• Title/Summary/Keyword: 창상(創傷)

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Effect of Sternal Closure Method on Sternal Dehiscence With or Without Infection (흉골 봉합 방법이 흉골 열개 및 감염에 미치는 영향)

  • 이삼윤;박권재;고광표;최종범
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.485-489
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    • 2001
  • Background: The most important factor in preventing sternal complications is stable sternal approximation. We have tried to find the most effective sternal closure method by examining the incidence of sternal dehiscence with or without infection in patients with cardiac surgery through median sternotomy. Material and Method: This study was performed in 489 patients over 45 years of age with median sternotomy for open cardiac surgery. Simple closure with interrupted 6 wires was performed in 159 patients, figure-of-8 closure technique in 119, overlapping interrupted closure using 10 wires in 150, and combined closure technique of interrupted simple closure and figure-of-8 suture closure in 61. Two hundred thirty-four patients underwent valve and aortic operations and 213 patients coronary artery bypass surgery. Result: Sternal dehiscence with or without infection occurred in 12 (2.5 %) patients. The complication developed in 5 of 159 patients (3.1%) with six interrupted simple closure, in 4 of 119 patients (3.4%) with figure-of-8 closure, and in 3 of 150 patients (2.0%) with overlapping interrupted closure using 10 wires, but there was no complication in 61 patients with combined closure technique (relative risk for other closure techniques, p<0.05). There was no significant difference in the incidence of the sternal complication between valve and aortic operation group and coronary artery bypass group (3.0% vs 2.3%, not significant), but diabetes mellitus was a significant independent risk factor (odds ratio and multivariate analysis, p<0.05). Conclusion: The sternal closure technique that combines simple interrupted suture closure and figure-of-8 suture closure may be a more useful technique to enhance sternal stabilization compared to other closure techniques, such as simple interrupted closure, 8-figure closure, and overlapping interrupted closure.

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Effects of Natural Honeybee (Apis mellifera ligustica) Venom Treatment on the Humoral Immune Response in Pigs (Beevenom 처리가 돼지의 체내 면역반응에 미치는 효과)

  • 조성구;김경수;이석천
    • Journal of Animal Science and Technology
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    • v.48 no.6
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    • pp.933-942
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    • 2006
  • This experiment was carried out to investigate effects of honeybee venom treatment on the humoral immune response in pigs. Corresponding author : S. K. Cho, Dept. of Animal Sci. Chung-Buk National University, Kaesin-dong, Cheongju, 361-763, Korea. phone : 043-261-2551. E-mail : deercho@chungbuk.ac.kr To investigate effects of natural honeybee venom on the concentration of immunoglobulin G, A, and M, 20 piglets(LY×D) from 3 sows were allocated into two groups bee venom-treated group(10 piglets) and non-treated control(10 piglets). Natural honeybee venom was treated at 0, 3, 6 days after birth and the acupoints were Hai-men(ST-25), Du-kou(CV-8) and Jiao-chao(GV-1) points at 0, 3 days after birth and the regions of castration and tail amputation point at 6 days. Control group was injected 1㎖ of saline to the same site. Concentrations of IgG, A, and M were measured with immunoturbidimetric method at 0, 3, 7, 14, and 21 days after treatment. To investigate the effect of bee venom on the production of antibodies against hog cholera and atrophic rhinitis vaccines that were used as indicator antigens, 40 piglets(LYxD) from 5 sows were grouped as bee venom-treated group (20 piglets) and control group(20 piglets). Natural honeybee venom was treated at 0, 3days(castration, tail amputation) and 21days after birth. The acupoints were Hai-men(ST-25), Du-kou(CV-8) and Jiao-chao (GV-1) points at 0 day, the regions of castration and tail ampution at 3 days and Jiao-chao(GV-1) and Bai-hui(GV-20) points at 21days after birth(weaning). Control group was injected 1ml of saline to the same site. Atrophic rhinitis vaccine was injected twice at 24 and 44 days after birth and hog cholera vaccine was also injected twice at 44 and 64 days after birth. Antibody titers against Bordetella bronchiseptica and hog cholera virus were measured by using tube agglutination and ELISA tests at 24, 34, 44, 54 and 74 days after birth. Concentrations of IgG of treated group were 339.52, 366.48, 296.52, 242.06 and 219.06mg/dl at 0, 3, 7, 14 and 21 days after birth, respectively. In contrast, concentrations of IgG in control group were respectively 347.10, 334.14, 243.28, 205.18 and 191.58mg/dl during same periods with treated group. Concentrations of IgG at 0 day was not significantly different between the treated group and control group but treated group were significantly increased by 10.28% at 3 days after birth (P<0.02), 21.88% at 7 days after birth(P<0.01), 18.0% at 14 days after birth(P<0.07) and 14.3% at 21 days after birth(P<0.01). Concentrations of IgA and Ig M were not significantly different. Antibody titers against hog cholera virus were significantly increased by 57.0% at 24 days after birth(P<0.03), 74.6% at 34 days after birth (P<0.006), 48.6% at 44 days after birth(P<0.017), 45.0% at 54 days after birth(P<0.16) and 44.4% at 74 days after birth (P<0.006) in bee venom treated group in comparison with control group. Antibody titers against the Bordetella bronchiseptica was significantly increased in Beevenom treated group as 9.1% (P<0.32) at 24days, 39.7% (P<0.002) at 34days, 31.9% (P<0.02) at 44days, 33.4% (P<0.01) at 54days and 57.3% (P<0.007) at 74 days after birth when compared with those of control group pigs. Collecting together, the results in this study showed that immune responses were increased by treatment of natural honeybee venom to pigs. These results suggested that the treatment of bee venom could be used effectively for the increase of productivity in livestock industry.

A Study on Wound Healing Factors in Diabetic Foot Ulcer Patients (당뇨발 궤양을 가진 환자에서의 창상치유인자에 대한 조사)

  • Gu, Ja Hea;Han, Seung-Kyu;Chang, Hyun;Lee, Byoung Il;Kim, Woo Kyung
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.543-550
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    • 2007
  • Purpose: Diabetic foot ulcer is a representative disease of chronic would with multiple defects of wound healing factors. Many nutrition factors have been known to be essential for wound healing, but objective data are lacking. The purpose of this study is to determine those factors essential for wound healing, and to find out which of those factors are lacking in diabetic foot ulcer patients through this pilot study. Methods: We studied 100 patients who visited our clinic from March 2005 to February 2006 for treatment of diabetic foot ulcers with a duration of more than 6 weeks. We checked serum levels of protein, albumin, vitamin A, C, E, iron, magnesium, zinc, copper and hemoglobin by drawing 23cc blood after 8 hours of fasting. Protein, albumin, iron, magnesium levels were measured by colorimetry; hemoglobin levels were measured by auto analysis. Vitamin levels were measured by high performance liquid chromatography (HPLC), copper and zinc levels were measured by Inductively coupled plasma (ICP). They were compared with normal values. The patients were divided by transcutaneous oxygen pressure levels, age and sex to study the effects of these parameters. Results: 76% and 61% of patients had within-normal range serum protein and albumin levels, respectively. Among vitamins, only the level of vitamin C was low in 55% of the patients. Levels of vitamin A, E were normal or high in 93% and 100% of patients. As for trace elements, levels of iron and zinc were low in 63% and 60% of patients, but levels of magnesium and copper were usually normal or high. Levels of vitamin C, iron and zinc were lower in the low-transcutaneous oxygen pressure group. There were no definite differences according to age and sex. Conclusion: Serum levels of Hb, vitamin C, iron, zinc were low in most diabetic foot ulcer patients. The deficit was very severe in the low-transcutaneous oxygen pressure group.

Transilluminated Powered Phlebectomy Using Arthroscopic Equipment in Varicose Vein of Lower Extremities (하지정맥류에서 관절경 장비를 이용한 광투시 전동형 정맥적출술)

  • 박형주;이철세;이길노;이석열
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.391-396
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    • 2003
  • Background: Recently transilluminated powered phlebectomy was introduced and used as a method of surgical treatment for varicose vein in lower extremities. The advantage of transilluminated powered phlebectomy are minimal scar and good cosmetic effect. However, the disadvantages of transilluminated powered phlebectomy is that a high priced Trivex system must be used which increases the patient's expenses. Therefore, we performed a transilluminated powered phlebectomy using an existing arthroscopic equipment instead of Trivex system and observed the effect of treatment and efficiency of the treatment. Material and Method: From March, 2000 to February, 2003, 78 patients (113 limbs) underwent transilluminated powered phlebectomy with an arthroscopic equipment. Patient's disease history, the number of operative scars and complications were reviewed. Result: The operation was performed in 133 limbs of the 78 patients (34 men, 44 women) and the age of patients were ranged from 16 to 72 years with mean age of 41.8 years. Operative time ranged from 20 to 65 minutes (average 48.7 minutes) per limb. The number of operative scar per limb from 2 to 7 (average 4.9). Postoperative complications are transient ecchymosis (78 cases) that desappeared spontaneously, edema persisting longer than 3 weeks (6 cases), remnant varicose vein (4 cases), skin perforation during operative procedure (2 cases), and contact dermatitis due to compression stocking (4 cases) The mean hospitalization day was 3.09 days. Subjective mean satisfaction degree of operation by the patients using a visual analogue scale was 92.6%. Conclusion: Our findings demonstrated that transilluminated powered phleectomy using arthroscopic equipment was possible and had good cosmetic results with acceptable complications.

Histopathology of Lesion Produced by Haemaphysalis longicornis Neumann (Acarina:ixodidae) with Reference to Acquired Immunity (실험용(實驗用) 가토(家兎)에 있어서의 Haemaphysalis longicornis 진드기 교상(咬傷)에 대한 획득면역(獲得免疫)에 관련(關聯)된 조직병리학적(組織病理學的) 관찰(觀察))

  • Kang, Yung-Bai
    • Korean Journal of Veterinary Research
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    • v.21 no.2
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    • pp.135-143
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    • 1981
  • 진드기의 흡혈(吸血)에 대對하여 경험(經驗)이 없는 가토(家兎)를 실험숙주(實驗宿主)로하여 Haemaphysalis longicornis 진드기를 부착(附着) 흡혈(吸血)시켰을때 형성(形成)된 교상(咬傷)에 대(對)한 조직병리학적(組織病理學的) 변화(變化)를 관찰(觀察)하고, 진드기의 흡혈(吸血)에 경험(經驗)이 있는 감작(感作)된 가토(家兎)에 1개월(個月) 간격(間隔)으로 제2차(第二次) 흡혈(吸血)까지 시도(試圖)하여 가토체내(家兎體內)의 획득면역(獲得免疫)의 형성(形成)과 그에 따른 조직병리학적(組織病理學的) 변화(變化)를 비교관찰(比較觀察)하여 다음과 같은 결론(結論)을 얻었다. 1. H. longicornis 진드기는 구기(口器)를 사용(使用)하여 가토(家兎) 이부위(耳部位)의 피용(皮庸)를 천자(穿刺)하므로서 교상(咬傷)을 일으키며, 흔히 진드기의 구기주변(口器週邊)에는 진드기의 안전(安全)한 부착(附着)을 기도(企圖)하는 편평원추상(扁平圓錐狀)의 시멘트 물질(物質)이 형성(形成)되었다. 2. 진드기 교상(咬傷)에 대(對)한 주요(主要)한 조직병리학적(組織病理學的) 변화(變化)는 국소부위(局所部位)의 출혈성(出血性) 염증성(炎症性) 반응(反應), 광범위(廣範圍)한 부종(浮腫), 백혈구(白血球) 침윤(浸潤), 그리고 세포조직(細胞組織)의 괴사(壞死)로 대징(待徵)지워졌다. 3. 진드기 기생(寄生)의 초기(初期)에 형성(形成)된 병변(病變) 또는 진드기 흡혈(吸血)에 대(對)하여 경험(經驗)이 없는 가토(家兎)의 병변(病變)에서는 호중구(好中球)를 흔히 볼 수 있었으며, 진드기 기생말기(寄生末期) 또는 진드기 흡혈(吸血)에 대(對)하여 경험(經驗)이 있는 감작(感作)된 가토(家兎)의 병변(病變)에서는 호산구(好酸球)가 많이 관찰(觀察)되었다. 4. 진드기의 구기(口器)가 창상내(創傷內)에 잔존(殘存)하는 한, 치유(治癒)은 단시일내(短時日內)에 이루어 지지 않았으며, 증상(症狀)이 진행(進行)됨에 따라 괴사성(壞死性) 염증성(炎症性) 반응(反應)은 더욱 확대(擴大) 되었는데, 이러한 소견(所見)은 감작(感作)되어 있는 숙주(宿主)에서 더욱 확실(確實)히 관찰(觀察)되었다. 5. 최초(最初)(1차(一次)) 흡혈(吸血) 시도후(試圖後) 감작(感作)된 가토(家兎)에 2차적(二次的)으로 부가흡혈(附加吸血)을 시도(試圖)하였을때 볼수 있는 진드기의 흡혈성취도(吸血成就度)의 저하현상(低下現象)은 숙주체내(宿主體內)의 교상병변(咬傷病變)에서 일어나는 조직병리학적(組織病理學的) 소견(所見)과 획득면역(獲得免役)에 깊이 관련(關聯)되어 있는 것으로 사료(思料)된다.

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Experimental Study on the Effect of Hyperbaric Oxygen Therapy on the Ischemic Wound Healing of Rats. (고압산소요법이 백서 구강내외 허혈성 연조직 창상치유에 미치는 영향에 관한 실험적 연구)

  • Park, Chang-Joon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.153-170
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    • 1989
  • Recently, frequently using hyperbaric oxygen therapy is known for its effectiveness on the healing of problem wounds such as osteomyelitis, osteoradionecrosis and gas gangrenous wound etc. The main objectives of this study was to determine the best protocol of its application of hyperbaric oxygen therapy. Author used 238 rats (Sprague-Dawley strain) deviding into 2 Groups, experimental I group for skin and experimental II group for palatal mucosal ischemic wounds, and observed its effects by microscopically. The obtained results summarized as follows; 1. Severe infiltration of inflammatory cells was observed in initial stages of both control and experimental I group. The infiltration showed decreasing tendency at 5th day of experimental D, E, F group while at 8th day in control group In d, f of experimental II group showed decreasing tendency at 8th experimental day while at 12th day in control group. 2. Macrophages appeared at 2nd day in D of experimental I group while at 6th day in control group. In d, f of experimental II group appeared at 6th day while at 10th day in control group. 3. As to the proliferation of capillary blood vessels showed at 3-4 day in most of experimental I group severely while at 8th day in control group. In experimental II group, it was at 8th day and 12th day respectively. 4. The proliferation of fibroblasts showed rather rapider in experimental I group, at 4-6th day, while at 8th day in control group. In experimental II group, it was at 8th day and 12th day respectively. 5. As to the collagen formations, it was at 4th day in experimental I group while at 8th day in control group. In experimental II group, it was at 6th day and 10th day respectively. 6. 5 rats (2.0 %) in E group and 8 rats (3.4 %) in f group showed oxygen toxic reaction, such as unstable attitude and tremor, during the experiments. This hyperbaric oxygen animal experiments disclosed excellent effects on the ischemic wound healing and it is thought to be the best protocol of its application was on D group (2.5 ATM. and 2 hrs, exposure).

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Preparation and Characterization of High Absorptive Cellulose Film Derived from Styela Clava Tunic for Wound Dressing (흡수성이 우수한 창상치료용 미더덕껍질 셀룰로오스필름의 제조 및 특성 분석)

  • Seong, Keum-Yong;Koh, Eun-Kyoung;Lee, Seunghyun;Kwak, Moon Hwa;Son, Hong Joo;Lee, Hee Seob;Hwang, Dae Youn;Jung, Young Jin
    • Textile Coloration and Finishing
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    • v.27 no.1
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    • pp.70-79
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    • 2015
  • To establish the optimal conditions for the manufacture of high absortive cellulose film(CF) originated from Styela clava tunic(SCT), the physicochemical properties included absorption was measured in CFs prepared under the various conditions. The highest absorption was observed for SCT-CF20 prepared from the cellulose solution dissolved at $80^{\circ}C$ for 20min, although the filtration treatment did not induce any significance alteration. Also, the absorption was higher in SCT-CF20-F prepared by the freeze drying than SCT-CF20-N(ambient air drying) and SCT-CF20-H(heat drying). The addition of porogen($NaHCO_3$) induced an increase of absorption in SCT-CF20-PF relative to SCT-CF20-F, while the number of interconnected porous structures was enhanced in SCT-CF20-PF. Furthermore, a high level of SK-MEL-2 cells viability was observed in SCT-CF20-PN and SCT-CF20-PF cultured group. These results show that SCT-CF may have high absorption and biocompatibility when prepared from SCT cellulose solution dissolved at $80^{\circ}C$ for 20min after addition of porogen and then subjected to freeze drying.

Reconstruction of the Defect after Resection of Tonsillar Carcinoma Using Pectoralis Major Myocutaneous Flap (편도암 수술후 대흉근피판을 이용한 결손부위의 재건)

  • Choi Eun-Chang;Lee Jeong-Joon;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.41-46
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    • 1995
  • The pectoralis major myocutaneous flap represents a major contribution to head and neck cancer reconstruction. Its advantages are improved viability, one-stage reconstruction, and carotid protection. The oropharyngeal defect especially tonsillar area reveals valley shaped one with loss of a wide mucosal area. Using pectoralis major myocutaneous flap to this defect is sometimes difficult due to its natural figure of bulkiness. This article reviews our experience with patients undergoing 14 pectoralis major myocutaneous flap in carcinoma of the tonsillar area. Complications and their incidences were I total loss, 3 marginal loss, 2 minor seperation of suture, I wound infection and 2 hematoma. Most of the complications did not require a second procedure for reconstruction. Bulkiness of the flap and gravity force to the upper suture line were thought to be causes of the complications. Modification of the flap design with bilobular figure was useful to reduce its bulkiness at the folding area. More stable suture around hard palate was needed to overcome seperation of the suture.

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The Use of Hyalomatrix$^{(R)}$ in the Treatment of Difficult To Heal Wound (치료하기 어려운 창상에서 하이알로매트릭스$^{(R)}$의 사용)

  • Koo, Hyun-Kook;Kim, Young-Seok;Hong, Jong-Won;Roh, Tai-Suk;Rah, Dong-Kwun
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.600-606
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    • 2010
  • Purpose: Although traditional and current treatment strategies may demonstrate success, persistence or recurrence of difficult-to-heal wounds remain significant problems. A novel product, Hyalomatrix$^{(R)}$ (Fidia Advanced Biopolymer, Abano Terme, Italy) is a bilayer of an benzyl esterified hyaluronan scaffold beneath a silicone membrane. The scaffold delivers hyaluronan to the wound, and the silicone membrane acts as a temporary epidermal barrier. We present the results obtained with Hyalomatrix$^{(R)}$ in the treatment of difficult-to-heal wounds. Methods: From November, 2008 to March, 2010, Hyalomatrix$^{(R)}$ has been used on total 10 patients with wounds that were expected difficult to heal with traditional and other current strategies. After average 37.4 days from development of wounds, Hyalomatrix$^{(R)}$ was applied after wound debridement. On the average, Hyalomatrix$^{(R)}$ application period was 17.6 days. After average 16.5 days from removal of Hyalomatrix$^{(R)}$, skin grafts was performed. Results: In all cases, regeneration of fibrous granulation tissues and edge re-epithelization were present after the application of the Hyalomatrix$^{(R)}$. And all of the previous inflammatory signs were reduced. After skin grafts, no adverse reactions were recorded in 9 cases. But in one case, postoperative wound infection occured due to a lack of efficient fibrous tissues. In this model, the Hyalomatrix$^{(R)}$ acts as a hyaluronan delivery system and a barrier from the external environments. In tissue repair processes, the hyaluronan performs to facilitate the entry of a large number of cells into the wounds, to orientate the deposition of extracellular matrix fibrous components and to change the microenvironment of difficult-to-heal wounds. Conclusion: Our study suggests that Hyalomatrix$^{(R)}$ could be a good and feasible approach for difficult-to-heal wounds. The Hyalomatrix$^{(R)}$ improves microenvironments of difficult-to-heal wounds, reduces infection rates and physical stimulus despite of aggravating factors.

Vacuum Assisted Wound Closure Appliance and Continuous Irrigation on Infected Chronic Wound (감염된 만성창상에서 국소음압세척치료의 이용)

  • Jeong, Jin-Wook;Kim, Jun-Hyung;Jung, Yung-Jin;Park, Mu-Sik;Son, Dae-Gu;Han, Ki-Hwan
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.227-232
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    • 2010
  • Purpose: Continuous irrigation method is an important step in managing wound infection. V.A.C. devices have been used in intractable wounds for reducing discharge, improving local blood flow, and promoting healthy granulation tissue. We expect synergistic effects of reduced infection and more satisfactory, accelerated wound healing when using both methods simultaneously. This study evaluated continuous irrigation combined with V.A.C. appliance for treatment of infected chronic wounds. Methods: We reviewed data from 17 patients with infected intractable chronic wounds. V.A.C. device (Group A) was used in 9 patients, and V.A.C. with antibiotics irrigation (Group B) was used in 8 patients. We placed Mepitel$^{(R)}$ on the surface of wound and placed an irrigation and aspiration tube on each side. A sponge was placed on the Mepitel$^{(R)}$ and covered with film dressing. The wound was irrigated continuously with mixed antibiotics solution at the speed of 200 cc/hr and aspirated through the wall suction at the pressure of -125 mmHg. V.A.C. applied time, wound culture and wound size were compared between the two groups. Results: No complication were seen in two groups. Compared with Group A, in the Group B, V.A.C. applied time was shortened from 32.7 days to 25.6 days and showed efficacy in the reduction rate of wound size. No statistical differences were shown in bacterial reversion. Conclusion: V.A.C. appliance with continuous irrigation is an effective new method of managing infected chronic wounds and useful to reduce treatment duration and decrease wound size. Moreover it could be applied more widely to infected wound.