Injuries, cuts and burns

• Abrasions(Scrapes)
• Contusions
• Cuts
• Lacerations
• Puncture wounds
• Bite wounds
• Contusions (e.g., traumatic dimples)
• Burns and scalds

A wound is caused when a person falls and touches his/her face or knee to asphalt road and a part of the epidermis or dermis is abraded off by external force such as friction. Healing is usually rapid because the skin appendages remain on the wound surface. Treatment consists of wound care dressings and ointments to promote epithelialization of the wound.

A contusion is an open injury of the subcutaneous tissue caused by a blunt external force, such as a fall while running that results in a split in the skin of the face or knee, with irregular wound edges, peeling of the skin and subcutaneous bleeding. If left untreated, it can result in a dirty scar and is best treated by a plastic surgeon. Treatment consists of excision (debridement) of the contused dirty tissue under local anesthesia and suture closure.

A sharp wound caused by cutting with a sharp knife or a piece of glass. The wound is often linear. The edges of the wound are sharp and there is less tissue destruction than in a contusion wound. Treatment is primary suture closure with nylon thread. If the wound is shallow, it may be closed with tape but exudate may seep out and cause the wound to peel open, resulting in a prominent scar so the best treatment is to suture as much as possible.
Another type of wound is the flap wound which is a sharp wound that is oblique in one direction and has a U or V-shaped shape with thinning at the ends. These wounds require plastic surgical techniques, such as excision and suturing of the thin areas, as they are prone to trap door deformity, which causes the valve-like area to bulge after healing.

These wounds are formed when the skin is stretched by strong traction or pressure and torn beyond the skin's elasticity, such as when the skin is peeled off by a wheelchair bracket. They tend to occur on the forearms and lower legs of elderly patients with atrophic skin. The surrounding contusion is minimal. The treatment is suture closure if possible but this may be difficult in the elderly because of thin skin. In such cases, treatment is secondary to moist therapy with a covering material.

A stab wound is caused by a pencil lead, kitchen knife, nail or piece of wood. Although the wound is small, deep tissue damage may have occurred. If blood vessel or nerve damage is involved, treatment at a university hospital or other institution may be recommended. In cases caused by a piece of wood or pencil lead, attention should be paid to lingering foreign substances and imaging tests such as echography may be performed. In addition, contaminated wounds, such as those caused by stepping on a rusty nail, require attention to infections such as gas gangrene and tetanus.

Bite wounds are caused by bites from animals such as dogs, cats, bears and humans. Because the wound is highly contaminated, it is often treated as an open wound without suture closure. However, since the majority of the injured area is the face, it may be sutured loosely after thorough cleaning and debridement, depending on the situation.

A contusion is a scar caused by a blunt external force, such as a bruise on the face caused by hitting the cheek against the edge of a desk, which does not damage the skin but damages the internal soft tissues and muscles. Minor contusions with hematomas or effusions are absorbed spontaneously and heal nicely, but may leave a depressed scar called a traumatic dimple. Residual depressed scars have been difficult to treat in the past, but new surgical methods have been reported, such as fat grafting and the recent Plastic and Reconstructive Surgery Journal. If you are concerned about residual traumatic dimples, please contact us for a consultation.

Burns and scalds are common everyday wounds, such as blisters from spilling soup on one's hands or from accidentally touching one's hand on a hot pan. Burns are classified from degree I to degree III according to the depth. Degree II burns may become deeper or lead to degree III burns, which may result in scarring (prominent scars) and functional and cosmetic disfigurement. Even small burn wounds can be very painful. Please consult our clinic for burn treatments.

• First-degree burns
• Second-degree burns
  　Shallow second-degree burns
  　Deep second-degree burns
• Third-degree burns

A burn wound in which the depth of injury is limited to the outer layer of the skin or epidermis. It presents with redness(erythema) and mild swelling, but no blister formation. They are accompanied by a burning sensation, hypersensitivity, and sometimes pain. These symptoms resolve within a few days. Although usually no treatment is required, children with thin skin may develop blisters the next day even if only redness is seen immediately after the injury.
We recommend that you visit a plastic surgeon after receiving a burn injury.

Burns extend to all layers of the outer layer of the skin or the epidermis and papillary dermis with blister formation. The surface of the wound beneath the blister is red. The wound is painful and swollen. Wound healing is rapid, approximately within 2 weeks with no scarring due to the presence of skin appendages, however hyperpigmentation may occur.

This burn wound goes deeper than the papillary dermis layer and also destroys hair follicles, sweat glands and other skin appendages. Healing takes 3 to 4 weeks and often leaves scars. Second-degree burns that form blisters may turn into deep second-degree burns, with abscesses accumulating beneath the blisters.
The blisters may act as a bandage in the early stages of the injury to reduce pain but caution is required depending on the course of the injury. In the case of deep second-degree burns, tissue damage may be severe and infection may occur, leading to third-degree burns.
Second-degree burns can be deep and may leave scars, so early intervention by plastic surgery is important.

These are burn wounds that involve all layers of the skin and sometimes even the subcutis and muscles. The wound surface is pale to brown parchment-like, and hard, leathery necrotic tissue (incrustation) is formed. Spontaneous healing occurs when the incrustation melts away and is epithelialized from the surrounding area after shedding. Surgical excision of the incrustation and skin grafting may be performed.
In the case of a third-degree burn, scar formation occurs and scarring remains. Therefore, a plastic surgical treatment is necessary to prevent a second-degree burn from becoming a third-degree burn or quickly heal a third-degree burn to minimize scarring.