• Journal of Trauma and Injury
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• 제20권2호
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• pp.119-124
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• 2007

Purpose: Management of the soft tissue defect in the lower extremity caused by trauma has always been difficult. Coverage with local and free muscle flaps after complete surgical excision of necrotic soft tissue and bone is a major strategy for treatment. There is no doubt that muscle provides a good blood supply, thus improving bone healing and increasing resistance to bacterial inoculation. However, accompanying problems are seen in cases with shallow dead space. This research was conducted to assess the efficacy of raising anterolateral thigh flaps and transferring them to the defect after complete debridement of non-viable, infected, and scar tissue as an alternative way to use local or free muscle flaps. Methods: From March 2005 to October 2007, 18 cases of soft tissue defect on lower extremities were re-surfaced with an anterolateral thigh perforator free flap. Results: The follow-up period ranged from 1 to 31 months with a mean of 15.9 months. All flaps survived completely. Satisfactory aesthetic and functional results were achieved. Under a two-point discrimination test, 13 patients had sensory recovery from 11 mm to 20 mm after 6 months postoperatively. Conclusion: Reconstruction of the lower extremity with anterolateral thigh perforator free flaps after appropriate debridement is a good alternative way to use local or free muscle flaps.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.228-234
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• 2020

Background A patient's overall condition sometimes does not allow for the complete removal of a dead eschar or injured slough in cases involving a pressure-injury skin lesion. This frequently occurs in clinical practice, particularly in bedridden and older patients receiving home care or intensive care. Even after debridement, it is also difficult to manage open exudative wounds in these patients. Nevertheless, when a mature or immature eschar is treated without proper debridement, liquefaction necrosis underneath the eschar or slough tends to reveal a large, open wound with infectious exudates. We hypothesized that if the presence of any bacteria under the eschar can be evaluated and the progression of the presumed infection of the subeschar can be halted or delayed without creating an open wound, the final wound can be small, shallow, and uninfected. Methods Using a punch instrument, we performed 34 viable subeschar tissue cultures with a secure junction between the eschar and the normal skin. Results The bacterial study had 29 positive results. Based on these results and the patient's status, appropriate antibiotics could be selected and administered. The use of suitable antibiotics led to relatively shallow and small exposed wounds. Conclusions This procedure could be used to detect potentially pathogenic bacteria hidden under black or yellow eschars. Since subeschar infections are often accompanied by multidrug-resistant bacteria, the early detection of hidden infections and the use of appropriate antibiotics are expected to be helpful to patients.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1995년도 학술대회
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• pp.13-13
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• 1995

The authors performed the arthroscopic decompression and cuff debridement on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome from July 1990 to January 1994. The summarized results are as follows. 1. 47 cases in 45 consecutive patients had arthroscopic decompression for the subacromial impingement syndrome. 2. There were 31 males and 14 females and the mean age was 40 years for men and 46years for women. 3. The follow up duration was from 3 years 9 months to 1 year (average 2 years 1month). 4. Among 47 cases, 19 cases were found to have no cuff tear (stageII) 13 cases partial thickness cuff tear (stage IIIa) 10 cases complete tear on cuff less than 3 cm long (stage IIIb) and 5 cases complete tear on cuff more than 3 em in length (stage IIIc). 5. The arthroscopic subacromial decompression and rotator cuff debridement was a good treatment method in stage II and stage IIIa and stage IIIb. in the case of stage IIIc rotator cuff tear, it was useful for pain relief and improvement of shoulder function.

• Archives of Plastic Surgery
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• 제35권4호
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• pp.400-406
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• 2008

Purpose: Since ancient times, larval therapy has been applied to help wound healing. Its use has recently been rediscovered, and the interest in this therapy has been increased in clinical practice, as well as in research. The objective of this study is to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds. Methods: Twenty patients, suffering mostly from chronic wounds were treated using maggots of greenfly (Phaenicia sericata). Sterile maggots were administered to the wound twice a week. The causes of the development of wounds were diabetic foot(14), trauma(3), plate exposure(1), and unknown origin(2). Results: Complete debridement was achieved in 10 wounds; in 8 wounds, the debridement was partially achieved; 2 patients escaped. Four patients were healed without any additional surgical procedures but fourteen patients were treated with skin graft. Pain, reported by six patients, was relatively well controlled with oral analgesics. Conclusion: We found larval therapy to be effective for chronic wounds. Maggot therapy is a relatively rapid and effective treatment, particularly in necrotic wounds or the wounds resistant to conventional treatment.

• Restorative Dentistry and Endodontics
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• 제41권1호
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• pp.63-67
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• 2016

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.

• 대한기관식도과학회지
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• 제17권1호
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• pp.61-64
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• 2011

Cervical necrotizing fasciitis is a rare but well known life-threatening soft tissue infection primarily affecting the superficial and deep cervial fascial planes. It may rapidly spread into the mediastinum along fascial planes. So, if proper diagnosis and prompt surgical debridement is delayed, the infection may cause descending necrotizing mediastinitis with extensive necrosis of overlying skin, destroying fascia and muscle. Therefore, the key to the successful outcome is early recognition and rapid initiation of definitive radical debridement. The authors report, along with a literature review, a case of cervical necrotizing fasciitis with atypical spreading into the lateral chest wall.

• Journal of Chest Surgery
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• 제33권8호
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• pp.688-692
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• 2000

Descending Necrotizing Mediastinitis(DNM) is a complication of oropharyngeal infections that can spread to the mediastinum. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. late diagnosis is the principal reason for the high mortality in DNM. An 18-year-old female admitted with Ludwig's angina from dental caries. Despite of combined antibiotics, dental extraction and drainge of submental abscess, infection spread to the cervical area. Chest computed tomogram revealed extension of the abscess to the pretracheal and periaortic space and development of bilateral pleural empyema. We performed bilateral cervical mediastinotomy and thoracotomy for drainage and debridement. Tracheostomy to secure the airway and postoperative pleural irrigation were performed. Postoperative course was uneventful and patient was discharged on the 40th postoperative day. It is important to perform chest CT scanning for early diagnosis of DNM when oropharyngeal infection spreads to the cervical area. Improved survival of patients with DNM implies early and radical surgical drainage and debridement via a cervical mediastinomy and thoracotomy.

• Journal of Korean Neurosurgical Society
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• 제47권1호
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• pp.74-77
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• 2010

Rhino-orbital-cerebral (ROC) mucormycosis is an uncommon, acute and aggressive fungal infection. It remains a challenging problem to clinicians despite aggressive debridement surgery and antifungal therapy. The authors describe a case of ROC mucormycosis with pericranial abscess occurring in a female patient with uncontrolled diabetes mellitus. The infection initially developed in the right-sided nasal sinus and later progressed through the paranasal sinuses with the invasion of the peri-orbital and frontotemporal region, due to the delayed diagnosis and treatment. Numerous non-septate hyphae of the zygomycetes were identified by a punch biopsy from the nasal cavity and by an open biopsy of the involved dura. The patient was treated successfully with extensive debridement of her necrotic skull and surrounding tissues, drainage of her pericranial abscess and antifungal therapy, including intravenous amphotericin B for 61 days and oral posaconazole for the following 26 days. She returned to a normal life and has had no recurrence since the end of her treatment 15 months ago.

• Restorative Dentistry and Endodontics
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• 제16권1호
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• pp.167-180
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• 1991

The purpose of theis study was to evaluate the effectiveness of ultrasonic instrumentation in removing debris and smear layer from the root canal walls. 54 extracted, permanent single rooted teeth were randomly divided into 6 groups of 9 teeth. After canal preparation, the teeth were longitudinally sectioned. The sepcimens were then naturally dried for 2 days, given a maximun thickness gold coating, and examined under the SEM (JSM-35C type, JAPAN). Photographs of all specimens were then taken of the middle and the apical third of the root canal wall. The results were as follows: 1. In all groups, debris and the smear layer were not completely removed from the canal wall 2. There were no significant differences between at the apical third and at the middle third in removing debris and the smear layer in all groups. 3. There were no significant difference between the step - back group and the ultrasound group in removing debris and smear layer. 4. In general, the step - back/ultrasonund groups showed greater canal debridement than the step - back group or ultrasound group. 5. The step - back/ultrasound group with a No. 25 file for 3 min. showed significantly greater canal debridement than the step-back group (p<0.05), or the other step - back/ultrasound groups(p<0.05).

• Advances in pediatric surgery
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• 제9권1호
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• pp.30-34
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• 2003

Spontaneous gastric perforation in the newborn is a rare disease that requires early diagnosis and prompt surgical treatment. Between 1988 and 2001 at the Department of Pediatric Surgery. Kyungpool National University Hospital, 9 cases of spontaneous gastric perforation were treated. Seven were males and two females. The mean gestational age and birth weight were 36.7 weeks and 2,455 g respectively. All patients presented with severe abdominal distention and pneumoperitoneum on cross table lateral film of the abdomen. Perforations were located on the anterior wall along the greater curvature of the stomach in six and on the posterior wall along the greater curvature in two. One case showed two sites of perforation on the anterior and posterior wall along the greater curvature. Six patients were managed with debridement and primary closure and the others with debridement and partial gastrectomy. Peritoneal drainage was not performed. There were four deaths; two from sepsis due to leakage from the anastomotic site, one as a result of acute renal failure, and the other by associated respiratory distress syndrome. Spontaneous gastric perforation in the newborn is usually located along the greater curvature. Elevated intragastric pressure is a possible cause of the perforation. Poor prognosis is related to associated diseases and prematurity.