• Archives of Plastic Surgery
• /
• v.49 no.2
• /
• pp.227-239
• /
• 2022

Complications experienced during lymphatic surgery have not been ubiquitously reported, and little has been described regarding how to prevent them. We present a review of complications reported during the surgical management of lymphedema and our experience with technical considerations to reduce morbidity from lymphatic surgery. A comprehensive search across different databases was conducted through November 2020. Based on the complications identified, we discussed the best approach for reducing the incidence of complications during lymphatic surgery based on our experience. The most common complications reported following lymphovenous anastomosis were re-exploration of the anastomosis, venous reflux, and surgical site infection. The most common complications using groin vascularized lymph node transfer (VLNT), submental VLNT, lateral thoracic VLNT, and supraclavicular VLNT included delayed wound healing, seroma and hematoma formation, lymphatic fluid leakage, iatrogenic lymphedema, soft-tissue infection, venous congestion, marginal nerve pseudoparalysis, and partial flap loss. Regarding intra-abdominal lymph node flaps, incisional hernia, hematoma, lymphatic fluid leakage, and postoperative ileus were commonly reported. Following suction-assisted lipectomy, significant blood loss and transient paresthesia were frequently reported. The reported complications of excisional procedures included soft-tissue infections, seroma and hematoma formation, skin-graft loss, significant blood loss, and minor skin flap necrosis. Evidently, lymphedema continues to represent a challenging condition; however, thorough patient selection, compliance with physiotherapy, and an experienced surgeon with adequate understanding of the lymphatic system can help maximize the safety of lymphatic surgery.

• Journal of the Korean Burn Society
• /
• v.22 no.2
• /
• pp.30-33
• /
• 2019

Purpose: Wound healing and scar management of donor site after skin graft should not be overlooked. Patients continue to complain of dryness, itching sensation. Such discomfort can cause irritation to the patients and lead to delayed healing or secondary infection. Thus, the author predicted Eucalyptus Oil, which acts on Transient Receptor Potential Melastatin 8 would be effective in regulating scar by reducing itching sensation in donor site when combining conventional silicone materials. Methods: The study was performed on 30 patients who underwent split thickness skin graft with lateral thigh as donor site between January 2017 and August 2018. First, primary evaluation of fully epithelized donor site scar three weeks after surgery was conducted. Control group (n=15) applied silicone gel (Kelo-cote, USA) solely two times a day. study group (n=15) applied Eucalyptus oil, combined with silicone gel. After 3 months of follow up, donor scar was evaluated using Vancouver scar scale and VAS scores of subjective patient reports regarding pain and itching sensation. Results: It was confirmed that both groups showed stable scar improvement comparing scar quality for 3 months. After 3 months, scar quality in study group showed superiority in pigmentation, pliability and pruritus compared to control group. Conclusion: Application of Eucalyptus Oil combined with conventional silicone gel is favorable to scar management and may give additional benefit of alleviating pruritis symptoms.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.8 no.1
• /
• pp.131-132
• /
• 1995

After studing of viewpoint of surgical disease in seven medical books related with Ju Dan Gye(朱丹溪) among four eminent physicians in the Jin and Yuan dynasties(金元四大家) I get conclsion as following. 1. Studied surgical diseases are total 40 kinds. 2. In 40 kinds surgical diseaes, case of having theory are 20 kinds, cases of having no theory and having only treatement by medicine are 20 kinds. 3. In therapy, cases that mainly use a method to eliminate pathogenic factors are 27 kinds; Acute mastitis(乳癰), Deep-seated mammary abscess(내巖), Acute appendicitis(陽癰), Bone cellulitis(附骨疽), Carbuncle of the lower abdomen near external genitalia(便毒), Leprosy(癩風), Macule(斑), Rash(疹), Urticaria(은疹), Scrofula(나역), Stagnant plegm(結核), Goiter andtumer(영유), Erysipelas(丹), Furuncle(정瘡), Scabies(疥瘡), Chancre(下疳瘡), Syphilitic skin disease(樣梅瘡), Incised wound (金瘡), Dermatopathy of lower limb and heel(脚足部瘡), Pemphigus(天疱瘡), Itching eruption due to blood-heat or wind heat(血風瘡), Dermatopathy of head(頭面瘡), Scald and burn(湯火瘡), Tetanus(破傷風) , Ecthyma(염瘡), Fistula(久漏瘡), Tinea(癬瘡), Cases that mainly use external therapy are 5 kinds; Rhagades of hand and foot(手足군裂), Vulvar ulceration(婦人陰瘡), Chilblain(凍瘡), Rabies(풍狗咬), Tinea capitis(白禿瘡), Cases that mainly use a reinforcing method are 4 kinds; Internal deep-rooted carbuncle(內疽), Pruritus and dryness of skin(皮膚乾燥), Anul fistula(漏瘡), Macule Caused by disorder of internal organ(內傷發斑), Cases that mainly use eliminating first and then reinforcing are 2 kinds; Pyogenic infection and ulcerous disease of slin( 疽瘡상癰疽瘡瘍), Lung abscess(肺癰), Case that mainly uses reinforcement and elimination in combination is only Haemorroid(痔瘡). Case divided into two groups that are reinforcing method and a method to eliminate pathogenic factor is only Trauma(打撲). Case that have no treatment by medicine is only Abscess of the scrotum(囊癰). 4. In 40 kinds surgical diseases, we can know that except a few important surgical diseases, Ju Dan Gye haven't distinguished viewpoint in many surgical diseases, because there are many cases that have no theory and have only simple treatment of medicine, and that mainly use a method to eliminate pathogenic factors and external therapy. 5. Representative theory of Ju Dan Gye, nourishing Yin and extinguishing fire(滋陰降火), has little effect on therapy of surgical disease. We need to try statistical division of internal and external remedy in the future, and by studing of surgical disase in medical books related with four eminent physicians in the Jin and Yuan dynasties, I think we can see their viewpoint of surgical disease.

• Korean Journal of Microbiology
• /
• v.46 no.3
• /
• pp.240-247
• /
• 2010

Pseudomonas aeruginosa is a Gram (-) opportunistic human pathogen causing a wide variety of infections on lung, urinary tract, eyes, and burn wound sites and quorum sensing (QS), a cell density-sensing mechanism plays an essential role in Pseudomonas pathogenesis. In order to investigate the importance of QS in the Pseudomonas infections of Korean patients, we isolated 189 clinical strains of P. aeruginosa from the patients in Pusan Paik Hospital, Busan, South Korea. The QS signal production of these clinical isolates was measured by signal diffusion assay on solid media using reporter strains. While most clinical strains (79.4%) produced the QS signals as similar level as a wild type strain, PAO1 did, where LasR, the initial QS signal sensor-regulator was fully activated, a minority of them (4.2%) produced much less QS signals at the level to which LasR failed to respond. Similarly, while 72.5% of the clinical isolates produced QS signals enough to activate QscR, an another QS signal sensor-regulator, some few of them (9%) produced the QS signals at much lower level where QscR was not activated. For further analysis, we selected 74 clinical strains that were obtained from the patients under suspicion of Pseudomonas infection and investigated the total protease activity that is considered important for virulence. Interestingly, significant portion of them showed very low protease activity (44.6%) or no detectable protease activity (12.2%). When the biofilm-forming ability that is considered very important in chronic infection was examined, most isolates showed lower biofilm-forming activity than PAO1. Similarly, significant portion of clinical isolates showed reduced motility (reduced swarming activity in 51.4% and reduced twitching activity in 41.9%), or non-detectable motility (swarming-negative in 28.4% and twitching-negative in 28.4%). Our result showed that the clinical isolates that produced QS signals at the similar level to wild type could have significantly reduced activities in the protease production, biofilm formation, and motility, and some clinical isolates had unique patterns of motility, biofilm formation, and protease production that are not correlated to their QS activity.