• Journal of Korean Foot and Ankle Society
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• v.25 no.2
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• pp.89-94
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• 2021

The surgical repair of an Achilles tendon acute rupture is a proven, traditional treatment for optimal functional recovery. However, concerns regarding complications such as re-rupture, wound problems and infections are driving new techniques, including minimally invasive approaches and nonoperative treatments. If we understand the characteristics and contemplate treatment strategies for possible complications, the surgical repair of the Achilles tendon is an attractive option and can be expected to yield satisfactory functional recovery.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.470-474
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• 2019

Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

• Advances in pediatric surgery
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• v.20 no.1
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• pp.7-11
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• 2014

The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.

• Molecules and Cells
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• v.37 no.9
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• pp.637-643
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• 2014

Wound healing is a complex multi-step process that requires spatial and temporal orchestration of cellular and non-cellular components. Hypoxia is one of the prominent microenvironmental factors in tissue injury and wound healing. Hypoxic responses, mainly mediated by a master transcription factor of oxygen homeostasis, hypoxia-inducible factor-1 (HIF-1), have been shown to be critically involved in virtually all processes of wound healing and remodeling. Yet, mechanisms underlying hypoxic regulation of wound healing are still poorly understood. Better understanding of how the wound healing process is regulated by the hypoxic microenvironment and HIF-1 signaling pathway will provide insight into the development of a novel therapeutic strategy for impaired wound healing conditions such as diabetic wound and fibrosis. In this review, we will discuss recent studies illuminating the roles of HIF-1 in physiologic and pathologic wound repair and further, the therapeutic potentials of HIF-1 stabilization or inhibition.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.56-61
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• 2018

Advances in medical technology has enabled better management of complicated and chronic wounds. Negative-pressure wound therapy (NPWT) is a novel dressing technique that uses negative pressure to drain exudates and blood from wounds. NPWT increases local blood flow and promotes reduction of edema and wound healing and is suitable for a variety of wounds. It is associated with few adverse effects and shows excellent efficacy and cost-effectiveness. NPWT promotes rapid growth of granulation tissue and wound contraction; thus, it is more advantageous than general dressings as it reduces the size skin of grafts or flaps required for repair, and patients with chronic wounds can be treated as outpatients. We investigated the general usage and mechanism of NPWT, its clinical applications and adverse effects.

• Herbal Formula Science
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• v.25 no.2
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• pp.123-134
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• 2017

Wounds are commonly created during almost every kind of surgery, trauma and skin diseases. Delayed wound healing affects a plenty of patients and requires prolonged treatments that seriously reduce the quality of life for patients. Skin damage involving large areas or great severity can lead to disability or even death. Wound healing involves a complicated series of actions, of various tissues and cell lineages, concerning inflammation, migration, proliferation, reepithelialization, and remodeling. Sopung-san is reported to have anti-inflammatory effect and has been used for various skin diseases such as allergic dermatitis and atopic dermatitis. In this study, the hypothesis that oral treatment with Sopung-san could enhances healing potential on rat full thickness skin wounds was tested. Twenty young male Sprague-Dawley rats were used for the studies. A full-thickness skin wound was made on the dorsal skin of the rats. Either Sopung-san water extract (SPS) or saline (Control) was orally administrated every day. The wound area was measured and the percentages of wound contraction, wound healed and wound epithelization were calculated. Wound tissue samples were excised following injection for histopathological and immunohistological examination. Wound area in rats of SPS group significantly was decreased compared to Control. SPS group showed significant promotion of wound healing compared to Cotrol group in the percentages of wound contraction, wound healed and wound epithelization. Histopathological examination revealed that SPS induces neo-vascularization potential in wound healing process. SPS treatment in rats significantly accelerated cutaneous wound healing in the neo-vascularization process by increasing VEGF and $TGF-{\beta}1$ synthesis. The results suggest that Sopung-san affects key cellular processes responsible for wound repair and point to a unique potential for this molecule in the therapy of skin wounds, particularly as an angiogenic agent.

• Journal of Physiology & Pathology in Korean Medicine
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• v.31 no.6
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• pp.334-340
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• 2017

Wound healing is the restoration in injured skin tissue and one of the most important therapeutic targets. The process consists of inflammation, proliferation, and remodeling. There have been reported multiple factors that accelerate and delay wound healing. In this study we tested the hypothesis that Sophorae Radix extract would improve the recovery of wound healing after full-thickness skin wound in rats. Twenty young male Sprague-Dawley rats were used for the studies. A full-thickness skin wound was made on the dorsal skin of the rats. Either Sophorae Radix water extract (SR) or saline (Control) was orally administrated every day. The wound area was measured and the percentages of wound contraction, wound healed and wound epithelization were evaluated. After 15 days, the skin tissues were excised and examined by histopathological and immunohistochemistrical method. In results, wound area in SR group was significantly decreased to compared with Control. SR group showed the significant enhancements in the percentages of wound contraction, wound healed and wound epithelization. Histopathological examination revealed that SR induces neo-vascularization potential in wound healing process. SR treatment in rats significantly accelerated cutaneous wound healing in the angiogenesis process by increasing VEGF and TGF-${\beta}1$ synthesis. These results suggest that Sophorae Radix enhance skin wound repair by increasing the angiogenic agents such as VEGF and TGF-${\beta}1$.

• Archives of Craniofacial Surgery
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• v.21 no.1
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• pp.45-48
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• 2020

In neurosurgical cases, problems related to wound healing can vary from simple wound dehiscence to multilayer defects. This study demonstrates an effective method to prevent persistent cerebrospinal fluid (CSF) leakage using reinforcing acellular dermal matrix in neurosurgical patients with wound dehiscence. A 52-year-old woman was admitted for management of recurrent glioblastoma. After tumor removal surgery, the patient experienced sustained CSF leakage from the wound despite reparative attempts. The plastic surgery team performed wound repair procedure after remnant tumor removal by the neurosurgery team. Acellular dermal matrix was applied over the mesh plate to prevent CSF leakage and the postoperative status of the patient was evaluated. No sign of CSF leakage was found in the immediate postoperative period. After 3 years, there were no complications including CSF leakage, wound dehiscence, and infection. We hereby propose this method as a feasible therapeutic alternative for preventing CSF leakage in patients experiencing wound problem after neurosurgical procedures.

• Asian-Australasian Journal of Animal Sciences
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• v.21 no.2
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• pp.277-290
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• 2008

The process of wound repair involves an ordered sequence of events such as overlapping biochemical and cellular events that, in the best of circumstances, result in the restoration of both the structural and functional integrity of the damaged tissue. An important event during wound healing is the contraction of newly formed connective tissues by fibroblasts. The polypeptide growth factors, like transforming growth factor-${\beta}$(TGF-${\beta}$, insulin-like growth factor I (IGF- I) and epidermal growth factor (EGF), play very important mediator roles in the process of wound contraction. Deer antlers, as models of mammalian regeneration, are cranial appendages that develop after birth as extensions of a permanent protuberance (pedicle) on the frontal bone. Antlers contain various growth factors which stimulate dermal fibroblast growth. They are involved in digestion and respiration and are necessary for normal wound healing and skin health. In order to investigate and evaluate the effects of red deer antlers on skin wound site, the speed of full-thickness skin wound healing and the expression of IGF-I, TGF-${\beta}$ and EGF in skin wounds, three groups of skin full-thickness rat models with a high concentration of antler ointment, a low concentration of antler ointment and without antler ointment were compared. At post-injury days 0, 2, 4, 8, 16, 20, 32, 40 and 60, the skin wound area was measured, the expressions of IGF-I, TGF- ${\beta}$ and EGF mRNA were detected by reverse transcriptase polymerase chain reaction (RT-PCR) and collagen formation by sirius red dye and the localization of IGF-I, TGF-${\beta}$ and EGF peptides were inspected by histological immunohistochemical techniques. Wound healing was significantly more rapid in antler treated skins. In addition, the wound treated with a high concentration antler ointment, a low concentration antler ointment, and the control closed completely at post-injury day 40, day 44 and day 60, respectively. Via RT-PCR, the expressions of IGF-I (day 8 and day 16), TGF-${\beta}$(day 8, day 16 and day 20) and EGF (day 4, day 8, day 16, and day 32) were obviously up-regulated in high concentration antler-treated skins compared to control skins. Similar results could be seen in the histological detection of collagen dye and immunohistochemical methods using the corresponding polyclone antibodies of IGF-I, TGF-${\beta}$ and EGF. These results illustrate that antlers stimulate and accelerate the repair of cutaneous wounds.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.842-846
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• 1995

Recently, the trauma patients have been markedly increasing due to the vast increase of traffic accident, industrial disaster, incidental accident and violence. The authors have analysed of 22 patients of thoracic injuries combined with abdominal injuries and summarized as follows. The ratio of male to female was 3.4:1 and their age distribution was from 5 years to 68 years and mean age was 34.4 years. The etiologies of injury were traffic accident, stab wound, fall down and violence. Associated injuries were fractures, bowel perforation, kidney rupture, head injury, liver laceration, spleen rupture and so forth. The modes of treatment were closed thoracostomy, repair of diaphragm, ruptured bowel repair, explo-thoracotomy, splenectomy, hepatic lobectomy in this order of frequency. The postoperative complications were atelectasis, wound infection, pneumonia, empyema, acute renal failure, respiratory failure and bleeding. The mortality rate was 13.6% [3/22 and the causes of death were respiratory failure 1 case, acute renal failure 1 case and hypovolemic shock 1 case.