• Title/Summary/Keyword: Open wound

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Irrigation-suction System for Management of Deep Sternal Wound Infection after Open Heart Surgery -Four cases- (개심술 후 발생한 심부 흉골 창상감염의 세척-흡입법을 이용한 치험 -4예 보고-)

  • 김상익;오상준
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.431-435
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    • 2003
  • Deep sternal wound infection (with or without acute mediastinitis) is a serious complication of open heart surgery, with high rates of associated morbidity and mortality, and prolonged hospitallization. The result of treatment largely depends on timely diagnosis and appropriate surgical management. Postoperative deep sternal wound infections in 4 cases were successfully treated with extensive debridement, pressurized jet irrigation with antibiotic solution, sternal refixation by Robicsek method, and dilute antibiotic irrigation via irrigation-suction system. We report 4 cases with review of articles.

COMPLICATIONS ASSOCIATED WITH OPEN REDUCTION OF MANDIBULAR FRACTURES (관혈적 정복술로 치료한 하악골 골절에서의 합병증)

  • Park, Young-Ah;Sohn, Woo-Ill;Chang, Ic-Jun;Song, Jae-Chul;Chin, Byung-Rho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.474-480
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    • 2001
  • Purpose: The aim of this study was to evaluate the complications of open reduction and internal fixation of mandibular fracture with miniplates. Patients and Methods: A total of 134 patients who presented with 196 fractures were analyzed retrospectively. Complications were evaluated for factors such as age, the site of fracture, the severity of fracture, delayed operation, preoperative wound contamination, the site and disposition of teeth in the fracture line and midfacial fractures. Statistical analysis was used to compare complications to risk factors. Results: Of the 134 patients, 20 patients had some form of postoperative complications and complication rate was 14.9%. These complications included infection, plate fracture, malocclusion, wound dehiscence, nerve injury and nonunion. There was a significant correlation between complication rate and the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth(p<0.05). Conclusion: The occurrence of postoperative complications in the treatment of mandibular fractures was related to the severity of fracture, preoperative wound contamination and the site of the fracture and disposition of teeth.

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Efficacy of Hydrogel Patch in Wound Rat Model (동물모델을 이용한 Hydrogel Patch의 상처치유개선 능력 평가)

  • Oh, Seung-Seok;Kim, Chul-Jun;Kim, Hee-Sook;Shin, Young-Hee
    • Journal of Pharmaceutical Investigation
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    • v.39 no.1
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    • pp.55-58
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    • 2009
  • Sodium polyacrylate based hydrogel patch was prepared and its wound healing efficacy in comparison with control groups was evaluated in thermal burn wound ($200^{\circ}C$, 10 sec burn) and excision wound rat model. Cytotoxicity of gamma irradiated (25 kGy) hydrogel patch was investigated in human fibroblasts and showed no significant cytotoxicity. Wound closure rates (H50%) in hydrogel patch group and BAND-$AID^{(R)}$ treated group were faster than that of control group (uncovered open wound). Hydrogel patch showed an enhancement in wound healing process.

Delayed Sternal Closure Using a Vacuum-Assisted Closure System in Adult Cardiac Surgery

  • Hyun Ah Lim;Jinwon Shin;Min Seop Jo;Yong Jin Chang;Deog Gon Cho;Hyung Tae Sim
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.206-212
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    • 2023
  • Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

ILIZAROV FIXATION FOR THE TYPE C TIBIAL PLAFOND FRACTURES (C형 경골천정 골절에 대한 일리자로브 외고정술)

  • Cho, Hyoun-Oh;Kwak, Kyoung-Duck;Cho, Sung-Do;Kim, Byung-Yong;Oh, Jang-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.1
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    • pp.51-58
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    • 1997
  • The purpose of this study is to evalute the efficacy af the Ilizarov external fixation for the surgical treatment. of the tibial plafond fractures. We reviewed retrospectively fourteen cases of tibial plafond fractures with moderate to severe soft. tissue damage, which were fixed with Ilizarov external fixator. Using the AO Muler classification, there were four Type C1 fractures, six Type C2 and four Type C3. In most, of the cases, the ankles were operated on with other associated fractures within a few days after injury. We reduced the fracture indirectly by soft issue taxis and fixed externally across the ankle joint. using the circular external fixator with tensioned wires and ankle hinge. In cases of inadequate closed reduction, we applied limited open reduction and internal fixation. Range of motion exercise began immediately. Postoperative follow-up averaged fourteen months (ranges, 8-30 months). Overall clinical results rated good or excellent in 7 cases, fair in 4 and poor in 3. There were three cases of pin tract infection which were resolved with short-term antibiotics and local care; one delayed wound closure in a patient. whose fracture was associated with Type III open wound; one wound slough in a patient associated with Type II open wound, which was closed later by skin graft; and one osteoarthritis. From this review, we concluded that cross-ankle circular external fixation with tensioned wires with or without. limited open reduction is a reasonable alternative for the treatment of the tibial plafond fractures with severe soft tissue damage.

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Evaluation of Topical Drug Containing Solcoseryl and Micronomicin on Surgical Wound in Mice

  • Chung, Kae-Jong;Chang, Man-Sik;Chun, Jong-Ok;Chun, Jae-Kwang;Kim, Sung-Chul;Park, Wahn-Soo;Lee, Hyang-Woo
    • Biomolecules & Therapeutics
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    • v.2 no.1
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    • pp.23-27
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    • 1994
  • Wound healing and antibacterial effects of solcoseryl-micronomicin combination gel on an open wound were studied in mice. A simple model was designed for assessing the effects. Using the model, we compared the efficacy of a combined topical gel of solcoseryl and micronomicin with those gels of solcoseryl or micronomicin alone. From the results of our experiment, the wound healing effect of open wounds by treatment with the combination gel was significantly enhanced when compared with those by treatment with solcoseryl gel or micronomicin gel alone. And the antibacterial effect of the combination gel was higher than those of solcoseryl gel or micronomicin gel alone.

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Outcomes of Immediate Operative Treatment of Ankle Trimalleolar Open Fractures (족관절 개방성 삼과골절의 즉각적인 수술의 결과)

  • Lee, Jun-Young;Cho, Yong-Jin;Kang, Sin-Wook;Cho, Yung-Min;Choi, Hyun-Bai
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.1
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    • pp.25-30
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    • 2020
  • Purpose: Generally, the treatment of ankle trimalleolar open fractures is divided into two stages: external fixation and debridement; and secondary internal fixation. On the other hand, this two-stage operation takes considerable treatment time and is challenging in procedures requiring reduction. The purpose of this study was to evaluate the radiologic and clinical results of an immediate one-stage internal fixation operation considering the wound conditions to overcome two stage operation disadvantages. Materials and Methods: From September 2009 to January 2018, 24 cases of ankle trimalleolar open fractures, who underwent immediate internal fixation and were followed up for at least one year, were studied retrospectively. The open wound was divided into the Gustilo-Anderson classification. Open reduction and internal fixation were performed on every medial and lateral malleolar fracture. On the other hand, with posterior malleolar fractures, surgical or conservative treatment was performed depending on the fragment size. The radiologic outcome was evaluated using the Burwell and Charnley criteria and American Orthopaedic Foot and Ankle Society (AOFAS) scores, and complications, such as infection and posttraumatic arthritis, were used for the clinical evaluation. Results: The wound was classified into eight cases (33.3%) of type I, 11 cases (45.8%) of type II, and five cases (20.8%) of type IIIa. The degree of reduction was anatomical, fair, and poor in 16 cases (66.7%), six cases (25.0%), and two cases (8.3%), respectively. The mean AOFAS score was 79 points, and there were complications, such as infection in three cases (12.5%) and post-traumatic arthritis in two cases (8.3%). Conclusion: Satisfactory results were obtained through immediate surgical treatment in ankle trimalleolar open fractures of types I, II, and IIIa.

Formulation of Water-soluble Topical Preparations of Epidermal Growth Factor (상피세포성장인자의 수용성 외용제제화)

  • Lee, Yoo-Cheol;Park, Eun-Seok;Chi, Sang-Cheol
    • Journal of Pharmaceutical Investigation
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    • v.25 no.3
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    • pp.177-184
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    • 1995
  • In order to formulate an aqueous topical preparation of epidermal growth factor(EGF) for the treatment of open wound and bum, the stability of EGF in aqueous vehicles containing various stabilizers was evaluated and the pharmacological activity of gel preparations formulated with poloxamer 407 was determined with wound model. Various additives, which are known as potent stabilizers for proteins and polypeptides so far, were used to increase the stability of EGF in aqueous vehicles. The contents of EGF in the vehicles containing stabilizers were determined with an HPLC method after the storage at $37^{\circ}C$. EGF was more stable in ultrapure water than RO water or saline. All the additives studied resulted in deleterious effects on EGF stability. Therefore, it was speculated that any additives or impurities in the vehicle made EGF unstable. However, nitrogen purge of solution increased the stability of EGF in aqueous vehicles. The aqueous topical preparations of EGF were formulated with poloxamer 407 as a gel base in saline. Gelatin or amastatin was employed as a protease inhibitor. The pharmacological effect of EGF gel was studied with open wound model in mice. EGF preparations, made of oleaginous base or poloxamer gel base, showed significant healing effect compared to the control group(p<0.05). The addition of protease inhibitor in poloxamer 407 gel resulted in significant healing effect compared to the gel without it(p<0.05). Body weights of mice treated with EGF preparation were increased at the first day after the formation of open wound, while those of the control group were decreased. The EGF gel made of poloxamer 407 containing a pretense inhibitor would be a promising aqueous topical preparation for EGF.

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Effect of Yeast Glucan on Wound Healing in Rabbits (가토 창상치유에 미치는 Yeast Glucan의 효과)

  • Park Jae-Heoun;Kweon Oh-Kyeong;Nam Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.11 no.1
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    • pp.427-436
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    • 1994
  • To investigate the effect of yeast glucan on wound healing in rabbits, histopathological findings and wound contraction after topical application of glucan on the open wound were observed. Formalin fixation and embedding of tissues at wound were prepared for histopathological findings at the other day after wounding. Wound size was measured for contraction. Macrophages appeared in the deeper site under the scab at day 1 after wounding in the glucan treated group, but not in the control. A number of macrophages, fibroblasts and a small number of neutrophils were observed at day 3 after wounding In the glucan treated group as compared with the control. Histopathological findings at day 5 after wounding in control were similar with those at day 3 in the glucan treated group. Glucan like granules were scattered in the cytoplasm of macrophages at day 5 in the glucan treated group. A great portion of wound reepithelialized at day 5 in the glucan treated group but a small portion of wound in the control. The Present study indicated that the treatment of 5,000$\mu\textrm{g}$/$m\ell$ of glucan has an effect on wound heal. ins in respect to migration of macrophage into the wound site, granulation tissue formation and epithelialization.

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Controlled Partial Skin Thickness Burns: Rabbit Ear as a 2nd Degree Burn Wound Model for Studies of Topical Therapy

  • Cho, Lee Ae-Ri;Moon, Hee-Kyung
    • Journal of Pharmaceutical Investigation
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    • v.36 no.5
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    • pp.339-342
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    • 2006
  • This study was designed to prepare an animal model for partial thickness bum wound which can be employed for testing topical therapy. We first evaluated whether rabbit ear and mouse back skin wound model could differentiate the wound healing process in terms of degree of re epithelialization, required days for complete wound closure, presence of scarring. $2^{nd}$ degree wet bum were prepared on mouse back skin and rabbit ear by applying 5 mL hot water($85{\pm}0.1^{\circ}C$) for 7 see followed by 5 mL ice-cold 0.5% acrynol solution for cooling and disinfecting the inflicted area. After removing the dead epidermis layer at 24 hr, tested dressings were applied for specified time and wound progression was investigated. In mouse model, wound contraction was the primary wound closing mechanism, which is quite different from human wound healing process. In rabbit ear model, epidermal regeneration was the major wound healing process rather than wound contraction and the difference in wound healing property among tested dressings could be clearly demonstrated. A rabbit ear model could differentiate the wound progression among open, occluded and epidermal growth factor(EGF) treated wound. Four sites of circular wound(diameter: 1 cm) on the anterior part of rabbit ear could be employed for the comparative wound healing study. For obtaining reproducible bum wound, degree of bum depth and bum sites should be carefully controlled in addition, employing rabbits of same strain and weight. The result suggests that rabbit ear could be employed as a reliable and human-resembled wound model.