PURPOSE: Phototherapy uses the changes caused by the athermal and atraumatic absorption of the photon's energy by the tissue for therapeutic effect. Phototherapy has been proven to be useful in various conditions, for example, in pain attenuation, wound healing and skin rejuvenation. The aim of this research was to evaluate the clinical efficacy of 830 nm LED phototherapy for burn patients. METHODS: We recruited 11 patients who visited this hospital between June and December 2012 with superficial 2nd degree burns to the face for comparative analysis. For phototherapy, we used infrared LED with wavelength of 830 nm. For comparative analysis, we covered one side of the face with sterile aluminum foil and fabric during the treatment. Photographs were taken at the time of each treatment and the time taken for epithelialization and the level of patient satisfaction were also investigated. RESULTS: All 11 patients were male and the mean age was 44.0+/-11.9 years (range of 28~63 years). The cause of the burns was flame burn for 7 patients, and electric sparks in 4 patients. The time taken to achieve epithelialization after the burns was 8.1+/-2.2 days (range 4~12 days) for the side that received phototherapy, while it was 9.1+/-2.9 days (range 4~14 days) for the side that was not treated with phototherapy. In terms of patient satisfaction, 3 patients were 'Very Satisfied', 6 patients were 'Satisfied', 2 patients replied 'Adequate' and none of the patients were 'Unsatisfied'. CONCLUSION: LED phototherapy of 830 nm wavelength can shorten the time taken for burn wound healing. It also was not associated with serious complications except for skin dryness, so it can be a useful treatment method for burns that produces satisfactory outcome for the patients.
Absorption ; Aluminum ; Burns ; Humans ; Infrared Rays ; Lasers, Semiconductor ; Male ; Patient Satisfaction ; Phototherapy ; Rejuvenation ; Skin ; Wound Healing

PURPOSE: Marjolin's ulcer is a rare malignancy that occur in chronic wounds or scars. Marjolin's ulcers tend to infiltrate adjacent tissue more extensively than squamous cell carcinoma that occurs in normal skin, and it is prone to recurrence and metastases, leading to a poor prognosis. Hence, its accurate diagnosis and treatment is very important. The aim of this study was to investigate the diagnostic value and clinical efficacy of preoperative 18F-FDG-PET/CT. METHODS: The study population consisted of 27 patients who were suspected to have Marjolin's ulcer who visited this hospital between January 2009 and June 2012, and who had also received preoperative PET/CT. To confirm the diagnostic efficacy of preoperative PET/CT, the PET/CT findings of the primary lesion and the lymph node, as well as the post-operative histology results were compared to investigate the sensitivity, specificity, false-positive and false-negative rates. RESULTS: The sensitivity and the specificity for the primary lesion of the Marjolin's ulcer in the preoperative PET/CT were 93.3% and 100% respectively. The false-positive rate and the false-negative rate here were 0% and 6.7% respectively. The sensitivity and the specificity for the lymph node metastases of the Marjolin's ulcer in the preoperative PET/CT were 100% and 66.7% respectively. The false-positive rate and the false-negative rate here were 33.3% and 0% respectively. The histological results of Marjolin's ulcer showed that 14 patients had squamous cell carcinoma and 1 had sarcoma. CONCLUSION: Preoperative PET/CT used for the assessment of Marjolin's ulcer and its primary lesion showed a high level of sensitivity and specificity. It was also useful because it allowed the assessment of the primary lesion, lymph node metastases, and distant metastases with a single test. However, the specificity for lymph node metastases was relatively lower, and more research would be needed to improve this.
Carcinoma, Squamous Cell ; Cicatrix ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Prognosis ; Recurrence ; Sensitivity and Specificity ; Skin ; Ulcer

PURPOSE: Burn is one of the oxidative stress generating of oxygen free radicals. It was reported that a vitamin C played an important role in the antioxidant defense mechanism by acting as antioxidants, scavenging oxygen free radicals, collagen synthesis, detoxification of histamine and inhibition of melanin synthesis. Nevertheless there is still no study on the plasma level or the effect of a vitamin C after initial management in major burn patients. Therefore we investigated the need for continuous administration of vitamin C in treatment for the burn patients. METHODS: From March 2013 to May 2013, total 36 patients admitted to the department of rehabilitation medicine of Hangang Sacred Heart Hospital Burn Center were routinely tested for the plasma level of vitamin C as a part of their nutritional screening. We also tested the plasma level of vitamin B6 and B12 with it as the control test. We compared the plasma level of vitamin C with the time between test and burn injury, and with total burn surface area. RESULTS: Of the 36 patients, 34 patients had lower plasma vitamin C level than the normal range. However there were no significant differences depending on the total surface area burned or the time between test and burn injury in their plasma vitamin C level. All patients had normal plasma vitamin B6 and vitamin B12 level. CONCLUSION: It is recommended that the continuous administration of vitamin C should be done after thermal injury.
Antioxidants ; Ascorbic Acid ; Burn Units ; Burns ; Collagen ; Free Radicals ; Heart ; Histamine ; Humans ; Mass Screening ; Melanins ; Oxidative Stress ; Oxygen ; Plasma ; Reference Values ; Vitamin B 12 ; Vitamin B 6 ; Vitamins

PURPOSE: The purpose of this study is examine the effects of clinical art therapy on self-esteem, anxiety, and pain of pediatric burn patients. METHODS: Hospitalized pediatric patients, age from 6 to 15, at H specialized burn hospital located in Seoul were chosen as subjects for this study. Total 11 people were participated. An experimental group received 8 sessions of a clinical art therapy program, twice a week with each 40 minutes long. As for measurement tools, a Rosenberg Self-Esteem Scale (RSES) and a State Anxiety Inventory for Children (SAIC) were used. And a Visual Analog Scale (VAS) was implemented before and after each session. Also, a Drawing a Person test was analyzed along with individual characteristics. RESULTS: 1) The self-esteem score after art-therapy was improved from 28.1+/-3.4 to 32.9+/-3.1 (P<0.001), 2) The Anxiety score after art-therapy was decrease from 34.6+/-3.7 to 26.8+/-2.8 (P<0.001), 3) Overall 8 sessions of each art-therapy, there were significant reduction in the pain scale score (least squares means: 2.5 (2.1~2.8), P<0.001). CONCLUSION: The study demonstrate positive effects of clinical art therapy on self-esteem, anxiety, and pain of pediatric burn patients.
Anxiety ; Art Therapy ; Burns ; Child ; Humans

PURPOSE: Skin graft is the gold standard surgical treatment in burn wound management. Until now, wet to dry dressing is regarded as the traditionally standard dressing for skin graft. But it needs to be changed daily, burdens the patients and medical caring team and is time consuming. The authors apply VAC to skin graft to secure the skin and compared the outcomes with previous standard dressing technique. METHODS: 38 burn patients who underwent skin graft were included in this study. Patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a VAC appliance after split-thickness skin graft, while those in the control group received wet to dry dressing after the procedure. Time to complete epithelization, rates of skin graft taken areas, satisfaction of patients and medical caring team was evaluated. RESULTS: A shorter time to complete epithelization (12.5 days) was observed in the experimental group than in the control group (14.6 days), and a higher rates of skin graft taken areas (89%) was observed in the experimental group when compared with the control group (84.5%), A higher satisfaction of both the patients and doctors was observed in the experimental group, compared to the control group, with all statistical significance (P<0.05). CONCLUSION: VAC shortens epithelization period and elevate skin graft taken rates. It also makes the patients and doctors the comfortable in burn patients. The VAC is an excellent alternative for securing skin graft.
Bandages ; Burns ; Humans ; Negative-Pressure Wound Therapy ; Skin ; Transplants

PURPOSE: Skin graft is the gold standard surgical treatment in burn wound management. But it has functional and aesthetic limitations, such as burn scar contracture, low quality of the grafted skin, unnatural looking skin, loss of skin elasticity, especially in extensive deep burn wound which has tendon or bone exposed. The authors used Matriderm(R), a dermal analogue, with split-thickness skin graft simultaneously in burn wound and evaluate the effectiveness of Matriderm(R) for treatment of burn wounds, in comparison with the skin graft only. METHODS: 40 burn patients with skin graft were included in this study. Patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a meshed Matriderm(R) appliance and a split-thickness skin graft, while those in the control group received only a split-thickness skin graft. Time to complete epithelization, rates of skin graft taken areas, Vancouver scar scale assessment, skin elasticity was evaluated. RESULTS: A better scores of Vancouver scar scale assessment (3 points) were observed in the experimental group with the control group (6 points) with statistical significance (P<0.05). A higher elasticity ratio of the affected side to the non-affected side was observed in the experimental group, compared with the control group (P<0.05), and a similar time to complete epithelization and rates of skin graft taken areas were observed in the experimental group when compared with the control group. CONCLUSION: Meshed Matriderm(R) enables effective healing and improves functional and aesthetic results in split thickness skin graft treatment of burn wounds.
Burns ; Cicatrix ; Contracture ; Elasticity ; Humans ; Skin ; Skin Transplantation ; Tendons ; Transplants

PURPOSE: Patients with work related burns suffer from anxiety, depression, insomnia and suicide ideation etc. Psychiatric symptoms could be reduced by treatment. Almost all patients are referred to psychiatric intervention in our hospital. However, a number of patients show non-adherence. The aim of this study is to figure out the reason of non-adherence and psychiatric symptoms of work related burns patients. METHODS: 123 patients participated in this study. Startle, Physiological arousal, Anger, and Numbness (SPAN), Feeling Suicide, Patient Health Questionnaire-2 (PHQ-2) were administered as screening tool. Questions about psychiatric intervention and reasons to refuse psychiatric intervention were asked. RESULTS: 32% patients were depressed, 34% patients had suicide ideation and 59% had PTSD after work related burns. However, 46% of burn patients had not been treated. Stigma of psychiatric intervention and concerns about dependency were major reasons for non-adherence. CONCLUSION: There are gap between necessity and reality of psychiatric intervention on work related burn patients.
Anger ; Anxiety ; Arousal ; Burns ; Dependency (Psychology) ; Depression ; Humans ; Hypesthesia ; Mass Screening ; Occupational Injuries ; Referral and Consultation ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic ; Suicide

PURPOSE: Marjolin's ulcer is rare but highly aggressive malignant cancer that is associated with chronic, nonhealing wounds such as burn wound. There are no confirmed effective protocols for treatment of this disease. This study was conducted to describe the clinical presentation and treatment modalities of Marjolin's ulcer in our hospital. METHODS: This was a retrospective study of Marjolin's ulcer. 20 cases were histologically confirmed malignant skin cancer seen at Chonbuk National University Hospital from January 2000 to December 2011. Data were retrieved from patients' medical records and photographs. RESULTS: The total 20 cases of Marjolin's ulcer were studied. Squamous cell carcinoma was the most common pathological type in 20 patients (100%). Lymph node metastasis at the time of diagnosis was recorded in 3 patient (15%). Wide excision was the most common surgical procedure performed in 17 patients (85%) of cases. The reconstruction modalities were various as free flap 3 patients (15%), skin graft 13 patients (65%), local advancement flap 2 patients (10%) and regional flap 1 patient (5%). Local recurrence was noted in 3 patients (15%) who had surgical treatment. And one patient (5%) expired in hospital. CONCLUSION: Marjolin's ulcer is an infrequent lesion. Unfortunately the diagnosis and treatment are often delayed. If the wound was histologically confirmed, aggressive excision and reconstruction is warranted in these highly malignant skin cancer. Early recognition and aggressive treatment of Marjolin's ulcers are essential to improve outcomes.
Burns ; Carcinoma, Squamous Cell ; Free Tissue Flaps ; Humans ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Skin ; Skin Neoplasms ; Transplants ; Ulcer

PURPOSE: The pain related to burn is moderate to severe and difficult to control regardless of medications. We evaluated the effect of intravenous patient-controlled analgesia (IV PCA) with weight-compensated regimen of fentanyl and ketorolac in burn surgery. METHODS: consecutive 82 patients received IV PCA after burn surgery. They were divided into two groups according to total body surface area% (TBSA%): group I (TBSA> or =25%, n=21) group II (TBSA<25%, n=61). The IV PCA consisted of fentanyl (20 mcg/kg), ketorlac (3 mg/kg), and ramoserton (8.5 mcg/kg) and was programmed to basal infusion rate 2 ml/hr, bolus rate 0.5 ml, and lockout time 15 min. Pain score and satisfaction were evaluatedduring 4 study periods within 48 hours after end of surgery: 0~6 h, 6~12 h, 12~24 h, and 24~48 h. Added recue drugs were evaluated at each interval. RESULTS: Improvement of pain score during study periods was significant in both groups (P<0.001). However, Group I showed significantly higher VAS score than Group II. Frequency of rescue drug use was significantly higher in Group I than Group II. Improvement of satisfaction score in group II were significant (P<0.001). However, there was no significant difference in satisfaction score between two groups. CONCLUSION: The pain of burn (TBSA> or =25%) was difficult to control by conventional IV PCA, even through weight-compensated regimen. Pain of burn (TBSA> or =25%) should be controlled by increased dose of analgesics and approaches other than conventional medication.
Analgesia, Patient-Controlled ; Analgesics ; Burns ; Fentanyl ; Humans ; Ketorolac ; Passive Cutaneous Anaphylaxis

PURPOSE: As in the case of the deep second-degree burn, proper eschar elimination and early epithelization is essential for spontaneous healing without surgical intervention. Accordingly, we have treated with using early dermabrasion and appling frozen cultured allogenic keratinocyte patients in deep second degree burns an eschar formed. METHODS: From January 2011 to January 2012 at Kepco medical center, we selected 46 patients who were suffered from deep second degree burn formed an eschar were enrolled. Patients were divided into two parts, study and control group. Study group were performed dermabrasion within first 3 days to 10 days of the injury and then applied frozen cultured allogenic keratinocyte. control group were managed moist dressing using hydrocolloid gel, form and alginate materials. We tried to prove its clinical efficacy by researching the period of wound healing, percentage of skin graft, and hospital days under chart review and photograph. RESULTS: In study group, the mean period of wound healing was 15.13+/-4.18 (mean+/-S.D.) days, and that of the hospitalization was 16.65+/-5.31 (mean+/-S.D.) days. For the 3 patients without the epithelization, skin graft was conducted. As for the control group, the mean period of wound healing was 24.22+/-2.79 (mean+/-S.D.) days, and that of the hospitalization was 28.30+/-3.33 (mean+/-S.D). 21 patients were conducted skin grafts. CONCLUSION: Based on these results, we concluded that the treatment in deep second degree burn patients eschar formed using early dermabrasion and frozen cultured allogenic keratinocyte is effective in reducing the duration of period of wound healing, hospital day and rate of skin graft.
Alginates ; Bandages ; Burns ; Colloids ; Dermabrasion ; Glucuronic Acid ; Hexuronic Acids ; Hospitalization ; Humans ; Keratinocytes ; Skin ; Transplants ; Wound Healing