• 대한장애인치과학회지
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• 제9권1호
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• pp.30-35
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• 2013

The four principles of treatment of odontogenic infection are as follows : (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including proper rest and nutrition. A separate incision is required to establish drainage, especially in the case of extensive fascial space infections. There are four principle causes for active bleeding in the immediate incision & drainage phase; (1) vascular wall alteration (infection, scurvy, chemicals), (2) disorder of platelet function, (3) thrombocytopenic purpuras, (4) disorders of coagulation (liver disease, anticoagulation drug). If the hemorrhage from incision & drainage site is aggressive, the site must be packed with proper wet gauze and wound closure & drainage dressing are applied. The specific causes of bleeding may be associated with hypoxia, changes in the pH of blood & chemical changes affecting vascular contractility and blood clotting. This is a case report of bleeding control by the circumferential suture & drainage on active bleeding incision & drainage site of temporal space abscess due to advanced odontogenic infection in a multiple medically compromised disabled patient.

• 대한치과마취과학회지
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• 제14권1호
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• pp.63-71
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• 2014

Extension of advanced odontogenic infection from deep neck fascial spaces into the mediastinum is heralded by chest pain, dyspnea, fever, and radiographic demonstration of mediastinal widening. The critical care should be done in a team approach by multiple medical and dental departments, such as, oral & maxillofacial surgery, otolaryngology, anesthesiology, chest surgery, and infection medicine. Especially, fluid & drug therapy, adequate incision & drainage and systemic supportive psychosedation care are important. But, acute hyperventilation can be produced by several distinct causes: severe anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The orofacial fears about acute pain, trismus, dysphagia, swelling and oral surgical treatment lead to the severe anxiety and increased blood catecholamine level by stress. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the care, hyperventilation was occurred during psychosedation and local anesthesia for incision and drainage of the masticatory fascial space abscess with deep neck infection & mediastinitis. We suggest that the dental patient with advanced odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

• 대한족부족관절학회지
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• 제13권2호
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• pp.236-239
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• 2009

Heel abscesses present as heel pain that progressively worsens, with associated tenderness and fullness a the heel pad. To our knowledge, there are fews reports in the literature describing a spontaneous heel pad abscess. A 48-years old woman presented spontaneously with pain, erythema, edema and increased warmth to this right foot. She has no underlying disease and steroid injection history. A radiologic examination was suggestive of an abscess. Follow incision and drainage, cultures that were taken during the surgical procedure did not produce any organism. The patient was discharged home and recovered from the abscess without recurrence or further surgical intervention.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권3호
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• pp.197-203
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• 2017

Once a submasseteric space infection is diagnosed, the key to resolving the infection is via surgical intervention to evacuate the pus. Although it is possible and occasionally practical to drain the submasseteric space via an intraoral approach, an extraoral approach may sometimes be required. Surgeons have encountered complications such as facial nerve damage during extraoral incision and drainage procedures, and they have felt that extraoral dissection was very difficult. As such, an easier and simpler technique is needed. Our department recently modified various drainage techniques for submasseteric space abscesses. Damage to the marginal branch of the facial nerve did not occur, and this technique was very simple and rapid, such that a novice physician could perform this procedure. This modified technique was possible with trismus and under local anesthesia. After intraorally checking the position of the drain, the intraoral wound is closed with an absorbable suture and the drain is fixed to the extraoral skin. When a masseteric space infection is diagnosed, multiple space involvement is ruled out, and dependent drainage is required, this modified drainage technique can be useful.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.538-542
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• 2010

Acute mediastinitis is a fatal infection which occurs related to connective tissue of mediastium, in the thoratic organs. Occurrence of mediastinitis due to craniocervical infection is very rare, and is defined as descending necrotizing mediastinitis. November 8th, 2008, man in his early fifties visited ER due to severe swelling on left neck area and dyspnea. Antibiotic were administered immediately, and vast amount of abscess formation on pneumomediastinum and adjacent tissues were observed via chest computed tomography. With cooperation of thoracic and cardiovascular surgery department, emergency incision and drainage with drain insertion was done to remove abscess, and control the infection. After surgery, everyday saline irrigation through drain was done during hospitalization, with continues antibiotic therapy. Descending necrotising mediastinitis is a most rare and dangerous infection which occurs on oropharyngeal area. In case of descending necrotising mediastinitis, accurate diagnosis, airway maintenance, remove of abscess by incision and drainage, aggressive antibiotic therapy and continuous saline irrigation is necessary to increase patient survivability. Also, computed tomography with contrast media is essential to figure out the size and location of the infection and abscess formation.

• Journal of Chest Surgery
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• 제24권12호
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• pp.1228-1231
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• 1991

One of the most lethal forms of mediastinitis is descending necrotizing mediastinitis, in which infection arising from the oropharynx spreads to the mediastinum. Despite the development of computed tomographic scanning to aid in the early diagnosis of mediastinitis, the past 30 years, in large part because of continued dependence on transcervical mediastinal drainage, Although transcervical drainage is usually effective in the treatment of acute mediastinitis due to a cervical esophageal perforation, these approach in the patient with descending necrotizing mediastinitis fails to provide adequate drainage and pre-disposes to sepsis and a poor outcome. In addition to cervical drainage, aggressive, early mediastinal exploration - debridement and drainage through a subxiphoid incision or thoracotomy - is advocated to salvage the patient with descending necrotizing mediastinitis.

• Journal of Chest Surgery
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• 제35권2호
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• pp.161-165
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• 2002

하행 괴사성 종격동염은 대부분 경부 부위의 농양으로 시작하여 종격동으로 파급되는 매우 치명적인 질환이며 저자에 따라 25∼40%의 사망률을 보고하고 있다. 빠른 진단과 적절한 수술적 치료가 중요하며 수술적 치료의 방법에는 아직 여러 가지 방법들이 보고되고 있지만 농양의 완전한 배농이 특히 중요하다고 보고하고 있다. 배농술은 경부 절개를 통한 배농과 함께 흉부 내의 종격동 배농술이 필요하며 종격동 배농술은 대부분 개흉술을 통하여 시행되어 왔으나 개흉술에 따른 합병증과 수술부위의 감염 등이 술후 이환율을 증가시키는 원인이 될 수 있다. 반면에 흥강경을 이용한 배농은 경부 배농술 및 흉부 배농술을 동시에 시행할 수 있으며 좋은 수술시야를 보여주고 술후 환자의 회복이 빨라 하행 괴사성 종격동염의 좋은 치료 방법이라 생각된다.

• 대한장애인치과학회지
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• 제7권2호
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• pp.107-114
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• 2011

Dental extraction is potentially stress-inducing in many disabled patient. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress, the stress reduction method was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk, (2) Complete medical consultation before dental therapy, (3) Schedule the patient's appointment in the morning, (4) Monitor and record preoperative and postoperative vital signs, (5) Use psychosedation during therapy, (6) Use adequate pain control during therapy, (7) Short length of appointment : do not exceed the patient's limits of tolerance, (8) Follow up with postoperative pain/anxiety control, (9) Telephone the risk patient later on the same day that treatment was given. Though the stress reduction method above was applied to the dental extraction in disabled patients with the advanced infected teeth, the complications(syncope, shock, bleeding & infection, etc.) may be occurred. For prevention of complications associated with the extraction, the authors treated the advanced infected teeth with endodontic drainage and incision & drainage before extraction. The final extraction and wound closure were then done after about 3 weeks.

• 대한관절경학회지
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• 제15권2호
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• pp.117-120
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• 2011

광범위 심부 농양의 치료는 일반적으로 절개 및 배농이 원칙이다. 그러나 철저한 절개배농을 위해서는 피부 절개의 범위가 커지게 된다. 또한 큰 절개에도 불구하고 좋지 않은 수술 영상 및 시야 확보가 힘든 경우가 있을 수 있어, 수술 과정에서 정상 조직에 대한 추가적인 손상과 큰 절개 반흔이 문제가 될 수 있다. 이를 해결하고자 저자들은 비복근 파열로 인한 혈종에 병발한 광범위 심부 농양에 대하여 내시경적 치료를 시행하여 만족스러운 결과를 얻었으며, 기존에 보고된 바 없기에 문헌고찰과 함께 이를 보고하고자 한다.

• Journal of Chest Surgery
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• 제27권8호
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• pp.708-709
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• 1994

Tuberculosis infection of sternum is extremely rare. The most common cause of sternal osteomyelitis is infection of a median sternotomy incision, employed for most cardiac operation. If a wound infection of this regeon becomes apparent, the wound should be opened wide to allow adequate drainage. Frequent irrigation and debridement are necessary to avoid extension of the infection into the bone. We have experienced a 16 years old female who has been operated upon due to ASD, was infected with tuberculosis in sternum. Our team have treated her for tuberculous osteomyelitis on sternum with curettage and drainage.