• 제목/요약/키워드: Burn-in procedure

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미세수술을 이용한 전기화상 및 동상의 치료 (Treatment of Electrical Burn and Frostbite using Microsurgery)

  • 정덕환;한정수;김진원;안옥균;조종훈
    • Archives of Reconstructive Microsurgery
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    • 제2권1호
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    • pp.70-76
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    • 1993
  • The authors analyzed the clinical results of the reconstructive surgery for injured hands and feet due to frostbites and electrical burn with microsurgery in 7 patients, 12 cases at the department of orthopaedic surgery, school of medicine, Kyung Hee university from Jan. 1989 to Jul. 1992, and the results were as foollowings. 1. The age at the time of injury was av 24.6 yrs ranging from 4 to 35 yrs, and all cases were male. 2. The follow up period was av. 24.4 Mo ranging from 12 Mo. to 56 Mo. 3. The causes of injury were frostbite in 9 cases, electrical burn in 2 cases. 4. Initial operative treatment was performed av. 69.3 days ranging from 2 to 210 days. 5. For the reconstructive procedure, scapular free flap was applied in 6 cases, radial forearm flap in 4, dorsalis pedis 1ffap in 1, neurovascular island flap in 1. 6. Among total 12 cases, there were 5 cases(41.7%) of wound infection and 3 cases (25.0%) of partial necrosis of donor flap. 7. In 11 cases(90.1%), the end result was satisfactory. In the analysis of above results the reconstruction with microsurgery is effective procedure for reconstruction of Injured hand and foot due to frostbite and electrical burn.

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요부 내측지 고주파 신경절리술 시행 시 유도침 경로를 따라 발생한 화상 -증례보고- (Burn Wound along the Guide Needle Trajectory as a Complication of Radiofrequency Neurotomy of the Lumbar Medial Branch -A case report-)

  • 윤홍준;심재철
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.257-260
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    • 2006
  • Radiofrequency neurotomy of the lumbar medial branch, via a caudal approach, is a representative interventional procedure for lumbar zygapophysial joint pain, which can be performed more accurately and easily using a guide needle technique. We experienced a case of burn wound formation along the guide needle trajectory, where heat conduction through the guide needle was suggested to have resulted in the burn wound.

37% 인산 부식제에 의해 발생한 안면피부의 화학 화상 (IATROGENIC CHEMICAL BURN ON FACIAL SKIN BY 37% PHOSPHORIC ACID ETCHANT)

  • 박종현;신혜진;박세희;김진우;조경모
    • Restorative Dentistry and Endodontics
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    • 제34권1호
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    • pp.38-41
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    • 2009
  • 복합레진 수복을 위해 상아질에 total-etch adhesive system을 적용할 경우, 37% 인산 산부식제가 널리 사용되고 있다. 37% 인산은 매우 강력한 부식제로 구강점막이나 안면피부와 접촉되었을 때 심각한 해로운 효과가 발생될 수 있다. 이 증례 보고에서는 복합레진 수복과정에서 사용된 인산 산부식제에 의해 안면피부에 발생된 의원성 화학적 화상을 보고하고자 한다. 산부식제에 의한 화학적 화상은 산부식제를 부주의하고 부적절하게 사용함으로 발생될 수 있으며, 이러한 의원성 손상을 방지하기 위해서는 산부식과 수세과정 후 산부식제가 완전히 제거되었는지를 확인하여야하며, 복합레진 수복 시 러버댐이나 적절한 격리 기구를 사용하는 것이 필요할 것이다. 화상이 발생하였다면, 적절한 응급처치 후 피부과로 의뢰하는 것이 필요할 것이다.

넓은 유리 광 배 근피부 판을 이용한 하지 재건술 (Reconstruction of the Lower Extremities with the Large Latissimus Dorsi Myocutaneous Free Flap)

  • 이준모;허달영
    • Archives of Reconstructive Microsurgery
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    • 제9권1호
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    • pp.80-87
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    • 2000
  • Acute high speed accidents that results in full thickness skin defect and exposure of tendon, nerve, vessel and periosteum over denuded bone demands soft tissue coverage. Exposed bone often ensues chronic infection and requires free flap transplantation which surely covers defects in one stage operation and enhances transport of oxygen-rich blood and converts a non-osteogenic or partially osteogenic site into a highly osteogenic site, but exposed bone which had performed free flap transplantation sometimes necroses and needs secondary bone procedure. Scar contracture limits joint motion should be excised and covered with normal soft tissue to restore normal range of motion. Authors have performed the large latissimus dorsi myocutaneous free flap in 8 cases of extensive soft tissue defect and exposed bone lesion in the leg and 1 case of the flap was failed. The secondary ilizarov bone procedure was performed in 3 of 8 cases. 2 cases of large burn scar contracture and 1 case of posttraumatic scar contracture in lower extremity were restored with the large latissimus dorsi myocutaneous free flap. Authors concluded that large latissimus dorsi myocutaneous free flap is the most acceptable microvascular procedure in large soft tissue defect combined with exposed periosteum and bone requiring secondary bone procedure and in large burn scar contracture limiting knee joint motion.

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심재성 2도 화상이 유발된 흰쥐의 조직 회복에 대한 침 및 한약외용제의 효과 (Therapeutic Effects of Acupuncture and Herbal External Preparation on Healing of Deep Partial Thickness Burn Wound in Rats)

  • 조희근;박애련;최진봉
    • 한방재활의학과학회지
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    • 제24권3호
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    • pp.87-98
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    • 2014
  • Objectives The present study aimed to investigate the effects of acupuncture and herbal external preparation on wound healing procedure in a deep partial thickness burn model in rats. Methods A total of 40 male Sprague-Dawley rats were allocated into four groups with an equal number in each group: acupuncture treatment group, herbal external perparation group, Silver sulfadiazine dressing group and control group. We describe the effect of acupuncture and herbal external preparation on morphologic and histologic changes, epithelial growth factor (EGF), hematological value of the deep partial thickness burn wound in rats. Results At 21th day after wounding the wound size in acupuncture treat group and herbal external preparation group were decreased more significantly compared to control group. In addition, epidermal regeneration on acupuncture treatment was than other treatment and control group in histological finding. Hematological findings revealed that acupuncture treatment group and herbal external prepartion group was more effective than control group in reducing inflammation response induced by burn. In acupuncture treated group, neutrophil and leukocyte level were significantly decreased compared to other treatment group. Also, this study showed that EGF was obviously expressed in nascent tissue when wounds were treated with the acupuncture and herbal external preparation after injury. In particular, acupuncture treatment group had a significant increase of EGF expression in burn wound healing area when compared with the other treatment groups. Conclusions These findings suggest that acupuncture and herbal external prepration may improve burn wound healing through decreasing inflammatory reaction, increasing tissue regeneration and expression of EGF. Moreover, acupuncture treatment could be more effective in comparison with Silver sulfadiazine dressing.

뜸 화상으로 발생한 피부석회증을 수술중 초음파를 이용하여 절제한 사례 (Excision of Calcinosis Cutis Caused by Moxibustion Burn Injury Using Intraoperative Ultrasonography Determining the Complete Resection Range)

  • 류형래;최환준;김준혁;이다운;안혜인
    • 대한화상학회지
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    • 제24권2호
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    • pp.34-37
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    • 2021
  • A 46-year-old female presented a mass on her right lower leg where she had a burn injury due to moxibustion 10 years ago. Physical examination revealed a 3 cm sized firm nodule with tenderness. Plain radiograph was performed and it revealed well-defined calcifications. According to the history of moxibustion burn injury and the result of plain radiograph, dystrophic calcinosis cutis caused by burn injury was suspected. The patient underwent excisional biopsy using pre-,intra-, and post-operative ultrasonography (USG). There was no sign of recurrence. Herein, we report a case of a 46-year-old healthy woman who presented with single hard nodule on the right lower leg. Our case is worthwhile in two respects. First, It is first case report of dystrophic calcinosis cutis due to moxibustion burn injury. In east asian culture, moxibustion is a commonly conducted procedure and it often induces burn injury. Second, USG was used pre-, intra-, and post-operatively to assess the shape, location, and depth of the calcinosis cutis and to determine the surgical margin.

NaOH 용액을 이용한 부식성 식도 협착 동물모델 형성에 관한 연구 (Corrosive Stricture Model Induced-Esophageal Burn : Animal Pilot Data)

  • 김민태
    • 한국방사선학회논문지
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    • 제15권5호
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    • pp.643-647
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    • 2021
  • 본 연구의 목적은 부식성 식도 협착 모델을 만들어 전임상연구 모델로서의 가능성과 활용성을 알아보고자 한다. 20마리의 백서를 Healthy group / Corrosive group으로 나누고, 부식성 화상은 하부 식도에 30% NaOH를 사용하여 모델링하였다. 수술 후 행동 및 체중 변화를 매주 모니터링했습니다. 수술 후 3주 뒤에 식도조영술을 시행한 후 모든 쥐를 안락사 희생시키고 병리학적 분석을 위해 하부식도를 파라핀블럭 제작하였다. 부식성 협착에 대한 기술적 성공은 100%였습니다. 총 2마리의 백서가 연하곤란과 관련된 부식성 화상으로 Corrosive group에서 14일 이내에 사망했다. 식도 협착 비율은 Corrosive group이 Healthy group보다 유의하게 높았다(각각 40.1 ± 9.2% 및 1.4 ± 7.2%; p = 0.001). 조직 증식 비율도 Corrosive group에서 유의하게 더 높았다(각각 62.5 ± 9% 및 22.08 ± 6%; p = 0.001). 결론적으로, 30% 농도의 NaOH를 이용한 백서 부식성 모델은 전임상 연구 평가 툴로서 다양한 부식성 식도 협착 치료 전임상 연구를 수행할 수 있을 것이라 사료된다.

Lymphovenous anastomoses with three-dimensional digital hybrid visualization: improving ergonomics for supermicrosurgery in lymphedema

  • Will, Patrick A.;Hirche, Christoph;Berner, Juan Enrique;Kneser, Ulrich;Gazyakan, Emre
    • Archives of Plastic Surgery
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    • 제48권4호
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    • pp.427-432
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    • 2021
  • The conventional approach of looking down a microscope to perform microsurgical procedures is associated with occupational injuries, anti-ergonomic postures, and increased tremor and fatigue, all of which predispose microsurgeons to early retirement. Recently, three-dimensional (3D) visualization of real-time microscope magnification has been developed as an alternative. Despite its commercial availability, no supermicrosurgical procedures have been reported using this technology to date. Lymphovenous anastomoses (LVAs) often require suturing vessels with diameters of 0.2-0.8 mm, thus representing the ultimate microsurgical challenge. After performing the first documented LVA procedure using 3D-augmented visualization in our unit and gaining experience with this technique, we conducted an anonymized in-house survey among microsurgeons who had used this approach. The participants considered that 3D visualization for supermicrosurgery was equivalent in terms of handling, optical detail, depth resolution, and safety to conventional binocular magnification. This survey revealed that team communication, resident education, and ergonomics were superior using 3D digital hybrid visualization. Postoperative muscle fatigue, tremor, and pain were also reduced. The major drawbacks of the 3D visualization microscopic systems are the associated costs, required space, and difficulty of visualizing the lymphatic contrast used.

Simultaneous two-layer harvesting of scalp split-thickness skin and dermal grafts for acute burns and postburn scar deformities

  • Oh, Suk Joon
    • Archives of Plastic Surgery
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    • 제46권6호
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    • pp.558-565
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    • 2019
  • Background The scalp, an excellent donor site for thin skin grafts, presents a limited surface but is rich in stem cells. The purpose of this study was to test a double harvesting procedure from the scalp and to evaluate the capacity of the dermal layer. Methods Two layers corresponding to a split-thickness skin graft (SSG) and a split-thickness dermal graft (SDG) were harvested from the scalp using a Zimmer dermatome during the same procedure. Healing of the scalp donor site, reason for recipient site grafting, and the percentage of graft loss were evaluated. Results Fourteen patients, comprising six men and eight women with a mean age of 34.2 years, were treated according to our protocol. The most common reason for a recipient site graft was a postburn scar deformity (10/14 patients). The mean area of scalp SSGs was 151.8 cm2. The mean area of scalp SDGs was 88.2 cm2. The mean healing time of scalp donors was 9.9 days. The only donor complication was a tufted scar deformity. Conclusions Skin defects in the scalp of donors healed faster and led to less scarring than defects at other donor sites. Scalp SDGs needed 10 days for adequate epithelization. The scalp was the best donor site for SSGs and SDGs for burn reconstructive patients.

수술방 화재: 수술 종료 시 알코올 함유 피부 소독액을 이용한 수술부위 세척 이후 전기소작기 사용 주의 (Operation Room Fire: Caution for Using Electrocautery after Rinsing Operation Field at the End of the Surgery with Alcohol-Based Cleansing Solutions)

  • 송종근;신효정;이준용
    • 대한화상학회지
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    • 제22권2호
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    • pp.34-37
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    • 2019
  • Fires in operating rooms rarely occur. However, this type of disaster can complicate almost any surgical procedure. Fuel, heat and oxygen are related with fire outbreak. When ignition sources such as alcohol-based surgical preparation solutions are present, the risk of an operating room fire increases, and burns are more severe in such conditions. Many manufacturers recommend waiting at least three minutes after application to allow complete drying for reduce fire risk. There are a few studies regarding flame burns in the operation room, although most of these studies are related to preoperative skin preparation. However, alcohol containing solutions can be used occasionally for cleansing of the operation field after the surgery, therefore, the surgical team should pay attention to surgical fires, even if they have completed the operation successfully. We present our case of a post-operative flame burn and introduce some precautions that will reduce the risk of alcohol burns.