Objective: Marjolin’s ulcers typically present as well-differentiated squamous cell carcinomas（SCC）; however, they have a worse prognosis than other SCCs. We clinically analyzed cases of Marjolin’s ulcers encountered in our department.
 Methods: We reviewed 18 patients diagnosed with Marjolin’s ulcers in our department over a 10-year period（2014 to 2023）. We examined the following parameters: age, sex, site of occurrence, predisposing lesion, duration from initial lesion to carcinogenesis, clinical stage, treatment, pathological diagnosis, presence of lymph node metastasis, and prognosis.
 Results: The mean age of patients was 72.4 years, with a male-to-female ratio of 13:5. The primary sites were the lower limbs (6 cases), upper limbs (5 cases), head (4 cases) , buttocks (2 cases), and back (1 case), with a predominance in the extremities. The predisposing lesions were burn scars (8 cases), traumatic scars (5 cases), inflammatory skin diseases (3 cases), and chronic ulcers (2 cases) . The latency period from initial lesion to carcinogenesis ranged from 6 to 77 years, with an average of 54.1 years. The clinical stages were stage I (2 cases), stage II (7 cases), stage III (8 cases), and stage IV (1 case). Excision was performed with a margin of at least 1 cm in all cases except for one case with a 6-mm margin. Sixteen patients underwent sentinel lymph node biopsy, whereas two patients declined the procedure. All amputation cases underwent primary wound closure. All other reconstructions were performed as secondary procedures. Histopathological diagnosis revealed SCC in all cases: well-differentiated（10 cases）, well-to-moderately differentiated（4 cases）, moderately differentiated（3 cases）, and poorly differentiated（1 case）. Lymph node metastasis was observed in four cases, all of which originated from traumatic scars. Regarding prognosis, 11 patients achieved disease-free survival, four experienced recurrence, one developed distant metastasis and died, and two had an unknown prognosis.
 Conclusion: Compared with conventional SCC, the recurrence rate and lymph node metastasis rate of Marjolin’s ulcers were higher. However, in comparison with previous reports on Marjolin’s ulcers, the prognosis was favorable, with no cases of recurrence, metastasis, or death observed in burn scar-associated cases. This favorable outcome may be attributed to early biopsy and definitive diagnosis, ensuring excision with a margin of at least 1 cm including the scar, universal application of sentinel lymph node biopsy, and secondary reconstruction for non-amputation cases.

 In August 2023, Nexobrid^®, a novel necrotic tissue removal agent for burn treatment, was introduced in Japan. However, its use in burn cases involving arteriovenous shunts for hemodialysis remains to be elucidated. We present a case of a 61-year-old woman who had been undergoing maintenance dialysis through an arteriovenous shunt in her left forearm. She sustained burns in a clothing fire, resulting in second-degree and third-degree burns covering 13% total burn surface area, including the site of the dialysis shunt on her left upper limb. On day 6 of hospitalization, debridement using Nexobrid^® was performed, followed by two skin graft procedures. The burn areas fully epithelialized, and dialysis was successfully resumed through the left forearm arteriovenous shunt. Debridement with Nexobrid^® was safely performed directly above the arteriovenous shunt, preserving the shunt without causing complications such as infection or bleeding. However, the initial skin graft failed to take, possibly due to inadequate debridement or improper management before the grafting. Further evaluation of the indications for Nexobrid^® use is necessary.

 The efficacy of Nexobrid^® for circumferential burns has been reported overseas; however, there are no reports from Japan. Herein, we present a case in which Nexobrid^® was effective in reducing compartment pressure. The patient was a man in his 50s. He sustained 22% deep dermal and 30% full-thickness burns following contact with a 25,000 V high-voltage overhead power line. On the day of injury, Nexobrid^® was applied to the left upper extremity and trunk, and the lower extremity was surgically excised. Compartment pressures were 81 mmHg in the upper arm and 55 mmHg in the forearm, which decreased to 12 mmHg and 5 mmHg, respectively, four hours after application of Nexobrid^®. The next day, the burns on the buttocks and posterior lower extremities were surgically excised, Nexobrid^® was applied to the back and left shoulder, and debridement was completed. Multiple skin grafts were performed, and the patient was discharged on day 97 of hospitalization.Nexobrid^® reduces tissue pressure in circumferential burns and allows early debridement in combination with surgical excision. It may be a useful option for managing acute burns.

 Deep burns that expose the Achilles tendon are difficult to cover with skin grafts and often require two-stage coverage or free flap surgery. Herein, we report a case where single-stage coverage of an exposed Achilles tendon was achieved without prolonged immobilization or external fixation, through combined application of the sandwich method with artificial dermis, negative pressure wound therapy (NPWT) , and longitudinal slit procedure. A 58-year-old man sustained deep burns to both lower extremities (8%TBSA) in a house fire. Initial debridement and split-thickness skin grafting were performed, but the graft over the Achilles tendon failed and ulcerated. On day 30, we performed a second surgery using a combination of the sandwich method with artificial dermis, NPWT, and longitudinal slit procedure. NPWT was discontinued on the fourth postoperative day. Complete epithelialization of the exposed Achilles tendon was confirmed on the 24th postoperative day. This combined approach may be a useful treatment option for coverage of a small area of exposed Achilles tendon.

 Kerosene is a commonly used fuel; however, prolonged contact with the skin and mucous membranes can cause chemical injury. Reports of kerosene immersion chemical injuries are limited. Kerosene consists primarily of hydrocarbons with high lipophilicity, allowing it to penetrate cell membranes and dissolve lipid components, leading to tissue damage. Short-term contact may cause mild dermatitis; however, prolonged exposure can result in erythema, blistering, and erosion, resembling a superficial burn.
  Case 1: A 76-year-old woman experienced pain two hours after kerosene was spilled on her clothing, resulting in erythema on both arms and the left lower back and thigh.
  Case 2: A 62-year-old man was immobile for three days due to a right putaminal hemorrhage that occurred after a kerosene spill during refueling. Both cases were diagnosed as chemical burns and treated conservatively with vaseline-based ointment and topical steroid for skin with intense erythema. Both cases healed without scarring in 2 weeks and in 4 weeks, respectively.
  Previous studies reported that most cases of gasoline immersion burns heal with conservative treatment. Our report suggests that proper topical management, infection control, and early intervention are crucial for favorable outcomes, regardless of exposure duration.

 We report a 60-year-old man with communication difficulties resulting from severe burns and an underlying mental disorder, whose activities of daily living (ADLs) improved through nursing interventions focused on interpreting his intentions. The patient had a history of epileptic psychosis, hearing loss, and cerebral palsy. He suffered burns on his face, trunk, and extremities (32% grade III, 2% grade II; burn index 33) and required multiple skin graft surgeries. Due to pre-existing conditions, hearing loss, and contractures of the upper extremities, he was unable to speak or write. The medical team developed a method to interpret his complaints from facial expressions and movements and created communication boards. With nursing support, his ADL gradually improved, and he was eventually able to walk using a walker. He also had dysphagia; therefore, after the team assessed his willingness to eat from eye and facial expressions, swallowing training was provided. Nursing interventions were shared among nurses to ensure consistent care. This case highlights the importance of nurses understanding and interpreting nonverbal cues to deliver effective care to patients with communication difficulties.

 Objective: To clarify how nurses cooperate in emergency and intensive care settings for the treatment of burn patients.
  Methods: A literature search was conducted using the Japanese Medical Abstracts Society Web, CINAHL, and PubMed. The search terms included the English words “burn,” “cooperation,” and “nurses” and their equivalents in Japanese. Relevant literature was analyzed by extracting and coding instances of cooperation by nurses in emergency and intensive care settings, followed by categorization based on similar codes. This study adhered to ethical standards by utilizing published literature and maintaining accurate citation of all sources.
  Results: Analysis yielded 31 codes, which were grouped into 15 subcategories and five main categories. These included: cooperation focused on post-discharge care, multidisciplinary cooperation across hospitals, and the role of nurses in team-based care.
  Discussion: In emergency and intensive care settings, nursing collaboration takes various forms, extending beyond team-based care to include inter-hospital coordination and family involvement. Such collaboration often begins at an early stage with a long-term care perspective and actively involves family members who provide post-discharge support.

 Introduction: Patient-reported outcome measures for burn survivors have primarily focused on physical and psychological health, with limited tools available to assess social participation. The aim of this study was to develop a Japanese version of the Life Impact Burn Recovery Evaluation Profile Short Form（LIBRE Profile-SF）to assess social participation among burn survivors in Japan.
  Methods: Two native Japanese speakers independently performed forward translations into Japanese. Backward translation was independently performed by two burn care providers. The original source and the backward translation were compared, and discrepancies were revised. Following revision, cognitive interviews were conducted with 10 burn survivors. The subjects were aged 18 years of age or older, resided in Japan, and could understand Japanese. All participants had sustained burns covering 5%–20% of total body surface area or burns to critical areas such as the face, hands, feet, or perineum.
  Results: The patients consisted of 50% females and 50% aged 65 years or older. Feedback highlighted difficulties in understanding double negatives and literal translations. However, the Japanese version of the LIBRE Profile-SF was considered understandable and appropriate, and the finalized version was completed.
  Conclusion: Language differences may have an impact on the interpretation of questionnaires.