• 제목/요약/키워드: Operative technique

검색결과 520건 처리시간 0.025초

Retrospective Analysis of the One-per-Million Tumescent Technique in Post-Burn Hand Deformity Surgeries

  • Prasetyono, Theddeus O.H.;Koswara, Astrid Felicia
    • Archives of Plastic Surgery
    • /
    • 제42권2호
    • /
    • pp.164-172
    • /
    • 2015
  • Background The use of a tourniquet in hand surgery is generally accepted as necessary to create a clear visualization of the operative field. This study aims to determine the effectiveness of one-per-million tumescent solution (1:1,000,000 epinephrine concentration) in creating a bloodless operative field in post-burn hand deformity surgeries performed without a tourniquet. Methods This retrospective observational study was conducted on a series of 12 patients with post-burn hand deformities who underwent surgery between February 2013 and January 2014. A total of 29 operative fields were recorded. The one-per-million tumescent solution was used for hemostatis instead of a tourniquet. The clarity of the operative field, volume of solution injected, duration of surgery, scar thickness and density, and functional outcomes at least three months after the surgery were observed. The relationship of scar thickness and density with the clarity of the operative field was analyzed with the chi-square test. Results Of the 29 operative fields in which the one-per-million tumescent technique was used, 48.2% were totally bloodless, 44.8% had minimal bleeding, and 6.9% had an acceptable level of bleeding. Both scar thickness and density were shown to have a significant relationship with operative field clarity (P<0.05). Conclusions The one-per-million tumescent technique is effective in facilitating post-burn hand deformity surgeries involving meticulous, multiple, and lengthy procedures by creating a relatively clear operative field without the use of a tourniquet. Although scar thickness and density are associated with the clarity of the operative field, this technique can be considered safe and effective in creating a clear operative field.

복합레진의 충전방법에 따른 변연접합성에 관한 주사전자현미경적 연구 (A Scanning Electron Microscopic Study for the Effect of the Filling Techniques of Composite Resin on the Marginal Adaptation)

  • 조현경;박동수;이찬영;이정석
    • Restorative Dentistry and Endodontics
    • /
    • 제13권1호
    • /
    • pp.139-150
    • /
    • 1988
  • The purpose of this study was to evaluate the marginal adaptation of Class V resin restorations by the filling techniques. The cavities were filled with Heliosit$^{(R)}$ light curing composite resin system in accordance with the following three filling techniques - bulk-pack placement technique, apical to occlusal layering placement technique, and buccolingual layering placement technique. And the interface between the restoration and the tooth structure was observed with scanning electron microscope. The following results were obtained. 1. Marginal adaptation of enamel showed excellent irrespective of the filling techniques. 2. Marginal leakage of dentin was observed irrespective of the filling techniques. 3. No difference of marginal adaptation according to the filling techniques was observed in light curing composite resin.

  • PDF

최소침습 방사능 유도 부갑상선 수술 (Minimally Invasive Radio-guided Parathyroid Surgery)

  • 정웅윤;장항석;이종두;박정수
    • 대한두경부종양학회지
    • /
    • 제15권2호
    • /
    • pp.194-199
    • /
    • 1999
  • Introduction: Since 1996, Dr. James Norman has successfully performed mimimally invasive radio-guided parathyroidectomy(MIRP) using intraoperative nuclear mapping with $^{99m}Tc$ sestamibi scanning and radioactivity detection probe. Objectives: We aimed to introduce this new surgical technique and evaluate it's efficacy by our own experiences. Method: From May to October 1999, five consecutive patients with primary hyperparathyroidism underwent parathyroidectomy by using modified MIRP technique. $^{99m}Tc$ sestamibi scanning was performed 1.0 or 1.5 hour before operation. After intraoperative localization of the tumor under the guidance of quantitative gamma counting with a NEVIGATOR probe, an unilateral small skin incision(3.0-4.0cm) was placed. Without a skin flap, the strap muscle was directly divided with the use of a Harmonic scalpel. After careful dissection, the parathyroid tumor was removed. Result: In all patients, a single adenoma could be easily detected and removed by this new technique. Mean incision length was 3.2cm(3.0-4.0cm) and operative time ranged from 40 to 110minute. All the patients were discharged within 2 days of surgery without any complication. Conclusion: This new operative technique could become the most minimally invasive alternative to the standard operative procedure for parathyroid adenoma.

  • PDF

함몰흉 교정의 변형수기 (A Modified Technique for the Correction of Funnel Chest)

  • 이상호
    • Journal of Chest Surgery
    • /
    • 제33권10호
    • /
    • pp.806-811
    • /
    • 2000
  • Background : The authors have modified the method of Ravitch technique. Material and Method ; This technique was applied to 6 patients out of 18 patients who underwent corrective surgery from May 1987 to July 1999. The technique is quite different from that of Ravitch. We did not divide the intercostal muscle bundles from the laterals of sternum and the Akin's struts were placed retrosternally crossing the chest horizontally to prevent flail motion during immediate post-operative period and retraction of the sternum afterwards. Anterior sternal osteotomy instead of the posterior one was performed for the latest 3 cases which made operative procedure more simple and easy. The struts were removed one year later. Result : Compared to the hospital stay of the patients who received standard Ravitch method that of the six cases who received our modification was definitely shortened from 13.1 days to 8.3 days(p<0.0000). Flail motion was not noted in any patient and chest wall stability was obtained more easily with this technique. Conclusion : Our modification is recommendable for correction of funnel chest in regards to shorter operation time better chest wall stability shorter hospital stay and less complication.

  • PDF

McSpadden Technique의 근관폐쇄효과에 대한 실험적 연구 (A STUDY ON THE SEALING ABILITY OF McSpadden TECHNIQUE)

  • 이상탁;이정식
    • Restorative Dentistry and Endodontics
    • /
    • 제10권1호
    • /
    • pp.127-134
    • /
    • 1984
  • This study was conducted to evaluate the sealing ability of McSpadden technique compared with lateral condensation and Engine reamer technique, and according to the degree of canal enlargement and the use and nonuse of sealer. Seventy single-rooted teeth were divided into 14 groups and each tooth was enlarged and obturated according to the purpose of this study. Obturated teeth were infiltrated by Indian ink and decalcified and cleared. The apical sealing ability was evaluated by measuring the degree of ink penetration into the canal. The results were as follows: 1. All the teeth filled by lateral condensation using gutta-percha cone and sealer proved better in canal sealing ability than McSpadden technique and Engine reamer technique, showing less ink penetration. 2. In the McSpadden technique, there was less ink penetration detected in using the sealer than not. 3. In all of the experimental methods, the difference of the degree of ink penetration according the degree of canal enlargement could not be accepted. 4. There was no significant difference in ink penetration degree between Engine reamer technique using sealer and McSpadden technique without sealer.

  • PDF

동맥전환술: 판상돔맥이식 수기변형과 수술사망의 위험인자 (Arterial Switch Operation: The Technical Modification of Coronary Reimplantation and Risk Factors for Operative Death)

  • 성시찬;이형두;김시호;조광조;우종수;이영석
    • Journal of Chest Surgery
    • /
    • 제37권3호
    • /
    • pp.235-244
    • /
    • 2004
  • 동맥전환술은 대혈관전위증이나 Taussig-Bing 기형의 가장 보편적인 수술법으로 인정되고 있다. 동맥전환술 후 수술사망에 영향을 미치는 위험인자와 함께 관상동맥 이식 수기변형의 유효성을 알아보고자 하였다. 1994년부터 2002년 7월까지 동맥전환술을 동아대학교 병원에서 한 명의 외과의에 의하여 시행된 85예의 대혈관전위증과 양대혈관 우심실기시증 환아를 대상으로 후향적 조사를 하였다. 관상동맥이식 수기변형 등 수술(병원)사망에 관여한다고 생각하는 여러 인자들을 다변량 회귀분석을 통해 수술사망에 미치는 위험인자들을 파악하였다. 전체 수술사망(병원사망)은 모두 17예(20%)였으며 수술사망률이 98년 이전은 31.0% (13/42), 98년 이후는 9.3% (4/43)로 감소하였다. 대동맥궁 기형을 동반하지 않은 경우는 전체 사망률이 12.5% (9/72)였으나 동반된 경우는 61.5% (8/13)로 높은 사망률을 보였다. 관상동맥이식 수기변형을 하지 않은 경우 사망률은 28.1%(18/64)를 보인 반면 관상동맥이식 수기변형을 한 경우는 4.8% (1/21)로 많은 사망률의 감소가 관찰되었다. 다변량 회귀분석에서 심폐기가동시간($\geq$ 250분), 대동맥차단시간($\geq$ 150분), 대동맥궁기형이 동반된 경우, 수술 전 사건(event)이 있었던 경우, 개방 관상동맥 이식술(open coronary reimplantation technique)이 수술사망의 위험인자로 파악되었다. 동맥전환술의 수술사망률은 수술시기가 경과함에 따라 감소하였으며, 대동맥궁 기형의 동반과 술 전 사건(event)이 수술사망의 중요 위험인자였다. 비전형적 관상동맥 형태는 수술사망의 위험요소가 아니었으며 관상동맥 이식의 수기변형이 수술사망을 낮추는 데 매우 유효하였던 것으로 생각된다.

Bioblock technique to treat severe internal resorption with subsequent periapical pathology: a case report

  • Mark Frater;Tekla Sary;Sufyan Garoushi
    • Restorative Dentistry and Endodontics
    • /
    • 제45권4호
    • /
    • pp.43.1-43.9
    • /
    • 2020
  • A variety of therapeutic modalities can be used for the endodontic treatment of a traumatized tooth with internal root resorption (IRR). The authors present a case report of the successful restoration of a traumatized upper central incisor that was weakened due to severe IRR and subsequent periapical lesion formation. A 20-year-old female patient was referred to our clinic with severe internal resorption and subsequent periapical pathosis destroying the buccal bone wall. Root canal treatment had been initiated previously at another dental practice, but at that time, the patient's condition could not be managed even with several treatments. After cone-beam computed tomography imaging and proper chemomechanical cleaning, the tooth was managed with a mineral trioxide aggregate plug followed by root canal filling using short fiber-reinforced composite, known as the Bioblock technique. This report is the first documentation of the use of the Bioblock technique in the restoration of a traumatized tooth. The Bioblock technique appears to be ideal for restoring wide irregular root canals, as in cases of severe internal resorption, because it can uniquely fill out the hollow irregularities of the canal. However, further long-term clinical investigations are required to provide additional information about this new technique.

Boerhaave증후군 환자의 외과적 치료 (Surgical Treatment of Boerhaave's Syndrome)

  • 김동원
    • 대한기관식도과학회지
    • /
    • 제18권1호
    • /
    • pp.9-12
    • /
    • 2012
  • Boerhaave's syndrome is a very fatal condition occuring esophageal rupture during emesis and has the worst prognosis of the esophageal perforation. From May 2007 to March 2012 11 patients underwent surgical treatment for Boerhaave's syndrome at Inje University Sanggye Paik Hospital. There were 11 males whose mean age was 49.9 years ranging from 42 to 59. 2 cases of primary closure was performed and 9 cases of anastomosis using EEA (Esophago-Enteric Anastomisis) stapler. Mean operation time was 154.4 minutes and one patient who undergone primary repair died because of mediastinitis and sepsis on $35^{th}$ post-operative day. There was no leakage at other patients. Post-operative complication was one operative wound infection and one post-operative bleeding which was treated completely. Surgical treatment for Boerhaave's syndrome using EEA stapler is simple and effective technique but further studies with large number of cases should be carried out for better outcome.

  • PDF