Purpose: The objective of this study was to evaluate the effects of Polyhexanid+poloxamer, Sodium pentaborate pentahydrate and Diphenylhydantoin, in the treatment of 3rd degree burn wounds.M ethods: Twenty eight Wistar albino rats were divided into 4 groups, each containing 7 animals. The experimental groups received every other day treatment with (A) Polyhexanid+poloxamer, (B) Sodium pentaborate pentahydrate (C) Diphenylhydantoin, (D) Control. In dorsum of all rats, third degree skin burn was performed. Three days later burn eschar was removed by fascial excision and skin substitude Nevelia® was applied to the wound. Then the wounds were applied locally with agents embedded in the dressing. In (Group A) %0,1 Polyhexanid+poloxamer, (Group B) %2 Sodium pentaborate pentahydrate, (Group C) Diphenylhydantoin and (Group D) Control-Saline solution. These treatments were performed every other day for 12 days. At the end of treatments, burn wounds were obtained and processed for immunohistochemical and histopathologic analysis. Results: Histologic evaluation of the Polyhexanide+poloxamer, Sodium pentaborate pentahydrate and Diphenylhydantoin-treated wound regions revealed an increased collagen deposition, fibroblast number, epithelization, and vascularization when compared to control group (P＜0.05). In all treatment groups wound regions demonstrated a strong immunostaining for Vascular Endothelial Growth Factor, Transforming Growth factor-β, and Basic fibroblast Growth factor according to control group. Conclusion Results of this study showed that treatment of burn wounds with Polyhexanid+poloxamer, Sodium pentaborate pentahydrate and Diphenylhydantoin enhanced collagen deposition, epithelization, and vascularization in healing of 3rd degree burn wounds.

In South Korea, humidifiers are commonly used to regulate indoor humidity, prevent irritation of the eyes and respiratory tract, and reduce respiratory illnesses. Heated humidifiers, which boil water to produce steam, became a preferred alternative after humidifier disinfectant incidents due to their lower risk of bacterial growth. However, careless use has led to burn accidents in children, who may tip over or touch these devices. According to the Korea Consumer Agency’s 2023 safety survey, burn incidents from heated humidifiers surged by 141.7% compared to the previous year. The clinical presentation of these burns varies by humidifier design. Rice-cooker-style humidifiers, heating water to 97~100°C, often cause multi-site burns with a larger affected area and depths ranging from superficial second-degree to third-degree, particularly when the lid opens after being tipped over. In contrast, covered humidifiers, which heat water in an internal chamber and release steam, typically cause localized superficial second-degree burns to the hand or fingers. By reporting clinical cases treated at our institution, we aim to highlight the risks of heated humidifiers and advocate for enhanced caregiver education on safe device use and placement. We also call for policy-driven safety campaigns to promote cool mist humidifiers and prevent pediatric burn injuries, reducing associated morbidity.

Tumoral calcinosis is a rare entity characterized by ectopic deposition of calcium phosphate in soft tissues, most commonly around large joints. While idiopathic and familial forms are well-documented, secondary tumoral calcinosis arising in previously traumatized or inflamed tissues is rare. We describe the case of an 83-year-old woman who presented with a chronic, non-healing ulcer on her right lateral thigh, nearly seventy years after sustaining a deep partial-thickness burn injury in childhood. Radiographic studies revealed dense calcified masses underlying the ulcer, and histologic evaluation confirmed the diagnosis of tumoral calcinosis. Wide excision of the calcified lesion was performed, and soft tissue coverage was attempted using a tensor fascia lata musculocutaneous rotation flap. However, postoperative complications included hematoma formation and partial flap necrosis, likely due to compromised vascularity in the scarred field. Revision surgery and split-thickness skin grafting were required to achieve final wound closure. This case illustrates the possibility of extremely delayed presentation of tumoral calcinosis in chronic burn scars and underscores the challenges of flap-based reconstruction in tissues with altered vascular anatomy.

Background: Cases of malignancy exacerbated by thermal injury are exceedingly rare, particularly in breast tissue. We report a unique case in which a preexisting, clinically occult breast lesion was subject to local uncontrolled heat lamp therapy, resulting in burn injury and apparent acceleration of tumor growth, later confirmed as invasive ductal carcinoma with squamous differentiation.Case: A 67-year-old female patient noted a right breast palpable nodule 1~2 months prior to presentation. Initial ultrasound measured 5.2×5.7 cm lesion and suggested malignancy; however, the patient deferred medical treatment and applied home heat-lamp therapy to the site, resulting in localized burn injury. After this, the lesion rapidly enlarged with budding and skin changes. Core needle biopsy yielded invasive ductal carcinoma with focal squamous differentiation. Imaging revealed right breast cancer with multiple enlarged lymph nodes on axilla. The patient underwent surgical excision and immediate reconstruction. Final pathology confirmed invasive ductal carcinoma with squamous differentiation, negative margins, with nodal metastasis. Postoperative adjuvant therapy was administered per tumor board decision. Conclusion Although a direct causal relationship cannot be proven, this case illustrates how unregulated thermal therapy can aggravate tumor progression and complicate oncologic presentation. Clinicians should be aware of alternative heat treatments and their potential to influence tumor behavior.

Purpose: Although chemical burns account for a small proportion of all burn injuries, they remain clinically significant because of the risk of progressive tissue necrosis caused by residual agents. These injuries require prompt removal of the offending substance and timely wound coverage when indicated. This study aims to present surgical treatment strategies, focusing on necessity of early escharectomy and selection of appropriate wound coverage, in patients with chemical burns.M ethods: A retrospective review was conducted of 66 patients with chemical burns admitted to the Department of Plastic and Reconstructive Surgery at Hanil General Hospital between 2019 and 2024. Data collected included causative agents, wound location, total body surface area (TBSA), burn depth, surgical interventions, and postoperative complications. Surgical procedures, such as early or delayed escharectomy, split-thickness skin grafting (STSG), STSG with an acellular dermal matrix (ADM), full-thickness skin grafting (FTSG), and local flap coverage, were selected according to the wound characteristics. Results: Of the 66 patients, 48 underwent surgical treatment, and 18 were managed conservatively. Among the surgical cases, early excision (escharectomy) was performed in 10 patients (20.8%), whereas delayed excision was performed in 38 patients (79.2%). Wound coverage procedures were performed in 30 patients (62.5%). Conclusion Early excision of necrotic tissue and appropriate wound coverage is associated with favorable outcomes in patients with chemical burns.

Purpose: Deep partial-thickness burns are prone to delayed healing and hypertrophic scarring. Epidermal growth factor (EGF) expedites re-epithelialization, yet further improvements are needed. This study examines whether combining topical insulin and timolol with EGF using alginate dressing and ofloxacin ointment can promote healing and minimize scarring.M ethods: Thirty-two adults with deep partial-thickness burns of the limbs were retrospectively reviewed. Topical insulin, timolol, and EGF ointment were applied every 48 hours, delivered with alginate dressing; ofloxacin ointment was used for infection prophylaxis. Clinical outcomes included days to full epithelialization, infection, surgical intervention, and scar status at 12 weeks. Representative wound photographs were obtained at initial, 5–8 days, and after epithelialization for each major burn etiology. Results: Average age was 41 years; injuries included scald (n=15), steam (n=3), contact (n=11), and flame burn (n=3). Mean epithelialization was 12.2±2.4 days. No patient developed infection or required skin graft. Only 2 patients (slowly healing low-temperature contact burns) developed hypertrophic (not keloid) scars by 12 weeks; all others healed with minimal or imperceptible scarring. Conclusion The protocol of topical insulin and timolol with EGF achieved rapid wound closure and, except for rare, mild hypertrophic scarring in slow-healing deep contact burns, yielded excellent scar outcomes. Alginate and ofloxacin provided supportive benefits in risk reduction and agent delivery.

Background: High-voltage electrical burn injuries, though relatively uncommon, often cause extensive deep-tissue destruction and severe functional impairment. Although standard reconstructive algorithms are well established, simultaneous bilateral hand involvement in a patient with systemic comorbidity poses a unique reconstructive challenge requiring individualized flap selection and staged planning.Case: A 56-year-old man sustained bilateral high-voltage arc burns (22,900 V) on the bilateral hands. The left hand was identified as the entry site and the right hand as the exit site. Because of poor graft take after split-thickness skin grafting (STSG) with an acellular dermal matrix (ADM) and recurrent tendon exposure, a tailored reconstructive strategy was implemented.Negative-pressure wound therapy (NPWT) was used to enhance granulation, followed by a pedicled groin flap for the dominant right hand and sequential local advancement flaps with continued NPWT for the left. Both flaps survived completely achieving stable coverage and restoration of near normal motion (range of motion: right 0~90°, left 0~95°) at 3 months. Conclusion This case highlights that even in the absence of microsurgical options, staged reconstruction combining NPWT, pedicled groin flap, and local flaps can achieve durable wound closure and functional recovery in medically compromised patients with bilateral hand electrical burns. The key clinical message is that flap selection should be individualized based on wound characteristics, systemic condition, and the balance between surgical risk and long-term function.

In patients who have severe burn injuries with a large surface area, inflammatory response of the immune system, which is subsequently followed by anti-inflammatory response, results in immune dysregulation and this makes burn victims vulnerable to infection. With the disruption of skin integrity, the body becomes vulnerable to infection. Thermal injury disrupts cellular integrity, and eschar forms over the wound bed. Successive escharotomy procedures performed as part of treatment also lead to increased susceptibility to infection. The cytokine adsorber is a treatment modality that can be useful in preventing the transition to infection by removing inflammatory mediators from the blood. In our case series, we wanted to present the patients who were followed up for a prolonged period in our hospital’s burn intensive care clinic due to 75~90% 4th degree burns as a result of an explosion in a coal mine and periodically received cytokine adsorbents.

A 71-year-old female patient developed cellulitis-like lesions at the burns from moxibustion of the right calf. The lesion was unilateral, a single confluent lesion with swelling and tenderness. Oral antibiotic treatment was performed with a poor clinical response. The patient was hospitalized and received intravenous broad-spectrum antibiotics, but the lesion progressed without improvement. Considering the possibility of erythema nodosum, the prescription was changed to methylprednisolone, and the redness, warmth and swelling improved the day after. A skin biopsy revealed features suggestive of panniculitis

In patients who have severe burn injuries with a large surface area, inflammatory response of the immune system, which is subsequently followed by anti-inflammatory response, results in immune dysregulation and this makes burn victims vulnerable to infection. With the disruption of skin integrity, the body becomes vulnerable to infection. Thermal injury disrupts cellular integrity, and eschar forms over the wound bed. Successive escharotomy procedures performed as part of treatment also lead to increased susceptibility to infection. The cytokine adsorber is a treatment modality that can be useful in preventing the transition to infection by removing inflammatory mediators from the blood. In our case series, we wanted to present the patients who were followed up for a prolonged period in our hospital’s burn intensive care clinic due to 75~90% 4th degree burns as a result of an explosion in a coal mine and periodically received cytokine adsorbents.