Pediatric burns are frequently encountered in daily practice. Among them, burns in infants account for a particularly high proportion. In this study, we performed a clinical and statistical review of 184 fresh infant burn patients who visited our hospital over an 11-year period from January 2011 to December 2021.
 The number of fresh infant burn cases showed a decreasing trend. Hot water and hot soup accounted for two thirds of the injuries, with hot water from electric kettles in particular increasing, whereas hot water from other causes generally decreased. One reason may be that the number of households with electric kettles has been increasing in recent years. It is necessary to share information about the dangers of electric kettles with families with infants, medical institutions, companies, and the mass media, and to implement countermeasures.

 Negative pressure wound therapy (NPWT) is now widely used for the purposes of wound bed preparation (WBP) in wound management. Burns deeper than DDB are usually treated with skin grafting. NPWT it is not covered by national insurance in Japan; however, it has many advantages as a skin graft fixation method. Herein, we investigate cases using NPWT for burns at our hospital and report its usefulness.
 Twenty-nine patients were divided into the following four groups and compared:
 1. WBP + Graft group (seven cases) using NPWT for both WBP and skin graft fixation
 2. WBP preservation group (four cases) with conservative epithelialization after only WBP with NPWT
 3. WBP + conventional method group (nine cases) where skin graft fixation was performed by a conventional method after WBP by NPWT
 4. Graft group (nine patients) who had a good graft bed and underwent NPWT only for skin graft fixation
 The reasons for performing WBP with NPWT were edematous granulation in eight cases and tendon/bone exposure in 12 cases. The average engraftment rate for skin graft fixation with NPWT was 95.6%.
 Previous studies have reported that NPWT provides good WBP for general wounds and that it can also be used as a fixation method for skin grafts. In addition, it is possible to easily fix special parts, such as hands, that require experience with conventional methods for fixing skin grafts. Improvement of QOL can be expected through rehabilitation from the early postoperative period. Our findings suggest that NPWT is a useful treatment option for burns in the elderly. Its use is expected to increase along with the increase in the elderly population.

 Aim: Burn patients are a high-risk group for developing invasive candidiasis, but there are few reports on risk factors for candidemia. The purpose of this study was to clarify the risk factors for candidemia in patients with severe burns.
 Methods: Data from 72 severe burn patients over a 14-year period from 2008 were retrospectively analyzed. Patients with severe burns were defined as those with more than 30% second-degree burns or more than 10% third-degree burns. Candidemia was defined as the isolation of Candida from blood culture samples.
 Results: Univariate analysis showed significant differences in total burn surface area (TBSA) and mortality between the candidemia and the non-candidemia groups. Multivariate logistic analysis revealed that TBSA was independently associated with the development of candidemia. The optimal TBSA cutoff value for candidemia was 50, and a TBSA value of 50 could predict complications of candidemia with a sensitivity of 63% and a specificity of 80%.
 Conclusion: TBSA value could be a risk factor for candidemia in severe burn patients. Patients with a TBSA of more than 50% should be considered as at risk for development of candidemia.

 Benzalkonium chloride (BZK) has become more accessible due to the COVID-19 pandemic. Herein, we report a case of subcutaneous injection of BZK as a suicide attempt.
 The patient was a 50-year-old female. The patient injected a 10% BZK solution subcutaneously into the dorsum of the left hand and cubital fossa as a suicide attempt. On admission, redness on the back of the left hand and induration in the cubital fossa were noted. We applied cooling and steroid ointment; however, redness and swelling worsened. On the 10th day, coagulated necrotic adipose tissue was widely observed under the skin, and debridement and local negative pressure wound therapy were performed. On the 29th day, the wound on her left back was partially sutured, the remaining skin defect was fixed with the artificial dermis, and local negative pressure wound therapy was applied. The scar healed, and we sutured the left cubital fossa wound.
 Subcutaneous injection of chemicals requires aggressive incision and debridement, even in patients with poor skin findings.

 Sauna burns have been reported to be triggered by loss of consciousness (LOC). At our hospital, we encountered five cases of sauna burns between 2012 and 2021. Age, sex, number of days from injury to first visit, mechanism of injury, injured site, causes of injury, % total body surface area, burn depth, presence or absence of surgery, hospitalization, and outcome were retrospectively investigated from medical records. The age of the subjects was 64-76 years old (mean 71±4), and all five cases were injured due to LOC. LOC may be associated with dehydration and decreased cerebral blood flow due to sauna bathing. Sauna burns are classified as contact burns or hot air sauna burns, both of which often deepen over time. We recommend informing sauna users about the risks of LOC and encouraging appropriate rehydration.

 A 34-year-old man accidentally came into contact with a high-voltage copper wire while working at a power substation. He was shocked by 30,000 volts of current. He had third-degree burns on his back and both thighs. Third-degree burns accounted for 3% on the back, 1% on the right thigh, and 1.5% on the left thigh. From the day after the injury, we routinely gradually removed necrotic tissue, including that from muscles of the back and both thighs, at his bedside. On day 21 post-injury, as no expansion of the injured area was detected on contrast-enhanced computed tomography or magnetic resonance imaging, tangential excision of necrosis and the application of artificial dermis on the third-degree burns were performed in the affected areas. We applied negative pressure wound therapy from day 33 to 52 and a split thickness skin graft on day 52. On day 73, the wounds had closed, and the patient was discharged. Electric current burns differ from normal ones in that they flow through the body, so it is important to wait a sufficient period to assess the extent of tissue damage using diagnostic imaging before closing the wound.

 Backdraft is a phenomenon in which an explosion occurs in an airtight space filled with flammable gas because of incomplete combustion when fresh air suddenly enters the space. Herein, we report a rare case of burn injury caused by a backdraft in a kotatsu fire. A kotatsu is a traditional Japanese heating appliance, consisting of a small table with an electric heater covered with a quilt.
 The patient was an 89-year-old woman. She noticed smoke coming from the kotatsu and pulled the quilt causing flame to erupt. She suffered burns on the face and hands similar to that of a blast injury.
 The fire was severe according to the fire brigade's onsite verification, which also reported that a backdraft phenomenon had occurred. Explosive fires caused by backdraft phenomena are extremely dangerous because of the high potential for serious burn injuries. In the present case, the patient received conservative treatment and was epithelialized for 3 weeks post-injury.
 Precursor signs of possible backdrafts may include thick smoke from a kotatsu and high temperature of the top panel. Recognizing that backdrafts can also occur in a kotatsu fire and educating people to be aware of the signs are necessary.

 In order to elucidate the difficulties faced by nurses providing care to burn patients in the context of plastic and reconstructive surgery, we conducted focus group interviews (FGIs) covering this topic with nine nurses working in a plastic and reconstructive surgery ward and performed qualitative descriptive analysis on the responses. After extracting and summarizing from the FGI transcripts, there were 101 codes for difficulties. From these, 27 subcategories were generated based on similarities and differences, and seven major categories were generated. The categories were as follows: “difficulties in burn wound care under analgesia and sedation”, “concerns about transitional care for severely burned patients”, “difficulties in supporting self-care with burn wounds”, “difficulties in supporting the body image acceptance process”, “difficulties in providing mental health care based on the injury process”, “difficulties in supporting discharge considering the patient's environment”, and “difficulties in supporting family members involved in the injury”. The background of difficulties included the need for care that requires a variety of specialized knowledge, the need for discharge support interventions that take into account complex background factors (such as the patient's mental state and relationships with family members), and the patient's individuality. In order to solve these difficulties, the following measures were considered useful: increasing the amount of knowledge gained from burn nursing experience (such as case studies of difficult cases and providing opportunities to learn about patient conditions after discharge through collaboration with outpatient departments), strengthening multidisciplinary collaboration, and utilizing specialists and resource nurses in various fields.