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Effect of Wound Healing by Physiotulle® in Donor Site of Split-Thickness Skin Graft.

Woon Hyeok JEONG ; Tae Bin YUN ; Jae Hoon CHOI ; Jun Hyung KIM

Journal of Korean Burn Society.2016;19(1):21-25.

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*

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Effect of an Ibuprofen Releasing Dressing (Biatain Ibu®) on Skin Graft Donor Site Wound Pain.

Tae Bin YUN ; Woon Hyeok JEONG ; Jae Hoon CHOI ; Jun Hyung KIM

Journal of Korean Burn Society.2016;19(1):16-20.

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*

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The Characteristics of Firefighter Burn Injuries in a Burn Center: A Retrospective Epidemiological Study.

Hyeongtae KIM ; Gu Hyun KANG ; Yong Soo JANG ; Wonhee KIM ; Hyun Young CHOI ; Jae Guk KIM ; Minji KIM ; Ki Cheol YOU ; Dohern KIM ; Haejun YIM ; Sung Hwan BANG ; Chang Sub LEE

Journal of Korean Burn Society.2016;19(1):12-15.

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

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Management of Split Thickness Skin Graft Donor Site: Comparison of Different Biologic Dressing Materials (Kaloderm® vs Xe-derma®).

Tae Bin YUN ; Woon Hyeok JEONG ; Jae Hoon CHOI ; Jun Hyung KIM

Journal of Korean Burn Society.2016;19(1):6-11.

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

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Usefulness of Negative Pressure Wound Therapy (NPWT) in Burn Center.

Sung Bak AN ; Young Min KIM ; Jae Chul YOON ; Hyeong Tae YANG ; Hae Jun YIM ; Yong Suk CHO ; Dohern KIM ; Jun HUR ; Wook CHUN

Journal of Korean Burn Society.2016;19(1):1-5.

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

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Effect of Ascorbic Acid at Early Fluid Resuscitation in Severe Burn Injured Patients.

Yong Hoon SON ; Young Ho JANG ; Sang Kyu KIM ; Joon Mo PARK ; Mi Young LEE

Journal of Korean Burn Society.2011;14(1):12-15.

PURPOSE: Ascorbic acid is a potent antioxidant capable of scavenging oxygen free radicals. We investigated the effect of ascorbic acid on initial management of a major burn. METHODS: A total of twenty two patients with extent of burn injury greater than 30% of the body surface area (BSA) were enrolled. Early fluid resuscitation was performed with Parkland formula (<40% BSA) and modified hypertonic formula (> or =40% BSA). In ascorbic acid group, ascorbic acid was continuously infused at a dose of 30 mg/kg/h during first 24 hours of fluid resuscitation. Target urine output was 0.5~1 ml/kg/h. RESULTS: There were no significant differences in age, sex, and BSA among the groups. In the cases of Parkland formula, there was no significant difference in the fluid requirement between control group (4.26+/-1.29 ml/kg/%burn) and ascorbic acid group (3.53+/-0.87 ml/kg/%burn). However, in the cases of modified hypertonic formula, there was significant difference in the fluid requirement between control group (3.31+/-0.95 ml/kg/%burn) and ascorbic acid group (2.34+/-0.35 ml/kg/%burn). CONCLUSION: High-dose ascorbic acid reduces fluid requirement at early fluid resuscitation in severely burned patients managed with modified hypertonic formula.
Ascorbic Acid ; Body Surface Area ; Burns ; Fluid Therapy ; Free Radicals ; Humans ; Oxygen ; Resuscitation

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Epidemiology of Burns in Korea.

Dong Chul KIM ; Dae Seung NA

Journal of Korean Burn Society.2011;14(1):6-11.

PURPOSE: The burns are one of the most devastating trauma. The epidemiological study for the national burn incidence is necessary to establish the national medical plan for providing the proper specialized burn care for these burn victims, burn prevention and burn safety for publics. METHODS: This study is done based on the burn patients data from the Korea National Health Insurance Corporation in 2005~2009 for the review of following issues; the average annual burn incidence, and tendency of burn occurrence in every year, sex distribution of burn patients, the yearly numbers of pediatric burn patients, incidence of specific-age pediatric burn patients, incidence of burns by specific-age group, and prevalent sites of burns. RESULTS: 1) The average annual burn patient is 472,404 in 2005~2009. The average annual incidence of burn patients per 100,000 population is 984. The total annual numbers of burn patient is gradually increasing in tendency. 2) Male and female sex ratio is 57 (mean 270,791 male burn patients per year): 43 (mean 201,613 female burn patients per year). 3) The average pediatric burn patient (1~15 age) is 138,153 and it consists of 29.3% of the average annual burn patients during 2005~2009. 4) The most prevalent age of pediatric burns reveals between 1~2 years old age (23.8%). The incidence of burn patients of 1~3 age occupy 42% of the total pediatric burn patients. 5) The four age group-specific burn incidence are pediatric group (0~15 age) 29.3% (138,153 patients), adolescence-middle age group (16~39 age) 32.1% (151,384 patients), middle-old age group (40~74 age) 36.3% (171,688 patients), super old age group (over 75) 2.3% (11,179 patients). 6) The most prevalent site of burns is hand (29%), and followed by foot (10.7%), lower extremities (10.6%), upper extremities (10.1%), face (7.1%), trunk (6.1%). the combined area etc. (26.2%), respiratory tract (0.2%). CONCLUSION: Based on the data from the Korea National Health Insurance Corporation, the average annual burn incidence is over 472,400 burn patients during 2005~2009 in Korea, and reveals increasing tendency. This epidemiological data could be attribute to providing the specialized burn care to domestic burn victims, and to establish the plans for burn prediction and prevention, burn safety, burn patient transportation, and the measures for mass burn patients.
Burns ; Epidemiologic Studies ; Female ; Foot ; Hand ; Humans ; Incidence ; Korea ; Lower Extremity ; Male ; National Health Programs ; Respiratory System ; Sex Distribution ; Sex Ratio ; Transportation ; Upper Extremity

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Effect of Platelet-rich Plasma on Burn Wounds according to Time of Application: An Experimental Study on Rats.

San Ha LEE ; Tae Hyun CHOI ; Suk Wha KIM

Journal of Korean Burn Society.2011;14(1):1-5.

PURPOSE: One of the main subjects that burn researches are focused on is saving the zone of stasis. Platelet-rich plasma stimulates angiogenesis, promoting vascular in-growth and fibroblast proliferation. In addition, platelet-rich plasma functions as haemostatic agent by forming a fibrin clot. Also application of platelet-rich plasma enhances wound-healing in both soft and hard tissue. In this study, the effect of the platelet-rich plasma on the zone of stasis was evaluated. METHODS: Sixteen F344/N Slc Inbred Rats were used and randomly separated into four groups. Autologous platelet-rich plasma was harvested and applied to each group of burn wound model at different times. RESULTS: After 20 days, burn wounds of each group healed well. However, healing speed was different in each group. The group to which platelet-rich plasma was applied 4 hours after burn injury had healed about 1.38 times faster than control group. CONCLUSION: The results showed that platelet-rich plasma is an effective substance for saving the zone of stasis. It is not only well-known, but also easy to harvest and easy to use. Thus autologous platelet-rich plasma could be a valuable addition to existing burn treatment methods.
Animals ; Burns ; Fibrin ; Fibroblasts ; Platelet-Rich Plasma ; Rats ; Wound Healing

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Skin Graft Fixation with Histoacryl Tissue Adhesive in STSG of Burn Patients.

Young Hwan CHOI ; Cheon Jae YOON ; Duk Ju MOON ; Ha Guen LEE ; Jin Kyung CHO

Journal of Korean Burn Society.2009;12(2):164-166.

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

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Effect of Laughter Therapy on Recovery of Facial Burn Scar.

Kyung Ja KIM ; Woon Ja SON ; Kiun JANG ; Jinhee KIM ; Cheong Hoon SEO ; Jonghyun KIM ; Wook CHUN ; Jun HUR ; Dohern KIM ; Yongsuk CHO ; Haejun YIM ; Byoung Chul LEE

Journal of Korean Burn Society.2009;12(2):159-163.

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

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