• 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.

• 대한수의학회지
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• 제61권3호
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• pp.26.1-26.8
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• 2021

Acinetobacter is a bacteria found in the environment and clinical specimens, causing nosocomial infection and antimicrobial resistance (AMR) threats. This study examined the prevalence, species, and AMR characteristics of Acinetobacter isolated from surgical practice and the laboratory dog husbandry room environments (n = 235) at Rajamangala University of Technology Tawan-ok veterinary hospital during 2018-2019. The prevalence of Acinetobacter in the laboratory dog husbandry room and veterinary belongings were 2.55% and 0.43%, respectively. Species determination was Acinetobacter hemolyticus (2.13%) and Acinetobacter baumannii (0.43%) from environments in the laboratory dog husbandry room, and Acinetobacter junii (0.43%) from the shoes used in the surgical practice room. AMR was observed in both study environments and the specimens sent to the Veterinary Diagnostic Center. These isolates had a high resistant percentage to amoxicillin-clavulanic acid (84.62%), sulfamethoxazole-trimethoprim (61.54%), and cephalexin (53.85%) but were susceptible to imipenem. Compared to the isolates recovered from the clinical specimens, most isolates derived from environments exhibited multidrug resistance and shared correlated resistance patterns. These results highlight the need for sanitization in the dog husbandry room. Furthermore, the AMR results can be used as a preliminary baseline for studying AMR Acinetobacter contamination in animals and their environments.

• Journal of Gastric Cancer
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• 제23권3호
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• pp.400-409
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• 2023

Artificial intelligence (AI) has made significant progress in recent years, and many medical fields are attempting to introduce AI technology into clinical practice. Currently, much research is being conducted to evaluate that AI can be incorporated into surgical procedures to make them safer and more efficient, subsequently to obtain better outcomes for patients. In this paper, we review basic AI research regarding surgery and discuss the potential for implementing AI technology in gastric cancer surgery. At present, research and development is focused on AI technologies that assist the surgeon's understandings and judgment during surgery, such as anatomical navigation. AI systems are also being developed to recognize in which the surgical phase is ongoing. Such a surgical phase recognition systems is considered for effective storage of surgical videos and education, in the future, for use in systems to objectively evaluate the skill of surgeons. At this time, it is not considered practical to let AI make intraoperative decisions or move forceps automatically from an ethical standpoint, too. At present, AI research on surgery has various limitations, and it is desirable to develop practical systems that will truly benefit clinical practice in the future.

• 대한간호
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• 제16권1호통권87호
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• pp.84-95
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• 1977

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.2.1-2.9
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• 2016

Background: We reviewed the biological and mechanical properties of porous hydroxyapatite (HA) compared to other synthetic materials. Computer-aided design/computer-aided manufacturing (CAD/CAM) was also evaluated to estimate its efficacy with clinical and radiological assessments. Method: A systematic search of the electronic literature database of the National Library of Medicine (PubMed-MEDLINE) was performed for articles published in English between January 1985 and September 2013. The inclusion criteria were (1) histological evaluation of the biocompatibility and osteoconductivity of porous HA in vivo and in vitro, (2) evaluation of the mechanical properties of HA in relation to its porosity, (3) comparison of the biological and mechanical properties between several biomaterials, and (4) clinical and radiological evaluation of the precision of CAD/CAM techniques. Results: HA had excellent osteoconductivity and biocompatibility in vitro and in vivo compared to other biomaterials. HA grafts are suitable for milling and finishing, depending on the design. In computed tomography, porous HA is a more resorbable and more osteoconductive material than dense HA; however, its strength decreases exponentially with an increase in porosity. Conclusions: Mechanical tests showed that HA scaffolds with pore diameters ranging from 400 to $1200{\mu}m$ had compressive moduli and strength within the range of the human craniofacial trabecular bone. In conclusion, using CAD/CAM techniques for preparing HA scaffolds may increase graft stability and reduce surgical operating time.

• Journal of Chest Surgery
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• 제47권3호
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• pp.201-210
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• 2014

During the last decade the role of minimally invasive surgery has been increased, especially with the introduction of the robotic system in the surgical field. The most important advantages of robotic system are represented by the wristed instrumentation and the depth perception, which can overcome the limitation of traditional thoracoscopy. However, some data still exist in literature with regard to robotic lobectomy. The majority of papers are focused on its safety and feasibility, but further studies with long follow-ups are necessary in order to assess the oncologic outcomes. We reviewed the literature on robotic lobectomy, with the main aim to better define the role of robotic system in the clinical practice.

• 기본간호학회지
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• 제23권4호
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• pp.383-392
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• 2016

Purpose: The purpose of this study was to assess critical care nurses' perception, knowledge, and nursing practices regarding enteral nutrition. Methods: A descriptive study was conducted with 187 nurse participants who worked in one of the eight medical and surgical intensive care units (ICUs) from four hospitals in Korea. Data were collected using a self-administered questionnaire. Results: Although critical care nurses' perception toward enteral nutrition was high, knowledge was relatively low. The overall perception and knowledge of the nurses did not differ significantly between medical ICU and surgical ICU nurses. Perception of their own knowledge, in particular, 'nutritional goal' was lower for medical ICU nurses compared to surgical ICU nurses. Nurses also had limited knowledge about the significance of enteral nutrition, confirmation of feeding tube location, and nutritional requirements for ICU patients. They inadequately performed the following: changing the feeding tube every 24 hours, inspecting nostrils daily, and adjusting feeding schedule if feeding was stopped. Conclusion: Our results indicate that ICU nurses need up-to-date information about enteral nutrition. Based on the improved perception and knowledge, nursing practice activities with regard to enteral nutrition should be emphasized to enable nurses to provide optimal nutrition for ICU patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.24.1-24.7
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• 2020

Background: In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. Review: We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. Conclusions: In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.

• 한국간호교육학회지
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• 제14권1호
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• pp.30-37
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• 2008

Purpose: This study proposed to examine the effects of a blended-learning orientation program executed for nursing students' clinical practice. Method: The participants were 61 nursing students in the experimental group and 57 in the control group. For the experimental group, a blended-learning orientation program was executed by e-learning (on-line) and lecture-led training (off-line) from two-week before the start of clinical practice in medical-surgical nursing. For the control group, orientation was given in the traditional lecture-led training by distributing printed materials before clinical practice. A pre-test was conducted on the experimental and control group before clinical practice, and a post-test was conducted after two-week of clinical practice in order to examine the effects of the orientation program. Results: After two-week of clinical practice, differences were observed between the experimental group and the control group in adaptation to clinical practice (F=10.242, p=.002), communication skills (F=4.305, p=.040) and clinical competence (F=6.823, p=.010). Conclusions: The blended-learning orientation program enhanced nursing students' adaptation to clinical practice, improved their communication skill and increased their clinical competence. Accordingly, it is recommended to develop and apply practical education using blended-learning in the area of nursing science.

• Journal of Korean Biological Nursing Science
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• 제13권2호
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• pp.125-133
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• 2011

Purpose: This study was performed to identify the affecting factors on hospital nurses' practice of disinfection focused on alcohol, chlorhexidine gluconate (CHG), and povidone iodine (PVI). Methods: The participants in this study were 196 nurses of 3 general hospitals and 2 upgrade general hospitals in 5 cities in Korea. Data were collected through self-reported questionnaires in January, 2011. The collected data were analysed by ANOVA, Pearson correlation and stepwise multiple regression using SPSS/WIN 18.0. Results: The subjects used alcohol and PVI daily for intravenous site care and surgical wound dressing respectively. The mean percentage of awareness in practicing main disinfectants were 80.0% and 72.5% respectively. The awareness and practice were highest in alcohol, but lowest in CHG. The mean percentage of practice of disinfectants was 72.5%. There was positive correlation among awareness and practice of main disinfectants. The awareness and nurses' salary explained 34.6% of variance in practice of disinfectants. Conclusion: An educational program focusing on strategy to enhance hospital nurses' awareness would be effective in improving their practice of disinfectants.