• Archives of Plastic Surgery
• /
• v.37 no.2
• /
• pp.199-201
• /
• 2010

Purpose: Except for continuous suture in skin layer, stitching out in facial laceration, we have to hold each knots up and cut the knots by No. 11 blade or small scissors. However, we often have difficulty in stitching out the knots on children who do not cooperate well. Therefore we introduce an easy and fast stitch out method of pediatric lacerations. Methods: From January to May 2009, we studied 15 pediatric patients (mean age 5.6 years old) who had facial laceration on face or underwent any surgery on operation room. For easy stitch out, we left the one string of the first knot long enough to extend at the opposite end of laceration site. And then the extended string was fixed to skin using Steri-strip. Next we do simple interrupted suture including the extended traction nylon string inside the knot. Through this method, we can stitch out all knots simply by lifting up the traction nylon needless to hold the each knot one by one. Results: Until stitching out, the traction nylon was just right position and there was no normal tissue injury during stitch out all knots. Patients were satisfied with the short stitch out time. Conclusion: By using the traction nylon on pediatric laceration suture, we can stitch out all the knots with no normal tissue injury in less time.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.13 no.1
• /
• pp.237-252
• /
• 2000

Pressure sore is an area of ulceration and necrosis of the skin and underlying tissues usually occuring over the bony prominences of the body after prolonged or often repeated pressure. We reviewed and summarized the published articles and treatise on the treatment of pressure sore. The results were as follows : 1. Pressure sore occur due to prolonged or often repeated pressure. So it is better than decubitus ulcer that is called pressure sore. 2. The most common lesions of pressure sore are sacrum, ischial tuberosity, greater trochanter. 3. The cause of pressure sore are change of comprehension. urine, moisture, change of the ability of activity and exercise, shearing force. 4. The elements to influence on wound healing are collagen accumulation velocity, nutrition condition, Vitamine C, copper, iron. oxygen pressure, steroids, cell-toxic drug, radiation. 5. Non-operative treatments are managements of skin such as avoiding consistant pressure, dressing, preventing moisture, understanding patient and protecter, preventing spasm, improvement of systemic nutrition condition. 6. Operative treatements are debridement, suture, skin transplantation, muscle flap and musculaocutaneous flap surgery. Recently V-${\Gammer}$ advancement surgery in use of muscle and musculocutaneous flap is generally maded. 7. Complications of post-operation are wound rupture, infection, disappearance of transmitted skin, necrosis of flaps.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.2
• /
• pp.189-195
• /
• 2010

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal & gastric aspiration and hypovolemic shock. Therefore, the rapid & correct bleeding control is very important for life-saving in the medical emergency room. In spite of the bleeding control methods of the wound suture & direct pressure, the postoperative bleeding can be occurred, because of the presence of various bleeding disorders & postoperative delayed wound infections. The proper care of bleeding disorders & wound infections are very important for the control of the delayed postoperative rebleeding. In spite of these methods, active oral bleeding can be presented by the other causes of head injury. A rare but particularly dangerous sort of bleeding that may have an especial importance to the patient with severe basal skull fracture that damage large vessels and even the cavernous sinus. The occurrence of profuse nasal or oropharyngeal bleeding may arise from damage to the anterior and posterior ethmoidal vessels, but when mixed with brain tissue it is evidence of mortal damage. In this condition, rapid entire oropharyngeal packing is essential for the control of active oral bleeding. This is a case report of rapid rational bleeding control method by much amount of wet gauze packings, in a 44-years-old male patient with active oropharyngeal bleeding by basal skull fractures.

• Journal of Periodontal and Implant Science
• /
• v.34 no.4
• /
• pp.711-722
• /
• 2004

The purpose of this study is to evaluate the regenerated bone histollogically using titanium reinforced ePTFE(TR-ePTFE) membrane and to investigate cell occlusiveness, wound stabilization and tissue integration of TR-ePTFE membrane. Adult male rabbits (mean BW 2kg) and TR9W (W.L.Gore&Associate.INC,USA) were used in this study. Intramarrow penetration defects were surgically created with round carbide bur(HP long #6) on calvaria of rabbits. TR-ePTFE membrane was applied to defect. Then guided bone regeneration was carried out using TR-ePTFE membrane and resorbable suture. At 2,4,8,12 weeks after the surgery, animals were sacrificed. Nondecalcified specimens were processed for histologic analysis. The result and conclusion of this study were as follows: 1. TR-ePTFE membrane had good ability of biocompatibility and cell occlusiveness. 2. space making for guided bone regenerayion was good at TR-ePTFE membrane. 3. Tissue integration was not good at TR-ePTFE membrane. So, wound stabilization was not good. 4. At 8 weeks, 12 weeks after GBR procedure, bone formation was seen. From the above results, TR-ePTFE membrane fixed tightiy on alveolar bone might be recommended for the early bone formation.

• Archives of Craniofacial Surgery
• /
• v.13 no.1
• /
• pp.46-49
• /
• 2012

Purpose: The forehead flap is the workhorse in nasal reconstruction, which provides a similar skin color, texture, structure, and reliability. There are some disadvantages, including donor site morbidities, 2- or 3-stage operations, and postoperative management after initial flap transfer. Furthermore, there has been little attention to the exposed raw surface wound, after the first stage of an operation. This article describes the authors' modification to overcome this problem, using artificial collagen membrane. Methods: An Artificial collagen membrane is composed of an outer silicone membrane and an inner collagen layer. After a forehead flap elevation, the expected raw surface was covered by an artificial collagen membrane with 5-0 nylon suture. A simple dressing, which had been applied to the site, was changed every 2 or 3 days in an outpatient unit. At 3 weeks postprocedure, a second stage operation was performed. Results: With biosynthetic protection of the raw surface, there were no wound problems, such as infection or flap loss. Thus, the patient was satisfied due to an effortless management of the wound and a reduction in pain. Conclusion: The application of an artificial collagen membrane to the raw under-surface of the flap could be a comfortable and a protective choice for this procedure.

• Journal of Korean Critical Care Nursing
• /
• v.15 no.3
• /
• pp.75-87
• /
• 2022

Purpose : This retrospective investigation study aimed to determine the predictive validity of superficial surgical site infection assessment tools by measuring the risk score at the surgical site. Methods : This study included patients hospitalized to the general surgery department of a Hospital from January 2021 to December 31, 2021. The inclusion criteria were age ≥19 years, general abdominal surgery under general anesthesia, and hospital stay longer than 2 days. Patients who had undergone transplantation were excluded. Results : Tool validity results showed that tools including surgical time and operative procedure were more accurate than previously developed tools, with a sensitivity of 71.1%, specificity of 71.4%, positive prediction of 12.3%, negative prediction of 97.8%, and area under the curve of 0.743 (95% confidence interval, 0.678~0.745). The tool's cut-off score was 15, and the risks of infection was increased by 6.14 times at or above this cut-off point. Preoperative hair removal period, surgical wound classification, surgery time, body temperature on the second day after surgery, drainage tube type, and suture type affected the risk of infection at the surgical site. Conclusion : The incidence of healthcare-associated infections has been declining in the past decade; however, surgical site infections still account for a considerable proportion. Therefore, early identification of high-risk groups for surgical site infection is crucial for reducing the incidence of surgical site infection using appropriate management.

• Korean Journal of Head & Neck Oncology
• /
• v.11 no.1
• /
• pp.41-46
• /
• 1995

The pectoralis major myocutaneous flap represents a major contribution to head and neck cancer reconstruction. Its advantages are improved viability, one-stage reconstruction, and carotid protection. The oropharyngeal defect especially tonsillar area reveals valley shaped one with loss of a wide mucosal area. Using pectoralis major myocutaneous flap to this defect is sometimes difficult due to its natural figure of bulkiness. This article reviews our experience with patients undergoing 14 pectoralis major myocutaneous flap in carcinoma of the tonsillar area. Complications and their incidences were I total loss, 3 marginal loss, 2 minor seperation of suture, I wound infection and 2 hematoma. Most of the complications did not require a second procedure for reconstruction. Bulkiness of the flap and gravity force to the upper suture line were thought to be causes of the complications. Modification of the flap design with bilobular figure was useful to reduce its bulkiness at the folding area. More stable suture around hard palate was needed to overcome seperation of the suture.

• Journal of Chest Surgery
• /
• v.21 no.6
• /
• pp.990-995
• /
• 1988

Seventeen cases of vascular injuries treated in Chungnam National University Hospital during the period from Apr. 1980 to Sep. 1988 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries. Of the 11 arterial injuries, 3 were femoral artery which was the commonest in frequency, the next was 2 cases of subclavian, common carotid, iliac artery. Of the 10 venous injuries, the subclavian vein and internal jugular vein were common in frequency. The most frequent type of injuries was laceration[13 cases in 21]. Vascular reconstruction was done by lateral suture repair in 8 cases, autogenous vein graft in 2, prosthetic vascular graft in 5, direct anastomosis in 1 case. Simple ligation was done in 5 cases. There was 1 case of visual field defect as a sequelae in right common carotid artery transaction and 1 case of mortality.

• Journal of Chest Surgery
• /
• v.23 no.2
• /
• pp.309-315
• /
• 1990

The introduction of end-to-end anastomosis stapler [EEA stapler] into esophageal surgery has reduced the mortality and morbidity associated with esophageal resection mainly owing to a reduction in the incidence of accidence of anastomotic leak. We now report the results of the 37 patients undergoing esophagectomy or esophagogastrectomy with EEA stapler in the department of cardiothoracic Surgery, Kosin Medical Center No leakage was demonstrated in the 37 esophagogastric anastomotic sites, but dehiscence of the TA stapled gastrotomy suture line occurred in two patient One patient was recovered with conservative treatment but the other patient was died due to hepatic metastasis of esophageal carcinoma during conservative treatment. And one severe esophagogastric anastomotic stricture was developed at the 30th postoperative day, but improved after dilatation with balloon dilatation catheter of Swiss Med. Tech. Company. The other complications were postoperative pneumonia[1 case], wound disruption and infection[3 cases], but all of 4 patients were recovered with conservative treatment. We experienced relative good postoperative results with use of EEA stapler in esophageal surgery. On the basis of our experience, we believe that the EEA stapler has definite place in esophageal surgery.

• Archives of Plastic Surgery
• /
• v.36 no.3
• /
• pp.327-332
• /
• 2009

Purpose: Several methods of the nipple reduction have been reported. However, the methods described previously are difficult or have some demerits. This study proposes a simple technique for reduction of the nipple height as well as diameter. Methods: The purposed nipple height is marked. A pentahedral design of excision was marked around the nipple. Local anesthetic solution was infiltrated and a 4 - 0 Nylon traction suture was applied at the nipple apex. Excision of the nipple inside both two triangles and a rectangle was made. Remaining two flaps were approximated using 5 - 0 Nylon simple interrupted sutures. However, a part of wound closure was not done in the central area of the nipple. Results: 83 patients(166 nipples) underwent this procedure from December 1999 to December 2008. Follow up ranged from 6 months to 2 years with a mean of 10 months. 78 patients were female and 5 patients were male. No major complication occurred and remaining scars were very inconspicuous. Conclusion: This simple technique has the advantage of nipple reduction in both height and diameter, and provides good aesthetic outcomes.