• Title/Summary/Keyword: Infected wound

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Microbiology and Antibiotic Selection for Diabetic Foot Infections (감염된 당뇨병성 족부 병변의 균주 조사 및 항생제 선택)

  • Park, Se-Jin;Jung, Haw-Jae;Shin, Hun-Kyu;Kim, Eu-Gene;Lim, Jong-Jun;Yoon, Ji-Woong
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.150-155
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    • 2009
  • Purpose: To help the empirical antibiotics selection in diabetic foot infection patients, we investigated prevalence of microorganisms and their antibiotics sensitivity results. Materials and Methods: Patients who came to our clinics to treat diabetic foot infections with deep ulceration and were followed up more than 6 months until complete recovery were adopted. From March 2006 to June 2009, there were 140 patients who corresponded with such a inclusion criteria. Wound cultures were done by deep tissue or bone debris at first visit to our clinics. Microorganisms which was documented by wound culture and most susceptible antibiotics by minimum inhibitory concentrations were surveyed retrospectively. Results: Microorganisms were confirmed in 113 cases (80.7%). In the other 27 cases (19.3%), there were no cultured microorganisms. In bacterial growth group, there were 72 cases (63.7%) of gram-positive bacteria and 41 cases (36.3%) of gram-negative bacteria. All of them were aerobic microorganisms and there were no anaerobic microorganisms. Methicillin-sensitive staphylococcus aureus was the most common pathogen and accounted for 35 cases (31.0%). As other common pathogens, there were Enterobacter cloacae (11 cases, 9.7%), pseudomonas aeruginosa (10 cases, 8.8%), Methicillin-resistant staphylococcus aureus (10 cases, 8.8%) and enterococcus faecalis (6 cases, 5.3%), and so on. Common susceptible antibiotics in gram positive microorganism were vancomycin (60 cases, 83.3%), teicoplanin (60 cases, 83.3%), nitrofurantoin (60 cases, 83.3%) and ciprofloxacin (53 cases, 73.6%). In gram negative ones, common susceptible antibiotics were imipenem (35 cases, 85.3%), piperacillin/tazobactam (33 cases, 80.5%) and gentamicin (31 cases, 75.6%). Conclusion: Methicillin-sensitive Staphylococcus aureus in gram positive and enterobacter cloacae in gram negative was the most common pathogen in each group. Ciprofloxacin and gentamicin might be adaptable as a first-line empirical antibiotics in infected diabetic foot patients.

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ACTIVE BLEEDING CARE DURING SURGICAL EXTRACTION OF MANDIBULAR THIRD MOLAR: REPORT OF TWO CASES (하악지치 발치 중 극심한 출혈 치험례)

  • Kim, Jong-Bae;Yoo, Jae-Ha;Moon, Seon-Jae;Kim, Seung-Beom
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.6
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    • pp.560-564
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    • 2001
  • The experienced surgeon can be surprised & challenged by the hazards of active bleeding during oral & maxillofacial surgical procedure, because of alterations in the surgical anatomy, bleeding disorders and surgical intervention of infected tissues. This is a report of two cases of active bleeding during surgical extraction of mandibular third molar, that had the pericoronitis, osteitis and adjacent neurovascular bundle in its apex. When the abrupt active bleeding was occurred during surgical extraction of mandibular third molar, pressure packing by hemostatie agent(bone wax) & wet gauze biting were applied into the extraction socket during 30 minutes. After 30 minutes, the wound was explored about the bleeding and active bleeding was then continued. In spite of repeated bleeding control method of the pressure dressing, the marked hemorrhage was generated continuously. Therefore, the author decised the bleeding as immediately uncontrollable hemorrhage and the pressure dressing was again applied for the more longer duration without wound closure. After 3 days, the pressure dressing was removed and iodoform gauze drainge was then established without the bleeding. The drain was changed as the interval of 3~5 days for prevention of infection & secondary hemorrhage and relatively good wound healing was then resulted in 6 weeks.

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Soft Tissue Reconstruction Using Perforator Flap in Patients with Infected Knee Prosthesis

  • Lee, Jin Won;Kim, Sung Hoon;Yoo, Jun Ho;Roh, Si Gyun;Lee, Nae Ho;Yang, Kyoung Moo
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.70-75
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    • 2014
  • Purpose: Soft-tissue reconstruction in the knee area requires thin, pliable, and tough skin. The range of motion of the knee also acts as a limitation in using only local flaps for coverage. The author has successfully used various perforator flaps for soft tissue reconstruction around the knee while preserving its functional and cosmetic characteristics. Materials and Methods: Out of the twenty patients assessed from April 2009 to March 2011, seven received anterolateral thigh perforator flaps, four received medial sural perforator island flaps, four received lateral supragenicular perforaor perforator flaps, and five received medial genicular artery flaps. The age of the patients ranged from 44 to 79 and the size of the defects ranged from $4{\times}5cm$ to $17{\times}11cm$. Fifteen of the twenty patients had histories of total knee replacement (TKR) surgery. Results: There were no flap losses in any of the twenty patients assessed. Two patients showed partial losses in the distal area of the flap, but were treated through careful wound care. One patient presented with pedicle adhesion at the drainage site from a past TKR, but it did not hinder the flap survival. Primary closure at the donor site was possible in nine patients, while split skin graft was necessary for the other 13. Conclusion: In soft tissue reconstruction of the knee, various perforator flaps can be used depending on the condition of the preoperation scar, wound site, and size. It also proved to provide better functional and cosmetic results than in primary wound closure or skin grafts.

Morphological and Cultural Characteristics of Glomerella cingulata Causing Anthracnose of Citrus (감귤 탄저병균의 형태 및 배양적 특성)

  • Koh, Young-Jin;Song, Jang-Hoon;Ahn, Mi-Yeon;Moon, Doo-Khil;Han, Hae-Ryong;Kwon, Hyeog-Mo;Moon, Duck-Young
    • The Korean Journal of Mycology
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    • v.25 no.1 s.80
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    • pp.30-34
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    • 1997
  • Glomerella cingulata (conidial state: Colletotrichum gloeosporioides) was identified as the causal organism of anthracnose of citrus on the basis of morphological characteristics of the conidial state of the fungus isolated from infected leaves of Satsuma mandarin and its ascigerous state isolated from diseased twigs. The pathogen infected the leaves of Satsuma mandarin, citron and Natsu daidai only by wound inoculation. The optimum temperature range for mycelial growth and sporulation of conidia of the strain was $25{\sim}30^{\circ}C$, respectively. The characteristics of anthracnose strain of Satsuma mandarin such as growth rate and color of colony, shape and size of conidia, and appressoria were similar to those of FGG strain. However, the strain isolated from infected leaves and twigs of Satsuma mandarin was different from FGG strain to cause postharvest anthracnose of citrus, because some of morphological and pathological characteristics of the strain isolated did not correspond to those of FGG strain.

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EFFECT OF DRAINAGE AS A STRESS REDUCTION METHOD BEFORE EXTRACTION OF ADVANCED INFECTED TEETH IN DISABLED PATIENTS : REVIEW OF LITERATURE & REPORT OF CASES (장애환자에서 과도한 감염치아 발치전 스트레스 감소법으로서 배농술의 효과 : 문헌적 고찰 및 증례보고)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Lee, Chun-Ui;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.2
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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.

Surgery for Synovial Fistula after Excision of the Lateral Malleolar Bursitis of the Ankle: A Case Report (족관절 외과의 점액낭염 절제술 후 발생한 활액막 누공의 수술적 치료: 증례 보고)

  • Jang, Hyo-Seok;Choi, Hong-Joon
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.3
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    • pp.118-121
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    • 2015
  • Lateral malleolar bursitis of the ankle is a commonly encountered disease in the department of orthopedic surgery. Although most cases of lateral malleolar bursitis are managed by conservative treatments, operative treatment is considered in cases of infected bursitis or complication after surgery. There are several potential complications associated with operative treatment, including wound healing problem, skin necrosis, nerve injury, or recurrence. However, synovial fistula of the ankle as a complication after surgery for lateral malleolar bursitis has not been previously reported. The author experienced the complication of synovial fistula after surgery for lateral malleolar bursitis and obtained a satisfactory result in revision surgery for the complication, which was coverage of the fistular formation with a periosteal flap from the distal fibula.

Facial Skin Tuberculosis by Mycobacterium abscessus (Mycobacterium abscessus에 의한 안면부 피부결핵)

  • Ahn, Hee Chang;Baik, Eui Hwan;Oh, Jung Kun;Sung, Kun Yeong
    • Archives of Plastic Surgery
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    • v.33 no.1
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    • pp.127-130
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    • 2006
  • The incidence of the tuberculosis infection has decreased worldwide, but it is still easy to find the patients in some areas or some races. And it is very difficult to diagnose and treat the patients who are infected by the atypical tuberculosis. Facial skin infection by atypical tuberculosis has not been reported. We report the case of a 62-year-old woman who developed facial skin and soft tissue necrosis caused by Mycobacterium abscessus after receiving liquid silicone injections and face lift operation. We cultured the pathogenic organism and treated the wound with radical curettage, debridement, skin graft and tuberculosis medication.

Osteoradionecrosis of the jaws (악골에 발생된 방사선골괴사)

  • Ahn Hyoun-Suk;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.31 no.1
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    • pp.57-65
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    • 2001
  • Osteoradionecrosis is one of the most serious complication after heavy irradiation of bone and most particularly following treatment of cancers within the head and neck. The irradiated bone has the decreased vascularity and is easily infected. As a result, the spread of infection may cause a nonhealing wound that is very difficult to be treated. A comprehensive prophylactic dental care as well as proper blocking of the radiation field before radiotherapy must be considered to reduce the risk of osteoradionecrosis. We present three cases of osteoradionecrosis which developed after extraction of teeth in irradiated patients.

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Case Report of Squamous-cell Carcinoma of the Mandibular Gingiva with Invasion of The Bone, Treated by Resection and Tibial Bone Graft (악골결손부에 경골이식술로 성형한 치험예)

  • Kim, Kwang-Hyun;Kim, Hong-Ki;Choi, Mock-Kyun
    • The Journal of the Korean dental association
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    • v.11 no.3
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    • pp.195-198
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    • 1973
  • The authors have treated a squamous-cell carcinoma occurred in molar region of the right mandible in 52-year old woman by means of bony resection and banked tibial bone graft, and made the normal appearance of her face. The result as follow: 1) The healing of a graft is similar to the healing of an uninfected fracture except that it will take considerably longer. It is of the utmost importance that it should be well immobilized, otherwsie there is danger of absorption of bone and fibrous union. 2) Until the graft acquires a blood supply it is easily infected, for it has no defence against organisms, so it is most important to prevent wound infection set in.

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Venous Occlusion Detected by Caregiver with Implantable Doppler in a Buried Free Flap

  • Hur, Su Won;Kim, Tae Gon;Lee, Jun Ho;Chung, Kyu Jin;Kim, Yong-Ha
    • Archives of Craniofacial Surgery
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    • v.15 no.3
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    • pp.121-124
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    • 2014
  • The use of the implantable Doppler device eases the burden of free flap monitoring, and allows caregivers to notify healthcare personnel of a potential vascular event. A 24-year-old female patient underwent anterolateral thigh adipofascial flap surgery to provide a buried flap on the left temporal area for a depressed and infected skull wound. The author was able to salvage the flap from two venous occlusions, which was made possible by early notifications from the caregiver who reported changes in the Doppler signal.