• 제목/요약/키워드: Chronic wound

검색결과 189건 처리시간 0.018초

무세포 진피 기질을 활용한 재건 수술에 대한 문헌적 고찰 (Use of Acellular Dermal Matrix in Reconstructive Surgery: A Review)

  • 박지원;채수욱;윤병민
    • Journal of Medicine and Life Science
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    • 제18권3호
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    • pp.56-60
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    • 2021
  • In recent decades, tissue engineering advances have led to more skin substitutes becoming available. Acellular dermal matrix, initially developed for use in the treatment of full-thickness burns, is made by removing the cellular components from the dermis collected from donated bodies or animals. This class of scaffold is used to replace skin and soft tissue deficiencies in a variety of fields, including breast reconstruction, abdominal wall reconstruction, and burn treatment. Herein, we provide a detailed review of the clinical applications of acellular dermal matrix.

하악 체부에서 과두부까지 이환된 만성 화농성 골수염 환자의 보존적 외과술식을 이용한 치험례 (CONSERVATIVE TREATMENT OF CHRONIC SUPPURATIVE OSTEOMYELITIS ON MANDIBULAR BODY TO CONDYLE AREA: A CASE REPORT)

  • 이대정;최문기;오승환;이종복
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권6호
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    • pp.474-480
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    • 2009
  • These is a cases of chronic suppurative osteomyelitis occurred in the mandibular body to condyle of 48-year-old male patient. Extensive bone destruction was noted on the right mandibular body, angle, ascending ramus, mandibular notch and condylar region. We made a treatment plan that radicular mandibular resection from body to condyle and mandibular reconstruction with vascularized fibular flap at first time. But, we could observe marked bone regeneration with only mild curettage, local wound care and massive antibiotic therapy. So we preserved the anterior ramus portion of mandible. Defected mandibular condyle was reconstructed with costochondral graft. In this paper we present the case of a patient who has chronic osteomyelitis in mandibular area.

Chest Wall Reconstruction for Chronic Intrathoracic Wounds Using Various Flaps

  • Hong, Joon Pio;Cho, Pil-Dong;Kim, Sug Won;Chung, Yoon-Kyu;Kim, Eun-Gi
    • Archives of Reconstructive Microsurgery
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    • 제9권1호
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    • pp.68-74
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    • 2000
  • The treatment of chronic chest wounds should be focused on eradicating the infection and obliterating the dead space thus providing improved pulmonary function. Chronic chest wounds, although the incidence has decreased over the years, is still associated with high morbidity and prolong hospitalization. In cases where the disease is advanced and conventional measures fail, aggressive approaches achieve adequate resolution or significant improvement. This paper reports four cases of chronic chest wound including bronchopleural fistula and osteomyelitis managed by debridement followed by muscle coverage using latissimus dorsi, rectus abdominis, and omental flap. The intrathoracic reconstruction entails thorough debridement of empyema cavities, bronchpleural fistulas and infection focus. The infection must be completely eradicated prior to or at the time of flap transposition. The flaps used for obliteration of dead spaces provided adequate bulk, abundant blood supply, and minimal donor morbidity. The results were satisfactory with improved respiratory function without complications.

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만성 교약성 심낭염의 외과적 치료 (Surgical Treatment of Chronic Constrictive Pericarditis)

  • 강면식
    • Journal of Chest Surgery
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    • 제22권1호
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    • pp.67-73
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    • 1989
  • Forty two patients with chronic constrictive pericarditis, who were admitted to the Yonsei University College of medicine over a period of 18 years from January, 1970 to August, 1988, were analyzed retrospectively. Mean age of the patient was 33.5 year ranging from 6.8 to 60 years old. Male to female ratio was 1.3 to 1. Twenty-one cases [50%] were tuberculous origin [based on either associated pulmonary tuberculosis and/or caseous necrosis in thickened pericardial specimen] and 17 cases [40.5%] were idiopathic [non specific chronic inflammatory change was considered to be idiopathic]. Dyspnea on exertion was evident in 30 cases [71.4%] and abdominal distention in 21 cases [50%]. On physical examination, hepatomegaly [83.3%], neck vein distention [54.8%], distant heart sound [47.6%] and ascites were found. Thirty-nine patients showed low voltage of QRS and/or T wave flattening or inversion on EKG. Thirty-one cases had undergone cardiac catheterization which showed data compatible with chronic constrictive pericarditis. Midsternostomy group [n=15] had shown the most remarkable CVP decline [12.20 mmHg] as compared with bilateral submammary incision group [n=25, 8.96 mmHg] and left thoracotomy group [n=2, 7.75 mmHg] but difference was not significant statistically There was four early death among 42 patients [9.5%] including 3 cases of left ventricular failure and one cardiac tamponade. Main postoperative complications were wound infection [6 cases] and arrhythmia [3 cases]. Follow-up of 24 patients [mean; 55.3 months, ranging from 2 months to 155 months] revealed good functional status.

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내시경적 교통정맥 결찰술과 부분층 피부이식술로 치료한 정맥성 궤양의 치험례 (A case of venous stasis ulcer treated by subfascial endoscopic perforator ligation and split thickness skin graft)

  • 문성호;이종욱;고장휴;서동국;최재구;장영철
    • Archives of Plastic Surgery
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    • 제36권3호
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    • pp.336-340
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    • 2009
  • Purpose: The wound of a patient who has chronic venous insufficiency is easy to recur. Also they develop a complication even after the conservative therapy or skin graft. We have to diagnose the venous stasis ulcer correctly and remove the cause to improve the effectiveness of treatment. We operated endoscopic perforating vein ligation and splitt thickness skin graft on a patient with venous stasis ulceration on right leg. Methods: A 26 year old male patient who had a scalding burn on his right leg in July 2005 checked into our hospital in March 2008. Even though he got three operations - the split thickness skin graft - at different clinics, the wound did not heal. The size of the wound was 12 by $8cm^2$ and granulation with edema and fibrosis had been formed. We kept observation on many collateral vessels and perforating vein through venogram and doppler sonography and firmly get to know that the wound came with chronic venous insufficiency. After a debridement and an application of VAC$^{(R)}$ for two weeks, the condition of granulation got better. So we proceeded with the operation using subfascial endoscopic perforating surgery and split thickness skin graft. Results: Through the venogram after the operation, we found out that the collateral vessels had been reduced compared to the previous condition and the widened perforating vein disappeared. During a follow up of 6 months, the patient did not develop recurrent stasis ulcer and postoperative complications. Conclusion: Subfascial endoscopic perforator ligation is relatively simple technique with a low complication rate and recurrence rate. Split thickness skin graft with subfascial endoscopic perforator surgery can be valuable method for treating severe venous stasis ulcers.

종골 골절의 합병증 (Complications of Calcaneal Fracture)

  • 배서영
    • 대한족부족관절학회지
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    • 제17권2호
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    • pp.84-92
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    • 2013
  • Quite high prevalence of acute and chronic complications of calcaneal fractures has been reported. Acute complications include blisters, wound necrosis or infection. Late complications include subtalar arthritis, calcaneal malunion, lateral subfibular impingement, tendon problems, sural nerve complications. There are many surgical or nonsurgical treatment modalities to manage those complications. However strategic initial surgical approach with gentle soft tissue handling accompanied by comprehensive understanding about numerous complications might be the best tool to achieve pain free and functional heel after treating calcaneal fractures.

맥동전자장에너지의 미세전류가 가토의 상처치유에 미치는 영향 (The Effects of Pulsed Electromagnetic Energy and Microcurrent on Wound Healing in Rabbits.)

  • 권원안;박래준;박윤기;황태연
    • The Journal of Korean Physical Therapy
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    • 제12권3호
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    • pp.319-329
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    • 2000
  • The purpose of this study w8s to evaluate the effects of pulsed electromagnetic energy(Diapulse) and microcurrent on the wound healing in rabbits. 15 domestic rabbits were randomly assigned to the PRME(n=5). MC(n=5) and CON(n=91 group. Each rabbits were anesthetized with lidocaine HCL $2\%$. Skin wounds were created laterally on the back of IS domestic rabbits(33cm). From 24 hours after being injured, the rabbits of the PEME group were irradiated with an intensity of 3 at a 300 pulses per second, which were applied for 15 minutes every day during the 12 days. The MC group were stimulated with an intensity of $50{\mu}A$ at frequency of40 pulses per second, which were applied for 15 minutes every day during the 12 days. The CON group were not stimulated. The rabbits were sacrificed and the incised wound pans were processed appropriately for the light microscopic examination on the 3rd day, 6th day and 12th day before the beginning of wound treatment. The areas of wound were measured with metric graph paper. The results were as tallows. 1 The PRME and MC group compared with control group showed that wound closure rate increased on 6th, 12th day. 2. It was found that the CON group did not show a complete maturation and had a chronic inflammatory response. Judging from the irregularity of intercellular space and the loose alignment of connective tissue. these findings showed that wound healing was delayed. 3. It showed that inflammatory cells. fibroblasts and epithelial cells activity rapidly processed in the PEME group compared with the CON group. It was found that the PEMI; group showed a advanced remodeling of epithelial layer and a positive repair of connective tissue. 4. It showed that fibroblasts, epithelial cells and inflammatory cells activity rapidly processed in the MC group compared with the CON group. It was found that the MC group showed a improved remodeling of epithelial layer and a dense connective tissue.

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Therapeutic effect of marine bioactive substances against periodontitis based on in vitro, in vivo, and clinical studies

  • Tae-Hee Kim;Se-Chang Kim;Won-Kyo Jung
    • Fisheries and Aquatic Sciences
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    • 제26권1호
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    • pp.1-23
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    • 2023
  • Marine bioactive substances (MBS), such as phlorotannins, collagens, peptides, sterols, and polysaccharides, are increasing attention as therapeutic agents for several diseases due to their pharmacological effects. Previous studies have demonstrated the biological activities of MBS including antibacterial, anticoagulant, antidiabetic, antimicrobial, anti-inflammatory activities. Among numerous human diseases, periodontitis is one of the high-prevalence inflammatory diseases in the world. To treat periodontitis, several surgeries (bone grafting, flap surgery, and soft tissue graft) are usually used. However, the surgery for patients with chronic periodontitis induces several side effects, including additional inflammatory responses at the operated site, chronic wound healing, and secondary surgery. Therefore, this review assessed the most recent trends in MBS using Google Scholar, PubMed, and Web of Science search engines to develop marine-derived therapeutic agents for periodontitis. Further, we summarized the current applications and therapeutic potential of MBS to serve as a reference for developing novel technologies applied to MBS against periodontitis treatment.

Context-Dependent Regulation of Type17 Immunity by Microbiota at the Intestinal Barrier

  • Begum Akuzum;June-Yong Lee
    • IMMUNE NETWORK
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    • 제22권6호
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    • pp.46.1-46.25
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    • 2022
  • T-helper-17 (Th17) cells and related IL-17-producing (type17) lymphocytes are abundant at the epithelial barrier. In response to bacterial and fungal infection, the signature cytokines IL-17A/F and IL-22 mediate the antimicrobial immune response and contribute to wound healing of injured tissues. Despite their protective function, type17 lymphocytes are also responsible for various chronic inflammatory disorders, including inflammatory bowel disease (IBD) and colitis associated cancer (CAC). A deeper understanding of type17 regulatory mechanisms could ultimately lead to the discovery of therapeutic strategies for the treatment of chronic inflammatory disorders and the prevention of cancer. In this review, we discuss the current understanding of the development and function of type17 immune cells at the intestinal barrier, focusing on the impact of microbiota-immune interactions on intestinal barrier homeostasis and disease etiology.

상악동염이 있는 안와 하벽 골절에서 예방적 항생제의 중요성 (Antibiotic Prophylaxis' Effect on Enophthalmos in Orbital Floor Fracture with Chronic Maxillary Sinusitis)

  • 성형우;김진우;신한경;정재학;김영환;선욱
    • 대한두개안면성형외과학회지
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    • 제9권2호
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    • pp.67-71
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    • 2008
  • Purpose: Orbital floor fracture has open wound to maxillary sinus and if the patient has chronic maxillary sinusitis, it may be have more risk of infection, complications. The purpose of this comparative study is to be the effectiveness of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis. Methods: We studied 20 patients who diagnosed as orbital floor fracture with chronic maxillary sinusitis from march, 2005 to may, 2006. Among them 16 were male, 4 were female and age was ranged from 15 to 68, average was 42. A day before operation, Prophylactic antibiotics were used to 10 patients. Prophylactic antibiotics were not used to 10 patients. We defined control group as prophylactic antibiotics injection group a day before operation. After surgery, we confined use of same antibiotic for 7 days in both group. After 6 month from surgery, we compare the degree of enophthalmos from healthy side to legion side with hertel exopthalmometry(Inami, Japan) in control group and non-prophylactic antibiotics injection group. Results: In control group, comparison of discrepancy between enophthalmic eyeball and normal eyeball with Hertel exophthalmometer was 1.1 mm and non-prophylactic antibiotics injection group was 2.1 mm. In independent sample t-test, control group was showed statistically significant difference with non-prophylactic antibiotics injection group(p=0.007). Conclusions: In orbital floor fracture with chronic maxillary sinusitis, bacteria in maxillary sinus can increase post-operative complication by infecting infraorbital soft tissue, and it is thought to be antibiotic prophylaxis is play a role in decrease in degree of enophthalmos. We feel the need to further study of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis.