• Title/Summary/Keyword: debridement

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Massive Necrotizing Fasciitis of the Chest Wall: A Very Rare Case Report of a Closed Thoracostomy Complication

  • Chun, Sangwook;Lee, Gyeongho;Ryu, Kyoung Min
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.404-407
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    • 2021
  • We present a case study of necrotizing fasciitis (NF), a very rare but dangerous complication of chest tube management. A 69-year-old man with shortness of breath underwent thoracostomy for chest tube placement and drainage with antibiotic treatment, followed by a computed tomography scan. He was diagnosed with thoracic empyema. Initially, a non-cardiovascular and thoracic surgeon managed the drainage, but the management was inappropriate. The patient developed NF at the tube site on the chest wall, requiring emergency fasciotomy and extensive surgical debridement. He was discharged without any complications after successful control of NF. A thoracic surgeon can perform both tube thoracostomy and tube management directly to avoid complications, as delayed drainage might result in severe complications.

An Atypical Case of Chronic Invasive Fungal Sinusitis with Concurrent Fungal Ball (진균구를 동반한 비정형적 만성 침습형 진균성 부비동염 1예)

  • Jung, Young Do;Kim, Bo Mun;Kang, Byung Jun;Shin, Seung Heon
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.264-268
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    • 2018
  • Chronic invasive fungal sinusitis (CIFS) is a relatively rare disease which occurs in immunocompetent or immunocompromised patients. We report a case of CIFS in ethmoid sinus with concurrent fungal ball in maxillary sinus. After surgical debridement and antifungal therapy, CIFS recurred with submucosal invasion in nasopharynx and osteomyelitis of clivus. Although CIFS encompasses a slowly progressing invasive fungal disease but potentially aggressive. It should be noted that CIFS could progress and extend through submucosal route without evidence of mucosal lesion.

Anterior Lateral Thigh Free Flap and Achilles Tendon Reconstruction Surgery for Contact Dermal Burn of Heel Including Achilles Tendon: A Case Report -Surgical Treatment for Functional Recovery- (아킬레스건을 포함한 뒷발굽 접촉성 피부 화상에 대해 시행한 전외측 대퇴피부 피판술 및 아킬레스건 재건술: 증례 보고 -기능적 회복을 위한 수술적 치료법-)

  • Park, Jun-Sik;Baek, Seung-Ha;Kim, Gab-Lae
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.127-130
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    • 2018
  • A 3rd degree burn on the heel including the Achilles tendon is vulnerable and requires active treatment to improve the functional outcomes. Previously, there have been a few treatments on severe burns, such as amputation, debridement or simple skin graft. The cooperative technique of an anterior lateral thigh flap with Achilles tendon reconstruction can be an innovative procedure that preserves the major arteries. The authors review a case and report the clinical outcome.

Bentall Operation in a Patient with a Unicommissural Unicuspid Aortic Valve

  • Park, Sung Joon;Lee, Jae Hoon;Chung, Eui Suk
    • Journal of Chest Surgery
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    • v.52 no.5
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    • pp.368-371
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    • 2019
  • A unicuspid aortic valve is a rare congenital malformation that frequently presents with valvular dysfunction and dilatation or aortic aneurysm, requiring combined aortic valve surgery and aortic repair. Some patients show severe valve calcification extending into the interventricular septum, possibly resulting in damage to the conduction system during debridement for valve replacement. We present a rare case of severe aortic stenosis with a unicommissural unicuspid aortic valve diagnosed by preoperative transesophageal echocardiography in a 36-year-old man. After composite graft replacement of the aortic valve, aortic root, and ascending aorta, a permanent pacemaker was placed because of postoperative complete heart block.

Chronic Osteomyelitis of Cranial Bones in a Patient with High-Voltage Electrical Burn on the Scalp: A Case Report (두피의 고압전기화상 환자에서의 두개골 만성골수염: 증례보고)

  • Jung, Sung Won;Choi, Joo Heon;Yoo, Kyung-Tak;Lim, Changsoo
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.53-59
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    • 2021
  • High-voltage electrical burn injuries on the scalp often result in scalp and cranial bone necrosis. Repetitive debridements and rich-vascularized flap coverage of the cranium are required. However, despite successful flap coverage, chronic osteomyelitis of cranial bones may occur. Treatment of chronic osteomyelitis of cranial bones is surgical debridement of the necrotic bone with re-coverage by a well-vascularized flap. The latissimus dorsi musculocutaneous flap is suitable not only for coverage of the cranium after the burn injury, but also for treatment of chronic osteomyelitis of the skull.

Successful Surgical Management of a Tracheo-Innominate Artery Fistula in a Patient with Duchenne Muscular Dystrophy: A Case Report

  • Yun, Ju Sik;Song, Sang Yun;Na, Kook Joo;Kim, Eunchong
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.88-90
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    • 2022
  • Tracheo-innominate artery fistula (TIF) is a rare, life-threatening complication of tracheostomy that makes it difficult to secure the airway due to massive bleeding, constituting a medical emergency. Therefore, most successful surgical treatments include innominate artery debridement and tracheal fistula repair. Herein, we report a case of successful surgical treatment of a TIF while maintaining cerebral blood flow through an artificial vascular graft.

Acute pyomyositis of the adductor magnus muscle involving the posterior and lateral thigh compartments: a case report of diagnosis and management

  • Bawale, Rajesh;Watson, Jay;Yusuf, Karshe;Pillai, Dilip;Singh, Bijayendra
    • Journal of Trauma and Injury
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    • v.35 no.2
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    • pp.139-143
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    • 2022
  • Bacterial infection of skeletal muscle can lead to the formation of abscesses. Primary pyomyositis is typically seen in tropical countries, and Staphylococcus aureus is the commonest causative organism. We present a case of acute adductor magnus muscle abscess (pyomyositis) with spread to adjacent thigh compartments via the perforators without iliopsoas muscle involvement. Due to the involvement of the entire thigh compartment, systemic antibiotic treatment alone was insufficient, whereas surgical drainage improved the clinical picture. The aetiological organism was S. aureus. Herein, we report the case of a patient who had primary pyomyositis, rather than a secondary type, that spread to the posterior and lateral aspect of the thigh through the second and third perforators, which pierce the adductor magnus muscle belly before entering the femur.

A rare case report of neonatal calcinosis cutis induced by distant and delayed extravasation of intravenous calcium gluconate

  • Ahn, Kwang Hyeon;Park, Eun Soo
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.641-645
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    • 2021
  • A 3,480 g male neonate showed tachypnea symptom with a serum ionized calcium level of 0.66 mmol/L by routine clinical analysis. He was injected calcium gluconate intravenously through femoral vein catheter to treat the hypocalcemia. On second day after the injection, he started to show erythema in the flank area. The lesion became firm and changed into whitish crust consist of small crystals. Abdominal X-ray and ultrasonography showed the accumulation of calcium deposit in the subcutaneous layer of the lesion. Surgical debridement was performed to remove the crust with calcium deposit and acellular fish skin graft rich in omega-3 (Kerecis) was applied to the defect site for secondary intention of the defect wound. After 2 months, the skin and soft tissue defect were fully covered with healthy normal skin without depression or contracture. This report is a first case of iatrogenic calcinosis cutis without extravasation symptom.

Intralesional Injection of Autologous Platelet-Rich Plasma as an Effective Regeneration Therapy: A Case Report of Chronic Wagner Grade 2 Diabetic Foot Ulcer (증례 보고: 병변 내 자가 혈소판풍부혈장 주사로 효과적으로 재생된 만성화된 Wagner Grade 2 당뇨발 궤양 1예)

  • Moon Hee, Kim
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.4
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    • pp.187-191
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    • 2022
  • The author experienced a case of autologous platelet-rich plasma (PRP) affecting the recovery of a chronic neuropathic diabetic foot ulcer combined with infection. A 65-year-aged male with uncontrolled diabetes presented with a Wagner grade 2 diabetic foot ulcer on his left forefoot of more than 2 weeks duration. Osteomyelitis, gangrene, and ischemia requiring acute intervention were absent. Although infection was controlled to a moderate degree, wound healing was unsatisfactory following surgical debridement and simple dressing. Therefore, intralesional autologous PRP injection was performed 5 times as an adjuvant regeneration therapy, and the recalcitrant ulcer healed in 3 months. Intralesional PRP injections are worthwhile as they promote wound regeneration, are evidence-based, safe, and can be easily performed in ambulatory care facilities.

Clinical efficacy of activated irrigation in endodontics: a focused review

  • Amelia Wan Tin Cheung;Angeline Hui Cheng Lee;Gary Shun Pan Cheung
    • Restorative Dentistry and Endodontics
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    • v.46 no.1
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    • pp.10.1-10.16
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    • 2021
  • Root canal debridement, which includes the removal of infected tissues and microbial biofilms, is considered the corner stone of root canal treatment. Chemical adjuncts play a multitude of functions in this regard, as tissue solvents, antimicrobial agents and for removing the smear layer. These adjuncts (irrigants) are usually delivered using a syringe and needle. With increasing knowledge of the complexity of root canal anatomy and tenacity of microbial biofilms, the need for strategies that potentiate the action of these irrigants within the root canal system cannot be overemphasized. Several such activated irrigation strategies exist. The aim of this review is to comprehensively discuss the different irrigant activation methods from the context of clinical studies.