PURPOSE: The purpose of this study is to evaluate the effectiveness and validity of the wound dressing using heterogenic type I collagen dressing (Collaheal(R)). METHODS: From January 2010 to April 2010, 46 burn patients with deep second degree or third degree burn wound were treated with Collaheal(R). And we followed up the patients to assess the treatment result with Vancouver scar scale after 6 months. RESULTS: Of the 46 patients, 42 patients had deep second degree burn only and 4 patients had deep second degree burn with third degree burn. It took 18.5 days to re-epithelialize for patients with deep second degree burn and 40.5 days for third degree burn wound. After 6 months, follow-up was performed to assess the wound result. We can observe that 24 patients had mild scar and 5 patients had moderate scar and 2 patients had severe scar. The severity of scar increased as the re-epithelialization period increased. CONCLUSION: It took 18.5 days to re-epithelialize the deep second degree burn wound with collagen dressing. And the long term result was good. Type I collagen dressing can be used for treatment option for the patients with deep second degree burn wound and the patients with small third degree burn wound who cannot be operated.
Bandages ; Burns ; Cicatrix ; Collagen ; Collagen Type I ; Follow-Up Studies ; Humans ; Re-Epithelialization

PURPOSE: This study was designed to compare the quality of life and physical function after group education program in burn rehabilitation program. METHODS: In a prospective clinical trial, group rehabilitation education program was done in 20 burn injury patients. One group pretest-post test design was done. After 2 weeks group education session, we measured stress test, quality of life (Burn specific health scale) and range of motion. Stress status was assessed with objective measurement tools such as heart rate variability. RESULTS: Stress resistance and parameter value was changed significantly (P<0.05). Heart stability increased (P=0.05). Total range of motions were changed significantly (P<0.05). Quality of life evaluation using BSHS does not show significant change (P>0.05). CONCLUSION: Group therapy in burn rehabilitation patients could be an alternative rehabilitation treatment for quality of life. In the future, more studies are yet to come how group education program may affect the burn rehabilitation patients' disability.
Burns ; Exercise Test ; Heart ; Heart Rate ; Humans ; Prospective Studies ; Psychotherapy, Group ; Quality of Life ; Range of Motion, Articular

PURPOSE: The purpose of this research is to evaluate the efficacy and side effect of 5-Fluorouracil (5-FU) and Triamcinolone (TA) as a therapeutic agent in the treatment of burn hypertrophic scars. METHODS: This is a prospective and randomized design. Twenty patients with burn hypertrophic scars of varying size and more than 3 months duration were included in this study. All the patients were given intralesional 5FU and TA in different scars at weekly intervals for 4 weeks. Improvement was assessed by the thickness, melanosis, erythema, pliability, and the side effects experienced were noted at each scar. RESULTS: The thickness score was significantly improved in both TA and 5FU injection, more improvement in 5FU than TA. The melanosis score, erythema score, and pliability score were all reported insignificantly different outcome. The side effects were not encountered in TA group, but melanosis in 40%, slough in 20% were observed in the 5-FU group. CONCLUSION: The efficacy of 5-FU is comparable to TA as a treatment option for burn hypertrophic scar. Its effect on lightening of the lesion was promising with the exception of the incidence of adverse effects of melanosis and slough.
Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Erythema ; Fluorouracil ; Humans ; Incidence ; Melanosis ; Pliability ; Prospective Studies ; Triamcinolone

PURPOSE: The last decade has focused on healing as the major outcome of burn management with little attention paid to other important patient-centered outcomes, such as pain. Traditional standard dressings using silver sulfadiazine cream and vaseline gauze may result in significant pain at dressing change, wound dryness, increase necessity for dressing change, and also traumatizing the skin and wound bed. In this paper we introduce Mepitel(R), a new silicone dressing material showing satisfactory result than previous traditional standard dressings in burn dressing. METHODS: We conducted a prospective, observational study of 15 adult patients with second degree burn. At the arrive, we initially applied Mepitel(R) after bullae aspiration and changed the cover dressing depending on the degree of exudate from burn while still applying Mepitel(R) for 3 days. After dressing change, pain intensity was measured on an 11-point numeric rating scale. RESULTS: Mean time to wound reepithelization was 10.2 days and mean pain scores on a 11-point scale associated with dressing changes was 5.2 while requiring 0.5 intravenous narcotic administrations per dressing change. CONCLUSION: Mepitel(R) is a new grid like silicone coated nylon dressing containing no additional biologic compounds. The advantages of the Mepitel(R) are easy of use, non-adhesion to the wound, very good tolerance, keep moisture of wound and absence of pain during dressing change. This product has been used in our clinics and this paper serves as a report on our experiences with it.
Adult ; Bandages ; Blister ; Burns ; Exudates and Transudates ; Humans ; Nylons ; Petrolatum ; Prospective Studies ; Silicones ; Silver Sulfadiazine ; Skin

PURPOSE: Chronic soft tissue defects resulting from pressure sore, trauma or comorbid disease such as diabetes, osteomyelitis are difficult to treat. Although many advances have been made, consensus on the best treatment to hasten healing of chronic soft tissue defects has not been reached. Recently, it has been found that the wound healing could be accelerated by the action of growth factors. Fibroblast growth factor (FGF) stimulate proliferation and differentiation of neuroectodermal and mesodermal tissues (endothelial cells and fibroblasts), playing a key role in regeneration of granulation tissues. We report the effect of recombinant basic fibroblast growth factor, Fiblast(R) (Kaken Pharmaceutical, Japan) to chronic soft tissue defect. METHODS: From October 2009 to December 2009, 10 patients (7 men and 3 women) with chronic soft tissue defect were treated using bFGF. Average age, sex, treatment period, cause of soft tissue defect, size (volume, cm3) of wound during treatment, investigator global assessment were assessed. The bFGF was sprayed then foam dressing was applied to soft tissue defects. RESULTS: The average treatment period is 18.6 days (6~45days) and the average age is 41.5 (4~73 years old). Among 10 patients, 7 patients were with pressure sore and other 3 were with trauma, postoperative wound, burn. The size of wound was measured by volume (cm3), and it was decreased 49.5% (0~100%) after treatment. The Average investigator global assessment for these subjects was 2.4 on a 0~3 scale. (3; excellent, 2; good, 1; minimal effective, 0; no effective). No complication was seen locally or systemically with bFGF. CONCLUSION: Using of bFGF for chronic soft tissue defect decreased the size of wound while short period. Clinically, wound treatment with bFGF lead to reduction of the surgery area and healing of wound. Additional researches on investigating the different type of wounds, biological effects and underlying mechanisms are needed.
Bandages ; Burns ; Consensus ; Fibroblast Growth Factor 2 ; Fibroblast Growth Factors ; Granulation Tissue ; Humans ; Intercellular Signaling Peptides and Proteins ; Male ; Mesoderm ; Neural Plate ; Osteomyelitis ; Pressure Ulcer ; Regeneration ; Research Personnel ; Wound Healing

PURPOSE: Central venous catheterization is associated with infection. We evaluated the colonization rate in the two different kinds of central venous catheter (CVC) in patients with major burn injuries. METHODS: Eighty four burn patients with over 20% of total body surface were randomly assigned to undergo catheterization with standard CVC (STD group) or antimicrobial Vantex(R) CVC (VTX group). Following catheter removal, the distal tip was aseptically removed and cultured. Burn injured skin was also cultured. RESULTS: There was no significant difference in characteristic of patients and catheterization, and the severity of burn between the two groups. The overall CVC colonization rate was significantly decreased in VTX group (40.0%, 29.9 in 1,000 catheter-days) compared to STD group (64.1%, 43.9 in 1,000 catheter-days) (P=0.031). In case of the distance between the catheterization site and burn injured skin was less than 10 cm, the CVC colonization rate was higher in STD group compared to VTX group (P=0.015). CONCLUSION: Central venous catheterization with antimicrobial Vantex CVC lowered catheter-related colonization in major burn patients. The decrease in colonization rate with Vantex CVC compared with standard catheter is more dramatic when the distance between burn injured skin and CVC placement site is closer.
Burns ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Colon ; Humans ; Skin

PURPOSE: Split-thickness skin grafts (STSG), as a treatment of full thickness burn have played a significant role in re-surfacing to date. The major disadvantage of traditional STSG is related to donor site morbidity, including scar formation and cosmetic changes. SureDerm(TM) is acellular human dermis, which is intended for the repair or replacement of damaged soft tissue. Then, we present our experience of using SureDerm(TM) as a tool for the skin graft of full thickness burns. METHODS: We reviewed the medical records of 20 patients treated in our burn center who received SureDerm(TM) graft with thin STSG in full thickness burns since November 2006 to October 2008. RESULTS: SureDerm(TM) was used with thin STSG (range 0.006~0.008 inches) concurrently. Thickness of SureDerm(TM) was 0.2~0.4 mm and the type of SureDerm(TM) was meshed. The average size of SureDerm(TM) used in the burn patients was 329.6 cm2 (32~1,384). All burn areas grafted SureDerm(TM) were full thickness burns and the locations were upper and lower extremities including joints (8 and 6 cases), trunk (3 cases), ankle (2 cases), and axilla (1 case). Each SureDerm(TM) grafted area had more than 95% take-rate. No complications were observed except 1 case of partially infected STSG. The mean follow up period was 8.7 months (1~17), and the assessment of scars, which had more than six months follow up periods was performed by Modified Vancouver Scar Scale and the results were good. CONCLUSION: SureDerm(TM) can be used as a dermal substitute for the treatment of full thickness burns and the result seems to be good cosmetically and functionally while it solves donor site morbidity followed by autograft.
Animals ; Ankle ; Axilla ; Burn Units ; Burns ; Cicatrix ; Cosmetics ; Dermis ; Follow-Up Studies ; Humans ; Joints ; Lower Extremity ; Medical Records ; Skin ; Tissue Donors ; Transplants

PURPOSE: Recent studies have already demonstrated experimentally that the topical application of epidermal growth factor (EGF) accelerates the healing of partial-thickness wounds. Although previous studies have proved the effect of recombinant human EGF (rhEGF), the clinical use of rhEGF in case of patients have generated some controversy in advantage. In this study, twelve patients had partial thickness wounds because of burn and skin graft donor site were treated with rhEGF and we investigated the clinical effect of rhEGF on partial thickness wounds of patients. METHODS: We evaluated two groups of patients had partial-thickness wounds. One group (n=5) is consisted of the patients have second degree burn wounds, and the other group (n=7) is consisted of the patients have donor site wounds after skin graft. Each wound was divided two area, one area was applied twice daily with rhEGF and the other area was treated without rhEGF. The extent of reepithelized area was recorded by percentage ratio. And the statistical analysis was conducted about the difference of the number of days between two area until total wound was reepithelized. RESULTS: In the group treated with rhEGF, the mean of time to healing was about 9.75 days, whereas, in the group without rhEGF, it was about 11.08 days. In the number of days until total wound was reepithelized, there were statistically significant difference between two groups (P<0.05). CONCLUSION: It was concluded that the topical application of rhEGF accelerated the healing of partial-thickness wound clinically.
Burns ; Epidermal Growth Factor ; Humans ; Imidazoles ; Nitro Compounds ; Skin ; Tissue Donors ; Transplants

PURPOSE: Many burn patients have been suffered from sequelae of burn injury (itching, pain, heating sense, etc.). The treatment of those symptoms was not successful even though they are approached multiply. Some patients depend on folk remedies. We try to find the effectiveness of microneedling procedure (dermastamp(R)) which is used for esthetic purpose. METHODS: 25 patients were included who had been treated with the skin massage therapy from September 2008 to March 2009. They received the dermastamp(R) procedure once a week and surveyed from 2 months after procedure. The survey items were itching, pain, tightness, firmness, shape of scar, joint deformities. We divided the severity of symptoms into digit scale form 0 (no symptoms) to 10 (too severe to sleep) and the severity was estimated by patients. Statistical method was Wilcoxon signed rank test. RESULTS: The patient group consisted of 8 males and 17 females. The mean age was 22.2+/-13.8 years old. The average time that felt the effectiveness was 4.4+/-2.3 times. Statistically significant responses showed in itching, firmness (P<0.05), pain and tightness (P<0.01). Improvement of the shape of scar and joint deformities were not statistically significant. CONCLUSION: Even now, no definite treatment against the sequelae of burn injury. Multimodalities of treatment in sequelae of burn injury are using and dermastamp(R) can be an additional method for sequelae of burn injury.
Burns ; Cicatrix ; Congenital Abnormalities ; Female ; Heating ; Hot Temperature ; Humans ; Joints ; Male ; Massage ; Medicine, Traditional ; Pruritus ; Skin

PURPOSE: Electrical injuries may cause many psychiatric complications such as depression, acute stress disorder, post-traumatic stress disorder (PTSD), etc. The purpose is to search the incidence of psychiatric complications in electrical injury and to compare its associated risk factors with other burn and trauma. METHODS: We reviewed the medical records of 709 electrically injured patients who were admitted to Hanil General Hospital from 2002 to 2007. Psychiatric complications were defined as depression, acute stress disorder and PTSD according to DSM-IV. We sorted the medical records into demographics, hospitalization, electrical voltage, injured type, extent or site of burn and type of amputation. RESULTS: Total incidence of psychiatric complications was 27.5% (Depression; 15.8%, acute stress disorder or PTSD; 17.6%). High voltage injured patients had psychiatric complications 2.38 times higher than low voltage. Incidence of psychiatric complications were 1.83 times in 6~10% of BSA, 2.01 times in 11~20% and 2.41 times in 21~30% higher than in 0~5% of BSA. If the site of burn included face, psychiatric complications occurred 1.96 times more than other sites. Patients with history of minor and major amputation showed 2.39 and 7.70 times incidence of psychiatric complications, respectively. CONCLUSION: The risk factors of psychiatric complications were high voltage electrical injury, facial burn, extent of burn and history of amputation. If the patients have risk factors, earlier psychiatric consultation may help to manage the psychiatric complications of electrical injury.
Amputation ; Burns ; Demography ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Facial Injuries ; Hospitalization ; Hospitals, General ; Humans ; Incidence ; Medical Records ; Risk Factors ; Stress Disorders, Post-Traumatic ; Stress Disorders, Traumatic, Acute