• Archives of Plastic Surgery
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• 제34권2호
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• pp.203-208
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• 2007

Purpose: Myocutaneous flap was widely used for trochanteric pressure sore but it had many drawbacks such as donor site morbidity, dog-ear deformity and functional muscle sacrifice. We have performed fasciocutaneous flap based on perforating vessels and succeeded in overcoming its drawbacks. Methods: We experienced 11 cases of perforator-based fasciocutaneous flap for the coverage of trochanteric pressure sore in 9 patients, 2 cases of which were bilateral. The ambulatory status of patient group is as follows: 6 of them used a wheelchair, 2 of them are free walking, 1 of them use a wheelchair or crutches. Flap was supplied by cutaneous perforating vessel of descending branch of the lateral circumflex femoral artery and the third perforating artery of the deep femoral artery. The size of wounds were from $4{\times}6.5cm$ to $10{\times}13cm$. Results: We did not find any flap loss or congestion except 2 partial wound dehiscences and 1 wound infection. Donor site morbidity was not found. We observed no recurrence of the pressure sore during the 2.5 year follow-up period. Conclusion: We considered that perforator-based fasciocutaneous flap could overcome the traditional drawbacks of the conventional myocutaneous flap and its modified flap for trochanteric pressure sore. And this flap has many advantages for covering trochanteric pressure sore without any donor site deformity and morbidity, which would greatly improve the aesthetic result.

• 대한한방내과학회지
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• 제42권2호
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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.

• Journal of Korean Biological Nursing Science
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• 제22권3호
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• pp.204-212
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• 2020

Purpose: The purpose of this study was to examine the effect of nebulizer therapy with normal saline on thirst and sore throat among postoperative patients. Methods: A quasi-experimental nonequivalent control group, pretest-posttest design was used with 50 participants. The experimental group received nebulizer therapy with normal saline every two hours for 10 minutes three times and wet gauze (n= 25), and the control group received only wet gauze (n= 25). Data were collected using the Numeral Rating Scale for Thirst and Sore Throat. Measurements were calculated before applying nebulizer therapy and total five times for 12 hours after treatment. Data were analyzed using the repeated measured ANOVA. Results: Thirst for the experimental group using the nebulizer therapy with normal saline improved more than for the control group (F= 3.06, p= .043). Sore throat was not significantly different between the two groups (F= 0.63, p= .565). Conclusion: Study results indicate that using nebulizer therapy with normal saline can reduced thirst for postoperative patients. So nurses can apply nebulizer therapy with normal saline to reduce thirst and to improve comfort for postoperative patients.

• 재활간호학회지
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• 제14권2호
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• pp.136-144
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• 2011

Purpose: A purpose of this study was to identify the effects of cold water gargling on thirst, oral cavity condition and sore throat in orthopedics surgery patients who underwent general anesthesia. Methods: Pretest-posttest non-synchronized design with a nonequivalent control group was used. A total of 52 participants were conveniently selected and assigned to each group. The experimental group gargled hourly with cold water for 8 hours after operation. The control group received wet gauze as needed. We compared the thirst, oral cavity condition and sore throat at 0, 2, 4 and 8 hours after operation. Results: The score of thirst and oral cavity condition was lower in the experimental group than in the control group. However, there was no significant differences in the levels of sore throat between the experimental and control group. Conclusion: These findings suggest that cold water gargling can be a useful nursing intervention for alleviating thirst and improving oral condition for patients with orthopedic surgery after general anesthesia.

• 근관절건강학회지
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• 제28권1호
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• pp.41-49
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• 2021

Purpose: This study aimed to compare the effects of the Difflam spray 0.3% with the sodium bicarbonate-normal saline spray on oral care for postoperative patients. Methods: The participants were randomly allocated to either the Difflam (n=22) group or the saline solution (n=23) group. The data were collected at the 1-, 4-, 7-, and 10-hour marks after returning to the ward post operation using the Beck's subjective oral discomfort scale, Visual Analogue Scale for sore throat, and portable halitosis detector. Results: The sore throat (F=7.25, p=.001) score significantly decreased after oral care using the Difflam spray 0.3%. However, the difference in the scores of oral comfort (F=0.34, p=.797) and halitosis (F=0.91, p=.443) between the two groups was not statistically significant. Conclusion: These findings suggest that the Difflam spray 0.3% is effective in improving postoperative sore throat. A further study that explores the effect of various oral solutions for postoperative patients is needed to present systemic and effective evidence-based oral care guidelines.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.531-534
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• 2007

Purpose: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. Methods: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. Results: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. Conclusion: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.

• 한국전문물리치료학회지
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• 제9권3호
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• pp.93-99
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• 2002

Traditionally, ultraviolet (UV) has been used for treating the pressure sore and skin wound. The effects of UVA and UVB radiation on disinfection have been reported. The purpose of this study was to examine the effectiveness of UVC radiation on disinfection of Escherichia coli, Staphylococcus aureus, Salmonella typhimurium in vitro. Three bacterium were radiated by UVC (250 nm, 20 seconds) and incubated at $37^{\circ}C$ for 24 hours at the agar culture medium. Kill rates of all three bacterium were 99.9%. UVC radiated on three kinds of bacterium for 30 or 60 seconds. Kill rates were 99.9% both 30 and 60 seconds. This data suggests that UV light at 250 nm could be a useful method to minimize infection and shorten healing time in pressure sore and skin wound condition.

• Archives of Plastic Surgery
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• 제34권2호
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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.

• 대한간호
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• 제6권6호통권32호
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• pp.75-84
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• 1967

• 대한한방내과학회지
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• 제22권4호
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• pp.709-715
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• 2001

Pressure sore(Decubitus ulcer) is an area of ulceration and necrosis of the skin and underlying tissues occurring over the body prominence such as the sacrum, greater trochanter, scapula, lateral malleolus, thoracic spine and heels after prolonged or often repeated pressure. These days incidence of pressure sore have been increased because of the many population of the old, traffic accidents and cerebral vascular disease. But the treatment was not confirmly established. As for treatment, we used Talcum powder for 10 days in case 1 and 6 days in case 2. The patients were improved within 14 days after treatment in case 1 and 10 days in case 2.