• 제목/요약/키워드: debridement

검색결과 467건 처리시간 0.031초

교정용 Elastic Band에 의한 의원성 연출치의 치험예

  • 김혜란;강구한
    • 대한치과의사협회지
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    • 제20권3호통권154호
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    • pp.233-237
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    • 1982
  • A review of the literature was presented, illustrating the effect that gingivally retained orthodontic elastic bands have on the periodontal tissues. A case report was presented for treatment of mobile maxillary central incisors secondary to a subgingival elastic band. Following surgical removal of elastic band and periodontal debridement, the teeth were successfully retained with active orthodontic appliances. Until a harmless radiopaque medium can be safely incorporated into elastic bands, extreme caution in their use should be observed. Not only should all attempts be made to anchor the elastic bands to the clinical crown, but the patient should receive through instructions in their placement and removal.

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개심술 후 발생한 흉골의 결핵성 골수염 -1례 보고- (Tuberculous Osteomyelitis on Sternum after Open Heart Surgery -A Cases of Report-)

  • 은종화
    • Journal of Chest Surgery
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    • 제27권8호
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    • pp.708-709
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    • 1994
  • Tuberculosis infection of sternum is extremely rare. The most common cause of sternal osteomyelitis is infection of a median sternotomy incision, employed for most cardiac operation. If a wound infection of this regeon becomes apparent, the wound should be opened wide to allow adequate drainage. Frequent irrigation and debridement are necessary to avoid extension of the infection into the bone. We have experienced a 16 years old female who has been operated upon due to ASD, was infected with tuberculosis in sternum. Our team have treated her for tuberculous osteomyelitis on sternum with curettage and drainage.

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임플란트주위염 처치에서 레이저의 이용: 문헌고찰 (Laser therapy in peri-implantitis treatment: literature review)

  • 이경중;이종호;금기연;임영준
    • 구강회복응용과학지
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    • 제31권4호
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    • pp.340-348
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    • 2015
  • 임플란트주위염(peri-implantitis)은 기능중인 골유착 임플란트 주위의 조직에서 생기는 사이트 별 감염성 질환이며 임플란트 후기 실패(late failure)의 원인으로 가장 높은 비율을 차지한다. 여러 연구들을 통해 미생물 침착이 임플란트주위염에 미치는 영향이 보고된 바 있으며 세균막의 제거는 임플란트주위염의 치료 시 필수조건이 된다. 최근에 여러 연구들을 통해 티타늄 임플란트에 레이저를 사용하여 표면을 살균, 정화 시키는 방법에 대한 실험이 많이 보고되고 있다. 본 논문에서는 임플란트주위염 처치에 있어 레이저가 갖는 효능에 대한 최근 연구 결과들을 문헌고찰을 통해 되짚어보고자 한다.

생비골 이식술을 통한 대퇴골의 난치성 감염성 불유합의 치료 - 3예 보고 - (Vascularized Fibular Graft in the Treatment of Intractable Infected Nonunion of Femur - 3 Cases -)

  • 정덕환;정비오;소동혁;한정수
    • Archives of Reconstructive Microsurgery
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    • 제16권1호
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    • pp.6-13
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    • 2007
  • Purpose: To report the clinical results of the vascularized fibular graft in the treatment of intractable infected nonunion of femur. Materials and Methods: We reviewed 3 patients who were performed vascularized fibular graft in treated for intractable infected nonunion of femur. They had received an average of 5.6 times($4{\sim}8\;times$) surgical treatment at different hospitals. 1 case was of a infected nonunion in a fracture treated with internal fixation, the fracture having occurred after resection of a malignant tumor and transplantation of pasteurized autologous bone. 2 cases occurred after internal fixation in closed fractures. Surgical treatment was performed an average of 4 times($3{\sim}5\;times$) at our hospital and in all of the cases debridement of necrotic tissue and sequestrectomy. And vascularized fibular graft was performed. In all cases unilateral external fixation devices were used, of these, 1 case was changed into internal fixation. The final conclusion was made by assessment of functional outcomes and complications according to the standards of Paley. Results: As a result, in all of the cases bone union was achieved, and in the last follow up the functional results were excellent in 2 cases and good in 1 case. There were not presented leg length discrepancy of more than 2 cm, and further loss of knee joint motion. After previous treatment, average 23.3 months($16{\sim}30\;months$) was taken to eliminate infection and achieve complete bone union via vascularized fibular graft in our hospital. Conclusion: In treatment of intractable infected nonunion of femur, fairly good results can be expected after firm fixation, through debridement and vascularized fibular graft.

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Anterior Interbody Grafting and Instrumentation for Advanced Spondylodiscitis

  • Lim, Jae-Kwan;Kim, Sung-Min;Jo, Dae-Jean;Lee, Tae-One
    • Journal of Korean Neurosurgical Society
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    • 제43권1호
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    • pp.5-10
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    • 2008
  • Objective : To evaluate the surgical outcomes of ventral interbody grafting and anterior or posterior spinal instrumentation for the treatment of advanced spondylodiscitis with patients who had failed medical management. Methods : A total of 28 patients were evaluated for associated medical illness, detected pathogen, level of involved spine, and perioperative complications. Radiological evaluation including the rate of bony union, segmental Cobb angle, graft- and instrumentation-related complications, and clinical outcomes by mean Frankel scale and VAS score were performed. Results : There are 14 pyogenic spondylodiscitis, 6 postoperative spondylodiscitis, and 8 tuberculous spondylodiscitis. There were 21 males and 7 females. Mean age was 51 years, with a range from 18 to 77. Mean follow-up period was 10.9 months. Associated medical illnesses were 6 diabetes, 3 pulmonary tuberculosis, and 4 chronic liver diseases. Staphylococcus was the most common pathogen isolated (25%), and Mycobacterium tuberculosis was found in 18% of the patients. Operative approaches, either anterior or posterior spinal instrumentation, were done simultaneously or delayed after anterior aggressive debridement, neural decompression, and structural interbody bone grafting. All patients with neurological deficits improved after operation, except only one who died from aggravation as military tuberculosis. Mean Frankel scale was changed from $3.78{\pm}0.78$ preoperatively to $4.78{\pm}0.35$ at final follow up and mean VAS score was improved from $7.43{\pm}0.54$ to $2.07{\pm}1.12$. Solid bone fusion was obtained in all patients except only one patient who died. There was no need for prolongation of duration of antibiotics and no evidence of secondary infection owing to spinal instrumentations. Conclusion : According to these results, debridement and anterior column reconstruction with ventral interbody grafting and instrumentation is effective and safe in patients who had failed medical management and neurological deficits in advanced spondylodiscitis.

Autogenous Bone Grafts versue Metal Cage with Allogenic Bone Grafts for Post-Corpectomy Anterior Column Reconstruction in Patients with Infectious Spondylitis

  • Cha, Jae-Ryong;Hwang, Il-Yeong;Kwon, Sun-Hwan;Chung, Hee-Yoon
    • Journal of Korean Neurosurgical Society
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    • 제63권2호
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    • pp.218-227
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    • 2020
  • Objective : To evaluate and compare the clinical and radiographic features of 25 patients with infectious spondylitis treated with anterior debridement and reconstruction using autogenous bone grafts vs. a metal cage with allogenic bone grafts. Methods : The study analyzed 25 patients diagnosed with infectious thoracolumbar spondylitis who underwent anterior radical debridement and reconstruction. Autogenous bone grafts were used in 13 patients (group 1), and a metal cage with allogenic bone grafts was used in 12 patients (group 2). Clinical outcomes were assessed by the visual analogue scale (VAS) scores and neurological status. Additionally, the serological results and the radiographic results using the sagittal Cobb angle were compared. Fusion was evaluated by computed tomography (CT) imaging at 24 months postoperatively. Results : Both groups showed a significant decrease in the postoperative mean VAS scores; however, only, group 1 patients showed a significantly higher VAS score than group 2 patients, 1 month postoperatively (p=0.002). The postoperative neurological status significantly improved. Elevated C-reactive protein levels and erythrocyte sedimentation rate values returned to normal limits at the 2-year follow-up without recurrent infection. No significant intergroup difference was observed in Cobb angle. Bony fusion was confirmed in all patients at CT 24 months postoperatively. Conclusion : Although the use of a metal cage with allogenic bone grafts for anterior column reconstruction remains controversial, our results suggest that it can be considered as an effective treatment of option for anterior column reconstruction in patients with infectious spondylitis.

Candida pelliculosa에 의한 진균성 슬관절염의 관절경적 치료 - 증례 보고 - (Arthroscopic Treatment of Fungous Arthritis of Knee Joint by Candida pelliculosa - A Case Report -)

  • 김형천;안수한;김광열;황연수;이지훈;이동은
    • 대한관절경학회지
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    • 제17권1호
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    • pp.79-83
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    • 2013
  • 슬관절에서의 칸디다 감염증은 매우 드물다. 칸디다 감염증은 임상 증상이 뚜렷하지 않아 진단이 어렵다. 슬관절에서 발생하는 칸디다 감염 중 Candida albicans가 가장 흔한 균주이고 Candida pelliculosa는 거의 보고된 적이 없는 균주이다. 이에 저자들은 스테로이드 주사 후 슬관절의 Candida pelliculosa 감염증이 발생한 1예를 반복적 관절경하 변연 절제술 및 세척술 그리고 관절경하 항진균제 혼합 시멘트정 충전물 삽입술을 이용하여 성공적으로 치료하였기에 보고하는 바이다.

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역행성 임플란트 근단병소 주위염(Retrograde Peri-implantitis) 치료의 7년 관찰 (Treatment of retrograde peri-implantitis: seven-year follow-up study)

  • 이주연
    • 구강회복응용과학지
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    • 제30권3호
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    • pp.259-264
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    • 2014
  • 역행성 임플란트 근단병소 주위염은 임상증상을 동반한 근단부의 방사선 투과성 병소로 정의되며 임플란트 식립부위 또는 인접한 치아의 잔존하고 있는 감염에서 유래한 세균감염, 골 삭제시의 열 발생 등의 다양한 원인에 의해 야기될 수 있고, 다양한 치료방법으로 임플란트를 제거하지 않고 유지할 수 있는 증례들이 보고되고 있다. 본 증례에서는 근관 치료 실패로 발치한 상악 우측 제2소구치 부위에 식립한 임플란트에서 발생한 역행성 임플란트 근단병소 주위염을 표면의 detoxification과 차폐막과 골이식재를 동반한 골유도재생술로 해결하여 기능을 회복하였으며, 7년간 장기적으로 안정적으로 유지되고 있는 증례에 대해 보고하고자 한다.

당뇨병 환자에서 관절경적 회전근 개 봉합술 후 발생한 화농성 견관절염의 치료 - 증례 보고 - (Treatment of the Septic Shoulder after Arthroscopic Rotator Cuff Repair in Diabetes Mellitus - A Case Report -)

  • 박재현;최원기;김세식;최창혁
    • 대한관절경학회지
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    • 제13권1호
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    • pp.72-76
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    • 2009
  • 당뇨환자로서 관절경적 회전근 개 봉합술을 시행 후 견관절의 화농성 관절염으로 진단된 2예에 대해 관절경적 치료 및 추가적인 개방성 치료를 시행하였다. 관절경적 회전근 개 봉합술 후 감염은 평균 18일 뒤에 발생하였으며, 증상 발현으로부터 수술까지의 평균 기간은 65일이었다. 또한 기능 평가는 KSS, ASES, UCLA, Constant 점수를 이용하였다. 관절경적 변연 절제술과 추가적인 시술 후 평균 22.5일의 항생제 치료로 4개월에 염증이 치료되었으며 최종 결과는 KSS점수가 82점, UCLA점수가 33점, ASES점수가 91점, Constant점수가 71점이었다. 관절경적 회전근 개 봉합술 후 발생한 화농성 견 관절염은 관절경적 치료 및 추가적인 시술로 치료되었고, 관절 운동 범위 및 기능적 결과와 통증 및 만족도는 많이 개선되었다.

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