Objectives : Fire needling has been applied as the treatment for various diseases and been getting much attention from Oriental medicine due to its excellent effectiveness as the results of clinical studies have reported. However, the research findings on the safety of treatment method, materials for the Fire needling needle materials and the possibility of burn injury during the procedure are still insufficient. Methods : A thermo imaging camera was used to confirm the temperature distribution on acupuncture needle and the treatment area during the fire needling therapy. Then the degree of thermal injury was observed by H&E stain and TUNEL assay. In addition, in order to assess the safety of acupuncture materials, we conducted MTT assay using a L6 cell line. Results : The average temperature of the skin surface was observed at $47{\sim}51^{\circ}C$ after classic fire needling and $30^{\circ}C$ after warming fire needling. Warming fire needling therapy does not induce a burn on the tissue and a third degree burn was observed locally in the muscle and skin layers after classic fire needling treatment. This confirms that hwa-acupuncture therapies do not cause major burns. According to the safety assessment test result, no cytotoxicity was detected in the warming fire needling materials. This confirms the safety of the acupuncture materials Conclusions : Various research results on the biological safety of fire needling. Since fire needling therapy induces a burn locally without leaving any scar, and as other results indicate, it is considered a safe treatment method.
A 26 year old male patient had admitted to the department of plastic surgery for the treatment of skin defect of forearm and spastic contracture of right hand, attributable to burn injury following carbon monoxide intoxication. After receiving skin graft the patients tenotomy of flexor tendons, the patients was consulted to pain clinic for further evaluation and treatment of allodynia, hyperalgesia, and hyperpathia with marked emotional insufficiency. The patient was treated with stellate ganglion blocks, intermittent or continuous epidural blocks, and intermittent brachial plexus blocks for 3 months. with this treatment the patient's pain level improved to(VAS 10 to 4~5) and was discharged. The patient was readmitted 3 months later, due to the aggrzvation of pain. Brachial plexus blocks were given again by interscalene, supraclavicular, or axillary route, sometimes using a catheter, together with cervical epidural blocks. Tricyclic antidepressant was also prescribed. The results were remarkably good(VAS 2~3) and the patient did not require any further analgesic medication.
Large scalp defects resulting from high-voltage electrical burns require free flaps, preferably skin, to permit optimal coverage and enable future or simultaneous cranial vault reconstruction. The anterolateral thigh permits the harvest of a large area of skin supplied by a reliable perforator. The superficial temporal vessels offer the proximate choice of recipient vessels to enable adequate reach and coverage. The lack of a second vein at this site implies the inability to perform a second venous anastomosis; however, this obstacle can be overcome by using an interposition vein graft, to the neck veins primarily. This assures adequate venous drainage and complete flap survival.
Kim, Min-Keun;Yoo, Ki-Yeon;Kwon, Kwang-Jun;Kim, Seong-Gon;Park, Young-Wook;Lee, Kwang-Gill;Jo, You-Young;Kweon, Hae-Yong
Maxillofacial Plastic and Reconstructive Surgery
/
v.36
no.3
/
pp.111-115
/
2014
Purpose: This study evaluated powdered burn wound dressing materials from wild silkworm fibroin in an animal model. Methods: Fifteen rats were used in this experiment. Full-thickness $2{\times}2cm$ burn wounds were created on the back of rats under anesthesia. In the two experimental groups, the wounds were treated with two different dressing materials made from silkworm fibroin. 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: By gross observation, there were no infections or severe inflammations through 14 days post-injury. The differences among groups were statistically significant at seven days and 14 days, postoperatively (P<0.037 and 0.001, respectively). By post hoc test, the defect size was significantly smaller in experimental Group 1 compared with the Control Group and experimental Group 2 at seven days postoperatively (P=0.022 and 0.029, respectively). The difference between Group 1 and Group 2 was statistically significant at 14 days postoperatively (P<0.001). Group 1 and control also differed significantly (P=0.002). Group 1 showed a smaller residual scar than the Control Group and Group 2 at 14 days post-injury. Histologic analysis showed more re-epithelization in Groups 1 and 2 than in the Control Groups. Conclusion: Burn wound healing was accelerated with silk fibroin spun by wild silkworm Antheraea pernyi. There was no atypical inflammation with silk dressing materials. In conclusion, silk dressing materials can be used for treatment of burn wound.
Lee, Ju Ho;Shin, Se Ho;Kim, Hyeon Jo;Lee, Seong Joo;Kim, Seong Hwan;Suh, In Suck;Kim, Jae Hyun
Journal of the Korean Burn Society
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v.23
no.2
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pp.54-59
/
2020
Purpose: A fourth degree burn is a full-thickness burn of the skin usually accompanied by damage to deep structures and commonly results in extensive damage to surrounding tissues which makes the treatment of the wound difficult. Coverage of these wound using free flap is known to effective but not commonly used. The purpose of our study is to review our experience and suggest early application of free flap surgery. Methods: A retrospective review was performed from 2010 to 2019, on a total of 34 fourth degree burn patients undergone free flap surgery as primary treatment in our hospital. We reviewed the location of the injury, etiology, TBSA (%), Presence of osteomyelitis, flap choice, complications, period of injury to surgery and healing. Results: Using free flap as a primary reconstrcuction, the outcome is satisfactory. The treatment period was shortened, and there was less loss of function due to complications. Also the incidence of osteomyelitis and amputation was significantly low. Conclusion: Applying free flap surgery as soon as possible in fourth degree burns is effective, such as reducing complications such as infection, reducing amputation, shortening treatment period, and preventing severe sequelae.
Purpose: The two major concerns in skin grafting are poor color match in the recipient site and the donor site morbidity. And, glabrous skin on the palmar aspect of the hands and plantar aspect of the feet attributes define the skin on the palm and fingers sole as functionally and aesthetically different from skin on other parts of the body. When there is a glabrous skin defect, it should be replaced with similar skin to restore function and aesthetics. The palmar crease areas were used to minimize these problems. The purpose of this study is to present the precise surgical technique of the full thickness skin graft using distal palmar and midpalmar creases for aesthetic better outcome for hand injuries. Methods: From May 2006 to April 2010, 10 patients with 11 defects underwent glabrous full thickness skin grafting of finger defects. Causes included seven machinery injuries, two secondary burn reconstructions, and one knife injury. Donor sites included ten glabrous full thickness skin graft from the distal palmar crease and one from the midpalmar crease. Results: Follow-up ranged from 3 months to 24 months. All glabrous skin grafts demonstrated complete taking the recipient sites and no incidence of the complete or partial loss. The donor site healed without complications, and there were no incidences of significant hypopigmantation, hyperpigmentation, or hypertrophic scarring. Conclusion: The important aspects of this method involve immediate return of glabrous skin to the defect site and restoration of the recipient site's crease by simple primary closure from adjacent skin. The glabrous skin of the palm provides the best tissue match for the reconstruction of the hands, but only a limited amount of tissue is available for this purpose. Full thickness skin grafting using palmar crease of the defects is the ideal way of reconstructing glabrous skin to restore both function and aesthetics and minimize donor site morbidity.
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.
Lellouch, Alexandre G.;Ng, Zhi Yang;Pozzo, Victor;Suffee, Tabrez;Lantieri, Laurent A.
Archives of Plastic Surgery
/
v.47
no.2
/
pp.194-197
/
2020
Anterior neck burns represent a major reconstructive challenge due to severe sequalae including restriction in movement and poor aesthetic outcomes. Common treatment options include skin grafting with/without dermal matrices, and loco-regional and distant free flap transfers with/without prior tissue expansion. Such variation in technique is largely influenced by the extent of burn injury requiring resurfacing. In order to optimize like-for-like reconstruction of the anterior neck, use of wide, thin and long flaps such as the anterolateral thigh (ALT) perforator flap have been reported with promising results. Of note, some patients have a tendency towards severe scar contractures, which may be contributed by the greater extent of inflammation during wound healing. We report our experience at 4 years' followup after secondary reconstruction of severe, anterior neck burn contractures in two patients by harvesting the ALT flap with a butterfly design. This technique provides adequate wound resurfacing of the burned neck and surrounding areas, and provides good neck extensibility by addressing both anterior and lateral aspects of the scar defect simultaneously. Such a flap design reduces tension on wound edges and thus, the risk of contracture recurrence in what remains a particularly challenging type of burn reconstruction.
The Journal of Korean Academic Society of Nursing Education
/
v.9
no.2
/
pp.234-243
/
2003
The researcher has studied the types of accidents and injuries that most often occur to infants, toddlers and preschool children. Using this knowledge, a first aid program was developed for mothers. This researcher used a Quasi experimental study which consisted of a nonequivalent control group pretest - posttest design for injury first-aid knowle. The experimental group consisted of 32 mothers, and the control group consisted of 29. The education program consisted of the types of injury, the structure and function of skin, the methods of obsevation, first-aid awareness, and the standard of professional support in case of contusion, abrasion, laceration, fracture and burn. The education program was developed and based on 'the systemetic design of instruction' by Dick & Carey(1996) and utilized multimedia text book, pictures, examples, practice and discussions to increase understanding and effectiveness of learning. The data for this study was collected from September to early November, 2001. There were two fomative evauations, pretest and posttest with an intervention of education program. The analysis of the collected data was analyzed by descriptive analysis, ANOVA, t-test and paired t-test using the SPSS 10.0 program. The results as follows; 1. The experimental group, who was given an education program before the test, got higher marks on the injury first-aid knowledge than the control group. There was a significant difference in knowledge between experimental group and control group(t=6.578, p=.000). 2. The experimental group got higher marks on the action evaluation than the control group. There were significant differences in the certainity of action (t=8.546, p=.000) and the accuracy of action (t=7.654, p=.000) between experimental group and control group. This study examined how a first aid education program increased effectiveness in the knowledge and action of injury first-aid.
Fire fighters rely on fire fighter protective clothing (FFPC) to provide adequate protection in the various hazardous environments. To enhance its protection performance, the FFPC material must be thick and thus it is difficult to achieve weight reduction. One of the methods of overcoming this problem, the addition of phase change material (PCM) to FFPC, is a new technology. In previous studies, the researches was mostly related to the temperature characteristics of the fibers incorporating PCM, but little information is available about its effect on burn injuries. Thus, in this study, the inhibitory effects of adding PCM to FFPC on second degree burns were investigated through numerical calculations. Thermal analyses of biological tissues and FFPC with embedded PCM exposed to several fire conditions causing severe tissue damage were studied by using a finite difference method based on the Pennes bio-heat equation. FFPC with embedded PCM was found to provide significantly greater protection than conventional fire fighting clothing, because the heat of absorption due to the phase change within the material is used to limit the heat conduction of the material.
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