Purpose: The aim of this study was to analyze by age group the characteristics of patients with dog bite injuries, as well as determine which factors were associated with wound infections in those patients. Methods: We reviewed patients with dog bite injuries who presented to Gachon University Gil Medical Center in Incheon, Korea from January 1, 2014 to December 31, 2018. They were classified by age group: children (0-18 years), adults (19-59 years), or elderly (≥60 years). Event profiles, wound characteristics, and infections were compared across these age groups. Multivariable logistic regression was used to identify factors associated with wound infections. Results: Of the total 972 dog bite injuries, 272 (28.0%) were in children, 606 (62.3%) were in adults, and 94 (9.7%) were in the elderly. The median age was 30 years (interquartile range, 16-48 years) and the majority of patients (60.5%) were female. The most common place of injury was at home (73.8%) and indoors (77.0%). In children, the head and neck were the most frequent sites of injury (43%), while the most frequent site in adults and the elderly (50.8% and 59.6%, respectively) was the upper extremity. The odds ratio (OR) for wound infection was 3.997 (95% confidence interval [CI], 1.279-12.491; P=0.017) for head and neck injuries and 3.881 (95% CI, 1.488-10.122; P=0.006) for lower extremity injuries. The OR for wound infection was 4.769 (95% CI, 2.167-10.494; P<0.001) for significant injuries. Elderly patients had a higher risk for wound infection than other age groups (OR, 2.586; 95% CI, 1.221-5.475; P=0.013). Conclusions: When analyzing patients with dog bite injuries, differences across age groups were found, with the elderly at the highest risk for significant injury and wound infection. It is recommended that age-specific approaches and strategies be used to prevent dog bite wound infections.
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.
Advances in medical technology has enabled better management of complicated and chronic wounds. Negative-pressure wound therapy (NPWT) is a novel dressing technique that uses negative pressure to drain exudates and blood from wounds. NPWT increases local blood flow and promotes reduction of edema and wound healing and is suitable for a variety of wounds. It is associated with few adverse effects and shows excellent efficacy and cost-effectiveness. NPWT promotes rapid growth of granulation tissue and wound contraction; thus, it is more advantageous than general dressings as it reduces the size skin of grafts or flaps required for repair, and patients with chronic wounds can be treated as outpatients. We investigated the general usage and mechanism of NPWT, its clinical applications and adverse effects.
We reviewed 10 cases of traumatic diaphragmatic injuries at Soonchunhyang University Gumi Hospital from January 1990 through April 1993. seven patients were male and three patients were female. The age distribution was ranged from 25 to 79 years, predominant 4th decades occurred in male. The traumatic diaphragmatic injuries were due to blunt trauma in 9 cases (traffic accident 7 and crash injury 2) and penetrating wound in 1 case (stab wound). The common symptom were dyspnea (60%), chest pain and abdominal pain in order frequency. In the blunt trauma and crash injury, te rupture site was all located in the left(9 cases). In the penetrating wound, the rupture site was located in the right(1 case). The surgical repair of 10 cases were performed with transthoracic approach in 9 cases and thoracoabodominal approach in 1 case. The postoperative mortality was 10% (1/10). The cause of death was multiple organ failure with pulmonary edema.
The author used rabbits in order to examine the effect of Ga-As low power generating semiconductor laser on artificially produced injuries of experimental animals. Artificially produced injuries include surgical wound of 3mm length, 2mm depth in size on ventral skin surface of rabbit and buccal mucosa, and electrical injury formed on opposite side of skin and buccal mucosa by electrical cauterization of same length and depth, and chemical injury formed by FC(Formocresol) solution applied on the anterior dorsal part of tongue. And then, on the experimental group, Ga-As laser was irradiated beginning on the day after the wound formation and continued to irradiate every each other day for five minutes. After1, 3, 6, 9, 13th day, certain number of animals of control and experimental group were sacrified, and wound site tissue was excised to make samples and was observed under light microscope. The following is the conclusions after comparing the healing procedure of experimental and control group. The following results were obtained : 1. Inflammation was decreased more rapidly in the experimental group than the control group. 2. In the surgical, the electrical and the chemical injuries in the oral mucosa, re-epithelialization was completed more rapidly in the experimental group than the control group. In the electrical injury on the skin, re-epithelialization was completed about 6 days after wound formation on both groups. 3. In the electrical and the surgical injuries on the oral mucosa, granulation tissue formation started at 3 days after injury on both groups, but in the chemical injury, it was completed about 3 days faster in the control group than the experimental group. In the surgical wound on the skin, it was completed about 9 days after injury, but faster in the experimental group. In the electrical injury on the skin, it was faster in the control group than the experimental group. 4. In the electrical and the surgical injuries on the oral mucosa, fibrosis was started at 6~9 days after injury on both groups, but regeneration of connective tissue in the experimental group was observed much more than the control group. 5. When comparing the effect of wound healing on skin and oral mucosa of control and experimental group, granulation tissue formation and re-epithelialization in the oral mucosa was more vigorous. In conclusion, the difference of timing and the sequence of wound healing process(inflammation, re-epithelialization, granulation tissue formation, fibrosis) following Laser irradiation between control and experimental group was not observed, but the healing tissue was observed much more in the Laser irradiated group.
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.
The records of 25 patients with traumatic diaphragmatic injuries seen at Chosun University Hospital from February 1977 to May 1991 were reviewed. We treated 20 male and 5 female patients ranging in age from 6 to 72 years. The diaphragmatic injuries were due to blunt trauma in 19 cases[traffic accident 13, fall down 4, compression injury 2] and penetrating trauma in 6 cases[stab wound 5, gun shot 1]. Most common symptoms were dyspnea[72%], chest pain[56%] and abdominal pain [40%], Chest X-ray were normal in 7 cases[28%] and 22 cases[88%] were diagnosed or suspected as diaphragmatic injuries preoperatively. The repair of 25 cases were performed with thoracic approach in 16 cases, thoracoabdominal approach in 6 cases and abdominal approach in 3 cases. Postoperative complications included atelectasis, wound infection and empyema. there was no postoperative death.
Twelve cases of traumatic diaphragmatic injuries were treated at the Chosun University Hospital from Feb. 1977 to Inn. 1980. The following results were obtained. l. Sex ratio incidence was 5:1, which male patients were predominant. 2. The age distribution at these cases, were ranged from 16 to 43 years of age, and average age was 27 years. 3. Left sided traumatic diaphragmatic injuries were far more common than right, which approximately incidence of 5:1 diaphragmatic injuries were due to blunt trauma [7 cases-traffic accident, 1 case-fall down], and stab wound [4 cases] in etiology. 4. Surgical repairs were done through only thoracotomy incision in blunt trauma cases, and through each thoracic and abdominal incision same time in 2 cases of stab wound. 5. 2 cases {16.7%] of blunt trauma were died before operation at emergency room, and no man died during or following operation. An overall mortality was 16.7%.
Lee, Sang Bong;Kim, Jae Hun;Park, Chan Ik;Yeo, Kwang Hee
Journal of Trauma and Injury
/
v.28
no.3
/
pp.215-218
/
2015
Traumatic iliac vessel injuries constitute approximately 25% of all abdominal vascular injuries. Hospital mortality has been reported at 25~60% and is a result of uncontrolled hemorrhage and hypovolemic shock caused by extensive blood loss. We report the case of a 25-year-old female patient who experienced an external iliac artery injury caused by abdominal minimal stab wound. Traumatic iliac vessel injuries are life-threatening complication of abdominal or pelvic injuries and prompt diagnosis and accurate treatment are important.
Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971 to May 1974 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.[KTCS 1974;1:109-116] Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.
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