• Title/Summary/Keyword: Wound suture

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Clinical evaluation of atrial septal defect (심방중격결손증의 외과적 고찰)

  • Kim, Hyeon-Sun;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.16 no.4
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    • pp.511-517
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    • 1983
  • For the purpose of clinical analysis of secundum atrial septal defect, the patients with atrial septal defect operated on during the period from Aug. 1959 to Aug. 1983 were analysed. The age of the patients was ranged from 3 months to 60 years and there were 132 males [45.3%] patients and 145 female patients [54.6%] in this series. The most frequent type was oval type defect in 219 [86.9%]. The PAPVC were present in 7 patients of high defect group. Clinical analysis revealed 53 patients [19.9%] were asymptomatic. The QP/QS above than 3.61 were 45 patients and less than 1.5 were 24 patients. The pulmonary artery pressure was 10 to 100 mmHg. The majority of the defects were closed in primary suture and closed with a Dacron patch in 19 patients. The postoperative complications occurred in 35 patients [13.1%] and the most frequent complication was wound problem which was present in 10 patients. The hospital mortality rate was 1.6%.

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Two-ports Technique of VATS in the Primary Spontaneous Pnemothorax (일차성 자연기흉에서 2개의 삽입구를 이용한 흉강경 폐기포절제술)

  • Kim, Keun
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.651-652
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    • 2001
  • Usually, Bullectomy with VATS requires three ports on a chest wall for thoracosope, endo lung grasper, and endo auto-suture. However, in some case, the author could successfully accomplish operation using the endo-loop through two ports on a chest wall. The technique reduces postoperative pain and decreases operative wound.

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The Use of Pedicled Buccal Fat Pad Graft in Dental Surgery: Case Reports (치과 수술에서 유경 협지방대의 이용: 증례보고)

  • Kim, Young-Kyun;Yun, Pil-Young;Lee, Chang-Su
    • The Journal of the Korean dental association
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    • v.41 no.9 s.412
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    • pp.637-646
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    • 2003
  • Euccal fat pad is special fat tissue which is different from subdermal fat. Anatomically, buccal fat pad is easy to harvest in the course of dental surgery procedure. In 1802, it was introduced by Bichat, Since Egyedi used buccal fat pad flap for the closure of oro-antral fistula and oro-nasal fistula, it has been widely used as an alternative method for the reconstruction of small to medium-sized intraoral defects in oral and mzxillofacial surgery. Kim et al. reported successful results in the all cases they applied buccal fat pad for the reconstruction of intraoral defect from their 31 months follow-up data. Because intraonal wounds are difficult to complete the layered suture and there are high risks of infection related with wound dental implant surgery, double layer closure using some kind of local flaps or other procedure is recommended. So we are to introduce the useful applications of the pedicled buccal fat pad in the dental surgery procedure from the various case presentations.

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Modified drainage of submasseteric space abscess

  • Choi, Moon-Gi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.3
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    • pp.197-203
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    • 2017
  • Once a submasseteric space infection is diagnosed, the key to resolving the infection is via surgical intervention to evacuate the pus. Although it is possible and occasionally practical to drain the submasseteric space via an intraoral approach, an extraoral approach may sometimes be required. Surgeons have encountered complications such as facial nerve damage during extraoral incision and drainage procedures, and they have felt that extraoral dissection was very difficult. As such, an easier and simpler technique is needed. Our department recently modified various drainage techniques for submasseteric space abscesses. Damage to the marginal branch of the facial nerve did not occur, and this technique was very simple and rapid, such that a novice physician could perform this procedure. This modified technique was possible with trismus and under local anesthesia. After intraorally checking the position of the drain, the intraoral wound is closed with an absorbable suture and the drain is fixed to the extraoral skin. When a masseteric space infection is diagnosed, multiple space involvement is ruled out, and dependent drainage is required, this modified drainage technique can be useful.

Traumatic Ventricular Septal Defect Secondary to Nonpenetrating Chest Trauma -A Case Report- (비관통성 외상에 의한 심실중격결손증 -수술치험 1례-)

  • 홍기표
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.161-165
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    • 1994
  • We have experienced a case of ventricular septal defect due to blunt chest trauma. A 22 year old male patient was admitted due to chest pain after Motor cycle accident on July 1st,1993. On 5th hospital day, sudden onset of dyspnea was noted and auscultation represented newly developed systolic murmur. A cardiac catheterization and Left ventriculogram revealed ruptured septum at the apical portion. Because there was open wound on anterior chest wall and congestive heart failure was medically controlled, the patient was discharged for elective operation. He was readmitted on August 14th, 1993.At operation, ventricular septal defect was found in apico-posterior muscular septal area, about 2.0 x 1.5 cm in size. The defect was repaired by double velour patch with interrupted suture and ventriculotomy was closed with Teflon felt. The patient`s postoperative course was uneventful and discharged 10 days postoperatively without complication. The patient have been followed up~ for 2 months. He is on functional class I with small amount of residual shunt at the ventricular septum.

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NON SURGICAL TREATMENT OF SOFT PALATE LACERATION (연구개 열창의 비외과적 처치술)

  • Chae, Kyu-Ho;Choi, Byung-Jai;Choi, Hyung-Jun;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.3
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    • pp.450-454
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    • 2002
  • Laceration of soft palate and oropharynx is relatively common in children. Soft palate laceration has been reported patients of all ages, ranging from new born to geriatric patients. However, young children often place objects their mouth, they may fall on the object or receive a direct force on the object which then perforates the soft palate tissue. Most frequently affected site is the left supra-tonsillar area. Lesions are predominately in the soft palate with-out perforation. Linear and superficial wounds are frequent. A typical injury is the flat- U-, or V-shaped with apex directed anteriorly. In those cases without any through-and-through lacerations or any tissue loss, suture is not necessary. Furthermore, suture of the affected site may hinder wound healing. Healing of the wound should be complete by three weeks with minimal scarring. There have been reports of carotid artery injury due to soft palate laceration causing neurologic complications. For such reasons, traumatized child must be in close observation for 2-3days, and if symptoms of complication are noticed consultation with oromaxillofacial surgeons, E.N.T., or neurologist is required. These are two reports of boys 2 and 3 years of age who had soft palate laceration caused by a falling-down-in jury with an object in their mouth. They were treated non-surgically and neurologic evaluation was carried out for 1 week with complete healing.

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Repair of Large Spinal Soft Tissue Defect Resulting from Spinal Tuberculosis Using Bilateral Latissimus Dorsi Musculocutaneous Advancement Flap: A Case Report (척추결핵으로 인한 광범위한 결손에 대해 양측 넓은등근전진피판술을 이용한 치험례)

  • Kim, Yeon-Soo;Kim, Jae-Keun
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.695-698
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    • 2011
  • Purpose: Since spinal tuberculosis is increasing in prevalence, it appears that a repair of spinal soft tissue defect as a complication of spinal tuberculosis can be a meaningful work. We report this convenient and practical reconstructive surgery which use bilateral latissimus dorsi musculocutaneous advancement flap. Methods: Before the operation, $13{\times}9.5$ cm sized skin and soft tissue defect was located on the dorsal part of a patient from T11 to L3. And dura was exposed on L2. Under the general endotrachel anesthesia, the patient was placed in prone position. After massive saline irrigation, dissection of the bilateral latissimus dorsi musculocutaneous flaps was begun just upper to the paraspinous muscles (at T11 level) by seperating the paraspinous muscles from overlying latissimus dorsi muscles. The plane between the paraspinous muscles fascia and the posterior edge of the latissimus dorsi muscle was ill-defined in the area of deformity, but it could be identified to find attachment of thoracolumbar fascia. The seperation between latissimus dorsi and external oblique muscle was identified, and submuscular plane of dissection was developed between the two muscles. The detachment from thoracolumbar fascia was done. These dissections was facilitated to advance the flap. The posterior perforating vasculature of the latissimus dorsi muscle was divided when encountered approximately 6 cm lateral to midline. Seperating the origin of the latissimus dorsi muscle from rib was done. The dissection was continued on the deep surface of the latissimus dorsi muscle until bilateral latissimus dorsi musculocutaneous flaps were enough to advance for closure. Once this dissection was completely bilateraly, the bipedicled erector spinae muscle was advanced to the midline and was repaired 3-0 nylon to cover the exposed vertebrae. And two musculocutaneous units were advanced to the midline for closure. Three 400 cc hemovacs were inserted beneath bilateral latissimus dorsi musculocutaneous flaps and above exposed vertebra. The flap was sutured with 3-0 & 4-0 nylon & 4-0 vicryl. Results: The patient was kept in prone and lateral position. Suture site was stitched out on POD14 without wound dehiscence. According to observative findings, suture site was stable on POD55 without wound problem. Conclusion: Bilateral latissimus dorsi musculocutaneous advancement flap was one of the useful methods in repairing of large spinal soft tissue defect resulting from spinal tuberculosis.

BLEEDING CONTROL BY THE CIRCUMFERENTIAL SUTURE & DRAINAGE ON ACTIVE BLEEDING INCISION & DRAINAGE SITE OF TEMPORAL SPACE ABSCESS DUE TO ADVANCED ODONTOGENIC INFECTION IN A MULTIPLE MEDICALLY COMPROMISED DISABLED PATIENT : REPORT OF A CASE (다발성 전신질환 장애환자에서 진행성 치성감염에 의한 측두간극농양 절개 배농시 창상주위 봉합과 배농술에 의한 과도한 출혈조절 : 증례보고)

  • Son, Jeong-Seog;Oh, Ji-Hyeon;Yoo, Jae-Ha
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.1
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    • pp.30-35
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    • 2013
  • The four principles of treatment of odontogenic infection are as follows : (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including proper rest and nutrition. A separate incision is required to establish drainage, especially in the case of extensive fascial space infections. There are four principle causes for active bleeding in the immediate incision & drainage phase; (1) vascular wall alteration (infection, scurvy, chemicals), (2) disorder of platelet function, (3) thrombocytopenic purpuras, (4) disorders of coagulation (liver disease, anticoagulation drug). If the hemorrhage from incision & drainage site is aggressive, the site must be packed with proper wet gauze and wound closure & drainage dressing are applied. The specific causes of bleeding may be associated with hypoxia, changes in the pH of blood & chemical changes affecting vascular contractility and blood clotting. This is a case report of bleeding control by the circumferential suture & drainage on active bleeding incision & drainage site of temporal space abscess due to advanced odontogenic infection in a multiple medically compromised disabled patient.

Transconjuctival Incision with Lateral Paracanthal Extension for Corrective Osteotomy of Malunioned Zygoma

  • Chung, Jae-Ho;You, Hi-Jin;Hwang, Na-Hyun;Kim, Deok-Woo;Yoon, Eul-Sik
    • Archives of Craniofacial Surgery
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    • v.17 no.3
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    • pp.119-127
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    • 2016
  • Background: Conventional correction of malunioned zygoma requires complete regional exposure through a bicoronal flap combined with a lower eyelid incision and an upper buccal sulcus incision. However, there are many potential complications following bicoronal incisions, such as infection, hematoma, alopecia, scarring and nerve injury. We have adopted a zygomaticofrontal suture osteotomy technique using transconjunctival incision with lateral paracanthal extension. We performed a retrospective review of clinical cases underwent correction of malunioned zygoma with the approach to evaluate outcomes following this method. Methods: Between June 2009 and September 2015, corrective osteotomies were performed in 14 patients with malunioned zygoma by a single surgeon. All 14 patients received both upper gingivobuccal and transconjunctival incisions with lateral paracanthal extension. The mean interval from injury to operation was 16 months (range, 12 months to 4 years), and the mean follow-up was 1 year (range, 4 months to 3 years). Results: Our surgical approach technique allowed excellent access to the infraorbital rim, orbital floor, zygomaticofrontal suture and anterior surface of the maxilla. Of the 14 patients, only 1 patient suffered a complication-oral wound dehiscence. Among the 6 patients who received infraorbital nerve decompression, numbness was gradually relieved in 4 patients. Two patients continued to experience persistent numbness. Conclusion: Transconjunctival incision with lateral paracanthal extension combined with upper gingivobuccal sulcus incision offers excellent exposure of the zygoma-orbit complex, and could be a valid alternative to the bicoronal approach for osteotomy of malunioned zygoma.

New Approach to the Care of Suction Drain Insertion Site by Using Occlusive Transparent Film Dressing (투명필름 밀폐 드레싱을 이용한 새로운 배액관 관리법)

  • Kwon, Soon Hong;Oh, Deuk Young;Choi, Youn Suk;Lee, Paik Kwon;Rhie, Jong Won;Han, Ki Taik;Ahn, Sang Tae
    • Archives of Plastic Surgery
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    • v.33 no.1
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    • pp.131-134
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    • 2006
  • The closed suction drain is commonly inserted after various surgical procedures. It has an important role to prevent possible hematoma or seroma that can cause postoperative wound problems. But there is still no consensus on managing the insertion site of suction drain after operation. Suture-tie fixation of drain to skin and classical Y shape gauze dressing is a usually accepted method, but it has many limitations. We introduce a new approach to the care for the insertion site of suction drain by using occlusive transparent film dressing, $IV3000^{(R)}$(Smith & Nephew, London, UK). By using transparent film, insertion site of drain can be easily checked without removal of dressing. Because it can reduce the tension of suture-tie fixation, it helps to prevent skin injury. Furthermore, occlusive film dressing can block air leakage from insertion site of drain, and the water-proof character of film allows patients to take a shower without dressing change. This new method is more convenient, more efficient, and less harmful to skin than classic one.