• Title/Summary/Keyword: scalp management

Search Result 51, Processing Time 0.026 seconds

Analysis of Complications Following Decompressive Craniectomy for Traumatic Brain Injury

  • Ban, Seung-Pil;Son, Young-Je;Yang, Hee-Jin;Chung, Yeong-Seob;Lee, Sang-Hyung;Han, Dae-Hee
    • Journal of Korean Neurosurgical Society
    • /
    • v.48 no.3
    • /
    • pp.244-250
    • /
    • 2010
  • Objective : Adequate management of increased intracranial pressure (ICP) is critical in patients with traumatic brain injury (TBI), and decompressive craniectomy is widely used to treat refractory increased ICP. The authors reviewed and analyzed complications following decompressive craniectomy for the management of TBI. Methods : A total of 89 consecutive patients who underwent decompressive craniectomy for TBI between February 2004 and February 2009 were reviewed retrospectively. Incidence rates of complications secondary to decompressive craniectomy were determined, and analyses were performed to identify clinical factors associated with the development of complications and the poor outcome. Results : Complications secondary to decompressive craniectomy occurred in 48 of the 89 (53.9%) patients. Furthermore, these complications occurred in a sequential fashion at specific times after surgical intervention; cerebral contusion expansion ($2.2{\pm}1.2$ days), newly appearing subdural or epidural hematoma contralateral to the craniectomy defect ($1.5{\pm}0.9$ days), epilepsy ($2.7{\pm}1.5$ days), cerebrospinal fluid leakage through the scalp incision ($7.0{\pm}4.2$ days), and external cerebral herniation ($5.5{\pm}3.3$ days). Subdural effusion ($10.8{\pm}5.2$ days) and postoperative infection ($9.8{\pm}3.1$ days) developed between one and four weeks postoperatively. Trephined and post-traumatic hydrocephalus syndromes developed after one month postoperatively (at $79.5{\pm}23.6$ and $49.2{\pm}14.1$ days, respectively). Conclusion : A poor GCS score ($\leq$ 8) and an age of $\geq$ 65 were found to be related to the occurrence of one of the above-mentioned complications. These results should help neurosurgeons anticipate these complications, to adopt management strategies that reduce the risks of complications, and to improve clinical outcomes.

An Integrative Review and Meta-analysis of Oncology Nursing Research : 1985-1997.2 (국내 암환자와 관련된 연구논문의 메타분석 - 실험연구를 중심으로 -)

  • 임선옥;홍은영
    • Journal of Korean Academy of Nursing
    • /
    • v.27 no.4
    • /
    • pp.857-870
    • /
    • 1997
  • The purposes of this study were to describe 12 years of patient-related oncology nursing research in Korea, identifying various nursing interventions, and assesing the effectiveness of the interventions, through analysis and synthesis of the accumulated research papers. One hundred and seventy-nine studies were selected for this study and these were mostly descriptive in design (69.2%). Of the 179 studies, 25 met the criteria for meta-analytic treatment. Twenty-five experimental studies were found in theses and dissertations (68%), 92% used convenience sample, and the median sample size was 40. Subjects were predominantly in treatment and rehabilitation (76%). Most studies(68%) were not derived from a theory base, with only 8% reporting use of a nursing theory. Results of the meta-analysis are as follows. The effect size of the nursing intervention type was found to be significantly effective. The standardized mean difference ranged from a high positive of 2.55 to a low negative of -0.22. Direct personal nursing intervention method was more effective than indirect group method. Two nursing intervention methods were more effective than one. The greatest effect size was thyxical intervention. The greatest mean effect size was scalp hypothermia technique. Teaching was a frequent intervention after 1990, although a wide range of treatments were studied. Effect size of intervention for symptom management was largest in relieving pain. Effective intervention method for relieving anxiety was exercise.

  • PDF

Atlantoaxial Rotatory Fixation in Adults Patient

  • Jeon, Sei-Woong;Jeong, Je-Hoon;Moon, Seung-Myung;Choi, Sun-Kil
    • Journal of Korean Neurosurgical Society
    • /
    • v.45 no.4
    • /
    • pp.246-248
    • /
    • 2009
  • Atlantoaxial rotatory fixation (AARF) in adult is a rare disorder that occurs followed by a trauma. The patients were presented with painful torticollis and a typical 'cock robin' position of the head. The clinical diagnosis is generally difficult and often made in the late stage. In some cases, an irreducible or chronic fixation develops. We reported a case of AARF in adult patient which was treated by immobilization with conservative treatment. A 25-year-old female was presented with a posterior neck pain and limitation of motion of cervical spine after a traffic accident. She had no neurological deficit but suffered from severe defect on the scalp and multiple thoracic compression fractures. Plain radiographs demonstrated torticollis, lateral shift of odontoid process to one side and widening of one side of C1-C2 joint space. Immobilization with a Holter traction were performed and analgesics and muscle relaxants were given. Posterior neck pain and limitation of the cervical spine' motion were resolved. Plain cervical radiographs taken at one month after the injury showed that torticollis disappeared and the dens were in the midline position. The authors reported a case of type I post-traumatic AARF that was successfully treated by immobilization alone.

The Changing Aspect of Appearances in Male Fashion Magazines (남성패션잡지에 나타난 외모의 변화양상)

  • Park, Su-Jin;Park, Kil-Soon
    • Korean Journal of Human Ecology
    • /
    • v.17 no.1
    • /
    • pp.105-114
    • /
    • 2008
  • This study aims on observing the social recognition and its aspects for men taking care of their outer appearances at current point where men are rapidly rising as the main consumer in the beauty industry while their interest for outer appearances are increasing. Therefore, we observed the overall trend and changes in social recognition for male looks by analyzing the contents of articles in fashion magazines that play the critical role of spreading the trend while suggesting and delivering the diverse trend changes to the public to correspond to the individual and concrete demands of certain class segmented into gender, age, hobby, and more. As a result, articles related to outer appearances were divided into fashion, cosmetic and skin, hair and scalp, body figure care, cosmetic surgery, and others, and among them, fashion category took up the highest ratio. Also, articles related to outer appearances increased even more according to the change in time, where articles related to fashion and hair increased while articles of other categories decreased.

Encephalitis and Motor Paresis Caused by Herpes Zoster -A case report- (대상포진에 의한 뇌염 및 운동신경 마비 -증례 보고-)

  • Heo, Hu Man;Lee, Kang Chang;Yang, Hyun Duck;Lee, Sung Ik
    • The Korean Journal of Pain
    • /
    • v.18 no.1
    • /
    • pp.85-88
    • /
    • 2005
  • Encephalitis is known as a rare complication of varicella zoster virus (VZV) reactivation. It is usually regarded as a complication of a cutaneous infection in patients with impaired cellular immunity. The reported incidence of herpetic motor involvement range between 0.5 and 31%, but is possibly more frequent as the weakness is readily obscured by pain. A 53-years-old woman, who presented with severe shoulder pain, fever, headache and seizure, which developed the day after skin eruptions, also developed motor paresis 7 days after the seizure. Her cerebrospinal fluid (CSF) was VZV-Polymerase chain reaction (PCR) negative, but VZV specific IgG antibody positive, and her brain MRI was found to be normal. With the early diagnosis and proper treatment, such as intravenous administration of acyclovir, stellate ganglion block and Yamamoto New Scalp Stimulation (YNSS), the patient completely recovered, without psychoneurological sequelae. Herein, we present this case, with a discussion of the relevant literature on the incidence, pathophysiology, diagnosis and management of central nervous system VZV involvement.

Aesthetic soft tissue management in facial trauma (안면 외상에서 연부조직 치료에 있어 미용적 재건)

  • Chung, Kyu Jin;Kim, Tae Gon;Lee, Jin Ho
    • Journal of the Korean Medical Association
    • /
    • v.61 no.12
    • /
    • pp.715-723
    • /
    • 2018
  • Facial soft tissue injury due to trauma is common. Severe damage of soft tissue causes functional and cosmetic problems. In the initial evaluation of patients with facial trauma, airway maintenance and respiratory maintenance are the most important. The principles of treatment include adequate irrigation and debridement, primary closure, or secondary wound healing. Postoperative care such as taping, silicone gel sheeting, and sun screening is important to prevent scarring. The scalp and forehead are abundant in blood and can cause severe bleeding. The eyelid is very thin and has a multi-layered structure, requiring accurate suturing and reconstruction of the layers. It is advisable to determine the presence of hematoma in the ear and treat it. When the cheek area is damaged, it is necessary to identify and treat the damage of the parotid gland and the facial nerve branch. The lips should be sewn with the white roll of lip and vermillion.

Comparison of postoperative pain according to the harvesting method used in hair restorative surgery

  • Kim, Yang Seok;Na, Young Cheon;Park, Jae Hyun
    • Archives of Plastic Surgery
    • /
    • v.46 no.3
    • /
    • pp.241-247
    • /
    • 2019
  • Background Postoperative pain is one of the most common concerns of patients undergoing hair transplantation surgery. Because most patients are satisfied with the cosmetic improvement after transplantation, amelioration of postoperative pain would help to increase patient accessibility to hair restorative surgery and greatly impact patient satisfaction with the final cosmetic results. This study was performed to investigate postoperative pain after hair transplantation. Methods In total, 241 patients (202 who underwent follicular unit transplantation [FUT] and 39 who underwent follicular unit extraction [FUE]) were eligible for the study. Postoperative pain was evaluated on postoperative days 1, 2, 3, 4, 5, and 7 using the Wong-Baker Faces Pain Scale. The patients' medical records were retrospectively reviewed for information on the harvesting method, number of transplanted grafts, size of donor design, and laxity, elasticity, and glidability of the scalp in relation to postoperative pain. Results Postoperative pain after hair transplantation, assessed with the Wong-Baker Faces Pain Scale, seemed to provide very subjective results. None of the variables were correlated with postoperative pain in the FUT group. Such pain, however, tended to disappear by postoperative day 3. Patients in the FUE group experienced significantly less severe pain than those in the FUT group. Conclusions Postoperative pain was significantly less severe in patients whose donor hair was harvested by the FUE than FUT method. Postoperative pain had almost disappeared by postoperative day 3 in the FUT group, whereas only minimal pain was present even on postoperative day 1 in the FUE group.

Free Tissue Transfer in Sickle Cell Disease: A Case Report and Systematic Review

  • Anne Huang;Ronak A. Patel;Lawrence J. Gottlieb
    • Archives of Plastic Surgery
    • /
    • v.50 no.3
    • /
    • pp.315-324
    • /
    • 2023
  • Hemoglobinopathies such as sickle cell disease (SCD) are traditionally considered a relative contraindication to free tissue transfer, due to concerns that erythrocyte sickling will increase the risk of microvascular thrombosis and flap failure. This article describes a case report with the successful use of free tissue transfer in a patient with SCD and provides a systematic literature review on free tissue transfer in SCD. A retrospective chart review was performed of a patient with SCD who underwent free tissue transfer at the authors' institution. A systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed using the keywords "free tissue transfer," "free flap," or "microsurgery" and "sickle cell" on PubMed, Ovid/Medline, and Scopus. A 29-year-old male with delayed presentation of an electrical burn to the face and scalp underwent wound closure with a free anterolateral thigh flap. Key management principles included red blood cell transfusion to keep hemoglobin S under 30% and hemoglobin greater than 10 g/dL, maintenance of hydration, normothermia, adequate analgesia, and postoperative anticoagulation. Systematic literature review identified 7 articles describing 13 cases of free tissue transfer in 10 patients with SCD, with combined complete free flap success in 10 of the 13 flaps. Free tissue transfer can be successfully performed in patients with SCD. However, evidence on the optimal management of this unique patient population in the perioperative period after free tissue transfer is limited to case reports in the literature.

SURGICAL MANAGEMENT OF THE TUMOR IN THE PARAPHARYNGEAL SPACE AND INFRATEMPORAL FOSSA USING ZYGOMATIC ARCH AND MANDIBULAR OSTEOTOMY (하악골 및 관골궁 절단술을 이용한 측두하와와 인두주위간극에 발생한 종양적출술 1례)

  • Lee, Bong-Seo;Nam, Jung-Soon;Koo, Myoung-Sook;Kim, Shin-Yu;Kwon, Dae-Hyun;Lee, Yong-Gyu;Kwon, Tae-Geon;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.27 no.6
    • /
    • pp.565-569
    • /
    • 2001
  • A new surgical approach to the area of the infratemporal fossa and parapharyngeal space is described. This approach results in a wide-field exposure of the infratemporal fossa, pterygomaxillary space and parapharyngeal space. We used two osteotomies on the patient's mandible and temporary resection of zygomatic arch for superior margin of tumor. Lower lip splitting was not needed because the incision was started in the frontal scalp, curved in front of and below the external auditary canal, and extended anteriorly to the greater horn of hyoid bone on the neck along a skin crease. We had good results without sacrifice of the facial nerve, mandibular function and sensory supply of the face and oral cavity.

  • PDF

Clinical Guidelines for Hwabyung IV. (Medications & Acupuncture and Moxibustion) (화병 임상진료지침 IV. (약물치료와 침구치료))

  • Kang, Hyung-Won;Lee, Seung-Gi;Lee, Jae-Hyuk;Park, Bo-Ra;Lyu, Yeoung-Su
    • Journal of Oriental Neuropsychiatry
    • /
    • v.24 no.spc1
    • /
    • pp.37-46
    • /
    • 2013
  • Objectives : The Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry has attempted to develop the 'Clinical Guidelines for Hwabyung'. Methods : The Hwabyung Research Center constructed a committee of experts and advisory group. Relevant literature was collected and evaluated in order to find out effective Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping of Hwabyung. Results : We found some evidences that proved the effectiveness of Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping in the treatment of Hwabyung. 1) We recommend Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, cupping, psychotherapy and management, other therapeutic approaches and education for Hwabyung. 2) Pharmacotherapy (Herbal medicine) should be determined according to the pattern identification of Korean medicine. Further, the prescription should be cost-effective, safe and have no side effects. Also, the interaction between Herbal and Western drugs should be considered carefully. 3) There are general acupuncture, scalp acupuncture, Pharmacopuncture, Sa-am acupuncture as well as acupuncture treatments for Hwabyung. 4) Moxibustion and cupping are useful, relieving various somatic symptoms of Hwabyung. Conclusions : Pharmacotherapy (Herbal medicine), Acupuncture and Moxibustion, Cupping for Hwabyung were studied. We hope that the 'Clinical Guidelines for the Treatment of Hwabyung' are helpful for oriental medical doctors and patients.