• 제목/요약/키워드: dehiscence

검색결과 312건 처리시간 0.033초

Vanishing Venous Coronary Artery Bypass Grafts after Sepsis

  • Park, Soo Jin;Park, Ji Ye;Jung, Joonho;Hong, You Sun;Lee, Cheol Joo;Lim, Sang Hyun
    • Journal of Chest Surgery
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    • 제49권5호
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    • pp.387-391
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    • 2016
  • The dehiscence of saphenous vein grafts (SVGs) is a rare, often fatal, complication of coronary artery bypass grafting (CABG). We present the case of a 57-year-old man who underwent hemiarch graft interposition and CABG for a Stanford type A aortic dissection. Five months after discharge, the patient developed streptococcal sepsis caused by a hemodialysis catheter. Complete rupture of the proximal anastomoses of the saphenous veins and containment by the obliterated pericardial cavity was observed 25 months after the initial operation. The patient was successfully treated surgically. This report describes a patient who developed potentially fatal dehiscence of SVGs secondary to infection and outlines preventive and management strategies for this complication.

Myelomeningocele defect reconstruction with keystone flaps: vascular rationale for the design and operative technique

  • Kushida-Contreras, Beatriz Hatsue;Gaxiola-Garcia, Miguel Angel
    • Archives of Plastic Surgery
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    • 제48권3호
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    • pp.254-260
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    • 2021
  • Background Myelomeningocele is a frequently seen condition at tertiary care hospitals. Its treatment involves a variety of plastic reconstructive techniques. Herein, we present a series of myelomeningocele patients treated using keystone flaps. Methods We gathered information regarding soft tissue reconstruction and the use of bilateral keystone flaps to treat myelomeningocele patients. We obtained data from clinical records and recorded the demographic characteristics of mothers and children with the condition. The size, level of defect, and complications detected during the follow-up were analyzed. Results A series of seven patients who underwent bilateral keystone flaps for myelomeningocele closure was analyzed. There were no cases of midline or major dehiscence, flap loss, necrosis, surgical site infections, or cerebrospinal fluid leakage. No revision procedures were performed. Minor complications included one case with minimal seroma and three cases with areas of peripheral dehiscence that healed easily using conventional measures. Conclusions The use of keystone flaps is an adequate option for closure of dorsal midline soft tissue defects related to myelomeningocele. This technique offers predictable results with an acceptable spectrum of complications. Robust blood flow can be predicted based upon anatomical knowledge.

A형 대동맥박리의 대동맥 이식편 치환술 후 봉합선 열개의 혈관내 치료: 2건의 증례 보고 (Endovascular Treatment of Aortic Dissection due to Suture Line Dehiscence after Aortic Graft Replacement for Type A Aortic Dissection: A Report of Two Cases)

  • 심우진;김영환
    • 대한영상의학회지
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    • 제85권3호
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    • pp.668-675
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    • 2024
  • 대동맥 문합부 누출은 급성 대동맥 박리의 치료인 상행 대동맥 치환술 후 발생할 수 있는 흔하지 않은 합병증이다. 대동맥 문합부 누출의 치료로는 재수술이 전통적인 치료 방법으로 추천되나 높은 사망률과 이환율을 보인다. 최근에는 몇 건의 증례 보고에서 중재 시술이 대안적인 접근방식으로 시도되고 있다. 이에 저자들은 A형 대동맥박리의 치료인 대동맥 이식편치환술 후 봉합선 열개에 의한 대동맥 문합부 누출을 코일과 N-butyl cyanoacrylate로 색전술을 시행한 증례와 혈관마개로 성공적으로 치료한 증례를 보고하고자 한다.

비디오 흉강경을 이용한 자연성 기흉의 수술 (Video-Assisted Thoracic Surgery for the Spontaneous Pneumothorax)

  • 김경훈;강경훈
    • Journal of Chest Surgery
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    • 제30권11호
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    • pp.1111-1116
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    • 1997
  • 1994년 9월 부터 1996년 9월까지 본원에서는 38명의 환자가 비디오 흉강경수술로써 자연성 기흉질환에 대 해 치료를 받았다. 이 중 자연성 기흉 환자는 38명이었으며 남자가 31명 여자가 7명이었고 평균연령은 30세 였다 사망은 없었고 비디오 흉강경을 통한 술후 합병율은 자연성 기흉의 경우에서 7.9%(3/38)였다. 비디오 흉강경을 이용한 자연성 기흉의 수술의 경우에 재발성 기흉은 없었고 창상 열개가 3례, 7일 이상의 지속적 공기 누출이 3례 있었고 동일한 환자였다. 같은 시기에 비디오 흉강경을 이용하여 자연성 기흉을 수술한 38 례의 A군과 개흉술을 이용한 21례의 B군과의 비교 분석을 하였다. A군에서는 평균 추적기간 14.3717.48개 월간 재발성 기흉은 없었으나, B군에서는 16.81$\pm$7.12개월간 1례의 재발이 있었다. 비디오 흉강경 수술과 개 흉술에서의 마취 유도시간을 포함하여 수술시간에는 유의적인 차이는 없었으나 술 후 입원 기간과 술 후 흉관 삽입 기간은 비디오 흉강경 수술시에 보다 적었다. 술 후 합병율은 A군에서 7.9%(3/38)로 B군 42.9%(9/21) 보다 훨씬 적었다. A군에서 동일한 환자에서 창상 열개와 7일 이상의 지속적인 공기누출이 \ulcorner시에 있었던 경우가 3례였고, B군에서는 기흉의 재발 1례와 창상 열개 2례가 동반하는 7일 이상의 지속적인 공기 누출이 8례가 있었고 1례에서는 농흉이 발생하였다. 비디오 흉강경 수술은 개흉술에 비해 자연성 기흉에 대해서 효과적인 치료 방법이다.

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Evaluation of the clinical and radiographic effectiveness of treating peri-implant bone defects with a new biphasic calcium phosphate bone graft: a prospective, multicenter randomized controlled trial

  • Jae-Hong Lee;Hyun-wook An;Jae-Seung Im;Woo-Joo Kim;Dong-Won Lee ;Jeong-Ho Yun
    • Journal of Periodontal and Implant Science
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    • 제53권4호
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    • pp.306-317
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    • 2023
  • Purpose: Biphasic calcium phosphate (BCP), a widely used biomaterial for bone regeneration, contains synthetic hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), the ratio of which can be adjusted to modulate the rate of degradation. The aim of this study was to evaluate the clinical and radiographic benefits of reconstructing peri-implant bone defects with a newly developed BCP consisting of 60% β-TCP and 40% HA compared to demineralized bovine bone mineral (DBBM). Methods: This prospective, multicenter, parallel, single-blind randomized controlled trial was conducted at the periodontology departments of 3 different dental hospitals. Changes in clinical (defect width and height) and radiographic (augmented horizontal bone thickness) parameters were measured between implant surgery with guided bone regeneration (GBR) and re-entry surgery. Postoperative discomfort (severity and duration of pain and swelling) and early soft-tissue wound healing (dehiscence and inflammation) were also assessed. Data were compared between the BCP (test) and DBBM (control) groups using the independent t-test and the χ2 test. Results: Of the 53 cases included, 27 were in the test group and 26 were in the control group. After a healing period of 18 weeks, the full and mean resolution of buccal dehiscence defects were 59.3% (n=16) and 71.3% in the test group and 42.3% (n=11) and 57.9% in the control group, respectively. There were no significant differences between the groups in terms of the change in mean horizontal bone augmentation (test group: -0.50±0.66 mm vs. control groups: -0.66±0.83 mm, P=0.133), postoperative discomfort, or early wound healing. No adverse or fatal complications occurred in either group. Conclusions: The GBR procedure with the newly developed BCP showed favorable clinical, radiographic, postoperative discomfort-related, and early wound healing outcomes for peri-implant dehiscence defects that were similar to those for DBBM.

기관협착증 치료에 대한 외과적 고찰 (Surgical Study in Treatment of the Tracheal Stenosis)

  • 지청현
    • Journal of Chest Surgery
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    • 제24권8호
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    • pp.765-772
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    • 1991
  • Between 1985 and 1990, 41 patients underwent treatment of the tracheal stenosis. Nineteen patients underwent resection and end-to-end anastomosis including three cases of the subglottic stenosis. Other patients had had treatment such as LASER therapy, bronchoscopic removal, insertion of the Montgomery silastic T-tube or stent insertion Nineteen patients which underwent resection and end-to-end anastomosis were excellent result from three years to sixth months. Other patient were followed at OPD for the other complication or restenosis. There were no hospital death but one patient was managed by bronchoscopic removal of the granulation tissue and other one patient had underwent reoperation for the dehiscence at the anastomotic site.

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Vestibular-evoked myogenic potentials: principle and clinical findings

  • Choi, Jeong-Yoon
    • Annals of Clinical Neurophysiology
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    • 제22권2호
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    • pp.67-74
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    • 2020
  • Vestibular-evoked myogenic potentials (VEMPs) are useful for evaluating the vestibulocollic reflex arising mostly from the saccule and the vestibuloocular reflex originating from the utricle. VEMPs can vary with the characteristics of the applied stimuli and the effects of aging and diseases. VEMPs have been found to be useful for diagnosing superior canal dehiscence, but their usefulness for other clinical disorders remains unclear. This review discusses the principles of VEMP tests and summarizes the findings for VEMPs in common vestibular disorders.

Short-term, Multi-center Prospective Clinical Study of Short Implants Measuring Less Than 7mm

  • Kim, Young-Kyun;Yi, Yang-Jin;Kim, Su-Gwan;Cho, Yong-Seok;Yang, Choon-Mo;Liang, Po-Chin;Chen, Yu-Yal;I, Lee-Long;Sim, Christopher;Tan, Winston;Ser, Go Wee;Yue, Deng;Yi, Man;Ping, Gong
    • Journal of Korean Dental Science
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    • 제3권1호
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    • pp.11-16
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    • 2010
  • Objective : This prospective study sought to verify the stability of three types of short implants measuring 7mm or less. Materials and methods : Implants measuring 7mm or less were placed in patients at multicenter dental clinics in Korea, China, Taiwan, and Singapore. Initial stability, intraoperative and postoperative complications, crestal bone loss, and survival rate of the implant were prospectively evaluated. Results : The primary stability of a 6-mm implant was lower than that of a 7-mm implant. The marginal bone loss of short implants measuring less than 7mm was minimal. Complications such as wound dehiscence, implant mobility, and peri-implant mucositis developed, and these were associated with initial implant failure. The short-term survival rate of 6-mm implant was 93.7%, and that of 7-mm implant, 96.6%. Conclusion : Short implant for the mandible with insufficient height for the residual ridge can be selectively used. Poor primary stability and wound dehiscence can cause osseointegration failure and alveolar bone loss.

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Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography

  • Baysal, Asli;Uysal, Tancan;Veli, Ilknur;Ozer, Torun;Karadede, Irfan;Hekimoglu, Seyit
    • 대한치과교정학회지
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    • 제43권2호
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    • pp.83-95
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    • 2013
  • Objective: To evaluate the changes in cortical bone thickness, alveolar bone height, and the incidence of dehiscence and fenestration in the surrounding alveolar bone of posterior teeth after rapid maxillary expansion (RME) treatment using cone-beam computed tomography (CBCT). Methods: The CBCT records of 20 subjects (9 boys, mean age: $13.97{\pm}1.17$ years; 11 girls, mean age: $13.53{\pm}2.12$ year) that underwent RME were selected from the archives. CBCT scans had been taken before (T1) and after (T2) the RME. Moreover, 10 of the subjects had 6-month retention (T3) records. We used the CBCT data to evaluate the buccal and palatal aspects of the canines, first and second premolars, and the first molars at 3 vertical levels. The cortical bone thickness and alveolar bone height at T1 and T2 were evaluated with the paired-samples t-test or the Wilcoxon signed-rank test. Repeated measure ANOVA or the Friedman test was used to evaluate the statistical significance at T1, T2, and T3. Statistical significance was set at p < 0.05. Results: The buccal cortical bone thickness decreased gradually from baseline to the end of the retention period. After expansion, the buccal alveolar bone height was reduced significantly; however, this change was not statistically significant after the 6-month retention period. During the course of the treatment, the incidence of dehiscence and fenestration increased and decreased, respectively. Conclusions: RME may have detrimental effects on the supporting alveolar bone, since the thickness and height of the buccal alveolar bone decreased during the retention period.