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Clinical Consideration of Contact Burn Caused by Hair Straightener.

Jae Un LEE ; Soo A LIM ; Jin Kyung SONG ; Hong Sil JOO

Journal of Korean Burn Society.2015;18(2):93-96.

PURPOSE: Hair straightener is a common tool among various household electric appliances used for hair styling. Hair straightener has plate consists of metal or ceramic, which lead to possible burn if contacted. Main users of hair straightener are young women whereas main victims of hair straightener caused-burn are infants. Among patients visiting our burn medical center, the case of attending hospital due to contact burn by hair straightener tends to increase. METHODS: Retrospective research was conducted 72 patients with contact burn by hair straightener among patients admitted to our burn medical center from Jan 2012 to Dec 2014. Subjects were classified by age, gender, affected site and degree and treatment method. RESULTS: 72 subjects consisted of 39 infants, 9 children, adolescence and 24 adults. Affected sites were presented as hands in 31, face in 21, foot in 13, arms in 5 and legs in 2 subjects. Degree of burn was presented as deep second degrees in 67 and third degrees in 5 subjects; 70 subjects were cured through conservative treatment whereas 2 subjects had local flap. CONCLUSION: Contact burn by hair straightener can be ranged from partial to full thickness skin defect. It is important to note this kind of burn develops more frequently in infants and is preventative. Education for young women who use hair straightener is crucial. Training regarding function and design improvement of hair straightener is also essential. Uncovering the heated plate after use through a separate lock device might be great help for prevention of contact burn if developed.
Adolescent ; Adult ; Arm ; Burns* ; Ceramics ; Child ; Education ; Family Characteristics ; Female ; Foot ; Hair* ; Hand ; Hot Temperature ; Humans ; Infant ; Leg ; Retrospective Studies ; Skin

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Coverage of Skin Defect in Deep Second Degree Burn by Using Skin Graft After Advancement Flap.

Gun Hyung AHN ; Soo A LIM ; Jin Kyung SONG ; Hong Sil JOO

Journal of Korean Burn Society.2015;18(2):88-92.

PURPOSE: Skin graft is useful treatment in burn wound. The major disadvantage of traditional skin graft is related to recipient site scarring and donor site morbidity. Then we present our successful experience of using skin graft after advancement flap. METHODS: The study is based on 22 patients who has deep 2nd burn wound with eschar and 3rd degree burn wound. We performed split-thickness skin graft in 17 patients, and fullthickness skin graft in 5 patients. After undermining of wound margin about 1.3 cm~4 cm, we performed suture of wound marginal skin and subcutaneous tissue with absorbable suture materials. Then we harvested skin according to reduced wound size, and we applied donor skin in recipient area. RESULTS: The skin graft area of the 17 patients who had split skin-thickness graft showed a decline of 25% compared with that of the initial burn wound. 5 patents who had full-thickness skin graft also showed a decrease of 10% in the skin graft area compared with that of the initial burn wound. All Grafts were well taken in 22 patients without skin loss. By observing the progress 12 to 15 months after the operation, minor hypertrophic scar on the boundary of grafted skin area was observed in the 2 patents and hypertrophic scar or contracture was not seen in all 22 patients. CONCLUSION: Skin graft after advancement flap can be used as a treatment in deep 2nd degree and 3rd degree burn wound. Compared with traditional skin graft, the result seems to be good cosmetically and functionally.
Burns* ; Cicatrix ; Cicatrix, Hypertrophic ; Contracture ; Humans ; Skin* ; Subcutaneous Tissue ; Sutures ; Tissue Donors ; Transplants* ; Wounds and Injuries

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Reconstruction of Postburn Sideburn and Frontal Hairline Alopecia by Various Tailored Scalp Flaps Transfer.

Dong Chul KIM ; Ji Hyun KIM ; Ryun LEE ; Hee Young LEE

Journal of Korean Burn Society.2015;18(2):81-87.

PURPOSE: Reconstruction of sideburn and frontal hairline alopecia after burn injuries is one of the challenging tasks in reconstructive surgery. We report on the successful experiences to reconstruct the sideburn and frontal hairline alopecia with various scalp flaps such as Beak scalp flap, scalp rotation flap, scalp transposition flap and scalp expansion operation. METHODS: We experienced the patients who had postburn scalp alopecia after severe facial burn injuries. Among them we selected 8 patients of postburn sideburn and frontal hairline loss and reconstructed with variable scalp flaps. The types of scalp flaps for reconstruction were the Beak scalp flap which is made of the extended postauricular scalp flap combined with the central scalp rotation flap, scalp rotational flap, scalp transposition flap, and scalp expansion operations. We studied the indication of the transferred various scalp flaps for each case considering the size and shape of hair loss lesion, complications, problems of donor site, appearance of reconstructed frontal hairline and sideburns through follow survey. The follow-up periods were 3 months to 2 years. RESULTS: We experienced 8 patients of postburn sideburn and frontal hairline alopecia. Patients' age ranged from 13 to 16 years. male to female ratio was 2:6. Reconstruction methods were 1 case of Beak scalp flap, 1 case of scalp rotation flap, 1 case of scalp transposition flap and 5 cases of scalp expansions. All transferred scalp flaps were completely survived. As complications, 1 case hematoma, 1 case partial edge extrusion of expander, 1 case of persistent headache in scalp expansion operation were noted. There were no remarkable problems in scalp donor site. After 3 months to 2 years follow up, satisfactory results were obtained in all patients. Illustrated Case: The 31-years-old female patient had loss of right frontal hairline, sideburn caused by flame burn. With aid of 3D computerized graphic design, the extended posterior auricular scalp flap with the central frontal scalp rotation flap, which is called as the Beak scalp flap, is a newly designed scalp flap for correction of her frontal hairline and sideburn alopecia. The size of the central frontal scalp rotation flap was 12x11 cm, and the size of the extended postauricular scalp flap was 7x1.5 cm. This flap is elevated simultaneously and could cover the sideburn and frontal hairline alopecia in a single procedure. At postoperatively, the transferred the Beak scalp flap was survived completely. The 9 months follow-up after operation, well reconstructed her right sideburn and frontal hairline was shown. CONCLUSION: For reconstruction of postburn sideburn and frontal hairline alopecia, the scalp flaps transfer should be precisely design in accordance with size, location of hair loss, direction of hair, and also it is emphasized to minimize postoperative scalp donor scars. We had successful reconstruction of postburn sideburn and frontal hairline alopecia by the Beak scalp flap, as a newly designed the composite scalp flap, which is made of the extended postauricular scalp flap combined with the central frontal scalp rotation flap, this flap can be used for reconstruction of loss of sideburn and frontal hairline in a single stage procedure. And also we have used scalp rotation flap, scalp transposition flap, and scalp expansion operations for this purpose. We present these method's reliability and validity.
Alopecia* ; Animals ; Beak ; Burns ; Cicatrix ; Female ; Follow-Up Studies ; Hair ; Headache ; Hematoma ; Humans ; Male ; Reproducibility of Results ; Scalp* ; Tissue Donors

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The Mechanism of Low Temperature Burn and Clinical Cases.

Seungsoo KIM ; Wansuk YANG ; Jeonghyun SIM ; Daewoo SUH ; Seunghyun BAIK ; Bongsoo BAIK

Journal of Korean Burn Society.2015;18(2):74-80.

PURPOSE: This study was designed to better understand the mechanism of low temperature burn and to show clinical cases of low temperature burn. METHODS: The local temperature increase of electric pad was investigated at 4 different surface cooling conditions. Blocks (5x5x2 cm3) made of silicone rubber, aluminum, or urethane foam were placed on the top of the electric pad, and temperature between the blocks and electric pad was measured up to 7 hours after switching on maximally (level 7). Each block has different thermal conductivity (TC) and TC of silicone rubber (0.2 W/m.degrees C) is similar to TC of human skin (0.37 W/m.degrees C). TC of aluminum is higher and TC of urethane foam is lower than TC of human skin. Experiments were performed on two occasions with or without a blanket covering over the electric pad and blocks. RESULTS: The initial surface temperature (18degrees C) of the electric pad under the silicone rubber block was elevated to 36.5degrees C at 1 hour, 41.8degrees C at 3 hours, 44.2degrees C at 5 hours, and 45.5degrees C at 7 hours. After covering the electric pad and blocks with a blanket, the temperature of the electric pad under the silicone rubber block was elevated to 40.9degrees C at 1 hour, 51.8degrees C at 3 hours, 56.1degrees C at 5 hours and 58.1degrees C at 7 hours. Under the same conditions, surface temperatures under the urethane foam and aluminum blocks were 70.8degrees C and 50.degrees C respectively at 7 hours. CONCLUSION: The local temperature increase of electric pad was dependent on the surface cooling conditions, heating time and blanket covering over the electric pad. The surface temperature increased to 56.1degrees C at 5 hours after blanket covering over the silicone block which temperature can cause severe injuries on the human skin within a minute.
Aluminum ; Beds ; Burns* ; Heating ; Hot Temperature ; Humans ; Silicon ; Silicone Elastomers ; Silicones ; Skin ; Thermal Conductivity ; Urethane

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Modified Y-V Flaps for Treatment of Postburn Scar Contractures and Scar Reduction in Extremity.

Hee Young LEE ; Dong Chul KIM ; Ryun LEE ; Ji Hyun KIM ; Tae Yeon KIM ; Kwan Chul TARK

Journal of Korean Burn Society.2015;18(2):69-73.

PURPOSE: Reconstruction of postburn scar contractures is one of difficult tasks in burn plastic surgery. A linear scar contracture is usually repaired by using skin grafts, traditional or modified Z-plasty. However, the scar itself remains even if the contracture is released. Therefore, it should be suggested to reduce scars at the time of release of scar contractures. For this purpose, we have designed the Y-V flap method. This paper is presents our clinical experiences for reconstruction of postburn linear scar contractures and scar reduction by newly designed the Y-V flap. METHODS: We had 3 cases of postburn scar contractures with depressed deformities in extremities, buttock using the newly designed the Y-V flaps. The Y-V flap is made by the V shaped flap at a right angle to the scar band and it is advanced to Y incision site of opposite edge of the scar band, and this flap can correct the linear contracted scar band with moderate scar reductiontion. RESULTS: 2 cases of the postburn scar contractures were treated using the Y-V flaps. 1 case of scar contractures of extremities was reconstructed using Y-V flap and multiple Z-plasties. After postoperative follow up, relatively satisfactory results were obtained in all cases. CONCLUSION: We have had successful reconstruction of postburn scar contractures with depressed deformities by newly designed Y-V flap. The design of Y-V flap and its reliability have been introduced. The Y-V flap can be used effectively for the correction of linear scar contractures with depressed contour deformities and scar reduction.
Burns ; Buttocks ; Cicatrix* ; Congenital Abnormalities ; Contracture* ; Extremities* ; Follow-Up Studies ; Skin ; Surgery, Plastic ; Transplants

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Treatment with Pursestring Suture Technique in Third Degree Burn on Breast: A Case Report.

Bang Suk LEE ; Yong Il YOON ; Soo A LIM

Journal of Korean Burn Society.2013;16(1):67-69.

PURPOSE: Authors present the case of one patients who underwent local flap with pursestring suture technique to reconstruct third degree burn on breast. METHODS: A 66-year-old man visited emergency room with multiple whitish vesicles with serous discharge on face, neck, anterior chest and right arm. We performed dressing with foam and cultured allogenic keratinocyte. 14 days after burn injury, right breast wound was remained with eschar and granulation tissue. The size was 5x10 cm. We performed local flap with pursestring suture technique. The nipple was preserved. RESULTS: Postburn breast reconstruction using local flap with pursestring suture technique had results of small linear scar and minimum nipple-areolar complex deformity. There was no significant difference on both sides of the breast mound. CONCLUSION: Local flap with pursestring suture technique had results of small linear scar and minimum nipple-areolar complex deformity and it could be an effective method for reconstruction of postburn breast.
Arm ; Bandages ; Breast ; Burns ; Cicatrix ; Congenital Abnormalities ; Emergencies ; Female ; Granulation Tissue ; Humans ; Keratinocytes ; Mammaplasty ; Neck ; Nipples ; Suture Techniques ; Sutures ; Thorax

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Debridement of Necrotic Tissues Using Sterilized Peeler.

Myung Soo SHIN ; Jae Kyung KANG ; Jung Kook SONG ; Byung Min YUN

Journal of Korean Burn Society.2013;16(1):64-66.

Debridement of necrotic tissue can be done by mass, dermatome(hand, electrical), laser, or ultrasound. The authors aims to introduced the another way of debridement of necrotic tissue using sterilized peeler.
Debridement

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Comparison of Wound Healing Process between Burn and Skin Defect in a Porcine Model.

Sung Phil CHUNG ; Tae Sik HWANG ; Keun Jeong SONG ; Myung Ha SHIN ; Sung Jun LEE

Journal of Korean Burn Society.2013;16(1):58-63.

PURPOSE: The purpose of this study was to develop porcine full thickness skin wound healing model of thermal burn and skin defect and to compare wound healing process between them. METHODS: Twelve thermal burns and 12 skin defect wounds were created on the back of 3 domestic pigs. A round shaped heated electric iron was contacted for 30 seconds to develop full thickness burn. Appropriate dressings were applied for 30 days after wounding. Full thickness skin biopsies were obtained for histologic analysis by a pathologist. The amount of wound discharge, the surface area of each wound, and wound culture results were compared between skin defect and burn wound. RESULTS: Of 12 burn wound sections, 7 (58%) were identified to full thickness dermal injury. Complete wound reepithelialization was seen between postburn days 21 and 28 in both wounds. The initial wound area was smaller in burn than skin defect (P<0.001, 14.4+/-0.8 cm2 vs 22.8+/-3.4 cm2). The wound area of both burn and skin defect was slightly increased for 9 days after wounding and rapidly decreased after that time. The linear advancement length of wound edge was significantly slower in burn (P=0.009, 1.06+/-0.28 vs 1.48+/-0.42 cm). The amount of wound discharge was greater in skin defect than burn (P=0.002, 35.1+/-8.3 vs 49.5+/-11.2 g). CONCLUSION: We developed a porcine model of both thermal burn and skin defect. Time for complete reepithelialization was similar but the linear advancement length of wound edge was slower in burn than skin defect wound.
Bandages ; Biopsy ; Burns ; Hot Temperature ; Iron ; Models, Animal ; Re-Epithelialization ; Skin ; Sus scrofa ; Wound Healing

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Scalding Burns Affected by Instant Ramen in Children.

Young Ho JANG ; Sang Kyu KIM ; Ho Sung AHN ; Mi Young LEE

Journal of Korean Burn Society.2012;15(2):87-91.

PURPOSE: Ramen is one of the most favorite instant noodles in Korea. Ramen is usually cooked by hot water and it may cause scald burns. The aim of this study was to determine the characteristics of reman-related scald burns (RRSBs) in children. METHODS: From Jan 2007 to Dec 2011, RRSBs in children under 14 years-old were retrospectively evaluated. Age, burn surface area, burn location, ramen source, and seasonal variation were evaluated. RESULTS: During 4 years, 191 children were treated with RRSBs (9.6% of total scalding burns). The average age was 5.6 years and the sex ratio was 1:0.93 for males and females. The mean burn surface area (BSA) was 2.2%. The peak age was 1 year (17.3%) followed by 2 years (12.0%). The packet ramen and cup ramen ratio was 1:0.24. August was the peak month (13.1%) and the most affected skin lesion was lower extremity (45.1%). CONCLUSION: Approximately 5% of scald burn injured children were affected by ramen. Toddlers are the most affected age group. The lower extremity was the most common lesion. Burns from ramen is preventable. Parents and carers should be careful when handle hot water to prevent burns in their children.
Burns ; Caregivers ; Child ; Female ; Humans ; Korea ; Lower Extremity ; Male ; Parents ; Retrospective Studies ; Seasons ; Sex Ratio ; Skin

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A Retrospective Epidemiologic Analysis of Burn Patients at Hanil Hospital.

Dae Seong SONG ; Hyun Chul KIM ; Go Woon WOO

Journal of Korean Burn Society.2009;12(1):21-37.

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

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