• 대한족부족관절학회지
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• 제19권3호
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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.

• Journal of Chest Surgery
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• 제27권7호
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• pp.634-638
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• 1994

Infection of a median sternotomy incision may result in a large, unsightly,unstable,and potentially fatal wound. During the past 8 years, 5 consecutive patients [ 4 male and 1 female ] had repair of infected sternotomy wound. We describe our current preferred techniques and the results we have achieved with them. As soon as the sternal infection was shown, operative wound was opened and irrigated more than 4 times a day with 0.5% Betadine iodine solution until the exudate became clean with no growth of bacteria. Operation was performed in one-stage, which consisted of aggressive debridement of the infected bone and muscle transposition. Reconstruction was with one-side or both pectoralis flaps in all patients and rectus abdominis in 2 patients. There was no mortality or morbidity within 30 days postoperatively. We conclude that early aggressive debridement and muscle transposition remain the treatment of choice for most patients with infected median sternotomy wounds.

• 대한기관식도과학회지
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• 제18권1호
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• pp.9-12
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• 2012

Boerhaave's syndrome is a very fatal condition occuring esophageal rupture during emesis and has the worst prognosis of the esophageal perforation. From May 2007 to March 2012 11 patients underwent surgical treatment for Boerhaave's syndrome at Inje University Sanggye Paik Hospital. There were 11 males whose mean age was 49.9 years ranging from 42 to 59. 2 cases of primary closure was performed and 9 cases of anastomosis using EEA (Esophago-Enteric Anastomisis) stapler. Mean operation time was 154.4 minutes and one patient who undergone primary repair died because of mediastinitis and sepsis on $35^{th}$ post-operative day. There was no leakage at other patients. Post-operative complication was one operative wound infection and one post-operative bleeding which was treated completely. Surgical treatment for Boerhaave's syndrome using EEA stapler is simple and effective technique but further studies with large number of cases should be carried out for better outcome.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.247-253
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• 2001

Objective : In general, to perform posterior lumbar interbody fusion(PLIF), it has been used more invasive procedure than simple discectomy. However we try to perform PLIF with TFC with smaller invasion almost same as in simple discectomy. This study is about its procedure and clinical results. Materials and Methods : The authors retrospectively analyzed 43 cases of minimally invasive PLIF with TFC from July 1998 to May 2000. Operative procedure, operative complication, change of disc height, blood loss, ambulation time, hospitalization period, clinical success rate, and bony fusion rate were analyzed. Results : 40 patients were capable to walk on the 2nd day of the post-operation. The average hospitalization period is 5.6 days. The average blood loss was 0.19L/level with no transfusion or wound drainage. The height of disc changed from 8.84mm to 13.54mm. Clinical success rate is 95% when evaluated by the Prolo's scale. The complication was delayed wound infection(2) and transient paresthesis(1). The bony fusion was shown in 17 patients (94.4%) out of 18 patients who passed one year. Conclusion : As a result of minimally invasive PLIF, pain was decreased and early ambulation and short hospitalization was possible. Complication was similar or lower than other studies, and the bony fusion rate and clinical success rate were also similar during follow-up.

• Journal of Gastric Cancer
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• 제7권4호
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• pp.248-253
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• 2007

목적: 수술 절개창 합병증은 의료진 및 환자에게 많은 노력과 비용을 발생 시킨다. 수술 절개창 합병증을 줄이기 위한 노력중 하나로 수술 시 절개창 보호 방법에 대한 연구가 있어왔으나 주로 절개창 감염에 국한된 연구였기 때문에 절개창 보호 방법이 절개창 합병증에 미치는 영향에 대해 알아보고자 하였다. 대상 및 방법: 위 절제술을 시행받은 295예의 위선암 환자를 대상으로 하였으며 연구기간은 2006년 5월부터 2006년 9월까지로 하였다. 수술 전 성별, 나이, body mass index, 음주 및 흡연력, ASA 분류를 조사한 후 환자의 동의를 얻어 무작위로 절개창 보호 방법을 결정하였다. 수술중 절개창을 보호를 하지 않은 비보호군(137명)과 폴리에틸렌(polyethylene) 보호막으로 절개창을 보호하는 보호군(432명)으로 분류하였으며, 발생한 합병증과 합병증 치료 기간을 조사 하였다. 결과: 수술 중 절개창을 보호하지 않은 비보호군과 절개창을 보호한 보호군 간에 환자의 기본 인자 및 수술 관련인자의 차이는 없었다. 전체 절개창 합병증은 비보호군에서는 42예, 보호군에서는 12예가 발생하여 통계학상으로 유의한 차이를 보였다(P=0.001). 장액종은 비보호군에서 29예, 보호군에서 6예(P=0.001), 감염은 비보호군에서 13예, 보호군에서 4예(p=0.030), 열개는 비보호군에서 6예와 보호군에서 2예(P=0.282)가 발생하였다. 재원기간은 절개창 비보호군에서 $12.3{\pm}9.7$일, 절개창 보호군에서 $10.3{\pm}5.4$일로 유의한 차이가 있었다(P=0.040). 결론: 본 연구를 통해 폴리에틸렌 보호막을 이용해 절개창을 보호하였을 때 전체 절개창 합병증이 감소하는 것을 확인하였다. 따라서 수술 중 보호막을 이용하여 절개창을 보호하여 절개창 합병증의 발생을 감소시킬 수 있으며, 나아가 불필요한 치료 기간의 연장을 줄일 수 있다.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.291-302
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• 2019

Median sternotomy is the most popular approach in cardiac surgery. Post-sternotomy wound complications are rare, but the occurrence of a deep sternal wound infection (DSWI) is a catastrophic event associated with higher morbidity and mortality, longer hospital stays, and increased costs. A literature review was performed by searching PubMed from January 1996 to August 2017 according to the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The following keywords were used in various combinations: DSWI, post-sternotomy complication, and sternal reconstruction. Thirty-nine papers were included in our qualitative analysis, in which each aspect of the DSWI-related care process was analyzed and compared to the actual standard of care. Plastic surgeons are often involved too late in such clinical scenarios, when previous empirical treatments have failed and a definitive reconstruction is needed. The aim of this comprehensive review was to create an up-to-date operative flowchart to prevent and properly treat sternal wound infection complications after median sternotomy.

• Journal of Chest Surgery
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• 제11권4호
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• pp.378-384
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• 1978

Injuries to the major vessels in the thoracic inlet require early recognition and expedient operative approach. Delayed diagnosis difficulties encountered in the operative exposure of the region are the major factors limiting successful management. This report is a review of 13 patients with vascular injuries to the neck base who were managed at Busan National University Hospital from March 1975 to September 1978 about 3 years and 6 months. The important clinical problems are delineated with emphasis on the technical aspects of operative management. 1] Among 13 cases, 8 cases were male 5 cases were female. 2] Of 28 vascular injuries, subclavian axillary vascular injuries were 22 [78%]. Stab wound was the cause in 70% of these patients. 3] Without extension 7 cases[53.8%] were managed successfully with supraclavicular, and axillary incision. Posterolateral thoracotomy one of extending 4 cases, 2 cases were used right musculoskeletal flap for management of proximal part of the subclavian artery and innominate vessel, 2 cases were used left supraclavicular incision with anterolateral thoracotomy for management of left proximal subclavian artery. One Expired. 4] Repair of vascular injury was accomplished by lateral suture of debridement and end-to end anastomosis in 17[74%]. Autogenous vein was used one for interposition graft. Ligation was required 2 arterial, 6 venous injuries. Of 8 cases which were pulseless preoperatively, 5 cases were able to palpable distal pulse. 5] Post operative complications occurred 50%. Complication of vasular repair was rare. The majority was neurologic deficit (33.3%).

• 대한두개안면성형외과학회지
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• 제17권3호
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• pp.111-118
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• 2016

The medial wall and floor of the bony orbit are frequently fractured because of the delicate anatomy. To optimize functional and aesthetic results, reconstructive surgeons should understand the anatomy and pathophysiology of orbital fractures. Appropriate treatment involves optimal timing of intervention, proper indications for operative repair, incision and dissection, release of herniated tissue, implant material and placement, and wound closure. The following review will discuss the management of orbital floor fractures, with the operative method preferred by the author. Special considerations in operation technique and the complication are also present in this article.

• Journal of Chest Surgery
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• 제33권3호
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• pp.245-251
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• 2000

Backround: Pulmonary aspergilloma is a potential life-threatening disease resulting from massive hemoptysis. Pulmonary aspergilloma has been treated surgically for many years, however, it has also had higher risk of mortality and complication rate. The purpose of this study is to analyze the operative methods and the types of complications. Material and Method: Sixty patients who underwent surgical resection for pulmonary their medical reconrds. Result: The mean age was 46.3$\pm$13.4 years(range 20 to 76 years). The most common clinical presentation was hemoptysis which occurred in 48 patients(80%). Pulmonary tuberculosis was the most common pre-existing disease, occurri9ng in 28 patients(46.7%). The other associated lung diseases were bronchiectasis(n=11), silicosis(n=2), and chronic pnumonia(n=1). Operative proceudres wer lobectomy in 35 patients, pneumonectomy in 6, segmentectomy in 5, lobectomy and thoracoplasty in 3, segmentectomy and thoracopasty in 1, and cavernostomy in 10. The operative mortality was 6%(n=3) in lung resection patients but 0% in cavernostomy patients. The most common complications were prolonged air leakage, wound infection and postoperative bleeding. Conclusion: In most cases of pulmonary aspergilloma surgical resectin remains the only effective therapy. However, cavernostomy may be more effective for pulmonary aspergilloma patients with decreased pulmonary functions and for patients with high risk for lung resection.

• Journal of Trauma and Injury
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• 제24권2호
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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.