• 제목/요약/키워드: Simple suture

검색결과 126건 처리시간 0.032초

삼첨판 성형술 [De Vega 술식]의 원격 성적에 대한 고찰 (Long term resuls of De Vega tricuspid annuloplasty)

  • 김병열
    • Journal of Chest Surgery
    • /
    • 제26권11호
    • /
    • pp.827-832
    • /
    • 1993
  • From Jan 1982 through Dec.1991, thirty-three DeVega`s tricuspid annuloplasties were performed in association with mitral and combined mitral and aortic valve disease. Preoperatively,all of the patients were in NYHA functional class III or IV.There were one early death and 4 patients died during follow up period of 18 to 138 months [ mean follow up : 67.3 months ]. Nine patients required reoperation because of biological mitral valve failure at 4.7 to 11 years after tricuspid annuloplasty[TAP]. Among these patients,2 cases needed for reoperation of TAP due to loosening of suture material. Twenty four [86%] of the survivors were in NYHA functional class I or II after TAP.The actuarial survival rate for the TAP was 74% at 138 months. Rt atrial pressure of 9 reoperation cases were significantly decreased [P<0.05] compared with initial Rt.atrial pressure [ Mean period; 93.6 months].Doppler echocardiographic studies for tricuspid regurgitation were performed in 15 cases after TAP [Mean period: 42.3 months].These results showed significantly reduced [P<0.01] tricuspid annulus diameter and tricuspid regurgitation distance [ P<0.05 ].Our surgical experience that the DeVega`s TAP is a simple,safe,effective procedure and resulted in good hemodynamic improvement with moderate to severe functional tricuspid regurgitation.

  • PDF

Surgical Reconstruction of the Severe Tongue Laceration with Mandibular Fracture in a Siberian Husky Dog

  • Lee, Jae-Hoon;Kim, Tae-Hoon;Yang, Wo-Jong;Kang, Eun-Hee;Chang, Hwa-Seok;Chung, Dai-Jung;Choi, Chi-Bong;Lee, Jeong-Ik;Kim, Hwi-Yool
    • 한국임상수의학회지
    • /
    • 제25권6호
    • /
    • pp.545-548
    • /
    • 2008
  • A 3-year-old castrated male Siberian husky was presented for evaluation after being hit by a car. On physical examination, the dog showed open-mouth, displacement of mandible and hypersalivation with blood ting. The base of tongue was transected almost 80% on the bias from right dorsal side to the left ventral side. Radiography demonstrated separation of mandible symphysis, and fracture of right condyle and vertical ramus. After debridement of the necrotic tissue, tongue apposition with simple interrupted suture was performed. Mandibular symphysis, condyle and mandibular vertical ramus fractures were fixed using pin, cerclage wire, T-plate, and K-wires. The mouth was irrigated daily using chlorhexidine after surgery. The sutures that were loose here or untied at tongue were re-sutured under sedation. The transected tongue was healed and recovered its normal movement after 6 weeks.

Long V-Y advancement technique for large nipple reconstruction in Asian women

  • Jang, Nam;Kim, Junekyu;Shin, Hyun Woo;Suk, Sang Woo
    • Archives of Plastic Surgery
    • /
    • 제48권1호
    • /
    • pp.44-48
    • /
    • 2021
  • Previously reported nipple-areolar complex reconstruction (NAR) methods involve multiple incisions and wide skin redraping, which increase retraction forces and heighten the risk of nipple-areolar complex (NAC) flattening. We introduce a NAR method using the long V-Y advancement technique that can overcome these disadvantages. A V-shaped flap is designed with the width of the flap base 4-5 mm larger than the diameter of the normal nipple. The flap length is designed to be at least 2.5 times its width. Dissection is performed to the top of the artificial dermal matrix or muscle layer. The nipple is constructed with the same projection as the contralateral side by folding the elevated flap. The tip of the elevated flap is apposed in the middle of the donor defect to minimize the deformity during donor site closure. A 3-point skin suture is applied to the upper third of the folded flap to mold its shape. Using this long V-Y advancement technique, we successfully decreased skin tension in NAC flaps and improved the maintenance of reconstructed nipple projection. The long V-Y advancement technique provides an easy, simple NAR method, effectively maintaining longer nipple projections and reducing breast deformities, especially in Asian women with relatively large nipples.

원위지골 내연골종에 이차적으로 발생한 심수지 굴곡건의 견열손상 (Flexor Digitorum Avulsion Secondary to Enchondroma of the Distal Phalanx)

  • 문성훈;홍철기;이운상;박진우
    • 대한정형외과학회지
    • /
    • 제54권5호
    • /
    • pp.447-451
    • /
    • 2019
  • 원위지골의 내연골종에 이차적으로 발생한 심수지 굴곡건의 견열 손상은 매우 드문 손상으로 아직 국내에 보고된 증례는 없다. 내연 골종의 병적 골절에 대해서는 단순 소파술 후 주두돌기로부터 채취한 자가골을 이식하여 치료하였고, 견열 손상에 대해서는 끌어내기 봉합법을 통해 골편을 원위지골에 재부착하였다. 저자들은 이러한 치료를 통해 골 유합과 좋은 기능적 결과를 얻게 되어 이에 대해 보고하고자 한다.

급성 경막하 혈종에서 응급 두개골 천공의 위치 (Emergency Trephination Site of Acute Subdural Hematoma)

  • 문수현;김근회;권택현;박윤관;정흥섭;서중근
    • Journal of Korean Neurosurgical Society
    • /
    • 제29권5호
    • /
    • pp.659-663
    • /
    • 2000
  • The motality rate of acute subdural hematoma(ASDH) associated with closed head injury is high in spite of recent advances in neurosurgery. Many variables in regard to outcome of ASDH have been assessed. But among them, intracranial pressure(ICP) control and the time interval between injury and operative evacuation are the only things that can be affected by doctor. We introduced a simple method to the management of ASDH for reducing the time interval between injury and operation. When the immediate decompressive operation of ASDH was impossible by any causes, we made a burr hole at the center of hematoma, usually on 2-3cm above temporal squama and 1-2cm behind coronal suture under local anesthesia before main operation. Partial hematoma evacuation was achieved through the burr hole and it was effective in preventing further worsening of patients neurological status before main operation. Prompt hematoma evacuation through the burr hole seemed to be effective in delaying secondary ischemic brain damage and made easy to closing the dura opening and replacement of the bone flap at the end of main decompressive operation. This easy method may reduce the time interval between injury and operation. We represent surgical technique with two cases of ASDH managed with this simple method.

  • PDF

Direct Brow Lift Combined with Suspension of the Orbicularis Oculi Muscle

  • Lee, Jeong Woo;Cho, Byung Chae;Lee, Kyung Young
    • Archives of Plastic Surgery
    • /
    • 제40권5호
    • /
    • pp.603-609
    • /
    • 2013
  • Background Although the conventional direct brow lift operation provides a simple means of managing lateral brow ptosis, the scars produced have been unacceptable. However, using the modifications proposed here, scarring showed remarkable improvement. This article reviews our experiences with the presented technique, mainly with respect to postoperative scarring. Methods Measured amounts of supra-eyebrow skin and subcutaneous fat were excised en bloc in the conventional manner under 'hyper-hydrated' local infiltration anesthesia. The lower flap and the edge of the upper flap were undermined above the muscular plane, and the orbicularis oculi muscle was directly suture-plicated and suspended upward to the distal frontalis muscle. Skin closure was performed in a basic plastic surgical manner. Results From April 2007 to April 2012, a consecutive series of 60 patients underwent surgery using the above method. The average width of the excised skin was 8 mm (range, 5-15 mm) at the apex of the eyebrow. Preoperative complaints were resolved without occurrence of significant complications. The surgical scars showed remarkable improvement and were negligible in the majority of the cases. Conclusions The direct brow lift operation combined with plication/suspension of the superior and lateral portion of the orbicularis oculi muscle provides a simple, safe, and predictable means of correcting lateral brow ptosis. The scars were acceptable to all of the patients. For proper management of the frontalis tone, upper blepharoplasty and/or repair of eyelid levator function must be considered in addition to brow lift procedures.

CO2 gas와 RF 고주파를 적용한 피부 주름 개선용 봉합사 동물 실험에 따른 주름 개선 효과 검증 (Verification of wrinkle improvement effect by animal experiment of suture for skin wrinkle improvement by applying CO2 gas and RF radio frequency)

  • 정진형;신운섭;송미희;이상식
    • 한국정보전자통신기술학회논문지
    • /
    • 제13권3호
    • /
    • pp.226-234
    • /
    • 2020
  • 고령사회의 진입과 더불어 인간의 평균 수명이 연장됨에 따라 현대 사회의 남성 및 여성의 외모에 대한 관심이 증가하는 추세이다. 사람의 노화를 가장 외면적으로 판단할 수 있는 것이 바로 얼굴의 피부 주름이다. 깨끗하고 주름이 없으면서 탄력성 있는 건강한 피부를 갖기 위하여 사람들은 각종 시술을 받고 있다. 시술 중 간단하면서도 효과적인 시술을 원하는 경향이 있어 실리프팅 시술 방법이 많이 시행되고 있다. 본 연구에서는 실 리프팅 시 리프팅 효과를 개선시키기 위하여 기존의 PDO봉합사 시술에 RF고주파와 CO2 gas를 주입하여 주름의 개선을 확인하기 위한 동물 실험을 진행하였다. 시술 전과 후의 주름 개선의 비교는 Labview를 이용한 주름 평가 프로그램으로 진행하였으며, 동물실험의 데이터는 시술 후 10주차 측정 데이터를 사용하였다. 실험그룹은 자연노화 그룹, PDO 시술 그룹, PDO에 RF고주파를 주입한 그룹, PDO에 CO2 gas를 주입한 그룹, PDO에 CO2 gas와 RF를 동시에 주입한 그룹으로 진행하였다. 자연노화 그룹의 개체들은 시술 전 평균 주름의 깊이는 0.408mm이었고, 10주째의 평균 주름의 깊이는 0.68mm으로 자연노화가 진행되었다. PDO 시술 그룹의 개체의 주름의 깊이는 시술 전 평균 0.384mm이었고, 시술 후 10주째에는 평균 0.348mm이었다. PDO에 RF고주파를 주입한 개체의 시술 전 평균 주름의 깊이는 0.42mm이었으며, 10주째 평균 주름의 깊이는 0.378mm이었다. PDO에 CO2 gas를 주입한 개체는 시술 전 평균 주름의 깊이는 0.4mm이었으며, 시술 후 10주째 평균 주름의 깊이는 0.332mm로 감소하였다. PDO에 CO2 gas와 RF고주파를 주입한 개체는 시술 전 평균 0.412mm, 시술 후 10주차 0.338mm로 감소를 볼 수 있었다. 동물 실험을 통하여 PDO봉합사에 CO2 gas와 RF를 주입한 시술이 가장 높은 17.96%의 감소율을 보였다.

승모판막치환술 후 발생한 급성 제1형 좌심실 파열에 대한 심외막적 봉합 - 1예 보고 - (Epicardial Repair of Acute Atrioventricular Groove Disruption Complicating Mitral Valve Replacement - A case report -)

  • 조광리;강재걸;진성훈
    • Journal of Chest Surgery
    • /
    • 제40권12호
    • /
    • pp.855-858
    • /
    • 2007
  • 승모판막 치환술 후 발생하는 좌심실파열은 치명적인 합병증이다. 30년 전 국외에서 승모판막에 대한 수술을 받은 병력이 있는 54세 여자 환자가 심한 승모판막 협착증과 심한 삼첨판막 폐쇄부전을 주소로 내원하여 승모판막 치환술 및 삼첨판막륜 성형술을 시행받았다. 심폐기 이탈 후 수술장 내에서 발생한 대량출혈로 심폐기 재가동 상태에서 평가한 결과 좌심방으로부터 3 cm 후방부위의 방실 골짜기에서 발생한 급성 제I형 좌심실 파열로 진단하고 심외막 접근법으로 테프론 펠트를 이용한 일차 봉합술, 심막첨포를 이용한 밀봉 봉합술 및 피브린 접착제를 적용하여 성공적으로 봉합하였으며 환자는 수술 14일째 합병증 없이 퇴원하였다. 이에 승모판막 치환술 후 발생하는 제I형 좌심실 파열에 대한 문헌고찰과 함께 증례를 보고하고자 한다.

동맥관개존증의 임상적 고찰 (The Clinical Analysis of Patent Ductus Arteriosus)

  • 박상섭
    • Journal of Chest Surgery
    • /
    • 제21권3호
    • /
    • pp.510-517
    • /
    • 1988
  • With the ligation of a patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease, and treatment of the patent ductus is representative of the rapid advance made in thoracic surgery in the last 40 years. We have had clinical experiences about 36 cases of this in the department of Thoracic & Cardiovascular surgery, Pusan Paik Hospital, Inje medical college from March 1891 to June 1987. And the results were summarized as follows. 1. There were 11 males, 25 females. The age range of the patients were from 8 months to 36 years with the mean age of 7.9 years. 2. The chief complaints of the patients on admission were frequent URI[50%], dyspnea on exertion[29.8%], chest pain[11.1% k 1%], growth retardation[2%], cough[2.8%], anorexia[2.8%]. But there were 11 patients[30.6%] having no subjective symptoms. 3. In auscultation, the usual continuous machinery murmur was noticed in 30 patients[83.3%], only systolic murmur in 6[16.7%]. 4. In the preoperative chest P-A views, there were noticed cardiomegaly in 20 cases, enlarged pulmonary conus and / or pulmonary plethora in 22 patients[61.1%]. 5. In the preoperative EGG findings, there were noticed pattern of LVH in 8 patients[22.2`], RVH in 2[5.6%], BVH in 4[11.5%] and normal in 19[52.89o]. 6. The size of PDA[mean] was 9.5 mm[length] and 8.8 mm[width], the range of length was from 4 to 29 mm and the range of width was from 4 to 18 mm. 7. There were noticed 6 cases which were combined with other anomalies[VSD in 2 cases, Coarctation of aorta in 2, Mitral regurgitation in 1, and AP window in 1]. 8. On operation, simple ligation of the ductus was performed in 30 cases[83.3%], division and suture-ligation in 5[13.9%]. 9. Postoperative complications were noticed in 4 cases[pneumonia in one case, wound infection or disruption in 3], but there were no mortality.

  • PDF

골내 침범을 동반한 견관절 석회화 건염 - 증례 보고 - (Calcific Tendinitis of Shoulder Associated with Intraosseous Involvement -A Case Report-)

  • 구정회;조형래;박만준;김정철
    • Clinics in Shoulder and Elbow
    • /
    • 제14권2호
    • /
    • pp.242-247
    • /
    • 2011
  • 목적: 골내 침범이 동반된 비전형적인 견관절 석회화 건염 1예를 보고하고자 한다. 대상 및 방법: 만성적인 좌측 견관절 동통의 급성 악화와 운동 제한을 주소로 내원한 59세 여자 환자로 단순 방사선 상 견봉하 석회 침착과 자기 공명 영상 상 감염이나 종양과 유사하게 골 피질을 침범하고 석회 물질이 골 내부로 연장되어 있었다. 관절경하 석회 제거술과 골내 석회의 소파술, 건 결손부에 봉합 나사못을 이용한 회전근 개 봉합술을 시행하였다. 결과: 환자의 급성 견관절 통증은 술 후 즉각적인 호전을 보였고 순조로운 재활 경과와 관절 운동범위의 회복을 보였다. 술 후 5개월에 촬영한 단순 방사선 상 석회 침착의 재발은 관찰되지 않았다. 결론: 견관절 석회화 건염은 주위 골조직으로 연장된 다양한 영상 소견을 나타 낼 수 있으며, 질환을 정확히 판별함으로써 불필요한 검사나 치료를 피할 수 있을 것으로 생각된다.