• Journal of Korean Physical Therapy Science
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• v.3 no.2
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• pp.1011-1019
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• 1996

The incidence of spinal cord injury increase due to traffic accident, industrial accident and leisure sports. Spinal cord injury damages motor and sensory function below the injury level, also affects autonomic functions associated with voiding and defecation. Sexual dysfunction and psychosocial, vocational maladaptations are also some of the unwanted consequences of injury. The purpose of this study is look for means to prevent and to manage complications in spinal cord injury through investigation and analysis. The subjects of this study in spinal cord injured patients were admitted to the department of physical therapy, Kwangju christian Hospital, Nam Kwang Hospital, Chun Nam university Hospital and Cho Sun university Hospital, from April, 1, 1995 to March, 31, 1996. The results are as follows: 1. The subjects comprised 96 cases of spinal cord injury, ranging from 17 to 85(mean-40.8 yrs) and included 72 males and 24 females. Among these patients, 58 were cervical injury, 20 were thoracic injury and 18 were lumbar injury. 2. As for a major causative of spinal cord injury were traffic accident(59.4%), fall down (27.1 %), and motocycle(4.2%).. 3. The bladder control were taken by indwelling cathetar(41.7%), Crede maneuver(37.5%) and self voiding(16.7%). The bowel control were taken by all aid(61.5%), assitance(32.3%) and self defecation(6.2%). 4. Possible of sexual function were 35 cases (47.9%). 5. The device of transfer used wheel chair(69.8%) and bed(16.7%). 6. The patients with higher cord lesion got more serious pain than lower cord lesion. Also the patients with higher cord lesion got a serious spasticity. 7. The incidence of decubitus ulcer among 96 patients were in case 46(47.9%). The largest group of the pressure sore sites were sacral portion(82.0%), less than 1 month of onset occured a large numbers(50%). Incidence of pressure sore by spasticity occured many patients in case of mild or moderate. Incidence of pressure sore by pain occured many patients in case of severe pain.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.107-112
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• 2010

Purpose: Recently, the change to a more complex social structure has led to an increased frequency of traumas due to violence, accident and so on. In addition, the severity of the traumas and the frequency of penetrating injuries have also increased. Traumas to cervical and abdominal areas, what are commonly seen by general surgeons, can have mild to fatal consequences because in these areas, various organs that are vital to sustaining life are located. The exact location and characteristics of the injury are vital to treating patients with the trauma to these areas. Thus, with this background in mind, we studied, compared, and analyzed clinical manifestations of patients who were admitted to Wonju Christian hospital for penetrating injuries inflicted by themselves or others. Methods: We selected and performed a retrospective study of 64 patients who had been admitted to Wonju Christian Hospital from January 2005 to December 2009 and who had cervical or abdominal penetrating injuries clearly inflicted by themselves or others. Results: There were 51 male (79.7%) and 13 female (20.3%) patients, and the number of male patients was more dominant in this study, having a sex ratio of 3.9 to 1. The range of ages was between 20 and 86 years, and mean age was 43.2 years. There were 5 self-inflicted cervical injuries, and 19 self-inflicted abdominal injuries, making the total number of self-inflicted injury 24. Cervical and abdominal injuries caused by others were found in 11 and 29 patients, respectively. The most common area involved in self-inflicted injuries to the abdomen was the epigastric area, nine cases, and the right-side zone II was the most commonly involved area. On the other hand, in injuries inflicted by others, the left upper quadrant of the abdomen was the most common site of the injury, 14 cases. In the neck, the left-side zone II was the most injured site. In cases of self-inflicted neck injury, jugular vein damage and cervical muscle damage without deep organ injury were observed in two cases each, making them the most common. In cases with abdominal injuries, seven cases had limited abdominal wall injury, making it the most common injury. The most common deep organ injury was small bowel wounds, five cases. In patients with injuries caused by others, six had cervical muscle damage, making it the most common injury found in that area. In the abdomen, small bowel injury was found to be the most common injury, being evidenced in 13 cases. In self-inflicted injuries, a statistical analysis discovered that the total duration of admission and the number of patients admitted to the intensive care unit were significantly shorter and smaller, retrospectively, than in the patient group that had injuries caused by others. No statistically significant difference was found when the injury sequels were compared between the self-inflicted-injury and the injury-inflicted-by-others groups. Conclusion: This study revealed that, in self-inflicted abdominal injuries, injuries limited to the abdominal wall were found to be the most common, and in injuries to the cervical area inflicted by others, injuries restricted to the cervical muscle were found to be the most common. As a whole, the total duration of admission and the ICU admission time were significantly shorter in cases of self-inflicted injury. Especially, in cases of self inflicted injuries, abdominal injuries generally had a limited degree of injury. Thus, in our consideration, accurate injury assessment and an ideal treatment plan are necessary to treat these patients, and minimally invasive equipment, such as laparoscope, should be used. Also, further studies that persistently utilize aggressive surgical observations, such as abdominal ultrasound and computed tomography, for patients with penetrating injuries are needed.

• Journal of Home Health Care Nursing
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• v.8 no.1
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• pp.25-37
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• 2001

Spinal cord injury patients need rehabilitation after the acute stage. They should be cared for at home to decrease hospitalization. Home care nurses play an important role in making spinal cord injury patients who have physical. and psychosocial problems do their best. For effective care, home care nurses need standardized nursing intervention protocols for spinal cord injury patients, but they are rarely developed. Therefore, this study was conducted to develop home care nursing protocols, based on NIC, that are applicable to spinal cord injury patients at home. Forty home care nursing charts of spinal cord injury patients registered in a home care nursing agency from July 1st, 1994 to August 31st, 1999 in S city were analyzed. Fifteen home care nurses participated in this study as a user validity validation group, The results of this study are as follows. 1. Fifteen nursing diagnoses were classified through the frequency analysis of home care nursing charts and previous literature for 40 spinal cord injury patients: altered urinary elimination, constipation, high risk for impaired skin integrity, chronic pain, impaired skin integrity, impaired social interaction, knowledge deficit, bowel incontinence, high risk for injury, altered role performance, care giver role strain, impaired physical mobility, sexual dysfunction, dysreflexia, and ineffective breathing pattern. 2. Based on validation by experts and user validities, 93 nursing interventions which were above ICV(Index of Content Validity) .80 were chosen. 3. Nursing intervention protocols which showed above ICV .80 were developed.

• Journal of Korean Academy of Nursing
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• v.24 no.1
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• pp.129-142
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• 1994

The purpose of this study determine and compare spinal cord injured(SCI) patients’ and nurses’ perceptions of SCI patients’ learning needs about altered elimination and then provide nursing data for more effective SCI patients’ learning process. Data collection was done from September 3 to October 2, 1993. For this study, 36 SCI Patients(12 paraplegia, 24 quadriplegia) and 20 nurses who were working neurosurgery or rehabilitation unit in 3 general hospitals in C and I city were selected. Data collection was accomplished by Questionnaire method and the instrument developed by the investigator, elicited information about learning needs about altered elimination of SCI patients from SCI patient, nurse, rehabilitation doctor, nursing professor, nursing graduate students. The questionnaire composed altered urinary elimination part with 10 categories and altered bowel elimination part with 10 categories. The results of this study were as follows : 1. There was no significant difference in learning needs about altered urinary elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered urinary elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=2.48, p=.017). 2. There was no significant difference in learning needs about altered bowel elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered bowel elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=-3.00. p=.005). 3. Degree of paraplegic SCI patients’ perceived learning needs about altered urinary elimination was 2.4083 and quadriplegic SCI patients’ perceptions were 2.0750. Degree of paraplegic SCI patients’ perceived learning needs about altered bowel elimination was 2.3972 and quadriplegic SCI patients' perceptions were 2.181.

• Journal of Trauma and Injury
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• v.33 no.3
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• pp.170-174
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• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.447-450
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• 2023

Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.

• Journal of Trauma and Injury
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• v.28 no.4
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• pp.284-291
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• 2015

The aim of this study is to present a nonoperative treatment for abdominal injuries in patients with multiple traumas and to discuss the role of metropolitan tertiary hospital, non-regional trauma centers. We collected data from patients with multiple traumas including abdominal injuries from 2009 to 2014. Patient characteristics, associated injuries, short-term outcomes and departments that managed the patients overall were analyzed. Based on treatment modalities for abdominal injury, patients were divided into two groups: the operative treatment group and the nonoperative treatment group. We compared differences in patient characteristics, injury mechanisms, initial vital signs, detailed injury types, lengths of hospital and ICU stays. Of the 167 patients with multiple traumas, abdominal injuries were found in 57 patients. The injury mechanism for 44 patients (77.2%) was traffic accidents, and associated extra-abdominal injuries were shown in 45 patients (78.9%). The mean lengths of hospital and ICU stays for the 57 patients were 36.4 days and 8.3 days, respectively. The in-hospital mortality rate was 8.8%. Ten patients (17.5%) were treated operatively, and 47 patients (82.5%) were treated nonoperatively. Among the 47 patients in the nonoperative treatment group, 17 patients received embolization, and 3 patients underwent a percutaneous drainage procedure. Operative treatments were used more in patients with injuries to the pancreas and bowel. No patient required additional surgery or died due to the failure of nonoperative treatment. No differences in the clinical characteristics except for the detailed injury type were observed between the two groups. In appropriately selected patients with multiple traumas including abdominal injuries, nonoperative treatment is a safe and feasible. For rapid and accurate managements of these patients, well-trained trauma surgeons who can manage problems with the various systems in the human body and who can decide whether nonoperative treatment is appropriate or not are required.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.258-260
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• 2023

Traumatic rupture of the right hemidiaphragm occurred following a high-velocity motor vehicle collision in the case presented herein. The resulting herniation of small bowel loops into the thorax resulted in hemodynamic and respiratory compromise due to pressure effects on the right heart and major vessels. The patient's hemodynamic status improved with reduction of enterothorax, and the diaphragmatic defect was repaired. We discuss the available literature and learning points from this rare case.

• Journal of Trauma and Injury
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• v.30 no.2
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• pp.70-73
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• 2017

Traumatic abdominal wall hernia is a rare condition that can follow any blunt trauma to the abdomen. Generally there has been an increase in the incidence of blunt abdominal trauma, although the case of traumatic abdominal wall hernias are rare. Probably due to the elasticity of the abdominal wall for resisting the shear forces generated by a traumatic impacts. In this case, we are reporting 1 rare case, diagnosed as an abdominal wall hernia associated with herniation of bowel loops due to blunt trauma without intra-abdominal injury including peritoneum.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.206-211
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• 2017

Aortic dissection caused by blunt trauma is a rare injury that can be complicated by malperfusion syndrome resulting from obstruction of branch vessels of the aorta. Here, we present a case of traumatic type B aortic dissection with right renal and small bowel ischemia, successfully managed by endovascular fenestration.