• Archives of Plastic Surgery
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• 제36권6호
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• pp.803-805
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• 2009

Purpose: Many conditions can mimic the presentation of burns. Herpes zoster is one of them. The characteristic features of herpes zoster such as vesicles, pustular lesions and crusts can also be found in burns. Herpes zoster ophthalmicus is a disease caused by recurrent infection of varicella - zoster virus in the ophthalmic division of the trigeminal nerve. This virus frequently affects nasociliary branch and serious ocular complications can occur. Thus, early diagnosis and proper treatment of this disease is important to prevent further ocular manifestations. We report a man who sustained minor facial burn injury that was complicated with herpes zoster ophthalmicus. Methods: A 66 - year - old man visited emergency room with multiple whitish vesicles with serous discharge on right forehead, right medial canthal area and nose. At first he was thought to have a secondary infection of facial burn injury. The vesicles on his face began to form crusts on the next day. Since his skin lesion was located on the ophthalmic division of trigeminal nerve, we also suspected herpes zoster ophthalmicus. He was referred to dermatologist and ophthalmologist. Results: We used antiviral agent (Acyclovir) and NSAIDs for treatment. The patient had no ocular complications. His skin lesion was almost healed after 1 month and remained scars. We treated a patient with minor facial burn complicated with herpes zoster ophthalmicus with antiviral agent. Conclusion: In this work, we describe a case of old patient with herpetic infection and emphasize the need for careful examination to diagnose accurately.

• Archives of Plastic Surgery
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• 제47권2호
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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.

• 한국의료질향상학회지
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• 제3권1호
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• pp.78-93
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• 1996

Background : The goal of this study was to establish the QA items and guidelines for preventing and improving of safety management. Therefore we investigated the nurses' recognition and knowledge of the safety and risk procedures and policies, and the agreement between the nurses beliefs on the degree of importance of those procedures and policies, with actual implementation in hospitals. Method : The subjects of this study were 201 nurses who participated in a program called continuing education for nurses, which held in December, 1993. Result: The results of this study were as follows: 1. Among 18 types of hospital risks, the items that scored highest or the need of closer attention in safety management was the needle stick, medication errors, falling, and bed sores. 2. In most questions of the 18 incidences, the nurses showed that the estimated result would have positive signs except for hospital infections, burns, and bed sores. 3. Even though the survey shows that incidences and types of occurences varies according to the person's age and the time of incident, they mostly occur between midnight to 6AM. Falls and bed sores can be seen more in the elderly. Medications errors, hospital infections and burns are frequently found between the ages of one through twenty. 4. There was a higher mean score for recognizing the importance of those items than the importance of implementing them. Conclusion : In summary, nurses did perceive the need of safety management but the hospital policy for proper safety management was not established. So we recommended that the hospital administration would undertake an early detection and proper management system for hospital precautions, based on QA items & guidelines presented in this study.

• 한국임상약학회지
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• 제12권2호
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• pp.55-64
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• 2002

Infection is one of the main causes of death in severe burn cases. Treatment of burn patient includes fluid therapy, wound care, complication care and antibiotic therapy for infection. The objective of this study was to evaluate the characteristics of burn patients, the type of isolated microorganisms and their susceptibility, and the systemic antibiotics used. This is a retrospective study of 126 burn patients treated in the Hanil General Hospital from January to December 2001. Total 126 patients were assessed with 103 males and 23 females (4.5:1). The average age was $34.8\pm17.6$ years and extent of burn $(TBSA\;\%)\;was\;24.5\pm18.5\%$. The burn was caused by electric accident $(47.6\%),\;flame\;(29.4\%),\;scalding\;(21.4\%),\;and\;chemical\;accident\;(1.6\%)$. The overall mortality rate was $7.14\%$ (9/126) and all expired patients were males. The average age (n=9) was $48.8\pm15.6$ yrs and the extent of burn was $65.0\pm19.0\%$. The causes of death were due to flame burns $(13.5\%)$ and electric burns $(6.7\%)$. The culture sites of the isolated microorganisms were wound $(85.3\%),\;sputum\;(9.3\%),\;urine\;(2.7\%),\;blood\;(1.3\%)\;and\;catheter\;tip\;(1.3\%)$. Pseudomonas aeruginosa was the most commonly isolated organism $(35\%)$, followed by Staphylococcus aureus $(30.1\%)$, Acinetobacter baumannii $(21.4\%)$, and Enterococcus spp. $(3.9\%)$. The number of systemic antibiotics administered was 4.5. The classes of the antibiotics were cephalosporines $(38.5\%)$, aminoglycosides $(31\%)$, quinolones $(13.3\%)$, penicillins $(12.4\%)$, carbapenems $(2.4\%)$, glycopeptides $(1.9\%)$ and others $(0.6\%)$. In conclusion, most of burn patients had wound infection and Pseudomonas aeruginosa was the most commonly isolated organism. Cephalosporins were administered the most frequently among antibiotics.

• 한국학교보건학회지
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• 제24권1호
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• pp.12-22
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• 2011

Purpose: The purpose of this study was to identify incidence of nonfatal unintentional injuries (accidents) among students, and to investigate compensation payment for five years (2000~2004) in schools located in Seoul. Methods: Subjects were 14,783 students injured among elementary, middle and high school students. The accumulated data for 5 years (2000~2004) was from the Seoul School Safety and Insurance Association. Chi-square, ttest, logistic regression, and MANCOVA were conducted. Results: The most frequent accidents occurred among males (73.2%), and in special school students (3.86 per 1,000) followed by middle school students (3.05 per 1,000), in May (0.25 per 1,000) followed by June and October, in physical education classes (0.73 per 1,000) followed by special activities (0.40 per 1,000), recess (0.31 per 1,000) and lunch (0.29 per 1,000). Fractures (0.86 per 1,000) were followed by mild injuries (0.39 per 1,000), joint and ligament injuries (0.31 per 1,000), and teeth injuries (0.26 per 1,000). After adjusting for potential confounding variables, the highest means of final compensation payment was for burns (810 thousand KRW) followed by the teeth injuries (506 thousand KRW), cleaning injuries (550 thousand KRW) followed by injuries incurred during special activities (510 thousand KRW) and injuries incurred at special schools (556 thousand KRW). Conclusion: In school, the highest incidences of nonfatal unintentional injuries were in special schools, among males, fractures and physical education. However, the highest compensation payments were for burns, and injuries taking place at special schools and during cleaning hour. Proper health education including teaching healthy habits for safety/injury prevention is needed to prevent injuries and decrease compensation.

• Acute and Critical Care
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• 제33권4호
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• pp.260-268
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• 2018

Background: The purpose of this study was to evaluate the clinical application of modified Burns Wean Assessment Program (m-BWAP) scoring at first spontaneous breathing trial (SBT) as a predictor of successful liberation from mechanical ventilation (MV) in patients with endotracheal intubation. Methods: Patients requiring MV for more than 72 hours and undergoing more than one SBT in a medical intensive care unit (ICU) were prospectively enrolled over a 3-year period. The m-BWAP score at first SBT was obtained by a critical care nursing practitioner. Results: A total of 103 subjects were included in this study. Their median age was 69 years (range, 22 to 87 years) and 72 subjects (69.9%) were male. The median duration from admission to first SBT was 5 days (range, 3 to 26 days), and the rate of final successful liberation from MV was 84.5% (n=87). In the total group of patients, the successful liberation from MV group at first SBT (n=65) had significantly higher m-BWAP scores than did the unsuccessful group (median, 60; range, 43 to 80 vs. median, 53; range, 33 to 70; P<0.001). Also, the area under the m-BWAP curve for predicting successful liberation of MV was 0.748 (95% confidence interval, 0.650 to 0.847), while the cutoff value based on Youden's index was 53 (sensitivity, 76%; specificity, 64%). Conclusions: The present data show that the m-BWAP score represents a good predictor of weaning success in patients with an endotracheal tube in place at first SBT.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.397-404
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• 2022

Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.668-675
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• 2022

Background Educational resources on the internet are extensively used to obtainmedical information. YouTube is the most accessed video platform containing information to enhance the learning experience of medical professionals. This study systematically analyzed the educational value of microsurgery-related videos on this platform. Methods A systematic review was conducted on YouTube from April 18 to May 18, 2020, using the following terms: "microsurgery," "microsurgical," "microsurgical anastomosis," "free flap," and "free tissue transfer." The search was limited to the first 100 videos, and two independent reviewers screened for eligible entries and analyzed their educational value using validated scales, including a modified version of the DISCERN score (M-DISCERN), Journal of the American Medical Association (JAMAS) benchmark criteria, and the Global Quality Score (GQS). Evaluation of video popularity was also assessed with the video power index (VPI). Results Of 356 retrieved videos, 75 (21%) were considered eligible. The educational quality of videos was highly variable, and the mean global scores for the M-DISCERN, JAMAS, and GQS for our sample were consistent with medium to low quality. Conclusions A limited number of videos on YouTube for microsurgical education have high-educational quality. The majority scored low on the utilized criteria. Peer-reviewed resources seem to be a more reliable resource. Although the potential of YouTube should not be disregarded, videos should be carefully appraised before being usedas an educational resource.

• Medical Lasers
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• 제10권1호
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• pp.22-30
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• 2021

Background and Objectives Ocular alkali burns cause severe damage to the ocular tissues and vision loss. Solcoseryl is a standardized calf blood extract that normalizes the metabolic disturbance and aids in maintaining the chemical and hormonal balance and has been used to treat burns in various tissues. This study examined the effects of Solcoseryl on a rat corneal alkali burn model. Materials and Methods Twenty rats were assigned randomly to four equal groups, including alkali burn, hyaluronic acid, Solcoseryl eyedrop, and Solcoseryl gel. A corneal alkali burn was induced by a NaOH-soaked paper disc. The treatments were given twice a day, every day. The wound area was measured after 24 and 48 hours, and the degree of neovascularization and corneal opacity were scored every week. The rats were sacrificed after three weeks for immunohistochemistry (IHC) to compare the level of inflammatory cytokines, IL-1β, IL-6, and TNF-α. The thickness of the retinal layers was compared to observe any changes in the retina. Results The use of Solcoseryl on corneal alkali burn accelerated wound healing with less neovascularization, greater opacity, and less cataract. IHC showed that the inflammation of the cornea was controlled by both the hyaluronic acid and Solcoseryl treatments. On the other hand, the inflammation had spread to the retina. When the dosage forms were compared, eyedrops were more effective on corneal inflammation, while the gel-type had a greater effect on retinal inflammation. Conclusion Solcoseryl was effective in accelerating the wound healing rate on a corneal alkali burn but could not prevent the spread of inflammation from the cornea to the retina. Eyedrops were more effective on inflammation in the cornea, and the gel was more effective in the retina.

• 가정간호학회지
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• 제30권2호
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• pp.194-201
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• 2023

Purpose: Post-burn pruritus is one of the most prevalent complications experienced by burn patients. Though medications are prescribed for pruritus, managing this condition can prove challenging. The aim of this research was to develop and disseminate non-pharmacological self-management educational resources, and subsequently evaluate the effectiveness of implementing a percussion therapy approach. Methods: A one-group pretest-posttest design was employed to evaluate the effect of percussion therapy on one hundred patients, all of whom had suffered deep second-degree burns and undergone skin graft surgery. Variables such as the severity of pruritus, distress caused by pruritus, and satisfaction with pruritus treatment were scrutinized. A paired t-test was conducted to compare these variables before and after the intervention. Results: The majority of participants were diagnosed with third-degree burns, and the average Total Body Surface Area (TBSA) affected was 25.2%. Post-test results revealed a marked reduction in both severity and distress caused by pruritus. The intervention led to significant decreases in average severity and pain due to itchiness, and an increase in the satisfaction level following the application of percussion therapy. Conclusions: The implementation of the percussion was identified as effective in diminishing post-burn pruritus, alleviating pruritus-associated pain, and enhancing satisfaction with pruritus treatment. The percussion approach presents itself as a non-invasive, non-pharmacological strategy for managing pruritus in burn patients.