• 제목/요약/키워드: Surgical Wound Infection

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Management and rehabilitation of moderate-to-severe diabetic foot infection: a narrative review

  • Chi Young An;Seung Lim Baek;Dong-Il Chun
    • Journal of Yeungnam Medical Science
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    • 제40권4호
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    • pp.343-351
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    • 2023
  • Diabetic foot is one of the most devastating consequences of diabetes, resulting in amputation and possibly death. Therefore, early detection and vigorous treatment of infections in patients with diabetic foot are critical. This review seeks to provide guidelines for the therapy and rehabilitation of patients with moderate-to-severe diabetic foot. If a diabetic foot infection is suspected, bacterial cultures should be initially obtained. Numerous imaging studies can be used to identify diabetic foot, and recent research has shown that white blood cell single-photon emission computed tomography/computed tomography has comparable diagnostic specificity and sensitivity to magnetic resonance imaging. Surgery is performed when a diabetic foot ulcer is deep and is accompanied by bone and soft tissue infections. Patients should be taught preoperative rehabilitation before undergoing stressful surgery. During surgical procedures, it is critical to remove all necrotic tissue and drain the inflammatory area. It is critical to treat wounds with suitable dressings after surgery. Wet dressings promote the formation of granulation tissues and new blood vessels. Walking should begin as soon as the patient's general condition allows it, regardless of the wound status or prior walking capacity. Adequate treatment of comorbidities, including hypertension and dyslipidemia, and smoking cessation are necessary. Additionally, broad-spectrum antibiotics are required to treat diabetic foot infections.

Elbow Reconstruction Using Island Flap for Burn Patients

  • Hur, Gi Yeun;Song, Woo Jin;Lee, Jong Wook;Lee, Hoon Bum;Jung, Sung Won;Koh, Jang Hyu;Seo, Dong Kook;Choi, Jai Ku;Jang, Young Chul
    • Archives of Plastic Surgery
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    • 제39권6호
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    • pp.649-654
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    • 2012
  • Background Deep burns of the elbow lead to soft tissue necrosis and infection, with exposure of deep structures. Adequate wound coverage of this area requires thin, pliable, and durable tissue, while optimal functional recovery requires early coverage and functional rehabilitation. We have found 3 types of island flaps that provide reliable coverage for the elbow. Methods A retrospective study was performed on all patients who underwent flap coverage of an elbow defect at our hospital. The patients' data including age, sex, cause of injury, wound dimensions, timing of flap coverage, postoperative elbow motion, and complications were investigated. Results Between 2001 and 2012, 16 patients were treated at our hospital. The mean age was 53.3 years. Three kinds of flaps were performed: 9 latissimus dorsi flaps, 4 lateral arm flaps, and 4 radial forearm flaps. The average defect size was 183.5 $cm^2$ (range, 28 to 670 cm2). Wound coverage was performed at mean duration of 45.9 days (range, 14 to 91 days). The mean postoperative active elbow flexion was $98^{\circ}$ (range, $85^{\circ}$ to $115^{\circ}$). Partial flap failure occurred in 1 latissimus dorsi flap. Minor complications included partial flap loss (11.8%), hematoma (23.5%), seroma (35.3%), and wound infection (5.9%). Conclusions Flap selection for elbow reconstruction is determined by the defect size and the extent of the adjacent tissue injury. Elbow reconstruction using an island flap is a single-staged, reliable, and relatively simple procedure that permits initiation of early rehabilitation, thereby improving a patient's functional outcome.

식도암의 임상적 고찰 (Surgical Treatment of Esophageal Cancer)

  • 최진호
    • Journal of Chest Surgery
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    • 제28권3호
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    • pp.287-292
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    • 1995
  • From March 1989 to June 1994, 24 casesof esophageal cancer were treated surgically. Among 24, male was 22 cases, female was 2 cases, and the age ranged from 46 to 75, the mean was 59.8. Symptoms were dysphagia[86.9% , weight loss[65.2% and retrosternal pain or discomfort[47.8% . The tumor was located cervical esophagus in two, upper esophagus in three, middle esophagus in 12 and lower esophagus in 7. Among 24 patients, 22 were curative resection, partial esophagectomy with esophagogastrostomy[18 cases or colon interposition [3 cases , with total esophagectomy with musculocutaneous flap[1 case , with feeding jejunostomy or gastrostomy in two cases.Postoperative complications revealed 10 patients[45.4% , as followed ; pleural effusion and pneumonia in 5, passage disturbance in 4, empyema and wound infection in 3, esophagopleural fistula and sepsis in 2, anastomotic site leakage and respiratory failure in each 1. The operative mortality was 13.6 % [3/22 and causes of death were respiratory failure in 1 case and sepsis in 2 cases.During follow-up work, 8 cases died during follow-up period, mean survival time was 15.2 months in curative resection group. One year survival rate was 55.3% in resected group. Also, cancer recurrence revealed in 1 cases.

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폐 국균증에 대한 외과적 치료 (Surgical Treatment of Pulmonary Aspergillosis)

  • 주홍돈
    • Journal of Chest Surgery
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    • 제25권10호
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    • pp.1025-1029
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    • 1992
  • We experienced eleven cases of pulmonary aspergllosis treated surgically in the period from 1981 to 1992. There were 5 men and 6 women, ranging in age from 28 to 64 years [mean age 40.4 years]. The most common chief complaint of the patients was hemoptysis and blood tinged sputum[7 cases, 63.6%], On preoperativechest film, the case of cavity with fungus ball[7 cases] and only cavity[4 cases] were seen. The location of the lesion were both upper lobe[6 cases] and lower lobe[5 cases]. The underlying disease were tuberculosis[5 cases], bronchiectasis[2 cases], tuberculosis and bronchiectasis[1 case], pneumonia[1 case] and none[2 cases]. The operative procedures of pulmonary aspergillosis were lobectomy[8 cases], cavernostomy[1 case] and thoracoplasty[2 cases]. The postoperative complications were postoperative massive bleeding[reoperation, 2 cases], wound infection[2 cases] and no operative mortality.

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Implantable Port System을 이용한 복합부위통증증후군 치험 1예 -증례 보고- (A Case of CRPS Treated with Implantable Port System -A case report-)

  • 신성식;김태삼;양인숙
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.274-277
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    • 1997
  • The complex regional pain syndrome(CRPS) exhibit symptoms such as: abnormal skin color, temperature change, abnormal pseudomotor activity, edema. If CRPS is not treated appropriately at acute stage, then the affected extremity may become a useless, painful appendage. Treatment of CRPS by sympathetic blockade may be achieved by repeated intravenous regional guanethidine blocks, repeated anesthetic sympathetic blocks, surgical sympathectomy or oral sympatholytic therapy. We treated 29-year-old male patient with CRPS of left upper extremity by continuous cervical epidural blockade. Due to wound infection and dislocation of the epidural catheter, we inserted an implantable port system to inject the mixture of local anesthetics and small amount of morphine. After 10 months of treatment, patient was cured of symptoms and signs of CRPS and was able to resume a normal life.

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비조절성 제2형 당뇨 환자의 치아 탈구 손상에 따른 치수 괴사: 증례 보고 (Pulp necrosis following luxated injury to teeth in a patient with uncontrolled type II diabetes mellitus: a case report)

  • 신한얼;이승종;정일영;이찬영
    • Restorative Dentistry and Endodontics
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    • 제37권1호
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    • pp.61-65
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    • 2012
  • Patients with diabetes mellitus show delayed wound healing and increased susceptibility to infection. Therefore, the effects of diabetes on pulpal and periodontal healing should be taken into consideration when treating diabetic dental traumatized patients. This case presents the treatment for dental traumatized 20 yr old female with uncontrolled type II diabetes. The traumatized upper central incisors had showed pulpal healing in early days. However, 7 mon after the trauma, the teeth had been diagnosed with pulp necrosis with apical abscess. Eventually, non surgical root canal treatment on the teeth had been performed.

국소마취를 통한 정계정맥류 제거술 (Inguinal Varicocelectomy Under Local Anesthesia)

  • 명순철;김왈범;이두형;김영선
    • Clinical and Experimental Reproductive Medicine
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    • 제24권3호
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    • pp.341-345
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    • 1997
  • The management of varicoceles was performed on 24 patients with testicular dragging pain and/or left lower abdominal pain under local anesthesia. The surgery was completed within 20 to 45 minites, postoperative complications were severe cord edema 3 cases, wound infection 1 case, epididymitis 1 case, and postoperative anesthetic duration was 90 to 150 minites. Therefore, these procedures is cost effective and safe surgical method.

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급성 아킬레스건 파열의 치료: 비수술적 치료 (Nonoperative Treatment of Acute Achilles Tendon Rupture)

  • 성기선;원재연
    • 대한족부족관절학회지
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    • 제25권2호
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    • pp.72-75
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    • 2021
  • The incidence of Achilles tendon rupture is increasing as more people participate in sports and physical activities. However, whether to treat a complete rupture of the Achilles tendon, conservatively or operatively, is still controversial. Current studies show that the nonoperative treatment of acute Achilles tendon rupture with short-term immobilization for up to two weeks and subsequent accelerated functional rehabilitation with protected weight-bearing results in similar functional outcomes and re-rupture rates compared to those treated surgically. Also, nonoperative treatment does not risk any surgical morbidity such as wound problems, infection, and nerve injury. Therefore, the treatment options for acute Achilles tendon rupture should be carefully chosen in consultation with patients regarding possible clinical outcomes and complications of both treatment options.

A Complication of Diaphragm Repair Using a Gore-Tex (Expanded Polytetrafluorethylene) Membrane: A Case Report

  • Lee, Seungwook;Hong, Sung Yeon;Son, Jung A;Hyun, Seungji;Haam, Seokjin
    • Journal of Chest Surgery
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    • 제55권2호
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    • pp.171-173
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    • 2022
  • A 65-year-old man underwent right trisectionectomy of the liver and reconstruction of the chest wall and diaphragm with a 2-mm Gore-Tex membrane due to recurrent hepatocellular carcinoma. After 3 years, the Gore-Tex membrane in the diaphragm migrated to the abdominal cavity and perforated the colon. We report a rare complication of a Gore-Tex membrane after diaphragm repair.

Complex facial degloving injury: a case report of a complication and its management

  • Sarkar, Dibya Falgoon;Dutta, Debanwita
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권3호
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    • pp.174-177
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    • 2022
  • Facial degloving injuries are due to separation between the skin and subcutaneous tissues from the underlying muscles, bones, and fascia. These injuries often create a reconstructive challenge for surgeons especially when there are associated complications like wound infection or necrosis of the avulsed flap. This case report presents management of a case of facial degloving injury with full thickness necrosis of the avulsed flap. The authors concluded that treatment of such complex wounds requires a multi-disciplinary approach along with proper planning and staging of the surgical procedures for optimum aesthetic and functional outcomes.