67 (12.7%) patients were injured at school. The overall mortality rate was 1.13% (n=6). 5 mortalities were related to automobile accident and one was fall down. Mean Injury Severity Score (ISS) was 4 (2, 8). No statistical significance was observed in the mean ISS between each age group. The peak time of accident occurrence was between 16 and 17 o'clock. The mean ISS was higher in blunt injury group than penetrating injury with statistical significance ($6.50{\pm}7.60$ vs. $3.00{\pm}8.10$; p<0.05). The most common injury site was upper extremity. Mean ISS was highest in thorax injury. However, mean ISS of thorax injury was higher with statistical significance only compared with face, neck and upper extremity injury. Conclusions: We reported our pediatric trauma patients data of our hospital level I trauma center, which is the only one level I trauma center of Gangwon Province. These data is useful to prevent and prepare for pediatric trauma.

Maternal Uncertainty in Childhood Chronic Illness (만성질환아 어머니의 아동질병으로 인한 불확실성 경험)

  • Park Eun Sook;Martinson M.I.
    • Child Health Nursing Research
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    • v.4 no.2
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    • pp.207-220
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    • 1998
  • The purpose of this study was to build a substantive theory about the experience of the maternal uncertainty in childhood chronic illness. The qualitative research method used was grounded theory. The interviewees were 12 mothers who have cared for a child who had chronic illness. The data were collected through in-depth interviews with audiotape recording done by the investigator over a period of nine months. The data were analyzed simutaneously by a constant comparative method in which new data were continuously coded into categories and properties according to Strauss and Corbin's methodology. The 34 concepts were identified as a result of analyzing the grounded data. Ten categories emerged from the analysis. The categories were lack of clarity, unpredictability, unfamiliarity, negative change, anxiety, devotion normalization and burn-out. Causal conditions included : lack of clarity, unpredictability, unfamiliarity and change ; central phenomena : anxiety, being perplexed ; context. seriousness of illness, support ; intervening condition : belief action/interaction strategies devotion, overprotection ; consequences : normalization, burn-out. These categories were synthesized into the core concept-anxiety. The process of experiencing uncertainty was 1) Entering the world of uncertainty, 2) Struggling in the tunnel of uncertainty, 3) Reconstruction of the situation of uncertainty. Four hypotheses were derived from the analysis : (1) The higher the lack of clarity, unpredictability, unfamiliaity, change, the higher the level of uncertainty (2) The more serious the illness and the less the support, the higher the level of uncertainty. (3) The positive believes will influence the devoted care and normalization of the family life. Through this substantive theory, pediatric nurses can understand the process of experiencing maternal uncertainty in childhood chronic illness. Further research to build substantive theories to explain other uncertainties may contribute to a formal theory of how normalization is achieved in the family with chronically ill child.

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Two Cases of Severe Eczema Herpeticum after Herbal Medication in Children with Atopic Dermatitis (아토피 피부염 환아에서 한방 치료 후 발생한 중증 포진상 습진(Eczema Herpeticum) 2례)

  • Kim, Jin-Man;Lee, So-Yeon;Kim, Young-Ho;Shin, Eon-Woo;Jang, Woo-Yung;Oh, Phil-Soo;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.208-212
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    • 2005
  • It has been known that the eczema herpeticum is the one of most severe skin manifestation of external herpetic infection. It is developed by skin infection of Herpes simplex Virus(HSV) that superimposed on children with atopic dermatitis, and this could be fatal. The secondary bacterial infection happens frequently in eczema herpeticum. Staphylococcus aureus is the most frequently isolated aerobic strain. The important point of treatment of eczema herpeticum is the immediate start of systemic antiviral treatment and use of antibiotics to decrease the secondary infection. We report two cases of severe eczema herpeticum after herb medical treatment in atopic dermatitis. They have been improved after systemic acyclovir and antibiotic therapy with burn dressing.

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Algorithm for Primary Full-thickness Skin Grafting in Pediatric Hand Burns

  • Park, Yang Seo;Lee, Jong Wook;Huh, Gi Yeun;Koh, Jang Hyu;Seo, Dong Kook;Choi, Jai Koo;Jang, Young Chul
    • 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.