• Title/Summary/Keyword: Wound management system

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Development of LED Traffic Light Lens with snow removing function (제설 기능을 갖는 LED 신호등 렌즈 개발)

  • Lee, Dongeun;Seol, Dongyoul
    • Journal of Korea Society of Digital Industry and Information Management
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    • v.13 no.4
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    • pp.41-48
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    • 2017
  • It is necessary to develop an LED traffic light lens having a snow removal function capable of clearly providing a traffic signal to the driver even when a traffic light is blurred due to heavy snow and wind in the winter season. This study is focused on the research and development of the traffic light lens in the process of developing the LED traffic light with the snow removal function. In the developed traffic light lens, instead of attaching the film heater, the coated nichrome wire was wound into a coil shape and inserted directly into the groove in the lens. The developed heater system facilitates the insertion of the heating wire with high elasticity into a curved lens and can provide a sufficient heat without deformation of the PC lens. The proposed traffic lights were tested in various external environments and the test results showed that complete snow removal is possible without tunnel effect.

Reconstruction of Ankle and Heel Defects with Peroneal Artery Perforator-Based Pedicled Flaps

  • Ahn, Deok Ki;Lew, Dae Hyun;Roh, Tai Suk;Lee, Won Jai
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.619-625
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    • 2015
  • Background The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions. Methods From July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review. Results The mean age of the patients was 52.4 years. The size of the flaps ranged from $5{\times}4$ to $20{\times}8cm^2$. The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities. Conclusions Peroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.

ANALYSIS OF MINOCYCLINE IN TISSUE AND SERUM AFTER LOCAL APPLICATION OF MINOCYCLINE OINTMENT (by High-Performance Liquid Chromatography) (미노싸이클린 연고의 근육 내 투여 후 조직 및 혈중 약물농도의 분석 (High-Performance Liquid Chromatography를 이용하여))

  • Hwang, Hye-Wook;Lee, Sang-Chull;Kim, Sung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.304-310
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    • 1999
  • This study was designed to find the effect of Minocycline loaded microcapsule applied locally to tissue by measuring drug concentration in tissue and serum by HPLC and to achieve optimal drug delivery system and duration to a specific target site. Control group were administrated minocycline intramuscularly twice a day with $0.2{\mu}g/100g$ for 1 to 10 days. In experimental group, surgical wound was created on Rt. cheek and then minocycline loaded microcapsule was applied into the space between superficial and deep layer of masseter muscle. Animals were sacrificed at 1, 3, 5, 7, 10 days after initial administration, blood was obtained from heart and right masseter muscle was excised. Blood sample was centrifuged at 3000rpm for 15min. Tissue sample was homogenized, left at room temperature for 48hr and centrifuged at 4000g for 5min. Supernatant was completely dried and dissolved in distilled water. Analysis was conducted using a ${\mu}Bondapack$ C18 column. The mobile phase was 0.2M Ammonium Oxalate/0.1M EDTA/DMF=11/4/5 solution, which was injected into the column and detected with photodiode detector at 344nm wavelength. The results were as follows : 1. This method was reliable, could be replicated and suitable for minocycline analysis in tissue as well as serum. 2. In tissue, concentration of minocycline of experimental group was higher than that of control group for 5days. 3. Except 1 day, concentration of minocycline in serum of experimental group was lower than that of control group. 4. Concentration of minocycline in tissue was much higher than that in serum. From these results, minocycline loaded microcapsule might be effective tool for local drug delivery system might be useful for treatment of infections of oral and maxillofacial region and management of infected surgical wound, minimizing systemic effects.

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Analysis of Nursing Interventions Performed by Orthopedic Surgery Nursing Unit Nurses Using NIC (간호중재분류(NIC)에 근거한 정형외과 간호단위의 간호중재 수행분석)

  • Kim Hye-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.12 no.1
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    • pp.21-29
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    • 2005
  • Purpose: The purpose of this study was to identify the frequency with which nursing interventions according to domains and classes, and core nursing interventions of the Nursing Intervention Classification (NIC) were performed by nurses on orthopedic surgery nursing units. Method: For this purpose, the third edition of NIC was used. Of the 486 nursing interventions, 424 were selected at 75% consent by experts. Data were collected from June, 2003 to July, 2003 5 hospitals and 69 nurses(return rate : 95.8%) in Gwang-ju and Chonnam region. 5 point Likert scale describing frequency was used. Results: The most frequently performed domain was 'physiological : basic'($2.97{\pm}.60$), followed by 'health system'($2.65{\pm}.65$) and 'physiological : complex'($2.55{\pm}.46$). The most frequently performed class was 'activity and exercise management'($3.82{\pm}.89$), followed by 'immobility management'($3.64{\pm}.62$), 'skin/wound management'($3.41 {\pm}.60$), 'physical comfort promotion'($3.23{\pm}.68$) and 'thermoregulation'($3.01{\pm}.91$). The most frequently performed nursing intervention was 'medication administration' ($4.96{\pm}.21$), followed by 'medication administration : intravenous'($4.93{\pm}.31$), 'analgesic administration'($4.91{\pm}.51$), 'pain management'($4.87{\pm}.34$) and 'medication administration : intramuscular'($4.78{\pm}.68$). Conclusion: In conclusion, the third edition of NIC was found to be a general and comprehensive classification system for application on orthopedic surgery nursing units. These findings will help in building of a standardized language for orthopedic surgery nursing units and enhance the quality of nursing care.

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A technique for treating exposed cardiac Pacemaker (피부괴사로 노출된 심장 Pacemaker에 대한 처치 : 증례 보고)

  • Sin, Geuk-Seon;Yu, Jae-Deok;Hong, Seung-Rok
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.125-128
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    • 1984
  • The management of the exposed cardiac pacemaker or its lead is a new challenge to the plastic surgeon. This complication is not rare. Coburn et al. [1972] reported less than 5 percent, but Sowton et al. [1974] showed that over a period of 19 years, in a series of 372 patients, the pacing system had to be removed because of local wound breakdown or infection in 10 percent of the cases. The methods used to treat exposure may vary from removal and re-introduction at anterior site to the rotation of local flaps to cover the exposed pacemaker. Recently we have experienced 6 times of migration and recurrent skin ulcerations without pyogenic infection overlying the pacemaker in one patient. We developed a new technique, anchoring the pacemaker to the clavicle by a wire through the hole of clavicle and by creating a pocket under the pectoralis major muscle. Then we would like to emphasize this operating method could be choice of treatment to prevent the migration of pacemaker and the ulceration of skin when complication of implantation of pacemaker is occurred.

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A Case of Descending Necrotizing Mediastinitis (하행 괴사성 종격동염의 치험례)

  • Lee, In Soo;Choi, Hwan Jun;Lee, Han Jung;Lee, Jae Wook;Lee, Dong Gi
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.351-355
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    • 2009
  • Purpose: Cervical necrotizing fasciitis tends to involve the deep soft tissues and spread caudally to the anterior chest and mediastinum, often resulting in major complications and death. It may rapidly spread into the thorax along fascial planes, and the associated diagnostic delay results in this descending necrotizing mediastinitis. So, aggressive multidisciplinary therapy with surgical drainage is mandatory. We present a very rare case of descending necrotizing mediastinitis with literature review. Methods: A 53 years old male visited our department 7 days after trauma in neck. His premorbid conditions and risk factors of necrotizing fasciitis were concealed hepatoma, trauma history, chronic liver disease, and nutrition deficit. Computed tomographic scans of the head and neck region were performed in this patient : signs of necrotizing fasciitis, were seen in the platysma, sternocleidomastoid, trapezius muscle and strap muscles of the neck. Fluid accumulations involved multiple neck spaces and mediastinum. At the time, he diagnosed as necrotizing fasciitis on his neck and anterior chest. Necrotic wound was excised serially and we treated this with the Vacuum - assisted closure(VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge and achieving additional 3 pieces drainage tubes in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, abscess drainage with the VAC system, and then split thickness skin graft. The postoperative course was uneventful. Conclusion: The refined technique using the VAC system can provide a means of simple and effective management for the descending necrotizing mediastinitis, with better cosmetic and functional results. Finally, the VAC system has been adopted as the standard treatment for deep cervical and mediastinal wound infections as a result of the excellent clinical outcome.

Clinical Experience of Anterior Cervical Interbody Fusion with the PCB System (전방 경추 유합술에서의 PCB System의 임상적 경험)

  • Kim, Sung Han;Kim, Ho Jin;Kang, Jae Kyu;Doh, Jong Oung;Lee, Chun Dae
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1170-1176
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    • 2001
  • Objective : The purpose of the study was to evaluate the clinical and radiological results after discectomy and Lubboc bone graft in the surgical management of the cervical diseases with a new titanium interbody implant and integrated screw fixation(PCB) by anterior approach. Methods : The authors retrospectively analyzed 28 cases of anterior cervical fusion with PCB system and Lubboc bone(xeno graft) from september 1998 to december 2000. Twenty-eight patients with cervical diseases underwent decompression cervical lesion and followed from 5 to 27 months with a mean follow-up of 14 months. There patients were evaluated with clinically and radiologically at immediate postoperative period and at 3, 6, 9, and 12 months. Result : The authors investigated the pre- and postoperative intervertebral disc space, clinical outcomes, radiography fusion rate, and Cobb angle in the fixed segments by anterior approach. The lordotic angles and height of disc space were increased after the operation. The clinical outcome of patients follow-up was good or excellent result based on Odom's criteria with improvement of clinical symptom in about 92.9% of the cervical diseases. Two patients showed loosening of the lower and upper cervical screw of PCB instruments, and two patients showed swallowing difficulty and wound infection Conclusion : The PCB system is a new implant for anterior cervical interbody fusion in the degenerative cervical disease and disc herniations. It provides immediate stability and segment distraction. The results of this study indicate that the PCB system is safe, easy handling of hardware, less complications, high fusion rate, and has provide the keeping the intervertebral disc space height and lordotic angles.

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Design of Pressure Injury Management Mobile Application Structure and User Interface (욕창관리 모바일 어플리케이션 구조 설계 및 사용자 인터페이스 구현)

  • Lee, Jisan;Kim, Jungjae;Lee, Yun Jin;Park, Seungmi
    • Journal of muscle and joint health
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    • v.26 no.3
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    • pp.223-231
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    • 2019
  • Purpose: This study aimed to design user interfaces of a mobile application for managing pressure injury patients in a long-term care hospital based on the user's needs. Methods: To reflect users' needs in the mobile application, the user interfaces in this study were designed in five steps: brainstorming and mind mapping, persona and scenario, needs list and priority, a draft version of flow chart and user interfaces and expert review. These steps were conducted with a step nurse at a long-term care hospital, a professor who majored in nursing informatics, a professor who had lots of research experiences about pressure injury and a wound ostomy continence nurse. Results: Two personas, scenarios and needs' lists were derived. Listed Needs included the followings; Accurate staging of pressure injury; Appropriate management by staging; Acquisition of professional knowledge about pressure injury; Acquisition of easy pressure injury information through text, picture and video; and Sharing pressure injury information in unit. The structure, menus and features of the pressure injury mobile application were visualized with user flow based on two personas' scenarios and needs' lists. Conclusion: Our study suggests and visualizes the key features of the 'Pressure Injury Guide', a pressure injury management mobile application for nurses in a long-term care hospital, which can be utilized by nurses, application developers, and related researchers.

Improvement of Transfusion Practice in Cardiothoracic Surgery Through Implementing a Patient Blood Management Program

  • Hee Jung Kim;Hyeon Ju Shin;Suk Woo Lee;Seonyeong Heo;Seung Hyong Lee;Ji Eon Kim;Ho Sung Son;Jae Seung Jung
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.390-398
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    • 2024
  • Background: In this study, we examined the impact of a patient blood management (PBM) program on red blood cell (RBC) transfusion practices in cardiothoracic surgery. Methods: The PBM program had 3 components: monitoring transfusions through an order communication system checklist, educating the medical team about PBM, and providing feedback to ordering physicians on the appropriateness of transfusion. The retrospective analysis examined changes in the hemoglobin levels triggering transfusion and the proportions of appropriate RBC transfusions before, during, and after PBM implementation. Further analysis was focused on patients undergoing cardiac surgery, with outcomes including 30-day mortality, durations of intensive care unit and hospital stays, and rates of pneumonia, sepsis, and wound complications. Results: The study included 2,802 patients admitted for cardiothoracic surgery. After the implementation of PBM, a significant decrease was observed in the hemoglobin threshold for RBC transfusion. This threshold dropped from 8.7 g/dL before PBM to 8.3 g/dL during the PBM education phase and 8.0 g/dL during the PBM feedback period. Additionally, the proportion of appropriate RBC transfusions increased markedly, from 23.9% before PBM to 34.9% and 58.2% during the education and feedback phases, respectively. Among the 381 patients who underwent cardiac surgery, a significant reduction was noted in the length of hospitalization over time (p<0.001). However, other clinical outcomes displayed no significant differences. Conclusion: PBM implementation effectively reduced the hemoglobin threshold for RBC transfusion and increased the rate of appropriate transfusion in cardiothoracic surgery. Although transfusion practices improved, clinical outcomes were comparable to those observed before PBM implementation.

Analysis for Compatibility of Gyejibongnyeong-hwan and Its Biological Activities (계지복령환(桂枝茯苓丸)의 배오(配伍)분석과 그 생리활성)

  • Kim, Do Hoy;Jung, Yang Sam;Yoon, Michung;Yoon, Yoosik;Shin, Soon Shik
    • Herbal Formula Science
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    • v.24 no.4
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    • pp.353-365
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    • 2016
  • Objectives : We analysed Gyejibongnyeong-hwan's compatibility principle and investigated biological activities by categorizing with molecular level, cellular level, animal level and human level based on Korean study for this formula. Methods : Gyejibongnyeong-hwan's compatibiltity principle was examined by the system of chief, deputy, assistant, and envoy. We looked into studies that presented in Korea from 1956 to 2016 about Gyejibongnyeong-hwan through Korea Institute of Oriental Medicine, Korean medicine information system (OASIS). Then classify into molecular level, cellular level, animal level and human level to analyse. Results : According to the system of chief, deputy, assistant, and envoy, chief herb is Cinnamomi Ramulus, deputy herb is Persicae Semen, assistant herb is Moutan Cortex, Paeoniae Radix, Poria, and envoy herb is Mel. Biological activities can be detected in transcription factors, enzymes, and inflammatory mediators for molecular level. For cellular level, it can be determined in human uterine endometrial cancer cell, human hepatocarcinoma cell, and human platelets. In mouse and rats for animal level, in overian cystoma, menorrhalgia, quality of life improvement in postmenopausal women, and blood stasis with motor vehicle accident for human level, biological activities was caught. Conclusions : From above results, Gyejibongnyeong-hwan is composed in line with the system of chief, deputy, assistan, and envoy. Biological activities are effective to improvement of menorrhalgia, anti-cancer, anti-oxidative, anti-inflammation, improvement of atherosclerosis, analgesic, anti-convulsion, wound healing, and improvement of liver function.