• Title/Summary/Keyword: Burn patients

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Superficial temporal artery flap for reconstruction of complex facial defects: A new algorithm

  • Elbanoby, Tarek M.;Zidan, Serag M.;Elbatawy, Amr M.;Aly, Gaber M.;Sholkamy, Khallad
    • Archives of Plastic Surgery
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    • v.45 no.2
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    • pp.118-127
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    • 2018
  • Background A variety of island flaps can be based on the superficial temporal artery with variable tissue composition. They can be used for defect reconstruction, cavity resurfacing, facial hair restoration, or contracture release. Methods Seventy-two patients underwent facial reconstruction using a superficial temporal artery island flap from October 2010 to October 2014. The defects had various etiologies, including trauma, burns, tumors, exposed hardware, and congenital causes. We classified the patients by indication into 5 groups: cavity resurfacing, contracture release, facial hair restoration, skin coverage, and combined. The demographic data of the patients, defect characteristics, operative procedures, postoperative results, and complications were retrospectively documented. The follow-up period ranged from 24 to 54 months. Results A total of 24 females and 48 males were included in this study. The mean age of the patients was $33.7{\pm}15.6years$. The flaps were used for contracture release in 13 cases, cavity resurfacing in 10 cases, skin coverage in 17 cases, facial hair restoration in 19 cases, and combined defects in 13 cases. No major complications were reported. Conclusions Based on our experiences with the use of superficial temporal artery island flaps, we have developed a detailed approach for the optimal management of patients with composite facial defects. The aim of this article is to provide the reader with a systematic algorithm to use for such patients.

A Study on Pain and Anxiety of Burn Patients (화상환자가 지각하는 통증과 불안에 관한 연구)

  • Park Young Sook;Kim Eun Hee
    • Journal of Korean Public Health Nursing
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    • v.15 no.1
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    • pp.83-95
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    • 2001
  • The purpose of this study is to examine intensity of pain and anxiety of burn patients. This study selected 99 adult patients of 18 years old or older who have been hospitalized and treated for a second-degree burn at the surgery ward or burn ward of 3 university hospitals which are located in 2 metropolitan cities, and a university hospital in Seoul Special City from July 1 to October 20, 2000. This study used STAI(State-Trait Anxiety Inventory) developed by Spielberger, and translated by Kim, Jung Taek and Shin, Dong Kyun to examine the degree of anxiety and VAS to examine the pain. This study was carried out by interview and using SPSS 9.0 statistical program. Results were as follows : 1) As for general characteristics of the subjects, they were mostly male. 30s-40s, married, and high school graduates. 2) Forty-seven patients were burned by fire and $49.6\%$ of the patients had burn 10 to $20\%$ of BSA. seventy-nine percents of patients received one dressing change a day and $74.3\%$ received medication once or twice a day. 3) As for intensity of anxiety and pain. the mean intensity of pain was 6.41. The intensity of trait anxiety and the state anxiety were 39.76. and 51.81. 4) Subject's age was significantly different in their pain intensity and other variables were insignificant. Correlations between trait-anxiety and state-anxiety(r=.286, p=.004), and state-anxiety and VAS(r=.294, p=.003) showed weak correlation. There wasn't statistically any significance in trait- anxiety and VAS(r=.183, p=.070).

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Fragmented Split-Thickness Skin Graft Using a Razor Blade in Burn Induced Diabetic Foot (화상을 동반한 당뇨발 환자에게 Razor Blade를 이용한 부분층피부조각 이식술의 효용성)

  • Park, Cheol-Heum;Choi, Manki;Kang, Chan-Su;Kim, Tae-Gon
    • Journal of the Korean Burn Society
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    • v.23 no.1
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    • pp.20-24
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    • 2020
  • Diabetic patients have an increased risk of burn injuries on foot. Because of their diabetic neuropathy, they could contact with hot water or warming device without being aware of it. Split-thickness skin graft (STSG) is successful in treatment of various wound types; however, donor site wounds are sometimes problematic, and complications such as pain and impaired healing often occur. Although, donor site wounds in healthy young individuals can rapidly heal without complications, the wound-healing capacity of elderly patients or those with a comorbidity has been reported to be low. The dermatome is the most commonly used tool because it can harvest a large skin graft in one attempt. However, it is difficult to harvest tissues if the area is not flat. Furthermore, because the harvested skin is usually rectangular, additional skin usually remains after skin grafting. Therefore, use of razor blade and fragmented STSG on a large defect area is advantageous for harvesting a graft with a desired size, shape, and thickness. From January 2018 to July 2018, fragmented STSG was used in 9 patients who suffered from burn induced open wound on foot with diabetic neuropathy. With this approach, healing process was relatively rapid. The mean age of patients was 70 (57~86 years) and all of 9 patients had diabetes mellitus type 2. In all patients, the skin graft on the defect site healed well and did not result in complications such as hematoma or seroma.

Effects of a Recreation Therapy Program on Mental Health and Heart Rate Variability in Burn Rehabilitation Patients (치료레크리에이션 프로그램이 화상재활환자의 정신건강 상태와 심박동 변이에 미치는 효과)

  • Kil, Myung-Sook;Lee, Mi-Hwa;Lee, Yong-Mi
    • Journal of Korean Biological Nursing Science
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    • v.17 no.2
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    • pp.179-187
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    • 2015
  • Purpose: This study was done to evaluate the effects of a recreation therapy program on burn rehabilitation patients to determine if the program is an effective nursing intervention which can affect mental health problems and heart rate variability. Methods: Subjects were 54 hospitalized burn rehabilitation patients (25 in the control group, 29 in the experimental group). The experimental group participated 6 times in a recreation therapy program led by a qualified instructor. Brief symptoms inventory-18 (somatization, anxiety, depression) questionnaire, and heart rate variability were checked before and after the recreation therapy program. Results: The mental health scale showed significant differences in somatization (p<.001), anxiety (p<.001) and depression (p<.001). There was no significant difference in heart rate variability (autonomic activity, autonomic balance, stress resistance, stress parameter and fatigue, mean heart rate, electro-cardiac stability). Conclusion: The findings from this study suggest that a recreation therapy program is an effective nursing intervention to decrease the level of mental health problems of burn rehabilitation patients. However, a subsequent study is needed to develop an intervention program that will induce the effect of physiological parameters like heart rate variability (HRV).

Cause and characteristic factors of burn in children and adolescents (소아청소년의 화상 발생원인과 특성 요인)

  • Nam, Young-Hee;Lee, Myung-Sun
    • The Journal of Korean Society for School & Community Health Education
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    • v.13 no.1
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    • pp.1-12
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    • 2012
  • Backgrounds: Burn of children and adolescents is an accident due to careless protector in many case. All the pediatric burns are preventable. We investigated the characteristics of pediatric burns. Such data can propose proper health educational program designs to suit the community. Purpose: This study aims to analyse the characteristics of pediatric burn patients and to discusses a possible prevention program for this population. Methods: The subjects were 77 patients reviewed burn injury in pediatric under 15 years old. Data were burn center of the B General Hospital from January 1 to December 31 2009 and a retrospective epidemiological study was collecting medical records. Results: seventy-seven children and adolescents with burn were admission treated for Burns and they were 54.5% boys and 45.5% girls. An incidence of age group with pediatric burn was less than one year of age(46.8%), 2-3 year(27.3%), 4~7year(10.4%), over 8 years old(15.6). Length of stay hospitalization was 1~2 week(32.9%) highest percentage and second-degree deep burns were 41.6% the highest percentage. Divided by the age of about 3, length of stay, ICU status, time of injury onset, cause, indication, place of accident, treatment, degree, region of burns had a statistically significant difference. Conclusion: Less than one year of age was the highest percentage. Divided by the age of about 3, Characteristics and factors affecting the range of burn were significant. Education and guide are necessary to reduce incidence of pediatric burns.

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Pain Relief Efficacy of Ibuprofen Releasing Foam Dressing (Biatain Ibu®) on Outpatient Patient with Partial Thickness Burn Wound (부분층화상을 입은 외래 환자에서 이부프로펜 방출성 드레싱 제재(Biatain Ibu®)의 창상부위 통증의 경감 효과에 대한 연구)

  • Lee, Jun-Ho;Choi, Bong Gyu;Lee, Jin Ho;Kim, Jae Won
    • Journal of the Korean Burn Society
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    • v.22 no.1
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    • pp.15-19
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    • 2019
  • 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.

Povidone-Iodine related Chemical Burn under the Tourniquet (A Case Report) (지혈대 내측의 포비돈-요오드 용액에 의한 화학 화상 (1예 보고))

  • Won, Jong-Kyoung;Lee, Kang
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.3
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    • pp.190-192
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    • 2012
  • In the extremity surgery, pneumatic tourniquet and povidone-iodine solution are commonly used to provide an aseptic, bloodless field, and their complication rate has remained low. However, chemical burn under tourniquet has been rarely reported. Patients sustained burn injuries over the dependent, weight-bearing regions such as posterior neck, back, buttocks and posterior thighs. This rare adverse complication occurred in a 22-year-old man who underwent modified Brostrom operation with arthroscopic os trigonum excision. 10% povidone-iodine was used as topical antiseptic, and full thickness burn occurred underneath the area of tourniquet application. Main causes of povidone-iodine related chemical burn are considered maceration, irritation of the skin, long term use of the tourniquet and pressure. To reduce the complications like chemical burn, awareness of the risk and the possible pathogenesis as well as the preventive measures is important in surgical practice.

Use of Hypnosis in the Management of Patients with Burn Pain (최면을 이용한 화상 환자의 동통 조절)

  • Park, Hee-Gwan
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.218-222
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    • 1997
  • Before the dressing and debridement of the wounds, patients received hypnosis and were taught self-hypnosis. They were instructed to let the burn areas being worked on "become relaxed and numb" in the trance. The author encouraged them to imagine wound-healing. Result of this hypnoanalgesia as an adjunct treatment for burn pain proved it most effective and facilitative. Theoretical and practical implications and future research directions were discussed.

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Reconstruction of Hand Using Peroneal Perforator Free Flap in High-Voltage Electrical Burn Patients (고압 전기화상에 의한 수부 손상 시 비골동맥 천공지 유리피판술을 이용한 재건)

  • Kim, Dong Hoon;Yoo, Jung Seok;Lim, Jun Kyu;Lee, Dong Lark
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.67-72
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    • 2008
  • Purpose: The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Electrical burn affecting the hand may produce full thickness necrosis of the skin and damage deep structures beneath the eschar, affecting the tendon, nerve, vessel, even bone which result in serious dysfunction of the hand. As promising methods for the reconstruction of the hand defects in electrical burn patients, we have used the peroneal perforator free flaps. Methods: From March 2005 to June 2006, we applied peroneal perforator free flap to five patients with high tension electrical burn in the hand. Vascular pedicle ranged from 4cm to 5cm and flap size was from $4{\times}2.5cm$ to $7{\times}4cm$. Donor site was closed primarily.Results: All flaps survived completely. There was no need to sacrifice any main artery in the lower leg, and there was minimal morbidity at donor site. During the follow-ups, we got satisfactory results both in hand function and in aesthetic aspects.Conclusion: The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized wound defect, especially hand with electrical burn injury.

Epidemiology of Burns in Infants: A Four-Year Retrospective Study (영유아 화상의 역학조사: 4년간의 후향적 연구)

  • Yu, Ha Hyun;Choi, Youngwoong
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.49-52
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    • 2019
  • Purpose: Little information has been published regarding minor burn injuries in infants, most of which are preventable. To fill this research gap, this study explored the patterns and mechanisms of burn injuries in infants to ascertain whether such incidents can be prevented. Methods: This was a retrospective study, based on data collected prospectively from all infants (<12 months old) admitted to our hospital with burns in the four-year period between January 1, 2015 and December 31, 2018. A medical record review provided basic demographic information, such as age at the time of injury, sex, cause of injury, duration of treatment, operative treatment, and the extent and type of burn, as well as the anatomical region involved. Results: Fifty-seven infants were diagnosed with burn injuries, with scalding being the most common type (47%), followed by contact (32%) and steam (14%). Seven infants of eight steam burn patients injured by pressure cooker. Superficial second degree was the most common depth of injury (72%) followed by first degree (17%) and deep second degree (8%). Average age per injury type was calculated by independent T-test. Average ages of patients with contact and steam burns were significantly lower (7.06 months; P=0.19) and higher (9.25 months; P=0.005), respectively, than for other burn types. Conclusion: Given that infants cannot control their body movements, talk, or manage by themselves, they are entirely dependent on the proper care of adults. Consequently, in addition to the prevention of burns, special care should be taken for the pressure cooker.