Facial Burns Research Articles

Plastic Surgery in Burn Care: A Call for Enhanced Burn Surgery Training Within Plastic Surgery Residency Programs.

A 10 year cohort of patients admitted to a verified burn unit were analyzed to assess the role of plastic surgeons in the operative management of those patients. All 3843patients were admitted during this study period. Of these, 1509 of those patients underwent surgical procedures. Plastic surgeons performed 658 operations on these patients, including acute and delayed reconstruction of hand and facial burn injuries. In this population, plastic surgeons played a critical role in acute and reconstructive burn injuries in anatomically complex areas. This series illustrates the need for plastic surgery training in burn care.

Stigma and self-esteem in facial burn patients: A correlation study

BackgroundA considerable number of burn patients have greater psychological stress due to the special trauma site. In clinical practice, it is found that medical staff pay more attention to the rehabilitation of physical function, while the mental health status of patients is greatly neglected. In contact with patients, we found that attention should be paid to the levels of stigma and self-esteem. However, there are few studies on stigma and self-esteem in patients with facial burns. Therefore, this study aimed to describe the stigma and self-esteem levels of facial burns, investigate the relationship between these two variables, and explore the influencing factors of stigma in patients with facial burns, in order to provide evidence for follow-up interventions to improve this population. MethodsFrom August 2020 to June 2021, we recruited patients with facial burns who met the inclusion criteria in one burn specialist clinic and three burn units of a tertiary A hospital in Guangzhou, China. The survey tools of this study include sociodemographic and disease-related information questionnaires, the Chinese version of the Social Impact Scale, and the self-esteem scale (these scales were validated). SPSS 25.0 software was used for data analysis through t test, analysis of variance, correlation analysis, multiple linear regression method for data statistics. ResultsThe total stigma score of facial burn patients was (58.01 ± 7.57), which was at a medium level; the self-esteem score was (19.72 ± 2.43), which was at a low level. Correlation analysis showed that there was a positive correlation between the self-esteem score and the total score of stigma (r = 0.286, P < 0.01). The family per capita monthly income, education level, way of medical expenses expenditure, and self-esteem of facial burn patients were the influencing factors of their stigma, and these factors explained 33.7% of the variation in stigma (F=8.659, P＜0.01). ConclusionsPatients with facial burns have low levels of stigma and self-esteem, which requires our efforts. In particular, there is a positive correlation between stigma and self-esteem, and self-esteem is an independent risk factor affecting stigma. Our findings suggest that interventions aimed at enhancing self-esteem have the potential to positively impact the reduction of stigma in this patient population.

Assessment of health-related quality of life in patients with burns injuries during the COVID-19 epidemic: A critical topic for burn survivors

PurposeIt is well known that the coronavirus disease 19 (COVID-19) epidemic had an adverse effect on the health-related quality of life (HRQOL) of patients with disabilities, or neurological or chronic conditions. The aim of this study was to examine the possible factors affecting HRQOL in patients with burn injuries during COVID-19 epidemic. MethodsThe study included a total of 40 burns patients. The demographic and burn injury information of the patients were recorded. The active range of motion was measured with a goniometer. The HRQOL, community integration, scar tissue quality and anxiety level were evaluated using the Burn-Specific Health Scale (BSHS), the Community Integration Questionnaire Revised (CIQ-R), Patient and Observer Scar Assessment Scale, and the State-Trait Anxiety Inventory, respectively. ResultsThe history of COVID-19 infection, total burn surface area (TBSA), community integration level, work-related burns, the presence of trunk burn injury, the presence of face burn injury, and the presence of a major burn injury were determined to be significantly associated with the HRQOL of burns patients (p < 0.05). ConclusionThe history of COVID-19 infection, community integration level, and burn-related parameters (TBSA, localization, severity etc.) were found to be factors associated with the HRQOL during the epidemic. The history of COVID-19 and community integration level should be evaluated in addition to the burn injury parameters to improve the quality of life of burn survivors. It can be recommended that these clinical parameters should be considered when planning the treatment program during and after the epidemic.

Facial burn in children: a review

Burns are a common cause of injury among children. Children with facial burns often experience pain, regardless of the cause, size, or depth of the burn injury. Burns in the facial area may lead to fatal consequences because of the involvement of the upper airway and cosmetic deformity of the face. Major burn injury in the facial area remains a significant cause of morbidity and mortality in children. Burn scars on the face in children may disturb the self-image and psychosocial processes. Multi-disciplinary approaches and advances in burn care are often helpful to manage the burn injury in children and increase the survival of the patients. Pain has adverse emotional and physiological impacts, and adequate pain control is an important factor in improving outcomes. The goal of the treatment of facial burns in children is to achieve a good aesthetic outcome and also normal head movement with neck mobilization.

COVID-19 positive cases in a pediatric surgery department from Romania: Case series from 2 years of pandemics.

The COVID-19 pandemic had a dramatic effect on various health systems in terms of admissions and outcomes, including pediatric surgery activity. The aim of this paper was to analyze the outcome of SARS-CoV-2-positive patients admitted to our department during the regional COVID-19 pandemic in North-Eastern Romania. We also evaluated the changes generated in our daily practice by the COVID-19 pandemic and the dynamic response to this major challenge. The patients presented with symptoms related to their primary diagnosis: local pain and deformity in case of fractures; pain, swelling, and erythema in case of abscess; pain and decreased range of motion (ROM) in case of intolerance to metal implants. Other specific concerns are mentioned on an individual basis. Eighteen patients (of which 4 had acute appendicitis and were included in a previous article), representing 1.18% of the total number of admissions, tested positive for SARS-CoV-2. There were 4 patients with fractures, 3 patients with soft tissue abscess or cellulitis, 2 patients with intolerance to metal implants, 1 patient with facial burn, 1 patient with thumb laceration, 1 patient with liver trauma, 1 patient with undescende testis, and 1 patient with symptomatic inguinal hernia, respectively. Boys represented 11/ 14 (78.57%) of the cases. The mean age of the patients was 9 years 11 months. There were only mild COVID-19 cases. Surgery was performed in 13/ 14 (95.71%) of cases. The fractures were treated with open reduction internal fixation (ORIF); incision and drainage (I & D) were performed in case of soft tissue abscess; the metal implants were removed in case of local intolerance. Other conditions (burn, inguinal hernia, undescended testis, skin laceration) were treated specifically. Only 1 patient with liver laceration was treated conservatively under close hemodynamic monitoring. The mean length of stay (LoS) was 2.71 days. The infection with the SARS-CoV-2 virus had no deleterious effect on the surgical outcome among the 14 patients included in the study. There were no surgical complications during admission and no patient returned for late complications related to their primary disease or SARS-CoV-2 infection. The SARS-CoV-2 infection had no significant influence on the outcome of pediatric surgical cases included in the study. We noticed a significant (31.54%) decrease in the number of admissions compared to the previous 2-year interval before the COVID-19 pandemic. Fast and adequate adjustment of the daily activity imposed by the COVID-19 pandemic was feasible and may be used in the future should similar epidemiological emergencies occur.

The epidemiology of alcohol burns at a major burn centre in North China

This study was designed to explore the epidemiological characteristics and potential preventive strategies of alcohol burns. In this five-year, retrospective study, 163 patients with alcohol burns (admitted from 1 January 2015 to 31 May 2020 were included. There was a male-to-female ratio of 1.1:1, a mean age of 34.1±16.8 years, and a mean burn size of 13.3±13.7% total body surface area (TBSA). The number of patients with alcohol burns was similar year by year during the five-year period. Just over half of patients (n=84, 51.5%) sustained a third-degree burn injury, which was significantly associated with a longer hospital stay and the need for surgery. The most prevalent aetiology was cupping (n=49, 29.5%), followed by cooking hotpot (n=37, 22.7%). Of the patients, seven (4.29%) sustained injuries during experiments at school and one patient sustained injury when using alcohol spray for disinfection against COVID-19. The incidence of facial burn injury (n=105, 64.4%) was significantly higher than previously reported data (33.2%). The result of the study showed that cupping and hotpot were the main causes of alcohol burns in Beijing, which should be taken into consideration for prevention. It is necessary to strengthen safety management of classes at school where experiments are undertaken and to educate the general public on the proper means of disinfecting against COVID-19.

A Novel Adjunct for Treatment of Orofacial Contractures After a Facial Burn Injury

Purpose: Surgical management of scar tissue and contractures from facial burns has systematic approaches, yet nonsurgical management continues to lack consensus regarding therapeutic approaches capable of providing stretching of the facial skin and muscles for both treating and preventing microstomia and orofacial contractures. This exploratory study introduces an intraoral splinting system designed to provide low-load, prolonged stretching of orofacial skin and musculature to treat contractures following a facial burn injury. The treatment adjunct described here has potential application across disciplines treating microstomia and orofacial contractures. Method: An 18-year-old man with full-thickness head and neck burns participated in a 5-week trial using intraoral splints to provide stretch to areas of contracture in the mid and lower face. The trial commenced 4 and a half months after his burn injury. Prescriptive placement, sizing, and time for use of the splints were provided. Changes in distance between facial landmarks were identified for 13 measurements taken for nine facial expressions. Results: Lengthening or shortening of the distances between two landmarks indicated the potential benefit from intraoral splints. For the expression “open mouth wide,” increased distance between two end points was noted in 11 of 13 measurements, ranging from 1.6 to 10.8 mm. This represents a lengthening of tissue, allowing for wider oral opening. Negative measurements between two end points occurred in two of 13 measurements, demonstrating elevation of the left and right nostrils. Visual data also demonstrated the appearance of change. Conclusions: When treating microstomia and orofacial contractures, consideration should be given to the use and further exploration of a more targeted intraoral methodology that uses a low-load, prolonged stretch to improve functional and aesthetic deficits. Oral splinting using an intraoral methodology is underutilized in the burn patient population and has application in both the acute care and chronic phases of recovery.

Pediatric Facial Burns and Consumer Products: A Nationwide Analysis.

Pediatric facial burns pose significant challenges in terms of physical, psychological, and social impacts on children. Understanding the causes of these burns is crucial for prevention and appropriate care. This study aims to provide a comprehensive analysis of causes and preventive measures related to pediatric facial burns caused by consumer products. Using data from the National Electronic Injury Surveillance System (NEISS) from 2012 to 2021, we analyzed 130,461 cases of pediatric facial burns. Common causes included household items such as cleaning supplies, hot water, kitchen appliances, and health and beauty products. Differences in burn causes were observed between genders, with boys more prone to burns from welding equipment, gasoline, and grills, while girls were more susceptible to burns from hair curling equipment, candles, and health and beauty products. The mean age of children burned by different items varied, highlighting the need for age-appropriate preventive measures. The authors discuss the importance of caregiver education, safe storage practices, supervision, and clear communication in preventing pediatric facial burns. By raising awareness of potential burn sources and implementing preventive strategies, the incidence of pediatric facial burns can be significantly reduced.

Application of red-blue LED phototherapy combined with external use of recombinant human epidermal growth factor for patients with head and face burns

Application of red-blue LED phototherapy combined with external use of recombinant human epidermal growth factor for patients with head and face burns

Enzymatic debridement of deep facial burns with Nexobrid™: the Queen Victoria Hospital experience

Enzymatic debridement of deep facial burns with Nexobrid™: the Queen Victoria Hospital experience

Outcome of Facial Burn Injuries Treated by a Nanofibrous Temporary Epidermal Layer.

The face is commonly affected in thermal injuries, with a demand for proper recognition and the correct choice of treatment to guarantee optimal aesthetic and functional outcomes. It is highly vascularized and often heals conservatively, highlighting the particular relevance of conservative treatment modalities, many of which require daily re-applications or dressing changes, which can be painful and tedious for both the patient and the healthcare providers. Motivated by encouraging results of a novel temporary nanofibrous epidermal layer, we herein present a case series of this technology in a case series of patients suffering from facial burns and treated in our Burn Center. Patients with superficial partial-thickness facial burns and mixed pattern burns, which were treated with SpinCare™, an electrospun nanofibrous temporary epidermal layer, between 2019 and 2021, at our institution were analyzed retrospectively. The Manchester scar scale (MSS) and numeric rating scale (NRS) were used for scar, pain, and outcome evaluation at different time points by five independent board-certified plastic surgeons with profound experience in burn surgery. Ten patients (m = 9; f = 1) were treated and evaluated retrospectively. The mean age was 38.8 ± years (SD ± 17.85). The mean healing time was 6.4 days (SD ± 1.56). The mean follow-up was 16.4 months (SD ± 11.33). The mean MSS score was 5.06 (SD ± 1.31), and the mean NRS Score for pain was significantly reduced from initially 7 to 0.875 upon application (mean (pre-application) 7 ± 0.7 and (application) 0.875 ± 1.26; p ≤ 0.0001). Patients reported a NRS score of 10 in terms of functional and cosmetic outcomes at their final follow-up appointment. No adverse effects were observed. The application of a nanofibrous temporary epidermal layer such as SpinCare™ represents a relatively easy-to-use, well-tolerated, and effective alternative for the treatment of partial-thickness facial burns.

The Impact of Facial Burns on Short- and Long-Term Quality of Life and Psychological Distress-A Prospective Matched Cohort Study.

Burn injuries are a major healthcare challenge worldwide, with up to 50% of all minor burns located on the head and neck. With this study, we sought to describe the effect of facial burns (FB) on health-related quality of life through a prospective and matched cohort study design. Patients completed the 36 Item Short Form (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Results were analyzed based on the distribution of datasets. In total, 55 patients with FB and 55 age-and sex-matched candidates were recruited. The most common mechanism of thermal injury was burns from flames. The FB group scored lower in physical and psychological dimensions than the control group, both acutely and one year after injury. An analysis of each domain showed that subjects in the FB group trended toward improvements in their score after one-year post-burn in physical functioning (acute: 71.0 ± 29.2; one-year: 83.7 ± 23.9; p = 0.02) and bodily pain (acute: 58.5 ± 30.3; one-year: 77.9 ± 30.5; p = 0.01) domains. Additionally, the FB group had significanlyt higher scores for anxiety (FB: 4.8 ± 3.2; control: 2.5 ± 2.8; p = <0.002) and depression (FB: 3.9 ± 3.5; control: 2.1 ± 2.7; p = 0.01) compared to the control. In conclusion, facial burns are associated with physical and psychosocial deficits, as well as elevated levels of psychological distress.

Cosmetic and visual outcomes following high-voltage severe electric facial and ocular burns: A case report

A 19-year-old male presented with accidental high-voltage electric burns following contact with a transformer while catching ball and developed right eye count finger vision and no perception of light in left eye. On examination, there were full thickness burns on upper half of left side of face, lids, and left leg involving 3rd, 4th, and 5th toes. Three surgeries were performed by the plastic surgeon for overall aesthetic look. The right eye regained vision following cataract surgery, but there was cosmetic and functional loss of left eye. This case report highlights that high-voltage electric burns of face and eye require proper surgical management and final visual outcome depends on amount of damage.15

Application of 3D transparent facemasks in long-term outpatient rehabilitation of facial scars after burns: a retrospective cohort study of improved appearance of target scars with different healing time.

Severe facial burns may cause scarring problems and affect living quality of patients. With the advent of 3D facemasks, it is being used to treat facial scars; however, its efficacy must be confirmed by adequate studies. A retrospective analysis of 26 patients who visited rehabilitation outpatient clinic from 2017 to 2022. Patients were separated into two groups based on the time to healing (TTH) following burn injury: early healing group (TTH ≤ 21 days) and late healing group (TTH > 21 days). To compare treatment outcomes and differences between the two groups, 3D facemask application was assessed using the Vancouver Scar Scale (VSS), patient satisfaction, and complications. In both groups, there were significant improvements in the total VSS scores (P<0.01) and each VSS subscore (P<0.01). These scar characteristics improved over time as the treatment progressed. Compared with the late healing group, the early healing group had more obvious effects on improving scar pigmentation (P<0.05) and vascularity (P<0.05) at similar assessment time points after burns. At the last assessment, there was a significant difference in total VSS scores between groups (P=0.009). For the early and late healing groups, respectively, the mean gradient value (SE) of the total VSS scores was 1.550 (0.373) and 1.283 (0.224) over the course of the treatment periods. 3D facemasks are effective in the rehabilitation of facial scars caused by burns, which should be used for prevention and treatment in the initial stages of scar development.

Manufacture and use of transparent facial orthotic masks for treating facial burn scars: A systematic review

BackgroundCustom-made transparent facial orthoses (TFOs) (face masks) are used to improve facial burn scars. We conducted a systematic literature review on TFO manufacture and use. MethodsPubmed and Cochrane databases were searched without restrictions for relevant articles. TFO manufacture details and use according to international recommendations (20–32 mmHg pressure, TFO worn 20–23 h/day for ≥2 months) were extracted. ResultsOf 279 retrieved articles, 11 published over the last 41 years (four in the last 5 years) discussed TFO manufacture/use. There were five technical notes, five case reports, and a patient-cohort study (total patients in the studies=21). TFO-manufacture methods could be categorized as classical, digital, or mixed classical-digital. Relative clinical efficacies and cost advantages were unclear. The plastics used, harness materials, harness-point number, and silicone-interface use differed from study to study. Target pressure, actual pressure, expected daily wearing time, and treatment duration ranged widely and often did not meet current guidelines. Actual wearing time and treatment duration were never measured. ConclusionsAlthough TFOs play an important global role in burn care, there is a grave paucity of research. Further research is needed to promote the standardization of TFO-related practices and thereby improve the outcomes of facial-burn patients.

Responding to burns - is our practice adequate?

Madam, Around 90% of burn related injuries are seen in low- and middle-income countries. Misfortune of such incidents lies in the fact that most of these are either preventable in the first place or can be efficiently managed before the casualty reaches the healthcare centre. According to a study1 conducted in Burns Ward of Civil Hospital Karachi, around 1,979 patients with burn-related injuries were admitted in just two-year period. Out of which, 715 patients (36.12%) expired. This mortality rate was higher in females (39.40%) and in people older than 60 (47.90%). A massive chunk of these deaths was accidental (95.80%), imposing the need to address the root cause of the issue. Another study2 showed that around 76% of students had never attended any formal training related to burns first aid management which is quite alarming. This again implies the extreme necessity to train and enable the masses to face burn related accidents. Another real dread comes with the prevalence of myths in the community that lead to the worsening burn wounds at home. According to a study3 conducted in POF hospital in Wah Cantt, a statistically significant (81.28%, p&lt;0.05) number of people lacked the understanding of burns first-aid. A vast fraction did not take immediate action upon facing a burn wound, making awareness sessions an exigency for such epidemiology. Another similar study4 interviewed parents and showcased that around 86.8% of parents didn’t irrigate the burn wound with tap water, which is considered a standard intervention for burn injury. Instead, a significant ratio (30%, p&lt;0.05) of parents used traditional remedies, among which toothpaste application (16.70%) tops the list. FRIP (First Response Initiative of Pakistan) is a non-governmental organization founded in 2010 aimed to educate the masses about the pre-hospital management of traumatic and non-traumatic injuries. One such aspect of its curriculum is burn management. Over more than ten years, it has instilled a standard method of burn wound care based on AHA’s (American Heart Association) guidelines among the masses and has taught ways to prevent it too. The effectiveness of such workshops is evidenced in a relevant study5 which reveals that a statistically significant difference (p&lt;0.05) existed after similar sessions conducted as illustrated in Figure 1. These figures prove the importance of first aid workshops and the crucial role FRIP plays in solving pre-hospital burn management problems.

24. Improving Re-epithelization after Burn Injuries: The Role of Pixel-grafting and Wet Wound Healing

PURPOSE: Complex facial and extremity burns present a difficult challenge affecting skin contour, mobility, and appearance. Management requires consideration not only to the skin, but to a patient’s quality of life. Interventions often require stage-reconstruction, revision for increasingly unsatisfactory results and a burdensome dressing during healing. This standard is costly, limited by donor-site availability, and often morbid. Currently, there are no single-stage interventions with simple dressings to address complex, full thickness burns. Our team has formerly shown the advantage of adipose-first reconstruction. Here we aim to provide a complete approach by demonstrating the efficacy of single-staged minced skin grafting plus adipose in an incubator-like microenvironment with a platform wound device (PWD) to achieve rapid reconstruction after burns. METHODS: A customized burn device was used to induce sixteen standardized full-thickness burns on Female Yorkshire swine. Delayed escharectomies were performed to the level of fascia. One group received standard of care skin grafting with either bolster or PWD. In another group, autologous split-thickness skin was cut into pixel size (0.3x0.3 mm) grafts, combined with or without adipose, and followed by application of either bolster or PWD. Wounds were followed for 4-weeks with weekly photography, ultrasound, histology, and tension measurements. RESULTS: The PWDs provided an optimized environment and protected the wounds from graft displacement despite no limitations in mobility. As early as one week, epithelialization started in the pixel with PWD group with visible epithelioid islands on the wound bed granulation tissue. This progressed with a similar trend throughout the 4-week period eventually leading to near-complete epithelization and keratinization. Immunofluorescence staining demonstrated reconstruction of trilaminar cutaneous architecture and viability of adipose. Distinct differences in contour were noted between the bolster and PWD groups. CONCLUSION: In both the bolstered and moist PWD-environment, pixel-grafts survived to form a viable basal layer. Use of positive-pressure (bolster) vs. negative-pressure PWD demonstrated distinct differences in the convexity/concavity and topography of the single-stage skin graft with critical implications for aesthetic reconstruction. Additionally, minced grafting minimized donor burden and alleviated the need for graft orientation. This study demonstrates the efficacy of a single-staged approach and the use of a sustainable dressing that both provides enhanced reconstruction and decreased burden.

715 Ocular Complications of Facial Burns in the Pediatric Population

Abstract Introduction Pediatric burns commonly involve the face and periocular areas, with a risk of impairing vision. The aim of this study is to characterize ocular injuries in burn patients and identify the patients at most risk of ocular complications. Methods This study is a retrospective review within a single academic, urban pediatric burn center. All burn patients under 18 years of age admitted from January 2010 to December 2020 with periorbital or ocular involvement were included. Variables analyzed included patient demographics, burn characteristics, presence of ophthalmology consultation, ocular exam findings, follow up time period, and early and late ocular complications. Results In the study period, 2,781 patients were admitted to our burn center, 300 of whom had facial burns involving the eyes and/or eyelids. Etiologies of burn injuries were as follows: 112 (37.5%) scald, 80 (26.8%) flame, 35 (11.7%) contact, 31 (10.4%) chemical, 28 (9.4%) grease, and 13 (4.3%) friction. Overall, 70.9% of patients with ocular burns received an ophthalmology consult. Of these patients, 61.5% had periorbital swelling and 39.8% had corneal injuries. Of the 207 patients who were followed as inpatients by ophthalmology, only 61 (29.5%) presented for a follow-up visit, as recommended, 6 of which had serious ocular sequelae including ectropion, entropion, symblepharon, and corneal decompensation, and 4 of whom had a firework-related injury. Conclusions While burns involving the ocular surface and eyelid margins are infrequent overall, they can lead to long-term sequelae. Ophthalmology consultation is critical, particularly in the setting of chemical and firework-related injury. As ocular and periocular burns can cause immediate as well as delayed sequelae, ophthalmologic evaluation is a key component of assessment. Applicability of Research to Practice This paper characterizes ocular injuries in pediatric patients with facial burn injuries and identifies patients most at risk for ocular complications. We believe this will be valuable for many burn researchers and clinicians in order to better identify patients who could benefit from ophthalmologic evaluation and those at risk for both immediate as well as delayed sequelae from periocular burns.

302 A Classification System and Surgical Algorithm for Pediatric Postburn Ear Deformities

Abstract Introduction The outward projection of the external ear makes this anatomically complex appendage susceptible to trauma. Notably, up to 40-60% of facial burns involve the ear, frequently impacting function and aesthetics. Significant postburn sensory deficits and changes to the ear’s intricate architecture can markedly impair physical health, psychosocial functioning, and quality of life. Scar tissue and contracture, traumatized cartilage, and compromised blood supply and surrounding soft tissues all influence the reconstructive plan. The authors describe a new classification system and surgical algorithm for pediatric postburn ear deformities informed by both their extensive operative experience on the traumatized ear and a retrospective study of different reconstructive techniques for more severe burn injuries to the pediatric ear. Methods To develop the classification system and surgical algorithm, three senior surgeons with over 85 years of combined experience reconstructing ears carried out an iterative joint review of their relevant clinical cases and insights, including their personal approach to assessing postburn ear trauma and developing an operative plan. Particular attention was focused on how the type and extent of soft tissue injury affects available reconstructive options. To inform classification of the most complex ear burn cases, a retrospective review was conducted on patients aged 0 to 21 years who underwent cartilage framework reconstruction between January 2004 to January 2021 at a specialized pediatric burn center. Medical records were screened and 54 patients (61 ears) who met study criteria were identified and patient demographics, procedural characteristics, and outcomes were analyzed. Results For postburn ear deformities (Table 1) involving total or near-total preservation of the ear’s anatomical structural elements (Type I and Type II deformities, respectively), scar release, local tissue rearrangement, and/or skin grafting are typically sufficient for optimal reconstruction. For cartilage defects involving less than or more than two-thirds of the helix (Type III and Type IV deformities, respectively), a partial to complete ear scaffold can be successfully reconstructed using a composite graft, conchal transposition flap, costal cartilage graft, or porous polyethylene implant. Conclusions The proposed classification system and surgical algorithm (not shown) for postburn ear deformities facilitate a tailored approach that addresses reconstructive course duration, anticipated aesthetic results, complication potential, and patient goals and expectations. Applicability of Research to Practice The authors provide a new classification system to pediatric postburn ear deformities that, along with a proposed surgical algorithm, can help guide planning for reconstruction.

Combustion Surface Calculation Method of Solid Rocket Propellant Based on Parameterized Volume Boolean Operation

In order to solve the problem of long time consuming and low efficiency in solving the complex combustion surface of solid rocket propellant, a combustion surface calculation method based on parameterized volume Boolean operation was proposed. After the solid model of propellant was created by using 3D modeling software, the parameterized burning surface model was used to perform Boolean difference calculation between the obtained burning surface growth entity and the propellant entity. Through Sensitivity Analysis function, the variation range of parameterized value was set, so as to obtain the burning face value under different burning thickness. In this paper, star shaped charge column is selected to calculate the combustion surface, and the feasibility of the method is verified. This method provides a basis for subsequent combustion surface calculation.