• Title/Summary/Keyword: Pre-surgery

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A comparative study between sterile freeze-dried and sterile pre-hydrated acellular dermal matrix in tissue expander/implant breast reconstruction

  • Cheon, Jeong Hyun;Yoon, Eul Sik;Kim, Jin Woo;Park, Seung Ha;Lee, Byung Il
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.204-213
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    • 2019
  • Background In implant-based breast reconstruction, acellular dermal matrix (ADM) is essential for supporting the inferolateral pole. Recent studies have compared non-sterilized freeze-dried ADM and sterilized pre-hydrated ADM, but have not assessed whether differences were attributable to factors related to sterile processing or packaging. This study was conducted to compare the clinical outcomes of breast reconstruction using two types of sterile-processed ADMs. Methods Through a retrospective chart review, we analyzed 77 consecutive patients (85 breasts) who underwent tissue expander/implant breast reconstruction with either freeze-dried ADM (35 breasts) or pre-hydrated ADM (50 breasts) from March 2016 to February 2018. Demographic variables, postoperative outcomes, and operative parameters were compared between freeze-dried and pre-hydrated ADM. Biopsy specimens were obtained for histologic analysis. Results We obtained results after adjusting for variables found to be significant in univariate analyses. The total complication rate for freeze-dried and pre-hydrated ADMs was 25.7% and 22.0%, respectively. Skin necrosis was significantly more frequent in the freeze-dried group than in the pre-hydrated group (8.6% vs. 4.0%, P=0.038). All other complications and operative parameters showed no significant differences. In the histologic analysis, collagen density, inflammation, and vascularity were higher in the pre-hydrated ADM group (P=0.042, P=0.006, P=0.005, respectively). Conclusions There are limited data comparing the outcomes of tissue expander/implant breast reconstruction using two types of sterile-processed ADMs. In this study, we found that using pre-hydrated ADM resulted in less skin necrosis and better integration into host tissue. Pre-hydrated ADM may therefore be preferable to freeze-dried ADM in terms of convenience and safety.

THE EFFECT OF PRE-OPERATIVE MAXILLARY OCCLUSAL PLANE ANGLE TO POST-OPERATIVE SKELETAL STABILITY AFTER TWO-JAW SURGERY (수술 전 상악 교합평면각이 상하악 동시 수술 후 골격 안정성에 미치는 영향)

  • Choi, Youn-Mo;Ryu, Dong-Mok;Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.2
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    • pp.141-147
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    • 2007
  • The purpose of this study was to evaluate the effects of maxillary occlusal plane angle to postoperative skeletal stability by comparative analysis after two-jaw surgery of patients with skeletal CIII malocclusion. This study was made with lateral cephalometric radiography of 52 patients with skeletal class III malocclusion that were performed to Le Fort I osteotomy and BSSRO. And 52 patients were divided to Group A(n=30) and B(n=22). Maxillary posterior impaction was not conducted in Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, and for Group B, which the pre-operative maxillary occlusal plane was low, the maxillary posterior impaction was conducted. The results were obtained as follows : 1. The relapse rate of Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, was relatively stable compared to Group B, which the pre-operative maxillary occlusal plane was low. 2. The relapse rate of each measurement of Group B, which had the maxillary occlusal plane altered during the operation, was somewhat high, and of those, the post-operative relapse rate of overjet, overbite, mandibular plane angle appeared to be significantly high in the statistics. The analyzed results above, was thought to be indicating that the pre-operative maxillary occlusal plane angle was closely related to the post-operative skeletal stability, and that obtaining post-operative skeletal stability only through operative normalization of occlusal plane angle may meet limitations.

CONSIDERABLE FACTORS FOR FINAL OCCLUSION IN PRE-ORTHODONTIC LOWER ANTERIOR SEGMENTAL SURGERY AND ITS AVAILABILITY (교정전 하악전치부 분절골절단술 시행시 고려사항 및 그 유용성)

  • Lee, Baek-Soo;Choi, Hyun-Jung;Nam, Kwang-Ho;Ryu, Dong-Mok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.1
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    • pp.43-47
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    • 2003
  • Anterior set back segmental surgery has been used for shortening the period of orthodontic treatment in case of bimaxillary or maxillary protrusion. In most cases, it requires pre-operative orthodontic treatment. Through properly performed leveling and tooth aligning, the operative porcedure can be easier and post-operative occlusal stability can be increased. But it takes time for orthodontic treatment. Recently, we have been using anterior segmental surgery before orthodontic treatment and have reliable results from that. Therefore, we have to consider arch shape, curve of Spee, tooth selection to be extracted for obtaining of post-operative occlusal stability without pre-operative orthodontic treatment.

Mid-face Lift with Preauricular Pre-excision Technique (귀 앞 피부 전 절제술을 이용한 중안면 거상술)

  • Lee, Min Woo;Jung, Jae Hak;Kim, Young Hwan;Sun, Hook
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.525-529
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    • 2006
  • Purpose: Facial nerve injury is a rare but feared complication of face lift. Uncertainty as to the depth and vulnerability of the facial nerve in face lift dissection causes some surgeon, particularly novices, to dissect slowly. Excessively thin flaps can be made because of fear of nerve injury, contributing to skin slough. Methods: From September 1998 to February 2003, the authors operated on 34 aging face patients using classical face-lift. We had analysed about quantity of skin removal and degree of elevated flap. The authors have found quantity of skin removal was 1.5-2.0 cm, degree of elevated flap was 40-45 degree on average. Results: The authors performed preauricular pre-excision face-lift technique on 12 aging face patients from July 2003 to Feburary 2005 based on experienced surgery. This technique reduced fear of dissecting skin flap necrosis and facial nerve injury because of firmly attached pre-auricular skin removed in advance. Conclusions: We easily dissected SMAS without visual field disturbance, nerve damage and reduced operation time and bleeding loss compared to classical face-lift.

Factors Influencing Intra-Operative Body Temperature in Laparoscopic Colectomy Surgery under General Anesthesia: An Observational Cohort

  • Kong, Mi Jin;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.19 no.3
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    • pp.123-130
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    • 2017
  • Purpose: This study aimed to identify factors influencing intra-operative core body temperature (CBT), and to develop a predictive model for intra-operative CBT in laparoscopic abdominal surgery. Methods: The prospective observational study involved 161 subjects, whose age, weight, and height were collected. The basal pre-operative CBT, pre-operative blood pressure, and heartbeat were measured. CBT was measured 1 hour and 2 hours after pneumoperitoneum. Results: Explanatory factors of intra-operative hypothermia (< $36^{\circ}C$) were weight (${\beta}=.361$, p< .001) and pre-operative CBT (${\beta}=.280$, p= .001) 1 hour after pneumoperitoneum (Adjusted $R^2=.198$, F= 7.56, p< .001). Weight was (${\beta}=.423$, p< .001) and pre-operative CBT was (${\beta}=.206$, p= .011) 2 hours after pneumoperitoneum (Adjusted $R^2=.177$, F= 5.93, p< .001). The researchers developed a predictive model for intra-operative CBT ($^{\circ}C$) by observing intra-operative CBT, body weight, and pre-operative CBT. The predictive model revealed that intra-operative CBT was positively correlated with body weight and pre-operative CBT. Conclusion: Influence of weight on intra-operative hypothermia increased over time from 1 hour to 2 hours after pneumoperitoneum, whereas influence of pre-operative CBT on intraoperative hypothermia decreased over time from 1 hour to 2 hours after pneumoperitoneum. The research recommends pre-warming for laparoscopic surgical patients to guard against intra-operative hypothermia.

Long-Term Effects of Adenotonsillectomy on Growth and Symptoms in Childhood (소아 성장 및 편도 비대 증상에 미치는 편도절제술의 장기 효과)

  • Park, Woo Sung;Ji, Yong Bae;Lee, Seung Hwan;Jeong, Jin Hyeok;Song, Chang Myeon;Tae, Kyung
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.12
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    • pp.681-685
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    • 2018
  • Background and Objectives This study was performed to evaluate the long-term effect of adenotonsillectomy on childhood growth by examining preoperative growth status and presenting symptoms. Subjects and Method One hundred and four patients who underwent adenotonsillectomy from January to December 2009 were enrolled in this study. Clinical data were collected from medical record reviews and through the administered questionnaire. We investigated symptoms and growth changes during 5 years following the surgery. Results The mean age of patients was $6.0{\pm}1.94$ years (range, 3-10), with the male to female ratio of 62:42. Pre-operative symptoms were significantly improved after the surgery. The mean pre-operative height and weight percentiles were $53.6{\pm}27.4$ and $59.6{\pm}29.2$ at initial evaluation, and $67.1{\pm}26.4$ and $59.6{\pm}28.6$ at 5 years post adenotonsillectomy (p<0.001, p=0.989), respectively. An increase in height percentile was more prominent in patients whose pre-operative height percentile was less than 50 compared to those with a percentile of 50 or more (p<0.001). Weight percentile was significantly increased in those with the pre-operative weight percentile of less than 50 and decreased in patients with a percentile of 50 or more. Conclusion Adenotonsillectomy has a positive effect on height growth in children with adenotonsillar hypertrophy, especially in patients whose height percentile is less than 50. Weight gain also can be expected in preoperative low-weight children.

The Effect of Pre-warming for Patients under Abdominal Surgery on Body Temperature, Anxiety, Pain, and Thermal Comfort (Forced-air Warming System을 이용한 수술 전 가온이 복부 수술 환자의 체온, 불안, 통증 및 온도 편안감에 미치는 효과)

  • Park, Ok-Bun;Choi, Hee-Jung
    • Journal of Korean Academy of Nursing
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    • v.40 no.3
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    • pp.317-325
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    • 2010
  • Purpose: The purpose of this study was to examine the effect of pre-warming on body temperature, anxiety, pain, and thermal comfort. Methods: Forty patients who were scheduled for abdominal surgery were recruited as study participants and were assigned to the experimental or control group. For the experimental group, a forced air warmer was applied for 45-90 min (M=68.25, SD=15.50) before surgery. Body temperature and anxiety were measured before and after the experiment, but pain and thermal comfort were assessed only after the surgery. Hypotheses were tested using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature than the control group from right before induction to two hours after surgery. Post-operative anxiety and pain in the experimental group were less than those of the control group. In addition, the score of thermal comfort was significantly higher in the experiment group. Conclusion: Pre-warming is effective in maintaining body temperature, lowering sensitivity to pain and anxiety, and promoting thermal comfort. Therefore, pre-warming can be recommended as a preoperative nursing intervention.

Balance Evaluation after Reconstruction of Medial Patellar Luxation in Small-Sized Dogs with Wii Balance Board

  • Lee, Shinho;Lee, Joo-Myoung;Park, Hyunjung;Cha, Yuri;Cheong, Jongtae
    • Journal of Veterinary Clinics
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    • v.36 no.6
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    • pp.301-305
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    • 2019
  • Wii® balance board (WBB, Nintendo, Japan) is a device that can measure and record the center of pressure path length (CPPL) and 95% confidence ellipse area (Area 95) in relation to body sway. For evaluating measure of improvement after reconstruction of medial patellar luxation (MPL) in small sized dogs, A total of 6 dogs with limping and lameness gait attributed to Grade II, III or IV MPL were evaluated. Dogs were measured for difference of extension and flexion range of motion in the stifle (dROM), muscle mass, lameness, willingness to bear weight on the affected limb while standing, and willingness to lift the contralateral limb scores, CPPL and Area 95 of WBB on pre-surgery, post-surgery 4, 8 weeks. CPPL was significantly different on pre-surgery compared with post-surgery 8 weeks (p < 0.05). Except for CPPL, measured variables were significantly different on pre-surgery compared with post-surgery 4 and post-surgery 8 weeks (p < 0.01).

Research on Computer-aided and Robotic-assisted Surgery of Fracture Reduction and Bone Deformity Correction under External fixation (외고정법을 이용한 컴퓨터이용 및 로봇지원 골절수술 및 골변형교 정술에 대한 연구)

  • Kim Y.H.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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    • pp.131-134
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    • 2005
  • This paper presents a computer-aided simulation and robotic-assisted execution technology of external fixation method to achieve fracture reduction and deformity correction in long bones. Combining the kinematic analysis with a graphic model of the tibia and the fixator allowed 3D simulation and visualization of the adjustments required to reduce fracture or correct bone deformity as a pre-operative planning tool. The developed robot model provided accurate deformity correction with small residual deformity based on the results of the planning. By incorporating the robot model with image-guided system and computer-aided planning, the integrated system could be useful for computer-aided pre-operative planning and robotic-assisted execution in fracture treatment and bone deformity surgery.

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Evolution of Process and Outcome Measures during an Enhanced Recovery after Thoracic Surgery Program

  • Lee, Alex;Seyednejad, Nazgol;Lawati, Yaseen Al;Mattice, Amanda;Anstee, Caitlin;Legacy, Mark;Gilbert, Sebastien;Maziak, Donna E.;Sundaresan, Ramanadhan S.;Villeneuve, Patrick J.;Thompson, Calvin;Seely, Andrew J.E.
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.118-125
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    • 2022
  • Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.