• Archives of Plastic Surgery
• /
• v.35 no.4
• /
• pp.407-412
• /
• 2008

Purpose: Hydrofluoric acid(HF) is one of the most dangerous mineral acids with the dissociated fluoride ions. The initial corrosive burn is caused by free hydrogen ion, and the second and more severe burn is caused by penetration of fluoride ions into subcutaneous tissues. Silver is a cation producing dressing, an effective antimicrobial agent, but older silver-containing formulations are rapidly inactivated by wound environment, requiring frequent replenishment. But, $Acticoat^{(R)}$ is a relatively new form of silver dressing which helps avoid the problems of earlier agents. The aim of this study is to evaluate effects of $Acticoat^{(R)}$, silver-containing dressing on the treatment for HF injury wound. Methods: From september 2006 to september 2007, the study was carried out with 10 patients who had HF partial thickness burns. $Acticoat^{(R)}$ dressing and 10% calcium gluconate wet gauze dressings in 10 cases. As a principle, in the emergency treatment, partial or complete removal of the nail and early bullectomy along with copious washing with normal saline was done, depending on the degree of HF invasion of the wound. Wound was dressed with $Acticoat^{(R)}$ and 10% calcium gluconate solution. The effect of dressing was investgated by serial bacterial culture and wound exudates assessment. Results: We therefore reviewed 10 cases of HF-induced chemical burns and treatment principle. The 10 cases who came to the hospital nearly immediately after the injury healed completely without sequelae. Conclusion: As the industrial sector develops, the use of HF is increasing more and more, leading to increased incidences of HF-induced chemical burns. The education of patients regarding this subject should be empathized accordingly. In conclusion, $Acticoat^{(R)}$ dressing is a better choice for HF partial thickness burn injuries because of shorter healing time, less pain and more comfortable dressing.

• Journal of Korean Medicine Rehabilitation
• /
• v.32 no.1
• /
• pp.1-19
• /
• 2022

Objectives This study aims to evaluate the wound healing effects of oral administered hot water extracts of Korean black ginseng (KBG). Methods 40 C57BL/6 mice were divided into five groups; normal, control, vitamin E 200 mg/kg, KBG 100 mg/kg, KBG 200 mg/kg, each n=8. Skin wounds were made in the back of all mice except normal group using biopsy punches. Wounds were observed on days 7 and 14 after injury. The anti-oxidant and inflammatory protein levels were evaluated using western blotting. Skin tissue was analyzed by hematoxylin & eosin and Masson's trichrome staining method. Results KBG significantly accelerated reducing wound area. KBG significantly decreased myeloperoxidase activity. KBG significantly decreased oxidative stress factors such as NADPH oxidase-4 and p22^phox and increased antioxidant enzymes including nuclear factor erythroid 2-related factor2, kelch-like ECH-associated protein-1, heme oxygenase-1, superoxide dismutase, catalase and glutathione peroxidase-1/2. Moreover, KBG significantly decreased inflammation factors including nuclear factor-κB, phosphorylated inhibitor of κBα, cyclooxygenase-2, inducible nitric oxide synthase, tumor necrosis factor-α and interleukin (IL)-6 and increased anti-inflammation cytokine such as IL-4 and IL-10. In addition, KBG significantly increased tight junction proteins including claudin-1, claudin-3, claudin-4. In histopathologic, KBG made the epithelium thin and uniform, and accelerated the remodeling of collagen. Conclusions The results suggest that KBG has healing effects on skin wound in mice by anti-inflammatory and antioxidant activity.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.19 no.4
• /
• pp.407-413
• /
• 1997

The soft tissue injuries of Oral & Maxillofacial region include abrasion, contusion, simple laceration, laceration of skin with underlying tissue, soft tissue injuries combined with facial bone fracture and involving functional structures such as facial nerve and vessel, orbit, lacrimal duct and salivary gland and so on. The results obtained were as follows ; 1. The age range was 1 to 97, and the highest incidence occured in the 3rd decade(23.4%), followed by the 1st decade(20.2%), 4th decade(18.1%), 4th decade(18.1), and 5th decade(14.3%) 2. The sexual ration was 4 : 1(M : F). 3. The most common cause of facial laceration was a accident(54.5), followed by blow(17.8%), traffic accident(15.9%) and unknown(10.8%). 4. The most frequently occurred site of injury was a forehead(24), followed by oral cavity(16.9%), lip(15%), eyebrow(14.5%), cheek(14%), chin(11.8%), nose(2%), scalp(1.4%) and neck(0.9%). 5. Most of wound size was less than 3cm in length. 6. 28 patients suffered facial bone fracture, representing 7%. 7. The major complications following facial laceration were infection and facial paralysis caused by facial nerve injuries, representing 4.5% and 1.9%.

• Archives of Plastic Surgery
• /
• v.32 no.4
• /
• pp.403-407
• /
• 2005

Following a transverse rectus abdominis musculocutaneous(TRAM) flap breast reconstruction, denervated state of the flap causes the flap skin prone to thermal injury, calling for special attention. During the last 5 years, 69 breast reconstruction with 72 free TRAM flaps, were performed. Four out of thesse 69 patients sustained burn injury. Heat sources were a warm bag(n=2), heating pad(n=1) and warming light (n=1). The thermal injuries occured from 2 days to 3 months following the reconstruction. Three patients healed with conservative treatment, but one patient required debridement and skin graft. Initially 3 out of 4 patients with the burn had shown superficial 2nd degree burn with small blebs or bullae. However all 4 patients healed with scars. Mechanism of burn injuries of the denervated flap are known to be resulting from; 1) loss of behavioral protection due to denervation of flap with flap elevation and transfer, 2) loss of autonomic thermoregulatory control with heat dissipation on skin flap vasculature contributing to susceptibility of burn injury. 3) changes of immunologic and normal inflammatory response increasing thromboxane, and a fall in substance P & NGF (nerve growth factor). Including the abdominal flap donor site, sensory recovery of the reconstructed breast varies individually from 6 month even to 5 years postoperatively. During this period, wound healing is delayed, resulting in easier scarring compared to that observed in the sensate skin. Patients should be carefully informed and warned of possible burn injuries and taught to avoid exposure to heat source at least until 3 years postoperatively.

• Journal of Korean Public Health Nursing
• /
• v.17 no.1
• /
• pp.96-112
• /
• 2003

The purpose of this study was to determine how often toddlers and preschoolers in kindergartens have accidents and what factors affect the accident rate. The study population consisted of 150 children who were attending at nursery schools and 150 children who were attending at kindergartens. The data was collected from ten nursery schools and five kindergartens from five districts in Daegu. The questionnaires were distributed to teachers of participating nursery schools and kindergartens to be completed using nursing care records in the institutions and by interviewing children's parents about all of the accidents happened in a previous year. Data were collected during the period of August 1 through 31, 2002. The results of the study are as follow: 1. Among 300 children, 282 had 506 accidental injuries during the study period. 2. The month, the day and the time with the highest accident rate were April. Monday, and between 2 and 4 o'clock in the afternoon, respectively. 3. Locations where the injury took place most included nursery schools or kindergartens, around the homes of the children, and inside the home. 4. Most accidents were occurred due to lack of carefulness of the children, and the most prevalent forms of injury was abrasions. 5. Most frequently injured part of the body was legs of the children. 6. Most injuries were healed within three days and required first aid measures to disinfect the wound. Mostly, these were performed by family members at home. Some children go to the hospital to suture the open wound. Most frequent type of complication was scar formation and the cost of the treatment ranged from 9,000 to 30,000 won. 7. Children's age. sex, birth order. personality. type of family composition. type of residency. father's occupation, father's age, and mother's age were significantly related to the frequency of injury among children. Children who were in nursery schools and kindergartens need their assessment for accident involving condition according to seasons, time. place. This study provided a very useful and important data to prepare accident prevention education program and accident prevention strategies, and to develop Injury Surveillance System.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.496-498
• /
• 2010

Purpose: Lacerations requiring formal wound closure compose a significant number of all childhood injuries presenting to the emergency department. The problem with conventional suture technique are that suture removal is quite cumbersome, especially in children. Unwanted soft tissue damage can result in the process of suture removal, which calls for sedation, stressful for both medical personnel and child. The purpose of this study is to introduce the convenient suture technique for pediatric facial lacerations. Methods: Children under the age of four, presenting to the emergency department with facial lacerations were enrolled in the study. From March 2008 to June 2009, 63 patients (41 males and 22 females) with an average age of 1.4 years were treated with our convenient suture technique using utilized a loop suspended above a double, flat tie. Clean, tension free wounds were treated with our technique, wounds with significant skin defect and concomitant fractures were excluded. Results: The Patients were followed-up in 1, 3 and 5 days postoperatively. On the third hospital visit, suture removal was done by simply cutting the loop suspended above the wound margin and gently pulling the thread with forceps. There were no significant differences in the rates of infection and dehiscence compared with conventional suture technique. Conclusion: The use of our technique was to be simple with similar operative time compared with conventional suture technique. Removal of suture materials were easy without unwanted injuries to the surrounding tissue which resulted in less discomfort for the patient and greater parental satisfaction, minimized the complications. It can be considered as a viable alternative in the repair of pediatric facial lacerations.

• Journal of Trauma and Injury
• /
• v.26 no.3
• /
• pp.111-124
• /
• 2013

Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

• Journal of Veterinary Clinics
• /
• v.24 no.2
• /
• pp.137-141
• /
• 2007

The medical records of 69 dogs with history of bite wounds, between 1998 and 2006, were reviewed. Information obtained from these files included the general statistics of the patients (sex, age, breed, weight), season on occurrence of injuries, body areas wounded, therapeutic regime used and mortality rates. Intact male dogs were more frequently bitten. The weight distribution of the bitten population was varied 41% for small, 16% for medium and 17% for large dogs. The highest incidence was in young animals. The distribution of bite wound injuries over the year was recorded with peaks in April (13%), March (12%), August (12%) and September (10%). The common regions of injury were the head (22), fore-limbs (17), hind-limbs (15), abdomen (15), thorax (15) and neck (14). Mortality tends to be increased in cases of thoracic or abdominal injury. The results about the prevalence of bite wounds in Daejeon and Chungnam area are intended to use as a reference data in veterinary practice.

• Journal of Trauma and Injury
• /
• v.23 no.1
• /
• pp.21-28
• /
• 2010

Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

• Journal of Chest Surgery
• /
• v.23 no.5
• /
• pp.905-915
• /
• 1990

A clinical evaluation was performed on 545 cases of the chest trauma those had been admitted and treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the past 11 years 5 months period from January 1978 to may 1989. Obtained results were as follows: 1. The ratio of male to female was 3.9: 1 in male predominance, and the majority[66.6%] was distributed from 3rd to 5th decade. 2. Nonpenetrating chest trauma was more common than penetrating about 4.6 times, and the most common cause of the nonpenetrating injuries was traffic accident[241/448, 53.8%] and of the penetrating injuries was stab wound[88/97, 90.7%]. 3. Only 79 cases[14.5%] were arrived to our emergency room within one hour after trauma. 4. The most common lesion due to trauma among these admitted patients was rib fracture[390/545, 71.6%], and the others were lung contusion[217/545, 39.8%], hemothorax[35%], hemopneumothorax[19.6%], and pneumothorax[11.8%] et al in decreasing order. 5. The associated injuries those required special treatment of other departments were 223 cases and its distributions were bone fractures[178/545, 32.7%], head injury[5.3%], and abdominal injury[6.6%]. 6. The others, but interesting chest injuries were follows: sternum fracture[3.1%], diaphragm rupture[2.6%], myocardial laceration and rupture[2 cases], bronchial rupture and laceration[2 cases], and traumatic thymoma rupture[1 case]. 7. The incidence of flail chest was 5.8%a[26/448] in the nonpenetrating injury, and the causes were multiple rib fracture which was in rows more than 4 rib fracture[20 cases], and sternum fracture[6 cases]. 8. We could managed the most of the patient with conservative treatment[43.1%] or closed tube thoracostomy[52.7%], but required emergency open thoracotomy in 64 cases