Staged Treatment of an Extensive Post-Burn Scar Contracture with Chronic Ulceration of the Knee Joint: A Case Report

A post-burn scar contracture (PBSC) can cause functional problems including limited range of motion (ROM) and, in turn, poor quality of life. We present a case with an extensive PBSC combined with chronic ulceration. Treatment involved scar tissue excision, rehabilitation, and delayed reconstruction using a free transverse rectus abdominis myocutaneous flap and a split-thickness skin graft. After scar tissue excision, negative pressure was applied to the open wound; this facilitated rapid ambulation and ROM recovery within 2 weeks. Ultimately, over 6 months, the initial flexion contracture of 60º improved to 10º, and the ROM improved from 75º to 125º.

Necrotizing fasciitis of the masticator space with osteomyelitis of the mandible in an edentulous patient

Necrotizing fasciitis (NF) is a rapidly progressive necrosis of the subcutaneous tissue and fascia, caused by bacterial infection. Usually presenting in the extremities, trunk, or perineum, it is uncommon in the craniofacial or cervical area. Cervicofacial NF is a potentially fatal infection, which should be managed with early detection and intervention. Most cases have a primary odontogenic source of infection, especially when the masticator space is involved. We report a case of masticator space NF that developed without odontogenic origin in a 78-year old female who was treated with prompt surgical drainage and intravenous antibiotics.

Feature Analysis of Burn Patients in Korea Using National Health Insurance Database

PURPOSE: Investigating epidemiological features of burn victims from a national frame has not been attempted recently. METHODS: South Korean National Health Insurance System (NHIS) provides a vast array of feature data on common diseases. A database search from January 2013 to December 2017 was undertaken with disease codes related to burn injuries and burn dressing procedures. After data cleaning, feature analysis was done with final dataset of 1,800 records. RESULTS: Demographic analysis showed gender preference to woman by 6:4. Age distribution showed bimodal peaks at 0~9 years and 40~60 years. Burns to the lower extremity seemed to increase with burn depth. Marked decrease in duration of hospitalization for first- and second-degree burns were noted over five years. CONCLUSION: Incidence to age analysis showed bimodal peaks in pediatric (age 0~9) and middle-aged (age 40~60) individuals. A decreasing trend towards shorter hospitalization is noted in mild to moderate burns. Further attention is needed to prevent third-degree burns to the elderly.