Burn and Scar Treatment in Korea
The Korean hospitals manage burns actively in early stages to lower the frequency of operation and minimize scars with using various latest techniques. Such as artificial skin, cultivated skin cell medicine (biologic dressing method), low-output laser and the latest dressing medicine. Advanced operation is used in consideration of functional and cosmetic aspects by using cultivated epidermis and artificial skin for the patients who need operation unavoidably. However, several sequels will be left according to the part if the burn is serious regardless of this action.
1. Acute burn treatment
In case of acute burns, a serious scars were left by enforcing skin transplant operation or missing the operation period in the past, but this center tries to manage burns actively in early stages to lower the frequency of operation and minimize scars with using various latest technique such as artificial skin, cultivated skin cell medicine (biologic dressing method), low-output laser, and the latest dressing medicine. Advanced operation is used in consideration of functional and cosmetic aspects with using cultivated epidermis and artificial skin for the patients who demand operation unavoidably. However, several sequels will be left according to the part if the burn is serious regardless of this action.
2. Burn reconstruction
1) Skin transplant operation
a. Reconstruction through full-thickness graft
The best result can be obtained in case of reconstruction by full-thickness graft. But it is important to reconstruct with using the limited given part effectively if the burned area is wide due to the limitation of given part. Full-thickness graft operation is the most difficult operation among skin transplant operations, though it is able to give a better result; thus, much surgical know-how and experiences are required for full-thickness graft.
b. Reconstruction through artificial skin transplant operation
If the surgery reconstruction area is wide and full-thickness graft cannot be fulfilled with the patient’s skin, various artificial skin used reconstruction is operated. Although a quite expensive price is required, it is used when the construction is serious and it is no longer able to transplant skin.
2) Decortication / Ultra-thin section skin transplantaion
If a pigment cicatrix leaves minutely or seems rough, it is mostly considered to be fully cured and the treatment is surrendered or stopped. However, stress and social activity become limited if scars are left on the parts where are exposed such as face or hands and arms. Cosmetic advancement is achieved by using know-how of decortications which is accumulated for several years and delicate skin graft technique of plastic surgery.
3) Glass Skin Flap Operation
In case of difficult correction of disability, it can be corrected with skin graft operation. A deep burns as electrical burn sometimes leads a serious loss of tissues. Moreover, the quality of life greatly falls by raising such a serious functional disorder and dysmorphia disorder after the scar is completely treated. In case of a difficult correction of disorder with skin graft operation, it is corrected by transplanting a new tissue of the other part with surrounding blood vessel.
4) bald head occurred after burn
The case of getting a deep-part burn which accompanies with thick skin follicle damage compared to the other parts. In case of the burn causing follicle damage as flame burn or electrical burn, hair loss phenomenon is caused so that a serious sequel in terms of appearance can be led.
5) facial burn
Since face is part exposing as the most and determines the impression, people are usually sensitive with even small scars. But it is difficult to correct by a simple skin graft and a wide correction is not proper as well. Various corrections are enforced by inducing the idea of cosmetic to burn.
The most general method is to remove the scar following its shape, and then suture delicately the surrounding skin with the layers. At this point, the scar becomes less appeared by suturing with straight line, zig-zag form, or W-shape. The second method is to remove the scar by expanding the normal tissues beside the scar by grafting skin from the other parts of the body or using a tissue dilator. The third method is to use skin decortications. Skin decortication is a method to smooth the rugged part around the skin by peeling the surface of skin or part of the corium. It is mainly used in case of pockmarked, chickenpox, or acne spot. Surgical method of scar correction should be considered according to the location, shape, and size. Thus, there are various surgical methods based on cicatrix.
1) Scar plastic surgery
Scar plastic surgery is a suture operation after removing scars when the scars are small or long. However, in case of burn, surrounding tissue and adhesion are serious even if the scar is small; thus, it tends to open if suture is operated simply and it can even recur.
2) Cicatrix correction with local skin flap operation
In case a deep burn is brought and a serious cicatrix construction is occurred, skin graft operation is usually enforced. Since skin graft operation is complied to form a new cicatrix while the skin is being taken from a given part, the patients sometimes hesitate to take the treatment. In such a case, the construction of cicatrix can be corrected by local skin flap operation if the circumstances around the cicatrix are proper. crowns, bridges, and veneers.