• 제목/요약/키워드: Surgical patient

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A simple technique to fabricate a surgical obturator restoring the defect in original anatomical form

  • Shambharkar, Vaibhao I.;Puri, Santosh B.;Patil, Pravinkumar G.
    • The Journal of Advanced Prosthodontics
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    • 제3권2호
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    • pp.106-109
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    • 2011
  • Oral cancer treatment involves the surgical removal of all or part of the maxilla, leaving the patient with a defect that compromises the integrity and function of the oral cavity. The postoperative restoration of esthetics, deglutition, and speech shortens recovery time in the hospital and expedites the patient's return to the community as a functioning member. The surgical obturator is the proven treatment option in such situations. This article describes a simple technique to fabricate a surgical obturator that restores patient's original dentition and facial and palatal tissue form. The obturator fabricated with this technique utilizes the vacuum formed index of patient's original tissue form and duplicated partly in heat and partly in auto polymerizing acrylic resin. Duplication of the original tissue form helps patient to minimize the immense physiological trauma immediately after the surgical resection. The obturator fabricated with this technique supports soft tissues after surgery and minimizes scar contracture and disfigurement, and thus may have a positive effect on the patients' psychology.

Experiences of Emergency Surgical Treatment for a COVID-19 Patient with Severe Traumatic Brain Injury at a Regional Trauma Center: A Case Report

  • Yun, Jung-Ho
    • Journal of Trauma and Injury
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    • 제34권3호
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    • pp.212-217
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    • 2021
  • Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

Total joint reconstruction using computer-assisted surgery with stock prostheses for a patient with bilateral TMJ ankylosis

  • Rhee, Seung-Hyun;Baek, Seung-Hak;Park, Sang-Hun;Kim, Jong-Cheol;Jeong, Chun-Gi;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.41.1-41.6
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    • 2019
  • Backgrounds: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion: For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

위해사건 예방을 위한 수술 환자 교육용 스마트폰 애플리케이션의 효과 (The Effects of Smartphone Application to Educate Patient on Patient Safety in Hospitalized Surgical Patients)

  • 최효진;이은주
    • 성인간호학회지
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    • 제29권2호
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    • pp.154-165
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    • 2017
  • Purpose: This study was designed to evaluate a patient safety application in the prevention of adverse event among surgical patients. Seventy three surgical patients with thirty six of them using the patient safety application and the rest (N=37) were provided educational booklet. Further, the instrument would measure patients' right to know, knowledge about patient safety, and attitude toward patient safety. Methods: The patient safety application was developed by the ADDIE along with input from experts, patients and an extensive literature review. Data were collected from 7 September through 20 October 2015. Results: The experimental group had significantly higher scores in patients' right to know (t=2.01, p=.024), knowledge on patient safety (t=3.80, p<.001) and attitude toward patient safety (t=2.74, p=.004) than those of the control group. Conclusion: The patient safety application developed using Smartphone could be an effective tool enhancing patient involvement in preventing adverse events that may occur to patients. Further studies are recommended with diverse subjects with varying medical conditions.

Surgical Thrombectomy for Extensive Cerebral Venous Sinus Thrombosis after COVID-19 Vaccination : A Novel Surgical Technique and Literature Review

  • Yuwhan Chung;Jiwook Ryu;Seok Keun Choi
    • Journal of Korean Neurosurgical Society
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    • 제67권5호
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    • pp.578-585
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    • 2024
  • Surgical treatment of refractory and extensive cerebral venous sinus thrombosis (CVST) has limited applications. Here, we describe an open, direct sinus thrombectomy in the early phase of extensive CVST. A 49-year-old man with extensive CVST that occurred after the coronavirus disease 2019 (COVID-19) vaccination and affected the drainage of the Labbé vein presented with clinical deterioration and left temporal hemorrhagic infarction. Since the patient had extensive CVST, we determined that systemic anticoagulation and endovascular treatment were not suitable treatment options. Therefore, we decided on an emergency surgical treatment and performed direct surgical thrombectomy. We followed extended suboccipital approach and made multiple incisions on the sinuses, exposing the posterior superior sagittal sinus to the transverse sigmoid junction. Consequently, the clinical condition of the patient dramatically improved, resulting in a favorable outcome with a modified Rankin scale score of 0. Performing emergency open surgical thrombectomy was a technically feasible treatment option that recanalize obstructed sinuses. Importantly, the patient recovered with a good clinical outcome. Early maximal surgical thrombectomy can be an effective and lifesaving method to treat extensive CVST with hemorrhagic infarction.

Surgical Extraction in Patient with McCune-Albright Syndrome: A Case Report

  • Dohee Kim;Jeong Joon Han;Hoon Myoung
    • Journal of Korean Dental Science
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    • 제16권1호
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    • pp.99-103
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    • 2023
  • McCune-Albright syndrome (MAS) is a disease with clinical features such as fibrous dysplasia in which normal bone tissue is replaced with abnormal fibrous tissue, abnormalities in the endocrine system, and cafe-au-lait spots on the skin. Although MAS patients are generally known to have reduced bone healing ability, postoperative healing after invasive surgical extraction is still not clearly known due to its relatively rare occurrence. In this report, a 25-year-old female patient, who had been diagnosed with MAS and had a history of abnormal bone healing after fractures of her extremities, underwent surgical extraction of the mandibular third molar with surrounding bone removal. Postoperatively, the patient showed favorable soft tissue and bone healing at the surgical site without abnormal findings such as newly developed fibro-osseous lesions, postoperative infection, or osteomyelitis.

천성 식도-기관지루의 외과적 교정 1례 (Surgical Repair of Acquired Esophagobronchial Fistula - Report of one case -)

  • 병순후
    • Journal of Chest Surgery
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    • 제21권3호
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    • pp.526-530
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    • 1988
  • Acquired communicated fistula between the esophagus and respiratory system are infrequent and they are caused by carcinoma, trauma, infection and traction. This report reviews the feature of acquired esophagobronchial fistula[that developed spontaneously]. Patient is 34 year old man with excellent result by surgical intervention. The surgical procedures consist of division and repair of the fistula. Clinically and radiologically, the patient is free from coughing after drinking, substernal distress, esophagorespiratory fistula, and esophageal stricture after surgical treatment.

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Surgical Complications Affecting the Early and Late Survival Rates after Lung Transplantation

  • Suh, Jee Won
    • Journal of Chest Surgery
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    • 제55권4호
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    • pp.332-337
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    • 2022
  • Since the first lung transplantation in humans was performed in 1963, patient selection, standardized procurement, and surgical techniques have been developed and established for this procedure. However, despite these developments, surgical complications continue to be important factors influencing patient morbidity and mortality, and efforts should be made to decrease morbidity and improve survival rates by understanding, rapidly detecting, and appropriately treating surgical complications.

일반외과 환자의 환자위험지수에 따른 수술창상감염 발생률 (Surgical Site Infection Rates according to Patient Risk Index after General Surgery)

  • 이혜령
    • 한국직업건강간호학회지
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    • 제11권1호
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    • pp.44-51
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    • 2002
  • Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

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수정체적출술과 편도절제술에 대한 통원수술과 입원수술의 진료비 및 만족도 비교 (Comparison of Hospital Charges and Patient's Satisfaction between Ambulatory Surgical Procedures and Inpatient Surgery in Vitrectomy and Tonsillectomy Patients)

  • 서재명;유승흠
    • 한국병원경영학회지
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    • 제4권2호
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    • pp.41-59
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    • 1999
  • Objectives: This study was done to compare patient satisfaction and hospital charges of surgery performed in an outpatient basis(ambulatory surgical procedures). Methods : This retrospective study was performed in 20(vitrectomy 11, tonsillectomy 9) randomly selected ambulatory surgical procedures patients and 50(vitrectomy 26, tonsillectomy 24) inpatients who. received the same procedure at a general hospital in Seoul since January 1, 1998 to October 31, 1998. The operative procedures were vitrectomy and tonsilletomy which could be performed on a ambulatory surgical procedures basis or on an inpatient basis. Results: The results of this study shows that the patients thought the expenses and the surgical operative time was an important factor in a ambulatory surgical procedures but there were no differences in the patient satisfaction by the method of surgery. The charges of vitrectomy and tonsilletomy were reduced up to 495,000 won and 380,000 won from l,589,000 won 842,000 won inpatient surgery respectively. Conclusions: This study focused only on the charges of the surgical procedures and did not include the cost of patient helper, the lost salary due to missing days of work to care for a member of the family, transportation costs, and other indirect costs. Therefore, if those fees were included, ambulatory surgical procedures would be more economical. Therefore, by giving incentives at the fee schedule, the government health policies it would reduce the total hospital charges.

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