Chronic Osteomyelitis of Cranial Bones in a Patient with High-Voltage Electrical Burn on the Scalp: A Case Report

High-voltage electrical burn injuries on the scalp often result in scalp and cranial bone necrosis. Repetitive debridements and rich-vascularized flap coverage of the cranium are required. However, despite successful flap coverage, chronic osteomyelitis of cranial bones may occur. Treatment of chronic osteomyelitis of cranial bones is surgical debridement of the necrotic bone with re-coverage by a well-vascularized flap. The latissimus dorsi musculocutaneous flap is suitable not only for coverage of the cranium after the burn injury, but also for treatment of chronic osteomyelitis of the skull.

Immediate Fasciotomy for Acute Thermal Contact Burn Combined with Compression Injury of the Right Forearm and Hand: A Case Report

Treatment of compartment syndrome is early decompressive fasciotomy to prevent dreadful sequelae of ischemic necrosis of muscles and nerves. We experienced one patient of impending or early compartment syndrome of right forearm and hand caused by a hot compress machine. We did immediate fasciotomy on forearm and late flap coverage with skin graft in this patient with good results.

Serum Prealbumin Affected More by Serum CRP Than by Residual Burned Surface Area

PURPOSE: Prealbumin is known as a biochemical marker for assessing nutritional status, and it is influenced by a systemic inflammatory condition. This study aims to find any correlation between patients' low serum prealbumin in electrical burn and unhealed burn surface area and insufficient nutritional support. METHODS: Data were collected by a review of the medical charts of patients admitted to Hanil General Hospital for electrical burn. Laboratory results such as prealbumin, albumin, total lymphocyte count (TLC), and C-reactive protein (CRP) were collected and tested every week. Residual burn surface area (residual BSA) during a specific period was calculated from the surgery record. Statistical analysis was conducted using Pearson's correlation and multiple regression analysis. RESULTS: A total of 30 subjects were selected, all male. Average total burn surface area was 20.9±14.9%, and patients were operated on about three times after admission. There was statistical significance among all variables in Pearson's correlation test, but in multiple regression analysis, albumin and CRP were significant compared with prealbumin. CONCLUSION: The results could indicate that burn causes a systemic inflammatory reaction, which could affect the serum prealbumin level. Further study concerning the biological plausibility of each variable is needed.

The Comparison of Blood Acid-Base Changes in Severe Burn Patients Resuscitation with Hartmann Solution and Plasma Solution-A

PURPOSE: Intravenous infusion of crystalloid solution is very important in the treatment of severe burn patients. But variable blood acid-base differences can be induced due to crystalloids. The aim of this study was to compare, in severe burn patients, the effects of two balanced fluids (Hartmann solution and plasma solution-A) on blood chemical differences. METHODS: A retrospective review was performed on 21 patients from January 2010 to December 2012 who admitted as severe burn patients to KEPCO Medical Center burn care unit. One group was resuscitated with Hartmann solution according to Parkland formula. The other one was resuscitated with plasma solution-A. RESULTS: 21 patients were enrolled. 14 patients belonged to plasma solution-A group and 7 patients belonged to Hartmann solution group. Bicarbonate, pH, serum lactate and serum electrolytes showed no statistic differences between plasma solution-A and Hartmann solution group (P>0.05). As time went by, pH and bicarbonate increased and serum lactate level decreased in both group. CONCLUSION: In this study, plasma solution-A had equally alkalinizing effect as Hartmann solution in severe burn patient resuscitation.