Rehabilitation of Amputee with Recurrent Squamous Cell Carcinoma Arising from Postburn Scar: A Case Report

A 73-year-old woman who has been suffering from ulcer pain on left lower leg of burn scars visited our clinic for prosthesis rehabilitation. Symptom has been developed since 12 months ago. She burned herself with oil at the age of 40. Biopsy on the skin lesion revealed squamous cell carcinoma. Marjolin's ulcer is a rare but highly aggressive squamous cell cancer that is most often associated with chronic burn wounds. Patient had undergone multiple prior split-thickness skin grafts for recurrent squamous cell carcinoma. She had undergone a trans-tibial amputation and subsequently given adjuvant chemotherapy for recurrent disease. After amputee training the patient was able to walk by herself and could perform all activities of daily living independently. Cancer induced amputees need prostheses with intensive rehabilitation training program for ambulation to prevent deterioration of physical function and mental health due to immobilization. However, she developed another recurrence and decided not to undergo further surgery and eventually died in hospice care due to progressive metastatic disease.

Clinical Application of Fiblast(R) in Second Degree Burn

PURPOSE: Nowadays importance of growth factors in wound healing is being focused. Wound healing can be accelerated by various growth factors. Wound healing cascade consists of inflammatory, proliferative, and remodeling phases. Basic fibroblast growth factor (bFGF) helps proliferation of fibroblast and promotes angiogenesis and formation of granulation tissue through proliferative phase. We investigated the effect of recombinant basic fibroblast growth factor Fiblast(R) (Kaken Pharmaceutical, Japan) on second degree burns. METHODS: 57 patients from July 2009 to September 2009 with second degree burn were treated with bFGF. Average age, sex, cause of burn, depth of burn, location of wound, epithelization period and number of operation were studied. Recombinant bFGF was used with spraying. The bFGT was sprayed and wait for 30 seconds and then foam dressing was applied to wounds. The bFGF administration continued until the wound healed. RESULTS: The average healing time in the bFGF-treated group was 8.4+/-2.2 days (4~14 days). Among 57 patients, 19 patients had superficial second degree burn and the average healing time in the bFGF-treated group was 7.2+/-1.5 days (4~9 days), 30 patients had deep second degree burn and the average healing time in the bFGF-treated group was 11.2+/-1.7 days (9~14 days). 20 patients had deep second degree burn and were clinically considered to get operation during hospital course but eventually 8 of patients (40%) with deep second degree burn treated with bFGF underwent operation. CONCLUSION: The use of bFGF for second-degree burns decreased the wound healing time. Especially the use of bFGF decreased the rate of getting operation in deep second degree burn and increased the convenience of treatment.