• Journal of Trauma and Injury
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• 제34권1호
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• pp.75-78
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• 2021

A Morel-Lavallée lesion is a post-traumatic closed degloving soft tissue injury after blunt trauma. Infection and skin necrosis frequently occur if it is not treated properly in the early stages. However, there is no clearly established treatment algorithm. In the acute stage, it is mainly treated with aspiration, simple compression, and incisional drainage. In the chronic stage, sclerotherapy is usually performed. If skin necrosis develops, the necrotic tissue is resected and a skin graft is needed. We describe a case of acute Morel-Lavallée lesion in the buttock region that was treated with limited incisional drainage and negative-pressure wound therapy, and also present a review of the literature.

• 대한족부족관절학회지
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• 제20권4호
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• pp.182-186
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• 2016

The tibialis anterior tendon functions as a major dorsiflexor of the ankle. A rupture in this tendon can cause serious problems in the ambulatory function. A closed traumatic rupture without open wound or an atraumatic rupture can delay diagnosis and treatment. There are not enough guidelines for an effective surgical treatment on this chronic condition. Herein, we report two cases of chronic tibialis anterior disruption successfully treated by semitendinosus autograft.

• 한국임상수의학회지
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• 제35권5호
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• pp.229-232
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• 2018

A 9-year-old intact female Poodle (weighing 3.6 kg) was presented for the treatment of a partial and full thickness burn that covering 45% of body including bilateral thigh and sacrolumbar region. Autologous platelet-rich plasma (PRP) stimulates angiogenesis, promoting vascular in-growth and fibroblast proliferation. On the unrecovered right thigh of the dog, autologous PRP was injected into the lesion after application of micro-needles. For macroscopic evaluation digital, photographs were taken from wounds at days 0, 3, 5, 13, 21, and 28. On the $3^{rd}$ day after PRP application, epithelialization was accelerated. Application of autologous PRP accelerated wound-healing rate and healing time in full thickness burns as well as secondary complications originating from unrecovered wounds. The delayed lesion was completely healed on the $28^{th}$ day by autologous PRP treatment. In human, PRP was increasingly used in the treatment of a variety of soft tissue in the management of chronic non-healing wounds. This study has shown that PRP treatment can be a valuable and effective aid on intractable wound healing in the dog with burns.

• Journal of Trauma and Injury
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• 제33권4호
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• pp.260-263
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• 2020

Necrotizing fasciitis is an infection of the subcutaneous tissue that results in destruction of the fascia and is disproportionately common in patients with chronic liver disease or diabetes. Necrotizing fasciitis of the head and neck is rare, but has a high fatality rate. A 50-year-old man with a past medical history of diabetes reported a chief complaint of a wound in the posterior neck due to trauma. The wound had grown and was accompanied by pus and redness, and the patient had a fever. When the patient was referred to department of plastic & reconstructive surgery, the sternocleidomastoid muscle, semispinalis capitis muscle, splenius capitis muscle, and trapezius muscles were exposed, and the size of the defect was about 25×20 cm. Dead tissue resection was performed before negative-pressure wound therapy, followed by a split-thickness skin graft (STSG). After a 2-week course of aseptic dressing post-STSG, the patient recovered completely. No postoperative complications were observed for 1 year. Necrotizing fasciitis is a life-threatening, rapidly spreading infection, requiring early diagnosis and active surgical treatment. In addition, broad-spectrum antibiotics are required due to the variety of types of causative bacteria. Broad necrotizing fasciitis of the posterior neck is rare, but can quickly progress into a life-threatening stage.

• 한국학교보건학회지
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• 제36권2호
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• pp.62-70
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• 2023

Purpose: The purpose of the study is to identify workload measurement indicators for school nurses in order to provide high-quality health care and deploy school nurses effectively. Methods: A second Delphi survey was conducted on 21 experts with more than 5 years of school nurses experience. To develop indicators related to the workload of school nurses, the importance and measurability of a total of 21 workload indicators were investigated, including school nurses characteristics, school characteristics, health needs of students, and socioeconomic determinants. Results: As a result of the Delphi survey, it was found that 6 indicators were suitable in terms of importance and 8 indicators in terms of measurability. The important indicators the panel agreed on include the size of the city where the school is located, the total number of students, the number of classes, the percentage of students with chronic illness, the percentage of students visiting the health office per day, and the percentage of wound care in the health office per day. Conclusion: The percentage of students with chronic illness and the percentage of wound care per day need to be reflected in school nurse workload indicators and follow-up studies are required to shed more light on the socioeconomic determinants of schools.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.156-162
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• 2007

Purpose: In the previous in vitro studies the bone marrow stromal cells(BSCs) have shown the superior effect for wound healing activity than fibroblasts, which includes cell proliferation, type I collagen synthesis, and the production of bFGF, VEGF and TGF-${\beta}$ in chronic wound healing. The aim of this study is to compare the effects of BSCs and fibroblasts on wound healing activity in vivo, especially on collagen synthesis. Methods: The fibroblasts and BSCs were harvested from patients and cultured. The cultured cells were infiltrated into the pores of polyethylene discs. These discs were divided into three groups according to the mixed cells. In groups I, II and III the discs were loaded with no cells, fibroblasts and BSCs, respectively. Twelve discs per group(total 36 discs) were made for this study. After creating 6 pockets in the back of each rats, each discs was implanted into each pockets. At three time intervals from 1 to 3 weeks, the implanted discs were harvested for the histological and quantitative analysis. The amount of collagen produced was evaluated using ELISA. Statistical comparisons were made using the Mann-Whitney U-test. Results: There was great difference in the collagen synthesis among the three groups by the 1st and 2nd weeks. The BSC group showed highest collagen level, followed by fibroblast group and no cell group(p<0.05). The 3rd week specimens also showed greater collagen amount in BSC and fibroblast groups compared to those of no cell group(p<0.05). However, there was little difference between BSC and fibroblast groups. Conclusion: This result demonstrates that BSC has superior effect on stimulating wound healing than fibroblast, which is currently used for wound healing.

• 대한족부족관절학회지
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• 제25권2호
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• pp.100-107
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• 2021

Purpose: The present study aimed to develop guidelines regarding initial choice of antibiotics for diabetic foot ulcers (DFU) by investigating bacterial isolates. Materials and Methods: This study included 223 DFU patients that visited a single tertiary hospital and underwent bacterial culture between January 2016 and February 2020. The study was conducted in two parts: 1) to compare bacterial isolates and wound healing according to comorbidities such as chronic kidney disease (CKD) and peripheral artery disease (PAD), and 2) to compare bacterial isolates according to wound depth using the Wagner classification. Results: Of the 223 patients, 43 had CKD (group A), 56 had PAD (group B), 30 had CKD and PAD (group C), and 94 had none of these comorbidities (group D). The isolation rate for multidrug-resistant gram-negative bacteria (MRGNB) and gram-negative to gram-positive bacteria ratio were highest in group C (p=0.018, p=0.038), and the proportion that achieved wound healing was lowest in group C (p<0.001). In the second part of the study, subjects were classified into 5 grades by wound depth using the Wagner classification; 13 grade I, 62 grade II, 60 grade III, 70 grade IV, and 17 grade V. No significant difference was observed between these grades in terms of isolation rates or gram-negative to gram-positive bacteria ratios. Conclusion: This study suggests antibiotics that cover gram-negative bacteria including MRGNB produces better results in the presence of CKD and PAD and that initial antibiotic choice should be based on the presence of CKD and PAD rather than wound depth.

• 한국전문물리치료학회지
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• 제3권3호
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• pp.67-81
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• 1996

This study was performed to assess the efficacy of high voltage pulsed galvanic current for the healing of wounds in rabbits. Skin wounds were created laterally on the flank of 12 domestic rabbits($3{\times}3cm$). The wounds of each group were treated with an intensity of 170 V at a frequency of 70 pulses per second, which was applied for 30 minutes a day for 10 days. The experimental groups were randomly assigned to either EXP I (n=3), EXP II(n=3), EXP III(n=3) or control(n=3). Each group was stimulated under the following conditions : 1) EXP I (Negative polarity), 2) EXP II (Change in polarity, negative electrode stimulation during the first 3 days and then positive electrode stimulation from 4 to 10 days), 3) EXP III(Positive polarity), 4) control(No stimulation). An active electrode was placed over the wound and a dispersive electrode on the buttock. The rate of wound closure was compared with the original wound size, evaluated by a tracing film in each measurement period. Finally, on the wound in each group, skin tissue was excised for histological evaluation after treatment for 10 days. The results obtained are as follows : 1) It was found that the control group did not show a complete remodeling of epitherial layer and had a chronic inflammatory response. Judging from the irregularity of intercellular space and the loose alignment of connective tissue, these findings show that wound healing was delayed. 2) EXP I showed a significant bactericidal effect, but a moderate response of vasodilation. The rate of wound closure was slower when compared with EXP II, III. 3) EXP II showed a complete remodeling of epitherial layer and a positive repair of connective tissue. Its rate of wound closure was best when compared with the others. 4) EXP III had a slower rate of wound closure than EXP II, but judging from the greater proliferation of collagen fibers and the dense alignment of connective tissue, this positive electrode was very effective in the formation of neo - connective tissue.

• Archives of Reconstructive Microsurgery
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• 제13권2호
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• pp.136-143
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• 2004

Purpose : We analyse retrospectively the clinical result of consecutive free flap and osteocutaneous flap transfer in the chronic osteomyelitis, nonunion combined with infection and soft tissue defect with infection. Materials and Methods : From December 1989 to Jun 2003, free flap and osteocutaneous flap transfer was performed in 225 patients with osteomyelitis or infected non-union. 44 cases of these patients had revealed antibitotics resistant organism in wound culture, and these 44 cases were investigated in the mechanism of the injury, recurrence of infection, radiographic union, follow-up clincal results, and postoperative complications. Results : Among the 44 cases, consecutive procedures of osteocutaneous flap transfers(26 cases) and free flaps(18 cases) were performed. Causative organisms were MRSA(20 cases), Pseudomonas aeruginosa(18 cases), acinetobacter(2 cases), and so forth. Initial bony union was obtained in the average 6.3 months. Recurrence of infection in free flap and osteocutaneous free flap were occurred in 3 and 4 cases respectively. Eventually, all the cases attained successful subsidence of the inflammation. Conclusion : Free flap and osteocutaneousflap transfer have provided the greatest improvement of surgical results in infected non-union, chronic osteomyelitis and soft tissue defect with infection. Further clincal studies maybe required to minimize failure rate.

• 대한화상학회지
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• 제22권1호
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• pp.15-19
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• 2019

Purpose: Pain management in burn treatment is important in improving wound healing and quality of life. Ibuprofen is a proven pain relieving agent in patients with partial thickness burn by intraveous injection. The purpose of this study is to evaluate the efficacy of Biatain Ibu^® (polyurethane foam containing ibuprofen) in pain control for outpatients with partial thickness burns. Methods: A prospective randomized clinical trial was performed in outpatients with partial thickness burn from August 1, 2017 to July 31, 2018. Acute pain, chronic pain, complications, days for re-epithelialization and patient's satisfaction were compared between Biatain Ibu^® and Biatain^® groups. Results: A total of 20 patients (Biatain Ibu^®, n=10; Biatain^®, n=10) were assessed in the trial. On Burn days 3, 5, 7, 11, 13, and 15, the acute pain levels were significantly lower in the Biatain Ibu^® group than in the Biatain^® group. Complications, chronic pain levels and days for re-epithelialization were not significantly different between the two groups. Patient's satisfaction was not statistically significant but was higher in the Biatain Ibu^® group. Conclusion: Biatain Ibu^® is effective in relieving pain in outpatients with partial thickness burn without decreasing patient satisfaction, wound healing ability or developing any complications.