• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.391-395
• /
• 2010

Purpose: Given that the critical nature of the microvascular anastomosis to what is often a long and difficult reconstructive operation, trainees need to have a high level of microsurgical competence before being allowed to perform microsurgery on patients. Some artificial substitutes and dead or live animal models have been used to improve manual dexterity under the operating microscope. Yet, most surgeons are not equipped with such models, so search for easy available and appropriate microsurgical practice model have been an issue. Umbilical artery, placental vessels and gastroepiploic arteries have been previously suggested as a microsurgical training model, which involves other surgical departments. The purpose of this article is to introduce that saphenous vein specimen obtained from varicose vein surgery is useful and has many advantages as training model for the practice of microvascular anastomosis. Methods: The conventional technique using perforation/inversion method with a metallic stripper is widely performed for varicose vein patients. The stripper is inserted through disconnected safeno-femoral junction and retrieved at the knee or the medial side of ankle. The length of saphenous vein specimens removed is about that of one's leg and inversed from inside out. Obtained saphenous vein specimens are re-inversed and cleansed with normal saline, to be readily available for microsurgical practice. Preserved in a squeezed wet saline gauze and refrigerated, frozen or glycerated specimens were investigated into their comparative quality for microsurgical practice. Results: Varicose vein surgery remains one of the common operations performed in the field of plastic surgery. Convenient informed consent regarding the vessel donation can be easily signed. The diameter of the obtained saphenous vein is as variable as 1.5 to 6 mm, which is already stripped, and is in sufficient length corresponding to that of patient's leg. Vessels specimens were available for microsurgical practice within 1 week period when preserved with squeezed wet saline gauze, and the preservation period could be extended monthly by freezing it. Conclusion: Saphenous vein obtained from varicose vein patients provide with variable size of vessel lumen with sufficient length. The practice can be cost effective and does not require microsurgical laboratory. Additionally there is no need of involving other surgical departments in acquiring vessel specimens. Furthermore, simple preservation method of refrigerating for a week or freezing with squeezed wet saline gauze for a month period, allow the saphenous vein obtained after varicose vein surgery as an excellent model for the microsurgical practice.

• Journal of Korean Clinical Nursing Research
• /
• v.29 no.1
• /
• pp.121-134
• /
• 2023

Purpose: The purpose of this study was to describe the job performance, importance, and difficulty in Surgical Clinical Practice Nurses (SCPNs), and to identify the priority of job tasks using Importance-Performance Analysis (IPA). Methods: One hundred SCPNs were recruited from two university hospitals and two general hospitals during November 2021 to April 2022. A total of 97 data were analyzed excluding 3 data due to missing responses. The data were analyzed by two groups, with Ward-Based SCPNs (W-SCPNs) and Operation Room-Based SCPNs (OR-SCPNs) according to different characteristics of job tasks. Results: There were differences of job performance between W-SCPNs and OR-SCPNs. As a result of the IPA, tasks of 'working practices in the ward' for W-SCPNs and those of 'surgery and treatments' for OR-SCPNs were included in the first quadrant (keep up the good work). 'Resarch' and 'leardership' were included in the third quadrant (low priority). Conclusion: Since there are differences in job tasks between W-SCPNs and OR-SCPNs, health care institutions should consider the differences in defining the scope of job performance. Furthermore, it is necessary to develop customized continuing education program based on our findings of IPA.

• Clinics in Shoulder and Elbow
• /
• v.26 no.3
• /
• pp.312-322
• /
• 2023

Background: Silicone radial head prostheses (SRHP) are considered obsolete due to reports of frequent failure and destructive silicone-induced synovitis. Considering the good outcomes of modern non-radial silicone joint implants, the extent of scientific evidence for this negative view is unclear. The aim of this research was to systematically analyze the clinical evidence on complications and outcomes of SRHP and how SRHP compare to both non-SRHP and silicone prostheses of other joints. Methods: A systematic literature review was conducted through the Cochrane, PubMed, and Embase databases. Results: Eight cohort studies were included, consisting of 142 patients and follow-up periods ranging from 23 months to 8 years. Average patient satisfaction was 86%, range of 71%-100%, and 58 complications were seen, but no cases of synovitis. These outcomes were in line with non-SRHP. Four case series with 11 cases of synovitis were found, all due to implant fractures years to decades after implantation. Six systematic reviews of currently used non-radial silicone joint implants showed excellent outcomes with low complication rates. Conclusions: Since SRHP have satisfactory clinical results and an acceptable complication rate when selecting a patient group in suitable condition for surgical indications, it is considered that SRHP can still be chosen as a potential surgical treatment method in current clinical practice.

• Journal of Korean Academy of Nursing Administration
• /
• v.19 no.4
• /
• pp.470-479
• /
• 2013

Purpose: This study was conducted to investigate and compare the characteristics and relations of nursing practice environment, professionalism and job satisfaction among nurses in general hospitals according to hospital size. Methods: The participants included 314 staff and charge nurses who were working in the general medical/surgical nursing units in one large hospital, three medium sized hospitals, and four small hospitals. Data collected through using self-report questionnaire were analyzed using the SPSS and SAS statistical programs. Results: Nursing practice environment and job satisfaction had significant differences according to hospital size. Both of these scales were highest for medium hospitals and lowest for small hospitals. For all hospital sizes there were positive correlations between each of the variables. Multiple regression analysis showed that both nursing practice environment and job satisfaction were affected by hospital size, but professionalism was not. Conclusion: The results of this study indicate that nursing practice environment and job satisfaction vary with the size of the hospital. Therefore, further study is necessary to identify the work environment variables of nurses for performance management and to implement appropriate policies.

• Journal of Society of Preventive Korean Medicine
• /
• v.23 no.1
• /
• pp.15-26
• /
• 2019

Background and Aim : Health care and cosmetics as well as quality of life is now a matter of concern and many categories of complementary and alternative medicine fall into the territory of the medical practice of Korean medicine. Accordingly, penalties are being taken for unlicensed medical practices of Korean medicine in so called complementary and alternative medicine area. There is a possibility of violating the law for the public part because it is not clearly stipulated in the law as to what is a licensed medical practice. Materials and Method : The significance of the Medical Service Act and the Act on Special Measures for the Control of Public Health Crimes were reviewed, and the related supreme court cases were discussed upon the legal aspect of processing the unlicensed medical practice of Korean medicine. The legal information was provided from the National Law Information Center of the Ministry of Government Legislation, and the information websites of the Supreme Court and the Constitutional Court. Results : The concept of medical practice, which is essential in judging the case of unlicensed medical practice, is 'prevention and treatment of diseases through diagnosis, examination, prescribing, medication, or surgical procedures based on medical expertise', and the 'acts that may result in harm and injury of health unless performed by a medical person'. With respect to the medical practice of Korean medicine, the concept includes 'prevention and treatment of diseases using the principle of traditional Korean Medicine'. Conclusions : The concept of medical practice should be clearly stipulated in the law for the control over the unlicensed medical practices of Korean medicine. And it is important to move from the current concept of medical person-oriented medical practice emerging from the national system of healthcare control, to a concept that can accept the era of health managing-oriented medical environment and the co-governance of the healthcare providers and consumers for the future.

• Journal of Trauma and Injury
• /
• v.33 no.2
• /
• pp.128-133
• /
• 2020

Traumatic abdominal wall hernias (TAWHs) are uncommon and the incidence of this, which is rarely encountered in clinical practice, has been estimated at 1%. Furthermore, blunt transection of the entire abdominal wall musculature caused by seatbelt is a very rare complication. We report a case of adult with a complete disruption of the entire anterolateral abdominal wall muscle following the seatbelt injury. A 32-year-old male was wearing a seat belt in a high speed motor vehicle collision. Abdominal computed tomography (CT) scan revealed the complete disruption of bilateral abdominal wall musculatures including TAWH without visceral injury. However, injuries of small bowel and sigmoid colon were observed in the intra-operative field. The patient underwent the repair by primary closure of the defect with absorbable monofilament sutures. This case suggests that especially in TAWH patients, even if a CT scan is normal, clinicians should keep the possibility of bowel injury in mind, and choose a treatment based on the clinical findings.

• The korean journal of orthodontics
• /
• v.54 no.2
• /
• pp.128-135
• /
• 2024

Objective: The number of three-piece maxillary osteotomies has increased over the years; however, the literature remains controversial. The objective of this study was to evaluate the skeletal stability of this surgical modality compared with that of one-piece maxillary osteotomy. Methods: This retrospective cohort study included 39 individuals who underwent Le Fort I maxillary osteotomies and were divided into two groups: group 1 (three pieces, n = 22) and group 2 (one piece, n = 17). Three cone-beam computed tomography scans from each patient (T1, pre-surgical; T2, post-surgical; and T3, follow-up) were used to evaluate the three-dimensional skeletal changes. Results: The differences within groups were statistically significant only for group 1 in terms of surgical changes (T2-T1) with a mean difference in the canine region of 3.09 mm and the posterior region of 3.08 mm. No significant differences in surgical stability were identified between or within the groups. The mean values of the differences between groups were 0.05 mm (posterior region) and -0.39 mm (canine region). Conclusions: Our findings suggest that one- and three-piece maxillary osteotomies result in similar post-surgical skeletal stability.

• Imaging Science in Dentistry
• /
• v.44 no.2
• /
• pp.155-160
• /
• 2014

Purpose: The purposes of this study were to develop a workstation computer that allowed intraoperative touchless control of diagnostic and surgical images by a surgeon, and to report the preliminary experience with the use of the system in a series of cases in which dental surgery was performed. Materials and Methods: A custom workstation with a new motion sensing input device (Leap Motion) was set up in order to use a natural user interface (NUI) to manipulate the imaging software by hand gestures. The system allowed intraoperative touchless control of the surgical images. Results: For the first time in the literature, an NUI system was used for a pilot study during 11 dental surgery procedures including tooth extractions, dental implant placements, and guided bone regeneration. No complications were reported. The system performed very well and was very useful. Conclusion: The proposed system fulfilled the objective of providing touchless access and control of the system of images and a three-dimensional surgical plan, thus allowing the maintenance of sterile conditions. The interaction between surgical staff, under sterile conditions, and computer equipment has been a key issue. The solution with an NUI with touchless control of the images seems to be closer to an ideal. The cost of the sensor system is quite low; this could facilitate its incorporation into the practice of routine dental surgery. This technology has enormous potential in dental surgery and other healthcare specialties.

• Korean Journal of Adult Nursing
• /
• v.23 no.2
• /
• pp.180-188
• /
• 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.

• Clinics in Shoulder and Elbow
• /
• v.21 no.1
• /
• pp.48-55
• /
• 2018

While non-operative treatment with structured rehabilitation tends to be the strategy of choice in the management of Rockwood type III acromioclavicular joint injury, some advocate surgical treatment to prevent persistent pain, disability, and prominence of the distal clavicle. There is no clear consensus regarding when the surgical treatment should be indicated, and successful clinical outcomes have been reported for non-operative treatment in more than 80% of type III acromioclavicular joint injuries. Furthermore, there is no gold standard procedure for operative treatment of type III acromioclavicular joint injury, and more than 60 different procedures have been used for this purpose in clinical practice. Among these surgical techniques, recently introduced arthroscopic-assisted procedures involving a coracoclavicular suspension device are minimally invasive and have been shown to achieve successful coracoclavicular reconstruction in 80% of patients with failed conservative treatment. Taken together, currently available data indicate that successful treatment can be expected with initial conservative treatment in more than 96% of type III acromioclavicular injuries, whereas minimally invasive surgical treatments can be considered for unstable type IIIB injuries, especially in young and active patients. Further studies are needed to clarify the optimal treatment approach in patients with higher functional needs, especially in high-level athletes.