• Title/Summary/Keyword: 창상감염

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Wall-Suction Assisted Vacuum Sealing for Treatment of Infected Diabetic Foot Ulcer (벽매립형 중앙 흡인장치를 이용한 감염성 당뇨병성 족부 궤양의 밀봉 치료)

  • Bae, Su-Young;Lee, Chang-Wook;Seo, In-Seock
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.26-30
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    • 2004
  • Purpose: The infected diabetic foot patients were reviewed to analyze the result of new dressing methods using a wall-suction instruments. Materials and Methods: Eighteen patients treated with wall-suction assisted vacuum dressing were included. After debridement under local anesthesia, a sponge pad, a drain, and a surgical drape were used to seal the wound. Negative pressure applied by the wall-suction at around 200 mmHg and dressing were repeated in every two to three days. The results of repeated wound cultures, growth of granulation tissues, and CRP level were closely observed on the regular basis. Results: Rapid growth of granulation tissues was noticed around the wound in 16 cases. No organism was obtained in an average 5 days and wound coverage was possible in an average 18 days. The CRP level returned to normal in an average 4 weeks. Two patients with end stage renal disease, who were regularly hemodialised, underwent major amputation. Conclusion: New dressing method has the following advantages: a rapid wound improvement in the patients with infected diabetic foot, less expensive, less painful, impediment of bacterial contamination in the hospital room. However, further study will be needed for the end stage renal disease patients.

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Surgical Treatment of Pectus Excavatum (누두흉의 외과적 치료)

  • 윤경찬;박창권;유영선;이광숙;최세영;금동윤
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.286-290
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    • 1998
  • The pectus excavatum is the most common deformity of chest wall. The most common cause of surgical correction is cosmetic problem. From January 1981 to July 1996, 24 patients had undergone surgery for pectus excavatum and they were corrected by Ravitch operation(n=4) or modified Wada operation(n=20) respectively. We analyzed each surgical cases according to age, sex, chief complaint, degree of deformity, EKG findings, complications and satisfaction degree of patient. In some cases, we measured Welch index preoperatively and postoperatively. The postoperative complications were wound infection in two, pneumothorax in two and reccurrence in one. The average value of Welch index was significantly improved from 5.86$\pm$0.51 preoperatively to 4.10$\pm$0.51 postoperatively(P<0.05). The results by Humphreys' criteria were satisfiable in 88%(excellent 71%, good 17%). The findings of this study suggest that surgical correction of pectus excavatum with modified Wada rocedure and submammary s in incision is effective method in physical and psychiatric aspect.

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An Influence of Modified Robicsek Sternal Wiring after Median Sternotomy on the Postoperative Sternal Wound Infection (정중 흉골 절개 후 시행한 변형 Robicsek 흉골 봉합법이 수술 후 흉골감염에 미치는 영향)

  • Chang, Won-Ho;Youm, Wook;Kim, Dong-Hyun;Oh, Hong-Chul;Han, Jung-Wook;Kim, Hyun-Jo
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.763-769
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    • 2009
  • Background: In the majority of cases, sternal instability and wound infection concomitantly present after a cardiac operation following conventional median sternotomy, and these complications have a major influence on the postoperative course. The aim of this study is to compare the results of the different sternal wiring techniques of sternal infection. Material and Method: Between April 2004 and December 2008, 157 adult patients underwent cardiac in group A, whereas 71 patients who had undergone modified Robicsek sternal wiring were included in group B. The incidences of sternal wound complications in the two groups were assessed. Result: The mean age of the group B patients was older than that of the group A patients ($61{\pm}10$ years vs $57{\pm}13$ years). The incidence of preoperative left ventricular dysfunction (ejection fraction <30%), chronic obstructive pulmonary disease, renal failure requiring dialysis and diabetes mellitus were significantly higher in Group B, whereas the other perioperative risk factors for infection were not significantly different between the two groups. Two patients in group A experienced superficial wound infection, whereas 4 patients in group B displayed superficial wound infection, but the difference was not statistically significant (p=0.255). Yet poststernotomy deep sternal wound infection appeared in 6 patients of group A, whereas none of the patients in group B displayed this malady. Conclusion: The modified Robicsek sternal wiring technique showed greater sternal stability even for the patient with a high risk for infection, and the technique caused a lower incidence of deep sternal wound infection.

Effects of Low-Level Laser Irradiation on the ALP Activity and Calcified Module Formation of Rat Osteoblastic Cell (저수준레이저(GaAs 반도체)조사가 골모세포의 알칼리성 인산분해효소의 활성과 석회화결절의 형성에 미치는 영향)

  • Kyung-Hun Lee;Ki-Suk Kim
    • Journal of Oral Medicine and Pain
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    • v.21 no.2
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    • pp.279-291
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    • 1996
  • 저수준레에저요법에 대해서는 지난 10여년간 의학계 및 치과계에서 임상적으로 사용하여 좋은 결과가 있다고 많은 보고가 발표되고 있다. 특히 치근의 골결손에 관한 연구에서는 전기요법, 초음파요법, 전자장요법 등 뿐만아니라 저수준레이저를 사용하여 골절부내 Callus형성이 촉진되었음을 보고하고 새로운 치료법의 하나가 될 수 있음을 제안한 바도 있다. 본 연구에서는 칼륨비소를 다이오드로 사용한 저수준레이저조사가 골결손의 치유에 어떠한 영향을 미치는지 확인하고자 골모세포의 알칼리성 인산분해효소의 활성화와 석회화결절의 형성을 평가함으로 골모세포의 기능을 조사코저하였다. 실험은 첫째, 9개군으로 나누어 레이저 조사기간에 따른 알칼리성 인산분해효소의 활성화를 조사하였고, 둘째, 이를 근거로 9일간 계속 매일 1회 1.3 J/cm2의 레이저를 조사한 후 펄스의 종류별 차이를 비교하였으며, 세째,레이저펄스별 석회차 결절의 형성 정도를 광학현미경으로 관찰하여 비교분석하였다. 결과, 7일 계속 레이저를 조사한 경우 다른 군에 비해 서서히 ALP의 활성이 증가하였으나 유의한 차이는 없었으며. 따라서 9일동안 레이저를 계속 조사한 경우에는 전체 에너지량이 5.895 J/cm2 인 펄스13과 15가 뚜렷하게 유의한 증가를 보여주었다. 그러나 석회화결절의 형성은 전체 에너지량이 2.546 J/cm2 인 펄스11에서 가장 많았다. 결론적으로 골형성이나 알칼리성 인산분해효소의 활성을 촉진하는 데에는 적절한 레이저 조사조건이 필요하나, 알칼리성 인산분해효소의 활성을 촉진한 펄스와 석회화결절의 형성을 촉진하는 펄스가 서로 다르게 나타난 것은 골형성을 촉진하는 여러요인 들이 저수준레이저에 자극받았을 가능성이 높음을 보여준다 이러한 결과들로 보아 저수준레이저는 골모세포의 기능을 자극하여 골결손의 치유를 개선하는 데 도움될 것이라 사료된다.다. 각 백서의 양측 창상중 하나는 1,3,5,7일 마다 각 실험의 방법에 따라 레이저를 조사하고 실험동물의 다른 창상은 대조군으로서 사용하였다. 모든 창상의 면적은 실험 1,3,5,7 일째에 일정한 거리에서 사진촬영하여 면적계를 이용, 측정한 후 통계적인 의의를 조사하였다. 본 연구의 결과는 저수준레이저는 특정 조건하에서 S. aureus의 증식을 촉진하였다. 그러나 S. aureus에 감염된 창상을 저수준레이저로 조사시 치유가 촉진되었다. 중앙 조사법고 주변조사법에 의한 창상치유효과는 통계적인 의의가 보이지 않았다. 따라서 결론적으로 S. aureus 에 감염된 창상에 직접 또는 간접적이든 pulse의 종류에 관계없이 조사하는 경우 치유효과가 나타나는 것은 정사주위 조직의 LLLI 자극효과가 염증의 확산을 억제한다고 말할수 있다.4/1$0^{\circ}C$에서는 Shoa-Nan-Tsan과 Lenkwang이 가장 높았으며 백앙벼는 3 온도 조건 모두에서 활성이 낮았다. 발아소요일수와 amylase 활성과는 유의적인 정의 상관관계를 보였다., 다다조, 미국의 건답직파재배 품종 등이었으며 우리 나라 육성종들은 모두 지중에서 신장이 멈추어 제1본엽이 지중에서 추출하였으며, Scm파종심에서 불완전엽이 지면을 뚫고 나오는 품종은 Chinsura Boro뿐이었고 Nato, Labelle, Weld Pally, Italliconaverneco 등도 지면 가까이 까지 신장하였다. 6. 50% 출아일수는 제2절간장을 제외 한 모든 유아 형질의 신장도와 유의한 부의 상관을 보였는데 가장 높은 상관을 보인 것은 중배축장+제1절간장+불완전옆장이었으며, 다음이 불완전엽장이 었다. 7. 출아율은 중배축장+제1절간장+불완전엽장, 중배축장+초엽 장과 모든 파종심에서 높은 정의 상관을 보여 제1본엽의 추출 위치가 높을수록

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The Effect of Improved Operating Room and Intensive Care Unit on the Sternal Infection After Open Heart Surgery (집중치료실 및 수술장 개선이 개심술후 흉골감염에 미치는 영향)

  • 이종태;이상철;김성완;이응배;조준용;김덕실;장봉현;김규태
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.375-380
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    • 2002
  • Background: Sternal infection after open heart surgery is a serious complication associated with high rate of mortality. We reviewed the effect of improved operating room and intensive care unit un the sternal infection by analyzing the incidence and condition of that around the movement of operating room and intensive care unit in July 1997. Material and method: We reviewed a total of 453 patients. Group I contains 237 patients who underwent open heart surgery between January 1997 and December 1978 before we moved the intensive care unit and of operating room, and Group II contains 216 patients who underwent open heart surgery between January 2000 and July 2001 after we moved. We only included adult patients over age 15 who underwent cardiopulmonary bypass through median sternotomy and excluded the mortality cases except sternal infections in this study. Result: Sternal infection developed in 18 patients(8.0%) in Group I, and in only 1 patient(0.49%) in Group II. Emergency operation, cardiopulmonary bypass time, operation tilde, transfusion, tracheostomy, and reoperation are significantly associated with sternal infection among the known risk factors. The logistic regression analysis containing those six factors revealed that the movement of intensive care unit and operating roots is effective on the decreasing sternal infection(p=0.029, 95% confidence interval 0.011 ∼ 0.788). Conclusion: Although there have been studies on manly risk factors associated with the sternal infection after open heart surgery, we think that the improvement of operting room and intensive care unit is a method for decreasing the incidence of sternal infection.

A clinical study on the effect of attachable periodontal wound dressing on postoperative pain and healing (부착형 치주 창상 피복재가 치주수술 후 동통 및 치유에 미치는 효과에 관한 임상 연구)

  • Min, Han-Seul;Kang, Dae-Young;Lee, Sung-Jo;Yun, Sei-Young;Park, Jung-Chul;Cho, In-Woo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.1
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    • pp.21-28
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    • 2020
  • Purpose: After periodontal surgery, studies have found that the use of periodontal wound dressing reduces the risk of wound infection and increases healing. The purpose of this study is to evaluate the effect of attachable periodontal wound dressing on the healing and patient satisfaction after periodontal flap surgery. Materials and Methods: Twenty-eight patients requiring periodontal surgery underwent periodontal flap surgery on both quadrants of maxilla or mandible. Postoperative pain, bleeding, dietary discomfort and hypersensitivity in relation to attachable periodontal wound dressing was assessed using Visual Analogue Scale (VAS). Additional survey on frequency of burning sensation and overall satisfaction rates were assessed. Results: VAS mean values for pain, bleeding, and dietary discomfort depending on the presence and absence of attachable wound dressing were; pain: 2.82, 3.96 (P = 0.002), bleeding: 1.61, 2.54 (P = 0.008), dietary discomfort: 2.82, 4.18 (P < 0.001), respectively. Test groups with attachable wound dressing reported significantly lower rates of discomfort. No significant difference was observed in burning sensation and hypersensitivity related with wound dressing. Satisfaction was higher in 75% of patients who received wound dressing. Conclusion: According to the results of this study, patients who received attachable periodontal wound dressing reported less postoperative pain, bleeding, and dietary discomfort. There was no statistical significance related to the use of wound dressing with burning sensation and hypersensitivity.

Effect of Newly Developed Pectin/CMC Dressing Materials on Three Different Types of Wound Model (펙틴/CMC 드레싱의 세가지 유형별 창상에서의 치유효과)

  • Lim, Hyun-Ju;Kim, Hak-Tae;Oh, Eun-Jung;Choi, Jin-Hyun;Ghim, Han-Do;Pyun, Do-Gi;Lee, Soo-Bok;Chung, Dong-Jun;Chung, Ho-Yun
    • Polymer(Korea)
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    • v.34 no.4
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    • pp.363-368
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    • 2010
  • Adequate acidic environment in wound healing prevents the inflammation of virus, increases the cell activity, promotes cell proliferation and regular rearrangement of fibroblast, and results in matured epithelialization. In this study, we prepared dressing materials consisting of pectin and carboxymethylcellulose (CMC) with varied ratios. These dressing materials showed different pH values according to the composition ratio. The effect of acidity of pectin/CMC dressing materials on wound healing rates, degree of epithelialization, collagen deposition, and so on, in 3 types of wound models (fresh surgical wounds, $3^{rd}$ degree burn wounds, and infection wounds) were investigated by animal tests. From the results of wound contraction, wound healing, and epithelialization, it can be deduced that dressing material having pectin/CMC ratio of 16/19 (pH 4.67) is most effective among the 3 types of wound models.

Effect of ${\beta}$-glucan Originated from Aureobasidium on the Dermal Wound Repair in Vitro Model (생체외 모델에서 아우레오바지디움 유래 베타 글루칸이 피부창상 치유에 미치는 영향)

  • Lee, Jung-Woo;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.30 no.6
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    • pp.403-408
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    • 2013
  • The objective of the present study is to detect the effect of ${\beta}$-glucan originated from Aureobasidium on the proliferation and collagen production in human dermal fibroblast cells with wound repopulation in vitro. The proliferative effects were assessed using a MTT assay as well as cell counts at 24 and 48 hr after treatment. Hydroxyproline was measured as an index of procollagen production with reverse-phase high pressure liquid chromatography. Oncostatin M was used as a reference agent. In glucagon treated group, dose-dependent and significant increase of optical density or fibroblast cell numbers was demonstrated, when compared with those of control from 0.1 mg/ml concentration. In addition, the numbers of cells which had migrated into the wound defects were more significantly and dose-dependently increased than those of non-treated control. However, no meaningful effects on the procollagen production were observed.

Analysis of Risk Factors in Poststernotomy Sternal Wound Infection and Mediastinitis after Open-heart Surgery (흉골절개술을 이용한 개심술 후 발생한 흉골 감염 및 종격동염의 위험인자 분석)

  • Chang, Won-Ho;Park, Han-Gyu;Kim, Hyun-Jo;Youm, Wook
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.583-589
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    • 2003
  • With the purpose of identifying significant risk factors in poststernotomy sternal wound infection and mediastinitis, we underwent a retrospective analysis of the whole patients operated on at the our department of cardiovascular surgery for the two years. Material and Method: From March 200f to March 2003 at the depart-ment of cardiovascular surgery, medical school of Soonchunhyang University, major sternal wound infections had been developed in 12 (9.76%) of 123 consecutive patients. These patients underwent open-heart procedure through a midline sternotomy and survived long enough for infection to appear. For this group of patients, we evaluated possible risk factors such as age, sex, diabetes mellitus, chronic obstructive pulmonary disease, obesity, interval between hospital admission and operation, type of surgical procedure, elective or emergency surgical procedure, reoperation, duration of surgical procedures, duration of cardiopulmonary bypass, amount of blood transfused, post-operative blood loss, chest reexploration, rewiring of a sterile sternal dehiscence, duration of mechanical ventilation, and days of stay in the intensive care unit and analyzed these factors. Result: Analysis represented that age, sex, diabetes mellitus, type and mode of surgical procedure, reoperation, duration of operation, duration of cardio-pulmonary bypass, and interval between hospital admission and operation were not significantly associated with wound infection. For all other predisposing factors, p-values of less than .05 were demonstrated. Eight emerged as significant: early chest reexploration (p=0.001), sternal rewiring (p< 0.0001), chronic obstructive pulmonary disease (p<0.0001), blood transfusions (p<0.05), postoperative bleeding (p=0.008), days of stay in the intensive care unit (p< 0.0001), duration of mechanical ventilation (p=0.001), and obesity (p=.003). Conclusion: Contamination of pa-tients may occur before, during, and after the operation, and any kind of reintervention may predispose the patient to wound infection.

Bullectomy Using 2 mm Videothoracoscope in Primary Spontaneous Pheumothorax (원발성 자연기흉에서 2 mm 비디오흉강경을 이용한 기포절제술)

  • Lee, Yuen-Jae;Park, Cheul;Kim, Han-Yong;Yoo, Byung-Ha
    • Journal of Chest Surgery
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    • v.34 no.3
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    • pp.260-263
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    • 2001
  • 비디오흉강경을 통한 기포절제술이 술후 통증, 창상으로 인한 감염등의 합병증을 줄였고, 미관상의 효과와 더불어 짧은 입원기간으로 빠른 사회로의 복귀를 가져왔다. 1999년 11월 18일부터 2000년 4월 19일까지 6개월동안 수술적응증이 되는 20례의 원발성 자연기흉 환자를 개흉술로의 전환 없이 2mm 비디오 흉강경을 이요하여 기포 절제술을 시행하였다. 수술창성은 단순 흉강삽관술을 시행하였을때와 거의 흡사했다. 원발성 자연기흉 환자에서는 병변이 상엽에 국한되어 있는 경우가 대부분이고, 늑막유착이 없거나 심하지 않아서 2mm비디오 흉강경으로도 기포절제술이 가능하게 되어 수술창상을 줄일수 있었다.

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