• Archives of Plastic Surgery
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• 제35권4호
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• pp.393-399
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• 2008

Purpose: Chronic infected wounds sustained over 4 weeks with exposed tendon or bone are difficult challenges to plastic surgeons. Vacuum assisted closure (VAC) device has been well used for the management of chronic wounds diminishing wound edema, reducing bacterial colonization, promoting formation of granulation tissue and local blood flow by negative pressure to wounds. But Commercial ready-made VAC device might have some difficulties to use because of its high expenses and heavy weight. So we modified traditional VAC device with silver dressing materials as topical therapeutic agents for control of superimposed bacterial wound infection such as MRSA, MRSE and peudomonas. Methods: We designed the modified VAC device using wall suction, 400 cc Hemovac and combined slow release silver dressing materials. We compared 5 consecutive patients' data treated by commercial ready-made VAC device(Group A) with 11 consecutive patients' data treated by modified VAC device combined with silver dressing materials(group B) from September 2004 to June 2007. Granulation tissue growth, wound discharge, wound culture and wound dressing expenses were compared between the two groups. Results: In comparison of results, no statistical differences were identified in reducing rate of wound size between group A and B. Wound discharge was significantly decreased in both groups. Modified VAC device with silver dressing materials showed advantages of convenience, cost effectiveness and bacterial reversion. Conclusion: In combination of modified VAC device and silver dressing materials, our results demonstrated the usefulness of managing chronic open wounds superimposed bacterial infection, cost effectiveness compared with traditional VAC device and improvement of patient mobility.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.359-368
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• 2011

Purpose: Aquacel Ag$^{(R)}$ is a hydrofiber wound dressing integrated with ionic silver. Sorbact$^{(R)}$ is a hydrophobiccoated dressing that uses the hydrophobic interaction with microbes. In this study, we compared the wound healing effects and the antibacterial effects of Medifoam$^{(R)}$, Betadine soaked, Aquacel Ag$^{(R)}$ and Sorbact$^{(R)}$ dressings against MRSA-infected wounds. Methods: Eighty rats were divided into four groups: Medifoam$^{(R)}$; Betadine soaked; Aquacel Ag$^{(R)}$; and Sorbact$^{(R)}$. A $1.5{\times}1.5cm$ square full-thickness wound was made on the dorsum of each rat and infected with MRSA. Twenty-four hours thereafter, each dressing was applied to the wound and changed every other day. One, 3, 7, 11 and 15 days after the wound infection, swab culture grade, wound bed appearance score, and wound defect size change were evaluated, and 7 and 15 days after, histologic evaluation was compared between the groups. Results: The bacteria load of wounds in the Sorbact$^{(R)}$ group decreased earlier than in the other groups. The wound bed appearance score of the Sorbact$^{(R)}$ group also increased quicker, compared with the other groups. However, the size of wounds of the Aquacel Ag$^{(R)}$ group decreased more rapidly, compared with other groups. From the histologic point of view, there was no significant difference between Betadine soaked, Aquacel Ag$^{(R)}$ and Sorbact groups. Conclusion: The hydrophobic dressing using Sorbact$^{(R)}$ showed a more rapid reduction in the MRSA load and an elevation in the wound bed appearance score, but a slower decrease in wound size change due to detachment of wound bed tissue when the dressing was eliminated in the low exudate wound. The silver-containing hydrofiber dressing using Aquacel Ag$^{(R)}$ was more effective in ultimate wound size reduction, but some debris was trapped in the wound tissue and induced foreign body reaction in the high exudate wound. Thus, ongoing selection process of treatment based on the evaluation of the infectious wound state will be very important.

• 한국심리학회지 : 문화 및 사회문제
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• 제18권4호
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• pp.505-532
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• 2012

이 연구는 청소년학생들의 정신건강에 영향을 주는 성장과정의 상처, 열등감, 성격장애 간 관계를 분석하고자 하였다. 최종 분석대상은 중·고교생 2,119명을 표집, 조사·수집된 자료를 분석했다. 차이분석, 중다회귀분석, 경로분석 결과, 성장과정의 상처, 열등감, 성격장애, 정신건강 요인 면에서 여학생들과 고등학생들이, 그리고 가정경제 환경이 곤란한 학생들과 학업성적 수준이 하위권 학생들이 상대적으로 문제가 있음이 의미 있게 밝혀졌다. 열등감에 영향을 주는 성장과정의 상처 요인은 행복감, 안정감, 인정감의 상처 순으로 유의미하게 영향을 주는 것으로 확인되었고, 성격장애에 영향을 미치는 성장과정의 상처 요인은 행복감, 안정감, 자신감, 사랑, 평등감의 상처 순으로 유의미하게 영향을 주는 것으로 밝혀졌다. 또한 정신건강에 유의미하게 영향을 주는 성장과정의 상처 요인은 행복감, 안정감, 자신감, 사랑, 평등감의 상처 순으로 밝혀졌다. 그리고 정신건강에 미치는 관련변인들의 영향력은 전반적으로 성장과정 상처의 직접효과보다 성격장애와 열등감을 통한 간접효과가 높게 나타났다. 이는 성장과정의 상처가 열등감과 성격장애로 이어지고 궁극적으로 정신건강으로 악화될 수 있다는 교육적 시사점과 함께 가정환경의 건강성과 교육적 성장환경의 중요성을 일깨워 준다.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.343-346
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• 2005

It has been established that a graft of fibroblasts is able to improve wound healing. However, there has been no research on the effect of a graft of bone marrow stromal cells on wound healing. The wound healing process requires cell proliferation and production of extracellular matrix and various growth factors. The purpose of this study was to compare the abilities of human fibroblasts and bone marrow stromal cells, which contains mesenchymal stem cells, to proliferate and to produce collagen. Human bone marrow stromal cells and fibroblasts were isolated from bone marrow and dermis of the same patients and grown in culture respectively. Cell proliferation and production of type I collagen by human bone marrow stromal cells and dermal fibroblasts were examined by MTT method and by ELISA of cell culture media on day 1, 3, and 5 days post-incubating. The human bone marrow stromal cells showed 11-17% higher cell proliferation than fibroblasts at each time interval. The levels of type I collagen in the human bone marrow stromal cell group was also significantly higher than those in the fibroblast group. The results indicate that the grafts of human bone marrow stromal cells can show more promising effect than that of fibroblasts for healing of chronic wounds.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2003년도 생물공학의 동향(XIII)
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• pp.356-358
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• 2003

각질형성세포의 배양법이 개발 후 피부 결손 부위의 치료에 인체 각질형성세포를 배양하여 얻어진 표피를 이식하거나 세포부유물을 도포하는 기존의 방법들은 trypsin 처리 과정을 거치면서 배양된 세포의 부착능력을 가진 단백질이 손상되어 성공적인 피부 재생이 불가능하다. 이 연구에서는 면역결핍 생쥐 모델에서 인간 피부 각질형성에포와 EGF-피브린 고분자 혼합물을 분사하여 피부의 전층 상처를 재생하였다. 조직학 검사와 면역화학검사를 통하여 각질형성세포와 EGF-피브린 고분자를 함께 분사한 경우 이식된 인간 표피세포에 의한 빠른 표피재생을 확인할 수 있었다. 이 피부 재생술은 기존의 배양된 인공피부 sheet의 이식을 이용한 피부재생법에 비해 여러 가지 장점을 가지고 있으므로, 앞으로 화상이나 피부궤양과 같은 피부결손의 효율적인 새로운 치료법으로 사용되어질 수 있을 것이다.

• Tissue Engineering and Regenerative Medicine
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• 제15권6호
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• pp.721-733
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• 2018

BACKGROUND: Because three-dimensional (3D) models more closely mimic native tissues, one of the goals of 3D in vitro tissue models is to aid in the development and toxicity screening of new drug therapies. In this study, a 3D skin wound healing model comprising of a collagen type I construct with fibrin-filled defects was developed. METHODS: Optical imaging was used to measure keratinocyte migration in the presence of fibroblasts over 7 days onto the fibrin-filled defects. Additionally, cell viability and growth of fibroblasts and keratinocytes was measured using the $alamarBlue^{(R)}$ assay and changes in the mechanical stiffness of the 3D construct was monitored using compressive indentation testing. RESULTS: Keratinocyte migration rate was significantly increased in the presence of fibroblasts with the cells reaching the center of the defect as early as day 3 in the co-culture constructs compared to day 7 for the control keratinocyte monoculture constructs. Additionally, constructs with the greatest rate of keratinocyte migration had reduced cell growth. When fibroblasts were cultured alone in the wound healing construct, there was a 1.3 to 3.4-fold increase in cell growth and a 1.2 to 1.4-fold increase in cell growth for keratinocyte monocultures. However, co-culture constructs exhibited no significant growth over 7 days. Finally, mechanical testing showed that fibroblasts and keratinocytes had varying effects on matrix stiffness with fibroblasts degrading the constructs while keratinocytes increased the construct's stiffness. CONCLUSION: This 3D in vitro wound healing model is a step towards developing a mimetic construct that recapitulates the complex microenvironment of healing wounds and could aid in the early studies of novel therapeutics that promote migration and proliferation of epithelial cells.

• Archives of Pharmacal Research
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• 제25권1호
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• pp.71-76
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• 2002

Ginseng has been used as a traditional medicine with various therapeutic effects. However, it is still unknown which component of this plant is effective at promoting wound healing. Recently, ginsenoside $Rb_2$ has been reported to improve wound healing. In this study, to investigate the reported wound healing effect of the ginsenoside $Rb_2$, cell morphology and protein factors involved in epidermal formation were evaluated by immunshemical and immunoblotting analysis. $Rb_2$ stimulated epidermal cell proliferation, and the cell showed a 1.5-fold increase in thymidine uptake compared to the control (p<0.05, n=3). Futheremore $Rb_2$, was found to stimulate epidermis formation in a dose-dependent manner in raft culture, and to dose dependently enhance the expressions of protein factors related to cell proliferation, namely, epidermal growth factor and its receptor, fibronectin and its receptor, keratin 5/14, and collagenase 1 (p<0.05, n=3~9). It is believed that ginsenoside $Rb_2$, enhances epidermal cell proliferation by upregulating the expressions of these proliferation-related factors.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.227-232
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• 2010

Purpose: Continuous irrigation method is an important step in managing wound infection. V.A.C. devices have been used in intractable wounds for reducing discharge, improving local blood flow, and promoting healthy granulation tissue. We expect synergistic effects of reduced infection and more satisfactory, accelerated wound healing when using both methods simultaneously. This study evaluated continuous irrigation combined with V.A.C. appliance for treatment of infected chronic wounds. Methods: We reviewed data from 17 patients with infected intractable chronic wounds. V.A.C. device (Group A) was used in 9 patients, and V.A.C. with antibiotics irrigation (Group B) was used in 8 patients. We placed Mepitel$^{(R)}$ on the surface of wound and placed an irrigation and aspiration tube on each side. A sponge was placed on the Mepitel$^{(R)}$ and covered with film dressing. The wound was irrigated continuously with mixed antibiotics solution at the speed of 200 cc/hr and aspirated through the wall suction at the pressure of -125 mmHg. V.A.C. applied time, wound culture and wound size were compared between the two groups. Results: No complication were seen in two groups. Compared with Group A, in the Group B, V.A.C. applied time was shortened from 32.7 days to 25.6 days and showed efficacy in the reduction rate of wound size. No statistical differences were shown in bacterial reversion. Conclusion: V.A.C. appliance with continuous irrigation is an effective new method of managing infected chronic wounds and useful to reduce treatment duration and decrease wound size. Moreover it could be applied more widely to infected wound.

• 한방안이비인후피부과학회지
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• 제2권1호
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• pp.17-31
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• 1989

This study was under taken to investigate the healing of Sa Gun Ja Tang extract (SE) and Sa Gun Ja Tang added Radix Astragali extract (SHE) on the artificial wound on rabbit skin. The granulation tissues were observed by microscope at the five day interval for twenty days. In order to understand the healing mechanism chick embryo culture was carried out in the presence of the extracts and the growth ratio and fusion index were counted. The results obtained were as follows: 1. The healing power of SE treated group on wound was more significant than the control group. 2. The healing power on wound was more effective at the SHE than the SE. 3. The growth ratio and fusion index were higher at the SHE treated groups than the SE treated groups. From the above result, SHE was more effective than the SE on wound healing activity by the mechanism of stimulating the cell growth ratio and fusion index.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.632-636
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• 2006

Purpose: Methicillin-Resistant-Staphylococcus aureus(MRSA) has been increasingly recognized as a cause of nosocomial infection. MRSA is hardly-controllable organism among the pathogen of nosocomial infection, because it is resistant to most antibiotics except vancomycin, and local treatment with most antiseptics are not effective to eradicate MRSA from the infection. The effectiveness of Vacuum-Assisted-Closure(VAC) was reported widely. we tried to modify original VAC. We tried VAC dressing on MRSA infected wound to evaluate whether or not the VAC is effective to eradicate MRSA which existed in the open wound. Methods: From September 2003 to December 2003, 24 patients admitted to the plastic and reconstructive surgery and orthopedic surgery, were studied. All patients were found to be positive in previous wound. Using clinical randomized study, 24 patients were divided into two groups: VAC dressing group and the $Betadine^{(R)}$ dressing group(control). During treatment, wound culture was done twice a week for evaluation of MRSA infection elimination. Results: The mean period that MRSA become not detected in all case was 17.1 days in VAC dressing group, and 25.8 days in control group, respectively. The p value was 0.013. The result reveals that the VAC dressing group is more effective to MRSA infection control. As a result, the VAC dressing was more effective in MRSA infected wound than conventional dressing. Conclusion: Through this study, we found objective result of VAC dressing. We hope that VAC dressing is more widely applied to fresh and infected wound.