• Title/Summary/Keyword: surgeon

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MASSIVE POSTOPERATIVE BLEEDING: A CASE REPORT (극심한 술후 출혈 : 증례보고)

  • Kim, Young-Kyun;Kim, Hyoun-Tae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.367-370
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    • 1999
  • While oral and maxillofacial surgery such as orthognathic surgery, TMJ surgery is in progress, there always exists a risk of bleeding from maxillary artery, and this perplexes the surgeon in operation. In case of massive bleeding, it is mostly very difficult or even impossible to take an immediate action in order to stop bleeding. Even when hemostasis is possible by applying such methods as the use of local hemostatics, pressing, electrocoagulation or direct ligation, there is a high risk of secondary bleeding. Therefore, in case there is bleeding from maxillary artery, it is the best to restrain bleeding completely either by the ligation of the artery in bleeding in operation fields or by the ligation of the external carotid artery.

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Microsurgical Composite Tissue Transplantation in Reconstruction of the Head and Neck Tumor (미세수술로 복합조직 이식술을 이용한 두경부 종양의 재건)

  • Oh Suck-Joon
    • Korean Journal of Head & Neck Oncology
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    • v.1 no.1
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    • pp.63-74
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    • 1985
  • Although regional and myocutaneous flaps are still the standard in head and neck reconstruction. The capacity to transfer distant tissues by microsurgical technique expands the reconstructive surgeon's ability to restore severe deformities of the head and neck. From 1981 to 1985, thirteen patients with extensive defects of the head and neck after extirpative surgery of tumor have been reconstructed utilizing the technique of microsurgical composite tissue transplantation. In this series of patients, six presented with reconstructions in the different region of the head and neck with review of literatures. The results of case analysis are summarized as follows: 1) Transplantation was successful in twelve among thirteen patients (92%). 2) Seven patients presented with malignancy and six with benign tumor. 3) Frequent sites of reconstruction were face and mandible. 4) Fourteen free composite tissue transplantations for reconstruction of thirteen patients were obtained six different tissue compositions from eight different donor sites. 5) The recipient artery and vein was most often superficial temporal or facial vessels. 6) The average time of operation was ten hours.

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Free Flaps for Hand Soft Tissue Reconstruction (유리 피판술을 이용한 손의 연부 조직 재건술)

  • Kim, Yong-Jin;Hahm, Dong-Gil
    • Archives of Reconstructive Microsurgery
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    • v.21 no.1
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    • pp.76-80
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    • 2012
  • Various soft tissue defects can be occurred in the hand. In determining the most suitable means of reconstruction a defect, the benefit of the reconstruction has to outweigh the risk of donor morbidity. Flap selection will be based on the size of the defect, the requirements for sensibility, the surgeon's comfort level, and the patient profile such as gender, age, or systemic disease. The hand is the most important tactile sensory organ, hence sensory restoration is critical. Neurosensory free flaps can provide sensibility, vascularity, and soft tissue coverage to an injured hand. This paper will discuss free flaps which can be used for soft tissue reconstruction of the hand.

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Correction of Post Burn Extension Contracture of 4, 5th Toes Using Free Flap

  • Choi, Soo Joong;Jung, Jae-Kyun;Kwon, Bong Cheol;Lee, Yong Beom
    • Archives of Reconstructive Microsurgery
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    • v.22 no.2
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    • pp.90-93
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    • 2013
  • Old post burn contractures on feet still remain challenging problem for reconstructive surgeon. A 43-year-old male visited Hallym University Sacred Heart Hospital with the complain of foot deformity and difficulties in shoe fitting. His right 4th and 5th toes were inverted at dorsal foot. We released the contracture of 4, 5th metatarsophalangeal joint and lengthened extensor tendon by Z-plasty, and covered the resultant defect with the anterolateral thigh flap. The flap was successful and the deformity was corrected. As there have been few reports on reconstruction of foot dorsum, especially on post burn extension contractures in the toes, we report a rare case of contracture release and coverage by free flap.

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A Case of NRRL(Non-Recurrent Recurrent Laryngeal Nerve) in a Patient with the Parathyroid Adenoma (부갑상선 선종 수술시 관찰된 비회귀성 반회후두신경 (Non-Recurrent Recurrent Laryngeal Nerve) 1례)

  • 한수진;임재열;박헌이;최홍식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.2
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    • pp.188-191
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    • 2000
  • In thyroid and parathyroid surgery, damage to the recurrent laryngeal nerve(RLN) is the most common iatrogenic cause of vocal cord paralysis. Identification and preservation of the BLNs and meticulous technique can siginificantly decrease the incidence of this complication. We experienced one case of NRRLN in a patient with the parathyroid adenoma. During the dissection, there was no branch to be considered as RLN in tracheoesophageal groove. While searching for the RLN, We found a white structure coursing horizontally at the level of cricoid cartilage directly arising from the vagus nerve in the carotid sheath. That structure was nonrecurrent recurrent laryngeal nerve(NRRLN) and NRRLNs are exceedingly rare. Awareness of the possibility of NRRLN will prevent the surgeon from accidentally severing one if it is encountered during surgery.

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Modified Temporary Tarsorrhaphy (변형된 안검봉합술)

  • 우흥명
    • Journal of Veterinary Clinics
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    • v.16 no.1
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    • pp.189-192
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    • 1999
  • Tarsorrhaphy is widely used to protect the cornea, reduce evaporation of tears, and facilitate reepithelialization of the ocular surface. However, a dilemma ensues in patients when frequent neurological evaluations and postoperative examinations are needed. The modified temporary tarsorrhaphy in this study was simple to perform, provided stable eyelid closure, and could be opened and closed as needed. It could be easily reversed with minimal complications of the eyelid and it allowed the surgeon to control traction of the bolsters in all of 45 dogs with corneal epithelial defects. Also, The globe could be examined without further anesthesia, sutures, and pain at any time after surgery. It was concluded that this modified method might be effective for evaluation of the corneal healing process and useful for ocular surface reconstruction clinically.

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Reexpansion Pulmonary Edema -Report of 2 Case- (재팽창성 폐부종;2례 보고)

  • 김동관
    • Journal of Chest Surgery
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    • v.26 no.9
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    • pp.718-721
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    • 1993
  • Reexpansion pulmonary edema[ RPE ] with hypoxemia and hypotension is a very rare complication of the treatment of lung collapse secondary to pneumothorax and pleural effusion. We experienced two cases of RPE. One is a 29 year old male with complete right pneumothorax and the other is a 20 year old female with massive right pleural effusion. Life threatening pulmonary edema was developed soon after insertion of chest tube in both. Fortunately, RPE was detected early and intensive treatment was performed. They were discharged without complication. Although RPE with hypoxemia and hypotension is rare , it is very serious and occasionally life-threatening. So, chest surgeon treating lung collapse must be aware of the possibility of RPE and make an effort to prevent the occurence of this condition.

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A technique for treating exposed cardiac Pacemaker (피부괴사로 노출된 심장 Pacemaker에 대한 처치 : 증례 보고)

  • Sin, Geuk-Seon;Yu, Jae-Deok;Hong, Seung-Rok
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.125-128
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    • 1984
  • The management of the exposed cardiac pacemaker or its lead is a new challenge to the plastic surgeon. This complication is not rare. Coburn et al. [1972] reported less than 5 percent, but Sowton et al. [1974] showed that over a period of 19 years, in a series of 372 patients, the pacing system had to be removed because of local wound breakdown or infection in 10 percent of the cases. The methods used to treat exposure may vary from removal and re-introduction at anterior site to the rotation of local flaps to cover the exposed pacemaker. Recently we have experienced 6 times of migration and recurrent skin ulcerations without pyogenic infection overlying the pacemaker in one patient. We developed a new technique, anchoring the pacemaker to the clavicle by a wire through the hole of clavicle and by creating a pocket under the pectoralis major muscle. Then we would like to emphasize this operating method could be choice of treatment to prevent the migration of pacemaker and the ulceration of skin when complication of implantation of pacemaker is occurred.

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Familial Surpravalvular Aorctic Stenosis in Two Silings (남매에서 발생한 가족성 판상부 대동맥협착증)

  • 강재걸
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1145-1151
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    • 1988
  • Supraventricular tachyarrhythmias are readily characterized and understood, but the surgical procedures for their correction are complex and not easily mastered. Conversely, ventricular tachyarrhythmias are frequently difficult to characterize and localize electrophysiologically and their basic mechanisms are poorly understood. The role of the surgeon in the treatment of cardiac arrhythmia has changed dramatically during the past decade. This report is a case of 26 years old male with supraventricular tachyarrhythmia. The result of endocardial electrophysiologic study demonstrated accessory pathway connecting left atrium to left ventricle which located at left atrial free wall about 4 cm apart from the coronary sinus orifice. The accessory bundle interruption has been successfully accomplished utilizing the internal open heart technique. The operation consisted of dissection of the atrioventricular fat pad and division of all the superficial fibers going from the ventricle to the annulus. Following this, cryoablation made with cryoprobe at - 60` for 90 seconds. The accessory pathway was successfully ablated without specific problems.

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Penetrating Wounds of the Heart: A Report of Four Cases (심장손상 4례에 대한 치험)

  • 이성구
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.189-194
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    • 1973
  • A cardiac injury is one of the most dramatic and demanding emergencies than may be cared by the surgeon. Four patients who sustained penetrating wound of the heart have been experienced in the Depart-ment of Thoracic Surgery, Kyungpook National University Hospital. They were 3 males and one female. The age was between 21 and 25. All of this series had stab wounds on the heart by instruments of scissors, gimlet, kitchen knife and glass. Injured sites were two cases of right ventricle, one of the right atrium and one of indifinitive with pericardial laceration. Three of these patients have been successfully treated by emergency thoracotomy with 3-0 silk sutures for myocardial penetrating wounds. One of these patients occurred cardiac arrest during surgery and expired, who was in penetrated right ventricular injury through which massive bleeded. The classic clinical description of tamponade, Beck`s triad, seemed to be useful for making diagnosis of the tamponade but not entirely reliable as diagnostic criterion of the tamponade. In the studing of 3 tamponade cases in these series, the triad of Beck was presented in only two cases. Elevated venous pressure was thought to be a valuable diagnostic factor in pericardial tamponade.

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