• 대한화장품학회지
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• 제41권4호
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• pp.401-411
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• 2015

본 연구에서는 피부재생 화장품 소재로 활용하고자 저분자화 시킨 Polydeoxynucleotide (PDRN)의 창상 치유 효과를 조사하였다. 이를 위하여 연어 정소 유래 PDRN 단백질 제거공정, 내독소 제거공정을 거쳐 순수분리 정제하였고 분자량 저감공정을 거쳐 기존 PDRN 보다 피부 침투율을 높인 고순도 PDRN을 제조하였다. 상처 치료 과정 중 PDRN 처리에 의한 효능을 평가하기 위해 sprague-dawley rats (SD)의 배부에 bioxy punch를 이용한 4개의 창상을 유발하고, 시료를 포함한 총 5종의 실험시료를 마리당 $500{\mu}L$씩 도포한 후 7일 간격으로 4주간 피부조직 변화를 관찰하였다. 상처에 PDRN을 도포한 후, 절개된 상처의 표피화와 수축이 더 빨라졌고, 창상면적에 있어서 PDRN의 도포는 양성대조군인 $Fucidin^{(R)}$ 도포군과 비교하여 유의하게 줄어들었다. 염색한 조직의 현미경 관찰 결과에서는 양성대조군이 가장 빠르게 재상피화가 이루어졌으며, 그 다음으로는 PH군, PD군, HA군으로 교원질 재합성 및 형성 수준을 보였다. 또한, 병변의 형질전환성장인자($TGF-{\beta}$) 및 혈관 내피성장인자(VEGF) 등의 성장인자에서도 염색 조직의 결과와 유사하게 나타났다. 이러한 결과를 종합하여 볼때, 저분자화된 PDRN은 창상에 치료효과가 있다고 판단되며, 화장품 및 의료산업 분야의 기능성 소재로 활용 가능할 것으로 판단되어 진다.

• 폴리머
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• 제34권4호
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• pp.363-368
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• 2010

창상 회복에 있어 적절한 산성의 환경은 세균의 증식을 막을 뿐만 아니라 세포의 활성도를 증가시키고 섬유아 세포의 증식을 촉진시키며 배열을 고르게 유지하여 결국 성숙된 상피화를 가져오게 된다. 본 연구에서는 펙틴과 CMC 의 다양한 조성으로 이루어진 드레싱제를 이용하여 펙틴과 CMC의 조성비와 이에 따른 pH의 변화가 신선창상, 감염 창상 및 화상에 있어 창상치유속도, 상피화 정도 및 콜라겐 침착 등에 미치는 영향과 이의 새로운 드레싱 재료로서의 가 능성을 알아보기 위해 동물실험을 시행하였다. 실험 결과로부터 pH 4.67인 펙틴/CMC＝16/19 군이 급성창상의 창상 회복에 있어 창상의 수축률, 치유율 및 상피화율이 다른 군에 비해 높은 정도를 보여 가장 우수한 창상 치유 효과를 보임을 알 수 있었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.35-41
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• 2006

It is well known that concentration of C-reactive protein(CRP) in the serum increase as nonspecific reaction of the various tissue injury. The CRP, synthesized in the hepatocyte, is one of 'acute phase proteins' in the serum. The main signal patterns of this protein are regulated by synthesis of interleukin-I secreted from macrophage in the area of tissue injury. Many studies were performed for quantitative analysis for CRP according to various surgical operation, but the study for fracture patients associated with trauma, especially in mandible, are rare. The mandible fracture have intrinsic danger for infection in oral bacteria associated with open wound in oral cavity, and, are difficult for detection of tissue reaction between surgical swelling and infection by facial swelling. In this study, quantitative analysis for CRP associated tissue injury in mandibular fracture and surgical intervention was done, the results were as follows: 1. After initial mandibular trauma, the value of serum CRP diminished sequentially, most high value was presented in post-traumatic 2 days. 2. The CRP was diminished significantly 2 days after surgical intervention, and maintained normal value in 5 days after surgery. 3. The change of CRP are higher value in surgical intervention than initial trauma, it suggested that tissue injury from surgery was severe than trauma. 4. The high value of CRP was obtained in mandibular fracture combined soft tissue injury than no associated soft tissue injury. 5. In measurement of CRP according to surgical approach, highest serum value in patients of combined intra-oral and extra-oral approach was showed, and intra-oral approach, extra-oral approach, in sequential orders. 6. The CRP value are more higher in patient of 2 fracture site than only one fracture site. From the results obtained in this study, CRP has showed different values in mandibular fracture associated with severity of tissue injury and surgical intervention, and quantitative analysis of CRP value in serum can be applied to the clinical management of mandibular fracture.

• 대한치과의사협회지
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• 제47권9호
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• pp.585-595
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• 2009

Purpose : The aim of this study was to compare surgical complications between simple implant placement and implant placement combined with complicated surgical procedures. We also evaluated prosthetic complications according to the specific types of prosthesis. Material and Method : A retrospective analysis of dental chart of patients who was performed implant therapy during the period from June 2003 to December 2005 was carried out. This study was performed on 408 patients (208 male, 200 female). In addition, 1671 implants were performed. Based on their medical record and radiographs, the authors evaluated surgical and prosthetic complications, surgical procedures accompanied at the time of implant, risk factors of implant failure etc. Result : Surgical complications were developed on 358 implants(21.4% on total placed implants) and wound dehiscence was most prevalent complication. On maxillary posterior area, surgical complications developed more frequently on implants with major surgery and showed a significant difference. And complication rate of implants accompanied with GBR was higher than that of simple implants placement and also showed significant difference. The implant supported prosthesis showed no statistical difference in the occurrence of complications according to the types of prosthesis, and food retention was the most common post-prosthetic complication. Also we speculated that length and width of implant showed significant correlation to the failure of implant primary osseointegration. Conclusion : Based on the result, clinician should provide more careful maintenance for patients with implant placement accompanied by complicated surgical procedure. And periodic maintenance for the patient is requested for long-term survival of implant therapy.

• 대한족부족관절학회지
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• 제1권1호
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• pp.51-58
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• 1997

The purpose of this study is to evalute the efficacy af the Ilizarov external fixation for the surgical treatment. of the tibial plafond fractures. We reviewed retrospectively fourteen cases of tibial plafond fractures with moderate to severe soft. tissue damage, which were fixed with Ilizarov external fixator. Using the AO Muler classification, there were four Type C1 fractures, six Type C2 and four Type C3. In most, of the cases, the ankles were operated on with other associated fractures within a few days after injury. We reduced the fracture indirectly by soft issue taxis and fixed externally across the ankle joint. using the circular external fixator with tensioned wires and ankle hinge. In cases of inadequate closed reduction, we applied limited open reduction and internal fixation. Range of motion exercise began immediately. Postoperative follow-up averaged fourteen months (ranges, 8-30 months). Overall clinical results rated good or excellent in 7 cases, fair in 4 and poor in 3. There were three cases of pin tract infection which were resolved with short-term antibiotics and local care; one delayed wound closure in a patient. whose fracture was associated with Type III open wound; one wound slough in a patient associated with Type II open wound, which was closed later by skin graft; and one osteoarthritis. From this review, we concluded that cross-ankle circular external fixation with tensioned wires with or without. limited open reduction is a reasonable alternative for the treatment of the tibial plafond fractures with severe soft tissue damage.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권1호
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• pp.31-34
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• 2009

Purpose: This study compared the frequency of postoperative infections in patients for a closed mandibular fracture with that without the postoperative antibiotic prophylaxis. Patients and Methods: 48 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The 24 patients in group 1 received only a second-generation cephalosporin ($Cefotetan^{(R)}$) intravenously from admission to immediate after the surgery. Likewise, 24 patients in group 2 received 1.0g of $Cefotetan^{(R)}$ twice daily longer than the third day after surgery. The mean (SD) duration of antibiotics administration after surgery was 6.9 (${\pm}3.56$). The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. Results: Postoperative infections were encountered in 2 out of 24 patients in group 1, who received antibiotic medication until shortly after surgery, and in 3 out of the 24 patients in group 2, in whom the medication was continued even after the surgery. There was no sig nificant difference in the incidence of postoperative infections between the two groups. Conclusion: From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.293-308
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• 1996

Recently, dental laser have been applied for removal of soft tissues, hemostasis and blood coagulation, removal of benign and malignant tumor, treatment of leukoplakia, aphthous ulcer and herpetic lesion, implant second surgery, removal of granulation tissue, frenectomy, clinical crown lengthening, gingivectomy, gingivoplasty, and treatment of dentin hypersensitivity. Even though the frequency of laser treatment is increasing, the research on the healing process after gingivectomy using pulsed Nd : YAG laser is very rare. The purpose of this study was to observe and compare the wound healing after gingivectomy using scalpel and pulsed Nd : YAG laser in the rat. Gingivectomy was performed using pulsed Nd : YAG laser(SUNRISE Technologies, U.S.A., 1.5 Watts, 10 pps) on the buccal gingiva of right maxillary first molar and using scalpel(No.12) on the contralateral side. Those sites treated by surgical scalpel were designated as the control, and by pulsed Nd : YAG laser as the experimental group. Animals were sacrificed at 1, 2, 3, 5, 7, 11 and 14 days postoperatively, and specimens were histologically observed under light microscope. The results were as follows : 1. Clinical observation Normal color and shape were observed at the 5th day ill the control group and the 7th day in the experimental group. 2. Histologic findings 1) In the control group, denser inflammatory infiltration was observed. 2) Epithelialization started at the 2nd day in the control group, similar to the experimental group, and completed at the 11th to the 14th day postoperatively. 3) In the experimental group, connective tissue showed the vacuole formation and degenerative change during early healing period. Healing of connective tissue was slower in the experimental group than in the control group by 2 days. 4) In the both groups, wound healing was completed at the 2nd week. From this study, gingivectomy using pulsed Nd : YAG laser seems to result in a little delayed wound healing process, compared to the gingivectomy using scalpel. Considering the clinical advantages of laser surgery, pulsed Nd : YAG laser might be useful device for gingivectomy.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.308-312
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• 2017

Background Donor site seroma is the most common complication after latissimus dorsi (LD) flap harvest. This study aimed to evaluate the efficacy of negative-pressure wound therapy (NPWT) in preventing donor site seroma formation after the harvest of an LD flap for breast reconstruction. Methods In this prospective matched-pair study, 40 patients in whom an LD flap was harvested for breast reconstruction were enrolled. NPWT was used in 20 patients, and in a control group composed of another 20 patients, the conventional donor site dressing technique was used. Information was collected regarding postoperative complications, the incidence of seroma, total drainage volume, the number of percutaneous seroma aspirations, and the volume aspirated. Results In the NPWT group, the incidence of seroma formation after drain removal was significantly lower than in the control group (15% vs. 70%; odds ratio=0.07; relative risk, 0.24). Both the mean percutaneous aspirated volume (P =0.004) and the number of percutaneous aspirations (P=0.001) were also significantly lower in the NPWT group. There were no significant differences in the total drainage volume or the duration of wound drainage between the NPWT dressing group and the control group (P>0.05). Conclusions This study showed that NPWT is a promising tool for reducing the incidence of seroma formation after removing the drain at the donor site after LD flap harvesting. It is a simple and safe technique.

• 대한후두음성언어의학회지
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• 제20권1호
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• pp.36-41
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• 2009

Background and Objectives: Topical administration of mitomycin-C (MMC) has been reported to reduce or delay scar formation in airway surgery. However, it is not infrequent to experience recurrent stenosis or adhesion of operative wound even after a meticulous MMC application during the laryngeal surgery. Therefore we aimed to evaluate the effectiveness of repeated postoperative MMC applications and the technical feasibility of MMC applications to the laryngeal wound at an outpatient clinic. Methods: We reviewed medical records of 13 consecutive patients who received office-based MMC applications after laryngeal airway surgery at Samsung Medical Center, Seoul, Korea. The patients were grouped into 3 categories according to the site of surgical wound and the purpose of MMC application; group I : supraglottic stenosis (n=5), group II : cordectomy and arytenoidectomy site granulation prevention (n=3), Group III : laryngeal web prevention (n=5). Outcomes in each group and adverse effects of repeated MMC applications were evaluated. Results: Office-based MMC application was successfully performed one to four times with a week interval for each patient. No significant complications were observed except slightly decreased mucosal wave in one female patient who received 4 times of MMC application at the anterior commissure of vocal fold. Repeated MMC applications at the outpatient clinic resulted in wide or acceptable supraglottic airway in group I, clean wound healing without granulation formation in group II, and negligible or no web formation at the anterior commissure in group III. Conclusion : Office-based topical administration of MMC to the larynx was technically feasible. Postoperative repeated MMC applications were effective to reduce recurrent stenosis or adhesion of supraglottic structures, to prevent granuloma formation after laser arytenoidectomy and glottic web formation after anterior commissure resection.

• Archives of Plastic Surgery
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• 제45권1호
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• pp.62-68
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• 2018

Background Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Methods Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated $90^{\circ}$ cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. Results The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. Conclusions While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.