inhalation injury, contact injury caused by dichloromethane is not well known. Two patients who had undergone skin grafting to treat chemical burn of the hand caused by dichloromethane exposure were evaluated, and a literature review was done. Two healthy men aged 37 and 40 years visited our hospital with chief complaints of pain on the hands due to dichloromethane exposure. The patients had not worn protective clothing. Multiple bullae were initially noted. On the next day, fluctuation in bullae and purulent discharge were observed, and central eschar change was noted. On the 18th day after the burn, escharectomy and full-thickness skin graft were performed. Therefore, workers who use dichloromethane should wear protective clothing at workplaces. If exposed to the chemical, the worker should be instructed to do a quick wash and visit the hospital.]]>
Burns ; Burns, Chemical ; Hand ; Humans ; Inhalation ; Male ; Methylene Chloride ; Paint ; Protective Clothing ; Skin ; Skin Transplantation ; Transplants

Injuries of the larynx are common in patients with a history of inhalation burns. When anesthesia is performed in such patients, the possibility of tracheal intubation should be thoroughly checked in advance, and preparation should be made in case of possible failure. 73-year-old woman who underwent laser cordotomy due to posterior glottic stenosis due to inhalation burn. Her height and weight were 140 cm and 58.9 kg. We proceeded anesthesia, because preoperative fiberoptic laryngoscopy and otolaryngology consultation showed that tracheal intubation was possible. However, the intubation failed and the manual ventilation was not performed afterwards, so the cricothyroidotomy was performed as an emergency. Anesthesia in patients with posterior glottic stenosis due to inhalation burns requires a great deal of attention and, above all, thorough evaluation in order to confirm the possibility of tracheal intubation. If this is not possible, you should look for alternatives and be prepared, and even if you think it's possible, try anesthesia with thorough preparation for the possible failure.
Aged ; Anesthesia ; Burns, Inhalation ; Constriction, Pathologic ; Cordotomy ; Emergencies ; Female ; Humans ; Inhalation ; Intubation ; Laryngoscopy ; Larynx ; Otolaryngology ; Ventilation

FeCl₂ is often used in stainless steel surface processing, wastewater treatment, or in laboratories. Effects of exposure to FeCl₂ include predominantly systemic side effects that can occur when inhalation or oral intake occurs. However, it is known that skin irritation or burning can be caused by exposure to skin, but there has never been reported a case of deep FeCl₂ burns. We will introduce a case of a patient treated with deep second degree burn due to FeCl₂ exposure. A 27-year-old healthy man came in contact with FeCl₂ on his right wrist. The patient didn't wear any protective clothing, and the clothes were contaminated with FeCl₂ about one hour ago, but the patient was not aware of the danger of exposure. After an hour, the patient felt tingling, so he took off his exposed clothes and washed exposed skin, then came to our hospital. Initially there were mild erosion, erythema, and tingling symptoms. Two days later, eschar began to develop and wound began to deepen. Surgical procedure was not performed and it took 5 weeks for the patient's wound to heal. As a rule, workers using FeCl₂ are required to wear protective clothing. In Korea, companies and laboratories using FeCl₂ are not strictly required the use of protective clothing. Workers handling FeCl₂ should be strictly encouraged to wear protective clothing, if exposed, should be instructed to visit the hospital after a quick washing away.
Adult ; Burns* ; Burns, Chemical ; Clothing ; Erythema ; Humans ; Inhalation ; Korea ; Protective Clothing ; Skin ; Stainless Steel ; Waste Water* ; Wounds and Injuries ; Wrist

Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation ; Consensus ; Humans ; Lung ; Practice Guidelines as Topic ; Smoke Inhalation Injury ; diagnosis ; therapy

Airway edema, stenosis, obstruction and even asphyxia are easy to occur in patients with extensive burn, deep burn of head, face, and neck area, inhalation injuries, etc., which threaten life. Timely tracheotomy and intubation is an important treatment measure, but lack of knowledge and improper handling in some hospitals resulted in airway obstruction. The technique of percutaneous tracheotomy and intubation provides convenience for emergency treatment of critical burns and mass burn. The Burn and Trauma Branch of Chinese Geriatrics Society organized some experts in China to discuss the indications, timing, methods, extubation, and precautions of tracheotomy and intubation for burn patients. The (2018 ) .
Airway Obstruction ; prevention & control ; Burn Units ; Burns ; complications ; therapy ; China ; Consensus ; Humans ; Intubation, Intratracheal ; methods ; Practice Guidelines as Topic ; standards ; Smoke Inhalation Injury ; therapy ; Tracheotomy ; methods

Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation ; Consensus ; Humans ; Lung ; Smoke Inhalation Injury ; diagnosis ; therapy

PURPOSE: The aim of this study was epidemiologic research on morbidity rate changes and causes of sepsis in severe burn patients, as they are highly vulnerable to sepsis which is closely related to mortality rate. METHODS: A retrospective review was conducted on 1,026 patients admitted to Burn Intensive Care Unit (BICU) of Hangang Sacred Heart Hospital from September 2011 to December 2015. Age, sex, burn size, whether the patient has inhalation injury, LOS (length of stay), LOSICU (Length of Stay in the Intensive Care Unit), and route of infection were taken into account. RESULTS: The average age, total body surface area (TBSA), the degree of inhalation injury, abbreviated burn severity index (ABSI), acute physiology and chronic health valuation score (APACHE) II, and LOS were higher in the dead than the survivors, and the differences were statistically significant. Incidence rate of sepsis was also meaningfully higher in the dead group, 64.8%. Patients with sepsis had higher average age, degree of inhalation injury, TBSA, and LOS, showing statistically significant differences as well compared to patients without sepsis. For five years from 2011 to 2015, rates of severe burn patients diagnosed with sepsis were 43.3%, 54.3%, 46.4%, 51.9%, and 43.9% respectively. CONCLUSION: Severe burn patients with higher age, larger burn size, and inhalation injury require more careful monitor as they are likely to be infected with sepsis. In addition, more laboratory parameters for early detection of sepsis need to be developed, so that follow-up studies can be conducted on prognostic factors correlated to sepsis.
Body Surface Area ; Burns* ; Critical Care ; Follow-Up Studies ; Heart ; Humans ; Incidence ; Inhalation ; Intensive Care Units ; Mortality ; Physiology ; Retrospective Studies ; Sepsis* ; Survivors

Laryngeal neoplasm is the second most common malignancy of the upper aerodigestive tract. About 85% to 95% of laryngeal malignancies are squamous cell carcinoma that arises from the epithelial lining of the larynx. The exact cause of laryngeal neoplasm is unknown, but certain risk factors can affect the chances of developing it. Chronic inflammation is a mutagen factor confirmed in the carcinogenesis of various tumor. Inhalation injuries cause histopathologic damage to laryngeal mucosa and inflammation change. This long term inflammation may leads to the development of dysplasia and malignant transformation. Recently, we experienced a case of malignant transformation of laryngeal mucosa after inhalation injury patient 25 years ago. Herein, we reported this rare case and review the relevant literature.
Burns ; Carcinogenesis ; Carcinoma, Squamous Cell ; Humans ; Inflammation ; Inhalation* ; Laryngeal Mucosa ; Laryngeal Neoplasms ; Larynx ; Mucous Membrane* ; Risk Factors

BACKGROUND: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries. METHODS: A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association. RESULTS: The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems. CONCLUSION: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports.
Burn Units ; Burns* ; Humans ; Inhalation ; Lightning ; Renal Insufficiency ; Resuscitation ; Smoke Inhalation Injury ; Wound Healing

A 36-year-old woman was admitted to the intensive care unit because of an inhalation burn injury. Five days after admission, she developed dyspnea and hypercarbia. Therefore, fiberoptic bronchoscopy was performed through the endotracheal tube, which revealed foreign bodies in the tube. Tracheostomy was performed to remove, albeit incompletely, the foreign bodies (endotracheal debris). As sudden movement of the patient or airway reaction could cause the foreign bodies to move deeper into the bronchus during manipulation of the rigid bronchoscope, general anesthesia was induced and maintained by using total intravenous anesthesia with extracorporeal membrane oxygenation (ECMO). The foreign bodies were successfully removed without any other complications. This case showed that sloughed endobronchial debris after an inhalation burn injury caused acute airway obstruction. In such cases, alternative ventilation methods such as tracheostomy and ECMO may have to be applied, which can support a surgeon to focus on the procedure regardless of prolonged procedural time.
Adult ; Airway Obstruction* ; Anesthesia, General ; Anesthesia, Intravenous ; Bronchi ; Bronchoscopes ; Bronchoscopy ; Burns, Inhalation* ; Dyspnea ; Extracorporeal Membrane Oxygenation* ; Female ; Foreign Bodies ; Humans ; Inhalation* ; Intensive Care Units ; Tracheostomy ; Ventilation