• Title/Summary/Keyword: Burn Patient

검색결과 117건 처리시간 0.027초

응급실 화상환자의 역학적 요인에 대한 고찰: 추이변화와 예후에 미치는 영향을 중심으로 (A Study on Epidemiological Factors of Burn Patients in Emergency Rooms)

  • 정성태;하철민;이형주;정영윤
    • 대한화상학회지
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    • 제23권2호
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    • pp.42-53
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    • 2020
  • Purpose: It is important to consider both clinical factors and epidemiological factors in treating burn patients in emergency rooms. However, many emergency medical staffs happen to miss their chances of treating burns based on these considerations. This study is designed to find a better treatment for burn patients in emergency rooms along this approach. Methods: This study was conducted based on the data of the burn patients visiting the emergency room of a single general hospital from January 2015 to December 2019. The epidemiological and clinical factors were extracted out of the data, then the relationship between the prognosis and these factors were analyzed. Results: Most of burn accidents occurred at home, and were caused by hot water, soup, drinks, oil, etc. Especially, flame burns showed high hospitalization rate, surgical rate and mortality. In addition, their prognosis was poor when the affected area included facial, limb and perineal areas etc., or any inhalation burn co-existed. Also, the hospitalization rate and period increased when the treatment time was delayed or the pre-treatment was taken. There was a strong relationship between prognosis and the period of follow-up when patients were admitted during the period. Conclusion: It is difficult for medical staffs to evaluate prognosis of burns in emergency rooms due to progressive damages. Precise treatment and disposition are essential for patients' good prognosis. Therefore, medical staffs should establish treatment plans by identifying the patient's epidemiological and clinical factors, rather than giving prescriptions based on fragmentary and superficial symptoms.

3도 화상에 대한 동종 상피세포 치료제의 효과 보고 (Feasibility of Cultured Allogenic Keratinocyte Treatment for Third Degree Burns)

  • 최장연;조진태;최종윤;서보미;정성노
    • 대한화상학회지
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    • 제22권2호
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    • pp.45-48
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    • 2019
  • Allogenic keratinocyte application is widely used for treatment of second degree 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.

화상치료에 있어서 동종유래표피세포의 유용성 (The Usefulnesssof Cultured Allogenic Keratinocyte for Burn Treatment)

  • 윤신혁;심정수;정재민;박대환;송철홍
    • Archives of Plastic Surgery
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    • 제35권4호
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    • pp.413-418
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    • 2008
  • Purpose: When choosing dressing method to treat skin defect by second degree or higher burn, we have to consider method of rapid epithelization and minimization of pain during the treatment. In this study, we used biologic dressing with cultured allogenic keratinocytes for skin defect due to burn. We followed up the degree of epithelization, the degree of pain, and patient satisfaction. Methods: From June 2003 to June 2006, among the patients with skin defect due to burn, 31 cases with second degree burn(moderate to severe) were selected and biological dressing with cultured allogenic keratinocytes were done. 21 cases did not use cultured allogenic keratinocytes. Most of the patients had second degree burn. We applied cultured allogenic keratinocyte by Kaloderm. For wounds that were not deep enough to effect the dermis, escharectomy was done before applying Kaloderm. After the operation, moist wound site was maintained by dressing with saline gauze for 5 - 7 days. We compared the condition of the wound site before and after applying Keloderm by grading epithelization by standardized percentage scoring scale(1 - 5), and degree of pain and patient satisfaction by visual analogue scale(0 - 10). Results: When cultured allogenic keratinocytes were applied for the same period of time, the mean score of epithelization were $3.29{\pm}0.529$(mean ${\pm}$ S.D.). Without the application, the mean score of epithelization were $2.86{\pm}0.655$(mean ${\pm}$ S.D.). The degree of pain was $7.71{\pm}1.419$(mean ${\pm}$ S.D.) and $2.35{\pm}0.950$(mean ${\pm}$ S.D.) before and after the application, respectively. The patients' satisfaction score was $6.45{\pm}0.850$(mean ${\pm}$ S.D.) and $8.45{\pm}0.961$(mean ${\pm}$ S.D.) before and after the application, respectively. Conclusion: Applying biological dressing with cultured allogenic keratinocyte to skin defect due to second degree burn showed satisfactory results in the degree of the epithelization, degree of pain and patients' satisfaction.

대구시내 종합병원에 입원한 화상환자의 화상원인과 현장에서 취한 응급처치 (Causes of Burn and Emergency Care on the Spot for the Patients Admitted to Three Hospitals in Taegu)

  • 주민;박정한
    • Journal of Preventive Medicine and Public Health
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    • 제21권2호
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    • pp.238-244
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    • 1988
  • This study was conducted to investigate the causes of burn and emergency cares taken on the spot for the burn patient. Study population included 161 burn patients admitted to 2 university hospitals and 1 general hospital in Taegu from November 1, 1987 to April 30, 1988. Patients or guardians were interviewed with a structured questionnare. Out of 161 burn patients 111(68.9%)were males and 50(31.1%) females. Preschool children of 1-4 years old accounted for 29.8% of the total patients. Burns of children under 15 years of age took place at home in 91.0%, while 48.3% of burns of adult (15 years and over)males occurred at the working place, and 68.0% of adult females occurred at the home. Out of total burns occurred at home 39.8% took place at kitchen/dining room and 24.1% in the room. The most common cause of burns in children was the boiling water or hot food (74.3%). In adults the common causes were electrical burn(22.4%), hot water or food(19.0%) and explosion(12.1%) for males, and hot water or food(32.0%) and explosion (20.0%) for females. Common emergency cares for the burn taken on the spot were undressing(64.6%), pouring Soju(liquor)(13.7%), and pouring cold water(5.0%). There were a few cases who applied ash, soy or salt. To prevent burn, it is recommended to remodel the traditional kitchen and coal-briquet hole, to strengthen the safety control of LP Gas and LN Gas supply, to educate the public for the handling method for such gases, to strengthen the occupational safety control, to improve the safety device for the electric wire and socket, and to limit the temperature of hot water at home and public baths.

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치매환자 부양자의 스트레스와 소진경험 (Stress and Burn-Out Experience in Caregivers of Patients with Senile Dementia)

  • 손계순
    • 한국농촌간호학회지
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    • 제1권1호
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    • pp.40-48
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    • 2006
  • Purpose: This study was done to identify the experience of stress and burn-out in caregivers of patients with senile dementia. Method: To evaluate the degree of stress and burn-out in caregivers of patients with senile dementia, 64 caregivers and matched to 64 patients with senile dementia at a Primary Health Care Post in South Kyung Sung Province were selected. The study was carried out from March 6 to March 30, 2001. Data on the degree of dementia in the patients was measured by the MMSE-K (Mini-Mental State Examination-Korea) and caregiver characteristics such as, sex, age, marital status, educational level, job, socioeconomic status, religion, number in family, relationship with patient, duration of care, and chronic disease in caregiver were collected by direct interview with a questionnaire. Results: Of 64 patients with senile dementia, 15.6% were classified as mild dementia (MMSE score 20-24) and 84.4%, as severe dementia. There were no significant characteristics of caregivers associated with the degree of stress and burn-out experience. The degree of burn-out in these caregivers of patients with severe dementia (mean value 94.3) was significantly higher than the 81.4 for those caring for patients with mild dementia (p<0.05). However, the degree of stress was not significantly related with the degree of dementia. The proportion experiencing severe burn-out (above score 4) was 54.7% in the physical domain, 90.6% in the emotional domain, and 73.4% in psychiatric domain, respectively. Conclusion: The above findings suggest that the degree of stress and burn-out experienced by caregivers of patients with senile dementia are high. Also the degree of burn-out experienced by in caregivers of patients with severe dementia was higher than for those caring for patients with mild dementia.

뜸 화상으로 발생한 피부석회증을 수술중 초음파를 이용하여 절제한 사례 (Excision of Calcinosis Cutis Caused by Moxibustion Burn Injury Using Intraoperative Ultrasonography Determining the Complete Resection Range)

  • 류형래;최환준;김준혁;이다운;안혜인
    • 대한화상학회지
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    • 제24권2호
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    • pp.34-37
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    • 2021
  • A 46-year-old female presented a mass on her right lower leg where she had a burn injury due to moxibustion 10 years ago. Physical examination revealed a 3 cm sized firm nodule with tenderness. Plain radiograph was performed and it revealed well-defined calcifications. According to the history of moxibustion burn injury and the result of plain radiograph, dystrophic calcinosis cutis caused by burn injury was suspected. The patient underwent excisional biopsy using pre-,intra-, and post-operative ultrasonography (USG). There was no sign of recurrence. Herein, we report a case of a 46-year-old healthy woman who presented with single hard nodule on the right lower leg. Our case is worthwhile in two respects. First, It is first case report of dystrophic calcinosis cutis due to moxibustion burn injury. In east asian culture, moxibustion is a commonly conducted procedure and it often induces burn injury. Second, USG was used pre-, intra-, and post-operatively to assess the shape, location, and depth of the calcinosis cutis and to determine the surgical margin.

치아염소산 나트륨(유한락스®)에 의한 화학화상 증례보고 (A Case Report of the Chemical Burns Due to Sodium Hypochlorite(NaOCl))

  • 김기엽;박준;양원용;유영천;강상윤
    • Archives of Plastic Surgery
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    • 제35권6호
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    • pp.748-750
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    • 2008
  • Purpose: Chemical burn accounts for a small proportion of burns in burn patient population. However, chemical injuries own importance to their deep tissue destruction which continues long after the initial exposure. $YUHANROX^{(R)}$ is a domestic bleach which has been widely used in Korea. Chemical burn by the domestic bleach is an unusual case. Methods: A 70 yrs old female soiled with stool, her husband wiped the mess with $YUHANROX^{(R)}$. Skin edema, erythematous lesion was developed the second day, and she was admitted to our hospital via emergency department. Results: Complete epithelization was done after 3 times STSG but, severe scar was formed. Conclusion: We report this case to warn about the dangers of domestic bleaches chemical substances and to emphasize that they should be used with caution. Public relation of the primary care of the chemical burn injury is needed.

화상환자의 외상후 스트레스 장애 증상에 대한 영향 요인 : 울분, 우울, 삶의 의미 (Factors Influencing Posttraumatic Stress Disorder Symptoms in Burn Injured Patients : Embitterment, Depression and Meaning in Life)

  • 황지현;이병철;채정호
    • 대한불안의학회지
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    • 제15권1호
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    • pp.29-34
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    • 2019
  • Objective : To determine predictors of posttraumatic stress disorder (PTSD) symptoms in burn injured patients and evaluate factors for identifying high risk group of PTSD. Methods : This study examined sixty one patients aged in the range of 19-65 years with burn injuries. All subjects completed self-assessment inventories about PTSD (The PTSD Check List for DSM-5. PCL-5), depression (Patient Health Questionnaire-9, PHQ-9), embitterment (Posttraumatic embitterment disorder self-rating scale, PTED scale) and meaning of life (Meaning in Life Questionnaire, MLQ). Stepwise multiple regression and ROC curve analysis were the tools used for analysis. Results : The results revealed higher depression, embitterment and lower presence of meaning in life predicted severe PTSD symptoms. ROC analysis indicated PTED scale and PHQ-9 were useful for discriminating high risk group of PTSD. Conclusion : The present study established that the need to consider embitterment, depression and meaning of life for alleviation and prevention of PTSD symptoms in burn patients.

전기화상 환자에서 견관절 절단부 재건을 위한 상지 근피부 유리피판술의 증례 보고 (The Total Arm Musculocutaneous Free Flap for Reconstruction of Extended Forequarter Amputation in Electrical Burn Patient)

  • 이준협;이태섭;나민화;이동은
    • Archives of Reconstructive Microsurgery
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    • 제10권1호
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    • pp.44-48
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    • 2001
  • The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wounds. However, in case of complete extremity amputation in eletrical burn patient, the transfer of pedicled flaps from the amputated part is not possible. In such instances, we have designed total arm musculocutaneous free-fillet flaps from the amputated limb to provide wound coverage, when replantation of the amputated part was contraindicated. now we present such a case. This technique allows immediate wound coverage without the morbidity of an additional donor site. The flap provides the ideal combination of large surface area, muscle bulk, and long vascular pedicle. It can be dissected rapidly to minimize ischemic time and could therefore be applicable to traumatic forequarter amputations.

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