• Archives of Craniofacial Surgery
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• v.19 no.1
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• pp.20-34
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• 2018

Background: Polydeoxyribonucleotide (PDRN) influencing cellular growth and differentiation is recognized to promote wound healing by stimulating tissue repair. Although PDRN can be extracted from human placentas, PDRN medications have recently been extracted from the semen of trout (Oncorhynchus mykiss) and salmon (Oncorhynchus keta). The present study was designed to evaluate the wound healing effects of O. keta-derived PDRN for injection (Rejuvenex) and PDRN cream (Rejuvenex Cream) in comparison with those of O. mykiss-derived PDRN injection (Placentex). Methods: Full-thickness skin defects were made on the back of mice (n=60). The mice were divided into the following four groups according to the dressing used for the wounds: O. mykiss-derived PDRN injection group, O. keta-derived PDRN injection group, O. ketaderived PDRN cream group, and normal saline soaked dressing group (control group). We analyzed the gross findings, wound sizes, histological findings, immunohistochemistry and enzyme-linked immunosorbent assays for the groups immediately after the treatment, and again after 4, 7, and 10 days of treatment. Results: The wound healing effects were the greatest in the O. keta-derived PDRN injection and O. mykiss-derived PDRN injection groups, which showed similar scores, followed by the O. keta-derived cream and normal saline soaked dressing groups. Conclusion: The injection of PDRN extracted from O. keta was found to be as effective at healing full-thickness skin defects as the O. mykiss-derived PDRN injection, which is currently used in the clinic. Moreover, the O. keta-derived PDRN injection was also found to reduce the time required for wound healing.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.121-126
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• 2008

Purpose: Poly-N-acetyl glucosamine(PGlcNAc) nanofiber-based materials, produced by a marine microalga, have been characterized as effective hemostatic and angiogenic agents. The similarity between PGlcNAc patch and the natural extracellular matrix allows it to support new healthy tissue growth in an injured area and to encourage fluid absorption. In this study, we hypothesized that a poly-N-acetyl glucosamine fiber patch(PGlcNAc patch) may enhance wound healing in the db/db mouse. Methods: PGlcNAc patches were applied on one square centimeter, full-thickness, skin wounds in the db/db mouse model. Wounds(n=15 per group) were dressed with a PGlcNAc nanofiber patch for 1 hour(1 h), 24 hours(24 h) or left untreated(NT). After the application time, patches were removed and wounds were allowed to heal spontaneously. The rate of wound closure was evaluated by digital analysis of unclosed wound area in course of time. At day 10, wounds(n=7 per group) were harvested and quantified with immunohistochemical markers of proliferation(Ki-67) and vascularization (platelet endothelial cell adhesion molecule, PECAM-1). Results: Wounds dressed with PGlcNAc patches for 1 hour closed faster than control wounds, reaching 90% closure in 16.6 days, nine days faster than untreated wounds. Granulation tissue showed higher levels of proliferation and vascularization following 1 h treatment than the 24 h and NT groups. In addition to its hemostatic properties, the PGlcNAc material also appears to accelerate wound closure in healing-impaired genetically diabetic mice. Conclusion: This material, with its combination of hemostatic and wound healing properties, has the potential to be effective agent for the treatment of complicated wounds.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.166-169
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• 2002

Poststernotomy mediastinitis is a rare but potentially life-threatening complication of cardiac surgery. Up to present, poststernotomy wound infection has been treated by closure of wound directly or by use of myocutaneous flaps after irrigation and debridement of wound. We describe a new treatment of poststemotomy wound infection by using the vacuum-assisted closure technique. This technique was successfully applied in 3 patients with poststernotomy wound infection and mediastinitis, and a healed sternotomy wound could be achieved using this new technique.

• Journal of Veterinary Clinics
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• v.20 no.3
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• pp.294-301
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• 2003

This study was performed to compare the effects of hydrocolloid(Duoderm$\circledR$, HC in this study) and hydrogel (Nu-Gel$\circledR$, HG in this study) occlusive dressing materials on degree of exudate, wound contraction, epithelialization, and healing of full-thickness skin wound in dogs. Three wounds measuring 2${\times}$2 cm in size were created bilaterally(6 wounds/dog) on the dorsolateral aspect of the trunk of 12 dogs. In each dog, the wounds were treated with HC, HG, and normal saline, respectively. For a 4 week period, the wounds were evaluated gross aspects and histopathological aspects. There were no statistically significant differences between treatment groups in percentage of wound contraction, percentage of epithelialization, and percentage of wound total healing during the first week. Significant differences were first detected on day 14. On day l4(P < 0.01) and 21 (P < 0.05), mean percentage of epithelialization of HG-treated wound was significantly greater than those in HC- and normal saline-treated wound. Mean percentage of wound contraction of HG-treated wound was significantly greater than that in HC- and control wounds on day 21(P< 0.05). On day 21, mean percentage of wound healing of HG-treated wound was significantly greater than that in HC- and control wounds(P < 0.02). On day 1, 4, and 7 after wound creation, although severe infiltration of PMN (polymorphonuclear leukocyte) cells in HC- and control wounds were observed in the subcutis and moderate infiltration of PMN cells in HG-treated wound were observed in the subcutis, we did not detect significant differences. On day 14 after wounding creation, in the wounds treated with HG dressing, epithelial cells were found over the surface, and edema further decreased in the tissue under the wounds, and the granulation tissue was replaced with collagen fibers. On day 21 after wound creation, in HG-treated wound compared with other experimental material-treated wounds, regenerated epidermis covered most of the wound surface, and the granulation tissue was more replaced with collagen fibers than that on day 14. Overall results indicated that the use of hydrogel dressing materials(Nu-Gel$\circledR$) as hydrocolloid dressing (Duoderm$\circledR$) materials and normal saline treatment on full-thickness skin wounds in dogs increased the rate of healing at repair stage.

• Archives of Plastic Surgery
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• v.37 no.3
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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.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.181-188
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• 1973

8 cases of the heart wound which had been successfully operated on were reported. These wounds were caused by knife in 6 cases, by traffic accident in one case and by explosion in one case, and clinically classified as Hemothorax type in 4 cases, acute Tamponade type in 3 cases and combined type in one case. Some important problems for the diagnosis and treatment of stab wound of the heart were also discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.15-20
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• 2001

For the earlier diagnosis and treatment of delayed wound healing in extraction socket, we investigated the clinical, radiographic and histopathologic features of 106 patients with delayed wound healing diagnosed by biopsy. The patients were enrolled at the Department of Oral Pathology, Chosun University Dental Hospital. Among 106 delayed wound healing diagnosed by biopsy, cysts showed most significant 25 cases (23%), osteomyelitis showed 13 cases (12%), chronic maxillary sinusitis and squamous cell carcinoma showed 12 (11%) and 11 (10%) cases, respectively. We have analyzed these lesions through relevant literatures.

• Archives of Plastic Surgery
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• v.35 no.6
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• pp.653-658
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• 2008

Purpose: Skin and soft tissue defect is one of the major challenges faced by plastic surgeons. Adipose derived stromal cells, which can be harvested in large quantities with low morbidity, display multilineage mesodermal potential. Therefore, adipose derived stromal cells have been met with a great deal of excitement by the field of tissue engineering. Recently, Adipose derived stromal cells have been isolated and cultured to use soft tissue restoration. In order to apply cultured cells for clinical purpose, however, FDA approved facilities and techniques are required, which may be difficult for a clinician who cultures cells in a laboratory dedicated to research to utilize this treatment for patients. In addition, long culture period is needed. Fortunately, adipose derived stromal cells are easy to obtain in large quantities without cell culture. The purpose of this study is to present a possibility of using uncultured adipose derived stromal cells for wound coverage. Methods: Seven patients who needed skin and soft tissue restoration were included. Five patients had diabetic foot ulcers, 1 patient got thumb amputation, and 1 patient had tissue defect caused by resection of squamous cell carcinoma. The patients' abdominal adipose tissues were obtained by liposuction. The samples were digested with type I collagenase and centrifuged to obtain adipose derived stromal cells. The isolated adipose derived stromal cells were applied over the wounds immediately after the wound debridement. Fibrin was used as adipose derived stromal cells carrier. Occlusive dressing was applied with films and foams and the wounds were kept moist until complete healing. Results: One hundred to one hundred sixty thousand adipose derived stromal cells were isolated per ml aspirated adipose tissue. All patients' wounds were successfully covered with the grafted adipose derived stromal cells in a 17 to 27 day period. No adverse events related to this treatment occurred. Conclusion: The use of uncultured adipose derived stromal cells was found to be safe and effective treatment for wound coverage without donor site morbidity.

• Journal of Trauma and Injury
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• v.20 no.1
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• pp.1-5
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• 2007

Purpose: Grafting with autograft skin remains the most effective method for treating skin defects. When insufficient donor sites are present or patients are afraid of the operation, a skin graft is impossible. Cultured allogenic keratinocytes speed wound healing by providing cover and by producing growth factors and extracellular matrix protein. We report an application of cultured allogenic keratinocytes ($Kaloderm^{(R)}$, Tegoscience, Seoul, Korea) in the treatment of an acute partial thickness skin defect. Methods: From March 2005 to January 2006, 20 patients with a partial thickness skin defect were treated with cultured allogenic keratinocytes. The wound was covered with a sheet of cultured allogenic keratinocytes and ointment with $Bactigras^{(R)}$ gauze. The wound was inspected every two or three days. We regarded completion of epithelialization as wound healing. Results: The mean period between time of injury and time of $Kaloderm^{(R)}$ application was 7.5 days. The time taken from application of $Kaloderm^{(R)}$ to complete closure of the wounds was 7.2 days. Conclusion: In view of the favorable outcome, cultured allogenic keratinocytes are safe and effective biologic dressing materials for use in the treatment of open wounds.

• Journal of Yeungnam Medical Science
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• v.36 no.2
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• pp.136-140
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• 2019

Background: Epidermal cysts are the most common benign epithelial tumors in humans. The curative treatment of epidermal cyst is surgical excision. However, only few studies have investigated the cause and mechanism of postoperative complications of epidermal cysts. Therefore, this study aimed to evaluate the factors affecting complications of epidermal cyst after surgical treatment. Methods: Patients with histologically diagnosed epidermal cysts were selected from among 98 consecutive patients with excised benign cystic tumors from March 2014 to August 2017. Sex, age, size, mobility, site of occurrence, history of infection, history of incision and drainage, complications, history of reoperation, and method of overcoming complications was obtained by analyzing medical records retrospectively. Results: Five of the 98 patients had wound dehiscence due to surgical infection. Three of them underwent wound healing with conservative treatment without a second operation. The other two patients underwent a second operation and showed signs of preoperative infection. None of the factors showed statistical significance in relation to the occurrence of complications. Conclusion: Postoperative complications occurred when the excision of the epidermal cyst was performed at preoperative infection sites or at sites with high tension, so attention should be paid to postoperative care.