• Title/Summary/Keyword: Skin ulcer

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Application of Lumbar Artery Perforator Flap for Reconstruction of Back Ulcer: Clinical Study with Computed Tomographic Angiography

  • Cho, Jin-Woo;Kim, Deok-Woo;Kim, Deok-Yeol
    • Archives of Reconstructive Microsurgery
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    • v.22 no.2
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    • pp.43-47
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    • 2013
  • Purpose: Un-healing and centrally located defect on back area, it is sometimes a challenge for the reconstructive surgeon. Although skin grafts are considered as the first choice for reconstruction of large skin defect on the back region, it is not always helpful but vascularized flaps provide a superior functional and aesthetic outcome. The present study was designed to investigate the clinical anatomy of the lumbar artery perforator flap to reconstruct back ulcer. Materials and Methods: Clinical anatomy study was undertaken using computed tomographic angiographic analysis. We identified the courses of lumbar arteries and its perforators, measured pedicle length by layers. The location of the perforator vessel was charted against anatomical landmarks. Results: The pedicle lengths of the third and fourth lumbar artery perforator reached a mean of 27.8 mm and 37.1 mm respectively from superficial fascia to deep fascia. The fourth perforator was more laterally located than the third perforator and less than 1 cm above the iliac crest. A case in which the fourth lumbar artery perforator was used as flap pedicle is described. Conclusion: For the reconstruction of central defect on the back area, the lumbar artery perforator flap coverage may be a good alternative option. Computed tomographic angiography can easily identify the course and location of lumbar artery perforators and can be helpful to elevate the flap successfully.

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BEHCET DISEASE WITH SUPERIOR VENA CAVA THROMBUS IN A PATIENT PRESENTING DELAYED FACIAL WOUND HEALING : A CASE REPORT (단순안면열상환자에서 발생한 창상치유지연 및 상대정맥혈전증을 동반한 베체트병 : 증례보고)

  • Choi, Sun-Mi;Ha, Joo-Hyo;Kim, Sun-Ae;Choi, Mi-Ra;Jung, Su-Jin;Lee, Hyen-Soo;Yang, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.2
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    • pp.198-204
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    • 2008
  • Behcet Disease is a multisystem inflammatory disorder of unknown orign. It is characterized by recurrent oral ulcer, genital ulcer, skin lesions and ocular inflammation, and which may involve the joints, skin, central nervous system and gastrointestinal tract. Because Behcet Disease dose not have any specific symptoms and laboratory findings, the diagnosis is made on the basis of the criteria proposed by the the International Study Group for Behcet Disease. Behcet Disease is affecting both arteries and veins, and clinically manifest large vessel involvement occurs in between 7 and 49% of patients. Superior vena cava thrombosis is a rare but well-recognized manifestation of Behcet disease. We report a case of a Behcet Disease with superior vena cava thrombosis in a patient presenting delayed facial wound healing.

Innovation in the planning of V-Y rotation advancement flaps: A template for flap design

  • Dolen, Utku Can;Kocer, Ugur
    • Archives of Plastic Surgery
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    • v.45 no.1
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    • pp.85-88
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    • 2018
  • Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. We designed 2 templates to plan a V-Y rotation advancement flap. The template for a unilateral V-Y rotation advancement flap was used on the face (n=5), anterior tibia (n=1), posterior axilla (n=1), ischium (n=1), and trochanter (n=2). The template for a bilateral flap was used on the sacrum (n=8), arm (n=1), and anterior tibia (n=1). The causes of the defects were meningocele (n=3), a decubitus ulcer (n=5), pilonidal sinus (n=3), and skin tumor excision (n=10). The meningocele patients were younger than 8 days. The mean age of the adult patients was 50.4 years (range, 19-80 years). All the donor areas of the flaps were closed primarily. None of the patients experienced wound dehiscence or partial/total flap necrosis. The templates guided surgeons regarding the length and the placement of the incision for a V-Y rotation advancement flap according to the size of the wound. In addition, they could be used for the training of residents.

Pathology of Ulcerous Disease in Cultivated Snakehead, Channa argus (양식 가물치 궤양병의 병리 연구)

  • 이훈구
    • Korean Journal of Microbiology
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    • v.30 no.3
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    • pp.164-170
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    • 1992
  • Haemorrhagic ulcer in cultured snakehead(Chann0 argus) is widespread in Korea during the summer season. Round haemorrhagic ulcers as the main symptom of this epizootic disease can be found on the skin of the head. body, as well as fins of this fish. This study was conducted to investigate the pathology of this disease. First. Aeromonas veronii. the dominant species. was isolated from diseased snakeheads. Then this bacterium was injected into healthy snakeheads hypodermically. Such injection was found to induce haemorrhagic ulcers very similar to those observed in naturally infected fish. One or two days afier the injection, a red spot developed around the injection site. and grew bigger to from a red area. This enlarged area then developed into haemorrhagic ulcer, accompanied by substantial skin loss. Within five days. muscle necrosis proceeded to the extent that a perforation was made between the injection site and the opposite side. The fifty per cent lethal dosage was found to be $1\times10^{5}$CFU/0.25 ml by intraperitoneal injection. The results of this experiment lead us to conclude that Arromonas veronii is a major bacterium which causes haemorragic ulcer in cultured snakcheads.

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Development of Air-cell Mattress for Preventing Pressure Ulcer Using Anthropometric Model (인체계측 모델을 이용한 욕창방지용 공기셀 매트리스의 개발)

  • Kang Sung-Jae;Kim Gyu-Seok;Hong Jung-Hwa;Ryu Je-Cheong;Kim Kyung-Hoon;Mun Mu-Seong;Moon Inhyuk
    • Journal of Institute of Control, Robotics and Systems
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    • v.11 no.7
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    • pp.578-586
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    • 2005
  • Air mattress is now used widely to prevent the pressure ulcer by reducing the localized pressure peaks. The pressure control method based on the anthrophometric model of an air-cell mattress developed in this study is presented. The air-cell mattress has 18 cylindrical air cells made of porous material allowing air leakage. Even though the air leakage can contribute to reducing the development of pressure ulcer by lowering the pressure peak, temperature and humidity, the air pressure changes with time and the desired air-cell pressure has to be determined as an optimal value for each user. To select the desired air-cell pressure, we first divide the parts of the body into four sections such as head, trunk, hip, and leg. Then, the pressure of each section grouped with air-cells is calculated from the weight of each part estimated from the individual height and body weight. Air supply system for the air-cell mattress is implemented by using four electronic solenoid valves and an air compressor, and it is driven by a real-time microcontroller. We experimented with five subjects of the contact pressure on skin. The experimental results show that the proposed air-cell mattress is effective for the prevention of the pressure ulcer.

Prophylactic Effect of Transparent Film Dressing on Sacrum and Coccyx in SICU Patients (외과중환자실 환자의 천미골에 적용한 보호필름 드레싱의 예방적 효과)

  • Kim, Heejeong;Lee, Sun-Mi;Choi, Hee young;Min, Yu Kyung;Jung, Yoo Jin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.3
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    • pp.256-263
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    • 2016
  • Purpose: This study was done to examine the prophylactic effect of transparent film dressing on the sacrum and coccyx sites to reduce pressure ulcers. Methods: The participants were 317 patients admitted to an SICU in Seoul, Korea. Of the patients, 175 were assigned to the experimental group and 142 to the control group. For participants in the experimental group, a prophylactic transparent film dressing was applied on the sacrum and coccyx. The control group received the usual care. The nurses checked for pressure ulcers on the sacrum and coccyx at least once every duty. When pressure ulcer occurred, it reported on the record form. The results were analyzed using Poisson and Hierarchical logistic regression. Results: The prevalence and risk of pressure ulcer was lower in the experimental group compared to the control group but the difference was not significant. The ICU length of stay was significantly associated with pressure ulcer risk. Conclusion: Findings indicate that prophylactic transparent film dressing helps to reduce pressure ulcer in SICU patients.

A Case Report of Genital Ulcer Treated by Korean Traditional Medicine (한방치료를 통해 호전된 외음부궤양 1례 증례보고)

  • Park, Nam-Gyeong;Kim, Gyu-Tae;Choi, Min-Young;Jung, Hyun-Jae;Heo, Jin-Young;Park, Seung-Hyeok;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.2
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    • pp.157-170
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    • 2021
  • Objectives: The purpose of this study is to report the improvement of vulvodynia and genital pruritus caused by unidentified genital ulcer after Korean medicine treatment. Methods: The patient who complained vulvodynia and genital pruritus caused by unidentified genital ulcers was treated by acupuncture, moxibustion, fumigation, and herbal medicine as Eunhwasagan-tang, Guibi-tang-gami-bang for 5 days. The effect of treatment was evaluated by Numeral Rating Scale (NRS), The 5 level of EuroQol 5 Dimension scale (EQ-5D-5L), EuroQol-Visual Analog Scale (EQ-VAS). Results: After the treatment, the chief complaint and general conditions were improved. NRS was decreased from 8 to 3 and scores of EQ-5D-5L and EQ-VAS were increased from 0.416, 10 to 0.904, 80 each. Conclusion: This study shows that the skin lesion, vulvodynia, and pruitus caused by genital ulcer was improved after the Korean traditional treatment and it can be effective medical alternatives or options for genital ulcer patients.

Novel Three-Dimensional Knitted Fabric for Pressure Ulcer Prevention: Preliminary Clinical Application and Testing in a Diabetic Mouse Model of Pressure Ulcers

  • Kim, Sungae;Hong, Jamin;Lee, Yongseong;Son, Daegu
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.275-284
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    • 2022
  • Background Population aging has led to an increased incidence of pressure ulcers, resulting in a social burden and economic costs. We developed a three-dimensional knitted fabric (3-DKF) with a pressure-reducing function that can be applied topically in the early stages of pressure ulcers to prevent progression. Methods We evaluated the effects of the 3-DKF in a streptozotocin-induced diabetes mellitus pressure ulcer mouse model, and the fabric was preliminarily applied to patients. Twelve-week-old male C57BL/6 mice were used for the animal experiments. In the pressure ulcer mouse model, an ischemia-reperfusion injury was created using a magnet on the dorsa of the mice. Pressure was measured with BodiTrak before and after applying the 3-DKF to 14 patients at risk of sacral pressure ulcers. Results In the 3-DKF-applied mice group, the ulcers were shallower and smaller than those in the control group. Compared with the mice in the control group, the 3-DKF group had lower platelet-derived growth factor-α and neutrophil elastase expression, as parameters related to inflammation, and increased levels of transforming growth factor (TGF)-β1, TGF-β3, proliferating cell nuclear antigen, and α-smooth muscle actin, which are related to growth factors and proliferation. Additionally, typical normal tissue staining patterns were observed in the 3-DKF group. In the preliminary clinical analysis, the average skin pressure was 26.2 mm Hg before applying the 3-DKF, but it decreased to an average of 23.4 mm Hg after 3-DKF application. Conclusion This study demonstrated that the newly developed 3-DKF was effective in preventing pressure ulcers through testing in a pressure ulcer animal model and preliminary clinical application.

Wound Care in an Older Rural Patient With Diabetic Lower Extremity Ulcers: A Case Report (당뇨병성 하지궤양을 가진 농촌 노인의 상처간호 사례보고)

  • Shin, Eun Ji;Park, Kyung Hee;Yi, Kyunghee
    • Journal of Korean Academy of Rural Health Nursing
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    • v.18 no.2
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    • pp.92-98
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    • 2023
  • Purpose: This study describes a case report of wound care performed by a community health practitioner for a rural older adult with diabetic ulcers. Methods: Data were collected from a rural older adult who had a diabetic lower extremity ulcer, and wound dressing was applied over 20 weeks after the skin graft operation. Results: The patient visited a primary healthcare post for regular ulcer care, and a community health practitioner applied appropriate wound dressings and managed the patient's diabetic condition. Conclusion: In rural areas, where healthcare resources are scarce compared with urban areas, rural nurses, such as community health practitioners, are primarily required to manage rural residents' health problems. Advanced nursing practices such as complicated wound care should also be appropriately provided to patients by enhancing rural nurses' competencies in the changing health care environment.

A literature study on the treatments of the Decubitus ulcer (褥瘡의 治療에 關한 文獻的 考察)

  • Kim, Hong-jin;Choi, Jung-hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.12 no.2
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    • pp.104-121
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    • 1999
  • The results were as follows ; 1. The treatment method is most used reinforcing the spleen and strengthening of Ki(氣) detoxication and draining of pus on each stage. In first stage, the method of actirating blood and aeration of Lag(絡) nourishing blood and moisturizing skin is used. In ulcer stage, the method of expelling blood stasis and detoxication, promoting pus and drainage is used. In chronic stage, strengthening of Ki(氣) and blood, invigiration and dispersion is used. 2. In the frequency of prescription, the most numerous prescription is Paljintang(八珍湯) and the next are Insamyangyoungtang(人蔘養榮湯). Taglisodongum(托裏消耗飮) ect. In the frequency of medicine the most numerous medicine is Angelicae Gigantis Radix(當歸) and the next are Glycyrrhizae Radix (甘草), Astragali Radix(황기) etc. 3. In the frequency of prescription of exteral therapy. the most numerous prescription is Saengioghongo(生肌玉紅膏), Saengisan(生肌散) and the next are hongsungdan(紅升丹), guildan(九一丹) etc. In the frequency of medicine of exteral therapy, the most numerous medicine is Glycyrrhizae Radix (甘草) and the next are Calomelas(輕粉), Draconis Resina(血竭) etc.

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