Background: Cultured allogenic keratinocyte (CAK) and epidermal growth factor (EGF) are commonly used biological treatments for partial-thickness burn wounds. A comparative study was conducted on whether the combination therapy of CAK and EGF promotes partial-thickness burn wound healing.Methods: From January 2020 to March 2021, 73 patients who visited the hospital with partial-thickness burns were enrolled in the study. Patients were treated with CAK (Kaloderm) (n=20), EGF (Easyef) (n=17), and CAK+EGF (n=24). Wound healing rate, time to heal, factors affecting wound healing (age, sex, underlying disease, mode of injury, location of injury, initial wound size), and scarring were comparatively analyzed.Results: The wound healing rate for 20 days was 85% (17/20) in the CAK group, 88% (15/17) in the EGF group, and 92% (22/24) in the CAK+EGF group. The average healing time was 11.0±6.0 days, with the CAK group taking 12.6±5.5 days, EGF group taking 11.5±6.0 days, and CAK+EGF group taking 9.0±6.3 days. The patients who received CAK+EGF treatment had higher hazard than the patients without CAK+EGF treatment (hazard ratio, 2.078; 95% confidence interval, 1.021–4.228). Smaller wound size <5 cm2 (hazard ratio, 2.869; 95% confidence interval, 1.426–5.773) was associated with complete wound healing. Though statistically insignificant (P=0.218), less scars occurred in the CAK+EGF group.Conclusion: Combination therapy of CAK and EGF promotes wound healing in partial-thickness burn wounds.

Background: Though composite grafting is an easy, simple treatment for fingertip amputation, it is known to have a low survival rate. To increase the likelihood of composite graft survival, various adjuvant therapies such as hyperbaric oxygen therapy, ice-cooling, or vasodilator agents have been used. In this study, we attempted to validate the hypothesis that topical normobaric oxygen therapy (tNBO) could improve composite graft survival in fingertip amputation.Methods: Patients who sustained fingertip amputations and who were treated with composite grafting between January 2015 and July 2020 were included. The patients (n=154) were divided into two groups: those who received tNBO (n=102) and those who had not (n=52). The effect of tNBO on graft survival, survival rate by level of amputation, and risk factors of graft survival (age, smoking, time to surgery, diabetes mellitus, and crush-avulsion injury type) were examined.Results: tNBO significantly increased composite graft survival (75.3% vs. 50%, P<0.001) in amputations distal to the nail base area. Among risk factors, time to surgery >5 hours (odds ratio, 48.6; P=0.001) and crush-avulsion injury type (odds ratio, 10.1; P<0.001) significantly decreased graft survival in both groups. Smoking decreased graft survival only in the non-tNBO group (odds ratio, 28; P=0.015), not in the tNBO-treated group.Conclusion: tNBO increased composite graft survival in fingertip amputation distal to the nail base area. It can be helpful for composite graft survival in smokers.

Background: Conservative treatment of deep dermal or full-thickness skin defects often results in hypertrophic scars or contractures; thus, compressive therapy has been used after wound closure to prevent or treat scar deformities. However, wound contraction begins in the early proliferative phase and peaks after 2 weeks. We therefore attempted early compression therapy as a means of conservative treatment of deep-skin defects and evaluated its clinical outcomes. Methods: In 21 cases of deep skin defects (19 patients), early compressive therapy was started the second week after injury. Saline-moistened gauze or foam dressings were placed on open wounds, and foam dressings or silastic plates were used after epithelialization. The compression materials included elastic bandages, adhesive tapes, or garments. The final scars were assessed using the Vancouver Scar Scale (VSS) and satisfaction degree.Results: Defect size ranged from 1.4×0.7 to 5×5 cm. The duration of compression was 4 to 12 months. The follow-up periods were 4 to 61 months. Mild scar hypertrophy or contracture occurred in 15 cases and subsided after application of topical corticosteroid or triamcinolone injection. The final scar shapes were linear (n=12), geographic (n=5), and oval (n=4). The mean VSS score was 2.3. The degrees of satisfaction were excellent (61.9%) and good (23.8%). In most cases, aesthetically and functionally satisfactory outcomes without pathologic scars were demonstrated with minimal scar size, high scar quality, and high satisfaction.Conclusion: Early compression therapy might be a good option to prevent pathologic scars in the conservative treatment of deep skin defects.

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