• Title/Summary/Keyword: Delayed repair

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Clinical Characteristics of Small Bowel Perforation due to Blunt Abdominal Trauma (복부 둔상으로 인한 소장 천공의 임상 양상에 대한 고찰)

  • Bae, Jung-Min
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.125-128
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    • 2011
  • Purpose: Blunt small bowel injury (SBI) is frequently combined other organ injury. So, clinical outcome and characteristics of SBI are influenced by other combined injuries. Thus, we analyzed isolated SBI patients and studied clinical outcome and characteristics. Methods: Between 2005 and 2010, 36 consecutive patients undergoing laparotomy due to isolated SBI were identified in a retrospectively collected. Database. Clinical outcome and characteristics were analyzed. Results: Laparotomy was performed in 36 patients. Primary repair was performed 17 patients. Segmental resection of small bowel was performed 19 patients. Median time gap from trauma to operation was 9 hours. In 24 hours from trauma, operation was performed 31 patients. Post operative death was 5 patients. Mean hospital stay was 18 days and median hospital stay was 12 days. There were significant differences between operation type and minor complication and hospital stay. And there were significant differences between time gap in 24 hours and minor complication. But, there were no significant between time gap and mortality. Conclusion: Although this study had many limitations, some valuable information was produced. When operation above 24 hours was delayed in SBI, minor complications were significantly increased. Segmental resection of small bowel in SBI were significantly increased minor complications and hospital stay. So, preventive measures for surgical site infection was important to reduce wound complication and hospital stay. Further continuous study and multi-center study were should be performed to improve clinical outcome in SBI.

Pure esophageal atresia. 2 case

  • Jeong, Sang-Seok;Choi, Phil-Jo;Park, Kwon-Jae;Bang, Jung-Hee;Cho, Gwang-Jo;Woo, Jong-Soo;Jung, Jin-A
    • Korean Journal of Bronchoesophagology
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    • v.14 no.1
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    • pp.59-64
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    • 2008
  • Pure esophageal atresia without tracheoesophageal fistula is a uncommon form of congenital malformation of the esophagus, which is able to be suspected by fetal ultrasonograpy before delivery and diagnosed definitely by simple chest X-ray and esophagogram immidiately after delivery. We performed delayed primary repair in 2 cases of pure esophageal atresia by using stomach for conduit in one case and colon in the other case. But there were graft failure in the latter case, so reoperation was performed by using stomach. Postoperatively, two patients showed no stenosis and leakage in anastomotic site and were discharged in good oral intake without dysphagia.

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Primary Esophageal Repair of Long-gap Esophageal Atresia - Report of One Case - (원간격결손 식도폐쇄증의 일차적 식도복원)

  • Lee, Myung-Duk
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.53-58
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    • 1995
  • A delayed primary esophago-esophagostomy of a case of long-gap esophageal atresia without tracheoesophageal fistula was performed in success with three months' intermittent periodic bougienage of the upper pouch via mouth as well as the lower esophagus through Janeway gastrostomy. Meanwhile, an effective continuous sump suction from the upper pouch seemed to be a critical part of the patient management. The extra length of esophagus for primary anastomosis could be achieved by a circular myotomy. Stricture at the myotomy site, found 4 months later, was treated with periodic pneumatic baloon dilations only with temporary symptomatic reliefs. After 4 months' trials, operative esophagoplasty was performed successfully. A careful follow-up schedule for the myotomy site would be required for early detection of stricture. The previous neonatal patient is currently 8 years old, healthy school-boy, and has a normal barium swallow without stricture or gastroesophageal reflux.

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Clinical Analysis of Acquired Tracheoesophageal Fistula (후천성 기관식도루의 임상적 고찰)

  • 백효채;김도형;조현민;이두연
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.61-65
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    • 2002
  • Background : Acquired tracheoesophageal fistula(TEF) results mostly from Prolonged tracheal intubation and insertion of nasogastric tube. Although the incidence has decreased since the usage of low pressure, high volume cuff of endotracheal tube, it is seldom cured spontaneously and needs surgical treatment. Material and Methods : We have retrospectively reviewed five cases of TEF who underwent surgical treatment for cure from March, 1990 to September, 2001 and analyzed the cause, treatment, postoperative complications and prognostic factors. Results : Majority were men(80% : 4 of 5 patients) and the mean age was 29.4 years old(range, 11-58). The most predominant etiology was prolonged intubation or tracheostomy(80% : 4 of 5 patients) and 3 of 5 patients were treated by tracheal resection and end to end anastomosis with primary closure of esophagus. Postoperative complications occurred in 4 patients the most common complications were wound infection(4 cases) and esophageal leakage(2 cases). Extubation was done on postoperative day 11.5(range, 1-33) days, and factors causing delayed extubation were status esophagus. epilepticus, edema, and tracheal stenosis. Conclusion : Spontaneous closure of TEF is seldom possible and the surgical treatment of choice is tracheal resection and end to end anastomosis with primary repair of the esophagus. preoperative pulmonary rehabilitation and early extubation postoperatively are important factors for success.

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AN EXPERIMENTAL STUDY ON PULPAL RESPONSE TO THE SELP-CURING RESIN FOR THE DIFFERENCE OF MIXING TIMES IN CAT (상온중합(常溫重合) 레진의 혼합시간(混合時間) 차이(差異)에 따른 성묘(成描)의 치수(齒髓反應)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Lee, Hyun-Shick;Woo, Y.H.;Park, Nam-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.27 no.1
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    • pp.213-222
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    • 1989
  • It is considered that self-curing resin will induce a little pulpal irritation, if mixing time is insufficient. So this study was designed to compare four different conditions between control group and three experimental groups. Canine teeth of 20 cats used, and class V cavities were prepared on maxillary canine of cats. Control group was filled with zone and other experimental groups were filled with zone after the application of the self-curing resin. Animals of the experimental and control group were sacrified at 3 days, 1, 2, 3, 4 weeks after the experiment. The finding lead to the following conclusions ; 1. Odontoblasts of first and third experimental groups were condensed irregularly and were changed at early stage, and reapir was delayed. 2. Odontoblasts of second experimental group were condensed slightly but, histologic repair was appeared at 4 weeks after the experiment 3. In all groups, the damaged odontoblastic cell layer were eventually disappeared at 4 weeks after the experiment.

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Peroneal Artery Perforator-Based Propeller Flaps for Reconstruction of Soft Tissue Defect around the Ankle Joint: A Report of Four Cases (비골 동맥 천공지 기저 프로펠러 피판술을 이용한 족관절 주위 연부조직 결손의 재건술: 4예 보고)

  • Cho, Byung-Ki;Park, Ji-Kang;Park, Kyoung-Jin;Chong, Suri
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.222-226
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    • 2014
  • Four patients with soft tissue defects around the ankle joint were covered with peroneal artery perforator-based propeller flaps. Using color Doppler sonography, the flap was designed by considering the location of the perforator and soft tissue defects. The procedure was then performed by rotating the flap by $180^{\circ}$. Additional skin graft was required in a patient due to partial necrosis, and delayed wound repair was performed in another patient with poor blood circulation at the distal part of the flap. The remaining patients did not have any complications and results were considered excellent. Good outcomes were eventually obtained for all patients.

Drying Shrinkage and Strength Properties of High-Fluidity Polymer-Modified Mortar (고유동 폴리머시멘트모르타르의 건조수축 및 강도 특성)

  • Joo Myung-Ki;Lee Youn-Su;Jung In-Su
    • Journal of the Korea Concrete Institute
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    • v.16 no.5 s.83
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    • pp.651-657
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    • 2004
  • The effects of polymer-cement ratio, antifoamer content and shrinkage-reducing agent content on the air content, setting time, drying shrinkage and strength of high-fluidity polymer-modified mortars using redispersible polymer powder are examined. As a result, the air content of the polymer-modified mortars using redispersible polymer powder tends to decrease nth increasing polymer-cement ratio and antifoamer content. Regardless of the antifoamer content, the setting time of the polymer-modified mortars using redispersible polymer powder tends to delayed with increasing polymer-cement ratio. Irrespective of the antifoamer content, the drying shrinkage of the polymer-modified mortars using redispersible polymer powder tend to decrease with increasing polymer-cement ratio and shrinkage-reducing agent content. Regardless of the antifoamer content, the flexural and tensile strengths of the polymer-modified mortars using redispersible polymer powder tends to increase with increasing polymer-cement ratio, and tend to decrease with increasing shrinkage-reducing agent content. However, the compressive strength of the polymer-modified mortars using redispersible polymer powder decreases with increasing polymer-cement ratio and shrinkage-reducing agent content.

Material Properties of Ultra Rapid Hardening Mortar for Repairing Sewage Treatment Concrete Pipes (콘크리트 하수관거 보수용 초속경 수중불분리 모르타르의 재료적 특성)

  • Lee, Byungjae;Lee, Sunmok;Bang, Jin-wook;Kim, Yun-yong
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.24 no.3
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    • pp.57-62
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    • 2020
  • Among the sewage pipes installed in Korea, the length of concrete pipes exceeding 20 years is 66,334 km (42.5%). Deteriorated concrete sewer pipes need to be repaired due to the leakage of internal sewage, which causes problems such as sink holes by expanding the cavity around the pipeline. In this study, we tried to apply anti-washout underwater mortar with ultra rapid hardening cement and segregation reducing agent to sewage pipe repair. As a result of the setting time test, the final set time was delayed by up to 172% by incorporating segregation reducing agent. In the test for measuring the degree of mortar segregation in water, it was measured at pH 12 or less under all mixing conditions. In addition, the suspension amount was measured to be 50 mg / l or less to satisfy the KCI-AD102 standard by incorporating a segregation reducing agent. In terms of the average value of mortar compressive strength, by incorporating segregation reducing agent, the strength of the specimens produced in air was more than 80% of that of the specimens produced in water. Conversely, the bond strengths of the specimens produced in water were measured to be higher than those of the specimens produced in air. Water resistance was evaluated by measuring water absorption and water permeability. Water absorption and water permeability were reduced by 42.6% and 36.6%, respectively, by mixing segregation reducing agent.

Diagnosis and Treatment of Pharyngocutaneous Fistula After Treatment of Oral Cavity and Pharyngolaryngeal Cancer (구강과 인후두의 악성종양 치료시 발생한 누공의 진단과 치료)

  • Hong, Hyun Joon;Song, Seung Yong;Lee, Won Jai;Lew, Dae Hyun;Rah, Dong Kyun
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.611-616
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    • 2009
  • Purpose: The rate of fistulas occuring followed by resection of oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancer are reported to be 9 ~ 23% according to various documents. Neglected treatment of the fistula can result in a setback in proper treatment with restrictions in oral intake leading to delayed return to daily life. Furthurmore, in severe cases, it may injure important vessels and adjacent structures of the neck area. The author reviewed previously reported cases of treatment methods for fistulas recurring after diverse head and neck operations and with sharing the treatment experiments of our patients, we tried to present a treatment algorism for different fistula types. Methods: Our study was based on retrograde analysis of 64 patients who were clinically diagnosed with fistula after operation for cancer of the head and neck from 1997 to 2008 at Severance Hospital. Their primary sites of cancer were 8 oral cavity, 22 oropharynx, 25 hypopharynx, and 9 larynx. The patients were aged 45 to 75 years and the male to female ratio was 11 to 1. The patient's operation records and progress notes were evaluated for determination of degree of fistula and treatment methods. Results: Most fistulas were clinically suspected after postoperative 5 days and symptoms noted for detection of the fistula were erythema, purulent discharge, edema, tenderness, and fluctuation. The fistula was definitely diagnosed at postoperative 2 weeks with barium test and treatment method ranging from conservative management to operative procedure were applied to each patients. Total 21 patients were managed with conservative protocol. In 15 cases, direct repair of the fistula was done and more stable repair of the fistula was possible with using of TachoComb$^{(R)}$. Pharyngostoma was performed in 14 patients. Among them, 4 patients healed spontaneously, 5 patients were taken direct closure, 4 patients were taken pectoralis major musculocutaneous flap, and one patient was taken esophageal transfer. The other 14 patients were taken 11 pectoralis major musculocutaneous flaps and 3 free flaps without pharyngostoma formation. Conclusion: Fistula is a troublesome complication resulting after resection of head and neck cancer. Early detection and adequate treatment according to the period and condition of the fistula may prevent further complications and reduce the pain of the patient.

Complete Transsection of the Trachea by Blunt Trauma (둔상에 의한 기관 완전 절단 - 1예 보고 -)

  • Kim, Dae-Hwan;Yoo, Byung-Ha;Kim, Han-Yong;Hwang, Sang-Won
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.79-82
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    • 2007
  • Tracheobronchial rupture due to blunt chest trauma is an uncommon injury although the incidence is increasing. Early diagnosis and primary repair of tracheobronchial rupture not only restore a normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair We present one case of the tracheal transsection caused by traffic accident. Patient suffered from progressive dyspnea, subcutaneous emphysema on the neck and anterior chest wall and tension pneumothorax at both sides were noted. Although both closed thoracostomy were done, massive air leakage through the chest tube continued and subcutaneous emphysema spread to the anterior abdominal wall and scrotum and the degree of dyspnea aggravated. With the impression of tracheobronchial injury, we performed the emergency operation. Preoperative bronchoscopy at the operation room was proceeded, which revealed the trachea was near totally transsected in transverse direction. Operation was performed through collar incisiion on the anterior neck, and the trachea was anastomosed with 4-0 $Vicryl^{(R)}$ interruptedly. Postoperative course were uneventful and patient discharged without any complications.