JACE^® is an autologous cultured epidermal graft that was developed by Dr. Green in 1975 in the U.S. It has a crucial role in treating extensive burns. JACE^® gained regulatory approval in Japan in 2007 and became covered by insurance in 2009. Initially, it faced challenges due to its delicate nature, which caused poor graft take and detachment, and difficulty in selecting suitable wound beds.
 To enhance effectiveness, a hybrid approach combining JACE^® with autologous high-magnification mesh skin grafts was developed, which boosted the take rate. JACE^® has notably improved survival rates for severe burns. Between 2009 and 2022, about 32,000 sheets were transplanted, whereas only about 70% of the skin harvested from patients was transplanted. This was due to the considerable number of patients whose conditions deteriorated during the wearing period.
 Insurance reimbursement is categorized into reimbursement for collection and use of culture kits, and adjustment and transplantation kits for cases where the usage has surpassed limits. Despite gradual increases, many cases still require exceeding the kit limit for optimal outcomes. In the future, insurance revisions that ease these restrictions are necessary to allow the broader use of JACE^®.

 In April 2011, the Japanese Society for Burn Injury (JSBI) launched the JSBI burn registry 2011 to develop guidelines and enhance the quality of burn care in Japan. By the end of March 2022, there were 120 facilities involved in the registry, and the total number of registrations exceeded 20,000.
 The registry was established as a web-based database and its scope included requests for data entry from each registered facility. The 25 input items were tabulated by year and are shown in an annual report on the JSBI website. The survey covered not only the acute treatment for burn but also reconstructive surgery in the chronic phase.
 In our research, we report on the current status of burn care in Japan based on the JSBI burn registry 2011 from April 2011 to March 2021. This data may reflect the current quality provided by major medical institutions in Japan.
 Conversely, after 11 years of functioning, this registry is supposed to have become inadequately informative due to changes in treatment and revised JSBI clinical practice guidelines for the management of burn care. Since April 2023, the contents and the system of JSBI burn registry 2023 have been completely modified. We hope that the results of this analysis can be applied for further elaboration of burn care by the future generations.

 The anterior surface of the knee joint has thin soft tissue, making it susceptible to bone and joint exposure during burn trauma or soft tissue tumor resection. Therefore, appropriate tissue of the proper size and thickness must be used for reconstruction around the knee joint to avoid joint motion limitation. Additionally, cosmetic factors, such as skin tone, must be considered when reconstructing the exposed area. In this study, we used a superior lateral genicular artery flap to reconstruct two cases of contact burns in the knee joint. Postoperatively, there were no complications, such as infection or limitation of knee joint range of motion, and favorable results were obtained.

 There is growing awareness of the dangers of mobile phones overheating. We conducted a replication experiment to investigate the conditions in which mobile phones act as a heat source leading to deep burns, based on a case where an overheated mobile phone resulted in deep burns during sleep.
 A 72-year-old woman suffered from a low-temperature burn reaching the subcutaneous tissue caused by prolonged contact with an overheated mobile phone under her right shoulder for several hours during sleep. She was treated conservatively for about 5 months by her previous physician, but the condition did not improve, and she was referred to our department. Six months after the injury, the patient underwent a one-stage reconstruction with debridement and local skin flap.
 We conducted a replication experiment. The same model of mobile phone was used as a control device. The degree of thermal change was observed under three conditions: running an application, charging, and keeping the device warm. We found that the device was most likely to heat up and reach the critical temperature needed to cause deep burns when the application was running.
 Our findings suggest that prolonged use of a mobile phone, especially running an application, causes it to overheat and cause deep burns.

 There are various surgical techniques for skin grafts, among which grafting with artificial dermis has been suggested to enhance the skin function and esthetics. Artificial dermis usually takes a few weeks to be engrafted and is generally followed by split-thickness skin grafts (STSG). The sandwich technique using artificial dermis is relatively new, in which meshed STSG is covered by the artificial dermis during the same surgery. To elucidate the clinical effects of the sandwich technique, a multicenter prospective observational study was planned and initiated. Expected favorable effects of the sandwich technique include: 1) shortening the treatment period for deep skin wounds, compared with historical artificial dermis grafting that is followed by STSG, and 2) decreasing the donor-site area for extensive skin wounds, compared with the limited ratio of meshed STSG. Considering that many cofounding factors exist when determining the surgical technique for skin grafts, the appropriate selection of covariates and optimal methods for the evaluation of outcomes were discussed prior to study initiation. The current study will hopefully generate the background knowledge necessary for a randomized controlled trial.