• Title/Summary/Keyword: 봉합 가능성

Search Result 40, Processing Time 0.049 seconds

Reparability and Surgical Indications of Rotator Cuff Tears (회전근 개 파열의 봉합 가능성 및 수술 적응증)

  • Ko, Sang-Hun;Park, Han-Chang;Lee, Seon-Ho
    • Journal of the Korean Arthroscopy Society
    • /
    • v.16 no.1
    • /
    • pp.92-97
    • /
    • 2012
  • Purpose: The reparability of rotator cuff tears is very important to establish the indication of the surgical treatment of rotator cuff tears. We reviewed the factors that effect to reparability of rotator cuff tears, and considered about the surgical indication of rotator cuff tears. Materials and Methods: The reparability was considered by the surgical reparability and the postoperative healing potentials of rotator cuff. The natural history of rotator cuff tear gives us the information to make decision about the surgical treatment or the conservative treatment. Results: There are 3 general categories of factors that help predict the healing potential of a rotator cuff tear. These include surgical technique, biology, and environmental issues. Surgeon can control the surgical technique by himself. The control of biology comes from careful operative indications by age, acute trauma history, chronicity, and tear size. And the control of environmental factor can give better outcomes by cessation of smoking and nonsteroidal anti-inflammatory drug (NSAID). Conclusion: A better understanding of the natural history and the reparability of rotator cuff tear will help us to estabilish the indication of surgical treatement of rotoator cuff tears, and lead to satisfactory clinical outcomes.

  • PDF

The Contamination Levels and Exchange of Saline Used in Surgical Procedures (수술에 사용하는 생리식염수의 오염수준 및 교환방법)

  • Yoon, Hae S.;Song, Hae H.
    • Korean Journal of Adult Nursing
    • /
    • v.13 no.1
    • /
    • pp.171-181
    • /
    • 2001
  • 본 연구는 수술에 사용하는 생리식염수가 수술의 종류와 수술진행단계에 따른 오염수준을 파악하여 생리식염수의 적절한 교환시점과 교환방법을 제시하기 위하여 시도되었다. 1500 병상 규모의 대학병원에서 1명의 일반외과 의사가 집도한 37건의 수술을 대상으로 하였다. 37개의 수술 각각에서 피부 절개전, 장기절제 후, 그리고 피부 봉합시의 3 시점에서 수술에 사용된 생리식염수와 공기에 노출시킨 생리식염수에서 각각 50 mL의 생리식염수를 채취하여 얻은 균주의 수를 비교하였다. 공기에 노출시킨 생리식염수에 비해 수술에 사용된 생리식염수에서 균주가 보다 많이 검출된 것으로 나타났다. 특히 수술의 종류에 관계없이 수술 마지막 단계 즉 피부봉합 단계에서 수술에 사용된 생리식염수의 오염수준이 급격히 증가한 반면 공기에 노출시킨 생리식염수의 오염수준 변화는 미미했다. 수술에 사용한 생리식염수에서는 Enterococcus(9.5%), Enterobacter species(4.6%), E. col i(2.8%), Alcaligenes species(1.2%), Klebsiella species(0.9%) and Pasteurella multocida(0.8%) 등의 균주가 검출되었으나 공기에 노출시킨 생리식염수에서는 이러한 균종이 검출되지 않았다. 수술실의 공기가 수술에 사용하는 생리식염수의 오염요인으로 작용하기보다는 수술조직이 생리식염수의 오염요인으로 작용하는 것으로 사료된다. 특히 수술에 사용하는 생리식염수의 오염가능성을 최소화시키기 위해 수술소요 시간이 길어지거나 또는 오염 수술의 경우 절제부위가 봉합된 후에 수술에 사용하는 생리식염수, 생리식염수를 담는 용기 및 봉합에 이용되는 봉합감자 등을 새로이 준비하여 피부 봉합에 이용해야 할 것으로 사료된다.

  • PDF

CLINICAL STUDY OF BLEPHAROPLASTY USED BY SUTURED METHOD (봉합법을 이용한 중검술의 임상적 연구)

  • Park, Kwang;Seo, Ku-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.18 no.3
    • /
    • pp.353-357
    • /
    • 1996
  • One of the most common cosmetic surgery, the blepharoplasty can be divided two method. there were incisional method and sutured method. Authors try to understand the anatomic difference between the oriental upper eyelids and apply the surgical techniques of constructing upper eyelid crease of oriental case effectively. And we discussed the postoperative complications of the blepharoplasty and proposed the solve of these problems. The sutured method of blepharoplasty was more simple technique than conventional incision method and had low occurrence of complications. Even though slight recurrence, suture method was more esthetic due to no scar formation.

  • PDF

Patterns of Retear After Repair of the Rotator Cuff - MRI Analysis of 109Cases - (회전근 개 봉합술 후 발생한 재파열의 양상 - 109예의 자기 공명 영상 검사 분석 -)

  • Tae, Suk-Kee;Kim, Young-Sung;Lee, Ho-Min;Park, Pan-Kun
    • Clinics in Shoulder and Elbow
    • /
    • v.15 no.1
    • /
    • pp.16-24
    • /
    • 2012
  • Purpose: This study was designed to investigate the rate of incidence, location and the clinical value of the rotator cuff retear by analyzing MRI scans, which was taken after an arthroscopic rotator cuff repair. Materials and Methods: This study included a total of 109 patients, who underwent a shoulder MRI scan after an average of 10.6 months later from the arthroscopic rotator cuff repair. We only defined the 'retear' when the Sugaya type IV and V was observed in the sagittal section of the MRI. The location of the retear was divided into the medial and lateral areas by the site, which was 1 cm medial to the anchor insertion. We investigated the incidence rate and the location of the retear, in terms of the age, sex, initial tear size and the suture method. Also, we compared the functional score of the retear group and the non-retear group, after an average of 13.9 months follow-up. Results: There were 38 of the 109 patients that showed the rotator cuff retear. Of these patients, 25 were male patients, and 13 were female patients. Of the 38 patients with the rotator cuff retear, 21 patients were included in the <3 cm retear group, and 17 were included in the ${\geqq}3$ cm retear group. At the end of the follow up period, all 109 patients showed a statistical significant improvement in the shoulder functional score. Conclusion: According to the follow up of the MRI scan, which was taken after the rotator cuff repair, the retear rate reached 34.9 %, and there were no significant differences on the age and the suture method. More rotator cuff retear occurred in male patients, and the initial tear size was positively correlated with the incidence rate of the rotator cuff retear. Also, the retear was more frequently observed at the medial side. That is because when the suture was performed, excessive tension was loaded on the medial side of the suture site.

Arthroscopic Treatment of the Prepatellar Bursitis - A Report of Three Cases of Percutaneous Mattress Suture Technique - (슬개골전 점액낭염의 관절경적 치료 - 경피적 연차봉합술 3례 보고 -)

  • Lee, Byung-Ill;Min, Kyung-Dae;Choi, Keun-Sun
    • Journal of the Korean Arthroscopy Society
    • /
    • v.3 no.1
    • /
    • pp.35-39
    • /
    • 1999
  • The authors introduce an operative technique which is simple and effective for the treatment of the large prepatellar bursitis, avoiding problems by the conventional open technique such as tender scar, infection and recurrence. We treated three cases of the large refractory prepatellar bursitis caused by acute direct trauma. Bursectomies were performed by using an arthroscope and percutaneous multiple sutures were applied to the overlying skin with mattress fashion. There were no complications after treatment over one year follow-up. We suggest that this technique is very useful, greatly minimizes the chance of recurrence and reduces the possibility of post-operative infection.

  • PDF

Pulmonary Trunk Translocation from LV to RV in Double-Outlet Left Ventricle -A case report- (양대혈관 좌심실기시에서 좌심실에서 우심실로의 폐동맥간 전위술의 치험 -1례 보고-)

  • 김상익;최진호;전태국;박표원
    • Journal of Chest Surgery
    • /
    • v.34 no.11
    • /
    • pp.854-857
    • /
    • 2001
  • Double-outlet left ventricle(DOLV) is a rare congenital cardiac malformation, defined as the origin of both the aorta and the pulmonary artery being entirely or predominantly above the morphologically left ventricle, which is difficult to diagnose accurately. A 3-year old male was admitted for cyanosis and dyspnea. At the age of 2 months, he had undergone pulmonary artery banding and coarctoplasty. He was diagnosed as DOLV with subaortic ventricular septal defect(VSD). Biventricular repair was achieved by patch closure of VSD, primary closure of PFO, and pulmonary trunk translocation from left ventricle to right ventricle. The advantages of this procedure using native tissue for right ventricular outflow tract reconstruction are growth potential and preserved valve function, which contribute to a decreased likelihood of reoperation related to the right ventricular dysfunction related to pulmonary insufficiency.

  • PDF

Representation of Realism in Documentaries with the Case Analysis on the Application of the Off-Screen Space (다큐멘터리에서의 외화면 활용을 통한 리얼리즘의 구현)

  • Lee, Ja-Hye
    • The Journal of the Korea Contents Association
    • /
    • v.10 no.1
    • /
    • pp.230-238
    • /
    • 2010
  • Since 1960, there has been growing recognition that the moving images reveal the 'realistic illusion(L'illusion r$\acute{e}$aliste)' rather than the reality itself and many theorists and film directors have tried to suggest the methodology to solve the problem of verisimilitude of the moving images. In this paper, we describe through the case analysis of the practical use of 'off-screen space' as a methodology which actualize the reality in documentaries, by minimizing the 'suture' effect which occurs the problem of verisimilitude, based on the theories of Bazin and Burch. We, consequently, believe that the application of the 'off-screen space' could be one of the appropriate possibility for the successful representation of reality in documentaries.

Right Ventricle Perforation Caused by the Sternal Fracture .A Case Report (흉골골절에 의한 우심실 파열 치험 1례 보고)

  • 김정철;오상준
    • Journal of Chest Surgery
    • /
    • v.29 no.12
    • /
    • pp.1398-1400
    • /
    • 1996
  • The cardiac anatomic position immediately beneath the sternum leaves it vulnerable to injury when this bone is fractured. Cardiac rupture, however, is uncommon but survival following this injury is rare. We report the case of one patient who survived right ventricle perforation resulting from sternal fracture. The patient developed signs of pericardial tamponade and was brought to the operating theatre immediately for surgery through the emergency anterolateral thoracotomy Perforation of th right ventricle was repaired by direct closure without cardiopulmonary bypass. We believe that patients with cardiac rupture who reach the hospital alive can often be saved by prompt diagnosis and surgery.

  • PDF

Bone reaction to bovine hydroxyapatite grafted in the mandibular defects of beagle dogs. (성견의 하악 골 결손부에 이식한 생체 유래 골 이식재 (OCS-B)에 대한 치조골의 반응)

  • Byun, Yu-Kyung;Park, Jun-Beom;Kim, Tea-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Lee, Hye-Ja;Chung, Chong-Pyoung;Han, Soo-Boo;Rhyu, In-Chul
    • Journal of Periodontal and Implant Science
    • /
    • v.36 no.1
    • /
    • pp.39-49
    • /
    • 2006
  • 1. 목 적 이 연구의 목적은 성견의 하악 골 결손부에 이식한 생체 유래 골 이식재에 대한 치조골의 반응을 알아보는 것이다. 2. 연구방법 및 재료 생후 1년 이상 된 성견 4마리의 하악 제2소구치 및 제 4 소구치를 발거하고 발치와에 금원심 폭경 8mm, 협설 폭경 5mm, 치조정에서의 깊이 6mm인 결손부를 형성하였다. 4주간의 자연 치유 후 판막을 형성하여 결손부의 크기를 확인하였다. 각각의 결손부 크기가 일정하도록 수정한 후 '이식재+차폐막'군에는 OCS-B을 이식하고 Bio-gide을 차단막으로 사용한 후 봉합하고 '이식재군'은 OCS-B 이식 후 차폐막 없이 봉합하였으며 '비이식'군은 아무런 처치없이 일차봉합하였다. 수술 4, 6주에 실험동물을 각각 희생시켜 실험부위를 적출하고 비탈회 연마 표본을 제작하여 골 치유 양성을 조직학적 및 조직계측학적으로 관찰하였다. 3. 연구결과 이식재 비이식군 및 이식군 모돼서 별다른 부작용없이 잘 치유되었다. 세 실험군 모두에서 술후 4주에 비교하여 술 후 6주에서의 결손부 산생골 형성량이 증가하였다. 술후 4주 소견에서 비이식군은 결손부 주변부위에서 골이 생성되어 나오는 양상을 보였으며 이식군은 이식재 주변으로 골침착 시작되는 것을 관찰할 수 있었다. 술후 6주 소견에서 비이식군은 결손부 경계부로부터의 지속적인 골 생성을 관찰할 수 있었으며 이식군은 이식재 주변으로 침착된 골의 양이 많아지고 신생골이 가교를 형성하는 것을 관찰할 수 있었다. 4. 결 론 차폐막 유무와 상관없이 OCS-B는 염증반응을 전혀 일으키지 않았으며 우수한 골 전도성을 보였다. 또한 결손부의 형태를 잘 유지하여 골재생을 위한 공간을 확보할 수 있었다. 이는 OCS-B가 골이식재로서의 필요조건을 갖추었음을 확인한 결과이며 보다 장기적인 관찰에서 OCS-B의 흡수 가능성을 확인하는 것이 필요할 것으로 보인다.

A SCANNING ELECTRON MICROSCOPIC STUDY OF END-IN-END AND END-TO-END MICROVASCULAR ANASTOMOSIS IN THE RAT FEMORAL ARTERY (백서 대퇴동맥에서의 혈관함입문합술과 혈관단단문합술의 주사전자현미경적 비교연구)

  • kim, Uk-Kyu;Chung, In-Kyo
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.13 no.1
    • /
    • pp.16-29
    • /
    • 1991
  • The occurrence of thrombotic occlusion & endothelial injuries at the site of anastomosis have been considered as major problems in microvascular surgery. The purpose of this study was to ascertain whether a end-in-end(sleeve, telescope) anastomosis compared favorably with end-to-end anastomosis in healing procedures on the endothelium and to study the possibility of clinical application in end-in-end method. The microvascular anastomoses have been performed with end-in-end method in the femoral arteries of 20 rats group, also with end-to-end method on the same arteries of another 20 rats group, and then the four anastomosed vessels in subdivided groups on each group were taken after period of 1, 3, 7, 14, 21 days following by anastomoses for scanning electron microscope observation. The results were as following: 1. The patency rate was 90% in the end-in-end group and 85%in the end-to-end group and late thrombus occurred at 7, 14 days on both groups, which suggested -consistent monitoring of patency was required for two weeks at least. 2. Platelet aggregates at the site of anastomosis began to organize on post-operation 3 days and in the end-in-end group, the initially decreased lumen of inserted vessel was gradually increasing on 7 days due to atrophy of the medial layers. 3. Re-endothelialization was completed between 7 and 14 days in end-in-end group, whereas between 14 and 21 days in end-to-end group.

  • PDF