Self-harm is classified as a nonsuicidal self-injury and paraphilia disorder. On the other hand, domestic violence（DV）is a social problem that still tends to increase. DV includes various types of harm, including intentional burns caused by cigarettes.
 Herein, we report a patient who was diagnosed with a labial burn scar caused by self-harm and suggested paraphilia, which was initially thought to be due to DV.

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 We experienced a case involving a patient with extensive burns complicated by a necrotizing soft tissue infection. The infection was caused by Aeromonas hydrophila due to exposure to sewage. A 67-year-old man was driving his own car on the highway when he became involved in a single-car accident. His car caught fire and he sustained burn injuries. He was found lying in a nearby irrigation ditch by the emergency medical team. At the time of initial examination, he had deep, grade II and III burns on the head, face, both upper extremities, left back, and left lower extremity. The burn index was 22.5, and 30% of his total body surface area was burned. Despite early debridement and prophylactic antimicrobial therapy, necrotizing soft tissue infection due to Aeromonas hydrophila developed. Multiple additional debridements and major limb amputations were performed, but the infection could not be controlled. The patient died 37 days after the injury. When exposure to sewage occurs in patients with extensive burns that may cause them to become immunocompromised, it is important to consider the possible development of severe soft tissue infection and take early measures including adequate washing, early debridement, and major amputation as necessary.

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 Cultured epithelial autografts have been used for the treatment of extensive burns; however, such treatments often fail because of wound infection or mechanical deviation. Thus, the use of proper primary dressing is important for engraftment. Herein, we report treatment of extensive burns using a dialkylcarbamoyl chloride (DACC) -coated dressing as the primary dressing of cultured epidermis.
 A 75-year-old patient sustained burns on the head, face, back, and limbs. Thirty-one BPD, we performed debridement, and transplantation of cultured epidermis and meshed autografts (ratio 3:1). We covered the patient with DACC-coated dressing. When we removed the DACC-coated dressing on the 7th postoperative day, cultured epidermis and meshed autografts had survived.
 DACC-coated dressing irreversibly binds to pathogenic microorganisms by hydrophobic interaction and inactivates them. This effect lasts for up to 7 days. Our findings suggest that DACC-coated dressing is effective for infection prevention in cultured epidermis transplant regions.

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 In debridement with deep dermal burns on the Achilles tendon and the back of the hand, tangential excision is performed to excise and remove only the necrotic tissue in the tangential direction with a razor; however, a certain degree of technique is required. We report successful treatment of a patient by performing debridement with Ultra Curette^® for a burn on the Achilles tendon. The patient was a 73-year-old woman who was injured by flames. We could perform debridement with a small amount of bleeding without exposing the tendon with Ultra Curette^® for deep dermal burn on the Achilles tendon. The autologous split-thickness skin graft transplanted to the Achilles tendons was all engrafted, and 10 months after the operation, there was no contracture and limitation of the range of motion of the ankle joint. Ultra Curette^® can remove only necrotic tissue while preserving viable tissue. It is therefore considered to be an effective and useful device to perform debridement for deep dermal burns where the skin is thin and tendons and bones may be exposed such as the Achilles tendon and the back of the hand.

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 Higher brain dysfunction is a general term for mental and psychological functions including cognitive processes, such as perception, memory, learning, thinking, and judgment, and emotions. Higher brain dysfunction is a condition in which cognitive dysfunction occurs due to brain damage caused by cerebrovascular accidents, encephalitis, or brain trauma. In the present report, we describe treatment of higher brain dysfunction due to severe acute carbon monoxide poisoning in a patient with flame burns.
 The patient was a 20-year-old man who was found lying down in a fire at home when he was rescued. Due to his unstable respiratory condition, he was intubated in the trachea in the on-site ambulance and transferred to our hospital. At the time of admission, he showed a large amount of fresh bloody sputum from the tracheal tube, and bronchoscopy showed soot adhesion in the trachea and an abnormally high CO-Hb value (42.9%) . Extensive third-degree burns were found on his right forearm and back. Ventilator management was required for the treatment of airway burns and acute lung injury, and initial hyperbaric oxygen therapy (HBOT) could not be performed.
 Although he had higher brain dysfunction, he continued to undergo HBOT and rehabilitation during hospitalization and gradually improved. There are various findings about the effectiveness of HBOT, but in the present case, it was considered that HBOT was effective for treatment of higher brain dysfunction due to acute CO poisoning.

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