Nexobrid^® is a novel enzymatic debridement agent that removes eschar in burn wounds. It is a therapeutic alternative to surgical excision because it provides selective, minimally invasive, and quick eschar removal in early application from injury.
 The efficacy and safety have been shown by clinical studies in patients with deep partial and full-thickness burns. It reduces the physical burden of patients because it reduces autograft and blood loss compared to the standard treatment. In addition, its usefulness for hand and face burns for which advanced techniques are required in surgical excision has been reported. Nexobrid^® removes eschar without harming viable tissue.
 Nexobrid^® requires adequate treatment in addition to application such as pain control and soaking. In this study, we describe appropriate use and tips and techniques for using Nexobrid^® for treatment of debridement.

 We reviewed 119 cases of infant burns that visited the Department of Plastic and Reconstructive Surgery, Kanazawa Medical University Hospital, during the 10-year period from January 2012 to December 2021.
 We retrospectively examined sex, age at injury, cause of injury, month of injury, burn area, depth of injury, site of injury, hospitalization, and surgery of 119 eligible cases using electronic medical records. The results were compared with the Burn Registry of the Japanese Society for Burn Injuries.
 Burn injuries were mostly caused by caregiver negligence in the youngest infants and toddlers. The circumstances of burn injuries changed as the children grew older and their range of activities expanded. The causes of injury were influenced by the child's development and living environment and were characteristic of each growth stage.
 The occurrence of infant burns can be predicted; thus, it is important to educate parents and guardians to be aware of the causes of burns. It is also necessary to adapt to changes in lifestyle and new heat sources.

 We report a case of burn injury with an unfavorable outcome, as the patient's family declined for the patient to receive treatment. An 86-year-old man was brought to the hospital with flame burns. His level of consciousness was clear at the time of admission. We found burns of 16% total body surface area and a prognostic burn index of 97 on the face and both upper and lower limbs. At the time of admission, the patient and his family requested aggressive treatment. However, when we explained to them that we could not expect a functional prognosis, they refused the treatment due to the cost of nursing care. On day 12, the best supportive care policy was adopted. On day 44, the patient died. Recently published guidelines for treating burns include a section on liaison, which is expected to be applied in clinical settings. Consideration of clinical ethics by a multi-professional and multi-institutional committee is necessary.

 We performed MEEK micrografts on five patients (three males, two females, 64.0±17.0 years old). Patients had a burn area of 18.8±16.1% TBSA (mean±SD). MEEK skin grafts have been reported to have excellent skin expansion, faster epithelialization, and shorter operation times than mesh skin grafts. In the present study, outcomes, such as improved engraftment and accelerated epithelialization, were not obtained compared to mesh skin grafts.
 MEEK skin grafts are characterized by the continuous expansion of the interface between the epithelial cells and the wound. We hypothesized that cell proliferation was not suppressed because the cell density at the interface did not increase, which was advantageous for epithelialization.

 Phenol is classified as an aromatic compound. Although it is weakly acidic, it is strongly corrosive and causes protein denaturation on contact. Due to percutaneous absorption, widespread exposure may also cause ventricular tachycardia and central nervous system damage.
 Our patient was a man in his 20s. He was sent to our hospital by ambulance after being exposed to phenol at work when a phenol container broke. Cognitive disturbances arose shortly after the injury. He was sedated, intubated, and admitted to the intensive care unit, as he showed symptoms of central nervous system damage even though he was cleansed immediately upon arriving at the hospital. Phenol is absorbed rapidly into the body, and poisoning symptoms have been reported even when only a small area is affected. Hence, appropriate initial treatment is essential. Chemical injury caused by phenol should be immediately followed by rinsing with running water. Wiping with polyethylene glycol or ethanol (often substituted with rubbing ethanol) is also effective. Furthermore, it has been reported that 15 minutes of rinsing with running water significantly reduces phenol absorption.

 We combined the MEEK system with RECELL, which was approved for clinical insurance use in 2022. Effectiveness and cautionary points were identified during the treatment.
 A 47-year-old male patient suffered from 70%TBSA burn on the face, upper limbs, lower limbs, and back because of flame from a melting furnace. We performed split-thickness skin grafting (STSG) with the MEEK^TM system and RECELL^® on the left upper limb, which had lost previous STSG due to infection. After this procedure, we observed rapid epithelialization.
 The MEEK^TM system provides faster epithelialization compared to conventional mesh skin grafting; however, it still takes time especially when we choose a high expansion rate. This case demonstrates that the period of epithelialization can be shortened by utilizing the MEEK^TM system and RECELL^® together for burn ulcer.

 We treated burn patients with a split-thickness skin graft using MEEK. Case 1 had extensive burns for which we performed three mesh grafts and a skin graft to the neck. The donor site for the skin graft was limited due to the patient's general condition, so MEEK was used for grafting at the fourth surgery. Except for the shoulder area, the graft was successful, and the burn was epithelialized. Case 2 was treated with MEEK grafting and mesh graft after wound bed preparation using artificial dermis. All grafts were successful, and the burn epithelialized. MEEK grafting allows for more reliable expansion than mesh grafting, and the amount of required skin can be calculated. MEEK grafting may be useful for extensive burns with limited donor sites, although it requires more skill in the application of the technique.