• Journal of Veterinary Clinics
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• v.28 no.6
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• pp.555-561
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• 2011

Laparoscopic surgery is a well-established alternative to open surgery across disciplines. However, in veterinary medicine, laparoscopic surgery in dogs was rarely reported because of small abdominal size for multiple ports insertion. The concept of single-incision laparoscopic surgery (SILS) is to perform the entire laparoscopic operation through a single incision rather than conventional multiple small skin incisions. Indirect evidence of potential benefits of SILS, decreases operative morbidity related to reduction in port size, already exists. Therefore, this study was performed to evaluate the safety and feasibility of the modified form of SILS using flexible endoscope in Cholecystectomy before clinical adoption. A 2 cm single periumbilical incision was performed, and flexible endoscope was introduced into the abdominal cavity. A laparoscopic grasper was inserted into the abdominal cavity for the traction of gall bladder. Cystic duct and artery were ligated by 5 mm Hem-o-lok$^{(R)}$. Then, gall bladder was dissected and resected from the liver with 5 mm Autonomy Laparo-Angle Maryland dissector and endoscopic needle knife. Resected gall bladder was wrapped by using specimen pouch and was retrieved through abdominal incision from the cavity. All three gall bladders were successfully removed. Hematological changes were not observed during examination periods. No leakage sign was identified at necropsy. The flexible endoscope, as distinct from conventional rigid laparoscope, allows the visualization from various angles and the wide range of motion, result in less crowding.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.2
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• pp.97-105
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• 2022

Background: The pentadecapeptide BPC-157 has been shown to have anti-inflammatory and wound healing effects on multiple target tissues and organs. Peptides have potent anti-inflammatory effects on periodontal tissues in rats with periodontitis. Few studies have investigated the effect of BPC-157 on pain after dental procedures or oral surgeries. The purpose of the present study was to investigate the antinociceptive effects of BPC-157 on postoperative incisional pain in rats. Methods: Sprague-Dawley rats were randomly divided into five groups: control (saline with the same volume), BPC10 (10 ㎍/kg of BPC-157), BPC20 (20 ㎍/kg of BPC-157), BPC40 (40 ㎍/kg of BPC-157), and morphine (5 mg/kg of morphine). A 1-cm longitudinal incision was made through the skin, fascia, and muscle of the plantar aspect of the hind paw in isoflurane-anesthetised rats. Withdrawal responses were measured using von Frey filaments at 0, 2, 6 h and 4, 7 d after incision. The formalin test was also performed to differentiate its anti-nociceptive effect from an inflammatory reaction or central sensitization. Pain behavior was quantified periodically in phases 1 and 2 by counting the number of flinches in the ipsilateral paw after injection with 30 µL of 5% formalin. Results: The threshold of mechanical allodynia was significantly increased in the BPC10, BPC20, BPC40 and morphine groups compared with that in the control group at 2 h. These increasing thresholds then returned to the levels of the control group. The BPC-157 group showed a much higher threshold at 4 days after incision than the control group. The thresholds of the BPC groups, except the morphine group, were normalized 7 days after incision. The flinching numbers of the BPC10, BPC20, BPC40 and morphine groups were significantly decreased in phase 1, but there was no decrease in the BPC-157 groups except the morphine group in phase 2. Conclusions: BPC-157 was effective only for a short period after incision. It was also effective during phase 1 but not during phase 2, as determined by the formalin test. BPC-157 might have a short antinociceptive effect, even though it has anti-inflammatory and wound healing effects.

• Journal of Korean Biological Nursing Science
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• v.5 no.1
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• pp.23-33
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• 2003

This morphological study was carried out to investigate the healing effect of open and occlusive dressing on rabbit skin wounds. The male white rabbits were given incision wound measuring 1.0cm in length and excision wound measuring $1.0{\times}0.2cm$ respectively on backs. Five rabbits among their received sterilization with beta dine twice a day and kept wound open. Another group of rabbits received sterilization and occlusive dressing with application of 1% sulfadiazine ointment and covering of gauze. The rabbits were observed at 5, 10, and 15 days after dressing with light microscope. The results were as follows. Both incision and excision wounds received open and occlusive dressing respectively revealed formation of scab and regeneration of epidermal epithelial cells at wound margin. The superficial dermis showed infiltration of neutrophils, monocytes, and lymphocytes, fibroblastic proliferation, and edema. On 10 days after opera and occlusive dressing the scab had disappeared and regeneration of epidermal epithelium was completed. The capillaries and inflammatory cells were decreased in number. However, edema and fibroblastic proliferation were more pronounced. On 15 days after opera and occlusive dressing, there were keratinization of regenerated epidermal epithelium, loss of inflammatory infiltration, edema, and capillary proliferation, and increase of fibroblastic proliferation and collagen fibers. The amounts of scars were less in incision wound than of excision one. There were no differences in healing processes between both dressing methods. According to the above results, it was conceived that sterilization of wound is more important in wound healing than dressing method in trivial wounds.

• Journal of Veterinary Clinics
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• v.29 no.5
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• pp.368-371
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• 2012

The present study evaluated the outcome of use of thoracostomy tube tunneling technique under the latissimus dorsi muscle for the evacuation of postoperative pneumothorax induced by thoracotomy in 11 dogs. A stab incision was made through the skin and the latissimus dorsi muscle over the rib in the fifth intercostal space caudal to a surgical window. The thoracostomy tube with a Kelly hemostat was advanced into the thoracic cavity in a cranioventral direction through the sublatissimal tunnel. After tube placement, a # 1 nylon horizontal mattress suture was placed around the skin incision. The thoracostomy tube was removed after creating a negative pressure in the thoracic cavity. Dogs were monitored after surgery for pneumothorax, subcutaneous emphysema, clinical signs including dyspnea, and tube kinking in a muscle tunnel using physical examination and postoperative radiography. There was no tube kinking in the sublatissimal tunnel in 11 dogs on introducing the tubes into the thoracic cavity. The mean (${\pm}SD$) follow-up period was $19{\pm}10$ months. On postoperative radiography, there was no evidence of pneumothorax in 11 dogs. Subcutaneous emphysema was identified around the stab incision in a dog postoperatively. The subcutaneous emphysema disappeared spontaneously within 3 days. On postoperative physical examination, there was no evidence of dyspnea in 11 dogs. Our results suggest that the sublatissimal tunneling technique for thoracostomy tube placement is effective to prevent air leakage around the thoracostomy tube while the tube remains in the thoracic cavity and along the thoracostomy tunnel after tube removal. Tunneling under the latissimus dorsi muscle should be considered the thoracostomy tube placement technique to prevent iatrogenic pneumothorax with first priority.

• Archives of Craniofacial Surgery
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• v.18 no.1
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• pp.50-53
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• 2017

Trichilemmal cysts are common fluid-filled growths that arise from the isthmus of the hair follicle. They can form rapidly multiplying trichilemmal tumors-, also called proliferating trichilemmal cysts, which are typically benign. Rarely, proliferating trichilemmal cysts can become cancerous. Here we report the case of a patient who experienced this series of changes. The 27-year-old male patient had been observed to have a $1{\times}1cm$ cyst 7 years ago. Eight months prior to presentation at our institution, incision and drainage was performed at his local clinic. However, the size of the mass had gradually increased. At our clinic, he presented with a $5{\times}4cm$ hard mass that had recurred on the posterior side of his neck. The tumor was removed without safety margin, and the skin defect was covered with a split-thickness skin graft. The pathologic diagnosis was a benign proliferating trichilemmal cyst. The mass recurred after 4months, at which point, a wide excision (1.3-cm safety margin) and split-thickness skin graft were performed. The biopsy revealed a trichilemmal carcinoma arising from a proliferating trichilemmal cyst. This clinical experience suggests that clinicians should consider the possibility of malignant changes when diagnosing and treating trichilemmal cysts.

• Archives of Plastic Surgery
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• v.41 no.3
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• pp.258-263
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• 2014

Background For early breast cancer patients, skin-sparing mastectomy or nipple-sparing mastectomy with sentinel lymph node biopsy has become the mainstream treatment for immediate breast reconstruction in possible cases. However, a few cases of skin necrosis caused by methylene blue dye (MBD) used for sentinel lymph node localization have been reported. Methods Immediate breast reconstruction using a silicone implant was performed on 35 breasts of 34 patients after mastectomy. For sentinel lymph node localization, 1% MBD (3 mL) was injected into the subareolar area. The operation site was inspected in the postoperative evaluation. Results Six cases of immediate breast reconstruction using implants were complicated by methylene blue dye. One case of local infection was improved by conservative treatment. In two cases, partial necrosis and wound dehiscence of the incision areas were observed; thus, debridement and closure were performed. Of the three cases of wide skin necrosis, two cases underwent removal of the dead tissue and implants, followed by primary closure. In the other case, the breast implant was salvaged using latissimus dorsi musculocutaneous flap reconstruction. Conclusions The complications were caused by MBD toxicity, which aggravated blood disturbance and skin tension after implant insertion. When planning immediate breast reconstruction using silicone implants, complications of MBD should be discussed in detail prior to surgery, and appropriate management in the event of complications is required.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.823-826
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• 2010

Purpose: Meningomyelocele is the most common type of neural tube defect disease. Early surgical treatment is recommended to prevent central nervous system infection. Several reconstruction methods were reported previously regarding surgical wound defect closure following meningomyelocele excision. In this article, we report two successful patients using the bilateral fasciocutaneous sliding V-Y advancement flap as a covering for meningomyelocele defects. Methods: Two patients with meningomyelocele were evaluated. Both patients were male and received their operations on the 1st and 4th day of life. After neurosurgeons completed their part of the operation, the V-Y advancement flap was used to close the defect. Initially a bilateral V-shape incision design was made on the skin such that the base of the V-flap measures identical to the size of the wound defect. An incision was made down to the fascia in order to allow the V-flaps to slide into the defect. Subfascial dissection was performed up to 1/3 to 1/4 the length of the V-flap from the wound while minimizing injury to the perforating vessels. Results: Both patients were treated successfully and there was no evidence of complication in 2 months follow up. Conclusion: Several reconstruction methods such as local flaps, skin graft and myocutaneous flaps were reported regarding meningomyelocele surgical wound defect closure. Bilateral fasciocutaneous sliding V-Y advancement flap is an easy method without involving the underlying muscles or a secondary skin graft in a short operation time. Therefore we recommend this treatment option for reconstruction of the wound defect following meningomyelocele excision.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.615-618
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• 2008

Purpose: Pyoderma gangrenosum is a rare cutaneous ulcerative disease. First described in 1930, the condition is characterized by progressive ulceration with deeply undermined purple-red edge. The lower extremities are most commonly affected but other parts of the skin and mucous membranes may also be involved. Although medical treatments with topical wound therapy are commonly used, surgical intervention is still controversial. In this paper, we report an atypical case of pyoderma gangrenosum which was characterized by extensive soft tissue breakdown. Methods: A 27-year-old male patient was referred to our institution with a $7{\times}8cm$ sized deeply undermined ulceration with pus-like discharge and fever. Incision and drainage was performed at another clinic 3 days prior to admission to our institution. After a thorough physical examination and the MRI review, a diagnosis of necrotizing faciitis was made. Accordingly, fasciotomy and debridement was performed. However, the wound enlarged progressively and the patient remained highly febrile for 9 days after the treatment. Septic screening did not reveal any occult infection. After a secondary review of the case, the initial diagnosis of necrotizing fasciitis was rejected and changed to pyoderma gangrenosum. With the use of dexamethasone intravenously, the wound improved dramatically and the fever was eliminated. Steroid mediation was tapered with duration of 1 month. The wound was stabilized and subsequently covered with split-thickness skin graft. Results: Split-thickness skin grafting with 1 : 1.5 mesh was successfully taken. Conclusion: Initial clinical features of pyoderma gangrenosum are very similar to that of necrotizing fasciitis. High fever and progressive ulceration with severe pain could invite earlier surgical approach. The advancing wound margins (the well defined violaceous, undermined border and necrotic ulcer base) and lack of isolation of pathogenic organism was used to make the correct diagnosis of pyoderma gangrenosum. We achieved a good result with proper medication and split-thickness skin graft.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.87-92
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• 2010

Purpose: The purpose of this study was to investigate the effect of electrical stimulation (ES) on the wound closure rate, collagen deposition, and TGF-${\beta}$1 mRNA expression in skin wound of rat. Methods: Twenty male Sprague-Dawley rats (222~271 g) were randomly divided into ES (n=10) and control group (n=10). The ES group received a cathodal stimulation with 50 V at 100 pps for 30 minutes for 7 days, while the control group was not given electrical stimulation. The wound closure rate, collagen density and TGF-${\beta}$1 mRNA ratio were measured. Results: The mean wound closure rates in the ES and control groups were $83.79{\pm}16.35$% and $51.57{\pm}17.76$%, respectively (p<0.001). The collagen density in the ES and control groups were $46.67{\pm}10.68$% and $25.03{\pm}13.09$%, respectively (p<0.001). The TGF-${\beta}$1 mRNA ratio in the ES and control groups were $1.35{\pm}0.60$ and $0.63{\pm}0.30$, respectively at 6 hours post-wound (p<0.01) and $1.69{\pm}0.47$ and $1.32{\pm}0.28$, respectively, at 7 days post-wound (p<0.05). Conclusions: ES accelerated the wound closure rate of skin incision wounds and was accompanied by an increase in collagen deposition in the regenerating dermis. In addition, ES increased TGF-${\beta}$1 mRNA expression during wound healing process. These findings suggest that ES may activate TGF-${\beta}$1 expression, and may increase synthesis activities of fibroblasts in regenerating skin wounds in rats.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.6
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• pp.1261-1266
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• 2009

The wrinkle is a typical sign showing aging. These days lots of people want to have a young and healthy appearance and many medical doctors are studying about wrinkle cure. In fact a young face without wrinkle looks more healthy and energetic. Therefore the wrinkle cure is important at the point of medical view. This research is an investigation of several studies about wrinkle cure using acupuncture needle. We have to consider the problem of the whole body which is related 12 meridians and meridian muscles as well as topical skin and tissues. There are three parts affecting wrinkle formation and cure. The first is a meridian and meridian muscle, the second is a local muscle and fascia on the head and neck, the third is a local skin structure. There are three kinds of method to cure the wrinkle locally. The first one is the perpendicular treatment of acupuncture, called the microneedle therapy, the process of this method is that lots of microneedles stab in the skin to dermis. The second one is the transverse treatment of acupuncture. The process of this method is that an acupuncture needle inserts just under the wrinkle skin. The third one is the incision treatment of acupuncture, called subcision, the process of this method is to cut the fibrous band which connect from the facial muscle to SMS(superficial musculoaponeurotic system) using cuttable needle. The hematoma after treatment let a collagen increase.