A patient with frontal sinus hypertrophy complained about an bossing in eyebrow region, increased width of the upper nasal pyramid, inferior displacement of the eyebrow and deep furrows in his forehead, etc. This case report illustrated a method of correction for frontal sinus hypertrophy. Surgery was performed via the bicoronal incision. After the anterior wall of the frontal sinus was removed, we tried a frontal bone remodeling by dividing it into three pieces, trimmming each piece at the margin and fixed with microplate. Bilateral thick bony portions around the frontal sinus were shaved with a surgical burr. At the same time, a 1cm-forehead lift and frontal muscle partial resection was performed. A satisfactory aesthetic result with a smooth and wide forehead could be obtained by employing this technique.
Eyebrows ; Forehead* ; Frontal Bone* ; Frontal Sinus* ; Humans ; Hypertrophy*

Purpose: Currently, the most recommended method for burn first aid is the cool running water for 20 minutes (CRW20). If CRW20 is not practicable, cooling dressing products with tea tree oil are used as substitutes. In this study, we analyze the effect of various burn first aids, including CRW20, cooling products, on the treatment period. Methods: This study was conducted on patients who suffered burns and visited Hangangsoo Hospital from March 2019 to March 2020. The study conducted in a retrospective method. The duration of treatment was analyzed by dividing the experimental group. Results: The treatment period was shortened when first aid was given (P＜0.001). Cold water, ice, and ice packs resulted in reduced treatment periods (P＜0.001, P=0.004). The treatment period was reduced when cooling dressing products were used in all groups (P=0.041). The implementation of first aid has reduced the duration of burn treatment. This means that cooling helps burn treatment. CRW20 did not show statistically meaningful results. This is the result of a failure to fully control the temperature and time of tap water. In addition, the change in temperature of tap water according to season, the use of water is higher than that of animal testing, and the general lack of information on proper burn first aid may have affected. Conclusion The treatment period was statistically significantly reduced in the group that performed first aid. Among the various first aid methods, cold water and ice reduced the treatment period.

Purpose: Currently, the most recommended method for burn first aid is the cool running water for 20 minutes (CRW20). If CRW20 is not practicable, cooling dressing products with tea tree oil are used as substitutes. In this study, we analyze the effect of various burn first aids, including CRW20, cooling products, on the treatment period. Methods: This study was conducted on patients who suffered burns and visited Hangangsoo Hospital from March 2019 to March 2020. The study conducted in a retrospective method. The duration of treatment was analyzed by dividing the experimental group. Results: The treatment period was shortened when first aid was given (P＜0.001). Cold water, ice, and ice packs resulted in reduced treatment periods (P＜0.001, P=0.004). The treatment period was reduced when cooling dressing products were used in all groups (P=0.041). The implementation of first aid has reduced the duration of burn treatment. This means that cooling helps burn treatment. CRW20 did not show statistically meaningful results. This is the result of a failure to fully control the temperature and time of tap water. In addition, the change in temperature of tap water according to season, the use of water is higher than that of animal testing, and the general lack of information on proper burn first aid may have affected. Conclusion The treatment period was statistically significantly reduced in the group that performed first aid. Among the various first aid methods, cold water and ice reduced the treatment period.

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.
Arm ; Biopsy ; Burns ; Calcium ; Cicatrix ; Female ; Granulation Tissue ; Humans ; Joints ; Leg ; Male ; Prognosis ; Recurrence ; Salts ; Skin ; Torso ; Transplants ; Ulcer

PURPOSE: The soft tissue injuries of the patellar area are difficult problems because of insufficient arterial blood supply and lack of muscle layer. There have been many methods for reconstructing the soft tissue injuries of the patellar area such as primary closure, skin graft, local flap and free tissue transfer. However, each method has some limitations in their application. After the first introduction, the fasciocutaneous flaps are widely used to reconstruct the soft tissue injuries. The saphenous nerve, one of the superficial sensory nerves in the lower leg, is supplied by the saphenous artery and its vascular network. We used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. METHODS: From March 2002 to May 2005, we used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. The flap was elevated with saphenous nerve, saphenous vein and saphenous artery and its vascular network. The flap donor site was reconstructed with primary closure or split-thickness skin graft. RESULTS: Five cases survived completely but 1 case developed partial necrosis of the skin on the upper margin of the flap. However, the necrosis was localized on skin layer, and we reconstructed with debridement and split-thickness skin graft only. After the operation, there was no contracture or gait disturbance in any patient. CONCLUSION: In conclusion, the saphenous fasciocutaneous island flap is safe, comfortable and effective method to reconstruct the soft tissue injuries of the patellar area.
Arteries ; Contracture ; Debridement ; Gait ; Humans ; Knee ; Leg ; Necrosis ; Saphenous Vein ; Skin ; Soft Tissue Injuries ; Tissue Donors ; Transplants

PURPOSE: Since Rheinwald and Green laid the foundation of epidermal cell culture technology in 1975, many clinicians and scientists have attempted to prove the effectiveness of cultured epidermal autologous(CEA) or homogenetic(CEH) grafts in the wound healing process. In contrast to CEA which cultured from a patient's skin on demand, Cultured Epidermal Homograft (CEH) can be readily available to use on cleaned wounds. In this study, we conducted a controlled clinical trial in order to confirm the effectiveness of CEH in treating partial-thickness 2nd degree burn wounds. METHODS: From July 2003 to January 2004 at Hangang Sacred Heart Hospital, we performed a clinical trial in which 35 patients who suffered from 2nd degree burns were enrolled. Wounds were randomly divided into two parts, control and test sites. Test sites were treated with allogeneic keratinocyte sheets (Kaloderm(R), Tegoscience Inc.), a CEH commercialized in Korea. RESULTS: All wounds healed completely without any major complication. The complete healing took 8.3+/- 2.8(mean+/-S.D.) days in the test sites as opposed to 11.7+/-3.3 days in the control sites. CONCLUSION: Based on these results, we concluded that CEH accelerates re-epithelialization of partial thickness burn wounds and CEH can be an safe alternative to skin grafts for 2nd degree burns.
Allografts* ; Burns* ; Cell Culture Techniques ; Heart ; Humans ; Keratinocytes ; Korea ; Re-Epithelialization ; Skin ; Transplants ; Wound Healing ; Wounds and Injuries*

PURPOSE: Pediatric burn still generates social problem leading to physical and mental sequelae for ages. We studied to help make a program for the prevention of pediatric burn. METHODS: We analyzed retrospectically 2759 acute burn patients under the age of 15 years in recent 5years (January 2000 - December 2004). RESULTS: 1553 males and 1226 females were investigated, with a male to female ratio of 1.25:1. The greatest number of burn patients were those with an age of 1-2 years(1435, 52%). Scalding burn was the most common cause of injury, which accounted for 1980 (71.8%) patients, followed by contact burns(286, 10.4%), flame burn(229, 8.3%), steam burn(141, 5.1%). Especially steam burn was the second cause of injury in the age under 1 year, while flame burn was the same in the age over 3 years. During recent 5 years, incidence of contact burn increased over twofold despite the others did not changed substantially. Variation of seasonal incidence is minimal and most of the patients(2545 cases, 92.2%) had burns of < = or 20% TBSA. The median hospital stay was 18.3 days, and the rate of operation was 35.4% with an high rate in electrical burn(70.6%), steam burn(68.8%), contact burn(65%). 27 patients died in this series, which yielded a mortality rate of 1%. CONCLUSION: We expect that these data will be used as a basis for prevention of pediatric burn.
Burns* ; Epidemiology ; Female ; Humans ; Incidence ; Length of Stay ; Male ; Mortality ; Seasons ; Social Problems ; Steam

PURPOSE: A wart is caused by epidermal infection with the human papilloma virus. Although wart naturally disappears in some cases, it require treatment because of pain, aesthetic problem, and the possibility of malignant change. Conventional non-surgical treatment cannot be a fundamental solution for the pain and has such disadvantages as frequent recurrence and difficulties in achieving a satisfactory outcome. A surgical procedure was performed on patients with wart and the procedure had a good outcome. METHODS: We investigated the gender, age, lesion site, mean treatment duration, and presence or absence of recurrence in 21 patients with a wart within the period of January 2007 to July 2011. For local lesions, primary closure, including subcuticular suture after the excision, was performed. If the defect size was too big to do primary closure, we performed rotation flap. For wide multiple lesions, a split thickness skin graft was performed. RESULTS: Among the 21 patients, 12 patients were male and 9 patients were female, and their mean age was 42 years(SD=17.38, range: 11~75 years). The lesion site was the foot in 10 patients, the hand in 8 patients, the face in 2 patients, and the scalp in 1 patient. The mean treatment duration was 13.5 days(SD=4.36, range: 6~15 days) for the primary closure or rotation flap, and 18.5 days(SD=2.12, range: 17~20 days) for the skin graft. 20 patients were cured without recurrence. No recurrence was observed in the patients who underwent primary closure or rotation flap. One of the two patients who underwent a skin graft of their wart that had covered their entire palm had local recurrence in part of her finger tips. CONCLUSION: We performed surgical procedure on recalcitrant wart. As a results, we can treat it with short treatment duration, low recurrence rate and less scarring and get high patient satisfaction.
Cicatrix ; Female ; Fingers ; Foot ; Hand ; Humans ; Male ; Papilloma ; Patient Satisfaction ; Recurrence ; Scalp ; Skin ; Sutures ; Transplants ; Viruses ; Warts

PURPOSE: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. METHODS: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis (Terudermis(R)) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases). RESULTS: The size of flaps varied from 6x12 to 15 x12cm (average, 12x7.8cm). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with Terudermis(R) were aesthetically better than those having skin grafts only. CONCLUSION: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.
Achilles Tendon* ; Ankle ; Cicatrix ; Clubfoot* ; Congenital Abnormalities* ; Contracture ; Dermis ; Equinus Deformity* ; Female ; Foot ; Forearm* ; Gait ; Heel ; Humans ; Incidence ; Leg ; Male ; Skin ; Tissue Donors ; Transplants ; Weight-Bearing

PURPOSE: High tension electrical injuries result in major tissue(eg. bones, tendons, vessels and nerves) destruction. Therefore, the management of mutilating wrist caused by electrical injuries still represents a challenge. There are various approaches to this problem including local and regional flaps as well as pedicled distant flaps and microsurgical free tissue transfer. Although it has not gained wide acceptance, because of the technically demanding dissection of the pedicle, posterior interosseous flap is now well accepted for the reconstruction of hand and wrist in hand surgery. The principal advantages of this flap are minimal donor site morbidity, minimal vascular compromise, one stage operation. This flap also offers the advantages of ideal color match and composition. In this report, we describe our experience with the reverse posterior interosseous island flap for reconstruction of mutilating wrist with main vessel injuries. METHODS: From October, 2004 to June, 2006, we treated 11 patients with soft tissue defects and main vessel injuries on the wrist that were covered with reverse posterior interosseous island flap. RESULTS: These 11 patients were all male. The ages ranged from 27 to 67 years(mean age 41.75) and the follow-up period varied from 4 to 19 months. Complete healing of the reverse posterior interosseous island flaps were observed in 11 patients(12 flaps). The majority of these flaps showed a certain degree of venous congestion, which in a flap was treated with medical leech. 1 flap has partial necrosis owing to sustained venous congestion, requiring secondary skin graft. flap size varied from 3.5x8cm to 10x12cm(mean size 6.4x8.9m). The donor site defect was closed directly in 5 flaps, and by skin graft in 7 flaps. CONCLUSION: We found that the reverse posterior interosseous island flap is reliable and very useful for reconstruction of mutilating wrist and we recommend it as first choice in coverage of soft tissue defects in the wrist with electrical arc injuries.
Follow-Up Studies ; Hand ; Humans ; Hyperemia ; Male ; Necrosis ; Skin ; Surgical Flaps ; Tendons ; Tissue Donors ; Transplants ; Wrist*