• Title/Summary/Keyword: post-surgical adhesion

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Fundamental Process Development for Bio-degradable Polymer Deposition and Fabrication of Post Surgical Anti-adhesion Barrier Using the Process (생분해성 고분자 용착을 위한 기반 공정 개발과 이를 이용한 수술 후 유착 방지막의 제작)

  • Park, Suk-Hee;Kim, Hyo-Chan;Kim, Taek-Gyoung;Jung, Hyun-Jeong;Park, Tae-Gwan;Yang, Dong-Yol
    • Journal of the Korean Society for Precision Engineering
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    • v.24 no.4 s.193
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    • pp.138-146
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    • 2007
  • Some biodegradable polymers and other materials such as hydrogels have shown the promising potential for surgical applications. Post surgical adhesion caused by the natural consequence of surgical wound healing results in repeated surgery and harmful effects. Recently, scientists have developed absorbable anti-adhesion barriers that can protect a tissue from adhesion in case they are in use; however, they are dissolved when no longer needed. Although these approaches have been attempted to fulfill the criteria for adhesion prevention, none can perfectly prevent adhesions in all situations. Overall, we developed a new method to fabricate an anti-adhesion membrane using biodegradable polymer and hydrogel. It employed a highly accurate three-dimensional positioning system with pressure-controlled syringe to deposit biopolymer solution. The pressure-activated microsyringe was equipped with fine-bore nozzles of various inner-diameters. This process allowed that inner and outer shapes could be controlled arbitrarily when it was applied to a surgical region with arbitrary shapes. In order to fulfill the properties of the ideal barriers f3r preventing postoperative adhesion, we adopted the pre-mentioned method combined with surface modification with the hydrogel coating by which anti-adhesion property was improved.

Fabrication and application of post surgical anti-adhesion barrier using bio-compatible materials (생체 적합성 재료를 이용한 수술후 유착 방지막의 제작과 응용)

  • Park S.H.;Kim H.C.;Yang D.Y.;Kim T.K.;Park T.K.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.203-204
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    • 2006
  • Studies on some biodegradable polymers and other materials such as hydrogels have shown the promising potential for a variety of surgical applications. Postoperative adhesion caused by the natural consequence of surgical wound healing results in problems of the repeated surgery. Recently, scientists have developed absorbable anti-adhesion barriers that can protect a tissue from adhesion in case they are in use; however, they are dissolved when no longer needed. Although these approaches have been attempted to fulfill the criteria for adhesion prevention, none can perfectly prevent adhesions in all situations. Overall of this work, a new method to fabricate an anti-adhesion membrane using biodegradable polymer and hydrogel has been developed. The ideal barrier for preventing postoperative adhesion would have the following properties; it should be (i) resorbable (ii) non-reactive (iii) easy to apply (iv) capable of being fixed in position. In order to fulfill these properties, we adopted solid freeform fabrication method combined with surface modification which includes the hydrogel coating, therefore, inner or outer structure can be controlled and the property of anti adhesion can be improved.

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Evaluation on Effectiveness for Preventing Post Surgical Adhesion of Sodium Hyaluronate/Sodium Carboxymethyl Cellulose (HA/CMC) Membrane in Rat Cecum/Peritonium Model (쥐 맹장/복벽 찰과상 모델에서 Sodium Hyaluronate/sodium Carboxymethyl Cellulose 멤브레인의 수술 후 유착방지에 대한 유효성 평가)

  • Lee, Young-Moo;Lee, Young-Woo
    • Membrane Journal
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    • v.15 no.3
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    • pp.213-223
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    • 2005
  • We prepared an anti-adhesion membrane made of sodium hyaluronate/sodium carboxymethylcellulose (HA/CMC) and evaluated its effectiveness for adhesion prevention in a rat model. The anti-adhesion membrane was prepared by lyophilizing HA/CMC solution and cross-linking properly with 1-Ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDAC). In a cecum/abdominal wall abrasion model of Sprague-Dawley rat, cecal serosa and abdominal wall were abraded in $1\times2\;(cm^2)$ with a bone burr after peritoneal midline incision and sutured at 3 points around the injured surface. The denuded cecum was covered with HA/CMC membrane (experimental group), or nothing (control group) and apposed to the abdominal wall. Most of the control group represented 3 or more of adhesion grade at POD 7, 14, 21, and 28, whereas $60\~70\%$ of the experimental group was 2 or less of adhesion grade at 14, 21, and 28. It was similar in the adhesion strength. In a general manner, the adhesion grade and strength showed gradual increasing until POD 14, almost same or a little increasing POD 21, but decreasing POD 28. Also the control group was much higher in adhesion grade, strength, and area than the experimental group. It is expected that the anti-adhesion membrane will have a good clinical result in postoperative adhesion prevention.

Surgical Treatment of Post-Infarction Ventricular Septal Defect with Left Ventricular Rupture -A Case Report- (심근 경색후 발생한 좌심실 파열을 동반한 심실중격 결손의 외과적 치료 -1례 보고-)

  • Kim, Hyun-jo;Kim, Doo-Sang;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.857-860
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    • 1995
  • In a 53-year old male with post-infarction ventricular septal defect [VSD , owing to an acute exacerbation of pulmonary edema, respiratory failure developed, and the ventilatory support and intraaortic balloon counterpulsation [IABP were applied. At the following day, operation was performed with the aid of IABP. Under the cardioplumonary bypass, he underwent infarctectomy, trimming of VSD margin, patch closure of VSD and infarctectomy site. Left ventricular free wall rupture was detected during operation, which was confined with pericardial adhesion. Post-operative course was uneventful, and he could be discharged with minimal degree of dyspnea [NYHA class II .

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Long-term Colchicine Prophylaxis on Operative Adhesion Formation in Embryo Transfer Donor Ewes and the Cytogenetic Evalution of Therapy (Embryo Transfer Donor Ewe에 생기는 수술상의 Adhesion 형성에 대한 장기간의 Colchicine 치료와 그에 따른 세포유전학적 분석)

  • 박석천
    • Korean Journal of Animal Reproduction
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    • v.18 no.1
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    • pp.63-70
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    • 1994
  • Thirty ewes received typical trauma to their oviducts and uterine horns from surgical embryo collection procedures. Ten percent Dexamethasone was used as an irrigant on the exposed abdominal tissue prior to closing the incision. The treatment group received 17mg colchicine Om! lewe) and the control group was administered a 1.0ml placebo(PSS). Fifteen ewes that were initially treated with 17mg /im colchicine showed acute colchicine toxicity within 2-5 days after initial treatment and were removed from the study. Due to acute colchicine toxicity at 17mg, the colchicine level was lowered to 8, 4 and 2mg(4 ewes/group). Treatments consisted of daily injections of colchicine. One ewe in the 8mg group developed toxicity on day 5. Therefore, ewes were then administered colchicine every other day from day 6 to day 14 postsurgeryat 4 and 2 mg. the second laparotomy was performed 9 weeks after first treatment. Following second laparotomy, the treatment group(n=5) received 4 mg colchicine every day for 14 days and there was no clinical symptoms of colchicine toxicity. The third laparotomy was performed by the same operators 5 weeks after final treatment and the adhesions scored. Adhesion grading was based on a scale of 0-4, with 4 being the most severe. The results of adhesion grading(> 3) at second laparotomy were not significantly different(P>0.05)between the two groups. Adhesion formation observed at third laparotomy showed a reduced, but not significant reduction (P>0.05) in the colchicine-treated ewes when compared with the controls. Ten ewes(5 control and 5 treatment)were examined cytogenetically by bone marrow analysis five days post-treatment. There was no difference(P>0.05)in the incidence of numerical or structural aberrations between the two groups.

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SURGICAL TREATMENT OF LARGE CYST ON THE MANDIBLE BY USING SAGGITAL SPLIT RAMUS OSTEOTOMY (하악골에 발생한 거대 낭종에서 하악지 시상분할골절단술을 이용한 외과적 치료)

  • Park, Hong-Ju;Ryu, Jae-Young;Kook, Min-Suk;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.1
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    • pp.100-107
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    • 2008
  • First of all a good surgical access is considered among various approach methods to the cystic lesion. A poor surgical access can lead to a failure of the whole treatment. A sagittal split ramus osteotomy (SSRO) on the large cyst occurring in the mandibular ramus lets us not only reduce operation time, but can additionally contribute to a good visual field. In addition, a merit exists that it lets this operating method provide soft tissue adhesion for proximal and distal segment and decrease post operative necrosis. We experienced three cases of a large cyst on the mandibular angle and ramus. By employing a sagittal splitting of the mandible, it provided good surgical access and operation results without recurrence during a follow-up period. The surgical technique described may be helpful in treating similar large cysts.

Decompression of the Sciatic Nerve Entrapment Caused by Post-Inflammatory Scarring

  • Son, Byung-Chul;Kim, Deog-Ryeong;Jeun, Sin Soo;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.123-126
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    • 2015
  • A rare case of chronic pain of entrapment neuropathy of the sciatic nerve successfully relieved by surgical decompression is presented. A 71-year-old male suffered a chronic right buttock pain of duration of 7 years which radiating to the right distal leg and foot. His pain developed gradually over one year after underwenting drainage for the gluteal abscess seven years ago. A cramping buttock and intermittently radiating pain to his right foot on sitting, walking, and voiding did not respond to conventional treatment. An MRI suggested a post-inflammatory adhesion encroaching the proximal course of the sciatic nerve beneath the piriformis as it emerges from the sciatic notch. Upon exploration of the sciatic nerve, a fibrotic tendinous scar beneath the piriformis was found and released proximally to the sciatic notch. His chronic intractable pain was completely relieved within days after the decompression. However, thigh weakness and hypesthesia of the foot did not improve. This case suggest a need for of more prompt investigation and decompression of the chronic sciatic entrapment neuropathy which does not improve clinically or electrically over several months.

The Comparison between Acupotomy Therapy and Epidural Neuroplasty(Lumbar Vertebra) (침도(도침)침술과 경막외 신경성형술의 비교 연구)

  • Song, In;Hong, Kwon-Eui
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.9-18
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    • 2010
  • Objectives : This study will broaden understanding of acupotomy therapy through comparison of side effects and complication which can be caused by the mechanism of treatment, surgical methods, and procedure by acupotomy therapy and epidural neuroplasty. Moreover, through an in-depth analysis of headache affected by two procedures, this research is supposed to find prospective cures for headache after acupotomy therapy. Methods : To compare acupotomy therapy with epidural neuroplasty this research was done using a comparative analysis eight theses about acupotomy therapy since 1995, as well as eleven theses about epidural neuroplasty since 2000. Other theses and data were used as references in the process of comparative analysis. Results : Acupotomy therapy and epidural neuroplasty, new treatments of damaged discs in the spine and stenosis made in 1990s, have the mechanism of treatment in common in that adhesion, a node or scar caused by the soft tissue damage is removed by putting catheter or acupuncture into the lesions. Epidural neuroplasty has additional injection into the lesions, which is different from acupotomy therapy in the process of surgical procedure. There are various reports of positive effects about curative effect in these two treatments. The two procedures may cause various complications. Headache may be a complication after surgery. The headache after acupotomy therapy is characterized as being an ache in the body, which is similar to that of post-dural puncture headache in the outbreaks and symptom. Headache after percutaneous epidural neuroplasty appears in general, which is similar to a headache as a result of the increased pressure of the brain spinal cord regardless of posture. Conclusions : Although they are alike in the mechanism of treatment, surgical methods and side effects, and complication after they are carried out as a result of analyzing theses related to acupotomy therapy and percutaneous epidural neuroplasty, there is a difference in aspects and mechanism of headaches experienced after the procedure.

Platysma Flap with Z-Plasty for Correction of Post-Thyroidectomy Swallowing Deformity

  • Jeon, Min Kyeong;Kang, Seok Joo;Sun, Hook
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.425-432
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    • 2013
  • Background Recently, the number of thyroid surgery cases has been increasing; consequently, the number of patients who visit plastic surgery departments with a chief complaint of swallowing deformity has also increased. We performed a scar correction technique on post-thyroidectomy swallowing deformity via platysma flap with Z-plasty and obtained satisfactory aesthetic and functional outcomes. Methods The authors performed operations upon 18 patients who presented a definitive retraction on the swallowing mechanism as an objective sign of swallowing deformity, or throat or neck discomfort on swallowing mechanism such as sensation of throat traction as a subjective sign after thyoridectomy from January 2009 till June 2012. The scar tissue that adhered to the subcutaneous tissue layer was completely excised. A platysma flap as mobile interference was applied to remove the continuity of the scar adhesion, and additionally, Z-plasty for prevention of midline platysma banding was performed. Results The follow-up results of the 18 patients indicated that the definitive retraction on the swallowing mechanism was completely removed. Throat or neck discomfort on the swallowing mechanism such as sensation of throat traction also was alleviated in all 18 patients. When preoperative and postoperative Vancouver scar scales were compared to each other, the scale had decreased significantly after surgery (P<0.05). Conclusions Our simple surgical method involved the formation of a platysma flap with Z-plasty as mobile interference for the correction of post-thyroidectomy swallowing deformity. This method resulted in aesthetically and functionally satisfying outcomes.