• Archives of Plastic Surgery
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• v.34 no.2
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• pp.209-216
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• 2007

Purpose: The ischial area is by far the most common site of pressure sores found in wheel chair bound paraplegic patients, because greatest pressure is exerted from the body on this area in a sitting position. Even after a series of successful pressure sore treatments, the site is very prone to relapse by the simplest ordinary tasks of everyday life. Therefore, it is crucial to preserve the main pedicle during primary surgery. Various surgical procedures employed to treat pressure sores such as myocutaneous flap and perforator flap have been introduced. After introduction of ischial sore treatment using the inferior gluteal artery perforator (IGAP) has been made, the authors experienced favorable clinical results of patients who have undergone IGAP flap procedure in a three year time period. Methods: A total of 17 patients received IGAP flap surgery in our hospital from January 2003 to May 2006, among which 14 of them being males and 3 females. Surgery was performed on the same site again in 6(35%) patients who had originally relapsed after receiving the conventional method of pressure sore surgery. Patients' average age was 49.4(27-71) years old. Most of the patients were paraplegic(11 cases, 65%) and others were either quadriplegic(4 cases, 23%) or ambulatory(2 cases, 12%). Based on hospital records and clinical photographs, we have attempted to assess the feasibility and practicability of the IGAP flap procedure through comparative analysis of several parameters: size of defective area, treatment modalities, occurrence of relapses, complications, and postoperative treatments. Results: The average follow-up duration of 17 subjects was 25.4 months(5-42 months). All flaps survived without any necrosis. Six cases were relapsed cases from conventional surgical procedures. All of them healed well during our follow-up study. Postoperative complications such as wound dehiscence and fistula developed in some subjects, but all were well healed through secondary treatment. A total of 2 cases relapsed after surgery. Conclusion: The inferior gluteal artery perforator flap is an effective method that can be primarily applied in replacement to the conventional ischial pressure sore reconstructive surgery owing to its many advantages: ability to preserve peripheral muscle tissue, numerous possible flap designs, relatively good durability, and the low donor site morbidity rate.

• Korean Journal of Adult Nursing
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• v.15 no.2
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• pp.267-277
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• 2003

Purpose: The purpose of this study was to evaluate the applicability of braden scale to assess pressure ulcer risk patients and to identify additional risk factors of pressure sores in an neurologic intensive care unit. Method: The subjects of this study were 66 patients in neurologic intensive care units. Data was prospectively collected from Sep. to Dec., 2002. Data were analyzed by mean, percentage, t-test, chi-square, discriminant analysis using Spss pc+. Result: The results of this study were as follows: 1) There was a significant difference between scoring of braden scale and pressure ulcer development. The subscales that predicted pressure ulcer development using braden scale only were sensory perception, moisture, mobility, friction & shear. By using these subscales, sensitivity was 86.7%, and specificity was 61.1%, and total hit ratio was 72.7%. 2) Additional pressure ulcer risk factors which showed significance for discriminating two group were protein, albumin, gender, level of consciousness, pattern of bowel elimination. By using the combination of these additional risk factors in addition to the braden scale, total hit ratio increased to 84.8%. Conclusion: This data suggest that albumin, protein, gender, level of consciousness, pattern of bowel elimination in addition to the braden scale should be included in the pressure sore assessment tool.

• Physical Therapy Korea
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• v.15 no.4
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• pp.59-63
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• 2008

Pressure sores are painful and needless complications of critical illness. and manifest as a localized area of ischemic necrosis of tissue caused by pressure. This study analyzed the bed-backrest elevation system combined with hip and knee flexion for lower extremity lower pressure reduction. Eight healthy adults aged 21 to 26 years were recruited. The Body Pressure Measurement Mat of the TekScan system was used to measure the location and magnitude of the peak pressures on the body bed interface. The SPSS statistical package was used to analyze the significance of differences between the general bed-backrest elevation system and the bed-backrest elevation system combined with hip and knee flexion using the paired t-test. The result showed that the body-pressure of the lower extremity was more significantly reduced for the bed-backrest elevation system combined with hip and knee flexion ($26.6{\pm}4.3$ mmHg) than a general bed-backrest elevation system ($37.3{\pm}5.2$ mmHg) (p<.05).

• Journal of Physiology & Pathology in Korean Medicine
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• v.36 no.1
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• pp.35-39
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• 2022

The purpose of this study is to report the effect of Jaungo and acupuncture and debridement for severe pressure ulcer in the elderly. Two Elderly patients with stage 4 pressure ulcer in the sacral region were eligible to participate in this study. Dressing using Jaungo was applied twice a day, and acupuncture was applied 4 times a week along the boundary between the normal epidermis and the pressure ulcer granulation tissue in contact with the pressure ulcer interface. Debridement was performed after partial or total removal, if necessary, under the judgment of the attending physician.In both cases, stage 4 pressure sores in the sacrum covered with crusts were cured in 193 days and 223 days, respectively, and no side effects were reported during treatment. This study shows that Jaungo and acupuncture and debridement may represent effective to treat pressure ulcer. but further studies are needed.

• Journal of Naturopathy
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• v.9 no.2
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• pp.71-78
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• 2020

Purpose: This study was to present home-care cases of gangrene sores or prevalent diseases using fake energy salt (FES) water containing energy. Methods: The health functional foods used for disease management were FES Water. Each product was Myeongil Leaf powder, dried yeast, propolis, fermented organic calcium, and royal jelly. Changes were investigated after taking this food. Some of them were combined with hospital treatment, and most of them were experienced by patients at home while managing the affected area. Results: One patient with high fever swine flu, who was treated in a hospital, had a fever dropping to the normal range in 2 hours, and one patient with a leg fracture healed in about six weeks, and one patient had bone adhesion in 2 weeks. Patients with rhinitis recovered after taking FES, and the intraocular pressure of patients with damaged retinopathy fell from 40 mmHg to 20 mmHg after taking FES. One patient with postpartum sequelae was said to have improved their aching limbs four days, and a Covid-19 confirmed patient admitted to the hospital was discharged ten days after starting taking FES during treatment. The size of the gangrene sores in 19 subjects initially ranged from 1 to 7 cm. Most of them were alleviated or healed by continuing to manage them at home with health functional food intake and FES for two weeks to a year. Conclusions: The above results are personal experiences and health functions, such as fake energy salts. It was possible to recognize that food was helpful for health promotion, but no final medical diagnosis was made.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.277-282
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• 2009

Purpose: The vegetative state is a clinical condition with complete unawareness of self and environment, but with preservation of brain - stem functions. Vegetative patients may have nosocomial infections in their wounds, like pressure sores and infected craniums after cranioplasties. Usually flap surgery is necessary for those wounds, but decision of undergoing surgery is difficult because of various adverse conditions of vegetative patients. We share our experience of several successful flap surgeries in vegetative patients, and evaluate obstacles and requirements to get satisfactory results. Methods: From December 2005 to September 2008, a total of 4 vegetative patients underwent surgeries. In 2 patients with infected artificial craniums, scalp reconstructions with free flaps were performed. In other 2 patients with huge pressure sores with sepsis, island flap coverage of wounds was done. Retrospective study was done on hospital day, vegetative period, number of surgeries done, underlying diseases, causative bacteria, and contents of informed consent. Results: Mean hospital day was 14 months and mean vegetative period was 17.5 months. Patients underwent average of 4.5 surgeries under general anesthesia. There were several underlying diseases like hypertension, DM, CHF and chronic anemia. MRSA(Methicilin - resistant Staphylococcus Aureus) was cultured from every patient's wounds. Informed consent included a warning for high mortality and a need of attentive familial cooperation. Conclusion: There are three requirements for doing flap surgeries in vegetative patients. First, to prevent aggravation of brain damage and underlying diseases by general anesthesia, multidisciplinary team approach is needed. Second, operation should be beneficial for prolonging patient's lifespan. Third, because postoperative care is very difficult and long hospitalization is needed, detailed informed consent and highly cooperative attitude of family should be confirmed before operation.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.223-228
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• 2008

Purpose: V.A.C. is a new concept which is closed dressing with negative pressure to promote wound healing. It has been widely used as the treatment of chronic and acute wounds such as pressure sores, burns, stasis ulcers, and other complicated wounds. However It has disadvantages such as high cost and the need of specific equipment. In this article, we described new method to overcome these disadvantages. Methods: We made newly innovated equipment with 50 cc syringe and spring to create negative pressure. From May 2006 to May 2007, we applied it to two patients with chronic wound. Results: The treatment period was 5 weeks for one case and 3 weeks for the other case. Both patients were healed completely without admission and wound healing was accelerated. During follow-ups, there were no complications. The mean cost for single dressing was 9,590 won. Conclusion: Modified portable negative therapy using newly innovated equipment could accelerate wound healing better than conventional dressing. It lowers the number of dressings, saves cost of treatment, and enables treatment as outpatient basis.

• Journal of Preventive Medicine and Public Health
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• v.47 no.5
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• pp.273-280
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• 2014

Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

• The Journal of Internal Korean Medicine
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• v.42 no.2
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• pp.122-130
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• 2021

The purpose of this study is to report the effect of Korean medicine treatment on a pressure sore in a stroke patient. An 86-year-old female patient diagnosed with spontaneous intracerebral hemorrhage in the right basal ganglia had symptoms of left hemiparesis, dysphagia, and a 4.5-cm-by-2.5-cm left trochanteric pressure sore. Clinical outcomes were measured using the National Pressure Ulcer Advisory Panel (NPUAP) pressure injury stages, the Agency for Health Care Policy and Research (AHCPR) pressure ulcer stages, and the Braden scales. Treatment with Korean medicine, including acupuncture, herbal medicine, and dressing therapy, significantly improved the trochanteric pressure sore, as reflected by a NPUAP stage change from III to I, an AHCPR stage change from III to I, and a Braden scale change from 13 to 18. These findings suggest that Korean medicine treatment may be effective to treat pressure sores in stroke patients.

• The Journal of Korea Robotics Society
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• v.15 no.3
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• pp.269-276
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• 2020

As we become an aging society, the number of elderly patients continues to increase. Pressure sores that can easily occur in patients with trauma cause serious socio-economic problems. In general, prevention of bedsores through predicting the patient's posture is being developed. Developed method usually use artificial intelligence techniques to estimate the patient's posture by measured pressure images in the mattress. In this method, it has a problem the reduction of estimation accuracy when posture of patient is changed. Therefore, it is necessary to use the filter of pressure images in the position transition of patient. In this paper, we propose an algorithm to predict the patient's posture, and an algorithm to reduce the ambiguity that can occur in the patient's posture transition section. By obtaining stable data through this algorithm, learning/prediction stability of the neural network can be expected, and prediction performance is improved accordingly. Through experiments, the effectiveness of the algorithm was verified.