The Factors Associated with Contact Burns from Therapeutic Modalities

Jeong-Hyeon Mun,서정훈,Jong-Hyun Jeon,Yun-Jae Jung,장기언,양형태,임해준,조용석,김도헌,허준,김종현,전욱 대한재활의학회 2012 Annals of Rehabilitation Medicine Vol.36 No.5

Objective To understand the injury pattern of contact burns from therapeutic physical modalities.Method A retrospective study was done in 864 patients with contact burns who discharged from our hospital from January 2005 to December 2008. The following parameters were compared between patients with contact burns from therapeutic modalities and from other causes: general characteristics, burn extent, cause of burn injury, place of occurrence, burn injury site, treatment methods, prevalence of underlying disease, and length of hospital stay were compared between patients with contact burns. Results Of the 864 subjects, 94 patients were injured from therapeutic modalities. A hot pack (n=51) was the most common type of therapeutic modality causing contact burn followed by moxibustion (n=21), electric heating pad (n=16), and radiant heat (n=4). The lower leg (n=31) was the most common injury site followed by the foot & ankle (n=24), buttock & coccyx (n=9), knee (n=8), trunk (n=8), back (n=6), shoulder (n=4), and arm (n=4). Diabetes mellitus was associated with contact burns from therapeutic modalities; the odds ratio was 3.99. Injuries took place most commonly at home (n=56), followed by the hospital (n=33), and in other places (n=5). Conclusion A hot pack was the most common cause of contact burns from therapeutic modalities, and the lower leg was the most common injury site. Injuries took place most commonly at home. The patients with contact burns from therapeutic modalities showed high correlation to presence of diabetes mellitus. These results would be helpful for the prevention of contact burns due to therapeutic modalities.

유리조직이식술을 이용한 심부화상의 치료

안경식,정철훈,이종욱,오석준,범진식 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.4

In small or superficial burns, wound coverage can be attempted using skin grafts, local or distant flaps. When more severe burns that involve bone, tendons or other soft tissues are present, the use of free tissue transfers allowed healing and ultimately satisfactory function. We performed 42 free tissue transfers for 40 patients with severe burns for 15 years. Their ages ranged from 17 to 72, with average age of 33.31 patients were male and 9 female. In the causes of burn, there were 20 cases of acute burns; 1 flame burn, 6 contact burns, 12 electrical burns, and 1 chemical burn. 20 cases were scar deformities after burn injuries; 2 flame burna, 12 scalding burns, 1 contact burns, 5 electrical burns. In the affected sites, 7 cases were head and neck areas, 22 upper extremities, and 11 lower extremities. In the free tissue transfers, 27 cases were cutaneous flap, 4 myocutaneous flap, 6 tenocutaneous flap, 1 tenomyocutaneous flap, 2 osteocutaneous flap, and 2 omental flap. As for accompanied surgical procedures, 5 cases were for tendon graft, and 6 for nerve graft. Complications were 4 marginal necroses of flap by wound infection and 1 total loss due to vascular thrombosis. But they were all completely restored with wound dressing, skin graft or local flap. Free tissue transfers were useful for the coverage of composite tissue defect in severe burns.

증기화상의 치료

김동철,장영철,김희석 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.1

From January 1991 to December 1993, 2280 burn patients had admitted to Hangang Sacred Heart Hospital. Among them, 52 steam burn patients out of 710 pediatric burn patients were injured by rice cookers, who were under the age of seven. And there were 41 patients, who were under the age of seven, with burn scar contracture of the hands. In these patients, retrospective study was done for the review of following parameters ; age and sex distribution, cause of burn, seasonal distribution, prevalent area of burn, duration of admission, complication, acquired disease during hospitalization, treatment modality, characteristics of newly prevalant steam burns. The results were as follows; 1) Pediatric burn patients under age of 7 were 31.1% of all admitted burn patients. 2) Incidence of steam burn was 7.3% of burn patients under 7 years old. 3) The most prevalent age group of steam burn was between 7 months and 1 year old(78.8%) and incidence was 23.3% of total burn injury during this period. 4) The all causative agent of steam burn were rice cookers.(100%) 5) the unilateral hand was primarily involved as localized area of steam burns. The predilection sites were middle finger(67%) and index finger(54%). the number of involved digits was variable, but two-finger involvement was most frequent(48%). 6) The majority of steam burns was deep second and 3rd degree.(98%) 7) There was a high incidence of postburn scar contracture of steam burns.(63%) ncidence of postburn scar contrature of steam burns.(63%)

『법화경』에서 ‘불(火)’의 의미와 번뇌 설에 대한 연구

한양순 ( Han Yang-soon ) 동아시아불교문화학회 2021 동아시아불교문화 Vol.- No.46

『법화경』 제3비유품에서는 양거, 녹거, 우거의 삼거(三車)로 방편을 열어 대백우거(大白牛車)의 진실을 나타낸다고 비유하고 있다. 이것은 곧 ‘모든 부처는 일대사인연으로 오탁악세에 출현하여, 중생들의 근기에 따라 장교·통교·별교의 방편으로 원교의 진실을 드러낸다.’는 것을 비유로 나타낸 것이다. 『법화경』의 화택삼거 비유에서 불(火)의 의미는 2가지가 있다. 하나는 본질적 의미이고, 둘은 비유적 의미이다. 먼저 불의 본질적 의미는 ‘탄다’는 것이다. ‘타는 불’의 의미는 다시 ‘태우는 불(能燒)’과 ‘태워지는 불(所燒)’로 나누어진다. ‘태우는 불’은 오욕(五慾)과 탐, 진, 치 삼독(三毒)을 태워 ‘뜨거운 번뇌’를 만든다. ‘태워지는 불’은 태우는 불에 의해 생·노·병·사 등의 고(苦)를 받는다. 이렇듯 불의 본질적 의미는 타는 불로 뜨거운 번뇌와 고(苦)를 만든다. 다음으로 ‘불’이 비유하는 의미는 2가지이다. 하나는 소소(所燒)로서 육도윤회 하는 과보에 비유한 것이고, 둘은 능소(能燒)로서 번뇌에 비유한 것이다. 오경(色聲香味觸)에 의해 일어나는 탐, 진, 치 삼독은 온갖 번뇌를 다 일으키는 능소이고, 이로 인해 받는 고(苦)는 생, 노, 병, 사로 소소이다. 말하자면 생·노·병·사의 4고(四苦)와 우비고뇌(憂悲苦惱), 그리고 애별리고(愛別離苦), 원증회고(怨憎會苦) 등의 온갖 고통은 육도의 과보인 소소이고, 5진(五塵)에 의해 오욕과 탐애 등으로 혼탁해져 버린 오탁의 번뇌는 능소이다. 이렇듯 화택삼거유에서 ‘불’이 비유하는 깊은 의미는 오탁8고(五濁八苦)이다. 고(苦)의 원인에는 번뇌와 업이 있다. 먼저 번뇌에는 탐, 진, 치 삼독의 근본번뇌와 천태학에서 분별하는 견사혹(見思惑), 진사혹(塵沙惑), 무명혹(無明惑)의 3혹이 있다. 이러한 번뇌는 공관, 가관, 중관의 삼관으로 파(破)할 수 있다고 하였다. 다음으로 업(業)은 신, 구, 의 삼업 중 의업(意業)이 가장 무거우며, 번뇌와 인연되어 번뇌장(煩惱障), 업장(業障), 고장(苦障)의 3장을 이루어 12연기를 이룬다. 12연기로 인해 번뇌, 업, 고(苦)를 받지만 수행하여 삼관(三觀)으로 혹(惑)을 파하면 고(苦)에서 벗어날 수 있다고 한다. 한편 대소승경전에서는 번뇌를 견사혹과 무명혹으로 설하고 있다. 특히『승만경』에서는 번뇌를 5주지 혹으로 나누어 상응무명(相應無明)과 불상응무명(不相應無明)으로 설하고 있는데 천태 지의는 이를 수용하여 『법화문구』에서 4주자과(四住子果)로 논하고 있다. 그는 또『법화현의』에서 대소승 경전에서 설하는 번뇌 설을 4종4제에 모두 수용하는 특성을 보이고 있다. 즉 견사혹, 진사혹, 무명혹을 생멸4제, 무생4제, 무량4제, 무작4제에 배대하여 모든 번뇌를 공관, 가관, 중관의 3관으로 파하고 있다. 이에 따른『법화경』의 수행은 원교의 수행으로 일심3관이다. 『법화경』 제3비유품의 번뇌 설은 대소승경전의 견사혹과 무명혹을 수용하였다. 특히 초기불교의 번뇌설인 견사혹으로 삼계의 오둔사(탐, 진, 치, 만, 의)와 오리사(신견, 변견, 사견, 견취견, 계금취견)의 10사를 집중 배대하였다. 『법화경』 번뇌설의 특징은 모든 경전의 번뇌 설을 포용하고 4종4제에 배대하여 수행방법을 통섭하고 있다는 점이다. 『법화경』 제3비유품에서 화택삼거유의 궁극적인 목적은 중생으로 하여금 오탁악세의 뜨거운 번뇌에 의한 고(苦)를 여의게 하는데 있다. 그 해탈의 방법은 3승을 타고 일불승으로 나아가 실상의 진리를 궁구하여 구경에는 일체종지(一切種智)를 얻는데 있다. The Chapter on Simile and Parable in the Lotus Sutra is revealing the truth, which is the vehicle drawn by a great white ox[大白牛車], by using the expedient means that are the three vehicles[三車] pulled by a goat, a deer, and an ox. It is a metaphor that explains all Buddhas emergence on the world[一大事因緣] stained with five defilements[五濁惡世] to edify sentient beings of different learning abilities. Within the process, the truth[圓敎] is revealed through expedient means[藏敎, 通敎, 別敎]. There are two meanings in ‘Fire’ in the parable of the Burning House and the Three Vehicles, one is fundamental, and another is the metaphoric meaning. The fundamental meaning of the ‘Fire[火]’ is that it is burning. In detail, the ‘Burning Fire’ is separated into ‘a Fire that Burns[能燒]’ and ‘a fire that is burned by the fire [所燒]’. ‘The Fire that Burns’ makes the ‘hot agony’ by burning the Five desires[五慾] and the Three poisons[三毒] of greediness, anger, and foolishness. ‘The fire that is burned by the fire’ is the suffering of birth, old age, sickness, and death occurred by ‘the fire that burns’. The fire makes the hot agony and the suffering. The metaphoric meaning of the fire is described in two ways. ‘The fire that is burned by the fire[所燒]’ is used as a metaphor for the retribution of rebirth in the six realms of existence. ‘The fire that Burns[能燒]’ is used as a metaphor for the agony. The three poisons[三毒] occurred by the five precepts[色聲香味觸] are ‘the fire that Burns[能燒]’ that triggers all of the agony. The suffering from this agony, the suffering of birth, old age, sickness, and death are described as ‘the fire that is burned by the fire[所燒].’ In other words, eight sufferings[生苦ㆍ老苦ㆍ病苦ㆍ死苦ㆍ 愛別離苦ㆍ怨憎會苦ㆍ求不得苦ㆍ五陰盛苦]. are the ‘the fire that is burned by the fire[所燒].’ The five defilements[命濁ㆍ衆生濁ㆍ煩惱濁ㆍ見濁ㆍ劫濁] are ‘the fire that Burns[能燒].’ Likewise, in the parable of the Burning House and the Three Vehicles, the deep meaning of ‘fire’ is ‘the Five Defilements and the Eight Sufferings [五濁八苦].’ Agony[煩惱] and Karma[業] are the cause of Suffering[苦]. Agony is the Three poisons[三毒] and the Three kinds of Delusions[三惑]. The remedy of overcoming the causes of Suffering that is suggested by the Tiantai sect, is the practice of Three Ways of Contemplation[三觀]. Three Ways of Contemplation are insight of emptiness [空觀], insight of pro-visionality[假觀], and insight of the middle[中道觀]. These three ways of contemplation defeat three kinds of delusions which are the illusion of thinking and desire[見思惑], the illusion arising from attachment[塵沙惑], and the illusion arising from ignorance[無明惑]. Karma, the karmic actions of body, speech, and mind[三業], causes three obstacles[三障] of afflictions, karma, and suffering that leads to the formation of twelve Nidanas. Sufferings caused by twelve Nidanas are also could be defeated through the practice of Three Ways of Contemplation. Meanwhile, suffering is described as the illusion of thinking and desire[見思惑] and the illusion arising from ignorance[無明惑] in the sutras of Mahayana and Hinayana. Especially, in Srimaladvi-simhanada-Sutra(『勝鬘經』), the suffering is described as five entrenchments of affliction[五住地惑] which is further classified as associative ignorance[相應無明] and non-associative ignorance[不相應無明]. Tiantai Zhiyi(天台 智顗) reflects this understanding in his writing Fahwa Wenju(『法華文句』). Also, in his another writing, Fahwa Xuanyi(『法華玄義』), the agony is coordinated with the Four kinds of the Four Truths[四種四諦]. Three kinds of delusions[見思惑·塵沙惑·無明惑] are related to the Four Truths as arising and perishing[生滅四諦], the Four Truths as non-arising[無生四諦], the Four Truths as immeasurable[無量四諦], and the Four Truths as spontaneous[無作四諦]. By doing so, all suffering is extinguished by the Three Ways of Contemplation[三觀]. The practice of Perfect Doctrine[圓敎] is the Threefold Contemplations in a Single Mind[一心三觀]. The Agony in the Chapter on Simile and Parable of the Lotus Sutra is showing its acceptance of the illusion of thinking and desire[見思惑] and the illusion arising from ignorance[無明惑] from the sutras of Mahayana and Hinayana. Specifically, the illusion of thinking and desire is explained in detail as the ten fundamental earthly desires[十使] that are five delusive inclinations[五鈍使] and five false views[五利使]. The distinct feature of agony explained in the Lotus Sutra is that it has contained all different types of agony that appear from the whole Buddhist Sutras by using the Four kinds of the Four Truths[四種四諦]. The Four kinds of the Four Truths are also suggesting the practice method. The purpose of the parable of the Burning House and the Three Vehicles is at liberating sentient beings, living in the world stained with five defilements, from the suffering caused by the hot agony. The method of liberating sentient beings is suggested in series of stages according to the learning ability of each sentient being. Start by three vehicles of expedient means and then sentient beings use the single Buddha-vehicle to pursue the All-knowing knowledge of Buddha[一切種智].

안면부 화상이 동반된 광범위 화상환자에게서 MEBO(Most Exposed Burn Ointment) 드레싱의 역할에 대한 연구

노순예,김애심,신현선,김도헌,허준,전욱 대한화상학회 2003 대한화상학회지 Vol.6 No.2

Structural Equation Modeling on Life-world Integration in People with Severe Burns

Gyeong Suk Lee,염영희 한국간호과학회 2013 Asian Nursing Research Vol.7 No.3

Purpose: The aim of this study was to construct and test a structural equation modeling on life-world integration in people with severe burns. Methods: A survey design was used. Data were collected in 2008 from 376 people who had experienced severe burns using questionnaires. The data were analyzed using structural equation modeling. Results: The fitness parameters of the modified model (χ2/df = 3.15, goodness of fit: .91, normal fit index: .93, Tucker Lewis Index: .93, root mean square error of approximation: .07, root mean square residual: .04, and comparative fit index: .95) indicated its suitability as the research model. Physical function directly influenced burn factor, and family support indirectly influenced life-world integration. Conclusion: Physical function should be directly improved to adjust to life-world integration. A comprehensive integration approach is also necessary to help people with severe burns successfully return to society. Purpose: The aim of this study was to construct and test a structural equation modeling on life-world integration in people with severe burns. Methods: A survey design was used. Data were collected in 2008 from 376 people who had experienced severe burns using questionnaires. The data were analyzed using structural equation modeling. Results: The fitness parameters of the modified model (χ2/df = 3.15, goodness of fit: .91, normal fit index: .93, Tucker Lewis Index: .93, root mean square error of approximation: .07, root mean square residual: .04, and comparative fit index: .95) indicated its suitability as the research model. Physical function directly influenced burn factor, and family support indirectly influenced life-world integration. Conclusion: Physical function should be directly improved to adjust to life-world integration. A comprehensive integration approach is also necessary to help people with severe burns successfully return to society.

湯火傷 醫案 연구

방성혜(Bang Sunh Hye),김홍균(Kim Hong-kyoon),김남일(Kim Nam Il) 한국의사학회 2008 한국의사학회지 Vol.21 No.2

Burn is a malady that has tormented mankind for a while, and Traditional Korean Medicine techniques of treating it has constantly improved. Detailed description of treatment methods of burns are mentioned in Traditional Korean Medicine texts. To treat burns both medicines for internal and external use are needed, and appropriate first aid is necessary in the first stages. A total of eleven medical cases about burns could be found in the process of researching texts, and studying these 의안s indicated that burns were admirably cured with Korean Traditional Medicine methods of treating burns. Differences in the treatment methods between different schools could also be observed. Further research and development of Traditional Korean Medicine methods of burns is needed.

화상의 침 치료에 대한 체계적 문헌고찰

이지은,정서윤,최유민,정민정 대한한방소아과학회 2017 대한한방소아과학회지 Vol.31 No.4

Objectives The study was conducted to evaluate the acupuncture treatment for burns by reviewing international randomized controlled studies and case controlled studies. Methods In the review, ten academic literature archives; NDSL, OASIS, PubMed, Cochrane library, CNKI, WANFANG, CINAHL, J-STAGE, CiNii, and EMBASE were used as the main databases to search for the randomized controlled trials or the case controlled trials about acupuncture treatment of burns using the keywords “burns AND acupuncture”, “burn AND acupuncture”, and “scald AND acupuncture”. Results Initially, a total of 852 studies were founded except duplicate studies. 801 studies were excluded after screening of title and abstract. After reviewing 51 papers, a total of four randomized controlled trials and two case controlled trials were selected. These studies were analyzed by year, subjects, treatment intervention, evaluation criteria, treatment effect, adverse events, and ‘Risk of Bias’ assessment for randomized studies and non-randomized studies. From the six papers out of 51 papers those were reviewed, patients with burns were divided into two groups. The experimental group received acupuncture treatment, while the control group did not. The results of the completed studies have shown that the experimental group receiving acupuncture treatment demonstrated significant improvement compared to the control group, and there was no serious adverse events. Conclusions According to some of the studies, acupuncture in burn treatment is worth to try. However, additional well-designed randomized controlled studies will be required to justify the effectiveness of acupuncture treatment of burns.

Evaluation of biomechanical and histological properties of corrosive chemical burns

Yuncho Choi,Yoonkyung Jang,조애리 한국약제학회 2012 Journal of Pharmaceutical Investigation Vol.42 No.4

This study was aimed to prepare a standard experimental chemical burns and evaluate biomechanical and histological properties. As a model corrosive acid burns,sulfuric acid burns were made on the peritoneal part of the rabbit ear with diameter 8 mm by varing sulfuric acid concentrations (1, 2, 18.8 M) and inflicted time (20, 40, 60 and 120 s). The progress of the chemical injury was evaluated for 3 weeks by macroscopic and microscopic observation. Degree of regeneration of damaged epidermis and dermis and presence of infected cells and arrangements of collagen were investigated. Histology of 18.8 Msulfuric acid for 20 s burns showed epidermal necrosis, diffuse vascular infiltrate and collagen degeneration at the level of the papillary dermis,which is a characteristic of a deep dermal burn. The stress–strain curves of normal skin, 18.8 M sulfuric acid treated wound, 6 mm surgical biopsy punch wound and at 21 days post wound were evaluated. As tensile strength measures the ability of matrix to withstand rupture, as the damage from corrosive acid chemical involved wider and deep skin area with permanent damage, the healing could not be processed complete and showed less than 16 % of tensile strength (0.05 ± 0.01 N/mm2) as compared with those of normal skin (0.31 ± 0.08 N/mm2). The sulfuric acid inflicted wound showed flatter, reflecting the small magnitude of their moduli of elasticity. The elasticity constant for sulfuric acid treated skin (1.46 ± 0.17 N/mm) is only 25 % of those of normal skin (5.87 ± 2.14 N/mm). Surgical punch wound showed higher tensile strength (0.10 ± 0.02 N/mm2) and elasticity constant (4.19 ±0.47 N/mm) than those of corrosive chemical acid burns. In conclusion, the proposed sulfuric acid burn condition (18.8 M, 20 s) could be employed as a useful corrosive chemical wound model. The degree of damage induced by corrosive acid chemicals is more significant than surgical full thickness wound and was dependent on the concentration and treatment time. By controlling the burn condition,the extent of damage could be designed. Biomechanical and histological study demonstrated that the corrosive acid burns induced full thickness permanent dermal injury and significant losses in tensile strength and elasticity modulus.

重症 體表 火傷에 의한 心筋의 超微形態學的 變化

宋善敎,孫允卿,郭精植,孫泰重 慶北大學校 醫科大學 1986 慶北醫大誌 Vol.27 No.3

저자는 체표의 중증화상이 심근에 미치는 영향을 초미형태학적으로 규명하기 위해 체중 250gm 정도의 Sprague-Dawley계 흰쥐수컷에 Strenberg방법으로 30%의 3도화상을 입힌 뒤 6시간, 1일, 3일, 5일 및 7일에 각각 3마리씩 좌심실의 심근을 광학 및 전자현미경적으로 관찰하였다. 광학현미경적으로는 간질조직의 경한 부종과 울혈이 일어났다. 전자현미경적으로는 화상후 6시간부터 sarcoplas-mic reticulum의 확장, myelin figure의 출현, mitochondria의 경한종창이 일어나 3일까지 지속되었고, 5일후에는 mitochondria의 심한 종창, 핵막강의 확장, 공포형성과 FCD등이 출현하였다. 그러나 이와 같은 변화는 모두 가역적이었다. 이러한 소견으로 보아 화상후 6시간부터 3일까지 일어나는 비교적 경한 퇴행성 변화는 핍혈성 세포손상으로 보이며 5일이후 일어난 mitochondria의 심한 종창은 화상독에 의한 특징적인 손상으로 생각된다. This study was carried out to investigate ultrastructural changes of myocardium after severe skin burns, Sprague-Dawley rats weighing approximately 250 gm were given 30% third degree burns of the skin and were observed by means of light and electron microscope at 6 hours, 1 day, 3 days, 5 days, and 7 days after burns. On light microscopy, interstitial edema and congestion appeared after burns. On electron microscopy, dilatation of T-tubules, formation of myelin figures, and slight swelling of mitochondria appeared. These changes were persisted for 3 days after burns. At 5 days after skin burns severe dilatation of mitochondria, widening of perinuclear spaces, vacuolar changes, and formation of focal cytoplasmic degradation appeared. But these changes were reversible. By these changes, it would be considered tht slight degradation of myocardium occurring from 6 hours to 3 days after severe skin burns were caused by ischemia, and latent changes, such as marked swelling of mitochondria, were characteristic onew caused by burn toxin.