• Journal of Korean Dental Science
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• 제6권1호
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• pp.4-12
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• 2013

Purpose: This study sought to verify the usefulness of mini-implant and surgical steel wire in the treatment of mandibular fracture through the objective identifi cation of the change of bone structure and bone density before and after reduction by evaluating radiological change through fractal analysis when mandibular fracture is treated using mini-implant and surgical wire. Materials and Methods: This study looked at 45 patients (males: 38, female: 7) diagnosed with mandibular fracture in the oral and maxillofacial surgery division of Chung-Ang University Dental Hospital and who received open reduction and intra-osseous fi xation. Result: The average fracture dimension values were higher for the group of the patients who had mini-implants and surgical wire treatment. Conclusion: Based on the results of the study on the usefulness of the reduction technique using mini-implant and surgical steel wire in the treatment of mandibular fracture through the fractal analysis method, the reduction technique using mini-implant and surgical steel wire is regarded as an effective method of minimizing the gap between mandibular fracture fragments.

• 대한기계학회논문집A
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• 제21권2호
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• pp.261-271
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• 1997

This paper presents the design process and characteristic test results of tension sensors for measuring the ultimate tension forces of surgical wires. Three types of sensor were designed and tested for calibration. The first two types which transfer the wire tension to the sensing element by direct contact have too much hysterisis errors due to the firctional effect. This error can be considerably reduced in the modified structure, where a cover and a loading button is used to transfer force and moment to the sensing element. The strains predicted by theoretical equations agree well with those by finite element calculations neglecting friction and the strains by finite element analysis considering friction are in good agreement with those measured by four strain gages. The modified ring type tension sensor developed in this paper is expected to be useful for measuring the tension of surgical wires with nonlinearity of 1.31%FS, hysterisis of 5.74%FS and repeatability of 0.19%FS.

• Journal of Chest Surgery
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• 제48권4호
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• pp.265-271
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• 2015

Background: Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. Methods: Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. Results: Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068). Conclusion: The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.336-343
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• 2019

Background Sternal rigid plate fixation (RPF) has been adopted in recent years in high-risk cases to reduce complications associated with steel wire cerclage, the traditional approach to sternal closure. While sternal RPF has been associated with lower complication rates than wire cerclage, it has its own complication profile that requires evaluation, necessitating a critical examination from a national perspective. This study will report the outcomes and associated risk factors of sternal RPF using a national database. Methods Patients undergoing sternal RPF from 2005 to 2016 in the American College of Surgeons-National Surgical Quality Improvement Program were identified. Demographics, perioperative information, and complication rates were reviewed. Logistic regression analysis was performed to identify risk factors for postoperative complications. Results There were 381 patient cases of RPF identified. The most common complications included bleeding (28.9%), mechanical ventilation >48 hours (16.5%), and reoperation/readmission (15.2%). Top risk factors for complications included dyspnea (odds ratio [OR], 2.672; P<0.001), nonelective procedure (OR, 2.164; P=0.010), congestive heart failure (OR, 2.152; P=0.048), open wound (OR, 1.977; P=0.024), and operating time (OR, 1.005; P<0.001). Conclusions Sternal RPF is associated with increased rates of three primary complications: blood loss requiring transfusion, ventilation >48 hours, and reoperation/readmission, each of which affected over 15% of the study population. Smokers remain at an increased risk for surgical site infection and sternal dehiscence despite RPF's purported benefit to minimize these outcomes. Complications of primary versus delayed sternal RPF are roughly equivalent, but individual patients may perform better with one versus the other based on identified risk factors.

• 한국임상수의학회지
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• 제27권3호
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• pp.240-245
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• 2010

대퇴골 머리의 골괴사는 특발성이며 진행성 질환이다. 골괴사증 연구를 위한 다양한 동물모델이 보고되었지만, 현재까지 표준화된 동물모델은 완성되지 않았다. 본 연구에서 랫드에서 세가지 외과적인 방법으로 유발한 골괴사모델을 비교하였다. 20마리의 SD 랫드 (24주령, 숫컷)를 각 5마리씩 대조군과 세개의 실험군으로 구분하였다. 세가지 외과적인 방법으로 골괴사를 유발하였다. 원인대를 자르고, 대퇴골목의 골막을 절개 (S군), 철사를 대퇴골목에 결찰 (W군), W군과 동일한 방법으로 대퇴골목에 철사를 감은 후, 전기소락기의 끝을 철사에 접촉시켜 소락, 그리고 철사를 제거 (B군). 2주후, 랫드는 안락사하고 대퇴골 머리와 목을 채취하였다. H/E 염색, 사프라닌 O염색, TUNEL 염색을 실시하여 대퇴골 머리의 골과 연골에 골괴사 병변을 평가하였다. 모든 외과적인 방법 (S, W, B군)에서 골괴사가 2주간의 단기간에 유발되었다. 연골부분에 대한 유의적인 괴사변화는 B군에서만 관찰되었다. 철사를 통한 소락 후, 철사를 제거하는 변형된 외과적 방법은 다른 방법에 비해 더욱 효과적으로 골괴사 실험모델을 완성하였다.

• Journal of Chest Surgery
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• 제30권3호
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• pp.348-348
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• 1997

48세 남자 환자의 전종격동을 깊게 침범하며 흉골에서 발생한 거대한 연골육종을 치료하였다. 환자는 흉골의 연골육종과 주변의 정상변연 4cm을 포함하여 광범 위 절제술을 받았으며 그 종양 자체 는 양측의 쇄골과제 1,2,3늑연골을 포함하는 15× 16X10cm크기였다. 종양의 광범위 절제술후 남은 결손 부위는 매우 컸으며 흉벽 재건술을 Marled mesh와 methylmethacrylate와 wire steels로 겹싸는 sandwich식의 방법으로 시행하였고 연부조직의 재건술 또한 대흉근을 이용한 근피 판 치환술을 시행하 였다. 그러나 환자는 수술후 결핵성 종격동염이 발생되었고 다량의 농이 배출되었다. 재수술은 흉벽 재건술시의 사용되었던 이물질 모두를 제거하고 괴사성 조직의 소파술과 배농술을 시행하였다. 환자는 1 년간 항결핵제요법을 시행하였으며 완치되었기에 문헌고찰과 보고하는 바이다.

• Journal of Chest Surgery
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• 제30권3호
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• pp.248-252
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• 1997

48세 남자 환자의 전종격동을 깊게 침범하며 흉골에서 발생한 거대한 연골육종을 치료하였다. 환자는 흉골의 연골육종과 주변의 정상변연 4cm을 포함하여 광범 위 절제술을 받았으며 그 종양 자체 는 양측의 쇄골과제 1,2,3늑연골을 포함하는 15$\times$ 16X10cm크기였다. 종양의 광범위 절제술후 남은 결손 부위는 매우 컸으며 흉벽 재건술을 Marled mesh와 methylmethacrylate와 wire steels로 겹싸는 sandwich식의 방법으로 시행하였고 연부조직의 재건술 또한 대흉근을 이용한 근피 판 치환술을 시행하 였다. 그러나 환자는 수술후 결핵성 종격동염이 발생되었고 다량의 농이 배출되었다. 재수술은 흉벽 재건술시의 사용되었던 이물질 모두를 제거하고 괴사성 조직의 소파술과 배농술을 시행하였다. 환자는 1 년간 항결핵제요법을 시행하였으며 완치되었기에 문헌고찰과 보고하는 바이다.