• Archives of Plastic Surgery
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• 제35권4호
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• pp.400-406
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• 2008

Purpose: Since ancient times, larval therapy has been applied to help wound healing. Its use has recently been rediscovered, and the interest in this therapy has been increased in clinical practice, as well as in research. The objective of this study is to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds. Methods: Twenty patients, suffering mostly from chronic wounds were treated using maggots of greenfly (Phaenicia sericata). Sterile maggots were administered to the wound twice a week. The causes of the development of wounds were diabetic foot(14), trauma(3), plate exposure(1), and unknown origin(2). Results: Complete debridement was achieved in 10 wounds; in 8 wounds, the debridement was partially achieved; 2 patients escaped. Four patients were healed without any additional surgical procedures but fourteen patients were treated with skin graft. Pain, reported by six patients, was relatively well controlled with oral analgesics. Conclusion: We found larval therapy to be effective for chronic wounds. Maggot therapy is a relatively rapid and effective treatment, particularly in necrotic wounds or the wounds resistant to conventional treatment.

• Journal of Chest Surgery
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• 제15권4호
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• pp.422-427
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• 1982

A clinical analysis of 82 cases who were sustained the penetrating gun-shot wound in the chest by 8 bullets was done during 4~ year-period from January 1978 to August 1982 in the department of thoracic surgery, CA FGH. Among 82 cases, 61 cases [74.4%] of them were brought to the Hospital by ambulance, 21 cases [25.6%] were by Helicopter and 76 cases [92.7%] of them were admitted within 4 hours after wounding. Thirty eight [46.3%] patients were treated by closed thoracotomy only, 19 cases [23.2%]by open thoracotomy, 18 cases [22.0%] by primary closure with debridement, and 7 cases [8.5%] by vascular surgery. Causes of open thoracotomy were due to massive intrapleural bleeding in 16 cases, rupture of diaphragm in 2 Gases, and heart injury in one case. Among 25 cases of surgical complications, wound infection was most common in 16 cases [53.5%] and recurrent pneumothorax in 3 cases [10%], empyema in 3 cases [10%], and BPF in one case [3.3%]. Hospital mortality was seen in 6 cases due to hypovolemic shock and respiratory insufficiency in 4 cases, spinal shock in 2 cases due to spinal injury.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.183-188
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• 2021

We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, if needed.

• Journal of Chest Surgery
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• 제9권1호
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• pp.63-68
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• 1976

Cardiac injury is a relatively uncommon entity, which calls for emergency surgical treatment. During the period from 1974 up to 1975, three cases of stab wound of the heart were treated in Department of Thoracic Surgery. Capital Armed Forces General Hospital among 70 chest injury cases. All of the cases had stab wounds on the heart by knife. Injured sites were found in two cases on the right ventricle, and one case on the right atrium and intrapericardial inferior vena cava. All patients were treated by thoracotomized and sutured with 000 silk for myocardial stab wounds. One of these died of cerebral hypoxia, who was resuscitated from cardiac arrest during operation. Pericardial tamponade signs were not definite except one case.

• Journal of Chest Surgery
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• 제28권9호
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• pp.842-846
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• 1995

Recently, the trauma patients have been markedly increasing due to the vast increase of traffic accident, industrial disaster, incidental accident and violence. The authors have analysed of 22 patients of thoracic injuries combined with abdominal injuries and summarized as follows. The ratio of male to female was 3.4:1 and their age distribution was from 5 years to 68 years and mean age was 34.4 years. The etiologies of injury were traffic accident, stab wound, fall down and violence. Associated injuries were fractures, bowel perforation, kidney rupture, head injury, liver laceration, spleen rupture and so forth. The modes of treatment were closed thoracostomy, repair of diaphragm, ruptured bowel repair, explo-thoracotomy, splenectomy, hepatic lobectomy in this order of frequency. The postoperative complications were atelectasis, wound infection, pneumonia, empyema, acute renal failure, respiratory failure and bleeding. The mortality rate was 13.6% [3/22 and the causes of death were respiratory failure 1 case, acute renal failure 1 case and hypovolemic shock 1 case.

• Journal of Chest Surgery
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• 제18권2호
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• pp.352-359
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• 1985

A clinical evaluation was performed on 811 cases of chest trauma who were admitted and treated at the department of thoracic & cardiovascular surgery, Catholic Medical College, during the past 19 years from Jan. 1966 to Dec. 1984. 1. The overall incidence rate of male to female was 3:1. 2. The common age groups were 4th, 5th, and 3rd decades. 3. The most common cause of chest trauma was stab in penetrating wound and traffic accidents in non penetrating wound. 4. The most common injury from non penetrating chest trauma was rib fracture [81.3%], and the incidence rate of flail chest was 14.5% of all cases of rib fractures. 5. The incidence rate of hemo-pneumothorax was 50.4% in non penetrating wounds, and 55.2% in penetrating wounds. 6. The most common method of surgical treatment was CTD [33.5%], and open thoracotomy was performed in 67 cases [8.3%]. 7, The overall mortality was 3.3% [27 cases], and common causes of the death were shock and respiratory insufficiency.

• Journal of Chest Surgery
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• 제24권2호
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• pp.197-201
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• 1991

Twenty-three patients with traumatic diaphragmatic injuries treated at the Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center from Aug. 1978 to Nov. 1990 were reviewed. There were 19 male and 4 female patients. The age distribution was ranged from 1.5 to 72 years, with a mean age of 34.3 years. Sixteen patients had blunt trauma[traffic accident 14, fall down 2], and 7 had penetrating injuries[stab wound 6, broken glass 1]. Sixteen [70 percent]of the injuries occurred on the left side and 7[30 percent] on the right side. Fifteen patients were operated on during the acute phase, 5 patients during the latent phase, 2 patients during the obstructive phase. The surgical approach in 20 patients was through a thoracotomy; in 2 patients, a thoracoabdominal incision was necessary, and in 1 patient, a laparotomy was performed. Herniated organs in thorax included stomach[10], colon[5], small bowel[5], spleen[4], liver[2]. Postoperative complications included wound infection, empyema, pneumonia, hepatitis and respiratory failure. There were 3 postoperative deaths, 2 with cerebral dysfunction and 1 with sepsis.

• 한국임상수의학회지
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• 제35권5호
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• pp.215-217
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• 2018

A one-year-old, intact male, 24 kg, mixed breed dog was referred to the Animal Medical Center, Iksan, Chonbuk, Korea for treatment of a gunshot wound to the head. Physical examinations revealed bilateral nasal bleeding and open-mouth breathing. Radiographic examination showed fracture of the right maxilla bone and multiple fractures of the nasal bone. A $1cm{\times}1cm{\times}1.8cm$ region of mineral opacity material was observed in the right-cranial ventralnasal cavity and a $6mm{\times}6mm{\times}9mm$ region of mineral opacity material was present in the left-cranial dorsal-nasal cavity. The surgical procedure involved removal of bone fragments and the lodged bullet as well as the installation of three intraosseous wires. At two weeks after surgery, the patient exhibited no complications and had a good prognosis.

• Archives of Plastic Surgery
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• 제41권1호
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• pp.81-84
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• 2014

In this article, we present two cases of femoral pseudoaneurysm (PA) at the femoral arterial puncture site followed by necrotizing fasciitis, which is rare but can be fatal when not managed appropriately. PA was revealed by lower-extremity angiography and color-flow Doppler ultrasonography. Hematoma removal, thrombolysis, and bleeder ligation with Gelfoam were repeatedly performed by a vascular surgeon. When necrotizing fasciitis developed, aggressive surgical drainage and creation of a viable wound bed for reconstruction were mandatory. We adopted a vacuum-assisted closure device (Kinetics Concepts International) as the standard treatment for complicated, serious, infected PA of the puncture site. Excellent clinical outcomes were obtained.

• Archives of Reconstructive Microsurgery
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• 제23권2호
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• pp.45-50
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• 2014

Palmar soft tissue defects are best reconstructed using a replacement flap of proper size with adequate soft tissue stability for mechanical resistance as well as with protective sensation. Reconstructive approaches are dictated by injury mechanism, defect size and location, and the status of the wound bed and tendino-skeletal structure. While uninjured portions of the hand can be used as a source for local flaps, the use of free flaps allows for maximal access for selection of the most ideal replacement tissue for the defect to be restored as close to the initial state as possible. Here, we review the garden variety of free flaps used in reconstruction of palmar soft tissue defects.