• 대한간호학회지
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• 제41권6호
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• pp.768-779
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• 2011

Purpose: This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. Methods: This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. Results: A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ${\leq}$.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. Conclusion: The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

• 한국임상수의학회지
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• 제16권1호
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• pp.193-198
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• 1999

Ketoprofen has been used as nonsteroidal anti-inflammatory (NSAI) agent for analgesia in surgical patients and increasing numbers of surgical patients are chronically take some forms of NSAI drugs. The purpose of this study was to investigate the therapeutic effects of ketoprofen on the healing of a closed linear surgical wound and on the contraction of an opened surgical wound in rats. The experimental groups were divided into two groups and ten rats were allocated in each group. In ketoprofen-treated group, the rats were given 2.5 mg/mg/day of ketoprofen by s.c. for ten days. In control group, the rats were given 1ml of benzyl alcohol and distilled water by s.c. for ten days. After time period, all rats were sacrificed, and the breaking strength and the collagen concentrations, at the wound site, were measured. In ketoprofen-treated group, the mean breaking strength and the mean collagen concentration were significantly decreased when compared with those of controls. The ketoprofen-treated group had shown a mean rate of wound contraction less than that of the control, although not statistically significant. These results suggested that ketoprofen impaired wound healing.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.630-632
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• 2013

Vacuum-assisted wound healing has been proven to be more efficacious than conventional dressings. Vacuum dressing has been frequently modified given the restrictions in resources available. Here we present a modified method of vacuum dressing by using surgical or gynaecological gloves for lower and upper limb wounds. Vacuum dressing was applied with parts of a surgical or gynaecological glove and Opsite with T-tailing of the suction outlet. Vacuum-assisted wound healing using the surgical gloves showed relatively good wound healing in the amputation stump, finger, arm, and leg in the cases studied.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.522-529
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• 2013

Background Despite advances in surgical techniques, sterile protocols, and perioperative antibiotic regimens, surgical site infections (SSIs) remain a significant problem. We investigated the relationship between wound classification (i.e., clean, clean/contaminated, contaminated, dirty) and SSI rates in plastic surgery. Methods We performed a retrospective review of a multi-institutional, surgical outcomes database for all patients undergoing plastic surgery procedures from 2006-2010. Patient demographics, wound classification, and 30-day outcomes were recorded and analyzed by multivariate logistic regression. Results A total of 15,289 plastic surgery cases were analyzed. The overall SSI rate was 3.00%, with superficial SSIs occurring at comparable rates across wound classes. There were similar rates of deep SSIs in the clean and clean/contaminated groups (0.64%), while rates reached over 2% in contaminated and dirty cases. Organ/space SSIs occurred in less than 1% of each wound classification. Contaminated and dirty cases were at an increased risk for deep SSIs (odds ratios, 2.81 and 2.74, respectively); however, wound classification did not appear to be a significant predictor of superficial or organ/space SSIs. Clean/contaminated, contaminated, and dirty cases were at increased risk for a postoperative complication, and contaminated and dirty cases also had higher odds of reoperation and 30-day mortality. Conclusions Analyzing a multi-center database, we found that wound classification was a significant predictor of overall complications, reoperation, and mortality, but not an adequate predictor of surgical site infections. When comparing infections for a given wound classification, plastic surgery had lower overall rates than the surgical population at large.

• 성인간호학회지
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• 제23권2호
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• pp.180-188
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• 2011

Purpose: This study was to identify nursing diagnosis-outcome-intervention (NANDA- NOC-NIC: NNN) linkages applied to inpatients in general surgical nursing units. Methods: We developed the NNN linkage computerized nursing process program, which consisted of the 107 nursing outcomes and the 190 nursing interventions linked to the 39 nursing diagnoses. This program was applied to 324 patients who admitted to those nursing units from July, 2004 to February, 2005. Results: First, nursing outcomes of each nursing diagnosis were identified as follows: for 'acute pain', pain control, pain level, and comfort level; for 'risk for infection', wound healing: primary intention, wound healing: secondary intention, and infection status; for 'nausea', nutritional status: food & fluid intake, comfort level, symptom severity and hydration. Second, major nursing interventions for each nursing outcome were analyzed as follows: for pain control or comfort level, pain management and medication management; for pain level, pain management and analgesic administration; for wound healing: primary intention, incision site care and wound care; for Wound healing: secondary intention or infection status, infection control; for nutritional status: food & fluid intake, fluid monitoring; for comfort level, nausea management; for symptom severity, nausea management and vomiting management; for hydration, fluid/electrolyte management. Conclusion: This identified NNN linkages will facilitate the use of nursing process in surgical nursing practice and documentation systems.

• 대한족부족관절학회지
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• 제26권2호
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• pp.78-83
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• 2022

Purpose: The purpose of this study was to evaluate the surgical outcome of split-thickness skin graft (STSG) for chronic diabetic wounds of the foot and ankle. Materials and Methods: The medical records of 20 patients who underwent surgery for chronic diabetic wounds of the foot and ankle between October 2013 and May 2018 were reviewed. Surgical management consisted of consecutive debridement, followed by negative-pressure wound therapy and STSG. We used an acellular dermal matrix between the wound and the overlying STSG in some patients with wide or uneven wounds. Patient satisfaction, comorbidities, wound size and location, length of hospital stay, wound healing time, and complications were investigated. Results: Of 20 patients, 17 (85.0%) were satisfied with the surgical outcome. Eight patients had diabetic wounds associated with peripheral vascular disease (PVD), 7 patients had diabetic wounds without PVD, and 5 patients had acute infection superimposed with necrotizing abscesses. The mean size of the wound was 49.6 cm². The mean length of hospital stay was 33.3 days. The mean time to wound healing was 7.9 weeks. The mean follow-up period was 25.9 months. Complications included delayed wound healing (4 cases) and recurrence of the diabetic wounds (2 cases), which were resolved by meticulous wound dressing. Conclusion: STSG remains a good treatment strategy for chronic diabetic wounds of the foot and ankle.

• 한국동물위생학회지
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• 제33권3호
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• pp.313-317
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• 2010

This study was conducted in the saltwater crocodile (Crocodylus porosus) for the occurrence of various surgical affections with their clinical management. During the period of January 2006 to June 2008, a total of 68 adult crocodiles were considered as reference population from the Reptiles Farm Ltd. at Bhaluka, Mymensingh. The occurrence of surgical affections of adult female (88.9%) was significantly (P<0.01) higher than male (11.1%). Prevalence of common surgical affections were wound: 72.2%, fibroma: 11.1% abscess: 5.6%, fracture: 5.6%, tail necrosis: 2.8%, myiasis: 2.8%. Wound was the highest among the affections. Among the identified wounds, biting wound was higher. In summer (57.7%) the occurrence of wound was higher compared to other seasons. In winter season (7.7%) the occurrence of abscess, myiasis, fibroma were higher compared to other seasons. Wounds and fibroma are the major surgical affections in salt water crocodile. The most common site of surgical affection was recorded in crocodile's tail (30.6%). It was suggested that minimal stress, allowing constant and easy access to water, removal of roots of the tree in the basking land of crocodiles pen, basking land of the pen is better filling up by sand, clinical surgical managements are essential for better health and production.

• Journal of Oral Medicine and Pain
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• 제19권1호
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• pp.73-91
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• 1994

The author used rabbits in order to examine the effect of Ga-As low power generating semiconductor laser on artificially produced injuries of experimental animals. Artificially produced injuries include surgical wound of 3mm length, 2mm depth in size on ventral skin surface of rabbit and buccal mucosa, and electrical injury formed on opposite side of skin and buccal mucosa by electrical cauterization of same length and depth, and chemical injury formed by FC(Formocresol) solution applied on the anterior dorsal part of tongue. And then, on the experimental group, Ga-As laser was irradiated beginning on the day after the wound formation and continued to irradiate every each other day for five minutes. After1, 3, 6, 9, 13th day, certain number of animals of control and experimental group were sacrified, and wound site tissue was excised to make samples and was observed under light microscope. The following is the conclusions after comparing the healing procedure of experimental and control group. The following results were obtained : 1. Inflammation was decreased more rapidly in the experimental group than the control group. 2. In the surgical, the electrical and the chemical injuries in the oral mucosa, re-epithelialization was completed more rapidly in the experimental group than the control group. In the electrical injury on the skin, re-epithelialization was completed about 6 days after wound formation on both groups. 3. In the electrical and the surgical injuries on the oral mucosa, granulation tissue formation started at 3 days after injury on both groups, but in the chemical injury, it was completed about 3 days faster in the control group than the experimental group. In the surgical wound on the skin, it was completed about 9 days after injury, but faster in the experimental group. In the electrical injury on the skin, it was faster in the control group than the experimental group. 4. In the electrical and the surgical injuries on the oral mucosa, fibrosis was started at 6~9 days after injury on both groups, but regeneration of connective tissue in the experimental group was observed much more than the control group. 5. When comparing the effect of wound healing on skin and oral mucosa of control and experimental group, granulation tissue formation and re-epithelialization in the oral mucosa was more vigorous. In conclusion, the difference of timing and the sequence of wound healing process(inflammation, re-epithelialization, granulation tissue formation, fibrosis) following Laser irradiation between control and experimental group was not observed, but the healing tissue was observed much more in the Laser irradiated group.

• Journal of Periodontal and Implant Science
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• 제48권5호
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• pp.274-283
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• 2018

Purpose: Numerous indices have been proposed to analyse wound healing in oral soft tissues, but each has specific shortcomings. A new method of analysis, the Early Wound Healing Score (EHS), was evaluated in the present study. The aim was to assess more accurately early healing by primary intention of surgical incisions in periodontal soft tissues. Methods: Twenty-one patients were treated with different surgical procedures comprising 1 or 2 vertical releasing incisions as part of a surgical access flap. Twenty-four hours after surgery, early wound healing at the vertical releasing incisions was assessed using the EHS. This score assessed clinical signs of re-epithelialization (CSR), clinical signs of haemostasis (CSH), and clinical signs of inflammation (CSI). Since complete wound epithelialization was the main outcome, the CSR score was weighted to be 60% of the total final score. Accordingly, a score of 0, 3, or 6 points was possible for the assessment of CSR, whereas scores of 0, 1, or 2 points were possible for CSH and CSI. Higher values indicated better healing. Accordingly, the score for ideal early wound healing was 10. Results: Thirty vertical releasing incisions were assessed in 21 patients. At 24 hours after incision, 16 vertical releasing incisions (53.33%) received the maximum score of CSR, while 6 cases (20%) received an EHS of 10. None of the cases received 0 points. Conclusion: The EHS system may be a useful tool for assessing early wound healing in periodontal soft tissue by primary intention after surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권4호
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• pp.279-285
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• 2021

Objectives: Wound healing is an integral part of any surgical procedure. Appropriate wound closure is critical to any successful surgical procedure, especially intraoral procedures. Various factors aid in wound healing, both pharmacological and non-pharmacological. Dehydrated human amniotic/chorionic membrane (dHACM) is an emerging bioinert material that contains anti-inflammatory properties, angiogenetic properties, osteogenic potential, and various growth factors. The purpose of this study was to evaluate the efficacy of wound healing properties of dHACM in bilateral alveoloplasty patients. Materials and Methods: A prospective split-mouth study was conducted on 10 patients. Site A received sutures with dHACM and site B was sutured without dHACM. Wound healing was assessed with the Landry, Turnbull, and Howley Index. Results: Sites A and site B were compared. A P<0.05 and a test value of 22 was obtained, indicating a statistical difference between the two sites. Conclusion: Our study showed better healing with dHACM than without.