burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found.CONCLUSION: The only method to increase the survival rate is to ‘suspect’ the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.]]>
Abdomen ; Allografts ; Amputation ; Burn Units ; Burns ; Cellulitis ; Communicable Diseases ; Debridement ; Electronic Health Records ; Fascia ; Fasciitis, Necrotizing ; Female ; Foot ; Fournier Gangrene ; Heart ; Hip ; Humans ; Hypertension ; Infection Control ; Injections, Intramuscular ; Inpatients ; Korea ; Leg ; Male ; Medical Records ; Methods ; Mortality ; Nutritional Support ; Sepsis ; Skin ; Stroke ; Survival Rate ; Toes ; Wounds and Injuries ; Wounds, Stab

burns is difficult to manage because the wound is deep and complex. The wound is progressively necrotic due to microvascular injury resulting in deep tissue exposure. So, coverage of the wound at the entry point and the exit point is cumbersome, often requiring flap coverage. We experienced a case of one patient for peroneal artery perforator free flap coverage on the palm of the right hand of the entry point of electrical burn. The left foot wound of electrical exit point was covered by full thickness skin graft. Also a small wound was on the left side of the lower back was the exit point of electrical burn. The lower back wound was healed and recurred repeatedly after burn. On postburn day 6 month, through the radiologic exam, metal shadow was identified in the left gluteus muscle forming chronic sinus. We explored the wound of sinus and a foreign body was identified in the sac as multi braid wires thin as hair. According to the patient's past history, we suspected that the back wound was caused by electrical burn injury through the wires.]]>
Arteries ; Burns ; Foot ; Foreign Bodies ; Free Tissue Flaps ; Hair ; Hand ; Humans ; Skin ; Transplants ; Wounds and Injuries

burns. However, there is no significant body of report on application of allogenic keratinocyte to third degree burns. A geriatric patient visited our burn center showing second to third-degree burn on dorsum of her left hand. Considering the surface area and wound depth, surgery was indicated but her medical condition and age made the surgery high risk for a long operation. Therefore, chemical escharolysis, serial bedside debridement, and cultured allogenic keratinocyte (Kaloderm®, Tegoscience, Seoul, Korea) application was done. The wound was completely epithelialized after four rounds of Kaloderm® application. For third-degree burns where definitive surgical reconstruction is precluded due to medical comorbidity of the patient, we investigated the possibility of allogenic keratinocyte treatment which may allow to avoid high-risk anesthesia and surgery.]]>
Anesthesia ; Burn Units ; Burns ; Comorbidity ; Debridement ; Hand ; Humans ; Keratinocytes ; Seoul ; Wound Healing ; Wounds and Injuries

wounds treatment of these patients. These patients are vulnerable to infection due to their weak immunity, so it is necessary to keep them in a state of isolation when a wound occurs. We report a case of a third degree burn by electric pad with a surface area of approximately 5% of the body surface of a patient who underwent a sensory depression, which is a side effect of antiretroviral drugs used for treatment in patients with AIDS. In this regard, we report the case with literature review, which is safely recovered using negative-pressure wound therapy and split-thickness skin graft.]]>
Acquired Immunodeficiency Syndrome ; Burns ; Depression ; Humans ; Incidence ; Negative-Pressure Wound Therapy ; Reconstructive Surgical Procedures ; Skin ; Transplants ; Wounds and Injuries

OBJECTIVES: Staphylococcus aureus is a nosocomial pathogen that provides a major challenge in the healthcare environment, especially in burns units where patients are particularly susceptible to infections. In this study, we sought to determine molecular types of S. aureus isolates collected from burns patients, based on staphylococcal protein A and coagulase gene polymorphisms. METHODS: Antibiotic susceptibility testing of 89 S. aureus strains isolated from burn wounds of patients was assessed using the Kirby-Bauer disk diffusion method. Strains were characterized by spa typing, coa typing, and resistance and toxin gene profiling. RESULTS: A total of 12 different spa types were identified with the majority being t790 (18%). Panton-Valentine leucocidin encoding genes were identified in spa types t044 (5.6%), t852 (2.2%) and t008 (2.2%). The most commonly detected antibiotic resistance gene was ant (4′)-Ia (60.7%). Ten different coa types were detected and the majority of the tested isolates belonged to coa III (47.2%). All the high-level mupirocin-resistant and low-level mupirocin resistant strains belonged to coa type III. CONCLUSION: The present study illustrated that despite the high frequency of coa III and spa t790 types, the genetic background of S. aureus strains in Iranian burns patients was diverse. The findings obtained are valuable in creating awareness of S. aureus infections within burns units.
Ants ; Burns ; Coagulase ; Delivery of Health Care ; Diffusion ; Drug Resistance, Microbial ; Genetic Background ; Humans ; Leukocidins ; Methicillin Resistance ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Methods ; Microbial Sensitivity Tests ; Mupirocin ; Staphylococcal Protein A ; Staphylococcus aureus ; Staphylococcus ; Wounds and Injuries

BACKGROUND: Split-thickness skin grafts (STSGs) are commonly used in the reconstruction of skin defects induced by trauma or burns. Although STSGs are used to successfully treat various wound types, donor site wounds can be challenging, and complications often develop. Therefore, optimal donor site dressings are required. In this study, we introduce an evidence base for patterns in how the discharge amount decreases over time, with the goal of providing insights into the selection of dressing materials. METHODS: Twenty patients with burns who received STSGs harvested from the thigh between January 2016 to April 2017 were prospectively reviewed. A donor site dressing with foam was changed daily. The weight of the foam dressing was measured before and after placement on the donor site. The wound area was calculated using Visi-Trak. The mean weight of the discharge amount per unit area (g/10 cm2) was calculated. RESULTS: The mean weight of the discharge amount per unit area (g/10 cm2) decreased from 3.84 to 2.02 (P < 0.05) and 1.09 (P < 0.05) on postoperative days 5 and 10, respectively. It further decreased to 0.61 by postoperative day 14. CONCLUSIONS: To prevent infections induced by donor site leakage, the use of highly-absorptive foam materials until 5 days after the operation is beneficial. Moreover, hydrocolloid or highly-absorptive foam materials can be used to promote re-epithelialization of the donor site after 5 days postoperatively. For re-epithelialization and wound protection, it is effective to use hydrocolloid materials starting on postoperative day 10.
Bandages ; Burns ; Colloids ; Exudates and Transudates ; Humans ; Prospective Studies ; Re-Epithelialization ; Skin Transplantation ; Skin ; Thigh ; Tissue Donors ; Transplants ; Wounds and Injuries

Regardless of size or severity, post-burn breast scars can be traumatic for patients. There are various approaches to post-burn scar management, but herein we present the results of a novel approach in which we tried to remove the scars in an early stage of treatment. Breast burn patients, whose wound area included the nipple-areolar complex, were treated using a periareolar incision design similar to that of periareolar reduction mammoplasty. The remnant scar was located only along the periareolar complex. As a result, more cosmetically satisfactory results were achieved compared to skin grafting or local flap procedures.
Breast ; Burns ; Cicatrix ; Female ; Humans ; Mammaplasty ; Skin Transplantation ; Wounds and Injuries

Full-thickness scalp burns secondary to hair coloring are rare; however, such defects can be large and complex reconstruction of hair-bearing tissue may be necessary. Many skin-stretching devices that use gradual traction have been applied to take advantage of the viscoelastic properties of the skin. A 21-year-old female patient was seen with a burn defect on her occipital scalp leading to exposed subcutaneous tissue after chemical application of hair coloring in a salon. The dimensions of the wound were 10 cm×5 cm, and a skin graft or flap would have been necessary to close the defect. Two long transfixing K-wires (1.4 mm) and paired 3-wire threads (23 gauge), which are readily available in most hospitals, were applied over a period of 12 days for trichophytic closure of the defect. The remaining scalp scars after primary trichophytic closure with this skin-stretching method were refined with hair follicle transplantation. This skin-stretching method is simple to apply and valuable for helping to close problematic areas of skin shortage that would otherwise require more complicated procedures. This case shows a relatively unknown complication of hair coloring and its treatment.
Burns ; Burns, Chemical ; Cicatrix ; Female ; Hair Color ; Hair Follicle ; Hair ; Humans ; Methods ; Scalp ; Skin ; Subcutaneous Tissue ; Traction ; Transplantation ; Transplants ; Wound Healing ; Wounds and Injuries ; Young Adult

PURPOSE: Pain management in burn treatment is important in improving wound healing and quality of life. Ibuprofen is a proven pain relieving agent in patients with partial thickness burn by intraveous injection. The purpose of this study is to evaluate the efficacy of Biatain Ibu® (polyurethane foam containing ibuprofen) in pain control for outpatients with partial thickness burns. METHODS: A prospective randomized clinical trial was performed in outpatients with partial thickness burn from August 1, 2017 to July 31, 2018. Acute pain, chronic pain, complications, days for re-epithelialization and patient's satisfaction were compared between Biatain Ibu® and Biatain® groups. RESULTS: A total of 20 patients (Biatain Ibu®, n=10; Biatain®, n=10) were assessed in the trial. On Burn days 3, 5, 7, 11, 13, and 15, the acute pain levels were significantly lower in the Biatain Ibu® group than in the Biatain® group. Complications, chronic pain levels and days for re-epithelialization were not significantly different between the two groups. Patient's satisfaction was not statistically significant but was higher in the Biatain Ibu® group. CONCLUSION: Biatain Ibu® is effective in relieving pain in outpatients with partial thickness burn without decreasing patient satisfaction, wound healing ability or developing any complications.
Acute Pain ; Bandages ; Burns ; Chronic Pain ; Humans ; Ibuprofen ; Outpatients ; Pain Management ; Patient Satisfaction ; Prospective Studies ; Quality of Life ; Re-Epithelialization ; Wound Healing ; Wounds and Injuries

The Stellate ganglion block (SGB) could be used to treat sympathetic dependent circulatory insufficiency. We report a 36-year-old female patient with burn-induced refractory ischemic ulcer in distal phalanges. The patient admitted in department of plastic surgery for second degree burn wound in the right second through fifth fingertips. Continuous dressing treatment was conducted. However digital burn wounds were not healed but seems to be refractory. The upper extremity angiography revealed decreased perfusion and the fingertip wounds were diagnosed as ischemic ulcer. Despite of botulinum toxin injection into the perineural tissue and aspirin prescription, burn wounds showed ulcerative necrotic change. The SGBs were performed twice a week for 3 weeks to restore vasoconstriction of the upper extremity arteries. The follow-up angiography showed significant improvement of fingertip perfusion. Consequently, wounds were completely healed. In conclusion, SGB could be a rational option to overcome burn-induced digital ischemia refractory to other medical therapy.
Adult ; Angiography ; Arteries ; Aspirin ; Bandages ; Botulinum Toxins ; Burns ; Female ; Follow-Up Studies ; Humans ; Ischemia ; Perfusion ; Prescriptions ; Stellate Ganglion ; Surgery, Plastic ; Ulcer ; Upper Extremity ; Vasoconstriction ; Wounds and Injuries