• Title/Summary/Keyword: Complex wound

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Closure of a full-thickness scalp burn that occurred during hair coloring using a simple skin-stretching method: A case report and review of the literature

  • Oh, Suk Joon
    • Archives of Plastic Surgery
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    • v.46 no.2
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    • pp.167-170
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    • 2019
  • Full-thickness scalp burns secondary to hair coloring are rare; however, such defects can be large and complex reconstruction of hair-bearing tissue may be necessary. Many skin-stretching devices that use gradual traction have been applied to take advantage of the viscoelastic properties of the skin. A 21-year-old female patient was seen with a burn defect on her occipital scalp leading to exposed subcutaneous tissue after chemical application of hair coloring in a salon. The dimensions of the wound were $10cm{\times}5cm$, and a skin graft or flap would have been necessary to close the defect. Two long transfixing K-wires (1.4 mm) and paired 3-wire threads (23 gauge), which are readily available in most hospitals, were applied over a period of 12 days for trichophytic closure of the defect. The remaining scalp scars after primary trichophytic closure with this skin-stretching method were refined with hair follicle transplantation. This skin-stretching method is simple to apply and valuable for helping to close problematic areas of skin shortage that would otherwise require more complicated procedures. This case shows a relatively unknown complication of hair coloring and its treatment.

Delayed rupture of a posttraumatic retromaxillary pseudoaneurysm causing massive bleeding: a case report

  • Hwang, Jae Ha;Kim, Woo Hyeong;Choi, Jun Ho;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.22 no.3
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    • pp.168-172
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    • 2021
  • Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

Flow diversion of a middle cerebral artery pseudoaneurysm secondary to a gunshot wound: A case report

  • Justin C. Gelman;Max Shutran;Michael Young;Philipp Taussky;Rafael A. Vega;Rocco Armonda;Christopher S. Ogilvy
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.434-439
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    • 2023
  • Pseudoaneurysms are rare but devastating complications of penetrating head traumas. They require rapid surgical or endovascular intervention due to their high risk of rupture; however, complex presentations may limit treatment options. Our objective is to report a case of severe vasospasm, flow diversion, and in-stent stenosis complicating the treatment of a middle cerebral artery pseudoaneurysm following a gunshot wound. A 33-year-old woman presented with multiple calvarial and bullet fragments within the right frontotemporal lobes and a large right frontotemporal intraparenchymal hemorrhage with significant cerebral edema. She underwent an emergent right hemicraniectomy for decompression, removal of bullet fragments, and evacuation of hemorrhage. Once stable enough for diagnostic cerebral angiography, she was found to have an M1 pseudoaneurysm with severe vasospasm that precluded endovascular treatment until the vasospasm resolved. The pseudoaneurysm was treated with flow diversion and in-stent stenosis was found at 4-month follow-up angiography that resolved by 8 months post-embolization. We report the successful flow diversion of an middle cerebral artery (MCA) pseudoaneurysm complicated by severe vasospasm and later in-stent stenosis. The presence of asymptomatic stenosis is believed to be reversible intimal hyperplasia and a normal aspect of endothelial healing. We suggest careful observation and dual-antiplatelet therapy as a justified approach.

Numerical Studies on the Effects of the Channel-Inlet-Pressure Difference in the Pressure-Retarded Osmosis (PRO) Power System (압력지연삼투(PRO) 발전 시스템에서 채널 입구 압력차의 영향에 대한 수치해석적 연구)

  • Hong, Sung Soo;Ryoo, Won;Chun, Myung-Suk;Chung, Gui Yung
    • Korean Chemical Engineering Research
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    • v.52 no.1
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    • pp.68-74
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    • 2014
  • In the spiral wound module of the pressure-retarded osmosis (PRO) system for the salinity gradient power generation, effects of the inlet pressure differences between feed-channel and draw-channel were studied. Fluxes of water and solute through membrane and power were estimated. The water flux through membrane decreased along the x-direction and increased along the y-direction with the increase of inlet pressure differences between two channels. On the other hand, the solute flux through membrane showed the opposite trend. The concentration of flow in the feed-channel increased a lot along the y-direction and that in the draw-channel decreased along the x-direction. In our system, for the inlet pressure differences of 1~11 atm, the flow rate in the feed-channel decreased about 8~13% and that in the draw-channel increased by the same amount. The power density increased and then decreased with the increasing inlet pressure difference.

Study of Legal Issues on Complex Regional Pain Syndrome (CRPS) - Focusing on issues in damage compensation lawsuit - (복합부위통증증후군(CRPS)에 관한 법적 문제 고찰 - 손해배상소송의 쟁점을 중심으로 -)

  • Bae, Hyun-Mo
    • The Korean Society of Law and Medicine
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    • v.11 no.1
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    • pp.91-116
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    • 2010
  • As Complex Regional Pain Syndrome (CRPS) is a new and rare illness, medical cause for it has not yet been clearly found out. Nevertheless, the patients continue to file lawsuits for damage compensation against wrongdoers or their insurers, claiming that the cause of the illness is certain actions of the wrongdoers. Moreover, the claim amount reaches to hundreds of millions of won through billions of won unlike other illnesses. Therefore, CRPS has become an important legal issue in the damage compensation lawsuit. Even though the wound is slight, the development and result may be serious in the case of CRPS. As a result, a sharp conflict arises even regarding medical diagnosis of CRPS in the lawsuit. And, even if the medical diagnosis of CRPS is admitted, severe debates occurs with regard to many issues, which include the causation between accident and CRPS in connection with establishment of damage compensation liability and scope of liability like anamnesis, determination standard of aftereffect disability, and scope of admitted aftereffect medical expense in connection with scope of damage compensation. In this study, I will review fundamental medical research on CRPS up to now and discuss principal legal issues in the damage compensation lawsuit focusing on lower court rulings.

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DRG2 Regulates G2/M Progression via the Cyclin B1-Cdk1 Complex

  • Jang, Soo Hwa;Kim, Ah-Ram;Park, Neung-Hwa;Park, Jeong Woo;Han, In-Seob
    • Molecules and Cells
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    • v.39 no.9
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    • pp.699-704
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    • 2016
  • Developmentally regulated GTP-binding protein 2 (DRG2) plays an important role in cell growth. Here we explored the linkage between DRG2 and G2/M phase checkpoint function in cell cycle progression. We observed that knockdown of DRG2 in HeLa cells affected growth in a wound-healing assay, and tumorigenicity in nude mice xenografts. Flow cytometry assays and [$^3H$] incorporation assays indicated that G2/M phase arrest was responsible for the decreased proliferation of these cells. Knockdown of DRG2 elicited down-regulation of the major mitotic promoting factor, the cyclin B1/Cdk1 complex, but upregulation of the cell cycle arresting proteins, Wee1, Myt1, and p21. These findings identify a novel role of DRG2 in G2/M progression.

Superior Gluteal Artery Perforator Turn-Over Flap Coverage for Lumboscaral Soft Tissue Defect in Ambulatory Patient (보행 환자에서의 위볼기동맥천공지뒤집기피판을 이용한 허리엉치 부위 연부조직 결손의 치료)

  • Moon, Suk-Ho;Kim, Dong-Seok;Oh, Deuk-Young;Lee, Jung-Ho;Rhie, Jong-Won;Seo, Je-Won;Ahn, Sang-Tae
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.712-716
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    • 2010
  • Purpose: Extensive lumbosacral defects after removal of spinal tumors have a high risk of wound healing problems. Therefore it is an effective reconstructive strategy to provide preemptive soft tissue coverage at the time of initial spinal surgery, especially when there is an instrument exposure. For soft tissue reconstruction of a lumbosacral defect, a variation of the gluteal flap is the first-line choice. However, the musculocutaneous flap or muscle flap that is conventionally used, has many disadvantages. It damages gluteus muscle and causes functional disturbance in ambulation, has a short pedicle which limits areas of coverage, and can damage perforators, limiting further surgery that is usually necessary in spinal tumor patients. In this article, we present the superior gluteal artery perforator turn-over flap that reconstructs complex lumbosacral defects successfully, especially one that has instrument exposure, without damaging the ambulatory function of the patient. Methods: A 67 year old man presented with sacral sarcoma. Sacralectomy with L5 corpectomy was performed and resulted in a $15{\times}8\;cm$ sized complex soft tissue defect in the lumbosacral area. There was no defect in the skin. Sacral stabilization with alloplastic fibular bone graft and reconstruction plate was done and the instruments were exposed through the wound. A $18{\times}8\;cm$ sized superior gluteal artery perforator flap was designed based on the superior gluteal artery perforator and deepithelized. It was turned over 180 degrees into the lumbosacral dead space. Soft tissue from both sides of the wound was approximated over the flap and this provided in double padding over the instrument. Results: No complications such as hematoma, flap necrosis, or infection occurred. Until three months after the resection, functional disturbances in walking were not observed. The postoperative magnetic resonance imaging scan shows the flap volume was well maintained over the instrument. Conclusion: This superior gluteal artery perforator turn-over flap, a modification of the conventional superior gluteal artery perforator flap, is a simple method that enabled the successful reconstruction of a lumbosacral defect with instrument exposure without affecting ambulatory function.

Effect of a Hot Water Extract of Sparasis Crispa on the Expression of Tight Junction-Associated Genes in HaCaT Cells (꽃송이버섯 열수추출물이 HaCaT의 세포 연접 관련 유전자의 발현에 대한 영향)

  • Han, Hyo-Sang
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.2
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    • pp.83-92
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    • 2021
  • Purpose : Keratinocytes are the main cellular components involved in wound healing during re-epithelization and inflammation. Dysfunction of tight junction (TJ) adhesions is a major feature in the pathogenesis of various diseases. The purpose of this study was to identify the various effects of a Sparassis crispa water extract (SC) on HaCaT cells and to investigate whether these effects might be applicable to human skin. Methods : We investigated the effectiveness of SC on cell HaCaT viability using MTS. The antioxidant effect of SC was analyzed by comparing the effectiveness of ABTS to that of the well-known antioxidant resveratrol. Reverse-transcription quantitative polymerase chain reaction (qRT-PCR) is the most widely applied method Quantitative RT-PCR analysis has shown that SC in HaCaT cells affects mRNA expression of tight-junction genes associated with skin moisturization. In addition, Wound healing is one of the most complex processes in the human body. It involves the spatial and temporal synchronization of a variety of cell types with distinct roles in the phases of hemostasis, inflammation, growth, re-epithelialization, and remodeling. wound healing analysis demonstrated altered cell migration in SC-treated HaCaT cells. Results : MTS analysis in HaCaT cells was found to be more cytotoxic in SC at a concentration of 0.5 mg/㎖. Compared to 100 µM resveratrol, 4 mg/㎖ SC exhibited similar or superior antioxidant effects. SC treatment in HaCaT cells reduced levels of claudin 1, claudin 3, claudin 4, claudin 6, claudin 7, claudin 8, ZO-1, ZO-2, JAM-A, occludin, and Tricellulin mRNA expression by about 1.13 times. Wound healing analysis demonstrated altered cell migration in SC-treated HaCaT cells and HaCaT cell migration was also reduced to 73.2 % by SC treatment. Conclusion : SC, which acts as an antioxidant, reduces oxidative stress and prevents aging of the skin. Further research is needed to address the effects of SC on human skin given the observed alteration of mRNA expression of tight-junction genes and the decreased the cell migration of HaCaT cells.

Postsurgical Wound Infection Caused by Mycobacterium conceptionense Identified by Sequencing of 16S rRNA, hsp65, and rpoB Genes in an Immunocompetent Patient (16S rRNA, hsp65, 및 rpoB 염기순서분석으로 동정한 Mycobacterium conceptionense에 의한 면역능이 정상인 환자에서 발생한 수술후 창상감염)

  • Lee, Ja Young;Kim, Si Hyun;Shin, Jeong Hwan;Lee, Hyun-Kyung;Lee, Young Min;Song, Sae Am;Bae, Il Kwon;Kim, Chang-Ki;Jun, Kyung Ran;Kim, Hye Ran;Lee, Jeong Nyeo;Chang, Chulhun L.
    • Annals of Clinical Microbiology
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    • v.17 no.1
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    • pp.23-27
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    • 2014
  • Rapidly growing mycobacteria are ubiquitous in the environment and are increasingly being recognized as opportunistic pathogens. Recently, a new species, Mycobacteium conceptionense, has been validated from the Mycobacterium fortuitum third biovariant complex by molecular analysis. However, there are few reports, and postsurgical wound infection by this species is rare. We report a case of postsurgical wound infection caused by M. conceptionense in an immunocompetent patient that was identified by a sequencing analysis of 16S rRNA, hps65, and rpoB genes.

Three-dimensional printing for craniomaxillofacial regeneration

  • Gaviria, Laura;Pearson, Joseph J.;Montelongo, Sergio A.;Guda, Teja;Ong, Joo L.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.5
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    • pp.288-298
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    • 2017
  • Craniomaxillofacial injuries produce complex wound environments involving various tissue types and treatment strategies. In a clinical setting, care is taken to properly irrigate and stabilize the injury, while grafts are molded in an attempt to maintain physiological functionality and cosmesis. This often requires multiple surgeries and grafts leading to added discomfort, pain and financial burden. Many of these injuries can lead to disfigurement and resultant loss of system function including mastication, respiration, and articulation, and these can lead to acute and long-term psychological impact on the patient. A main causality of these issues is the lack of an ability to spatially control pre-injury morphology while maintaining shape and function. With the advent of additive manufacturing (three-dimensional printing) and its use in conjunction with biomaterial regenerative strategies and stem cell research, there is an increased potential capacity to alleviate such limitations. This review focuses on the current capabilities of additive manufacturing platforms, completed research and potential for future uses in the treatment of craniomaxillofacial injuries, with an in-depth discussion of regeneration of the periodontal complex and teeth.