PURPOSE: Authors experienced a case of burn induced by magnetic resonance guided focused ultrasound (MRgFUS) which is performed for treatment of uterine myoma. The patient presented unusual progress from that of usual burns and did not cured by conservative treatment. At last the patient underwent surgical treatment. Authors report this rare case of burn induced by focused ultrasound. METHODS: A 26-year-old woman visited the department of gynecology with a abdominal mass. A 9.0x7.9x8.4 cm sized uterine myoma was found after evaluation. The patient was treated with MRgFUS after hormone therapy. Burn was noted on her lower abdomen immediately after MRgFUS and the patient was send to our department. Authors found 3.7x3.3 cm sized superficial second degree burn on her lower abdomen. The wound was treated with conservative methods but the depth extended to subcutaneous layer. 35 days after burn, debridement and primary repair was performed. RESULTS: The wound was healed clearly without any complication. There was no specific complaints or long-term complications during 6 months of follow-up. CONCLUSION: MRgFUS is known as a safe and reliable method for treatment of soft tissue tumors. Ultrasound is concentrated at inner body and generates high thermal energy. It might induce burn. The burn induced by ultrasound seems to have different progress and traits from usual burn wound. It is hard to make a precise diagnosis with external wound only.
Abdomen ; Adult ; Burns ; Debridement ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Myoma

PURPOSE: Comparing with suture and staple, skin graft fixation with Histoacryl (N-butyl-cyanoacrylate, B.Braun, Germany) has two advantages. Fixation is simple, painless and removal process is unnecessary. There are few reports that compare histoacryl with conventional methods for skin graft fixation in FTSG. However, there are no comparative studies in STSG. The purpose of this study is to show our experience of skin graft fixation with histoacryl in STSG of burn patients. METHODS: This study included those who was burned less than 10% of TBSA and needed STSG. The patients who had underlying disease (DM, hypertension, liver disease, lung disease) were excluded. 29 patients who visited Bestian burn center from January to July 2009 was enrolled in the study. In STSG, skin graft was fixed with histoacryl and authors marked the fixed points with pen. Fixation rate was checked in 7 days after STSG and take rate was checked in 14 days after STSG. RESULTS: The patient group consisted of 7 males and 22 females. The mean extent of burn area was 2.3%. The type of injury consisted of 18 contact, 8 scald, 1 flame, 2 friction. 31 STSG of 29 patients was done. STSG was done at 24th day after burn, the mean area of wound for STSG was 51 cm2. Mean numbers of fixation point with histoacryl per patients were 14.1. 430 of 436 fixation were stable and fixation rate was 98.6%. There was no infection case. Take rate was 99.1% in 14 days after STSG and it took 21 days for wound opening. CONCLUSION: Until now, suture and staple are common methods in skin graft fixation. However, it is disadvantageous that suture and staples should be removed. Histoacryl does not need those process. This study showed that take rate was 99.1% and fixation rate was 98.6% in fixation with histoacryl. In STSG, Skin graft fixation with histoacryl could be alternative methods for suture and staple.
Burn Units ; Burns ; Enbucrilate ; Female ; Friction ; Humans ; Hypertension ; Liver Diseases ; Lung ; Male ; Skin ; Sutures ; Tissue Adhesives ; Transplants

PURPOSE: To compare the scar formation after laughter therapy in facial burn scar and to make facial burn rehabilitation program. METHODS: In a prospective clinical trial, laughter therapy was done in 12 facial burn injury patients. One group pretest-posttest design was done. After 8 weeks group laughter therapy session, we measured scar condition. Facial burn scar were checked. Scars were assessed with objective measurement tools such as pigmentation, erythema, pliability, transepidermal water loss, thickness and perfusion. RESULTS: Pigmentation value was decreased significantly: 211.6+/-71.9 to 177.8+/-57.1 (p<0.05). Erythema value increased from 432.3+/-62.5 to 451.1+/-49.7 (p>0.05). Transepidermal water loss value changed from 40.7+/-15.9 g/h/m2 to 37.8+/-15.4 g/h/m2 (p>0.05). Microcirculation value was decreased significantly (0.80+/-0.05 volt to 0.43+/-0.19 volt)(p<0.05). Skin elasticity level (R0) was significantly increased (p<0.05). CONCLUSION: Laughter therapy in burn patients could be an alternative treatment to control burn scar contracture. In the future, more studies are needed how laughter therapy may affect the skin condition of the burn injuries.
Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Contracture ; Elasticity ; Erythema ; Humans ; Laughter ; Laughter Therapy ; Microcirculation ; Pigmentation ; Pliability ; Prospective Studies ; Skin

PURPOSE: Arteriovenous fistula (AV fistula) and immune suppressive drug have a different effect on wound healing. AV fistula supposed to have a positive role of wound healing by the increased blood flow around the wound. But immunosuppressive drug has a well known effect of delayed wound healing. METHODS: We experienced 55 years old female patient who suffered from 9% burn of TBSA, 2nd to 3rd degree burn of arm and chest wall with arteriovenous fistula in the burned arm. She also take immunosuppressive drugs for 13 years due to kidney transplantation. RESULTS: She takes two consecutive skin graft operations on post admission day 14 and 42. Bleeding from the surface of eschar excised arm was profuse so it makes us unable to finish in the first operation. But graft skins were well taken except partial take-off in chest wall area. Episode of shock make 2nd skin graft postponed for a month but the skin uptake of arm was very successful. CONCLUSION: The arteriovenous fistula has the positive effect in the case of burn wound healing including the skin graft, exceed the negative role of immunosuppressive drugs in the wound healing.
Arm ; Arteriovenous Fistula ; Burns ; Female ; Fistula ; Hemorrhage ; Humans ; Hydrogels ; Kidney ; Shock ; Skin ; Thoracic Wall ; Transplants ; Wound Healing

A 73-year-old woman who has been suffering from ulcer pain on left lower leg of burn scars visited our clinic for prosthesis rehabilitation. Symptom has been developed since 12 months ago. She burned herself with oil at the age of 40. Biopsy on the skin lesion revealed squamous cell carcinoma. Marjolin's ulcer is a rare but highly aggressive squamous cell cancer that is most often associated with chronic burn wounds. Patient had undergone multiple prior split-thickness skin grafts for recurrent squamous cell carcinoma. She had undergone a trans-tibial amputation and subsequently given adjuvant chemotherapy for recurrent disease. After amputee training the patient was able to walk by herself and could perform all activities of daily living independently. Cancer induced amputees need prostheses with intensive rehabilitation training program for ambulation to prevent deterioration of physical function and mental health due to immobilization. However, she developed another recurrence and decided not to undergo further surgery and eventually died in hospice care due to progressive metastatic disease.
Activities of Daily Living ; Aged ; Amputation ; Amputees ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Chemotherapy, Adjuvant ; Cicatrix ; Female ; Hospice Care ; Humans ; Immobilization ; Leg ; Mental Health ; Neoplasms, Squamous Cell ; Prostheses and Implants ; Recurrence ; Skin ; Stress, Psychological ; Transplants ; Ulcer ; Walking

PURPOSE: Effective management of pediatric hand burn is a considerable challenge for clinicians. Traditional dressings may result in significant pain, wound dryness, weak adhesive strength, and increase necessity for dressing change. Versiva(R)XC is combined dressing materials of hydrocolloid, hydrofiber, a polyurethane foam. Authors have used Versiva(R)XC in treatment of pediatric hand burns, and we experienced that maintenance of dressing is comfortable and decrease patient's discomfort. METHODS: Study enrolled 9 patients of mean age 3.6 years with second degree pediatric hand burn, Versiva(R)XC dressing initially applied after bullae aspiration and saline gauze dressing. After admission, we daily changed the dressing in first two or three days and had an interval of two or three days depending on the degree of exudate from the wound. RESULTS: The mean day of application was 6.3 days. None of patients required surgery and healed with no other complication of scar contracture and hypertrophic scar formation. CONCLUSION: The dressing with Versiva(R)XC was effective method because of decreased pain, easy dressing change, more comfort, and decreased hospital day.
Adhesives ; Bandages ; Blister ; Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Colloids ; Contracture ; Exudates and Transudates ; Hand ; Humans ; Polyurethanes

PURPOSE: The face is very important body area. So, for burns on the face, early wound healing is important of all. Since B.C.1500, Greeks started using phototherapy for wound healing. Although phototherapy has been studied a long time, the mechanism and result of researches have not been clearly defined. So, the authors will evaluate the effectiveness of the phototherapy, spectrum of 633 nm and 830 nm, and the effectiveness in second degree facial burn. METHODS: We studied 30 burn patients with second degree burn wounds with symptoms of edema, discharge, and redness whom admitted from August 2006 to May 2008. Wound healing of phototherapy was compared to that with hydro-gel dressing. We evaluated each groups by the time it took for wound to epithelize, swelling disappearance, the amount of exudates, hospital days. Satisfaction question surveyed by patients ranging from 0 to 5 scales with 0 being the lowest and 5 being the highest. RESULTS: The duration of epithelization was 10+/-2.3 days in cases with phototherapy. Setting the factor's point becoming 1, the duration of cases with hydro-gel dressings was redness 5+/-2.2 days, discharge 6+/-1.8 days, and the average admission days were 11+/-1.6 days. The group with phototherapy was evaluated superior to the control group in satisfaction index by 30%. CONCLUSION: Simple hydro-gel dressing on facial burn is a routine job. Considering the fact that face is the most prominent sight-catching point, we should try to heal the wound as soon as possible. Phototherapy is the choice that we can use to shorten the duration of redness, the time it takes to epithelize and increase satisfaction index. So if possible, when got a burn on face, authors recommend the phototherapy.
Bandages ; Burns ; Edema ; Exudates and Transudates ; Humans ; Phototherapy ; Weights and Measures ; Wound Healing

PURPOSE: The skin hyperpigmentation or hypermelanosis caused by burns results in social withdrawal due to cosmetic problem and depression as a psychiatric aspect. The treatment of the skin hyperpigmentation includes sunscreen, whitening material, skin massage, laser therapy and plastic surgery. Placenta extract can be used to reduce and inactivate the synthesis of the important enzyme (tyrosinase) that compose melanin. This study was performed to estimate the effect of intradermal injection of placenta extract (placenta hydrolysate) for the postburn hyperpigmentation. METHODS: Total 10 subjects who have postburn hyperpigmentation were selected. Two sites of skin area from each subject were randomly selected as possible as symmetrical body area, the one site was to be 'treated site' with placenta extract, the other site was untreated 'control site'. The injection was performed weekly for about 4 weeks only to the 'treated site', not to the control site. The both site were measured by pigment index using Mexameter. The index was also converted to the percentage that indicate a change of after-injection to before-injection. RESULTS: The pigment index of 'treated site' was 399.5+/-63.9 before treatment, and then it had decreased to 333.6+/-59.5 after 4 weeks of injection. The change after injection compared to before injection was significant statistically (p< 0.05). In the control sites which did not have placenta injection, the pigment index had changed from 284.5+/-67.8 to 290.7+/-52.3. But it was not significant statistically (p>0.05). CONCLUSION: As a result, in the posttburn hyperpigmentation scar, the intradermal injection of placenta extract may be helpful in the management of hyperpigmentation or rehabilitation process of the hypertrophic scar.
Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Cosmetics ; Depression ; Hyperpigmentation ; Injections, Intradermal ; Laser Therapy ; Massage ; Melanins ; Placenta ; Skin ; Surgery, Plastic

PURPOSE: As the mode of living has been changed, the chemical burn patients are increasing. In chemical injuries, tissue destruction continues until chemical agent is neutralized. METHODS: We reviewed medical records of 30 chemical burn patients who were admitted to Hanil General Hospital from January 2000 to September 2009. The charts were reviewed for sex, age, chemical agent, mode, site, treatments, kinds of operation and complications. All patients received massive saline irrigation as the first management. RESULTS: The ratio of male to female was 2.75:1. The prevalent age group was between 41 and 50 years old. The most common chemical agent was acetic acid which was used for treatment of skin disease. The incidence of work-related burns was 66%. The most common prevalent site was hand. The extent of burn below 5% of total body surface was 90%. The majority of patients were treated with conventional dressing, but some patients were treated by skin graft, amputation and flap. The most common complications were hypertrophic scar and hyperpigmentation. CONCLUSION: Both functional and cosmetic problems can occur in chemical burns. Education and guide are necessary to reduce incidence of chemical burns by carelessness and folk remedies.
Acetic Acid ; Amputation ; Bandages ; Burns ; Burns, Chemical ; Cicatrix, Hypertrophic ; Cosmetics ; Female ; Hand ; Hospitals, General ; Humans ; Incidence ; Male ; Medical Records ; Medicine, Traditional ; Skin ; Skin Diseases ; Transplants

PURPOSE: The management of gluteal wound originated with burn is same as pressure sore. Pressure sores are managed surgically with two therapeutic components. One is a gross and sharp debridement and the other is a flap providing well-vascularized tissue to cover wounds. Central to the flap considerations is the tendency for recurrence mainly due to a poor blood supply, failure of tension-free closure and naive nursing care after operation, when reconstructive surgeons employ numerous surgical techniques in sores repair. The author used the gluteal artery perforator sparing and gluteal fasciocutaneous rotation advancement flap with V-Y closure to manage gluteal wound originated from burn. METHODS: Three cases of gluteal wound were treated with the gluteal artery perforator sparing gluteal fasciocutaneous rotation advancement flap with V-Y closure. The skin incision of conventional gluteal rotation flap is shortened to get a minimized flap size and adapts an advancement flap in a back cut pattern, supported laterally with V-Y closure for a tension-free closure. This superiorly (or inferiorly) based flap is elevated subfascially until one or two large musculocutaneous perforators of the inferior gluteal artery are encountered. The perforator down to its emergent point at the level of the piriformis muscle is dissected intramuscularly by splitting fibers of the gluteus maximus muscle in order to pivot freely. Then, the dead space is obliterated with a portion of the gluteus muscle transposed independently. The skin paddle is rotated to the defect area with the saved perforator(s) and closed the defect area. RESULTS: This technique encompasses the advantages of a perforator sparing flap, a fasciocutaneous rotation flap and an advancement flap with V-Y closure, providing a better vascularity, the flexibility of rerotation in the event of recurrence, preservation of the gluteus maximus muscle for ambulatory function, tension-free mobilization. Compared with other flaps which are previously used to manage pressure sores, one advantage is noted that the minimized operation wound is effective not only to improve the quality of patient's life in terms of position care but also to mitigate the associated wound- healing problems. CONCLUSION: This technique can be chosen primarily for management of various types of gluteal region wound including burn.
Arteries ; Burns ; Buttocks ; Debridement ; Imidazoles ; Muscles ; Nitro Compounds ; Nursing Care ; Pliability ; Pressure Ulcer ; Recurrence ; Skin