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The Effect of Extracorporeal Shock Wave Therapy on the Scar Pain of Burn Patients: A Case Report.

Journal of Korean Burn Society.2014;17(1):38-42.

PURPOSE: Many burn patients are troubled with pain and paresthesia from healed wounds. Extracorporeal Shock Wave Therapy (ESWT) in various musculoskeletal disease and wounds is reported that it reduces the pain and promotes regenerating of tendon and healing of the wound. Therefore we investigated the effect of ESWT on the scar pain of burn patients. METHODS: On February 2014, three patients admitted to the department of rehabilitation medicine of Hangang Sacred Heart Hospital Burn Center underwent ESWT. One low-energy ESWT (0.05~0.12 mJ/mm2) a week was provided to them for 3 weeks in total. Numerical rating scale (NRS), Nirschl pain phase system, 70-point scoring system, Roles and Maudsley score were evaluated before ESWT, after first and third ESWT. RESULTS: In all three patients, the NRS score was decreased and total scores of Nirschl pain phase system and 70-point scoring system were improved after ESWT compared to before ESWT. Roles and Maudsley scores was poor in all three patients at before ESWT but was acceptable in two patients and good in one patient after third ESWT. CONCLUSION: Extracorporeal shockwave therapy (ESWT) is non-invasive, feasible and effective modality on the scar pain of burn patients.
Burn Units ; Burns* ; Cicatrix* ; Heart ; Humans ; Musculoskeletal Diseases ; Paresthesia ; Rehabilitation ; Shock* ; Tendons ; Wounds and Injuries

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Management of Major Burn Patients with Multiple Rib Fractures: 2 Case Report.

Chang Min SONG ; Hyo Ju CHAE ; Yang Hwan CHOI ; Yun Cheol JANG

Journal of Korean Burn Society.2014;17(1):34-37.

About 5% of burn patients come with other injuries. When patients with multiple rib fractures are put under general anesthesia, there is a higher rate of a variety of complications, such as hemothorax, pneumothorax, lung contusion, and etc. Also, symptoms of the complications are likely to get worse. Therefore, it is important to decide when it is appropriate to perform surgery. Our hospital delayed operation time on two burn patients who had multiple rib fractures and then performed surgery under general anesthesia, treating patients without any particular complications.
Anesthesia, General ; Burns* ; Contusions ; Hemothorax ; Humans ; Lung ; Pneumothorax ; Rib Fractures* ; Thoracic Injuries

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Staged Operation Using Fasciocutaneous Transposition Flap on Reconstruction of Exposed Patella Region in 4th Degree Burn: Case Report.

Jae Un LEE ; Soo A LIM ; Jin Kyung SONG ; Yong Il YOON

Journal of Korean Burn Society.2014;17(1):30-33.

PURPOSE: Soft tissue injuries of the patellar region are difficult problems because of insufficient arterial blood supply and lack of muscle. There have been many methods for reconstructing the soft tissue injuries of the patellar area such as primary closure, skin graft, muscle flap and free tissue transfer. However, each method has some limitations in their application. We used fasciocutaneous transposition flap according to limitations of patient's condition. METHODS: A 67-year-old-man was hospitalized by contact burn with TBSA 15% involving scalp, back, buttock, both legs. We found 20x30 cm2 sized eschar on right knee. We debrided necrotizing patella bone and found insufficient blood supply. In addition, general weakness, low weight (170 cm/42 kg), old age, DM made us to plan 2 staged operation. At first, coverage using medial fascio-cutaneous transposition flap. After 7 days, there were 1/4 necrosis by congestion. we used Vancomycin for systemic antibiotic treatments and betadine irrigation. 2 weeks after, We debrided necrotizing patella bone and coverage using lateral fascio-cutaneous transposition flap. RESULTS: There were no post-operative complications such as infection, hematoma, seroma or flap necrosis. And there was no contracture or contour deformity. CONCLUSION: Due to limitations of patient's condition, we used fasciocutaneous transposition flap instead of musculocutaneous flap or free flap. We gained satisfactory result by using fasciocutaneous flap in patella exposed wound reconstruction.
Burns* ; Buttocks ; Congenital Abnormalities ; Contracture ; Estrogens, Conjugated (USP) ; Free Tissue Flaps ; Hematoma ; Knee ; Leg ; Myocutaneous Flap ; Necrosis ; Patella* ; Povidone-Iodine ; Scalp ; Seroma ; Skin ; Soft Tissue Injuries ; Transplants ; Vancomycin ; Wounds and Injuries

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Effect of Plant Extracts Contained Dressing Material Which Is Rich in Procyanidins for Treatment of Deep Second Degree Burn.

Young Joo LEE ; Jaechul YOON ; Hyeong Tae YANG ; Yong Suk CHO ; Dohern KYM ; Jong Hyun KIM ; Jun HUR ; Wook CHUN ; Haejun YIM

Journal of Korean Burn Society.2014;17(1):25-29.

PURPOSE: This study was planned to evaluate the effect of plant extracts contained dressing material which is rich in procyanidins for treatment of deep second degree burn. METHODS: This study conducted from September 1, 2013 to February 28, 2014. Patients with the deep dermal burn wound which is larger than 200 cm2 were enrolled in this study. The test material was applied total 3 times every 2 days when the wounds were relatively clean, with thin eschar and scab removed and the dermal layer exposed. The test and control sites were treated with hydro-foam equally. The effectiveness was evaluated by comparing the re-epithelialization rates between the test and control sites. Two burn surgeons blindly evaluated for re-epithelialization. Evaluation of adverse reaction was also performed during study period. RESULTS: Total of 40 patients were enrolled. Mean total body surface area burned% was 12.3+/-5.5% and the test material was first applied at mean post burn day # 7.2+/-2.0.The re-epithelialization period was 9.0+/-1.7 days in the test site and 11.1+/-2.0 days in the control site. In the test site, re-epithelialization was 2.1+/-1.0 days faster than in the control site (P<0.0001). There was no significant adverse reaction during study period. CONCLUSION: The plant extracts contained dressing material which is rich in procyanidins accelerates wound healing time and shows the safety.
Bandages* ; Body Surface Area ; Burns* ; Humans ; Plant Extracts* ; Proanthocyanidins* ; Re-Epithelialization ; Wound Healing ; Wounds and Injuries

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Plasma Lactate and Base Deficit: Early Predictors of Morbidity in Burn Patients.

Chul Min HA ; Hyo Yong AHN ; In Soo CHO ; Young Min JUNG ; Soo Yerl CHOI ; Chang Hae PYO

Journal of Korean Burn Society.2014;17(1):20-24.

PURPOSE: Plasma lactate and base deficit has been used as a marker to determine the status of tissue perfusion in trauma and clinically ill patients and also to predict the outcome of these patients. This study was performed to investigate the effect of plasma lactate and base deficit in predicting burn patients outcome. METHODS: A retrospective review was performed on 102 patients from January 2012 to December 2013 who were admitted as severe burn patients to our burn care unit. Plasma lactate and base deficit were measured upon admission to the hospital and SIRS score, hospital day, ABSI and TBSA were collected after admission. RESULTS: 102 patients were enrolled. Initial base deficit, hospital day, burn surface area and ABSI score showed statistical differences between low SIRS group and high SIRS group. The SIRS score, hospital day and ABSI score showed statistical differences between high base deficit group and low base deficit group (P<0.05). But there were no statistical differences in plasma lactate between two groups (P>0.05). CONCLUSION: In this study, initial base deficit but not plasma lactate, was predictor of morbidity following burn injury.
Burns* ; Humans ; Lactic Acid* ; Perfusion ; Plasma* ; Retrospective Studies

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Clinical Significance of Carbon Monoxide Induced Myocardial Injury.

On KIM ; Yong Su LIM ; Jin Sung JO ; Jae Hyuk WOO ; Jae Ho JANG ; Hyuk Jun YANG

Journal of Korean Burn Society.2014;17(1):15-19.

PURPOSE: This study was performed for investigation of epidemiology, clinical characteristics, and serial value of cardiac troponin level of patients who had myocardial injury due to Carbon monoxide poisoning. METHODS: This study reviewed 98 cases of Carbon monoxide poisoning patients who visited Emergency Department from January 1, 2008 to October 31, 2013. We categorized them by two groups, one with elevation of cardiac troponin level and the other with normal level. We had comparison between two groups data using statistical analysis. RESULTS: Among 98 patients of Carbon monoxide poisoning who were admitted to hospital, 10 patients were excluded. 88 patients who were included to our study, 70 patients with normal value of Troponin, and 18 patients with elevated troponin level. Of all patients, Carbon monoxide inhalation due to suicided trial patients has more higher proportion in elevated troponin level group compared with normal group (40 (57.1%) vs 15 (83.3%), P=0.041). Furthermore, corrected QT interval, length of hospital stay, number of ICU admission, also were showed higher value in elevated troponin level group. CONCLUSION: Carbon monoxide induced myocardial injury is associated with subside trial, prolongation of correted QT interval, length of hospital stay, and number of ICU admission.
Carbon Monoxide Poisoning ; Carbon Monoxide* ; Emergency Service, Hospital ; Epidemiology ; Humans ; Inhalation ; Length of Stay ; Reference Values ; Troponin ; Troponin I

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The Effects of Laughter Therapy on Anxiety and Depression of Burn Patients.

Duk Su LIM ; Kyung Ja KIM ; Kyung A NAM ; Cheong Hoon SEO

Journal of Korean Burn Society.2014;17(1):8-14.

PURPOSE: The study was a non-equivalent control group, quasi-experimental study to find out the effect of the laughter therapy on anxiety and depression of burn patients. METHODS: Study subjects were 60 hospitalized patients with the diagnosis of 2nd degree burn (30 experimental group; 30 control group). Experimental group received laughter therapy by the certificated therapist. STAI questionnaire, blood pressure and pulse were checked before and after the laughter therapy. RESULTS: Before and after the laughter implementation, the experimental group's anxiety decreased, however, the comparison group's anxiety did not show significant difference. Moreover, experimental group's anxiety decreased after the implementation. Experimental group's systolic blood pressure and diastolic blood pressure did not decrease pre/post laughter therapy mediator. The comparison group showed that systolic blood pressure increased, and diastolic blood pressure did not show significant difference. Also, experimental group's systolic blood pressure and diastolic pressure did not show significant difference after the treatment. Pre/post laughter therapy mediation did not decrease the experimental group's pulse and comparison group's pulse. Furthermore, the experimental group's pulse did not show the significant difference after the treatment. In pre/post laughter therapy mediation, the experimental group's depression was decreased, however, the comparison did not how significance difference in pre/post depression score after the treatment. Moreover, the experimental group's depression was decreased after the treatment. CONCLUSION: According the results above, the laughter therapy had effect on decreasing anxiety and depression of the burn patients and it is efficient mediator for the burn patient. Repetitive research was needed to investigate the effect of laughter on cardiovascular system since it did not have decreasing effect on the blood pressure and pulse.
Anxiety* ; Blood Pressure ; Burns* ; Cardiovascular System ; Depression* ; Diagnosis ; Humans ; Laughter ; Laughter Therapy* ; Negotiating ; Surveys and Questionnaires

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Reconstruction of MCP Joint or Web Space Region with Adipofascial Turnover Flap in Electric Burn Injuries.

Jae Un LEE ; Soo A LIM ; Jin Kyung SONG ; Yong Il YOON ; Kyung Han YU

Journal of Korean Burn Society.2014;17(1):1-7.

PURPOSE: In many cases, electric burn can affect regional MCP joint or web space of hand, and reconstruction of these area is significant, because it can lead severe functional and aesthetical impairment of hand. Considering many respects like hand anatomy, flap characters, functional and aesthetical results, we applied reverse adipofascial flap and report the effectiveness of this method. METHODS: From June 2010 to January 2014, 21 cases of electric burn at MCP joint or web space area were reconstructed with reverse adipofascial flaps. Within a week after theses injuries, we performed a debridement of the necrotic tissue. After elevation adipofascial flap under the skin, the flap was transferred to defect site and then we performed STSG over the flap. The donor site was closed primarily. RESULTS: Complete flap survival was achieved in 75.5% of total cases. And the partial necrosis was occurred in 7 cases. There were no other complications and satisfaction of patient survey was performed by 'Likert scale, 1~5 points', the average point was 4 that meant significantly good result. CONCLUSION: Like fasciocutaneous flap or free flap, the adipofascial flap can cover soft tissue defect with exposed or injured tendon or bone because it has good vascularity. Also, compared with other flaps, it has suitable for MCP joint or web space area in respect of flap size or bulkiness and it has more aesthetical advantages. In conclusion, adipofacial flap can be considered as appropriate method to reconstruction of electrical injury at regional MCP joint area and web space.
Burns, Electric* ; Debridement ; Free Tissue Flaps ; Hand ; Humans ; Joints* ; Necrosis ; Skin ; Tendons ; Tissue Donors

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Treatment of Deep Second Degree Burn Wound using Heterogenic Type I Collagen Dressing.

Hyeong Tae YANG ; Haejun YIM ; Young Suk CHO ; Dohern KIM ; Jun HUR ; Wook CHUN ; Jong Hyun KIM ; Cheong Hoon SEO ; Boung Chul LEE ; Jang Hyu KOH

Journal of Korean Burn Society.2010;13(2):136-139.

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

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Group Education Program on Quality of Life of Burn Rehabilitation Patients.

Jeong Hyeon MUN ; Gum Jae LEE ; Jong Hyun JEON ; Ji Soo CHOI ; Ju Youn LEE ; Kiun JANG ; Cheong Hoon SEO ; Jonghyun KIM ; Wook CHUN ; Jun HUR ; Dohern KIM ; Yongsuk CHO ; Haejun YIM ; Ihn Geun CHOI ; Byoung Chul LEE

Journal of Korean Burn Society.2010;13(2):129-135.

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

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