Background:The use of cultured epithelial autografts for the treatment of extensive burn wounds has become popular in recent years. We examined extensive burn wounds in 14 patients by using a combination of autograft and cultured epithelial autografts developed in Japan (JACE).Methods:We undertook a skin biopsy at 2, 4, and 6 weeks after transplantation with JACE. By using electron microscopy we observed the engraftment process.Results:In transmission electron microscope findings, we recognized the engraftment process of JACE. Keratinocytes matured gradually. Collagen fibers formed thick bundles in the dermis layer. In scanning electron microscope findings, we observed papillary dermis development on the artificial dermis.Conclusions:After managing wound bed preparation by using artificial dermis, we were able to recognize the good result of grafting JACE on meshed 6:1 split thickness autografts. This is because the auto dermis from autograft extended under the JACE, binding between JACE, and the dermis became strong.

INTRODUCTIONChronic expanding hematoma is a relatively rare complication of soft tissue trauma and often clinically mistaken for a malignant neoplasm.PRESENTATION OF CASEA 71-year-old female presented with a chronic expanding hematoma that ruptured through the buttock skin 53 years after the original contusion. The diagnosis of CEH was made based on the results of the biopsy, physical examination, and CT. The tumor was completely excised, and the defect was covered with a rhomboid flap.DISCUSSIONThere are no reports of lesions rupturing through the skin. Almost all instances of chronic expanding hematoma previously reported in the English literature have a history ranging from 1 month to 20 years. There is a report of a thorax CEH that ruptured into the lung parenchyma after 24 years, so it is conceivable that other subcutaneous CEHs could break through the skin several decades after their inception.CONCLUSIONOnce this lesion has ruptured, its differentiation from other entities becomes more complicated.

The Japanese Society for Burn Injuries (JSBI) published the third edition of guidelines to present the standard of care for inpatient treatment of burn injuries in Japan. The guideline is not a mere revision of the first and second editions but has been carefully designed to be user friendly and of high quality for medical professionals engaged in burn care. We think it is important to share these guidelines with other countries to work toward a consensus of burn care, then develop new research to establish evidence for burn care and treatment in the future.