• Title, Summary, Keyword: Treating of wound

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A case of venous stasis ulcer treated by subfascial endoscopic perforator ligation and split thickness skin graft (내시경적 교통정맥 결찰술과 부분층 피부이식술로 치료한 정맥성 궤양의 치험례)

  • Moon, Seong ho;Lee, Jong wook;Koh, Jang hyu;Seo, Dong kook;Choi, Jai koo;Jang, Young chul
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.336-340
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    • 2009
  • Purpose: The wound of a patient who has chronic venous insufficiency is easy to recur. Also they develop a complication even after the conservative therapy or skin graft. We have to diagnose the venous stasis ulcer correctly and remove the cause to improve the effectiveness of treatment. We operated endoscopic perforating vein ligation and splitt thickness skin graft on a patient with venous stasis ulceration on right leg. Methods: A 26 year old male patient who had a scalding burn on his right leg in July 2005 checked into our hospital in March 2008. Even though he got three operations - the split thickness skin graft - at different clinics, the wound did not heal. The size of the wound was 12 by $8cm^2$ and granulation with edema and fibrosis had been formed. We kept observation on many collateral vessels and perforating vein through venogram and doppler sonography and firmly get to know that the wound came with chronic venous insufficiency. After a debridement and an application of VAC$^{(R)}$ for two weeks, the condition of granulation got better. So we proceeded with the operation using subfascial endoscopic perforating surgery and split thickness skin graft. Results: Through the venogram after the operation, we found out that the collateral vessels had been reduced compared to the previous condition and the widened perforating vein disappeared. During a follow up of 6 months, the patient did not develop recurrent stasis ulcer and postoperative complications. Conclusion: Subfascial endoscopic perforator ligation is relatively simple technique with a low complication rate and recurrence rate. Split thickness skin graft with subfascial endoscopic perforator surgery can be valuable method for treating severe venous stasis ulcers.

Study on Use of Mung Bean Porridge Reported in Daily Records of Royal Secretariat of Joseon Dynasty (「승정원일기」에 기록된 녹두죽 활용에 대한 고찰)

  • Park, Joo Young;Lee, Hyang Young;Lee, Jin Chul;Ahn, Sang Woo
    • Journal of the Korean Society of Food Culture
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    • v.31 no.6
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    • pp.541-553
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    • 2016
  • Medicinal porridge (藥粥) is made by putting rice or grains into a pot and boiling with water until a semi-liquid texture is obtained. Porridge is digested fast and absorbed by the body. Children or elderly people with weak digestive ability can eat it without difficulty. The authors of this literature focused on utilization of mung bean porridge (Nokdu-juk) based on SeungjeongwonIlgi (承政院日記), which is the daily record of the Royal Secretariat of the Joseon Dynasty from 1623 to 1910. Four cases were found. The first case used mungbean for treating fever diseases (熱症), the second as a meal alternative, the third for wound recovery, and the last case described the culture of the joseon dynasty. According to the actual cases in SeungjeongwonIlgi (承政院日記), mung bean porridge (Nokdu-juk) was actively used to lower fever and strengthen the spleen and stomach. When suffering from the after effects of a malignant tumor or serious liver disease (肝病), an infectious disease, or a serious physical wound, people ate mung bean porridge (Nokdu-juk). It is suggested that mung bean porridge (Nokdu-juk) can be used as an alternative food treatment for the current medical field due to the prevalence of pain-killers and psychotropic drug abuse.

Reconstruction Techniques for Tissue Defects Formed after Preauricular Sinus Excision

  • Lee, Myung Joon;Yang, Ho Jik;Kim, Jong Hwan
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.45-49
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    • 2014
  • Background Preauricular sinuses are congenital abnormalities caused by a failure of fusion of the primitive tubercles from which the pinna is formed. When persistent or recurring inflammation occurs, surgical excision of the infected tissue should be considered. Preauricular defects inevitably occur as a result of excisions and are often difficult to resolve with a simple suture; a more effective reconstruction technique is required for treating these defects. Methods After total excision of a preauricular sinus, the defect was closed by a plastic surgeon. Based on the depth of the defect and the degree of tension when apposing the wound margins, the surgeon determined whether to use primary closure or a posterior auricular flap. Results A total of 28 cases were examined. In 5 cases, including 2 reoperations for dehiscence after primary repair, reconstruction was performed using posterior auricular transposition flaps. In 16 cases of primary closure, the defects were closed using simple sutures, and in 7 cases, closure was performed after wide undermining. Conclusions If a preauricular defect is limited to the subcutaneous layer and the margins can be easily approximated, primary closure by only simple suturing may be used to perform the repair. If the defect is deep enough to expose the perichondrium or if there is tension when apposing the wound margins, wide undermining should be performed before primary closure. If the extent of the excision exposes cartilage, the procedure follows dehiscence of the primary repair, or the tissue is not sufficiently healthy, the surgeon should use a posterior auricular flap.

Semicircular Horizontal Approach in Breast Reduction: Clinical Experience in 38 Cases

  • Shin, Hee Su;Lee, Yong Hae;Jung, Sung Gyun;Lee, Doo Hyung;Roe, Young;Cha, Jong Hyun
    • Archives of Plastic Surgery
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    • v.42 no.4
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    • pp.446-452
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    • 2015
  • Background Various techniques are used for performing breast reduction. Wise-pattern and vertical scar techniques are the most commonly employed approaches. However, a vertical scar in the mid-lower breast is prominent and aesthetically less pleasant. In contrast, a semicircular horizontal approach does not leave a vertical scar in the mid breast and transverse scars can be hidden in the inframammary fold. In this paper, we describe the experiences and results of semicircular horizontal breast reductions performed by a single surgeon. Methods Between September 1996 and October 2013, our senior author used this technique in 38 cases in the US and at our institution. We used a superiorly based semicircular incision, where the upper skin paddle was pulled down to the inframammary fold with the nipple-areola complex pulled through the keyhole. Results The average total reduction per breast was 584 g, ranging from 286 to 794 g. The inferior longitudinal pedicle was used in all the cases. The average reduction of the distance from the sternal notch to the nipple was 13 cm (range, 11-15 cm). The mean decrease in the bra cup size was 1.7 cup sizes (range, a decrease of 1 to 3). We obtained very satisfactory results with a less noticeable scar, no complication such as necrosis of the nipple or the skin flap, wound infection, aseptic necrosis of the breast tissue, or wound dehiscence. One patient had a small hematoma that resolved spontaneously. Conclusions This technique is straightforward and easy to learn, and offers a safe, effective, and predictable way for treating mammary hypertrophy.

High-pressure Injection Injuries in the Hand (수부의 고압 분사 손상)

  • Kim, Seong-Ki;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyung-Moo
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.245-249
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    • 2010
  • Purpose: High-pressure injection injury is caused by accidental injection of the high-pressure injection devices in industry. The initial benign appearance of the wound fools patients into delays in an adequate treatment. And it can result in disastrous outcomes such as necrosis and amputation. To avoid the poor prognosis, the injuries require a prompt surgical intervention. The purpose of this article is to recognize the poor outcome of the highpressure injection injury and to introduce an adequate treatment in need. Methods: We have 4 cases of the high-pressure injection injuries in the hand from April, 2005 to March, 2009. Average age is 39 years (30 - 49 years old), 2 cases are the palm of dominant hand, 1 case is the thumb of dominant hand, and 1 case is the palm of non-dominant hand, respectively. We followed up these patients for 20 months on average. In 3 cases, the immediate, aggressive surgical intervention was carried out, but the other one was delayed in early adequate treatment. The wounds were covered by local advancement flap, anterolateral thigh free flap, conservative treatment with antibiotics and dressing. Results: No pathogens after culture were found nor any findings of fracture in imaging study. Conservative treatment, local advancement flap and anterolateral thigh free flap for the open wound resulted in a desirable aesthetic outcome. In a long-term follow up, functional capability of the patient was also satisfactory. Conclusion: Upon initial evaluation, most high-pressure injection injuries present as innocuous wounds with very few symptoms and result in delaying the proper management. And the majority of high-pressure injection injuries will produce significant morbidity to the hand, amputation. And the initial aggressive surgical debridement was needed to prevent the poor outcome. The key to success in treating high-pressure injection injuries of the hand is the prompt aggressive surgical intervention.

A study on Applications of prescriptions including Radix Angelicae Dahuricae as a main component in Donguibogam (동의보감(東醫寶鑑) 중(中) 백지(白芷)가 주약(主藥)으로 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察))

  • Lee, Sung-Jun;Jang, Sean-Il;Yun, Young-Gab
    • Herbal Formula Science
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    • v.15 no.2
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    • pp.47-64
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    • 2007
  • This report describes 94 prescriptions related to the use of Radix Angelicae Dahuricae main bl ended from Donguibogam. The following conclusions were reached through investigations on the prescriptions that use Radix Angelicae Dahuricae as a key component. 11.7% of wind. 10.6% of carbuncle and deep-rooted carbuncle. recorded the largest number of clinical frequency of the prescriptions in therapeutic use when Radix Angelicae Dahuricae was ta ken as a monarch drug in prescriptions, Prescriptions that utilize Radix Angelicae Dahuricae as t he main component are used in the treatment of apoplexy and carbuncle and deep-rooted carbuncle. headache. wound and they are also used for treating 26 different types of diseases. The prescriptions are compounded with Radix Angelicae Dahuricae as a monarch drug can ap ply to apoplexy, exogenous febrile disease, invasion by wind. wind-cold pathogen, wind-heat path ogen. epidemic disease, pestilence. bruise, bites, deficiency of liver and kidney, deficiency, phlegm-fire, phlegm-heat. The dosage of Radix Angelicae Dahuricae is 0.37g to 7.5g, however 3.75g has be en taken the most for clinical application. The function of Radix Angelicae Dahuricae is to expelling Wind and relieving pain, to expelling wound and forming muscle. to astrict and neutralizing poison. to expelling wind and to getting through body hole. to emit and relieving pain from the combination of drugs and prescriptions.

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Effectiveness of Nanocrystalline Silver(Acticoat®) Dressing at Wound Infected by Multidrug Resistant Bacteria (다제내성(多劑耐性)을 지닌 균주에 감염된 상처에서 Nanocrystalline Silver(Acticoat®) 드레싱의 효용)

  • Jeong, Tae Kwang;Yang, Ho Jik
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.691-696
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    • 2007
  • Purpose: The emergency of multi-drug resistant stains of bacteria represents a challenge in the field of plastic surgery. Especially, MRSA(methycillin-resistant Staphylococcus aureus) and Pseudomonas aeruginosa have strong pathogenicity as well as multi-drug resistance so that they have become a lot more problematic strains. This study has been planned to reduce the bacterial burden by applying $Acticoat^{(R)}$(Smith & Nephew Healthcare, Hull, England)dressing into the chronic wounds infected by multi-drug resistant strains and to facilitate their healing. Methods: Nanocrystalline silver dressings($Acticoat^{(R)}$) were applied to chronic wound infected by MRSA or Pseudomonas aeruginosa. Multi-drug resistant bacteria were smeared over a slide glass using sterilized cotton swabs and gram stains were performed directly before and after applying $Acticoat^{(R)}$ dressings at 1, 24, 48 and 72 hours. The gram-stained slides were observed using an optical microscope magnified 1000 times(${\times}1000$). The bacterial counts of the control group(0 hour) were compared to those of the experimental groups(1, 24, 48, and 72 hour). Paired T-test was used to assess a statistical significance. MRSA was cultured in two BAPs(blood agar plate) and two MacConkey plates with streak plate method. None were interventions on one culture plate, while on the other culture plate, $Acticoat^{(R)}$ was placed in a square shape and cultured for 72 hours at $37^{\circ}C$, then plates were examined. Pseudomonas aeruginosa was cultured in the same manner as MRSA. Results: There are the large amount of declination of bacterial counts with statistical significance after $Acticoat^{(R)}$ dressing. The bacteria grew in culture plate without specific intervention, but no bacteria grew in culture plate with applying of $Acticoat^{(R)}$ dressing. Conclusion: We believe that $Acticoat^{(R)}$ dressing could be used as an effective method of treating chronic wounds which are infected by multi-drug resistant organisms.

Development of LED Module for Tooth Care with Effect of Promoting Scar Treatment and Analysis of Optical Properties (흉터 치료 촉진 효과를 갖는 치아 케어용 LED 모듈 개발과 광학적특성 분석)

  • Yoo, Kyun-Man;Son, Jeong-Hueon;Jo, Hyun-Min;Kang, So-Hi;Kang, Seong-Soo;Park, Sung-Jun
    • Journal of the Korean Society of Industry Convergence
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    • v.23 no.4_2
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    • pp.701-708
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    • 2020
  • In this paper, we analyzed the optical properties of the LED module for dental care, which has the effect of promoting cell regeneration and scar treatment. The LED module is a U-shaped module suitable for the shape of teeth. It is manufactured with an LED module (632 nm) and an LED module (632 nm + 870 nm), analyzes the results of optical properties, sets the irradiation distance, irradiation time, and is effective in healing skin wounds. Evaluation was conducted. It was tested in 6 test groups according to the light irradiation conditions, and light was irradiated to the scar site every other day for 7 days, 1 day and 3 days. As a result, it was confirmed that the effect of scar treatment was the highest when the combined wavelength of 632 nm + 870 nm was irradiated in pulse mode than when the single wavelength was irradiated and the composite wavelength was continuously irradiated. In group C group irradiated with PW Mode: pulse mode (period 36 ms, pulse width 35 ms) using a composite wavelength with LED module (632 nm + 870 nm) than group A without light irradiation, the length of scar reduction was 19 %, the area of the scar was further reduced by 10%, and it was confirmed that it is effective in treating scars in the wound area.

The Treatment of Osmidrosis Axillae by Use of Modified Skoog's Method (Skoog씨 변법을 이용한 액취증의 치료)

  • Yim, Young-Min;Choi, Jong Woo;Kim, Gi Ho
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.245-249
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    • 2005
  • Various surgical procedures have been described for treating osmidrosis axillare. Elimination of the apocrine glands is prime goal. Optimal operative procedure is characterized as follows: minimal axillary scar(which has cosmetic merits), less complications such as hematoma and seroma, short and less painful recuperating period, minimal damage to the skin and low recurrence rate. Three types of incision technique in subdermal shaving method have beeb commoly used. First, single incision method has an advantage of minimal scarring but more recurrence due to incomplete removal of apocrine glands may occur. Second, double incision technique(Bipedicled flap) has advantages of complete excision, low recurrence rate and relatively minimal scarring, but it could cause frequent necrosis of skin and folding of skin flap. Skoog's method is the third method, which makes four flaps by offset cruciate incisions. It is a better technique in aspect of complete excision of apocrine glands and low recurrence rate but has disadvantages such as development of hypertrophic scar or scar contracture in the line that lies perpendicular to natural axillary skin crease. We used a modified procedure which has shorter length in vertical and transverse incision compared with the classic Skoog's method. We dissected further subcutaneous tissue through the diamond-shaped incision and utilize wide operation field that provide adequate excision of subdermal tissue and proper hemostasis. Between 1999 and 2004, we operated 160 osmidrosis axillare in 80 patients in this technique. Most patients obtained satisfactory result with very low complications. Hematoma or seroma 3.1% Infection 0.6% Partial wound disruption 10% Recurrence 1.2%. Modified Skoog's method for treating osmidrosis axillae could be a optimal technique providing wide operation field for adequate excision of apocrine glands and proper hemostasis and leaving relatively inconspicuous scar and low incidence of scar contracture.

XPS® Microresector for Treatment of Axillary Osmidrosis (XPS® Microresector(Shaver)를 이용한 액취증 수술)

  • Han, Byung Ki;Park, Sung Wook;Song, Jea Yong;Kim, Chung Hun
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.569-573
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    • 2008
  • Purpose: Surgical excision of the subcutaneous tissues, with or without skin excision in the axillary hair-bearing area, has been the treatment of choice in treating osmidrosis for several decades. However, long periods of postoperative immobilization of a shoulder joint, partial necrosis of skin flaps or the possibility of hematoma and scars have occurred frequently. So we used $XPS^{(R)}$ microresector(Shaver) in procedure which requires removal of soft tissue for comparing results between surgical excision and the laters. Methods: From January 2007 to February 2008, a total of 20 patients(8 male and 12 female) underwent $XPS^{(R)}$ microresector(Shaver) assisted aspiration for treating osmidrosis. The mean age of the subjects was 21.9, and we tried to analyze some advantages of $XPS^{(R)}$ microresector(Shaver). Results: The average operation time was 61.6 minutes. This results can show that the patients who received $XPS^{(R)}$ microresector(Shaver) assisted aspiration can accomplish better outcomes than any other procedures in terms of operation time at least. Moreover, no significant postoperative complications occurred in our studies. Subjects have been followed up from 2 months to 1 year and among these patients, no one suffered from critical complications. Conclusion: In brief, $XPS^{(R)}$ microresector(Shaver) is able to shorten the time of operation and simplify the procedures relatively and this device has more superiorities in wound healing by maintaining of vascularized dermal skin flaps. It means that $XPS^{(R)}$ microresector (Shaver) can prevent flap necrosis, axillary hair loss and minimalize scarring and bleeding. Thus, we expect that these advantages can lead to better patient's comfort and self-confidence than several previous procedures.