• 제목/요약/키워드: Simple suture

검색결과 126건 처리시간 0.026초

섬수약침 마취후 수술적으로 제거된 표피낭종 증례 (A Case of Epidermal Cyst Using Surgical Method After Bufonis Venenum Pharmacopuncture Anesthesia)

  • 이득주;권강;서형식
    • 한방안이비인후피부과학회지
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    • 제30권2호
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    • pp.165-169
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    • 2017
  • Objectives : The aim of this study is to report the effect of surgical method after Bufonis Venenum Pharmacopuncture Anesthesia on epidermal cyst. Methods : A 49-year-old male was presented with a $1.5{\times}1.5(cm)$ sized epidermal cyst on the upper back. Local anesthesia was achieved with Bufonis Venenum pharmacopuncture. After 5 minutes, 2.5cm incision was made using 11th blade. To minimize bleeding, the laser($CO_2$ Hani-maehwa laser-surgical mode) was excised to the cyst wall. After incision, cyst were separated and removed using adson forceps and iris scissors. Then buried intradermal suture and simple interrupted suture were performed. Yeonkyopaedok-san was administered for 5 days for anti-inflammatory effects. After 10 days, the suture was removed after confirmation of skin adhesion. Results : Cyst size measured $1.0{\times}1.0{\times}1.0(cm)$. Until the suture is removed, Adverse effects were not reported. Conclusions : Bufonis Venenum pharmacopuncture applies to local anesthesia. Korean medicine cautery method applies to laser($CO_2$ Hani-maehwa laser). It can be considered that To expand the application of surgical treatment in korean medicine.

봉합 실패로 발생된 과다 육아조직에 대해 한의과에서 시행한 절제 및 재봉합 증례 (A Case of Dissection and Resuture Performed at the Department of Korean Medicine for Excessive Granulation Tissue Caused by Suturing Failure)

  • 허은나;권강;서형식
    • 한방안이비인후피부과학회지
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    • 제36권4호
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    • pp.181-186
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    • 2023
  • Objectives : The purpose of this study is to report case of hypergranulation tissue that occurred after laparotomy and dissected by CO2 laser. Methods : A 72-year-old female had hypergranulation tissue on the epigastrium. Local anesthesia was achieved with bufonis venenum pharmacopuncture. The CO2 laser was used for dissection. After removal of granulation, irrigation with soyeom pharmacopuncture solution and simple interrupted suture were performed. Yeonkyopaedok-san were administered for 7 days and the suture was removed after 14 days. At last, saengkigo was applied. Results : Hypergranulation tissue sized 1.0×1.0×1.0cm was clearly removed. Including excessive growing of granulation tissue, adverse effects were not reported until the clear skin adhesion. Conclusions : Hypergranulation tissue was surgically removed and sutured completely without any complications by using pharmacopuncture, oral herbal medicine and ointment that have anti-inflammatory effects and wound healing. Through this study, it is hoped that surgery including suture will be actively performed in more diverse diseases in the Korean medicine community.

오면체 모양 절제법을 이용한 유두축소 (Nipple Reduction with a Pentahedral Excision Technique)

  • 홍윤기;심형보
    • Archives of Plastic Surgery
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    • 제36권3호
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    • pp.327-332
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    • 2009
  • Purpose: Several methods of the nipple reduction have been reported. However, the methods described previously are difficult or have some demerits. This study proposes a simple technique for reduction of the nipple height as well as diameter. Methods: The purposed nipple height is marked. A pentahedral design of excision was marked around the nipple. Local anesthetic solution was infiltrated and a 4 - 0 Nylon traction suture was applied at the nipple apex. Excision of the nipple inside both two triangles and a rectangle was made. Remaining two flaps were approximated using 5 - 0 Nylon simple interrupted sutures. However, a part of wound closure was not done in the central area of the nipple. Results: 83 patients(166 nipples) underwent this procedure from December 1999 to December 2008. Follow up ranged from 6 months to 2 years with a mean of 10 months. 78 patients were female and 5 patients were male. No major complication occurred and remaining scars were very inconspicuous. Conclusion: This simple technique has the advantage of nipple reduction in both height and diameter, and provides good aesthetic outcomes.

Bankart 수술 후 발생한 금속 봉합 나사못 합병증의 관절경적 치료 (Arthroscopic Treatment of Metallic Suture Anchor Failures after Bankart Repair)

  • 신상진;정재훈;김성재;유재두
    • 대한관절경학회지
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    • 제10권1호
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    • pp.70-76
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    • 2006
  • 목적: 금속 봉합 나사못을 이용한 견관절 습관성 전방 탈구 수술 후, 여러 원인에 의하여 발생한 금속 봉합 나사 못 돌출 합병증을 보고하고 발생 원인, 임상 양상 및 관절경적 치료에 대하여 알아보고자 하였다. 대상 및 방법: 견관절 습관성 전방 탈구로 봉합 나사못을 이용한 Bankart 수술을 시행 받은 후 운동시 들리는 관절내 마찰음 및 통증 또는 불안정성을 호소하며 내원하여 관절경 재수술을 시행받은 환자 5명을 대상으로 하였다. 처음 수술 이후 재수술까지의 평균 기간은 5.2개월이었다. 환자들은 관절경 재수술시 봉합 나사못의 돌출이 확인되었으며 관절경 술식을 이용하여 돌출 봉합 나사못을 제거하였다. 결과: 주 증상은 4명에서 통증을 동반한 관절내 마찰음이었으며 이 마찰음은 외전 및 외회전시 분명하게 들렸다. 1명은 통증과 함께 견관절 불안정성을 호소하였다. 견관절 운동 범위는 외회전만 약간 감소되었을 뿐 거의 정상 소견을 나타내었다. 돌출되었던 봉합 나사못의 위치는 5시 방향 1명, 4시 방향 2명, 2시 및 3시 방향 각각 1명씩이었다. 그 중 2명은 전방 관절와연에서 5 mm 정도 내측 관절면 위에 위치하였다. 나머지 3명은 올바른 위치에 삽입되어 있었으나 나사못 주변의 연골 마모 및 골소실이 관찰되었다. 재수술시 5명 모두 상완골두에 연골 손상이 발견되었으며 1명은 관절와에도 연골 결손이 동반되었다. 재수술 후 2년째 추시 결과 재탈구나 불안정성을 보이는 환자는 없었으며 통증에 대한 VAS 점수는 수술 전 3.4에서 수술 후 1.2로 감소되었다. Constant 점수는 수술 전 65점에서 수술 후 89점으로 증가하였으며 ASES 점수도 수술 전 67점에서 수술후 88점으로 증가하였다. 결론: 봉합 나사못 합병증으로 인한 증상은 불안정성을 동반하지 않는 경우가 많으며 대부분 재활 운동 시점부터 증상이 나타나지만 정상적인 수술 후 통증과 구분이 어려운 경우가 많다 그러나 돌출된 봉합 나사못은 상완골두 연골의 파괴를 유발하는 심각한 합병증을 초래하므로 봉합 나사못 돌출이 의심되면 관절경을 통하여 관절내의 변화를 관찰하며 돌출된 봉합 나사못을 다시 삽입하거나 제거하여야 한다. 봉합 나사못 제거에 본 수술 방법을 사용하면 용이하게 봉합 나사못 제거가 가능하리라 사료된다.

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당김줄을 이용한 소아 열상 환부의 쉽고 빠른 발사 방법 (Easy and Fast Stitch out Method with a Traction Nylon in Pediatric Sutured Wound)

  • 이윤정;이경석;김준식;김남균
    • Archives of Plastic Surgery
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    • 제37권2호
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    • pp.199-201
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    • 2010
  • Purpose: Except for continuous suture in skin layer, stitching out in facial laceration, we have to hold each knots up and cut the knots by No. 11 blade or small scissors. However, we often have difficulty in stitching out the knots on children who do not cooperate well. Therefore we introduce an easy and fast stitch out method of pediatric lacerations. Methods: From January to May 2009, we studied 15 pediatric patients (mean age 5.6 years old) who had facial laceration on face or underwent any surgery on operation room. For easy stitch out, we left the one string of the first knot long enough to extend at the opposite end of laceration site. And then the extended string was fixed to skin using Steri-strip. Next we do simple interrupted suture including the extended traction nylon string inside the knot. Through this method, we can stitch out all knots simply by lifting up the traction nylon needless to hold the each knot one by one. Results: Until stitching out, the traction nylon was just right position and there was no normal tissue injury during stitch out all knots. Patients were satisfied with the short stitch out time. Conclusion: By using the traction nylon on pediatric laceration suture, we can stitch out all the knots with no normal tissue injury in less time.

견관절 불안정성의 관절경적 치료에 있어 Beach chair position의 유용성 (The Usefulness of Beach-chair position in the Arthroscopic Treatment of Shoulder Instability)

  • 최창혁;신민철
    • Clinics in Shoulder and Elbow
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    • 제5권2호
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    • pp.118-123
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    • 2002
  • Purpose: The purpose was to identify the effectiveness of beach-chair position in the arthroscopic Bankart repair over conventional lateral decubitus position with distal traction. Materials & Methods: 36 arthroscopic Bankart repair through July 2000 to July 2001 was done under beach chair position. All cases were shoulder instability. Male patients were 6 and female were 4 with average age of 25 years. Arthroscopic suture anchor was used in 24 cases and average number was 3. Results: Interscalene block was tried in 29 patients and 1 case was changed to general anesthesia. Arthroscopic examination to identify Bankart lesion and associated pathology was done without difficulty Bankart lesions were easily reduced to anatomic position and placed suture anchor and hooking approprately. After the arthroscopic examination,3 cases were converted to open procedure without any positional change. Conclusion: Under interscalene block, the preparation was more simple and the patient could watch arthroscopic procedure with confidence. There was no hindrance in arthroscopic examination and arthroscopic repair could be dont: in more anatomic position. It can be easily changed to open repair if it needed

한의과에서 시행된 지방종(Lipoma)의 수술적 치료 증례 (A Case of Surgical Treatment of Lipoma Performed at the Korean Medicine Department)

  • 허은나;권강;서형식
    • 한방안이비인후피부과학회지
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    • 제36권4호
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    • pp.175-180
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    • 2023
  • Objectives : The purpose of this study is to report a case of lipoma removed by surgical method. Methods : A 69-year-old female was diagnosed with lipoma on the left upper shoulder. Bufonis venenum pharmacopuncture was used for local anesthesia. The 11th blade and the CO2 laser was used for incision. After removal of lipoma, irrigation with soyeom pharmacopuncture solution and simple interrupted suture were carried out. For 7 days, Yeonkyopaedok-san was given and the suture was removed after 14 days. At last, saengkigo was applied. Results : Local anesthesia was maintained. Lipoma sized 3.0×1.0×1.0cm was clearly removed. Adverse effects were not reported until the clear skin adhesion. Conclusions : Lipoma were surgically removed without any complications by using pharmacopuncture and oral herbal medicines that have anti-inflammatory effects. Korean medicine has the potential for surgery and needs to extend the range of surgical treatment.

선천성 및 후천성 심질환의 개심술 (A Clinical Evaluatuin on Open Heart Surgery of Congenital and Acquired Heart Disease)

  • 김근호
    • Journal of Chest Surgery
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    • 제12권1호
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    • pp.33-42
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    • 1979
  • The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

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어린 고양이에서 발생한 안구내출혈을 동반한 공막 파열의 수술적 치료 (Successful Surgical Treatments of Scleral Rupture with Hyphema in a Young Cat)

  • 박영우;정예찬;임재현
    • 한국임상수의학회지
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    • 제32권1호
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    • pp.127-129
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    • 2015
  • A 3-month-old, female Persian cat was presented with sclera mass. The mass was detected after cat's squeals during the playing with a dog before 2 days. On ophthalmic examination, a $2{\times}5mm$ dark purple colored raised mass was observed 1 mm behind the limbus in the right eye. Anterior chamber was filled with blood and epithelial defect was detected at 2 o'clock in the right central cornea. After general anesthesia, resection of the protruded iris was performed with iris scissors and bipolar cautery. Ruptured sclera and conjunctiva were closed with simple interrupted and simple continuous suture, respectively. Also, irrigation and aspiration (I/A) of the anterior chamber was performed to remove blood clot with bimanual I/A handpiece in the right eye. Four months after the surgery, the right eye was recovered completely and menace response was positive in spite of the retinal lesions.

양측 엉덩이의 거대 신경섬유종 (Giant Neurofibroma on Both Buttocks)

  • 김지훈;범진식;김양우;강소라;김형경
    • Archives of Plastic Surgery
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    • 제36권4호
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    • pp.512-515
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    • 2009
  • Purpose: Neurofibromatosis(NF) is an autosomal - dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop - shaped ligation before removal of the giant NF in both buttocks. And then we could successfully reduce the amount of hemorrhage during the operation. Methods: A 46 - year - old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about $30{\times}20cm$ in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop - shaped suture ligation(weaving the thread up and down in a loop - shaped pattern, leaving a space of 2 cm between each loop) with a straight needle and prolene 2 - 0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged - shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop - shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscense did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow - up, the functional and cosmetic result was excellent. Conclusion: A continuous loop - shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.