• 제목/요약/키워드: Wound and injuries

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Biomechanics of stabbing knife attack for trauma surgeons in Korea: a narrative review

  • Kun Hwang;Chan Yong Park
    • Journal of Trauma and Injury
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    • 제37권1호
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    • pp.1-5
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    • 2024
  • The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.

인후두의 개방적 외상에 대한 수술적 고찰 (A Surgical Idea for Wide Communicated Wound on Laryngopharynx)

  • 이종원;국태진;이정헌;염시경
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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    • pp.7.4-8
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    • 1982
  • 오늘 날, 물질 문명이 고도로 발달함에 따라 인두 및 인두 손상이 날로 증가하는 경향을 보이고 있다. 교통 사고나 운동 경기는 폐쇄적 외상을 일으키기 쉽고 빈도는 적지만 심각한 증상을 초래하는 개방적 외상의 원인으로는 총상이나 자상 등을 들 수 있다. 인후두의 개방적 외상에서 가장 문제가 되는 것은 적절한 치료에 있다. 이 부위의 외상은 손상의 정도나 범위에 따라 차이는 있지만 신속한 처치가 요구되고 협착이나 누출 등과 같은 심각한 후유증을 남기기 때문에 적절한 치료 방법이 요구되는 것이다. 일반적으로 이에 대한 치료는 적절한 기도 유지를 위한 기관절개술과 단순 봉합등을 일차적으로 시행하고 차후에 후유증에 대한 이차 수술을 시행하는 것이 보통이다. 최근, 저자들은 자상으로 인해 인두 뿐만 아니라 인두까지 광범위한 개방적 외상을 입고 이차 감염까지 일으켜 인후두 조직 및 전경부 피부의 심한 결손을 보인 환자에게 잔여 후두 적출술을 시행한 후 피부봉이나 육경피부변을 사용하지 않고 전경부 피부변을 이용해서 피부 결손부를 얻었기에 문헌적 고찰과 함께 보고하는 바이다.

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흉부외상의 임상적 고찰 (Clinical Evaluation of Chest Trauma - Analysis for 97 cases -)

  • 정원상
    • Journal of Chest Surgery
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    • 제21권2호
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    • pp.307-315
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    • 1988
  • A clinical analysis was performed on 97 cases of chest injuries experienced at Department of Thoracic and cardiovascular Surgery, Armed Forces Capital Hospital during 2 years period from 1986 to 1988. Of 97 patients of chest trauma, 39 cases were result from penetrating injuries whereas 58 cases were from non-penetrating injuries, and there were 77 cases of hemothorax and / or pneumothorax, 47 of rib fracture, 8 of foreign body, 6 scapular and clavicle fracture, 5 of diaphragmatic injuries, 4 of paraplegia. The majority of chest injuries were encounted in the age group between 21 and 30 years-old, mean age was 25.9 years-old and all cases were male except one. Gun-shot wound was the most common cause in the penetrating injuries and the majority of non-penetrating chest injury patients were traffic accident and fist or kick accounted for next. The principles of therapy for chest trauma were rapid expansion of the lung by closed thoracostomy[45 cases] and thoracentesis only[3 cases] but thoracotomy done at 27 cases because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic injury and bronchial rupture. The over-all mortality was 2.07 percent[2 cases among all], a case was from penetrating injuries and another was from non-penetrating injuries.

Outcomes of grafted skin on the dorsum of the foot after car-tire friction injuries

  • Kim, Shin Hyun;Lee, Won Jai
    • Archives of Plastic Surgery
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    • 제48권6호
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    • pp.678-684
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    • 2021
  • Background A car-tire friction injury on the dorsum of a child's foot often results in hypertrophic scarring of the wound margins. This study describes the clinical appearance of the injured areas and surgical complications that occurred during the follow-up period in a series of children with car-tire friction injuries who were treated with split-thickness skin grafts (STSGs). We describe the clinical features that we believe need to be highlighted when initially treating car-tire injuries in children. Methods From May 2003 to June 2016, our retrospective study included 15 patients with car-tire injuries on the dorsum of the foot who were treated with surgical excision and STSG to cover the wound. Results A total of 15 patients with car-tire injuries were treated. The average age was 6.26 years old. The average injury grade was 3.26. Two patients were treated using delayed repair, and 13 patients received STSG for initial management. Four patients experienced no complications, while 11 patients had hypertrophic scars and/or scar contracture after surgery. Conclusions A car-tire friction injury on the dorsum of a child's foot often results in hypertrophic scar formation or scar contracture even if proper management is undertaken. Since the occurrence of these complications in childhood can lead to a secondary deformity, it is important to properly treat car-tire friction wounds, inform patients and caregivers about potential complications, and ensure regular follow-up evaluations over a 12-month period following the initial surgery.

하공정맥 손상의 치험 1례 (An Experience of Inferior Vena Caval Ligation in Traumatic Injury)

  • 이성행
    • Journal of Chest Surgery
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    • 제6권2호
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    • pp.209-212
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    • 1973
  • Because of the. rise in the incidence of high speed automobile accident and various gun shot wound, complicated vascular injuries are becoming more frequent. Inferior vena caval injury seems to be also in high incidence, but reports in the literature were rare. because of potentially lethal. Recently we have experienced a case of inferior vena caval injury due to stab wound on the posterior aspect of the right abdomen. This was successfully treated with inferior caval ligation on the both, proximal and distal of the injured infrarenal vena cava.

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A Skin Fixation Method for Decreasing the Influence of Wound Contraction on Wound Healing in a Rat Model

  • Bae, Seong Hwan;Bae, Yong Chan;Nam, Su Bong;Choi, Soo Jong
    • Archives of Plastic Surgery
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    • 제39권5호
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    • pp.457-462
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    • 2012
  • Background The elasticity of the back skin of the rat reduced the tension around wounds during the wound healing process in that region, and thus activates wound contraction. The authors proposed two skin fixation methods using readily available materials to decrease the influence of wound contraction on wound healing and designed an experiment to determine their effects. Methods The authors made 36 skin wounds on the backs of 18 rats, and they divided them into three groups. Each group was treated with three different kinds of dressing materials, each with different skin fixing characteristics. Group A was a control group. Group B and group C were dressed by the first and the second skin fixation method. We measured the areas of the wounds post-surgically and calculated the wound area reduction rates. Results The two skin fixation methods both reduced the effect of wound contraction compared to the control group. Each of the two methods had different outcomes in reducing wound contraction. Conclusions The experiment demonstrated significant differences among the wound areas and the wound area reduction rates of the three groups as a result of differences in the degree of wound contraction. To obtain accurate results from wound healing experiments, appropriate skin fixation methods must be adopted.

Renal embolization for trauma: a narrative review

  • Peter Lee;Simon Roh
    • Journal of Trauma and Injury
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    • 제37권3호
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    • pp.171-181
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    • 2024
  • Renal injuries commonly occur in association with blunt trauma, especially in the setting of motor vehicle accidents. Contrast-enhanced computed tomography is considered the gold-standard imaging modality to assess patients for renal injuries in the setting of blunt and penetrating trauma, and to help classify injuries based on the American Association for the Surgery of Trauma injury scoring scale. The management of renal trauma has evolved in the past several decades, with a notable shift towards a more conservative, nonoperative approach. Advancements in imaging and interventional radiological techniques have enabled diagnostic angiography with angiographic catheter-directed embolization to become a viable option, making it possible to avoid surgical interventions that pose an increased risk of nephrectomy. This review describes the current management of renal trauma, with an emphasis on renal artery embolization techniques.

외상성 횡경막 손상 13례 보고 (Traumatic diaphragmatic injuries: report of 13 cases)

  • 조규석
    • Journal of Chest Surgery
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    • 제16권2호
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    • pp.255-259
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    • 1983
  • Thirteen cases of traumatic diaphragmatic injuries treated at the Dept. of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital from Jan. 1973 to Dec. 1982, were reviewed in this study. 1. Of 13 cues, 11 were male and 2 were female, a ratio of 5.5:1. This ratio revealed high incidence in male patients. The age distribution was ranged from 2 to 59 years. 2. The causes of traumatic diaphragmatic injuries; 6 were traffic accidents, 4 were stab wounds, 1 was falling down, 1 was gun shot wound and 1 was kick. 3. Operation were performed in 11 patients. No operation was done in 2 patients. 4. There were 100% of other associated injuries, the most frequent was having hemothorax. 5. 2 cases of death occurred in not operated patients. One was intracranial hematoma, and the other was hypertensive encephalopathy.

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Nonfatal injuries in Korean children and adolescents, 2007-2018

  • Yeon, Gyu Min;Hong, Yoo Rha;Kong, Seom Gim
    • Clinical and Experimental Pediatrics
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    • 제65권4호
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    • pp.194-200
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    • 2022
  • Background: Injury is the leading cause of death or disability in children and adolescents. Rates of deaths from injuries have recently declined, but studies of the occurrence of nonfatal injuries are lacking. Purpose: This study aimed to investigate nonfatal injuries in children and adolescents younger than 20 years based on data from the Korean National Health and Nutrition Survey, 2007-2018. Methods: A questionnaire survey was conducted to determine whether children and adolescents had experienced an injury requiring a hospital visit in the previous year. We investigated each injury's risk factors and characteristics. Results: Of a total of 21,598 children and adolescents, 1,748 (weighted percentage, 8.1%) experienced one or more injuries in the previous year. There was no yearly difference in the proportion of injuries experienced. Among the male subjects, 10.0% had an injury experience; among the female participants, 6.1% had an injury experience (P<0.001). The highest rate was 9.0% in children aged 1-4 years. In multivariate logistic regression analysis, male sex; having an urban residence; having restricted activity due to visual, hearing, or developmental impairment; and attention deficit/hyperactivity disorder were significant risk factors for injury experience. The characteristics of up to 3 injuries per patient were investigated, and 1,951 injuries were analyzed. Falls and slips accounted for 34.9%, collisions for 34.1%, and motor vehicle accidents for 11.3% of the total injuries. Ninety-six percent of injuries were unintentional, 20% caused school absences, and 10% required hospitalization. Conclusion: Among Korean children and adolescents, 8.1% experienced injuries at least once a year with no significant differences in incidence over the past 12 years. Greater attention and effort to prevent injuries are needed.

Massive traumatic abdominal wall hernia in pediatric multitrauma in Australia: a case report

  • Sarah Douglas-Seidl;Camille Wu
    • Journal of Trauma and Injury
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    • 제36권4호
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    • pp.447-450
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    • 2023
  • Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.