• Journal of Chest Surgery
• /
• v.8 no.1
• /
• pp.37-44
• /
• 1975

Authors have reviewed the records of seven patients of multiple rib fractures with severe flail chest who were admitted to Hanyang University Hospital during the 3 years period from 1972 through 1975. Of the seven patients studied, automobile accidents led to the injuries in 4 cases, two patients were injured in fall from a tree and on the ox-heading. All who had a blunt trauma without any open wound on the chest. The numbers of the fractured ribs accounted for 6 to 9 of the ribs including double fractures from 3 to 5 ribs. The left side fractures occurred in the 6 patients and in the right only one patient. Thus the flail segment was more often located in the left antero-lateral position than in the right lateral position [the ratio was 6:1].. All cases had associated injuries. The injuries and multiple fractures were the most common associated injuries occurring in four and five of the patients respectively. The patients were classified as having associated head injuries when they were admitted in comatose or semicomatose state. When a major degree of instability of the thoracic cage exists, adequate respiratory change is not possible. For this reason the tracheostomy was performed in five patients in an acutely injured patient with flail chest only after an endotracheal tube has been inserted or after an endotracheal suction. All patients had secondary complications in the pleural cavity, such as hemothorax or hemopneumothorax with or without intrapulmonary hemorrhage and subcutaneous emphysema. Therefore, closed thoracostomy was performed in five patients in the emergency room. The thoracotomy was required in four patients: immediate operation without closed thoracostomy was performed in two patients and the thoracotomy was indicated in two patients after closed thoracostomy, because of increasing intrathoracic hemorrhage. As to the fixation of the flail segments, authors employed two techniques; one was towel clip traction of the flail segments and the other was intramedullary insertion of Kirschner`s wire in to the double fractured rib fragments for the fixation of the flail segments [Kirschner`s wire fixation]. Because` of an different results in the course of treatment between two techniques, data from patients with towel clip traction was compared with those from patients with thoracotomy and Kirschner`s wire fixation of the flail segments. Of the three patients with towel clip traction, two patients required bronchoscopic toilet due to lung atelectasis which developed because of inadequate motion of thoracic cage and poor expectoration. This was in contrast to the four patients with thoracotomy and Kirschner`s wire fixation, who didn`t these complication because of adequate motion of the thoracic cage and subsequent good expectoration.

• The Journal of Korea CHUNA Manual Medicine
• /
• v.2 no.1
• /
• pp.111-120
• /
• 2001

We reviewed literatures of western and oriental medicine about postoperative management of spine. Traditionally, with orthoses and bed rest, many physicians restricted activity of daily life and back exercises of patients who had taken spine surgery. More aggressive early mobilization, however, such as strengthening exercise and stretching after 4 weeks of surgery gets grounds nowadays. Physical therapies including manipulation, TENS, MENS, ultrasound and cryotherapy are being used as helpful treatment modalities of postoperative pain and swelling. Failed back surgery syndrome occurs due to wrong patient, diagnosis and surgery and is managed with conservative treatment or reoperation. In oriental medicine, treatments of musculoskeletal injuries including surgical wound are based on the balance of chi(氣) and blood(血).

• Journal of Chest Surgery
• /
• v.56 no.6
• /
• pp.456-459
• /
• 2023

Penetrating chest trauma may result in significant intracardiac injury. A traumatic ventricular septal defect is a rare complication that requires surgical management, particularly if heart failure ensues. We report a case of delayed repair of an outlet-type ventricular septal defect and perforation of the aortic and pulmonary valve leaflets following a stab wound. This report highlights diagnostic and surgical considerations and also presents an opportunity to review the conotruncal anatomy, which may be relatively unfamiliar to many adult cardiac surgeons.

• Journal of Trauma and Injury
• /
• v.28 no.4
• /
• pp.276-279
• /
• 2015

Subcutaneous emphysema is a benign condition following trauma (pneumothorax and oropharyngeal), cervical or thoracic procedures, and mediastinal infection. However, severe subcutaneous emphysema may be related to serious complications such as respiratory failure, airway compromise, and tension- related phenomena. Many alternative therapies have been tried to treat patients with this condition. We report our experience with vacuum-assisted closure therapy for treating patients with severe subcutaneous emphysema.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.15 no.3
• /
• pp.182-188
• /
• 1993

A technical refinement for oral commissure reconstruction is presented. The oral commissure has an important role in oral sphincteric function. Once lost, the oral commissure is very difficult to restore and therefore, reconstruction of the oral commissure requires prevention of this function as well as prevention of microstomia. Trauma and tumor excisions are the most frequent reasons that will necessitate reconstruction of the oral commissure. Direct approximation of the wound margins after resection of the corner of the mouth could easily induce microstomia and difficulty in opening. Thus case presented here deals with distortion of noraml mouth angle and acquired microstomia due to burn and tissue deface following shotgun and explosive wounds. The a mucosal flap approach was used to rehabilitate a natural looking mouth angle showing satisfactory results function and esthetic wise.

• Archives of Plastic Surgery
• /
• v.49 no.3
• /
• pp.405-412
• /
• 2022

Although modern medicine has made great strides in the management of burn injuries, associated complications such as pain, infection, dyspigmentation, and scarring have yet to be fully dealt with. Although skin grafting and meshing are routinely performed on burn patients, this method poses a risk for adverse effects. Activated autologous platelet-rich plasma (aaPRP), which is increasingly used in the field of plastic surgery, contains growth factors beneficial for wound regeneration. Seven cases of burns with varying severity and conditions that were treated with intralesional subcutaneous injection and intravenous aaPRP are presented and discussed herein. This case series indicates that subcutaneous and intravenous aaPRP is a safe procedure with the potential to be an alternative when skin grafting cannot be done or as an adjunct treatment to skin grafting.

• Journal of Chest Surgery
• /
• v.23 no.1
• /
• pp.128-136
• /
• 1990

A Clinical analysis was performed on 717 cases of the chest trauma experienced at department of thoracic and cardiovascular surgery, Soonchunhyang Chunan Hospital from Mar. 1985 to Jun. 1989. 1. The sex ratio was 2.89:1 with male predominance. The patients in 75 % of total cases was between 3rd to 5th decade. 2. The most common causes were traffic accident in non-penetrating thoracic injury and stab wound by knife in penetrating injury. 3. The hemothorax, pneumothorax and hemopneumothorax were observed in 306 cases[42.7 %]. 4. The left thorax was the preferred site of penetrating and non-penetrating thoracic injury. The rib fracture was prevalent between 4th to 8th rib. 5. The open thoracotomy was performed in 55 cases[7.7 %] 6. The overall mortality was 3.07 %[22 cases] and causes of death were hypovolemic shock, adult respiratory distress syndrome, sepsis, disseminated intravascular coagulation, renal failure and pneumonia.

• Journal of Chest Surgery
• /
• v.33 no.7
• /
• pp.581-584
• /
• 2000

Because the penetrating cervical tracheoesophageal injury may be associated with significant morbidity and mortality, it is important to choose the optimal method of diagnosis and management in patient with tracheoesophageal injury. We obtained a satisfactory result from repair of tracheoesophageal injuries using cardiopulmonary bypass. If the bleeding from the unidentified deep injury and the spread of infection could be controlled, the repair using CPB might increase the margin of safety during operation in the similar cases.

• Archives of Plastic Surgery
• /
• v.47 no.2
• /
• pp.182-186
• /
• 2020

We report our experience of treating two patients with ankle amputation with different presentations. The first case was a clean-cut sharp amputation. The second case was an avulsion injury following a motor vehicle accident in a patient who arrived 8 hours after the injury. Replantation was successful in both cases. In avulsion injuries, a secondary operation for wound coverage is required at a later stage. With good strategy and a support team, encouraging limb survival outcomes are possible post-replantation.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1983.05a
• /
• pp.18.2-18
• /
• 1983

Children constitute a large majority of patients with foreign bodies in the nose. Adults with foreign bodies in the nose are usually mentally disturbed, and may be the victims of penetrating injuries or of operation on the nose. Foreign bodies enter the nose through the anterior naris, posterior naris, penetrating wound, $.$$.$$.$$.$ etc. Authors experienced a case of the broken pencil, 3.5cm in length, which entered the nose through the cheek and stayed there for 4 days.