• 대한화상학회지
• /
• 제23권1호
• /
• pp.20-24
• /
• 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.

• 대한화상학회지
• /
• 제22권2호
• /
• pp.66-70
• /
• 2019

Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were 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.

• Journal of Pharmaceutical Investigation
• /
• 제36권5호
• /
• pp.339-342
• /
• 2006

This study was designed to prepare an animal model for partial thickness bum wound which can be employed for testing topical therapy. We first evaluated whether rabbit ear and mouse back skin wound model could differentiate the wound healing process in terms of degree of re epithelialization, required days for complete wound closure, presence of scarring. $2^{nd}$ degree wet bum were prepared on mouse back skin and rabbit ear by applying 5 mL hot water($85{\pm}0.1^{\circ}C$) for 7 see followed by 5 mL ice-cold 0.5% acrynol solution for cooling and disinfecting the inflicted area. After removing the dead epidermis layer at 24 hr, tested dressings were applied for specified time and wound progression was investigated. In mouse model, wound contraction was the primary wound closing mechanism, which is quite different from human wound healing process. In rabbit ear model, epidermal regeneration was the major wound healing process rather than wound contraction and the difference in wound healing property among tested dressings could be clearly demonstrated. A rabbit ear model could differentiate the wound progression among open, occluded and epidermal growth factor(EGF) treated wound. Four sites of circular wound(diameter: 1 cm) on the anterior part of rabbit ear could be employed for the comparative wound healing study. For obtaining reproducible bum wound, degree of bum depth and bum sites should be carefully controlled in addition, employing rabbits of same strain and weight. The result suggests that rabbit ear could be employed as a reliable and human-resembled wound model.

• Archives of Pharmacal Research
• /
• 제28권11호
• /
• pp.1311-1316
• /
• 2005

To better define the relationship between dermal regeneration and wound contraction and scar formation, the effects of epidermal growth factor (EGF) loaded in collagen sponge matrix on the fibroblast cell proliferation rate and the dermal mechanical strength were investigated. Collagen sponges with acid-soluble fraction of pig skin were prepared and incorporated with EGF at 0, 4, and 8 $\mu$g/1.7 $cm^{2}$. Dermal fibroblasts were cultured to 80$\%$ confluence using DMEM, treated with the samples submerged, and the cell viability was estimated using MTT assay. A deep, $2^{nd}$ degree- burn of diameter 1 cm was prepared on the rabbit ear and the tested dressings were applied twice during the 15-day, post burn period. The processes of re-epithelialization and dermal regeneration were investigated until the complete wound closure day and histological analysis was performed with H-E staining. EGF increased the fibroblast cell proliferation rate. The histology showed well developed, weave-like collagen bundles and fibroblasts in EGF-treated wounds while open wounds showed irregular collagen bundles and impaired fibroblast growth. The breaking strength (944.1 $\pm$ 35.6 vs. 411.5 $\pm$ 57.0 Fmax, $gmm^{-2}$) and skin resilience (11.3 $\pm$ 1.4 vs. 6.5 $\pm$ 0.6 mJ/$mm^{2}$) were significantly increased with EGF­treated wounds as compared with open wounds, suggesting that EGF enhanced the dermal matrix formation and improved the wound mechanical strength. In conclusion, EGF-improved dermal matrix formation is related with a lower wound contraction rate. The impaired dermal regeneration observed in the open wounds could contribute to the formation of wound contraction and scar tissue development. An extraneous supply of EGF in the collagen dressing on deep, $2^{nd}$ degree-burns enhanced the dermal matrix formation.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제36권6호
• /
• pp.280-284
• /
• 2014

Purpose: This study evaluated woven silk textile for burn wound dressing materials in an animal model. Methods: Ten rats were used in this experiment. Full-thickness $2{\times}2cm$ burn wounds were created on the back of the rats under anesthesia. In the experimental group, the wounds were treated with three different dressing materials from woven silk textile. In the control group, natural healing without any dressing material was set as control. The wound surface area was measured at five days, seven days, and 14 days. Wound healing was evaluated by histologic analysis. Results: There were no statistically significant differences among groups at five days post injury. The mean defect size at seven days was largest in Group 3 ($462.87mm^2$), and smallest in Group 1 ($410.89mm^2$), not a significant difference (P=0.341). The mean defect size at 14 days was smallest at the Group 3 ($308.28mm^2$) and largest in the control group ($388.18mm^2$), not a significant difference (P=0.190). The denuded area was smaller in Group 1 ($84.57mm^2$) and Group 2 ($82.50mm^2$) compared with the control group ($195.93mm^2$), not statistically significant differences (P=0.066, 0.062). The difference between Group 3 and control was also not statistically significant (P=0.136). In histologic analysis, the experimental groups re-epithelialized more than control groups. No evidence was found of severe inflammation. Conclusion: The healing of burn wounds was faster with silk weave textile more than the control group. There was no atypical inflammation with silk dressing materials. In conclusion, silk dressing materials could be used to treat burn wounds.

• 대한의생명과학회지
• /
• 제7권3호
• /
• pp.139-143
• /
• 2001

The present study was conducted to determine whether skin spread of Myrrha has an effect on the cell regeneration as well as wound healing following dermal scald burn injury, keratinocyte growth factor (KGF) level was analyzed immunologically in conjunction with the histological changes occurred in skin tissue. The KGF contents in Myrrha skin spread group, which shows cell regeneration ability in skin tissue after burn, increased after 5 hours. After 24 hours, 'the content of Myrrha skin spread group is noticeably higher than at 5 hours postburn. After 72 hours, KGF was decreased compared to at 24 hours postburn. Acceleration effect of KGF production in Myrrha skin spread group was high. Together with the result of histological changes, skin spread of Myrrha reduced protein degeneration and edema in dermis, and induced proliferation of epithelial cells. The data suggest that Myrrha has accelerate cell regeneration and wound healing in case of scald burn skin by spreading of paste.

• 대한화상학회지
• /
• 제23권2호
• /
• pp.60-63
• /
• 2020

A 72-year-old man with diabetes, who underwent moxibustion, developed a foot wound but did not receive proper treatment. Examination showed a soft tissue defect (6×6 cm) on the dorsal aspect of the right foot with involvement of the first and second toes along with some phalangeal bone loss. The wound was treated with a skin graft and healed without complications. The right calf showed a raw surface (4×3 cm), which underwent epithelialization after conservative treatment. We observed four focal necrotic lesions (1.5×1.5 cm) on the right lower leg and anterior chest, which served as indicators of moxibustion, and debridement and primary closure were performed. Moxibustion is increasingly used as a therapeutic option; however, statistical data describing its adverse effects are limited. Moxibustion significantly increases skin temperature and can cause burn injuries. It is important to prevent moxibustion-induced adverse effects and avoid severe complications, particularly in patients with diabetes.

• 대한화상학회지
• /
• 제22권2호
• /
• pp.45-48
• /
• 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.

• BMB Reports
• /
• 제42권12호
• /
• pp.800-805
• /
• 2009

This study investigated the effect of subconjunctival injections of bevacizumab, an anti-VEGF antibody, on processes involved in corneal wound healing after alkali burn injury. Mice were divided into three groups: Group 1 was the saline-treated control, group 2 received subconjunctival injection of bevacizumab 1hr after injury and group 3 received bevacizumab 1 hr and 4 days after injury. Cornea neovascularization and opacity were observed using a slit lamp microscope. Corneal repair was assessed through histological analysis and immunostaining for CD31, $\alpha$-SMA, collagen I, and TGF-$\beta$2 7 days post-injury. In group 3, injection of bevacizumab significantly lowered neovascularization and improved corneal transparency. Immunostaining analysis demonstrated a reduction in CD31, $\alpha$-SMA and TGF-$\beta$2 levels in stroma compared to group 1. These results indicate that bevacizumab may be useful in reducing neovascularization and improving corneal transparency following corneal alkali burn injury by accelerating regeneration of the basement membrane.

• Korean Chemical Engineering Research
• /
• 제44권1호
• /
• pp.87-91
• /
• 2006

버섯 유래 다당체는 항암관련 면역활성이 매우 우수하다고 밝혀지고 있다. 이러한 다당체는 화상이나 상처에 의해 야기된 괴사조직 제거와 손상된 상피조직 재생에 관여하는 피부 면역체계를 활성화시킴으로써 치유 효과가 탁월하다고 알려지고 있다. 더욱이 다당체는 생물고분자로서 보습 효과가 우수하여 재생된 상피조직의 2차 감염 및 가피 생성을 억제하는 효과가 있다. 따라서 본 연구에서는 보습 효과와 면역활성이 우수한 치마버섯 유래 다당체를 이용하여 in vivo 실험 및 혈액학적 검사를 통하여 화상 및 상처치유 효과를 검토하였다. 더불어 2차 감염을 유발하는 병원성 미생물의 생육 정도를 검토하여 항균 활성을 확인하였다.