Objective: Current treatment for second-degree burn wounds, including silver sulfadiazine (SSD) application, may cause side effects such as delayed and incomplete wound healing, leaving a scar. Traditional plants empirically used for burn wounds, such as Aloe vera, seem to be a promising option with good safety profiles. Methods: We therefore compared Aloe vera to SSD for second-degree burn wounds based on a review of clinical trials obtained by an organized search through the Cochrane, PubMed, and DynaMed databases. Three randomized clinical trials studies were selected, two of which were critically appraised. The third study, with a different outcome assessment, was analyzed separately. Results: Two studies showed that Aloe vera was more effective in treating second-degree burn wounds than SSD 1% with an absolute risk reduction of 0.2, relative risk reduction of 0.83–1.0, and number needed to treat five patients. The Aloe vera group showed faster healing, earlier epithelialization, and earlier pain alleviation. The third study combined Aloe vera with other herbs, which showed better healing ability and restored skin hydration than those with SSD. Conclusion: Each of the three articles stated that Aloe vera was more effective than SSD for treating second-degree burn wounds. Nevertheless, each of the studies lacked methodology and comprehensive data reporting.

Background: Most hand flaps are local intrinsic flaps because hand perforators are small and fragile. The purpose of this review was to gather anatomical data on cutaneous perforators of the hand and their implications on intrinsic hand flaps. Methods: An electronic search was performed through PubMed, Scopus, ScienceDirect, ProQuest, and CINAHL in April 2021. The search terms included "hand," "palm," "manus," "cutaneous artery," "angiosome," and "perforasome." Studies were filtered according to the PRISMA flow chart, and critically appraised using the Quality Appraisal for Cadaveric Studies (QUAC) and Appraisal Tool for Cross-sectional Studies (AXIS). Results: A total of 33 studies were included, of which 20 were pure anatomical studies, 10 combined anatomical and clinical studies, and three imaging-based clinical studies. A total of 643 hands and 406 fingers were included. The dorsal aspect of the hand, the dorsal digits, hypothenar, midpalm, thenar, and dorsal wrist consistently have adequate, closely distributed perforators of small diameters and short pedicle lengths. A series of clinical studies proved the success of elevating local perforator flaps on each of these areas. Conclusions:The hand contained densely interlinked cutaneous perforators of varying sizes and pedicle lengths. Although some areas of the hand are still unexplored, knowledge on cutaneous perforators of the hand allows the creation of a variety of possibilities for intrinsic hand flap designs.

Introduction Blood loss is a common and important problem in burn surgery, and patients often require blood transfusions. Preparation of estimated blood transfusions needed prior to surgery is essential. Some studies have devised formulas that can predict blood loss during burn surgery. However, there were many different factors in each study that may influence the amount of blood loss, which were not included in the formulas. Until today, there is no standardized formula that is widely used. Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE database for cohort and trial studies that investigate blood loss in burn surgeries. Studies should have clear quantitative blood loss outcome. Results We included 15 studies from 1982 to 2018, 13 of which are cohort studies and 2 RCTs, with a total of 1613 subjects; all studies calculated blood loss and assessed possible relating factors, four of them proposed formulas to predict the volume of blood loss, 13 studies mentioned efforts used to reduce blood loss, and 6 studies assessed the timing of surgery. We found trends of blood loss within each variable and summarized them in tables. Conclusions From the studies included, there were a variety of results in the amount of blood loss and its related factors. This was due to confounding factors and dissimilarities between studies. However, several studies proposed blood loss prediction formulas, which pose promising benefits to betterment in burn surgeries.

Background: Foreign substance injections into the penile subcutaneous tissue to enlarge the penis frequently produce disastrous complications, such as penile granulomas. Here we reported a case of penile granuloma along with our reconstruction technique. Method: This report presents a 57-year-old male with a 4-year-old granuloma with recurrent ulcers. A penile reconstruction was conducted using unilateral inguinal full-thickness skin graft. Patient was discharged after one week and followed with regular visits to the outpatient clinic for 6 months. Results: No complication was reported post-surgery and wounds recovered well. However, the patient complained on reduced sensation and pain on the penile tip, and inability to erect after 6 weeks post-surgery. After 6 months post-surgery, the patient can retain erection with remaining sexual dissatisfaction. Conclusion: Inguinal full-thickness skin grafts provide adequate coverage for penile reconstruction in granuloma excision. Eventually, regaining sexual function and satisfaction remain an intricate challenge to face.

Extensive burn surgeries lead to a considerable amount of blood loss. Predicting pre-operative blood loss is essential for blood ordering and crossmatching. Accurate amount of ordered blood units ensures patients’ safety and minimizes cost. However, blood loss estimation is complicated due to a variety of factors influencing blood loss, including patient and operative-related variables. Currently, no standard method to predict blood loss exists prior to surgery. Our goal is to review factors influencing blood loss and formulas that can predict blood loss. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE databases for studies investigating blood loss in burn surgeries with a clear quantitative outcome. Fifteen studies were included, comprising 1613 subjects. All studies calculated blood loss and assessed possible related factors, and four studies proposed preoperative blood loss prediction formulas. Larger areas of tissue excised and grafted, younger age, and delayed surgery were correlated with increased blood loss. Varying decrease in blood loss was observed with tumescent usage and other bleeding control methods. Other variables produced inconsistent results. From four prediction formulas, only one formula, Dye’s Formula, had been applied and proven effective in reducing unused blood units clinically by up to 40% of cross-matched blood. Various confounding factors and dissimilarities between studies make reliable prediction method construction challenging. With consideration of diverse patient characteristics, some study develops formulas to achieve optimal patient care and avoid unnecessary hospital expenditure. Further research with consistent variables should be done to construct a standardized blood loss estimation formula.