• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.40-46
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• 2012

Purpose: This study evaluated the clinical outcome of arthroscopic debridement of anterior compartment and mini-open resection of posterior osteophyte for the treatment of primary osteoarthritis of the elbow. Materials and Methods: Between March 2003 and Feburary 2010, 19 cases who were performed arthroscopic debridement of anterior compartment and resection of posterior osteophyte through mini-open procedure for refractory osteoarthritis of the elbow were enrolled. Average follow-up period was 19 months. Mean age was 49 years old. Clinical results were evaluated by the scoring system of Andrew-Carson Rating Scale (ACRS) and Mayo Elbow Performance Score (MEPS). Results: In the range of motion, flexion contracture was improved from $28.7^{\circ}$ preoperatively to $17.9^{\circ}$ postoperatively, further flexion was improved from $105.1^{\circ}$ to $121.8^{\circ}$. In the scoring system of MEPS, score was improved from 51.1 points preoperatively to 87.9 points in last follow up, 3 cases had in excellent result, 13 good and 3 fair. According to the scoring system of ACRS, score was improved from 92.9 points to 168.2 points, 3 excellent, 14 good and 2 fair. Except one case, all cases returned to preoperative ordinary daily living activity and their own job. Conclusion: For the treatment of refractory osteoarthritis of the elbow, arthroscopic debridement of the anterior compartment and mini-open resection of posterior osteophyte would be helpful on pain relief and functional recovery of the elbow. But this procedure was required long term follow-up in aspect of recurrence of osteophytes and progress of arthritis of the elbow.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.99-105
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• 2010

Purpose: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. Materials and Methods: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. Results: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. Conclusion: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.57-61
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• 2008

Tuberculous arthritis on the sternoclavicular joint is an uncommon disease and a delayed diagnosis can be due to the obscure clinical symptoms. We should suspect tuberculous arthritis in patients with slowly progressive pain, swelling, mild fever and a previous history of tuberculosis. Early diagnosis is important through conducting a thorough physical examination and performing laboratory tests and radiologic study. Tuberculous arthritis on the sternoclavicular joint should be treated with a combination of systemic antituberculous agents and thorough surgical debridement in marked damaged joints. When performing this operation, it is important not only to minimized the injury of the costoclavicular ligament, but also to avoid injury to the surrounding the vital structures such as the mediastinum and pleura after aggressive resection or radical debridement. We describe here 2 cases of the tuberculous arthritis on the sternoclavicular joint: one case had a good result after surgical debridement with using an anti-tuberculous agent, and the other had fatal complications such as mediastinal abscess and pleural effusion after the operation.

• Archives of Reconstructive Microsurgery
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• v.8 no.2
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• pp.176-183
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• 1999

Chronic osteomyelitis have been treated with wound dressing and antibiotics therapy often results in healing but foul odor pus discharges from the fibrotic soft tissues reactivates and requires appropriate control of the infection. Debridement of the wound, curettage and sequestrectomy, bone graft and immediate free flap transplantation is the curative protocol for the chronic osteomyelitis in the lower extremity. Authors have treated 7 cases of chronic osteomyelitis in the lower extremity with microsurgical free tissue transplantation at Department of Orthopedic Surgery, Chonbuk National University Hospital from December 1993 through February 1998. The results are as follows. 1. The chronic osteomyelitis occurred in tibial shaft in 4 cases, in calcaneus 2 cases and in femur 1 case. 2. Duration of the chronic osteomyelitis was at average 31.6 years. 3. Squamous cell carcinoma in the surrounding fibrotic tissue was biopsied in 1 case. 4. 4 cases had no trauma and occurred through hematogenous infection and 3 cases had fracture trauma. 5. Wound debridement and immediate free muscle transplantation had done in 5 cases and wound debridement, sequestrectomy and immediate free muscle transplantation in 2 cases. 6. Rectus abdominis muscle transplantation had peformed in 4 cases(57.1%), latissimus dorsi mucle 1 case(14.3%), latissimus dorsi myocutaneous 1 case(14.3%) and gracilis 1 case (14.3%). 6 cases of 7 were success(85.7%). 7. 1 case of failed latissimus dorsi musculocutaneous flap in thigh had done above knee amputation and 1 case of chronic posttraumatic osteoarthritis of the ankle joint had done below knee amputation at other hospital.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.77-80
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• 2007

Purpose: Purpura fulminans is a rare but rapidly progressive, serious, often life-threatening disorder in childhood, which is complicated with septic shock or disseminated intravascular coagulopathy during acute infection. It occurs first as acute-onset petechial rash, and spreads rapidly into full thickness skin and soft tissue necrosis. In the past, it had high mortality rate, up to 80%, but recently, survival rate has increased due to early diagnosis, and rapid advancement of critical care and antibiotics. From our experiences of PF management, we would like to review the pathophysiology and suggest the surgical treatment guideline about meningococcal induced purpura fulminans. Methods: Two cases of purpura fulminans over the last 3 years were reviewed retrospectively about reconstructive management. After they were treated resuscitative management initially by the critical intensive care, reconstructive surgery was performed by plastic surgeon as soon as the patients were vitally and mentally stable. Results: There were 6 procedures in case 1, and 3 procedures in case 2. The mean delayed period from admission with sepsis to the first surgical debridement was 24 days and 42 days, respectively. Total hospitalization period was 103 days and 69 days, respectively. All of them were treated with debridement and split thickness skin graft, but delayed debridement was superior to early one in the point of preserving much more tissues. Conclusion: From our experience, we suggest that conservative therapy to the wounds appears to be the best tool in the initial vitally unstable period in order to preserve as much tissues and functions as possible if no active inflammation and compartment syndrome are detective.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.769-774
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• 2001

Background: Descending necrotizing mediastinitis(DNM) is a serious complication originating in odontogenic or oropharyngeal infection with previously reported mortality rates of 25% to 40%. We retrospectively reviewed the 4 years of our surgical drainage and debridement in DNM. Material and Method: We studied 7 cases diagnosed as DNM from 1997 through 2000. Primary oropharyngeal infection lead to DNM in four cases(57%) and odontogenic abscess in three cases(43%). All patients were received emergent cervicotomy and thoracotomy or sternotomy for debridement of necrotic tissue and mediastinal or pleural drainage. Result: Five cases were evolved well and were discharged after a mean of 42 days. Two patients(28.6%) died. Three patients required reoperation due to local surgical complication; empyema(two) and impending cardiac tamponade. One of these patients died on 12 post-reoperative day due to great vessel erosion, renal and respiratory insufficiency. The other patient died of broncho- esophageal fistula and asphyxia on 10 postoperative day without reoperation. Conclusion: On the basis of experience accrued in treating these patients, early diagnosis by cervicothoracic computed tomographic scan of neck and thorax aids in rapid indication of a surgical approach of DNM. We emphasize that performing early surgical drainage and debridement of necrotic tissues with intensive postoperative care can significantly reduce the mortality rate.

• Journal of Periodontal and Implant Science
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• v.51 no.1
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• pp.53-62
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• 2021

Purpose: This study aimed to evaluate the clinical and microbiological efficacy of adjunctive local delivery of minocycline (Periocline^®) in patients receiving supportive periodontal therapy (SPT) after initial treatment. Methods: The participants were 16 men and 8 women (age, 20-65 years) who had at least 15 natural teeth, underwent SPT for more than 1 year due to chronic periodontitis, had 4 or more periodontal pocket sites deeper than 5 mm, and showed >25% gingival bleeding on probing (BoP). They were randomly assigned to the test and control groups. In the test group, mechanical debridement and local antibiotic delivery were performed for all periodontal sulci/pockets; in the control group, mechanical debridement and saline irrigation were performed. In patients who underwent SPT for more than 1 year, clinical and microbiological examinations were performed at baseline and 1 and 3 months after SPT. The clinical examination included an assessment of the periodontal pocket depth, clinical attachment level, plaque index, and BoP. Microbial tests were performed using real-time polymerase chain reaction; the relative ratios of Porphyromonas gingivalis and Fusobacterium nucleatum were determined. Results: Both groups showed significant improvements in clinical parameters at 1 and 3 months from baseline; there were no significant changes between months 1 and 3. Intergroup differences were insignificant. The microbiological analysis revealed no significant differences in P. gingivalis and F. nucleatum ratios across time points. While intergroup differences were insignificant, there was a tendency for the P. gingivalis and F. nucleatum ratios to decrease in the test group. Conclusions: Mechanical debridement in patients receiving maintenance therapy resulted in clinically significant improvement; the effectiveness of additional local delivery of antibiotics was not significant. The ratios of P. gingivalis and F. nucleatum showed a tendency to decrease in the test group, although it was not significant.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.121-126
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• 1983

8 cases of the esophageal perforations were treated at the department of thoracic surgery, Chungnam National University Hospital during the period from July, 1980 to Dec., 1982. The causes of the perforation were various; swallowed a piece of glass, stocking pin, coiled wire, compressed air blow, strenuous vomiting, dog bite, tiller accident, and endoscopic procedure. The perforation sites were cervical esophagus in 3 cases, upper thoracic in 2 cases and lower thoracic in remains. We have performed following surgical procedure; Incision and drainage for cervical abscess, closed thoracostomy, thoracotomy and debridement, esophagoscopy and gastrostomy. Two cases were died. The causes of death were massive bleeding and sepsis.

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.165-169
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• 2009

연골 결손은 자체 치유 능력이 적어 그 크기가 1 cm 이상인 경우 골관절염이 발생할 수 있다. 최근에는 3-tesla MRI 등의 발전으로 인해 수술 전에 미리 연골 손상을 정확히 진단할 수 있어 연골 손상의 치료를 더욱 적극적으로 할 수 있다. 이제까지 연골 손상에 대한 수술적 치료는 세척술(lavage) 및 변연 절제술(debridement), 미세 천공술(microfracture), 자가 골연골 이식술(autologous osteochondral graft), 자가 연골 세포 이식술(autologous chondrocyte implantation, ACI), 동종 골연골 이식술(osteochondral allograft)이 있다.

• Proceedings of the Korean Society of Veterinary Pathology Conference
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• 2002.11a
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• pp.66-79
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• 2002

The basic treatments - Epithelial ＆ stromal debridement with a swab or diamond burr. - Possible placement of a collagen shield or nictitans flap. - Topical treatment with Adequan IM diluted in artificial tears : 1 ml Adequan + 4 ml tears : One drop four times daily. - Topical treatment with an antibiotic drop : Three times daily - 5％ sodium chloride ointment : Four times daily. If inflammation is severe - Topical treatment with nonsteroidal agent : Four times daily (Voltaren, Ocufen, or Profenyl) - Cyclosporine A (Optimmune) : Twice daily Healing time - Healing typically occurs rapidly - Fluorescein negative : 7-10 days - Vascular keratitis : Often several months