• 제목/요약/키워드: incision rate

검색결과 146건 처리시간 0.027초

Treatment of Peritonsillar Abscess: Needle Aspiration versus Incision and Drainage

  • Cho, Seung-Hyun;Kwon, Soon-Young;Lee, Seung-Hoon;Cho, Jae-Hoon;Choi, Ji-Ho;Baik, Seung-Hoon;Yoo, Chan-Kee
    • 대한기관식도과학회지
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    • 제13권1호
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    • pp.19-22
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    • 2007
  • Background and Objectives: The Objective of this study was to compare the effectiveness of the needle aspiration method and the I&D method in the treatment of peritonsillar abscess. Materials and Methods: A prospective clinical study was performed on 83 patients. All the patients were hospitalized after random treatment with either I&D or needle aspiration alone, received the same intravenous antibiotic therapy. Among the 83 patients, 73 patients who could be observed for longer than 6 months and had not undergone a tonsillectomy during the follow-up period, were analyzed for treatment outcomes. Results: There was no statistically significant difference in the initial failure rate(p=0.572), the hospitalized days(p=0.956), the recurrence rate(p=0.531) for the needle aspiration(35 patients) and I&D groups(38 patients). But, The mean duration of fever were statistically different in the needle aspiration(1.51 hours) and I&D groups(3.05 hours) (p=0.031). Conclusion: Two methods are thought to be similar in effectiveness, except that duration of fever was longer in the I&D group than in the needle aspiration group. However, taking advantages of the needle aspiration method into consideration, the needle aspiration of peritonsillar abscess may be more appropriate than I&D as an initial method for peritonsillar abscess

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The effectiveness of corticotomy and piezocision on canine retraction: A systematic review

  • Viwattanatipa, Nita;Charnchairerk, Satadarun
    • 대한치과교정학회지
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    • 제48권3호
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    • pp.200-211
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    • 2018
  • The aim of this systematic review was to evaluate the effectiveness and complications of corticotomy and piezocision in canine retraction. Five electronic databases (PubMed, SCOPUS, Web of Science, Embase, and CENTRAL) were searched for articles published up to July 2017. The databases were searched for randomized control trials (RCTs), with a split-mouth design, using either corticotomy or piezocision. The primary outcome reported for canine retraction was either the amount of tooth movement, rate of tooth movement, or treatment time. The secondary outcome was complications. The selection process was based on the PRISMA guidelines. A risk of bias assessment was also performed. Our search retrieved 530 abstracts. However, only five RCTs were finally included. Corticotomy showed a more significant (i.e., 2 to 4 times faster) increase in the rate of tooth movement than did the conventional method. For piezocision, both accumulative tooth movement and rate of tooth movement were twice faster than those of the conventional method. Corticotomy (with a flap design avoiding marginal bone incision) or flapless piezocision procedures were not detrimental to periodontal health. Nevertheless, piezocision resulted in higher levels of patient satisfaction. The main limitation of this study was the limited number of primary research publications on both techniques. For canine retraction into the immediate premolar extraction site, the rate of canine movement after piezocision was almost comparable to that of corticotomy with only buccal flap elevation.

독사 교상 환자에서의 음압요법: 예비보고 (Vacuum Assisted Closure Therapy in Snake Bite Wound: Preliminary Report)

  • 송우진;최환준;강상규
    • Archives of Plastic Surgery
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    • 제38권1호
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    • pp.121-126
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    • 2011
  • Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

흉강경을 이용한 하행 괴사성 종격동염의 치료 (Management of Descending Necrotizing Mediastinitis with Thoracoscopy)

  • 이성호;선경;김광택
    • Journal of Chest Surgery
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    • 제35권2호
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    • pp.161-165
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    • 2002
  • 하행 괴사성 종격동염은 대부분 경부 부위의 농양으로 시작하여 종격동으로 파급되는 매우 치명적인 질환이며 저자에 따라 25∼40%의 사망률을 보고하고 있다. 빠른 진단과 적절한 수술적 치료가 중요하며 수술적 치료의 방법에는 아직 여러 가지 방법들이 보고되고 있지만 농양의 완전한 배농이 특히 중요하다고 보고하고 있다. 배농술은 경부 절개를 통한 배농과 함께 흉부 내의 종격동 배농술이 필요하며 종격동 배농술은 대부분 개흉술을 통하여 시행되어 왔으나 개흉술에 따른 합병증과 수술부위의 감염 등이 술후 이환율을 증가시키는 원인이 될 수 있다. 반면에 흥강경을 이용한 배농은 경부 배농술 및 흉부 배농술을 동시에 시행할 수 있으며 좋은 수술시야를 보여주고 술후 환자의 회복이 빨라 하행 괴사성 종격동염의 좋은 치료 방법이라 생각된다.

Buccal infiltration injection without a 4% articaine palatal injection for maxillary impacted third molar surgery

  • Sochenda, Som;Vorakulpipat, Chakorn;Kumar, K C;Saengsirinavin, Chavengkiat;Rojvanakarn, Manus;Wongsirichat, Natthamet
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권4호
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    • pp.250-257
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    • 2020
  • Objectives: Palatal infiltration is the most painful and uncomfortable anesthesia technique for maxillary impacted third molar surgery (MITMS). This approach could cause patients distress and aversion to dental treatment. The aim of this study was to evaluate the anesthetic efficacy of a buccal infiltration injection without a palatal injection in MITMS. Materials and Methods: This prospective research study was a crossover split mouth-randomized controlled trial. Twenty-eight healthy symmetrical bilateral MITMS patients (mean age, 23 years) were randomly assigned to two groups. Buccal infiltration injections without palatal injections were designated as the study group and the buccal with palatal infiltration cases were the control group, using 4% articaine and 1:100,000 epinephrine. The operation started after 10 minutes of infiltration. Pain assessment was done using a visual analogue scale and a numeric rating scale after each injection and extraction procedure. Similarly, the success rate, hemodynamic parameters, and additional requested local anesthetic were assessed. Results: The results showed that the pain associated with local anesthetic injections between both groups were significantly different. However, the success rates between the groups were not significantly different. Postoperative pain was not significant between both groups and a few patients requested an additional local anesthetic, but the results were not statistically significant. For hemodynamic parameters, there was a significant difference in systolic pressure during incision, bone removal, and tooth elevation. In comparison, during the incision stage there was a significant difference in diastolic pressure; however, other steps in the intervention were not significantly different between groups. Conclusion: We concluded that buccal infiltration injection without palatal injection can be an alternative technique instead of the conventional injection for MITMS.

오대천의 특성과 하안단구의 형성과정 (Properties of Channel and Evolutions of Fluvial Terraces in Odae River)

  • 이광률
    • 대한지리학회지
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    • 제44권3호
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    • pp.224-239
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    • 2009
  • 본 연구는 오대천 상 하류의 하천 지형 특성을 분석하고, 오대천의 하천 및 하안단구 지형 형성과정에 대해 검토하였다. 오대천은 상류 화강암 지역보다 하류 퇴적암 지역에서 풍화 침식에 대한 저항력이 크기 때문에, 상류보다 하류 유역분지에서 해발고도가 높고, 기복량은 크며, 경사도가 높게 나타난다. 또한 상류보다 하류에서 평균 하곡 폭이 1/3 정도로 좁고, 평균 하도 폭도 더 좁은 것으로 측정되었다. OSL 연대 측정 결과 하안단구 1면의 형성시기는 최종 빙기 최성기인 MIS 2기말의 기온 상승기이며, 하안단구 2면은 최종 빙기 내의 아간빙기에 해당되는 MIS 3기 중반으로 측정되었다. 이를 토대로 하안단구 2면 형성 이후 현재까지 오대천의 평균 하각률은 상류 화강암 지역에서 0.205m/ka 하류 퇴적암 지역에서 0.269m/ka로 계산되었다.

Minimal invasive horizontal ridge augmentation using subperiosteal tunneling technique

  • Kim, Hyun-Suk;Kim, Young-Kyun;Yun, Pil-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제38권
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    • pp.41.1-41.6
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    • 2016
  • Background: The goal of this study was to retrospectively evaluate the prognosis of minimal invasive horizontal ridge augmentation (MIHRA) technique using small incision and subperiosteal tunneling technique. Methods: This study targeted 25 partially edentulous patients (10 males and 15 females, mean age $48.8{\pm19.7years$) who needed bone graft for installation of the implants due to alveolar bone deficiency. The patients took the radiographic exam, panoramic and periapical view at first visit, and had implant fixture installation surgery. All patients received immediate or delayed implant surgery with bone graft using U-shaped incision and tunneling technique. After an average of 2.8 months, the prosthesis was connected and functioned. The clinical prognosis was recorded by observation of the peri-implant tissue at every visit. A year after restoration, the crestal bone loss around the implant was measured by taking the follow-up radiographs. One patient took 3D-CT before bone graft, after bone graft, and 2 years after restoration to compare and analyze change of alveolar bone width. Results: This study included 25 patients and 39 implants. Thirty eight implants (97.4 %) survived. As for postoperative complications, five patients showed minor infection symptoms, like swelling and tenderness after bone graft. The other one had buccal fenestration, and secondary bone graft was done by the same technique. No complications related with bone graft were found except in these patients. The mean crestal bone loss around the implants was 0.03 mm 1 year after restoration, and this was an adequate clinical prognosis. A patient took 3D-CT after bone graft, and the width of alveolar bone increased 4.32 mm added to 4.6 mm of former alveolar bone width. Two years after bone graft, the width of alveolar bone was 8.13 mm, and this suggested that the resorption rate of bone graft material was 18.29 % during 2 years. Conclusions: The bone graft material retained within a pouch formed using U-shaped incision and tunneling technique resulted with a few complications, and the prognosis of the implants placed above the alveolar bone was adequate.

수술 예방적 항생제의 사용 현황 및 관리전후 효과 (The prophylactic uses of antibiotics for the prevention of surgical site infection and the effects: The 3-year experience in a tertiary hospital)

  • 양지연;김문숙;김유정;이은봉
    • 한국의료질향상학회지
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    • 제18권1호
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    • pp.71-78
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    • 2012
  • Background : The objective of this study was to examine the effect of management system for the appropriate prophylactic use of antibiotics in surgical patients at a tertiary hospital from 2007 to 2010. Methods : We collected clinical data of three different surgical procedures(colectomy, heart surgery, hysterectomy) for three months of 2007 and 2010, respectively. The number of total cases was 245(137, 54, 54) in 2007, 240(133, 42, 65) in 2010. We measured the rate of use of inappropriate prophylactic antibiotics, administration within 1 hour prior to the incision and the antibiotics prescription days after surgery. To evaluate the effectiveness of the management system, the results of the two groups(Group1=2007, Group2=2010) were compared by t-test, chi-square test or Fisher's exact test. Result : The rate of Aminoglycoside uses decreased drastically from 11.4% to 0.8%(P<.001). The selection of 3rd/4th Cephalosporin dropped from 11.8% to 5.8%(P=.020). The combination of antibiotics decreased from 27.8% to 11.7%(P<.001). The antibiotic prescription rate on discharge declined from 11.8% to 2.5%(P<.001) and the number of antibiotics prescription days after surgery was shortened from 4.2 days to 2.3 days(P<.001). No significant difference in the rate of administration within 1 hour between two groups was found. Through 3-year management, 5 out of 6 measures were significantly improved(except the administration within 1 hour). The rate of surgical site infection decreased from 2.4% to 1.3%(P=.504). Conclusion : The findings demonstrate that the management system for the prophylactic use of antibiotics in surgical patients was effective in decreasing the rate of surgical site infection during 3 years.

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자연위치의 복재정맥을 이용한 하지동맥 우회술 1례 보 (In Situ Saphenous Vein Arterial Bypass - A case report -)

  • 이홍섭;박국양;김창호
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.187-190
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    • 1987
  • The Saphenous vein is still the graft of choice for bypass of small calibered peripheral arteries, and many recent studies revealed that the "In Situ" technique had higher rate of long term patency than the conventional "reversed" one. A 71-year-old male who had atherosclerotic obstruction in the superficial femoral and popliteal trifurcation underwent In Situ saphenous vein arterial bypass. The saphenous vein is exposed by a long medial skin incision over the course of the vein. All branches of vein are ligated. A olive-tipped metal needle is introduced into the vein from above and everts the valves. The patient has been followed for 2 months after operation. The graft remained pulsatile and the gangrenous areas on the toe proceeded to heal. We think In situ vein bypass offers an excellent and safe method of revascularization of the arterial occlusion below the knee although it is technically demanding and the time consuming. time consuming.

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관절경하 유관 나사를 이용한 족관절 관절 고정술 (3례 보고) (TAnkle Arthrodesis Using Cannulated Screws under Arthroscopy -Three cases report-)

  • 김명구
    • 대한관절경학회지
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    • 제2권1호
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    • pp.59-63
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    • 1998
  • There have been numerous methods to obtain a stable arthrodesis of the tibiotalar joint. However, a controvercy has arisen over the most successful and reproducible method to obtain an arthrodesis. The objective of this report is to show that an ankle arthrodesis can be performed successfully and advantageously by using cannulated screws under arthroscopic control and that our csaes will be a part of the multicentric study of arthroscopic ankle arthrodesis in korea. Between May 1996 and May 1997, we perfomed 3 ankle arthrodesis under arthroscopy using cannulated screws. Two patients had post-traumatic osteoarthritis and one had rheumatoid arthritis. Clinical ankylosis in one case and radiological union in two cases were obtained in 12 weeks postoperatively. We propose that arthroscopic ankle arthrodesis is effective procedure in patient who has minimal deformity and bone loss, advantages like small incision, minimal morbidity, low infection rate and rapid return to normal daily activity, but more cases and comparision with open tecnique will be needed.

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