Hua, Cheng;Lyu, Lele;Ryu, Hyun Seok;Park, So Young;Lim, Nam Kyu;Abueva, Celine;Chung, Phil-Sang
Medical Lasers
/
v.9
no.1
/
pp.51-57
/
2020
Background and Objectives For experiments on simulated burn, the preparation of an animal model is a very important step. The purpose of the current experiment is to design a simple and controllable method for the preparation of third-degree scald in a mouse model using the boiling water method. Materials and Methods A total of 18 Swiss mice were used. After the anesthetization, the mice were scalded by boiling water (100℃) using a mold with a 1 cm2 circle area on the dorsum at contact times of 3s, 5s, and 8s. After confirming that 8 seconds of scald can cause a third-degree scald, the skin samples were collected at day 2, 4, 6, 8, 10, and 12, and analyzed by histopathological examinations. The wound retraction index (WRI) was also measured. Results Third-degree scald involving full-thickness skin was observed in the 8-second scald group, while a 3-second scald caused a superficial second-degree scald and a 5-second scald caused a deep second-degree scald. After third-degree scald, the burn wound continued to contract until day 14. Conclusion The scalding model of mice can be successfully established by the boiling water method. This method is easy to operate, it has a low cost, and it can control the scald depth by controlling the scald time. This is adequate to study skin thermal injury in the future. The scald model established by this method can last for 14 days.
Park, Jae Hee;Bang, Sa Ik;Kim, Suk Han;Im, So Young;Mun, Goo Hyun;Hyon, Won Sok;Oh, Kap Sung
Archives of Plastic Surgery
/
v.32
no.4
/
pp.408-415
/
2005
Following a transverse rectus abdominis musculocutaneous(TRAM) flap breast reconstruction, denervated state of the flap causes the flap skin prone to thermal injury, calling for special attention. During the last 5 years, 69 breast reconstruction with 72 free TRAM flaps, were performed. Four out of thesse 69 patients sustained burn injury. Heat sources were a warm bag(n=2), heating pad(n=1) and warming light (n=1). The thermal injuries occured from 2 days to 3 months following the reconstruction. Three patients healed with conservative treatment, but one patient required debridement and skin graft. Initially 3 out of 4 patients with the burn had shown superficial 2nd degree burn with small blebs or bullae. However all 4 patients healed with scars. Mechanism of burn injuries of the denervated flap are known to be resulting from; 1) loss of behavioral protection due to denervation of flap with flap elevation and transfer, 2) loss of autonomic thermoregulatory control with heat dissipation on skin flap vasculature contributing to susceptibility of burn injury. 3) changes of immunologic and normal inflammatory response increasing thromboxane, and a fall in substance P & NGF (nerve growth factor). Including the abdominal flap donor site, sensory recovery of the reconstructed breast varies individually from 6 month even to 5 years postoperatively. During this period, wound healing is delayed, resulting in easier scarring compared to that observed in the sensate skin. Patients should be carefully informed and warned of possible burn injuries and taught to avoid exposure to heat source at least until 3 years postoperatively.
Lee, Paik Kwon;Bae, Joon Sung;Ahn, Sang Tae;Oh, Deuk Young;Rhie, Jong Won;Han, Ki Taik
Archives of Plastic Surgery
/
v.32
no.4
/
pp.403-407
/
2005
Following a transverse rectus abdominis musculocutaneous(TRAM) flap breast reconstruction, denervated state of the flap causes the flap skin prone to thermal injury, calling for special attention. During the last 5 years, 69 breast reconstruction with 72 free TRAM flaps, were performed. Four out of thesse 69 patients sustained burn injury. Heat sources were a warm bag(n=2), heating pad(n=1) and warming light (n=1). The thermal injuries occured from 2 days to 3 months following the reconstruction. Three patients healed with conservative treatment, but one patient required debridement and skin graft. Initially 3 out of 4 patients with the burn had shown superficial 2nd degree burn with small blebs or bullae. However all 4 patients healed with scars. Mechanism of burn injuries of the denervated flap are known to be resulting from; 1) loss of behavioral protection due to denervation of flap with flap elevation and transfer, 2) loss of autonomic thermoregulatory control with heat dissipation on skin flap vasculature contributing to susceptibility of burn injury. 3) changes of immunologic and normal inflammatory response increasing thromboxane, and a fall in substance P & NGF (nerve growth factor). Including the abdominal flap donor site, sensory recovery of the reconstructed breast varies individually from 6 month even to 5 years postoperatively. During this period, wound healing is delayed, resulting in easier scarring compared to that observed in the sensate skin. Patients should be carefully informed and warned of possible burn injuries and taught to avoid exposure to heat source at least until 3 years postoperatively.
Kim, Dong Hoon;Yoo, Jung Seok;Lim, Jun Kyu;Lee, Dong Lark
Archives of Plastic Surgery
/
v.35
no.1
/
pp.67-72
/
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.
The Journal of the Korean Society for Microbiology
/
v.16
no.1
/
pp.19-28
/
1981
The Pseudomonas infection has been increased in incidence and suspected as a cause of opportunistic pathogen. Protease and elastase produced by Pseudomonas aeruginosa are reported to be closely associated with pathogenicity of Pseudomonas aeruginosa. We examined, in this work, the relationship between production of exoenzyme of Pseudomonas aeruginosa and susceptibility to antimicrobial agents in view of possible application to the management of Pseudomonas infection. 1. In 295 Pseudomonas aeruginosa isolated from clinical specimens, 34.6% were from pus, 20.7% from sputum, 15.6% from wound including burn sites and 12.9% from urine. 2. Distribution of protease and elastase production by clinically isolated Pseudomonas aeruginosa, showed that protease and elastase producing strains were 83.1%, protease producing strains were 7.5%, elastase producing strains were 2.0%, and non producing strains were 7.5%. 3. MIC(minimum inhibitory concentration) peak for tetracycline and chloramphenicol were observed at 25mcg/ml and 200mcg/ml respectively, but there were no Pseudomonas aeruginosa which correspond to MIC peak, 6.25mcg/ml. Gentamicin of aminoglycosides was highly susceptible to Pseudomonas aeruginosa clinically isolated from pus, sputum and wound sites, but susceptible to isolates from nasal discharge and urine. Regarding MIC peak of carbenicillin, 100mcg/ml, 81.8% of Pseudomonas aeruginosa were from urine, 54.8% from wound including burn sites, 52.7% from pus, and 50.8% from sputum. 4. Enzyme producing strains showed no susceptibility to kanamycine and carbenicillin at low concentration, but protease producing strains tend to resistant to antimicrobial agents.
In this study, we investigated the efficacy of ${\beta}$-cyclodextrin (${\beta}CD$) hydrorogel containing silk fibroin (SF) on healing burnt wound. Tosyl ${\beta}CD$ was conjugated to polyethyleneimine (PEI) using epichlorohydrin (EPI) as a cross-linker. The ${\beta}CD/PEI/SF$ hydrogel was applied on the back of mouse and then the efficacy of hydrogel was compared with both positive control group and negative control group. There was no wound healing efficacy showed neither in the drug loaded ${\beta}CD/PEI/SF$ hydrogel group nor in the drug unloaded ${\beta}CD/PEI/SF$ hydrogel group. On the other hand, in the positive control group, a significant reduction of the wound size after the usage of OTC hydrorogel was obtained. The burn-healing histological result showed a similar phenomenon. After hematoxylin-eosin staining the skin induced by burning, and the epithelial growth observed in the dermis, the efficacy of ${\beta}CD/PEI/SF$ hydrogel in healing burnt wound could not be clearly identified.
Poly-${\gamma}$-glutamic acid (${\gamma}$-PGA) is a natural edible polypeptide in which glutamate is polymerized via ${\gamma}$-amide linkages. First, we assessed the eye irritancy potential of ${\gamma}$-PGA in rabbits. Additionally, we studied the effects of ${\gamma}$-PGA on corneal wound healing, due to the anti-inflammatory properties and water retaining abilities of ${\gamma}$-PGA. In this study, the effects of ${\gamma}$-PGA on corneal wound healing after an alkali burn were evaluated. Thirty eyes wounded by alkali burning in 30 white rabbits were divided into three groups: group A was treated with 0.1% 5,000 kDa ${\gamma}$-PGA for 2 days; group B was treated with 0.1% hyaluronic acid; and group C was not treated, as a control. The area of corneal epithelial defect was examined at 12, 24, 30, 36, 42, and 48 h after corneal alkali wounding to determine initial wound healing. We found that ${\gamma}$-PGA promoted corneal wound healing, compared with controls, and showed similar effects to hyaluronic acid. These results indicate that ${\gamma}$-PGA stimulates corneal wound healing by an anti-inflammatory effect and enhancing cell migration and cell proliferation. ${\gamma}$-PGA is a promising biomaterial that may be a substitute for hyaluronic acid in corneal wound healing treatment.
Background : An area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion. Methods : From January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling. Results : The mean age of patients was $49.9{\pm}12.2$ years, with 8 male and 2 female. The size of the burn wound was an average of $119.6{\pm}36.7cm^2$. The mean expansion duration was $65.5{\pm}5.6$ days, and the inflation volume was an average of $615{\pm}197.6mL$. Mean defect size was $122.2{\pm}34.9cm^2$. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision. Conclusions : Successful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.
Purpose: Negative pressure therapy has been used in various conditions to promote wound healing. It has also been used to secure a skin graft by improving microcirculation and improving tight adhesion between the graft and the recipient bed. To reduce post burn scar contracture and improve aesthetical result, many types of dermal substitutes have been invented and used widely. The goal of this study was evaluate usefulness of the VAC (Kinetic concepts Inc., San Antonio, TX) in improving the take rate and time to incorporation of Integra$^{(R)}$ in reconstruction of burn scar contracture. Methods: A retrospective study was performed from October, 2006 to December, 2008. The VAC was utilized for 11 patients. The average patient's age was 19.7 years (range 5 - 27) and average surface area was $785cm^2$ (range 24 - 1600). The burn scars were excised deep into normal subcutaneous tissue to achieve complete release of the scar, Integra$^{(R)}$ was sutured in place with skin staple와 Steri - strip$^{(R)}$. Then slit incisions were made on silicone sheet only with No.11 blade for effective drainage. The VAC was used as a bolster dressing over Integra$^{(R)}$. Negative - Pressure ranging from 100 to 125 mm Hg was applied to black polyurethane foam sponge trimmed to the appropriate wound size. An occlusive seal over the black polyurethane foam sponge was maintained by a combination of the occlusive dressing, OP - site$^{(R)}$. The VAC dressing changes were performed every 3 or 4 days until adequate incorporation was obtained. The neodermis appeared slightly yellow to orange color. When the Integra$^{(R)}$ deemed clinically incorporated, The VAC was removed and take was estimated with visual inspection. Very thin STSG(0.006 ~ 0.008 inches) was performed after silicone sheet removal. Result: The mean time for clinically assessed incorporation of Integra$^{(R)}$ was 10.00 days (range 9 - 12). The mean dressing change was 3.5 times until take was obtained. In All patients, Integra$^{(R)}$ had successful incorporation in tissue without serious complications. Conclusion: Integra$^{(R)}$ in combination with Vacuum - Assisted Closure(VAC) may be incorporated earlier than conventional dressing method.
A 9-year-old intact female Poodle (weighing 3.6 kg) was presented for the treatment of a partial and full thickness burn that covering 45% of body including bilateral thigh and sacrolumbar region. Autologous platelet-rich plasma (PRP) stimulates angiogenesis, promoting vascular in-growth and fibroblast proliferation. On the unrecovered right thigh of the dog, autologous PRP was injected into the lesion after application of micro-needles. For macroscopic evaluation digital, photographs were taken from wounds at days 0, 3, 5, 13, 21, and 28. On the $3^{rd}$ day after PRP application, epithelialization was accelerated. Application of autologous PRP accelerated wound-healing rate and healing time in full thickness burns as well as secondary complications originating from unrecovered wounds. The delayed lesion was completely healed on the $28^{th}$ day by autologous PRP treatment. In human, PRP was increasingly used in the treatment of a variety of soft tissue in the management of chronic non-healing wounds. This study has shown that PRP treatment can be a valuable and effective aid on intractable wound healing in the dog with burns.
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