• Archives of Plastic Surgery
• /
• 제35권6호
• /
• pp.692-697
• /
• 2008

Purpose: Gluteal perforator flap has evolved to one of the standard tools for coverage of pressure sore. We used this flap to cover the defect adjacent to the buttock. Methods: From September 2004 to August 2006, gluteal perforator flaps were performed in 3 patients with sore and 9 patients with tumor. We made the rule for free style design of the flap. First, the defect should be covered fully regardless of the shape or area. Second, the location of perforators was decided to maximize flap mobility. Third, the donor-site should be closed directly. Results: Successful reconstruction was fulfilled. In 2 cases, initial flap congestion was observed but medical leech was applied and it was resolved. Partial flap loss occurred in one case. Infection was observed in one case. But there were no major complications. Conclusion: Gluteal perforator flap is very good option for the reconstruction of the defects adjacent to the buttock.

• Archives of Plastic Surgery
• /
• 제41권4호
• /
• pp.387-393
• /
• 2014

Background Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. Methods We retrospectively analyzed data from 14 patients (16 ischial sores) whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. Results All flaps survived the entire follow-up period. Seven patients (50%) had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years). The mean follow-up period was 27.9 months (range, 3-57 months). In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%), wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%), but resolved with conservative treatment. Among 16 cases, there was only one (6%) recurrence at 34 months. Conclusions The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores.

• Journal of Preventive Medicine and Public Health
• /
• 제47권5호
• /
• pp.273-280
• /
• 2014

Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

• 한국컴퓨터정보학회:학술대회논문집
• /
• 한국컴퓨터정보학회 2023년도 제67차 동계학술대회논문집 31권1호
• /
• pp.19-20
• /
• 2023

전이학습은 영상 분류를 진행한 모델을 사용하여 다른 종류의 영상 분류에 적용하여 문제를 푸는 것을 의미하며, 모델 설계부터 진행한 학습 모델보다 빠른 속도와 높은 정확도를 달성할 수 있다. 또한, 적은 데이터셋에 대하여 학습을 진행하여 좋은 결과를 도출할 수 있는 장점이 존재한다. 본 논문에서는 전이학습으로 사용되는 모델 중 Xception 모델을 사용하며, 욕창 이미지의 모델 입력 크기를 256, 512, 1024의 크기로 설정하여 학습을 진행 후 욕창 이미지 크기별 성능을 비교분석을 진행하고자 한다.

• 기본간호학회지
• /
• 제5권2호
• /
• pp.280-292
• /
• 1998

Pressure sores are a serious concerns in that respect to increasing risk of medical complications and medical costs. Prevention and care of pressure sores is an essential area of nursing practice. The nurse at ICU should be more careful of maintaining the skin integrity of patients especially than at any other place. This study was conducted to determine if the risk facotrs of pressure sores and nutritional status of the patients at risk for pressure sores is related the occurance of pressure sore. The risk group refers the patients having the below 14 scores of the braden scale. The 100 subjects were recruited from the ICU ward at an university hospital in Choongnam. The parameters for nutritional status are the blood chemistry including plasma protein, albumin, hemoglobin and the anthropometric measurements consisting of weight, BMI, LBM, the proportion of body fat, body fluid and triceps skin fold using bioimpedence analizer and caliper. The results are as follows : 1. The subjects were 55 years and stayed 8 days on average. Of the 100 subjects, males were 61%, neurologic/neurosurgical diseases were 68% and the incidence of pressure sores was 17% mainly occuring within 3days after the admission. 2. The present paralysis(or paraplegia) and edema(arm, leg, trunk) were showed more significantly the subjects with pressure sores than those without pressure sores. 3. Regarding with the nutritional status, the subjects with pressure sores had significantly lower the weight, BMI, LBM, body fluid, albumin than the ones without pressure sores. This results were supported the reports of previous studies that the decreased weight and albumin could be the important predictors of pressure sores. Thereafter we should encourage these factors to be utilized in predicting pressure sores for a comprehensive assessment. Nurse should identify patients at risk of the development of pressure sores, assess their nutritional status and dietary intake at regular intervals.

• Archives of Plastic Surgery
• /
• 제34권2호
• /
• pp.191-196
• /
• 2007

Purpose: Gluteal perforator is easily identified in the gluteal region and gluteal perforator flap is a very versatile flap in sacral sore reconstruction. We obtained satisfying results using the gluteal perforator flap, so we report this clinical experiences with a review of the literature. Methods: Between November of 2003 and April 2006, the authors used 16 gluteal perforator flaps in 16 consecutive patients for coverage of sacral pressure sores. The mean age of the patients was 47.4 years (range, 14 to 78 years), and there were 9 male and 7 female patients. All flaps in the series were supplied by musculocutaneous arteries and its venae comitantes penetrating the gluteus maximus muscle and reaching the intrafascial and suprafascial planes, and the overlying skin forming a rich vascular plexus arising from gluteal muscles. Patients were followed up for a mean period of 11.5 months. Results: All flaps survived except one that had undergone total necrosis by patient's negligence. Wound dehiscence was observed in three patients and treated by secondary closure. There was no recurrence during the follow-up period. Conclusion: Gluteal perforator flaps allow safe and reliable options for coverage of sacral pressure sores with minimal donor site morbidity, and do not sacrifice the gluteus maximus muscle and rarely lead to post-operative complications. Freedom in flap design and easy-to perform make gluteal perforator flap an excellent choice for selected patients.

• 문화기술의 융합
• /
• 제7권1호
• /
• pp.646-653
• /
• 2021

본 연구에서 개발된 의료용 침대는 N개의 건반으로 이루어져 각각이 엑츄에이터에 의해 수직으로 구동된다. 각 건반에는 M개의 센서가 실장되어 체압을 측정하므로 체압지도의 해상도는 MN에 의해 결정된다. 각 건반에는 센서 제어기가 실장되어 M개의 센서로부터 측정한 체압값을 CAN(Car Area Network)와 같은 직렬 통신 네트워크를 통해 메인제어기로 전달한다. 각 건반에는 모터를 구동하는 서보 드라이버가 하나씩 장착되며 메인 제어기와 CAN으로 연결되어 메인 제어기에서 지시된 변위값대로 건반의 높낮이를 제어하며 향후 개발될 인공지능 제어 알고리즘을 위해 신체 각부의 편안도를 조사하여 건반의 높낮이를 맞추었다. 또한, 건반 각부에 걸리는 최대 체압값과 체압비를 계산하여 인공지능에 의한 침대 편안도 제어를 위해 기초 데이터로 활용한다. 결과적으로 제시된 시스템은 향후 개발될 인공지능에 의한 신체의 안락함과 욕창 방지 제어를 위해 활용될 수 있는 토대가 될 수 있다.

• 대한한방내과학회지
• /
• 제36권3호
• /
• pp.419-426
• /
• 2015

Objectives This study reports three cases of pressure ulcer treated with Hwangryunhaedok-tang pharmacopuncture. Methods Three patients with pressure ulcers were treated by Hwangryunhaedok-tang pharmacopuncture and Jaungo at the Oriental Medicine Hospital of Daejeon University. Hwangryunhaedok-tang pharmacopuncture and Jaungo was administrated once a day with simple dressing. Thereafter, we observed the pressure ulcers macroscopically. Results and Conclusions After 3 weeks, wound sizes were reduced and tissue regeneration was accelerated. In conclusion, Hwangryunhaedok-tang pharmacopuncture and Jaungo are effective to treat pressure ulcers, but more studies will be required to validate its use in pressure ulcers.

• Archives of Plastic Surgery
• /
• 제39권4호
• /
• pp.412-416
• /
• 2012

Background Even though the quality of medical and surgical care has improved remarkably over time, iatrogenic injuries that require surgical treatment including injuries caused by cast and elastic bandage pressure, extravasation, and dopamine-induced ischemia still frequently occur. The goal of this study was to estimate the incidence and analyze the distribution of iatrogenic injuries referred to our department. Methods A retrospective clinical review was performed from April 2006 to November 2010. In total, 196 patients (116 females and 80 males) were referred to the plastic surgery department for the treatment of iatrogenic injuries. We analyzed the types and anatomic locations of iatrogenic complications, along with therapeutic results. Results An extravasation injury (65 cases, 37.4%) was the most common iatrogenic complication in our study sample, followed by splint-induced skin ulceration, dopamine-induced necrosis, prefabricated pneumatic walking brace-related wounds and elastic bandage-induced wounds. Among these, prefabricated pneumatic walking brace-related complication incidence increased the most during the 5-year study period. Conclusions The awareness of the very common iatrogenic complications and its causes may allow physicians to reduce their occurrence and allow for earlier detection and referral to a plastic surgeon. We believe this is the first study to analyze iatrogenic complications referred to a plastic surgery department in a hospital unit.

• Journal of Chest Surgery
• /
• 제23권5호
• /
• pp.1027-1034
• /
• 1990

Pectus excavatum, commonest developmental anomaly of chest wall, is manifested by depression of the sternum and lower costal cartilages that is of surgical interest. From 1982 through 1990, fifteen patients have undergone surgery for treatment of pectus excavatum and treated by Ravitch operation: 5, Modified Ravitch operation; 4, Wada operation, 1 and Modified Wada operation, 5. There was familial history of pectus excavatum in 3 patients. Associated congenital anomaly were seen in 6 patients; scoliosis in 3 patients, right inguinal hernia in 1, polydactyly in 1 and patent ductus arteriosus in 1 patent. Postoperative minor complications were developed in 3 cases; pneumothorax, 2 cases; pleural effusion, 2 cases; wound infection and dehiscence, 1 cases; pressure sore due to strut malposition, 2 cases; flail chest and 2 cases; seroma. The incidence of the postoperative complications were more common in cases who were treated by metal strut, pin or other prosthetic materials for supporting the chest wall integrity than the standard corrective procedure. All cases have no recurrence of chest wall depression and operative death.