• 한방안이비인후피부과학회지
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• 제37권1호
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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.

• Archives of Plastic Surgery
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• 제35권2호
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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%).

• Child Health Nursing Research
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• 제18권4호
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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.

• Archives of Plastic Surgery
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• 제40권4호
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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.

• Archives of Reconstructive Microsurgery
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• 제24권2호
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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.

• Parasites, Hosts and Diseases
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• 제35권1호
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• pp.31-38
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• 1997

BALB/c 마우스에서 감염부위와 감염기간에 따른 숙주 체액 면역반응의 변화를 알아보고자 하였다. 배양한 큰리슈만편모충의 전편모형(promastigote)을 BALB/c 마우스의 코. 등 발바닥 부위로 나누어 각각 $3{\;}{\times}{\;}10^6$마리씩 피하 감염 후 10-100일 동안에 궤양의 형성과정을 관찰하고 채혈하여 SDS-PAGE와 면역이적법을 시행하여 각 부위별로 나타나는 항체 반응을 관찰하였다. 외관상으로는 감염 15일부터 코에 감염시킨 마우스에서 먼저 궤양이 형성되기 시작하였고. 코에 궤양이 나타난 후 2-3일 뒤에 발에서 궤양이 형성되었으며 등에서는 감염시킨 후 90일이 되어서야 궤양이 관찰되었다. 감염후 20일에 실시한 면역이적법에 의하면 코 감염군에서는 202, 139, 98, 83, 81, 67, 65, 62, 59, 54, 52, 42, 26, 23 kDa의 항원성 분획이 관찰되었고 발 감염군에서의 항원 분획양상도 코 감염군과 같았으나 등감염군에서는 202, 83, 81, 65 kDa의 희미한 항원성 분획이 관찰되었다. 그러나 감염 후 90일이 경과한 등 감염군에서는 202, 83, 81, 74, 67, 65, 62, 59, 54, 52, 20, 17 kDa의 항원 분획이 관찰되었다 이상의 결과로부터 감염부위와 감염기간에 따라 큰리슈만편모충에 대한 혈청반응이 항원 분획에 따라 다르게 나타남을 관찰하였다. 이 차이는 세 감염부위의 온도차에 의한 결과일 가능성도 있으나 다른 부위에 감염될 경우 한 숙주 내에서도 다른 면역반응이 유발되어 나타날 수도 있다고 추측하였다. 특히 궤양 형성 시기와 혈청 내 67-52 kDa 분획에 대한 항체 출현 시기가 일치하는 것으로 보아 궤양 형성에 이 항체가 관여할 가능성이 있음을 시사한다.

• 대한족부족관절학회지
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• 제18권3호
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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.

• 한방안이비인후피부과학회지
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• 제13권1호
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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.

• Archives of Plastic Surgery
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• 제46권1호
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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.

• 기본간호학회지
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• 제13권2호
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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.