Aim: To investigate clinical characteristics and risk factors related to infectious complications in burn patients.
 Methods: In this retrospective study, we evaluated infectious complications that occurred more than 48 hours after admission of burn patients who spent more than 7 days at our center.
 Results: The participants were divided into an infected group（IG, 35 patients）and a non-infected group（NIG, 28 patients）. Total body surface area（TBSA）, burn index, and APACHE II score were significantly higher in the IG than the NIG. Multivariate analysis showed that TBSA was an independent factor affecting infectious complications in these severity scores（OR=1.242; 95%CI=1.019-1.589; p=0.0482）. Mortality was higher in the IG（17.1%）than in the NIG（0%）. Burn wounds were the most common sites of infection during the first week of admission, whereas central venous catheter-related infections increased in the second week of admission. The causative microorganisms were mostly gram-positive bacteria in the first week, and gram-negative bacteria in the second week. Burn wound infections decreased from the fourth week.
 Conclusion: TBSA was significantly associated with infectious complications in burn patients. In infection control and treatment, clinicians should consider that the sites of infection and causative microorganisms may change depending on the phase.

 Background: In the treatment of deep dermal burns, making treatment decisions in the early stages of the injury is challenging. Measuring and evaluating ‘red points’ in the erythema located on the necrotic surface layer of burn wounds may be helpful in devising treatment strategies.
 Methods: We observed the transition of the wound surface. The number of red points was used to evaluate the number of days from the initial diagnosis until epithelialization, and whether surgery was required.
 Results: A negative correlation was observed between the number of red points and the number of days until epithelialization (r=－0.47).
 Regarding the relationship between the number of red points and surgery, there was a significant difference in the average number of red points in the surgery group (2.06) and in the non-surgery group (6.37) (p=0.0023).
 Conclusion: We found a correlation between the number of red points, the number of days to epithelialization, and being in the surgery or non-surgery group. These findings may be useful in determining treatment strategies for burn injuries.

 Objective: Nexobrid was launched in Japan on August 1, 2023, as a chemical debridement agent for burn wounds. We examined the subsequent treatment course of patients treated with Nexobrid, based on changes in the burn wound surface.
 Method: We retrospectively examined image records and treatment course of patients who visited our hospital and were diagnosed with deep dermal burn (DDB) to deep burn (DB) and were administered Nexobrid.
 Results: A total of 14 cases of DDB to DB, totaling 23 sites, were enrolled. Fourteen sites required conservative treatment and nine sites required surgical treatment.
 We examined the wound surface color from the image records. We found that the subsequent treatment course could be predicted by classifying the changes into four major categories: 1. red (pink) , 2. white, 3. dark red, and 4. exposed fat. Furthermore, the dark red category was sub-classified into three subcategories based on subsequent changes.
 Discussion: The European consensus guidelines classify wound surface changes into four major categories and outline the subsequent course. We found that dark red cases in our classification, which correspond to ‘3. Large diameter red circle or oval patterns’ in the European guidelines, show different changes compared to the other categories. Our findings suggest that by further subclassifying the changes in the dark red category into three subcategories, formulation of a more precise treatment plan is possible.

 We encountered a case of facial deep burns caused by an induction cooktop (IH cooker). We investigated residual heat changes in IH cookers and present our findings as well as verification results.
 A 78-year-old female experienced loss of consciousness while using an IH cooker, sustaining deep burns to the face and the left wrist. On the 13th day post-injury, debridement, skin flap, and grafting procedures were performed. Additional surgeries were conducted on the 27th and 62nd days post-injury.
 The contents of a frying pan were kept boiling on an induction cooker for 5 minutes at a room temperature of 25 degrees Celsius. After the frying pan was removed, we observed and recorded the temperature of the top plate using thermography. Recordings were made every 2 minutes, until the temperature of the top plate surface decreased to 35℃.
 We found that it took 44 minutes for the top plate’s residual heat to decrease to 35℃.
 Our findings suggest that caution is warranted as the IH cooker’s top plate can become excessively hot as a result of heat conduction from a heated frying pan.

 In cases of deep dermal and deep (second and third-degree) burns on the dorsal hand, concerns arise about the invasion of normal tissue, exposure of extensor tendons, bones, and joint capsules, which presents challenges for surgical debridement. Recently, Nexobrid^®, a topical formulation containing proteolytic enzymes, has received approval in Japan, allowing for the selective removal of necrotic tissue. In this study, we applied Nexobrid^® as a non-surgical debridement method to six hands across three cases with dorsal hand burns. This approach resulted in a less invasive and more straightforward debridement process. Furthermore, we were able to achieve early intervention within 42 to 90 hours post-injury in cases of systemic extensive burns. Our findings suggest that bedside debridement can be performed without the need for an operating room. To maximize the effectiveness of Nexobrid^®, careful consideration and experience are essential during the application process. The subsequent treatment strategy after using Nexobrid^® should be considered individually, taking into account the background of each case. The accumulation of cases is necessary.

 After using an enzymatic debridement agent, such as Nexobrid^®, it is recommended that skin grafting should be delayed for at least 2 days. Herein, we report a case in which skin grafting was performed on the same day and all grafts were successful. An 88-year-old female patient sustained a 2% Total Burn Surface Area burn on her right lower leg due to contact with a candle in a Buddhist altar. On the 13th day following the burn incident, enzymatic debridement using Nexobrid^® was performed, followed by supplementary debridement using a hydrosurgery system. Same-day skin grafting was conducted, resulting in successful engraftment of all skin grafts. Our successful performance of same-day skin grafting suggests that delaying grafting for at least 2 days is not necessary. Our findings suggest the efficacy of Nexobrid^® as a treatment strategy.

 RECELL^® (Cosmotec, Japan/Avita Medical, Australia) is a novel cell spray kit containing non-culturable autologous epidermal and dermal cells. This kit has been available in Japan since 2022. It offers a promising alternative for burn treatment by reducing skin donor requirements and eliminating the wait time associated with autologous cultured epidermis. RECELL^®can be used alone or with autologous skin grafts; however, the optimal mesh ratio for major burn injuries remains to be elucidated. Herein, we present two cases of major burns successfully treated using RECELL^®and 1:6 meshed split-thickness skin grafts. In case 1, less epithelialization was observed in the waist region, possibly due to the wet environment. In case 2, several modifications were made to improve outcomes, such as postoperative dry-side management and preventing displacement by increasing the fixation of the skin grafts, which lead to sufficient epithelialization.

 Aim: This study aimed to elucidate the experiences of burn patients from the time of injury through hospitalization to after discharge.
 Methods: Semi-structured interviews were conducted with 10 burn patients, covering their experiences from the time when they were injured through hospitalization to after they were discharged. We performed qualitative inductive analysis of individual interviews and the whole dataset. The categories generated were classified into four time periods with differing treatment environments.
 Results: Analysis generated four categories for the period from injury through emergency department arrival, including “picking up on a sense of urgency from the initial response and situation at the time of injury;” nine categories for the period during emergency department hospitalization, including “pain and discomfort associated with burn injury treatment;” seven categories for the period during hospitalization in a Department of Plastic and Reconstructive Surgery, including “physical sensations of wound healing and concerns that the injured area of skin may not return to normal;” and six categories for the post-discharge period, including “living with remaining physical function as understood post-recovery.”
 Conclusion: Our findings suggest that the experiences of burn patients change through hospitalization and after discharge as they go through the healing process following injury.

 Purpose: Frozen allogeneic skin grafting for extensive severe burns is useful for life-saving treatment of patients. The Japan Skin Bank Network is the only tissue bank in Japan that stores and supplies frozen allogeneic skin. It has established a network of 80 burn treatment facilities nationwide. In this study, we monitored the temperature in a dry shipper and examined the effects of distance, transport time, season, and other factors on the ability of facilities in Japan to transport frozen allogeneic skin at a constant ultra-low temperature and supply safe and highly viable skin until transplantation.
 Methods: A temperature-recording sensor was attached to a tank filled with liquid nitrogen for transportation　(dry shipper). Samples were transported and temperature changes were recorded until the tank was returned. Test transfers were conducted at seven locations　(Okinawa, Kyushu, Shikoku, Tokai, Kanto, Tohoku, and Hokkaido) during two seasons (winter and summer).
 Results: The maximum range of temperature fluctuation outside the warehouse was 14.2℃ (summer: Okinawa Prefecture) and 25.0℃ (winter: Hokkaido) , depending on the region and seasonality, which may be due to differences in outside temperature and temperature inside the facilities during transport. The temperature was maintained at an average of －194.8 to －196.1℃ without any regional or seasonal influence.
 Conclusion: In all regions surveyed, there was little influence from seasonal and regional differences, and the quality of the product was maintained. Our findings suggest that cryopreserved skin can be delivered without problems using the current transportation method.