• 대한관절경학회지
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• 제11권1호
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• pp.20-23
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• 2007

목적: 슬관절의 외상 및 질환에 대한 관절경 수술 후 발생한 심부감염의 특성을 조사하고자 한다. 대상 및 방법: 1994년 2월부터 2006년 8월까지 슬관절의 관절경 수술을 시행 받은 총 894예의 슬관절을 대상으로 심부 감염의 빈도를 조사하였으며 감염으로 확진된 환자군에 관한 분석을 시행하였다. 결과: 총 894예의 슬관절 관절경 수술에서 7예의 심부 감염이 발생하여 0.9%의 발생율을 보였으며 419예의 절제와 봉합을 포함한 반월상 연골 수술에서 반월상 연골 봉합을 시행한 1예에서 감염이 발생하였다(1/419=0.2% 발생율). 십자인대 재건술 343예에서 6예의 감염 이 발생하였으며(6/343=2% 발생율) 전방 십자인대 단독 수술군에서 3예 (3/152), 후방 십자인대 단독 수술군에서 2예(2/70), 십자 인대에 부가하여 관절외 재건술을 시행한 25예의 환자 중에서 1예에서 감염이 발생하였다(1/26). 결론: 슬관절의 관절경 수술 후 감염 발생율은 비교적 낮았으나 이식물을 사용하여 관절강내 인대 재건술을 시행한 경우에서는 높게 발생 한 바 전후방 십자 인대 재건술 등의 수술시 이에 대한 주의를 요한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권1호
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• pp.37-41
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• 2017

Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.536-539
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• 2004

The apicoectomy is an operation in which the root apex is removed and the adjacent periapical pathologic tissue is curetted. In this operation, there are several factors that may lead to the surgical wound infection, such as, local, systemic, environmental, endogenous and surgical factor. The systemic medical and surgical factor that may compromise patients defense are more important cause of the wound infection. The postoperative infection is likely to occur owing to poor systemic condition(especially geriatric cancer patient with operation, radiotherapy and chemotherapy), postoperative accumulation of hematoma & seroma and other contaminated factors. So, the authors established the immediate rubber drainage into the sutured wound of dental apicoectomy for the prevention of postoperative infection. The results are more favorable without the wound infection in total 31 cases of the dentistry of Dong San Medical Center & Wonju Christian Hospital.

• Advances in pediatric surgery
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• 제20권2호
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• pp.28-32
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• 2014

Purpose: Laparoscopic appendectomy (LA) has become a gold standard for children even in complicated appendicitis. The purpose of this study was to compare the postoperative surgical site infection rates between laparoscopic and open appendectomy (OA) group in pediatric complicated appendicitis. Methods: A total of 1,158 pediatric patients (age ${\leq}$ 15 years) underwent operation for appendicitis over a period of 8 years. Among these patients, 274 patients (23.7%) were diagnosed with complicated appendicitis by radiologic, operative and pathologic findings, and their clinical outcomes were retrospectively analyzed. Results: Of the 274 patients with complicated appendicitis, 108 patients underwent LA and 166 patients underwent OA. Patients in the LA group returned to oral intake earlier (1.9 days vs. 2.7 days; p<0.01) and had a shorter hospital stay (5.0 days vs. 6.3 days; p<0.01). However, rate of postoperative intra-abdominal infection (organ/space surgical site infection) was higher in the LA group (LA 15/108 [13.9%] vs. OA 12/166 [7.2%]; p<0.01). Readmission rate was also higher in the LA group (LA 9/108 [8.3%] vs. OA 3/166 [1.8%]; p<0.01). Conclusion: The minimally invasive laparoscopic technique has more advantages compared to the open procedure in terms of hospital stay and early recovery. However, intra-abdominal infection and readmission rates were higher in the laparoscopy group. Further studies should be performed to evaluate high rate of organ/space surgical infection rate of laparoscopic procedure in pediatric complicated appendicitis.

• The Korean Journal of Pain
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• 제11권2호
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• pp.230-234
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• 1998

Background: Continuous epidural block is widely used for surgical operation and postoperative pain management. The potential infection due to the epidural catheter is a definite harzard of continous epidural block. We investigated the effectiveness of bacterial filter in prevention of infection due to the epidural catheter. Methods: Patients scheduled for transabdominal hysterectomy were assigned to two groups by simple randomization (50 patients per group). All catheters were placed in the 2nd and 3rd lumbar epidural space, using careful sterile technique. Group 1 received injections by the epidural catheter with a bacterial filter and group 2 received injections by the epidural catheter without a bacterial filter. The infection rate in the tips of epidural catheter left for 3 days were compared between the two groups. Results: There was no significant difference in the infection rate between two groups. Conclusions: A bacterial filter of the epidural catheter for surgical anesthesia and postoperative analgesia dose not prevent all kinds of infection in continuous epidural block.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3479-3483
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• 2015

Objective: Patients with hepatocellular carcinoma (HCC) in stage Barcelona Clinic Liver Cancer (BCLC)-A were grouped based on whether they were accompanied with hepatitis B virus (HBV) infection or not so as to explore the clinical characteristics and prognostic conditions of HCC patients with non-HBV/hepatitis C virus (HCV). Materials and Methods: Clinical data of 64 stage BCLC-A HCC patients with non-HBV/HCV infection (observation group) who received radical hepatectomy in the Affiliated Cancer Hospital of Guangxi Medical University from January, 2006 to November, 2014 were retrospectively analyzed and compared with those of 409 stage BCLC-A HCC patients with HBV infection (control group) in corresponding period. Results: The postoperative 1-, 3- and 5-year recurrent rates of the observation group were 25%, 38.6% and 48.8%, with postoperative mean and median disease-free survival time being 49.1 months and 62.0 months, respectively. Additionally, the postoperative 1-, 3- and 5-year survival rates of observation group were 90.1%, 72.7% and 62.0%, with the mean and median survival times being 54.4 months and 70.0 months, respectively. Conclusions: The 1-year recurrent rate is the highest in HCC patients with non-HBV/HCV, and almost half of the patients have recurrence within 1 year, after which the recurrent rate decreases along with the time.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.562-570
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• 2014

Background Knee disarticulations (KD) are most commonly employed following trauma or tumor resection but represent less than 2% of all lower extremity amputations performed in the United States annually. KDs provide enhanced proprioception, a long lever arm, preservation of adductor muscle insertion, decreased metabolic cost of ambulation, and an end weight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelming infection is less clear. The purpose of this study is to describe technique modifications and report surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods A retrospective study of medical records for all patients who underwent a through-knee amputation performed by the senior author (C.E.A.) between 2004 and 2012 was completed. Medical records were reviewed to collect demographic, operative, and postoperative information for each of the patients identified. Results Between 2004 and 2012, 46 through-knee amputations for 41 patients were performed. The mean patient age was 68 and indications for surgery included infection (56%), arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficial cellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case of surgical debridement (4%) and four transfemoral amputations (9%). 9 (22%) patients went on to ambulate. Postoperative ambulation was greatest in the traumatic cohort and for patients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infection reduced the likelihood of postoperative ambulation, P<0.01. Conclusions Knee disarticulations are a safe and effective alternative to other lower extremity amputations when clinically feasible. For patient unlikely to ambulate, a through-knee amputation maximizes ease of transfers, promotes mobility by providing a counterbalance, and eliminates the potential for knee flexion contracture with subsequent skin breakdown.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.703-708
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• 2008

Purpose: Microtia is a congenital anomaly resulting from abnormal development of the branchial apparatus. Although significant modification and improvement of operative procedures for the reconstruction of the auricle with a natural appearance have been reported, postoperative complications, such as infection, flap necrosis and deformity, still remain serious problems in patients. Many studies with long-term results have focused mainly on operative procedures for an acceptable auricular shape without consideration of possible complications. Methods: We conducted a retrospective study on postoperative complications at the recipient sites of 183 patients who underwent auricular reconstruction with autologous rib cartilage grafts from November 1987 to January 2007 at the Division of Pediatric Plastic Surgery, Seoul National University Children's Hospital. Patients were analyzed in terms of the kinds and incidences of complications, and their treatment options. Results: Postoperative complications included wound dehiscence, flap necrosis, infection, hypertrophic scar, auricular deformity and absorption of rib cartilage grafts. The complications occurred in 47 patients with a complication rate of 25.7%. Fourteen patients were successfully managed with conservative treatment. However, surgical treatment was required in 51 reoperations(33 patients) of total 329 operations. Conclusion: Postoperative complications at the recipient sites of autologous rib cartilage grafts occurred with relatively high incidences and required long-term treatments and multiple surgeries. The results of this study may provide information on the causes and proper management of postoperative complications as well as safe procedures for the reconstruction of the auricle.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.218-223
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• 2014

Objective : C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are often utilized to evaluate for postoperative infection. Abnormal values may be detected after surgery even in case of non-infection because of muscle injury, transfusion, which disturbed prompt perioperative management. The purpose of this study was to evaluate and compare the perioperative CRP, ESR, and white blood cell (WBC) counts after spine surgery, which was proved to be non-infection. Methods : Twenty patients of lumbar open discectomy (LOD) and 20 patients of posterior lumbar interbody fusion (PLIF) were enrolled in this study. Preoperative and postoperative prophylactic antibiotics were administered routinely for 7 days. Blood samples were obtained one day before surgery and postoperative day (POD) 1, POD3, and POD7. Using repeated measures ANOVA, changes in effect measures over time and between groups over time were assessed. All data analysis was conducted using SAS v.9.1. Results : Changes in CRP, within treatment groups over time and between treatment groups over time were both statistically significant F(3,120)=5.05, p=0.003 and F(1,39)=7.46, p=0.01, respectively. Most dramatic changes were decreases in the LOD group on POD3 and POD7. Changes in ESR, within treatment groups over time and between treatment groups over time were also found to be statistically significant, F(3,120)=6.67, p=0.0003 and F(1,39)=3.99, p=0.01, respectively. Changes in WBC values also were be statistically significant within groups over time, F(3,120)=40.52, p<0.001, however, no significant difference was found in between groups WBC levels over time, F(1,39)=0.02, p=0.89. Conclusion : We found that, dramatic decrease of CRP was detected on POD3 and POD7 in LOD group of non-infection and dramatic increase of ESR on POD3 and POD7 in PLIF group of non-infection. We also assumed that CRP would be more effective and sensitive parameter especially in LOD than PLIF for early detection of infectious complications. Awareness of the typical pattern of CRP, ESR, and WBC may help to evaluate the early postoperative course.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1185-1191
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• 1992

Cell mediated immunity is depressed following surgical procedure and the degree of immunosuppression is directly related to the magintude of the procedure, blood transfusion, and length of operation. So we would expect cardiac operations to be highly immunosuppressive, although little is konwn about their immunosuppressive effect. The nearly complete consumption of complement factors and decreased levels of IgM and IgG resulting in an impaired opsonizing capacity. Additionally, peripheral blood mononuclear cell counts including T-and B-lymphocytes and T-cell subsets are reduced. Depression of cell-mediated immunity following open-heart surgery is potentially detrimental because it could increase the susceptability of patients to viral and bacterial infection. We reviewed 20 patients after cardiac operation to search for changes in peripheral blood lymphocyte subsets. Lymphocyte subsets were measured by flow cytometer and the preoperative values of lymphocyte subsets were compared with those from the first, fourth, and seventh days after operation. After cardiac operation, total mumbers of T lymphocyte was severely depressed on the first postoperative day and returned to the preoperative level by the seventh day after operation. CD3, CD4, and CD8 lymphocytes were decreased on the first postoperative day and returned to the preoperative level by the seventh day also. There was four cases of wound infection and these patients had increased CD4 lympocyte and more decreased CD19 lymphocyte compared with the non-infected group. It is concluded from these data that cell-mediated immunity is significantly depressed for at least one week following open-heart surgery and this result was closely related to the postoperative infection.