• Title/Summary/Keyword: Skin ulcer

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A Case Study on Lower Extremity Ulcer (하지부 궤양 치험 1례)

  • Kyou Young Lee
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.37 no.1
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    • pp.86-96
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    • 2024
  • Objectives : The aim of this study is to report a case showing rapid skin regeneration and recovery by applying Korean medicine treatment to lower extremity ulcer. Methods : We treated a female patient with idiopathic right leg ulcer by Korean medicine treatment such as herbal medicine, acupuncture, pharmacopuncture, Coptidis Rhizoma distillate wet dressing, and Jawoongo application. The treatment effect was evaluated by visual observation through photography, measurement of the area of the affected area, NRS(Numeral Rating Scale) for the level of discomfort, DLQI(Dermatology life quality index), and treatment satisfaction. Results : After Korean medicine treatment, recovery of skin tissue, reduction in affected area, and decrease in NRS for discomfort and DLQI were observed, and satisfaction with Korean medicine treatment was also high at 80%. Conclusions : This study shows that Korean medicine treatment can be effective in treating skin ulcers. We hope that research of Korean medicine treatment on skin ulcers will be promoted in the future.

Prevalence of Fungal Infection in Diabetic Foot Ulcer (당뇨족 궤양에서 진균감염의 유병률)

  • Yoo, Yeon Sik;Han, Seung-Kyu;Kim, Woo Kyung
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.134-138
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    • 2008
  • Purpose: In a diabetic foot ulcer, superficial fungal infection of the foot may disrupt the skin integrity and provide an avenue for bacterial infection. The prevalence of fungal infection in diabetic foot ulcer has been reported as 12-30% in Caucasian patients. However, no data are available for Korean patients. The purpose of the study was to examine the prevalence of fungal infection in diabetic foot patients admitted in our clinic. Methods: This study included consecutive 30 diabetic foot ulcer patients(24 males and 6 females) admitted from May 2007 to July 2007. The mean age was 60.5 years. All patients underwent mycological examination including direct microscopic examination in KOH and culturing on slants and tubes with Sabouraud's glucose agar. Results: Clinical signs of presumed fungal infection, which were examined by dermatologists, were found in all patients included in this study. Direct microscopic examination was positive for the specimens of the skin and the toenails in 28(93.3%) and 25(83.3%) patients, respectively. In addition, culture result was positive for the specimens of the skin and the toenails in 5(16.73%) and 7(23.3%) patients, respectively. Conclusion: The prevalence of fungal infection in diabetic foot ulcer patients admitted in our clinic is much higher than that in Caucasian patients(83.3-93.3% vs 12-30%).

Incidence and Associated Factors of Pressure Ulcers in Newborns (신생아의 욕창발생실태 및 관련요인)

  • Choi, Won-Young;Ju, Hyeon-Ok
    • Child Health Nursing Research
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    • v.18 no.4
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    • pp.177-183
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    • 2012
  • Purpose: This study was done to examine the incidence of pressure ulcers and associated factors, by inspecting the skin of newborn babies in a newborn unit or newborn intensive care unit (NICU). Methods: The participants were 101 newborn babies in either a newborn unit or NICU in D general hospital. The incidence of pressure ulcer was measured using the skin inspection tool for pressure ulcer, suggested by Agency for Health Care Policy and Research. Results: Incidence rate of pressure ulcer was 19.8%, and 80% of the newborns with pressure ulcers were premature babies. The commonest region of onset was the ear (36.8%), followed by the foot (31.6%), occipital region (15.8%) and knee (15.8%). Those are the regions related to external medical devices like nasal Continuous Positive Airway Pressure and Pulse Oximetry. Factors related to pressure ulcers were gestational period of 37 weeks or less, hospitalization for 7 days or more, birth weight under 2,500 g and a low level of serum albumin. Conclusion: The results of the study show that the skin and underlying tissues of premature infants is at risk for pressure-related skin breakdown. As most pressure ulcers are caused by medical devices, nursing interventions are required to prevent further aggravation of the lesions.

Treatment of Diabetic Foot Ulcer Using Matriderm In Comparison with a Skin Graft

  • Jeon, Hyojin;Kim, Junhyung;Yeo, Hyeonjung;Jeong, Hoijoon;Son, Daegu;Han, Kihwan
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.403-408
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    • 2013
  • Background For patients with neuropathy, vasculopathy, and impairment of wound healing, treatment of a diabetic foot ulcer poses many challenges. A large number of dermal analogues have been invented in an effort to overcome these challenges. Matriderm, a dermal analogue, is made from bovine collagen and elastin. This study was conducted in order to evaluate the effectiveness of Matriderm for treatment of diabetic foot ulcers, in comparison with skin grafting. Methods Sixty patients with diabetic foot ulcer were included in this prospective study. The average age of the patients, who had type II diabetes mellitus, was 58 years old. The patients were allocated to an experimental or control group with their consents. The patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a Matriderm appliance and a split-thickness skin graft, while those in the control group received only a split-thickness skin graft. Results A shorter hospitalization period (7.52 weeks) was observed in the experimental group than in the control group (9.22 weeks), and a shorter period of time (8.61 weeks) was required for complete healing, compared with the control group (12.94 weeks), with statistical significance (P<0.05). A higher elasticity ratio of the affected side to the non-affected side was observed in the experimental group, compared with the control group (P<0.01). Conclusions Matriderm enables effective healing and improves elasticity in treatment of patients with diabetic foot ulcer.

Using the Dorsal Metacarpal Artery Perforator Flap for Reconstruction of Rheumatoid Ulcers

  • Choi, Min;Son, Kyung Min;Choi, Woo Young;Cheon, Ji Seon;Yang, Jeong Yeol
    • Archives of Reconstructive Microsurgery
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    • v.24 no.2
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    • pp.79-81
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    • 2015
  • Rheumatoid arthritis is a long lasting autoimmune disorder that primarily affects joints, and patients with rheumatoid arthritis are predisposed to development of chronic skin ulcers. In addition, skin ulcers with rheumatoid arthritis tend to persist despite treatment because of sustained inflammation and poor healing capacity. Treatment of skin ulcers involves medications, wound coating agents, and surgical procedures including skin grafting, however, wound dressing or skin grafts are generally excluded because of excessive cost and time and poor intake rate. The dorsal metacarpal artery perforator (DMAP) flap, a vascular island flap for coverage of soft tissue defects on the fingers, provides promising results including matched quality and color. We experienced a case of DMAP flap for reconstruction of a rheumatoid ulcer, and a DMAP flap may be considered as a good faithful option for treatment of patients with rheumatoid ulcer.

Skin ulcer and immunoblot patterns by inoculation sites in BALB/c mice infected with Leishmania major (BALB/c 마우스에서 큰리슈만편모충의 감염부위에 따른 궤양형성과 혈청 면역반응)

  • 이미정;이종국
    • Parasites, Hosts and Diseases
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    • v.35 no.1
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    • pp.31-38
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    • 1997
  • The skin ulcer in Leishmcnio mcior infection is known to be variable according to the inoculation sites even in a susceptible host. The present study traced the immunoblot patterns by the site of inoculation and duration of infection in BALB/c mice. L. mqior were subcutaneously inoculated on the nose, footpad, and back of the mice, in a dose of 3 × 106 promastigotes. Sera of the mice were collected every 10 days after inoculation. SDS-PAGE separated soluble protein bands of the promastigotes and immunoblot was carried out with the infection sera. The skin ulcer first appeared on the nose at 15 days, and on the footpad at 17 days after inoculation. The ulcer on the back appeared after 90 days. In the mice with ulcer on the nose or footpad, serum IgG antibody reacted to 202, 139, 98, 83, 81, 67, 65, 62, 59, 54, 52, 42, 26, and 23 kDa bands at 20 days after inoculation. In mice inoculated on the back, however, the immunoblot showed visible reactions with 202, 83, 81 74, 67, 65, 62, 59, 54, 52,20 and 17 kDa bands at 90 days after inoculation. The present result showed that the antigenic protein bands of L. mqior promastigotes were differed by the inoculation site and duration of infection. Since the skin ulcer and the serum antibodies to antigenic bands between 67-52 kDa appeared simultaneously, it is suggested that the serum IgG antibodies may play a role in formation of the skin ulcer in BALB/c mice.

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Ultrasound-guided Nerve Block for Skin Grafting on Large Diabetic Ulcer of Foot and Leg: A Technical Report (광범위 당뇨병성 족부 및 하퇴부 궤양의 피부이식술에 사용된 초음파 유도 신경 차단: 술기 보고)

  • Song, Jae-Hwang;Kang, Chan;Hwang, Deuk-Soo;Hwang, Jung-Mo
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.3
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    • pp.133-136
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    • 2014
  • Skin grafting is often required for diabetic ulcerative foot lesions. In skin grafting, effective regional or local anesthesia into the donor and recipient areas plays a significant role in continuous control of pain. We report on a technique of ultrasound-guided nerve block on the femoral, sciatic, and lateral femoral cutaneous nerves in large split-thickness skin grafting for ulcer of the foot and leg.

The literary review on the Treatment of Pressure Sore (褥瘡의 治療에 관한 문헌적 고찰)

  • Song, Jae-chul;Chung, Seok-hee;Lee, Jong-soo;Shin, Hyun-dae;Kim, Sung-soo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.13 no.1
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    • pp.237-252
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    • 2000
  • Pressure sore is an area of ulceration and necrosis of the skin and underlying tissues usually occuring over the bony prominences of the body after prolonged or often repeated pressure. We reviewed and summarized the published articles and treatise on the treatment of pressure sore. The results were as follows : 1. Pressure sore occur due to prolonged or often repeated pressure. So it is better than decubitus ulcer that is called pressure sore. 2. The most common lesions of pressure sore are sacrum, ischial tuberosity, greater trochanter. 3. The cause of pressure sore are change of comprehension. urine, moisture, change of the ability of activity and exercise, shearing force. 4. The elements to influence on wound healing are collagen accumulation velocity, nutrition condition, Vitamine C, copper, iron. oxygen pressure, steroids, cell-toxic drug, radiation. 5. Non-operative treatments are managements of skin such as avoiding consistant pressure, dressing, preventing moisture, understanding patient and protecter, preventing spasm, improvement of systemic nutrition condition. 6. Operative treatements are debridement, suture, skin transplantation, muscle flap and musculaocutaneous flap surgery. Recently V-${\Gammer}$ advancement surgery in use of muscle and musculocutaneous flap is generally maded. 7. Complications of post-operation are wound rupture, infection, disappearance of transmitted skin, necrosis of flaps.

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A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute

  • Kim, Jung Hwan;Shin, Hea Kyeong;Jung, Gyu Yong;Lee, Dong Lark
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.75-78
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    • 2019
  • It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.

A Study on the Pressure Ulcers in Neurological Patients in Intensive Care Units (신경계 중환자의 욕창발생에 관한 연구)

  • Im, Mi-Ja;Park, Hyoung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.2
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    • pp.190-199
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    • 2006
  • Purpose: To provide basic data and to identify the risk of pressure ulcers among neurological patients in ICU. Method: The participants in the study were on 78 neurological patients in the ICU of 3 hospitals. Data were collected every other day from 24 hours after admission, for up to 40 days or until discharge. The total period of data collection was 3 months. The risk assessment scales used for pressure ulcer were the Cubbin & Jackson(1991) scale and the National Pressure Ulcer Advisory Panel(1989) skin assessment tool. Results: There was a significant relationship between having a pressure ulcers and weight, skin condition, mental status, respiration, hygiene and hemodynamic status compared to not having a pressure ulcer. The incidence rate of the pressure ulcer was 28.2%(n=22). Of these patients the mean number of hospitalization days until pressure ulcer development was 5.2 days. The most common pressure ulcer site was the coccyx(39.3%). Based on a cut-off point of 24, 9 patients with risk scores <24 on admission also showed risk score for development of pressure ulcers, 10 patients with pressure ulcer scores ${\geq}24$ were older, hospitalized for a longer time, had low serum albumin, low hemoglobin, diabetes mellitus and surgery. Conclusion: In order to make the Cubbin & Jackson risk assessment scales more useful, there is a need to determine the reliability of the upper cut-off point 24. The result also showed a need to assess other risk factors and for early identification of at-risk patients in order to provide preventive care from admission to discharge.

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