• Title/Summary/Keyword: decubitus

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A Study on the Relationship between Vascular Perfusion and Interface Pressure on the Ischial Tuberosity in the Sitting Posture (않은 자세에서 둔부 좌골결절의 접촉압력과 혈류량과의 관계에 대한 연구)

  • Heo, Hyun;Bae, Tae-Soo;Mun, Mu-Sung
    • Journal of the Korean Society for Precision Engineering
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    • v.24 no.7 s.196
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    • pp.126-132
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    • 2007
  • Pressure-induced decubitus is a serious disease among the elderly people. Interface pressure occluding vascular perfusion is known to be a cause of decubitus. Therefore, it is essential to quantify the relationship between vascular perfusion and interface pressure among the elderly people to understand more about decubitus. Nine healthy elderly people (57.8$\pm$ 5.6 years, 63.3$\pm$ 7.0kg, 1.68$\pm$ 0.05m) were participated. Three healthy young people (31.7$\pm$ 3.2 years, 74.7$\pm$ 8.4kg, 1.75$\pm$ 0.04m) were also examined to be compared with the elderly group. Capillary vascular perfusion on the ischial tuberosity was recorded in the sitting posture as pressures were applied from 15mmHg to 135mmHg. The average interface pressure to occlude vascular perfusion (the average occlusion pressure) under the ischial tuberosity was 115.7mmHg in the elderly group. This value was not significantly different from the average occlusion pressure of the young group. Obesity effect on the occlusion pressure was investigated among the elderly group. The result was not significantly different between the obesity and the normal group in this study. This is a preliminary study to unveil the complicated cause of pressure-induced decubitus associated with occlusion of vascular perfusion. More subjects are required for the future study.

Outcomes of Internal Fixation with Compression Hip Screws in Lateral Decubitus Position for Treatment of Femoral Intertrochanteric Fractures

  • Park, Cheon-Gon;Yoon, Taek-Rim;Park, Kyung-Soon
    • Hip & pelvis
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    • v.30 no.4
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    • pp.254-259
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    • 2018
  • Purpose: Internal fixation using compression hip screws (CHS) and traction tables placing patients in the supine position is a gold standard option for treating intertrochanteric fractures; however, at our institution, we approach this treatment with patients in a lateral decubitus position. Here, the results of 100 consecutive elderly (i.e., ${\geq}45$ years of age) patients who underwent internal fixation with CHS in lateral decubitus position are analyzed. Materials and Methods: Between March 2009 and May 2011, 100 consecutive elderly patients who underwent internal fixation with CHS for femoral intertrochanteric fracture were retrospectively reviewed. Clinical outcomes (i.e., Koval score, Harris hip score [HHS]) and radiographic outcomes (i.e., bone union time, amount of sliding of lag screw, tip-apex distance [TAD]) were evaluated. Results: Clinical assessments revealed that the average postoperative Koval score decreased from 1.4 to 2.6 (range, 0-5; P<0.05); HHS was 85 (range, 72-90); and mean bone union time was 5.0 (range, 2.0-8.2) months. Radiographic assessments revealed that anteroposterior average TAD was 6.95 (range, 1.27-14.63) mm; lateral average TAD was 7.26 (range, 1.20-18.43) mm; total average TAD was 14.21 (range, 2.47-28.66) mm; average lag screw sliding was 4.63 (range, 0-44.81) mm; and average angulation was varus $0.72^{\circ}$(range, $-7.6^{\circ}-12.7^{\circ}$). There were no cases of screw tip migration or nonunion, however, there were four cases of excessive screw sliding and six cases of varus angulation at more than $5^{\circ}$. Conclusion: CHS fixation in lateral decubitus position provides favorable clinical and radiological outcomes. This technique is advisable for regular CHS fixation of intertrochanteric fractures.

Arthroscopic rotator cuff surgery without traction system in the lateral position (측와위에서 견인 기구 없이 시행하는 견관절경하 회전근 개 수술)

  • Moon, Young-Lae;Jung, Heuk-Jun
    • Clinics in Shoulder and Elbow
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    • v.6 no.1
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    • pp.50-54
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    • 2003
  • Object: To evaluate the efficiencies of the arthroscopic rotator cuff surgery which is Performed without the traction system in the lateral decubitus position. Methods: Twenty-nine cases of the arthroscopic rotator cuff surgery performed without the traction system in the lateral decubitus position were studied from February, 2002 to January, 2005. We performed a repair using the arthroscopic debridement and the arthroscopic rotator cuff repair, or using the mini-open incision technique after the confirmation of rotator cuff tear, then, the arthroscopic subacromial decompression was performed after the confirmation of subacromial lesions Results: We could easily find the subscapularis tear which was often overlooked in the arthroscopic rotator cuff surgery performed with the traction surgery by the relaxation of the subscapularis, as the arm position was internally rotate about 45 to 70 degrees from abducted position. We found that the operation time was reduced 14 minutes shorter than the operation time of the controlled group which had the surgery with the traction system on the average. We also found that there were no neurovascular complications from all cases. Conclusions: The arthroscopic rotator cuff surgery without traction system in the lateral decubitus position provided the better visual field, easy manipulation of the joint and reducing operation time.

Study on the Relationship between Vascular Perfusion and Interface Pressure under the Ischial Tuberosity in the Sitting Posture (앉은 자세에서 좌골결절의 접촉압력과 혈류량과의 관계에 대한 연구)

  • Heo H.;Bae T.S.;Lee S.M.;Kim S.K.;Kim K.H.;Mun M.S.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.645-646
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    • 2006
  • Pressure-induced decubitus is a serious disease among the elderly people. Interface pressure occluding vascular perfusion is known to be a cause of decubitus. Therefore, it is essential to quantify the relationship between vascular perfusion and interface pressure among the elderly people. Nine elderly normal people ($57.8{\pm}5.6\;years,\;63.3{\pm}7.0kg,\;1.68{\pm}0.05m$) were participated. Pressure was applied on the ischial tuberosity in the sitting posture from 0mmHg to 135mmHg as capillary vascular perfusion was recorded. The average interface pressure to occlude vascular perfusion under the ischial tuberosity is 120mmHg. Vascular perfusion values at the capillary occlusion is often lower than 60% of the vascular perfusion at 15mmHg. Higher sampling number is required to have more accurate results.

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Evaluation on Organ Dose and Image Quality by Changing kVp and Ion Chamber Combination while Taking Digital Chest Lateral Decubitus PA Projection (디지털 흉부 측와위 후전방향 검사 시 Ion chamber조합 설정과 관전압 변화에 따른 장기선량 및 화질 평가)

  • Lee, Jin-Soo;Park, Hyong-Hu
    • The Journal of the Korea Contents Association
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    • v.15 no.1
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    • pp.316-323
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    • 2015
  • In this study, we analyzed radiation dose and MTF with setting of Ion chamber and changing kVp so that we are able to suggest acquiring optimized diagnostic images and minimizing patient dose. we assumed right lateral decubitus position among chest decubitus projection and set 7 combination of Ion chamber. By changing kVp(100, 110, 120, 130kVp), we exposed x-ray five times respectively and calculated average value after measuring entrance dose. we input the entrance dose value to PCXMC Monte carlo simulation tool and calculated organ dose and effective dose. Then we did physical image evaluation with MTF for the purpose to compare image quality. As a result, the high kVp, entrance dose is reduced. As change of ion chamber, when selecting second ion chamber, both organ dose and effective dose were the lowest. In contrast, selecting first ion chamber was the highest. MTF is superior to set second Ion chamber and using 120 kVp. Consequently, when taking chest right lateral decubitus using Digital radiography, the optimized combination which have both reducing dose efficiently without declining image quality and aquring good qualified image is set 120 kVp and selecting second Ion chamber.

Amino Acid-Based Material for the Complementary Therapy of Decubitus Ulcers

  • Nogueira, Frederico;Gouveia, Isabel C.
    • Journal of Microbiology and Biotechnology
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    • v.27 no.4
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    • pp.747-758
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    • 2017
  • Chronic wounds, pressure sores, lesions, and infections of microbial origin in bedridden, paralyzed, or malnutrition patients remain the object of study of many researchers. A variety of factors behind the development of these disorders are related to the patient's immune system, making it unable to respond effectively to the treatment of the wound. These factors can be properly controlled, giving particular importance to the ethiology and stage of the wound, as well as the time periods corresponding to the replacement of the dressings. The present research reports a novel foam/soft material, ${{\small}L}$-Cys-g-PCL, with an application for decubitus/pressure ulcers, especially for wounds with a difficult healing process due to infections and constant oxidation of the soft tissues. During this work, the interactions between S. aureus and ${{\small}L}$-Cys-g-PCL foam were studied under conditions that simulate decubitus ulcers; namely, pH and exudate. The effects of duration of grafting (1 or 8 h) and pH (7.0 and 8.9) on wettability, surface energy, swelling, and porosity were also evaluated. Results showed an effective microbicidal activity exhibiting an inhibition ratio of 99.73% against S. aureus. This new ${{\small}L}$-Cys-g-PCL soft material showed saftey to contact skin, ability to be shaped to fill in sunken holes (craters) - pressure ulcers stage III - and to act as a smart material responsive to pH, which can be tailored to develop better swelling properties at alkaline pH where exudates are normally higher, so as to address exudate self-cleaning and prevention of desiccation.

Beach-chair lateral traction position using a lateral decubitus distracter in shoulder arthroscopy

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.164-164
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    • 2008
  • The beach-chair traction position is designed to allow the use of traction while allowing the surgeon to orient the shoulder in an upright position and convert to an open procedure, if necessary. The patient is placed in the beach-chair position under general anesthesia. A three-point shoulder holder (Arthrex, Naples, Florida) is attached to the rail of the operating table on the same side as the surgeon, whereas it is placed on the side opposite the surgeon in the lateral decubitus position. A shoulder traction and rotation sleeve (Arthrex) are affixed to the arm following the manufacturer's instructions. Positioning the thumb toward the closed side of the sleeve ensures a field for the anterior portion of the rotator cuff and prevents the tendency of the suspension apparatus to place the arm in internal rotation. The arm is maintained in 30 to 40 degree abduction and 30 to 40 degree flexion by controlling the length and height of the bar and the location of the universal clamp. The universal clamp allows multiple planes of adjustment to control abduction and forward movement of the arm. The sleeve is attached to the longitudinal traction cable using a sterile hook, and a lateral strap is secured around the proximal portion of the sleeve to the overhead traction cable to ensure a field for glenohumeral reconstruction. The use of a lateral strap permits ideal shoulder positioning for improved access to the anterior and inferior glenohumeral joint. The lateral strap can be released or removed to widen the subacromial space during subacromial decompression or rotator cuff repair. A 10-lb weight is attached to the longitudinal traction cable for an average-sized person.

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Impact of Position on Efficacy of Caudal Epidural Injection for Low Back Pain and Radicular Leg Pain Due to Central Spinal Stenosis and Lumbar Disc Hernia

  • Altun, Idiris;Yuksel, Kasim Zafer
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.205-210
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    • 2017
  • Objective : This study was performed to evaluate and compare the efficacies of caudal epidural injections performed at prone and lateral decubitus positions. Methods : A total of 120 patients suffering from low back pain and radicular leg pain were included and patients were randomly distributed into 2 groups according to the position during injection. In Group 1 (n=60; 32 women, 28 men), caudal epidural injection was performed at prone position, whereas it was implemented at lateral decubitus position in Group 2 (n=60; 33 women, 27 men). Visual analogue scale, Oswestry Disability Index (ODI), walking tolerance (WT) and standing tolerance (ST) were compared in 2 groups before and after injection. Results : In Group 1, ODI values were higher at 30th minute (p=0.007), 3rd week (p=0.043) and 6th month (p=0.013). In Group 1, ODI, VAS and ST values were improved significantly at all follow-up periods compared to initial values. In Group 1, WT scores were better than initial values at 30th minute, 3rd week and 3rd month. In Group 2, ODI scores at 30th minute, 3rd week, 3rd month and 6th month were improved while VAS and ST scores were improved at all periods after injection. WT scores were better at 30th minute, 3rd week and 3rd month compared to initial WT scores. Conclusion : Our results indicated that application of injection procedure at lateral decubitus position allowing a more concentrated local distribution may provide better relief of pain.

The literary review on the Treatment of Pressure Sore (褥瘡의 治療에 관한 문헌적 고찰)

  • Song, Jae-chul;Chung, Seok-hee;Lee, Jong-soo;Shin, Hyun-dae;Kim, Sung-soo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.13 no.1
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    • pp.237-252
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    • 2000
  • Pressure sore is an area of ulceration and necrosis of the skin and underlying tissues usually occuring over the bony prominences of the body after prolonged or often repeated pressure. We reviewed and summarized the published articles and treatise on the treatment of pressure sore. The results were as follows : 1. Pressure sore occur due to prolonged or often repeated pressure. So it is better than decubitus ulcer that is called pressure sore. 2. The most common lesions of pressure sore are sacrum, ischial tuberosity, greater trochanter. 3. The cause of pressure sore are change of comprehension. urine, moisture, change of the ability of activity and exercise, shearing force. 4. The elements to influence on wound healing are collagen accumulation velocity, nutrition condition, Vitamine C, copper, iron. oxygen pressure, steroids, cell-toxic drug, radiation. 5. Non-operative treatments are managements of skin such as avoiding consistant pressure, dressing, preventing moisture, understanding patient and protecter, preventing spasm, improvement of systemic nutrition condition. 6. Operative treatements are debridement, suture, skin transplantation, muscle flap and musculaocutaneous flap surgery. Recently V-${\Gammer}$ advancement surgery in use of muscle and musculocutaneous flap is generally maded. 7. Complications of post-operation are wound rupture, infection, disappearance of transmitted skin, necrosis of flaps.

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