PURPOSE: Split thickness skin graft (STSG) is frequently used for reconstructing wounds. The treatment of split-thickness donor sites demands several factors: maintenance a moist condition, minimization of pain, promotion of re-epithelization and ease of care. We have performed a study to evaluate efficacy of Physiotulle® for donor site management. METHODS: A prospective study was conducted from June 2015 to December 2015 and included 20 patients undergoing surgery for reconstructive purposes with the use of STSG. The grafts harvested with a same manner and the donor sites were managed with one of the two dressing material: Physiotulle® or Bactigras®. We campared post-operative pain scale, bleeding of donor site, period of re-epithelization and donor site infection. RESULTS: All of 20 patients were well healed after application of Physiotulle® or Bactigras® dressing without any complications. Pain level was similar between two groups until 3 days after operation but Physiotulle® (4.1±0.233) showed significant (P<0.01) pain increasing on 7 days after operation compared with Bactigras® (2.9±0.277). The bleeding index score on 7 days after operation of Physiotulle® (2.5±0.167) was higher than Bactigras® (2.0±0.211) but there is no difference. Statistically (**P<0.01), the period of re-eopithelization of Physiotulle® (13.50±0.87) was significantly shorten than Bactigras® (17.25±0.65). CONCLUSION: Physiotulle® is effective in re-epithelization. We recommend applying ointment on donor site when exudate is minimized, about 7 days after operation to prevent aggravation of pain and bleeing of donor site.
Bandages ; Exudates and Transudates ; Hemorrhage ; Humans ; Prospective Studies ; Skin* ; Tissue Donors* ; Transplants* ; Wound Healing* ; Wounds and Injuries*

PURPOSE: The purpose of management of split thickness skin graft (STSG) donor site is to promote healing process and minimize pain and infection. There are many dressing materials for managing donor site. The study aimed to compare the effect on management of donor site between Biatain Ibu® (polyurethane foam with incorporated ibuprofen) and Mepilex® (polyurethane foam coated with silicone). Especially, we focused on manage of donor site pain and treatment satisfaction. METHODS: This prospective study was conducted on 30 patients underwent STSG from January 2015 to June 2015. The grafts harvested with a same manner and the donor sites were managed with Biatain Ibu® or Mepilex®. Donor site pain, treatment satisfaction, days for re-epithelization and complication were compared between the two groups. RESULTS: All of 30 patients were well healed and there was no complications. Pain level of Biatain Ibu® (2.32±0.929) was lower than Mepilex® (4.77±1.224). Treatment satisfaction of Biatain Ibu® (8.40±0.632) was higher than Mepilex® (7.33±0.487). There is no statistically differences (P=0.455) in the days for re-eopithelization between Biatain Ibu® (14.73±0.789) and Mepilex® (14.53±0.639). CONCLUSION: The Biatain Ibu® dressing represents a valuable alternative in the management of STSG donor site by providing an appropriate wound healing, reduction of pain and improving treatment satisfaction.
Bandages* ; Humans ; Ibuprofen* ; Prospective Studies ; Skin* ; Tissue Donors* ; Transplants* ; Wound Healing ; Wounds and Injuries*

PURPOSE: Firefighters are vulnerable to burn injury during firefighting. In extensive fires, conducted heat and radiant heat can cause burn injury even though firefighters are not directly exposed to fire. There has been increasing interest in the health problems of firefighters considerably since Hongje-dong fire of 2001, which claimed the lives of six fireman. However, there have been no studies done on the characteristics of firefighter burn injuries in South Korea. Therefore, we investigated the characteristics of firefighter burn injuries in a burn center. METHODS: A retrospective, single-center research was performed between Jan 2006 to Dec 2015. 24 firefighters came to the burn center. The electronic medical records of patients were reviewed. RESULTS: Flame burns (87.5%) were the major cause of burn in firefighter. All the patients suffered second-degree or third-degree burns. Mean burn size was 6.1±6.7%. 22 of 24 patients were hospitalized and 2 of 22 hospitalized patients admitted to intensive care unit. Mean length of hospitalization was 29.1±23.7 days and mean length of intensive care unit hospitalization was 6.0±1.4 days. The face was the site most commonly burned, representing 25.8% of injuries. The hand/wrist, upper extremity, and neck were the next largest groups, with 19.4, 12.9, 11.3% of the injuries, respectively. CONCLUSION: Firefighter burn injuries occur to predictable anatomic sites with common injury patterns. The burn size was small but, admitted patients need about 30 days of hospitalization.
Burn Units* ; Burns* ; Electronic Health Records ; Epidemiologic Studies* ; Firefighters* ; Fires ; Hospitalization ; Hot Temperature ; Humans ; Intensive Care Units ; Korea ; Neck ; Retrospective Studies* ; Upper Extremity

PURPOSE: With the advances of knowledge in wound healing process and technology in various fields, dressing material of the split thickness skin graft (STSG) donor site was improved. Recently, biologic dressing materials attracted attention and these are used for wound management. The aim of the study was to compare the efficacy of Xe-derma® (porcine acellular dermal matrix) with Kaloderm® (cultured epithelial autografts) for treatment of the donor site. METHODS: From July 2015 to January 2016, 20 patients who had undergone STSG were enrolled. The grafts harvested with a same manner and the donor sites were managed with Xe-derma® or Kaloderm®. We compared days for re-epithelization, number of dressings, ease of application, ease of wound monitoring, pain level and complications. RESULTS: All patients managed by these dressing materials were well healed without any complications. There is no statistically difference (P=0.830) between the days for re-epithelization of Xe-derma® (11.10±0.944) and Kaloderm® (11.00±1.054). Number of dressings of Xe-derma® (1.2±0.421) was lower than Kaloderm® (2.3±0.483). Ease of application of Kaloderm® (7.40±0.516) was easier than Xe-derma® (6.36±0.343). Ease of wound monitoring of Xe-derma® (7.77±0.856) was easier than Kaloderm® (6.25±0.720). Xe-derma® was more painless in 1 day and 3 days after operation than Kaloderm®. CONCLUSION: Advantageous properties of Xe-derma® are improving wound healing, reducing pain by contact to the wound immediately after application and easy of wound monitoring due to its transparency. Therefore, we expected Xe-derma® can be used for management of various wound.
Bandages ; Biological Dressings* ; Humans ; Skin* ; Tissue Donors* ; Transplants* ; Wound Healing ; Wounds and Injuries

PURPOSE: Negative pressure wound therapy (NPWT) is an adjunct therapy using negative pressure to remove fluid from open wounds through a sealed dressing and a specialized tubing that is connected to a collection container. NPWT is suitable for acute and chronic wound condition because it was designed to accelerate granulation formation on deep wound. Therefore, we performed this study to assess the effectiveness of NPWT for various wound condition in burn center. METHODS: We enrolled 17 patients who were treated with NPWT from January 2014 to April 2016. We analyzed the characteristics and outcomes of the patients through retrospectively. RESULTS: Among 17 patients, there were 13 patients for contact burn, 2 patients for electrical injury, 1 patient for diabetic foot ulcer and 1 patient for Flame burn. Most of the contact burn victims were injured by the exposure of relatively low temperature for a long time and some of them were injured under the condition of sensory deterioration including spinal cord injury, diabetes or sedatives. Wound coverage was accomplished by split thickness skin graft (STSG) in 12 patients. Local flap was done in 1 patient. STSG with local flap was done in 3 patients. And there were 1 patient who got a conservative management. The duration of NPWT application was from 8 days to 101 days (average 36.2 days). CONCLUSION: NPWT showed good clinical outcomes under various wound condition. Therefore, we think that it can be a new treatment paradigm for difficult wound management in burn center.
Bandages ; Burn Units* ; Burns* ; Diabetic Foot ; Humans ; Hypnotics and Sedatives ; Negative-Pressure Wound Therapy* ; Retrospective Studies ; Skin ; Spinal Cord Injuries ; Transplants ; Ulcer ; Wound Healing ; Wounds and Injuries

PURPOSE: Burn injuries still produce a significant morbidity and mortality. The collection and analysis of burn epidemiology data would provide insights into new prevention management strategies in terms of nationwide profile. We reviewed and compared the data from other countries. METHODS: This study was carried out to analyze the epidemiology, current etiological factors (circumstances), treatment methods and mortality of 4,321 acute burn patients, excluding electrical burn, who were admitted to Hanil Hospital Burn Center during 12 years (1996~2007). RESULTS: 1) The male to female ratio was 1.3:1. The mean age of admission was 30.0 years. The children below 18 years made up 38.9%, and adult over 60 years 10.2%. 2) The scald was the most common cause making up 53.8% followed by flame (30.8%), contact (9.3%), steam (3.6%) and chemical (2.1%) burn. The mean extent was 9.8%, 19.1%, 3.8%, 7.2%, 8.7% respectively. 3) The etiologies of scald burn were boiled water (32.9%), hot food soup (28.1%), boiling water (13.8%), instant food (10.3%) at home (87.4%). The 13.7% of victims underwent surgery of STSG (12.9%), FTSG (0.6%), local flap (1.2%) and advanced flap (0.1%). 4) The majority of flame burn occurred at home (43.7%) and work place factory (23.5%). Leading causes were inflammables (29.3%), fire (14.0%), explosion of butane can (12.8%), gas range (10.1%) and LPG (8.7%). The 31.4% of victims underwent STSG (26.2%), FTSG (0.8%), local flap (0.2%) and major amputation (0.1%). 5) The major victims (50.6%) of steam were children below 2years by exposing to steam of rice cooker (70.0%) at home. The 28.9% of victims underwent STSG (14.7%), FTSG (16.0%) and local flap (5.1%). 6) The contact burns occurred at various places (home; 56.5%, work place; 16.9%, vehicles; 9.0%, sauna; 4.5%) by various causes (Ondol; 11.9%, hot pack; 11.2%, oriental herb medicine; 6.7%). The 45.8% of victims underwent STSG (36.3%), FTSG (6.7%), local flap (5.2%), advanced flap (2.0%) and minor amputation (1.2%). 7) The chemical burn occurred at various place (home; 39.3%, work place; 49.4%) by acids (43.8%), alkalies (11.2%), vinegar (15.7%) and herb moxa (16.9%). The 28.1% of victims underwent STSG (22.5%), FTSG (9.0%), local flap (7.9%) and minor amputation (6.7%). 8) Children<18 years old were burnt mainly by scald (79.0%) while for adults below 50 years old was flame, over 50 years was scald. Children below 2 years old had higher frequency of steam (9.2%) and contact (7.9%) burn. The contact burn had relatively higher frequency among 7th (17.6%) and over 8th (20.4%), while chemical among 6th (3.9%) decade. 9) Inhalation injury was accompanied in 13.8% of flame burn (4.3% of total). The inhalation injury only was 4.9% of flame (1.5% of total). 10) The overall mortality rate was 1.8%. The mean age of death was 47.3 years old and burn extent was 74.5%TBSA. There was a strong correlation between flame burn (96.2% of total death), TBSA (50~60%; 9.3% vs 70~80%; 65.2%, 80~90%; 71.4%, over 90%; 87.9%) and mortality. The prognosis was poor for those over 70 year old (7.7% vs 30~50 yo; 2.8%, 7 th decade; 3.7%), flame burn (5.6% vs scald; 0.04%) and combined inhalation injury (22.3%). The patients died at mean 17.3 PBD by ARDS (51.3%), sepsis (44.9%), burn shock (20.5%) and ARF (5.1%) 11) The severity and sequelae of scald by prepackaged instant food, steams of rice cooker, flame by used butane can, contact by Ondol, sauna and chemical by vinegar should be added to preventive programs. CONCLUSION: Further study for implications of changes in management protocols and policies on treatment outcomes would improve the provision of appropriate care for the patients.
Acetic Acid ; Adult ; Alkalies ; Amputation ; Burn Units ; Burns ; Burns, Chemical ; Butanes ; Child ; Explosions ; Female ; Fires ; Humans ; Hypogonadism ; Inhalation ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Penicillin G Benzathine ; Prognosis ; Retrospective Studies ; Sepsis ; Shock ; Steam ; Steam Bath ; Water ; Workplace

PURPOSE: To provide epidemiologic data of the burn injuries in stroke patients and to determine the most effective prevention and education methods. METHODS: We retrospectively reviewed the medical records of patients who had been admitted to the burn center at the Hangang Sacred Heart Hospital between January 2002 and June 2008. Burn cause, size, depth, duration of hospital stay, rate of operation performed, outcomes and time from stroke onset to burn were reviewed and compared. RESULTS: We reviewed the charts of total 87 patients (57 men and 30 women with a mean age of 61.95+/-14.48 years). Places of burn were divided into two groups (at home: n=52, outside: n=25) and patients injured at home were more than twice than who were outside. According to etiology of infarction, patients group was divided into ischemic (n=49) and hemorrhagic (n=38) group. Most of the patients were injured from flame burn. The rate of operation for ischemic group was significantly higher than hemorrhagic group. The etiology of infarction and cause of burn were not significant to prognosis. Chronic group (defined as burn occurred 6 months after the onset of stroke) had the higher incidence of burn injuries. But, there was no significant relationship between the time from stroke onset to burn and burn cause, prognosis, rate of operation, total body surface area burned. Non-survivor group had a higher operation rate than survivor group, although there was no difference in total burn surface area. CONCLUSION: Functional recovery of stroke was not associated with burn injury in our study. Flame burn took the highest percentage of burn causes. We believe that studies pooling different center's results are need to improve significance of conclusion drawn from these data.
Body Surface Area ; Burn Units ; Burns ; Female ; Heart ; Humans ; Incidence ; Infarction ; Length of Stay ; Male ; Medical Records ; Prognosis ; Retrospective Studies ; Stroke ; Survivors

The treatment application of cultured epithelial autograft (CEA) is the only selected treatment method when performing skin graft for treating massive burns over 70 to 80%. Clinically 2 types of CEA, sheet type and suspension type, are currently available in Korea. The sheet type of CEA, Holoderm(R), was commonly used since no other CEA were available. Since the recent introduction of the suspension type, Keraheal(R), the suspension type is also clinically used. Although 2 types are different in type of forms provided but both types are clinically effective for increasing survival rate of massive burn patients. The early treatment method of massive burn is selected based on the rage of burns using Warden or Parkland Formula. The escharectomy is performed within 3 to 7 days of burn then cadaver skin allograft is applied immediately. At this time, the full thickness skin biopsy in the size of 2x3 cm is obtained from non burned area such as axilla, inguinal or abdomen. Then the skin biopsy is sent to the labs. The length of culturing time is less than 3 weeks for Holoderm(R) and around 2 weeks for Keraheal(R). Holoderm(R) is provided as a sheet type. It is simply applied over 1:3~1:6 meshed skin autograft and fixed with staplers together with skin autograft. In the other hand, the suspension type of CEA, Keraheal(R), is provided in a glass vial and sprayed over 1:3~1:6 meshed skin autograft using Tissomat(R). The fibrin sealant is sprayed after application of Keraheal(R) as a fixation of suspension CEA sprayed. Extra wound care is necessary even after both types of CEA are successfully taken since CEA applied regions are much more fragile than those regions applied skin autograft only. The treatment methods of applying cadaver skin allograft and culture epithelial autograft (CEA) are the most advanced treatments available for increasing survival rate of massive burn patients. The sheet type and suspension type of CEA show difference in type of forms provided but they both show successful take rate that enhance the burn treatment. We suspect that both types of CEA still need ongoing efforts and researches to enhance their advantages and eliminate disadvantages to increase the efficacy that can promote wound healing process of massive burn patients.
Abdomen ; Axilla ; Biopsy ; Burns ; Cadaver ; Fibrin Tissue Adhesive ; Glass ; Hand ; Humans ; Korea ; Rage ; Skin ; Survival Rate ; Transplantation, Homologous ; Transplants ; Wound Healing

Tissue bank with profer personnels (medical director, tissue bank speciality, and so on), facilities, equipments, standard of procedures (SOP) and quality control (QC) programs should get the permission from Korea Food and Drug Administration (KFDA). All kinds of tissues are donated from live donors, cadavers or brain deaths without any rewards. Permission to acquire tissues shall be obtained through the granting of informed consent by a consenting person in accordance with applicable Korean law and regulations for anatomical gifts. One or two more tissue banks participate in recovery, preservation, quarantine, processing, packaging, storage, and/or distribution. The relationship and responsibilities of each shall be delineated in writing and that documentation shall be maintained at each participating bank or facility. Each tissue bank should keep the safety for all tissues under the strict SOP and QC programs, including donor screening, donor testing and donor exclusion criteria. And also, the final human tissue products should keep in sterile package and transfer to medical facilities for reconstruction of patients' defects under profer temperature within transportation containers. Potential adverse reactions, suspected transmission of disease or complications, directly or indirectly related the allograft, shall be reported to KFDA for the further safety
Brain Death ; Cadaver ; Donor Selection ; Financing, Organized ; Gift Giving ; Humans ; Informed Consent ; Jurisprudence ; Korea ; Product Packaging ; Quality Control ; Quarantine ; Reward ; Social Control, Formal ; Tissue Banks ; Tissue Donors ; Transplantation, Homologous ; Transportation ; United States Food and Drug Administration ; Writing

PURPOSE: Nowadays importance of growth factors in wound healing is being focused. Wound healing can be accelerated by various growth factors. Wound healing cascade consists of inflammatory, proliferative, and remodeling phases. Basic fibroblast growth factor (bFGF) helps proliferation of fibroblast and promotes angiogenesis and formation of granulation tissue through proliferative phase. We investigated the effect of recombinant basic fibroblast growth factor Fiblast(R) (Kaken Pharmaceutical, Japan) on second degree burns. METHODS: 57 patients from July 2009 to September 2009 with second degree burn were treated with bFGF. Average age, sex, cause of burn, depth of burn, location of wound, epithelization period and number of operation were studied. Recombinant bFGF was used with spraying. The bFGT was sprayed and wait for 30 seconds and then foam dressing was applied to wounds. The bFGF administration continued until the wound healed. RESULTS: The average healing time in the bFGF-treated group was 8.4+/-2.2 days (4~14 days). Among 57 patients, 19 patients had superficial second degree burn and the average healing time in the bFGF-treated group was 7.2+/-1.5 days (4~9 days), 30 patients had deep second degree burn and the average healing time in the bFGF-treated group was 11.2+/-1.7 days (9~14 days). 20 patients had deep second degree burn and were clinically considered to get operation during hospital course but eventually 8 of patients (40%) with deep second degree burn treated with bFGF underwent operation. CONCLUSION: The use of bFGF for second-degree burns decreased the wound healing time. Especially the use of bFGF decreased the rate of getting operation in deep second degree burn and increased the convenience of treatment.
Bandages ; Biological Dressings ; Burns ; Fibroblast Growth Factor 2 ; Fibroblasts ; Granulation Tissue ; Humans ; Intercellular Signaling Peptides and Proteins ; Wound Healing