• 기본간호학회지
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• 제11권1호
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• pp.6-12
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• 2004

Purpose: The purpose of this study was to evaluate self-study learning achievement in undergraduate nursing students who used a web-based wound care e-book. Method: The web-based wound care e-book was applied to 80 nursing students at Y university. The students studied the wound care e-book for four weeks and practiced wound dressing by themselves in open laboratory. Learning achievement was evaluated according to achievement of unit objectives and performance of an actual wound dressing. Result: 1. The total mean score for achievement of unit objectives was 3.06 (${\pm}0.41$) and the total mean score on the performance of the wound dressing was 89.40 (${\pm}5.47$). 2. There was no difference between the scores in the performance test (F=1.012, p=.366) for students who used self-study and those who were given a lecture. 3. A positive correlation was found between achievement of unit objectives and performance of the wound dressing (r=0.306, p<0.05). Conclusion: The web-based wound care e-book was effective in facilitating self-study for nursing students, and there is a need to continuously develop and up-date web-based nursing education e-books to facilitate self-study.

• Biomolecules & Therapeutics
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• 제7권1호
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• pp.7-13
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• 1999

The stimulatory effect of recombinant human basic fibroblast growth factor (bFGF) on wound healing was evaluated in healing-impaired animal models. Full-thickness wounds were made in prednisolone-treated mice, streptozotocin (STZ)-induced diabetic rats and mitomycin C (MMC)-treated rats. Saline or bFGF at a dose of 1, 5, or $25\mu\textrm{g}$ per wound was applied to the open wound once a day for three to five days. The degree of wound healing was assessed using wound size and histological parameters such as degree of epidermal and dermal regeneration. Local application of bFGF accelerated wound closure significantly in a dose-dependent manner in all healing-impaired wounds (p<0.05). The wound healing effect of bFGF was further confirmed by histological examination in MMC-treated rats. Epidermal and dermal regeneration were enhanced in bFGF-treated wounds with a dose-related response. Dermal regeneration parameters such as collagen matrix formation and angiogenesis were significantly increased in $5\mu\textrm{g}$, or $\25mu\textrm{g}$ of bFGF-treated wounds when compared to saline-treated wounds (p<0.05). pectin immunostaining on day 8 for vascular endothelium showed an increased number of neovessels in bFGF-treated wounds. These results suggest that topical application of bFGF has beneficial effects on wound healing by angiogenesis and granulation tissue formation in healing-impaired wounds.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.169-175
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• 2007

Purpose: $Allevyn^{(R)}$(Smith & Nephew, England) is a type of polyurethane foam material with good wound discharge absorption. $Acticoat^{(R)}$(Smith & Nephew, England) is a silver coated dressing material which is effective in infected wound. The purpose of this study is to compare the effects of dry gauze, $Acticoat^{(R)}$ and $Allevyn^{(R)}$ on infected full-thickness wound healing in rat. Methods: One hundred and twenty rats were divided into 3 groups: group I(dressing with dry gauze, n=40), group II(dressing with $Allevyn^{(R)}$, n=40), group III(dressing with $Acticoat^{(R)}$, n=40). A $15{\times}15mm$ square full-thickness wound was made on the dorsum and left open for 24 hours. The size of wound defects were measured each dressing changes. The histological evaluation was performed on the 3rd day, 7th day, 14th day, 21th day. Results: After the wound was left open for 24 hours, typical findings of bacterial infection was observed. After the 7th day, group III showed larger area of epithelialization, smaller defect size compared to those of two other groups. Complete replacement by fibrotic scar tissue was observed in group III with no signs of inflammation on the 14th day. By day 21, the average defect size in group III was decreased from initial 100% to 3.63%. while in group I and II, it was decreased to 62.66% and 53.62%, respectively. Conclusion: $Acticoat^{(R)}$ is an effective tool in the treatment of infected wound.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.87-90
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• 2015

Purpose: We evaluated the efficacy of ultrasound-guided lower extremity nerve block in trauma patients. Methods: From July 2013 to April 2014, 17 patients with multiple trauma had lower extremity nerve block for immediate management of open wound in the lower extremity. We evaluated the patient satisfaction of the anesthesia and any complications related to the block. Results: During the lower extremity nerve block, incomplete nerve block occurred in one patient. This is the second case, the reason for this was the lack of technique. There was no anesthetic complications. Conclusion: Ultrasound-guided lower extremity nerve block in trauma patients is an effective anesthesia technique in the immediate management of open wound in lower extremities.

• Journal of Trauma and Injury
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• 제35권3호
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• pp.168-172
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• 2022

Purpose: The neck is a particularly critical region for penetrating injuries due to the close proximity of the trachea, esophagus, blood vessels, and the spinal cord. An open neck injury has the potential for serious morbidity and mortality. The purpose of this study is to evaluate the assessment and management of open neck injuries. Methods: In this retrospective study, open neck injury patients who were admitted to the Trauma Center of Daejeon Eulji Medical Center, Eulji University between December 2015 and December 2017 were analyzed for epidemiology, the mechanism of trauma, the injured organ, complications, and mortality. Results: Thirty-two patients presented with open neck injuries. All patients underwent computed tomographic angiography to evaluate their injuries once their vital signs stabilized. Among these patients, 27 required surgical treatment. The most commonly injured organ was the airway. There were five deaths, and the main cause of death was bleeding. Mortality was associated with the initial systolic blood pressure at the hospital and Glasgow Coma Scale. Conclusions: Mortality from open neck injuries was associated with initial systolic blood pressure at the hospital and Glasgow Coma Scale.

• 대한안과학회지
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• 제59권11호
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• pp.1062-1070
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• 2018

목적: 소아청소년 환자에서 발생한 개방안구손상의 임상 양상을 분석하여 최종시력을 예측할 수 있는 인자를 알아보고, 최종시력을 예측하는 방법으로 안외상 점수(ocular trauma score, OTS)와 소아 안외상 점수(penetrating ocular trauma score, POTS)를 평가해 보고자 한다. 대상과 방법: 1993년 5월부터 2014년 4월까지 개방안구손상으로 본원에 내원한 18세 이하 소아청소년 환자 77명을 대상으로 의무기록을 후향적으로 분석하였다. 최종시력에 영향을 미칠 수 있는 인자들을 조사하였고, 최종시력을 예측하는 방법으로 OTS와 POTS를 receiver operating characteristic 곡선을 이용하여 평가해 보았다. 결과: 단변량 분석에서 20/200 미만의 초기시력, 안구파열, 7.0 mm 이상의 손상 크기, 망막박리, 수정체이탈, 총 수술 횟수는 불량한 최종시력(<20/200)과 유의한 관련성이 있었다. 반면에 20/32 이상의 좋은 최종시력의 경우 각막중심 침범 유무, 외상백내장 유무, 7.0 mm 미만의 손상 크기, 20/200 이상의 초기시력과 관련성이 있었다. OTS와 POTS 모두 최종시력을 예측하는 방법으로 진단적 가치가 있었으며, 통계적으로 두 점수 체계에 유의한 차이는 없었다. 결론: 소아청소년에게 발생한 개방안구손상에서 초기시력과 안구손상 크기는 최종시력에 영향을 주는 중요한 예측인자이다. 소아청소년 개방안구손상 환자의 최종시력 예측에 있어 기존의 안외상 점수(OTS)뿐만 아니라 소아 안외상 점수(POTS) 또한 좋은 예측도를 보여주어 둘 모두 유용한 평가 방법으로 생각된다.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.417-421
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• 2012

We present a case of a near total amputation at the distal tibial level, in which the patient emphatically wanted to save the leg. The anterior and posterior tibial nerves were intact, indicating a high possibility of sensory recovery after revascularization. The patient had open fractures at the tibia and fibula, but no bone shortening was performed. The posterior tibial vessels were reconstructed with an interposition saphenous vein graft from the contralateral side and a usable anterior tibial artery graft from the undamaged ipsilateral distal portions. The skin and soft tissue defects were covered using a subatmospheric pressure system for demarcating the wound, and a latissimus dorsi myocutaneous free flap for definite coverage of the wound. At 6 months after surgery, the patient was ambulatory without requiring additional procedures. Replantation without bone shortening, with use of vessel grafts and temporary coverage of the wound with subatmospheric pressure dressings before definite coverage, can shorten recovery time.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.470-474
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• 2019

Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.632-636
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• 2006

Purpose: Methicillin-Resistant-Staphylococcus aureus(MRSA) has been increasingly recognized as a cause of nosocomial infection. MRSA is hardly-controllable organism among the pathogen of nosocomial infection, because it is resistant to most antibiotics except vancomycin, and local treatment with most antiseptics are not effective to eradicate MRSA from the infection. The effectiveness of Vacuum-Assisted-Closure(VAC) was reported widely. we tried to modify original VAC. We tried VAC dressing on MRSA infected wound to evaluate whether or not the VAC is effective to eradicate MRSA which existed in the open wound. Methods: From September 2003 to December 2003, 24 patients admitted to the plastic and reconstructive surgery and orthopedic surgery, were studied. All patients were found to be positive in previous wound. Using clinical randomized study, 24 patients were divided into two groups: VAC dressing group and the $Betadine^{(R)}$ dressing group(control). During treatment, wound culture was done twice a week for evaluation of MRSA infection elimination. Results: The mean period that MRSA become not detected in all case was 17.1 days in VAC dressing group, and 25.8 days in control group, respectively. The p value was 0.013. The result reveals that the VAC dressing group is more effective to MRSA infection control. As a result, the VAC dressing was more effective in MRSA infected wound than conventional dressing. Conclusion: Through this study, we found objective result of VAC dressing. We hope that VAC dressing is more widely applied to fresh and infected wound.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.195-200
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• 2016

Enteroatmospheric fistula (EAF) is one of the most devastating complications in patients with an open abdomen and has associated morbidity and mortality rates. No gold standard therapy has been established for the treatment of EAF, and thus, treatment decision making is dependent on the experience of medical staff. Nevertheless, treatment involves the following; 1) sepsis must be managed, 2) sufficient nutritional support must be provided, and 3) effluent must be isolated from skin and open viscera. Here the authors present the case of a 29-year-old man who developed enteroatmospheric fistula after damage control laparotomy.