• 제목/요약/키워드: skin incision

검색결과 247건 처리시간 0.031초

Supraorbital Keyhole Approach for Intracranial Aneurysms : Transitioning from Concerns to Confidence

  • Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • 제63권1호
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    • pp.4-13
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    • 2020
  • For surgical minimalism to reduce iatrogenic traumatization, a supraorbital keyhole approach has already been successfully applied to treat many unruptured anterior circulation aneurysms. However, using this minimal approach also raises several technical concerns due to the small cranial opening and cosmetic impact of a facial incision. Yet, such technical limitations can be overcome by using favorable surgical indications, slender surgical instruments, and optimized surgical techniques, while excellent cosmetic outcomes can be achieved using a short skin incision located <1 cm from the supraorbital margin, reconstruction of any bone defects around the bone flap, and meticulous wound closure. Thus, given such reassuring surgical results, in terms of the clipping status, neurological effects, and cosmetic outcomes, any concerns can be transitioned into confidence.

개에서 난소자궁절제술과 양측 겸부 난소절제술의 비교 (Comparison of Ovariohysterectomy and Bilateral Flank Ovariectomy in Dogs)

  • 박용상;김준호;류재규;강태영
    • 한국임상수의학회지
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    • 제30권4호
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    • pp.253-257
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    • 2013
  • The objective of this study was to compare the total surgical time, pain score and hemorrhage after ovariohysterectomy (OVH) and bilateral flank ovariectomy (BFOVE) with hemoclips in dogs. OVH was operated on six dogs and BFOVE was performed on six dogs. In BFOVE group, both ovarian pedicle hemostasis applied using hemoclips after removing ovaries. Total surgical time was recorded from starting incision of skin to closure last skin suture. Pain score was measured at 2, 6, 12, and 24 hours after surgery based on University of Melbourne Pain Scale (UMPS). Hemorrhage around clipping area, uterus, abdominal muscles, and skin were monitored after surgery. BFOVE technique could reduce total surgical time and pain after surgery. There was no hemorrhagic problems near ovarian pedicles following surgery. BFOVE with hemoclips could be useful and recommended for sterilization in dog.

광배근 피판의 공여부에 대한 문제점의 분석 (Complications of Donor Site in Latissimus Dorsi Muscle Flap)

  • 정덕환;한정수;조창현
    • Archives of Reconstructive Microsurgery
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    • 제8권2호
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    • pp.149-153
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    • 1999
  • Purpose : To investigate the complication of donor site in latissimus dorsi muscle flap. Materials and Methods : From April 1983 to March 1999, forty patients with latissimus dorsi muscle flap for reconstruction of extremity and with a follow-up period of more than 12 months were included. We analysed the complication, shoulder function, degree of shoulder muscle weakness, skin scar width after operation. Results After 1 year, skin scar widening in 12 cases(30%), limitation of shoulder motion in 9 cases(12.5%), muscle weakness in 14 cases(17.5%) were found. Conclusion. The rate of complication at donor site after latissimus dorsi flap operation is around 10%. To minimize the complication, avoiding axillary skin incision, minimal invasive harvesting by endoscopy, meticulous suturing of subcutaneous layer are needed.

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Limited Incisional Drainage and Negative-Pressure Wound Therapy in an Acute Morel-Lavallée Lesion

  • Choi, Eui-Sung;Yang, Jae-Young;Ahn, Byung-Hyun
    • Journal of Trauma and Injury
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    • 제34권1호
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    • pp.75-78
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    • 2021
  • A Morel-Lavallée lesion is a post-traumatic closed degloving soft tissue injury after blunt trauma. Infection and skin necrosis frequently occur if it is not treated properly in the early stages. However, there is no clearly established treatment algorithm. In the acute stage, it is mainly treated with aspiration, simple compression, and incisional drainage. In the chronic stage, sclerotherapy is usually performed. If skin necrosis develops, the necrotic tissue is resected and a skin graft is needed. We describe a case of acute Morel-Lavallée lesion in the buttock region that was treated with limited incisional drainage and negative-pressure wound therapy, and also present a review of the literature.

결막절개를 제거통한 아래 눈꺼풀 부위의 미세자가지방이식편의 (Removal of Microfat Graft in Lower Eyelid with Transconjunctival Approach)

  • 신종인;장정우;김창연;김연환
    • Archives of Plastic Surgery
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    • 제38권1호
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    • pp.48-52
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    • 2011
  • Purpose: Microfat graft is a common procedure for correcting tear trough deformity and dark circle. Because the tissue in this area is very thin, the grafted fat, sometimes, induces palpable lumps and uneven skin contour. When it happens, the surgical removal of the grafted fat is often needed. The authors made attempt of transconjunctival approach for removal, and this made infraorbital fat repositioning possible at the same time. Methods: 15 female patients with history of microfat graft on lower eyelid, got operation for the grafted fat removal with transconjunctival approach from April of 2009 to July of 2010. The dissection was performed in accordance with infraorbital fat repositioning surgery. Through the transconjunctival incision, knotted fat on orbital septum and orbicularis oculi muscle was removed without damage on skin. After grafted fat removal, subperiosteal space was made 1~2 mm below the inferior orbital rim by elevating periosteum. With preserving orbital septum, infraorbital fat was repositioned and anchored to subperiosteal space. Finally, transconjunctival incision was closed with absorbable suture material. Results: 14 patients in the study showed satisfactory results. The problems like uneven skin contour and knotted fat mass, were all solved. In only one patient, incomplete correction was observed, as bulging on her right lower eyelid still remained. One patient complained of transient numbness on lower eyelid, but there was no specific complication other than this. Conclusion: The authors attempted the method of transconjunctival approach to remove former grafted fat in lower eyelid and reposition infraorbital fat simultaneously. Since the study brought great results, the method would be helpful to patients and surgeons.

비복근 파열 후 혈종에 병발한 광범위 심부 농양의 내시경적 치료 - 1예 보고 - (Endoscopic Treatment of Extensive Deep Abscess Occurred in Hematoma After Rupture of Gastrocnemius Muscle - A Case Report -)

  • 전호승;문찬삼;노행기;전성광;김종민
    • 대한관절경학회지
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    • 제15권2호
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    • pp.117-120
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    • 2011
  • 광범위 심부 농양의 치료는 일반적으로 절개 및 배농이 원칙이다. 그러나 철저한 절개배농을 위해서는 피부 절개의 범위가 커지게 된다. 또한 큰 절개에도 불구하고 좋지 않은 수술 영상 및 시야 확보가 힘든 경우가 있을 수 있어, 수술 과정에서 정상 조직에 대한 추가적인 손상과 큰 절개 반흔이 문제가 될 수 있다. 이를 해결하고자 저자들은 비복근 파열로 인한 혈종에 병발한 광범위 심부 농양에 대하여 내시경적 치료를 시행하여 만족스러운 결과를 얻었으며, 기존에 보고된 바 없기에 문헌고찰과 함께 이를 보고하고자 한다.

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Breast augmentation surgery using an inframammary fold incision in Southeast Asian women: Patient-reported outcomes

  • Randquist, Charles;Por, Yong Chen;Yeow, Vincent;Maglambayan, Joy;Simonyi, Susan
    • Archives of Plastic Surgery
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    • 제45권4호
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    • pp.367-374
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    • 2018
  • Background This analysis presents patient-reported outcomes of breast augmentation procedures performed in Singapore using an inframammary fold incision and the "5 Ps" best practice principles for breast augmentation. These data are the first of their kind in Southeast Asian patients. Methods Through a retrospective chart review, patients who underwent primary breast augmentation with anatomical form-stable silicone gel breast implants using an inframammary fold incision were followed for ${\geq}6$ months postoperatively. The BREAST-Q Augmentation Module (scores standardized to 0 [worst] - 100 [best]) and Patient and Observer Scar Assessment Scale (POSAS; 1 [normal skin] to 10 [worst scar imaginable]) were administered. Responses were summarized using descriptive statistics. Patient-reported events were collected. Results Twenty-two Southeast Asian patients (mean age, 35.1 years) completed ${\geq}1$ postoperative BREAST-Q and POSAS assessment and were assessed 11 months to 5.5 years postoperatively. The mean postoperative BREAST-Q satisfaction with breasts and psychosocial well-being scores were 69.2 and 84.0, respectively. The mean POSAS score for their overall opinion of the scar was 4.2; the mean scores for all scar characteristics ranged from 1.2 to 4.2. Over 90% of patients (20/22) said that they would recommend the procedure. Patient complaints following surgery included anisomastia (possibly pre-existing; n=2), sensory loss at the nipple (n=2) or around the nipple (n=3), scarring (n=4), and slight capsular contracture (n=1). No patients required reoperation. Conclusions Southeast Asian patients reported high long-term satisfaction scores on the BREAST-Q scale and with their scar characteristics following breast augmentation using an inframammary fold incision, and nearly all said they would recommend this procedure. No reoperations were necessary in patients assessed for up to 5.5 years postoperatively.

Sutureless Laparoscopic Ovariectomy in Small Dogs Using Two 3-mm Portal Sites

  • Hyeon-Han Ku;Ho Hyun Kwak;Jun-Hyung Kim;Kyung-Mee Park;Heung Myong Woo
    • 한국임상수의학회지
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    • 제39권6호
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    • pp.319-325
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    • 2022
  • Two-port laparoscopic ovariectomy (Lap-OVE) has been performed in small dogs, using 3-mm and 5-mm portal sites, and is associated with reduced surgical stress and postoperative pain. However, extension of the incision is often needed to extract the ovaries. In this study, we aimed to minimize invasiveness by using smaller-sized cannulas as well as a novel technique for ovary extraction. Lap-OVE was performed on six, healthy female dogs (range, 3 to 7.2 kg) using two 3-mm midline portals. The middle finger of a size M nitrile glove was cut at its base and sterilized preoperatively. The ovary was suspended at the body wall using a 1-0 blue nylon needle, and the ovarian pedicle and ligaments were transected using a 3-mm bipolar forceps. To facilitate the glove passing through the 3.9-mm port, it was turned inside out to expose the smooth inner surface, before being inserted into the abdominal cavity with an applicator. Both ovaries were placed inside, and the mouth of the glove was exteriorized through the port with a laparoscopic grasping forceps. The ovaries were morcellated inside the glove, using Adison-Brown tissue forceps and iris scissors, which enabled safe extraction without incision enlargement. Median incision lengths were 4.3 mm (3.5-mm cranial cannula) and 4.8 mm (3.9-mm caudal cannula). An advantage of this procedure was that there was no need for skin sutures. In conclusion, using our novel technique, sutureless Lap-OVE was possible in small dogs using two 3-mm portal sites without additional incision.

수술에 사용하는 생리식염수의 오염수준 변화 (A Study on the Contamination of Saline Used in the Operation)

  • 윤혜상
    • 대한간호학회지
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    • 제25권1호
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    • pp.99-109
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    • 1995
  • Post-operative wound infections have been the serious problems in nursing care in the operating room and appear to be strongly related to the infection occurring during the operation. The purpose of this study is to identify the level of contamination in saline used in the operation and also examine the correlation between the contaminated saline and the length of the operation, and unclean atmospheric factor. Subjects for this study include 13 cases of operation performed at the operative theatre of a hospital in Seoul area. Test samples and related data were collected from this medical facility between Oct. 6 through Dec. 10, 1994 by the author and anurse who worked in the operating room. For the study, multiple batches of saline sample were collected at the various time intervals duringthe operation and filtered through the membrane filters. Viable microorganisms retained on the filters were cultured on the appropriate culture media and the levels of existing cells in saline were enumerated according to Koch's method. In the analyses of the data, Pearson's correlation coefficient was obtained for the examination of relationship between the length of operation and numbers of microorganisms existing in saline and for the comparison of the differences in numbers if microrganisms in saline sample collected at the various operative stages, e. g. pre-incision, excision and skin suturing stages, ANOVA and Scheff Tests were performed. The results of this study are summarized as follows. 1) The lenth of the operation and numbers of microorganisms in the saline used in the operation appeared to be significantly correlated (r=0.5467, P<0,001). 2) In case of saline exposed to air, but not used in the operation, the length of exposure to the air and the numbers of microorganisms present in saline also showed an apparent correlation(r=0.5087, P<0. 001). 3) The frequencies of occurrence of microorganisms in saline used in the operation and in saline exposed only to the air in the given time showed significant differences(t=3.73, p=.0000). 4) In case of saline used in the operation, there is significant differences in its numbers of contained microorganisms between the operative stages ; pre-incision, excision, and skin suture (F=17.7500, p=.0000). 5) In case of saline exposed only to the air in the given time, there is significant differences in its numbers of contained microorganisms between the operative stages . pre-incision, excision, and skin suture(F=6.3807, p=.00031).

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Effects of Danggwieumja on the Healing of Full-Thickness Skin Injury in Rat

  • Kim, Bum-Hoi
    • 동의생리병리학회지
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    • 제25권5호
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    • pp.887-893
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    • 2011
  • The purpose of this study was to investigate the wound healing effects of Danggwieumja (DG), which is commonly used for skin inflammation, skin wound, skin pruritus, and chronic hives etc. The 1.5 cm ${\times}$ 1.5 cm full-thickness skin wound was induced to two groups, DG (n=16) and Saline (n=16) group. The DG extract and Saline were orally administrated daily for 15 days after skin wound induction. Then, the body weight of rats and the congestion indices were daily measured for 15 days after skin wound induction. The wound contractions and epithelizations were also measured. The wound contractions were daily measured for 15 days after wound induction and wound epithelizations were measured for 8 days from day 7 after wound induction. For evaluating angiogenesis, the immunoreactivities of vWF and VEGF protein were measured immunohistochemistrically on day 15. In results, although the percentage increases in mean body weight of rats in the DG and Saline groups hve no significant differences, DG extract decreased the time of wound healing and congestion around wound, and improved wound contraction and epithelization. The contraction percentage of DG group was significantly increased on day 5 (P<0.05) and day 7 (P<0.01) than that of Saline group. DG group showed significant increase of wound epithelization on day 7 (P<0.05) as compared to Saline group. Moreover, DG extract reduced the inflammation of skin dermis and promoted the growth of vascular vessels of dermis by accelerating vascular endothelial growth factor (VEGF) protein. These results suggest that DG has the beneficial effects on skin incision wound and can be the suitable wound healing agent for various surgical wounds.