• Archives of Plastic Surgery
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• v.34 no.1
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• pp.77-80
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• 2007

Purpose: Purpura fulminans is a rare but rapidly progressive, serious, often life-threatening disorder in childhood, which is complicated with septic shock or disseminated intravascular coagulopathy during acute infection. It occurs first as acute-onset petechial rash, and spreads rapidly into full thickness skin and soft tissue necrosis. In the past, it had high mortality rate, up to 80%, but recently, survival rate has increased due to early diagnosis, and rapid advancement of critical care and antibiotics. From our experiences of PF management, we would like to review the pathophysiology and suggest the surgical treatment guideline about meningococcal induced purpura fulminans. Methods: Two cases of purpura fulminans over the last 3 years were reviewed retrospectively about reconstructive management. After they were treated resuscitative management initially by the critical intensive care, reconstructive surgery was performed by plastic surgeon as soon as the patients were vitally and mentally stable. Results: There were 6 procedures in case 1, and 3 procedures in case 2. The mean delayed period from admission with sepsis to the first surgical debridement was 24 days and 42 days, respectively. Total hospitalization period was 103 days and 69 days, respectively. All of them were treated with debridement and split thickness skin graft, but delayed debridement was superior to early one in the point of preserving much more tissues. Conclusion: From our experience, we suggest that conservative therapy to the wounds appears to be the best tool in the initial vitally unstable period in order to preserve as much tissues and functions as possible if no active inflammation and compartment syndrome are detective.

• Journal of Biomedical Engineering Research
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• v.24 no.2
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• pp.121-126
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• 2003

The purpose of this work was to assess and quantify whether the beneficial effects in long-term gas exchange at exciting frequency were obtained at different frequencies as well and then to develop a vibrating intravascular lung assist device(VIVLAD), for Patients suffering from acute respiratory distress syndrome(ARDS) or chronic respiratory problems. We investigate the optimal condition of the frequency band excited with new vibrator at state of limit hemolysis when blood hemolysis came to through a membrane vibration action. The experimental design and procedures were given for a device used to assess the effectiveness of membrane vibrations. Quantitative experimental measurements were performed to evaluate the performance of the device . and to identify membrane vibration dependence on blood hemolysis. We developed an analytical solution for the hydrodynamics of flow through a bundle of sinusoidally vibrated hollow fibers that is used to provide some insight into how wall vibrations might enhance the performance of the VIVLAD. In the result, it was measured that the effect of various excited frequencies in gas transfer rate and hemolysis from the maximum gas transfer rate at no vibration when the maximum gas transfer rates showed at module type 6, module type 6 consisted of 675 hollow fiber membranes The maximum oxygen transfer rate was caused by the occurrence of maximum amplitude and transfer of vibration to hollow fiber membranes when it was excited by the frequency band of 7Hz at each blood flow rate. because this frequency became the End mode resonance frequency of the flexible in blood flow. Also, when module type 6 was excited at an excited frequency of 7Hz. blood hemolysis was low. Therefore, we decided that the limit of hemolysis frequency is 7Hz . because maximum amplitude occurred at this frequency.

• Neonatal Medicine
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• v.17 no.1
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• pp.84-93
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• 2010

Purpose : This study was performed to estimate the incidence of nosocomial sepsis and to identify the most relevant risk factors for nosocomial sepsis in high-risk very low birth weight (VLBW) infants. Methods : A retrospective review of 341 VLBW infants, admitted to the Neonatal Intensive Care Unit of the Eulji University Hospital (Daejeon & Seoul) between January 2002 and June 2009, who survived more than 72 hours was performed. The incidence, causative organisms, risk factors and prognosis of nosocomial sepsis in VLBW infants were analyzed. Results : The incidence of nosocomial sepsis was 16.1% and the onset date of nosocomial sepsis was 21.5$\pm$15.9 days (mean$\pm$SD) after delivery. Staphylococcus aureus (21.3%) was the most common organism in the patients with nosocomial sepsis in VLBW infants. The multiple logistic regression analysis showed that, gestational age [odds ratio (OR), 0.87; 95% CI, 0.83-0.91], umbilical artery catheter use for more than 5 days (OR, 2.2; 95% CI, 1.15-4.46), umbilical venous catheter use for more than 5 days (OR, 2.1; 95% CI, 1.11-4.16), peripheral arterial line use (OR, 2.1; 95% CI, 1.14-4.04) and intravenous intralipids (OR, 4.3;95% CI, 1.13-14.32) were identified as risk factors. Conclusion : The limited usage of intravascular catheter related procedures and the short providence of intravenous nutrition may decrease the incidence of nosocomial sepsis in VLBW infants.