Japanese Journal of Burn Injuries
Online ISSN : 2435-1571
Print ISSN : 0285-113X
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Displaying 1-8 of 8 articles from this issue
Original
  • Hiroyuki Morinaga, Yasuhiko Kaita, Yuya Tanaka, Kei Yoshikawa, Yoshihi ...
    2024 Volume 50 Issue 1 Pages 1-5
    Published: March 15, 2024
    Released on J-STAGE: March 15, 2024
    JOURNAL RESTRICTED ACCESS

     Background: Prognostic Burn Index (PBI) is a commonly utilized as a prognostic indicator for severe burn patients in Japan. Herein, we investigated the utility of a novel PBI that incorporates inhalation injury as a factor into the existing PBI.
     Methods: We enrolled burn patients hospitalized between 2008 and 2023. Patients with inhalation injury alone or those with cardiopulmonary arrest on admission were excluded.
     Result: We enrolled 252 patients, with a median age of 54 years and a total burn area (TBSA) of 15%, including second-degree burns (9%). Third-degree burns were not included. There were 42 non-survivors (17%) and 104 patients had inhalation injuries (41%). The survivors and non-survivors showed significant differences in age, TBSA, presence of second or third-degree burns, and airway burns. Multiple logistic regression analysis revealed that inhalation injuries contributed 19.33 times more than the standard BI. Therefore, we introduced a new PBI that added 20 to PBI when inhalation injuries were present. The area under the curve values for each index were 0.919 for PBI, 0.923 for Baux score, 0.941 for the revised Baux score, 0.931 for ABSI, 0.9123 for BOBI, and 0.9547 for our new PBI.
     Conclusion: Our new PBI is a useful prognostic index for burn patients.

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Case Report
  • Kento Yamashita, Kohei Aoki, Ayuka Yokota, Mai Yamaguchi, Norihito Ito ...
    2024 Volume 50 Issue 1 Pages 6-11
    Published: March 15, 2024
    Released on J-STAGE: March 15, 2024
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     Background: In this report, we describe pediatric cases of deep dermal burn (DDB) of the foot treated with enzymatic debridement using NexoBrid® and RECELL®. We achieved early and complete epithelialization; however, sedation and analgesia were difficult to manage. Adequate analgesia and sedation are important with regard to the use of NexoBrid®. This study aimed to assess the usefulness of the NexoBrid® and RECELL® combination in pediatric DDB and the problems associated with its management.
     Case: We experienced two cases of infants with dorsal foot burns. Case 1 was a 10-month-old boy who was burned by boiling water. Enzymatic debridement was performed under general anesthesia, but the patient had difficulty maintaining postoperative rest and debridement was partially inadequate. RECELL® was performed under general anesthesia on the 11th day after injury. Ten days after RECELL®, total epithelialization was confirmed. Case 2 was a 1-year-old boy who was burned by boiling water. Enzymatic debridement with NexoBrid® was performed under general anesthesia on the 6th day after injury. On the 7th day after the injury, the patient underwent RECELL® under general anesthesia in the ICU. Eight days after RECELL®, total epithelialization was confirmed.

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  • Kenta Nanri, Osamu Fujiwara, Kan Nakamoto, Hiroyuki Sakurai
    2024 Volume 50 Issue 1 Pages 12-17
    Published: March 15, 2024
    Released on J-STAGE: March 15, 2024
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     The patient was a 26-year-old male. He was undergoing medical treatment for depression and dissociative disorder. He had flame burn and was transported to our hospital. On the first day, he had a fever in the 39℃ range and an elevated inflammatory response. We did not suspect a wound infection; therefore, we performed standby surgery. After several days of treatment with antibiotics, the patient underwent surgery on the 7th day, but the fever did not resolve. The fever resolved on the 17th day, and the patient remained fever-free thereafter. When the source of the fever was retrospectively examined, the psychotropic medication he had been taking had been discontinued after his admission. Neuroleptic malignant syndrome caused by the discontinuation of psychotropic medication was suspected. In burn treatment, it is important to pay attention to fever caused by wound infection. However, because of the variety of causes of severe burns, all possibilities should be considered. In addition, since burn treatment often involves multiple departments, close information sharing is necessary.

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  • Koga Masuda, Takahiro Ueda, Tomofumi Ogoshi, Noriko Matsuo, Yusuke Oka ...
    2024 Volume 50 Issue 1 Pages 18-23
    Published: March 15, 2024
    Released on J-STAGE: March 15, 2024
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     Extensive pediatric burns easily become severe due to complications such as toxic shock syndrome and sepsis. Wound observation without skin grafting for an extended period of time is considered to hold higher risk in pediatric patients than adults. Autologous split-thickness skin grafting is often performed for early wound closure. For the pediatric population, frequent procedures and interventions are required to accommodate their growth and development, which further complicate the treatment plans for both wound size reduction and closure.
     In this case report, we managed a one-year-old child with extensive burn who was treated by constructing a wound bed of dermis-like tissue with artificial dermis. The burn was closed by transplantation of autologous culture epidermis instead of split-thickness skin graft. Although the utilization of autologous cultured epidermal transplantation for children under two years of age has not been established, our findings strongly suggest the need for further multi-center clinical studies to investigate this possibility.

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  • Takaya Nishiura, Ayami Machiyama, Takashi Noma, Yoshihito Ogawa, Tomok ...
    2024 Volume 50 Issue 1 Pages 24-28
    Published: March 15, 2024
    Released on J-STAGE: March 15, 2024
    JOURNAL RESTRICTED ACCESS

     Good bed preparation for burn wounds is necessary to obtain good graft attachment for the achievement of wound closure. The same wound bed preparation is also important for autologous cultured epidermal grafts. At our hospital, we use local negative pressure closure as a matrix formation technique for autologous cultured epidermis (JACE®) skin grafts in patients with extensive burns. We experienced six cases between January 2015 and December 2022 in which a high live implantation rate of > 80% was achieved. Local closed negative pressure therapy may be useful for wound bed preparation for autologous cultured epidermal transplantation.

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Nursing Care
  • Hiroya Sasaki, Saori Muranaka, Natsuko Makino
    2024 Volume 50 Issue 1 Pages 29-38
    Published: March 15, 2024
    Released on J-STAGE: March 15, 2024
    JOURNAL RESTRICTED ACCESS

     To elucidate perceptions among nurses regarding transitional care for severe burn patients who transfer from an emergency room department to a plastic and reconstructive surgery department, we conducted semi-structured interviews among five emergency room department nurses and five plastic surgery nurses at an Advanced Treatment Hospital. Qualitative descriptive analysis generated six categories of perceptions among emergency department nurses, including “supporting patients in achieving self-care, including the recovery process and the environment in the new department,” and “sharing concerns and acceptance of the process related to body image changes caused by burn scars occasioned on the change in environment,” and six categories among plastic surgery nurses, including “perceptions of information gathering with consideration for continuing care aimed at wound healing and recovery of function,” and “perceptions of orientation covering patient transfers between wards at different treatment stages.” Perceptions of transitional care among emergency ward nurses were related to continuing care after transfers, whereas perceptions among reconstructive ward nurses were primarily focused on care aimed at patient recovery and sharing information across wards about the healing process. These results suggest that effective hospital orientation during patient transfer and information sharing regarding the needs of nurses are necessary for furthering transitional care.

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