Jang Y C, Kwon O K, Lee J W, Oh S J
Department of Plastic and Reconstructive Surgery, Hallym University, Hangang Sacred Heart Hospital, Seoul, Korea.
J Burn Care Rehabil. 2001 Jan-Feb;22(1):15-20. doi: 10.1097/00004630-200101000-00005.
The steam burn caused by an electric rice-cooker is a unique mode of burn injury in Asian countries, especially Korea and Japan. This type of burn injury is characterized by 1) occurring most frequently on the volar aspect of the hand in toddlers younger than 2 years of age (92.8%); 2) the depth of burns are normally deep second-degree to third-degree (98%) and usually need surgery at the time of injury; 3) flexion contractures of multiple finger joints and web space contracture are common sequelae. We hypothesized that primary full-thickness skin graft (FTSG) would give more reliable results and eliminate the late reconstructive procedures. Between January 1997 and September 1999, 36 patients underwent primary FTSG, and the results of this primary FTSG group were compared with 124 patients who were treated with split-thickness skin graft (STSG; 79/124; 63.7%) or by conservative management (45/124; 36.3%), and readmitted for the correction of hand deformities between September 1995 and September 1999. In the primary FTSG group, 11.1% (4/36) of mild web contractures and 5.5% (2/36) of finger joint contractures were documented, and these did not require the reconstructive procedure during a follow-up period of 8.8 +/- 4.8 months. In 124 patients of the primary STSG or conservative group, the mean time interval to reoperation was 8.9 +/- 4.0 months and all patients received FTSG for correction of late hand deformities. In a retrospective study of the primary STSG group, 42 of 53 patients (79.2%) received reconstructive procedure during a 5-year follow-up period. In this report, we introduce the nature of steam burn caused by electric rice-cooker and propose that primary FTSG may be a reliable method for the treatment of this more severe type of acute burn in pediatric patients.
电饭煲导致的蒸汽烫伤是亚洲国家，尤其是韩国和日本特有的一种烧伤类型。这种烧伤具有以下特点：1）最常发生于2岁以下幼儿的手掌面（92.8%）；2）烧伤深度通常为深二度至三度（98%），受伤时通常需要手术治疗；3）多个手指关节的屈曲挛缩和指蹼间隙挛缩是常见的后遗症。我们推测，一期全厚皮片移植（FTSG）会取得更可靠的效果，并避免后期的重建手术。1997年1月至1999年9月，36例患者接受了一期FTSG，并将该一期FTSG组的结果与124例接受中厚皮片移植（STSG；79/124；63.7%）或保守治疗（45/124；36.3%）且在1995年9月至1999年9月间因手部畸形再次入院的患者进行了比较。在一期FTSG组中，记录到11.1%（4/36）的患者有轻度指蹼挛缩，5.5%（2/36）的患者有手指关节挛缩，在8.8±4.8个月的随访期内，这些情况均无需进行重建手术。在124例一期STSG或保守治疗组的患者中，再次手术的平均时间间隔为8.9±4.0个月，所有患者均接受了FTSG以矫正后期手部畸形。在对一期STSG组的一项回顾性研究中，53例患者中有42例（79.2%）在5年随访期内接受了重建手术。在本报告中，我们介绍了电饭煲导致的蒸汽烫伤的特点，并提出一期FTSG可能是治疗小儿患者这种更严重类型急性烧伤的一种可靠方法。
