• Physical Therapy Korea
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• v.9 no.3
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• pp.93-99
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• 2002

Traditionally, ultraviolet (UV) has been used for treating the pressure sore and skin wound. The effects of UVA and UVB radiation on disinfection have been reported. The purpose of this study was to examine the effectiveness of UVC radiation on disinfection of Escherichia coli, Staphylococcus aureus, Salmonella typhimurium in vitro. Three bacterium were radiated by UVC (250 nm, 20 seconds) and incubated at $37^{\circ}C$ for 24 hours at the agar culture medium. Kill rates of all three bacterium were 99.9%. UVC radiated on three kinds of bacterium for 30 or 60 seconds. Kill rates were 99.9% both 30 and 60 seconds. This data suggests that UV light at 250 nm could be a useful method to minimize infection and shorten healing time in pressure sore and skin wound condition.

• Journal of Medicine and Life Science
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• v.15 no.1
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• pp.23-26
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• 2018

The most common surgical repair method for fingertip injuries are replantation, flap coverage, and skin graft. In fingertip injury cases, acellular dermal matrix (ADM) is generally used in a two-stage operation. In the present case, only ADM was used in a 67-year-old male patient with a right fifth fingertip injury. The patient was undergoing chemotherapy after surgery for colon cancer, preventing prolonged hospitalization. In addition, wound healing was likely to be problematic. As a typical surgical method might have been difficult to apply in such a patient, we performed a one-stage operation, using only ADM on the injured area. Postoperative followup for 3 months showed good wound healing. Accordingly, we report a successful treatment outcome using ADM alone for a fingertip injury.

• Archives of Plastic Surgery
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• v.48 no.3
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• pp.329-332
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• 2021

Calcific myonecrosis is a rare condition in which hypoperfusion due to compartment syndrome causes soft tissue and muscle to become calcified. As calcific myonecrosis gradually deteriorates, secretions steadily accumulate inside the affected area, forming a cavity that is vulnerable to infection. Most such cases progress to chronic wounds that are unlikely to heal spontaneously. After removing the calcified tissue, the wound can be treated by primary closure, flap coverage, or a skin graft. In this case, a 72-year-old man had extensive calcific myonecrosis on his left lower leg, and experienced swelling and increasing tenderness. After removing the muscle calcification, we combined two anterolateral thigh free flaps, which were harvested from the patient's right and left thigh, respectively, to reconstruct the wound with a dead-space filler and skin-defect cover at the same time. The patient recovered without revision surgery or major complications.

• Journal of Medicine and Life Science
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• v.18 no.3
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• pp.56-60
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• 2021

In recent decades, tissue engineering advances have led to more skin substitutes becoming available. Acellular dermal matrix, initially developed for use in the treatment of full-thickness burns, is made by removing the cellular components from the dermis collected from donated bodies or animals. This class of scaffold is used to replace skin and soft tissue deficiencies in a variety of fields, including breast reconstruction, abdominal wall reconstruction, and burn treatment. Herein, we provide a detailed review of the clinical applications of acellular dermal matrix.

• 한국생물공학회:학술대회논문집
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• 2003.04a
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• pp.92-94
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• 2003

The standard cultured sheet grafts for large full-thickness burn wound has been tempered by weak points such as long culture periods, difficulty in handling the fragile sheets, high costs and the detachment of the skin cells from the culture dishes by enzymatic digestion. Here we report on a new technique of using skin cells cultured on spherical microcarriers for skin regeneration. We cultured the human skin cells on biodegradable polymer microcarriers and transplanted onto wounds in the back of nude mice. After 21 days, histological examination showed the regeneration of epithelium. The technique developed in this study overcomes the drawbacks of the current artificial skin grafts, and could be utilized as an efficient skin wound regeneration therapy.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.607-612
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• 2005

A traditional tie-over dressing may be applied to support the take of a skin graft. Although there are many advantage of this method, it has significant disadvantages, including time-consuming application. Furthermore, when the dressing is changed, the gauze becomes hard and can be stuck to the graft, causing damage and pain upon removal. The purpose of our study is to evaluate the effect of semi-occlusive dressing using polyurethane foam and film dressing($Allevyn^{(R)}$, $Opsite^{(R)}$) after full thickness skin graft. The authors treated 45 cases including burn scar contracture(n=38), syndactyly (n=1), absence of nipple-areolar complex(n=4), traumatic skin defect(n=1) and contact burn(n=1) with authors' method and 39 patients including burn scar contracture (n=39) with the tie-over dressing between 2000 and 2004. The patients in polyurethane foam and film dressing group ranged from 1 to 62 years of age (mean age, 15.1 years) and the patients in tie-over dressing group ranged from 2 to 60 years of age(mean age, 21.3 years). The postoperative results were analyzed according to the following measures: (1) the duration of graft-taking, (2) the admission period, (3) complications. Compared with the traditional tie-over dressing, polyurethane foam and film dressing was shown to be more successful in a reduced duration of graft-taking, in which was similar to the former in the rate of graft-taking, a reduced admission period and patient's discomfort. We concluded that semi-occlusive dressing using $Allevyn^{(R)}$ and $Opsite^{(R)}$ was an effective method after full thickness skin graft, which was easy to shape to difficult body locations, such as web spaces, fingers and maintains a moist environment for wound healing and does not stick to the wound.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.847-849
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• 2010

Purpose: Traditional radical surgery for vulvar cancer produces severe skin and soft tissue defects in the vulvar and vaginal area. Vulvoperineal V-Y advancement fasciocutaneous flaps have limitations in advancement and tension at the wound margin and vaginal orifice area, causing wound disruption or vaginal wall exposure. Therefore, we designed the "Butterfly flap" using a vulvoperineal V-Y advancement fasciocutaneous flap and an inguinal rotational skin flap for 3-dimensional reconstruction of vagina and vulvar area. Methods: A 27 year-old female was diagnosed with vulvar intraepithelial neoplasia. Radical vulvectomy and full-thickness-skin-graft was performed. We designed a vulvoperineal V-Y advancement fasciocutaneous flap as the greater wing and inguinal rotational skin as the lesser wing. After flap elevation, the inguinal flap was rotated $180^{\circ}$ to reconstruct the labia major and vaginal orifice. The perineum was reconstructed using V-Y advancement flaps. Results: The flap survived completely, without any complications. After 6 months, the patient was able to perform normal sexual activities and after 18 months, the patient was able to give birth to normal child by caesarean section. Conclusion: The traditional vulvoperineal V-Y advancement fasciocutaneous flap is thin, reliable, easily elevated and matches local skin quality. However, the vaginal wall becomes exposed due to limited advancement and tension of the flap. The "Butterfly flap" using a vulvoperineal V-Y advancement fasciocutaneous flap and an inguinal rotational skin flap is useful for the release of vaginal orifice contracture, reconstruction of the labia major, and 3-dimensional reconstruction of vagina and vulvar area.

• Archives of Craniofacial Surgery
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• v.22 no.4
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• pp.183-192
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• 2021

Background: The purse-string suture (PSS) is a simple and rapid wound closure method that results in minimal scarring. It has been used to treat circular or oval skin defects caused by tumor excision or trauma. However, due to obscurity, it is not widely used, especially for the head and neck. This study aimed to modify the PSS to obtain predictable and acceptable results. Methods: A total of 45 sites in 39 patients with various types of skin and soft tissue defects in the head and neck were treated with PSS. We used PDS II (2-0 to 5-0), which is an absorbable suture. Minimal dissection of the subcutaneous layer was performed. The suture knot was hidden by placing it in the dissection layer. Depending on the characteristics of the skin and soft tissue defects, additional surgical interventions such as side-to-side advancement sutures, double PSS, or split-thickness skin graft were applied. Results: All wounds healed completely without any serious complications. Large defects up to 45 mm in diameter were successfully reconstructed using only PSS. Postoperative radiating folds were almost flattened after approximately 1-2 months. Conclusion: PSS is simple, rapid, and relatively free from surgical design. Owing to the circumferential advancement of the surrounding tissue, PSS always results in a smaller scar than the initial lesion and less distortion of the body structures around the wound in the completely healed defect. If the operator can predict the process of healing and immediate radiating folds, PSS could be a favorable option for round skin defects in the head and neck.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.551-556
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• 2007

Purpose: Pseudomonas aeruginosa is an etiologic agent in serious wound infection. Pseudomonas aeruginosa infection is problematic because this organism is resistant to many antimicrobial drugs. The purpose of this study was to compare the bactericidal effect of commonly used topical agents and their effect on wound healing. Methods: Pseudomonas aeruginosa-infected full-thickness skin defect was developed on the mouse to compare 3 commonly used topical agents-Betadine, 2% Gentamicin solution and 0.3% Acetic acid with the control group. Wound size change, bacterial colony counts and histologic findings of each groups were analyzed. Results: The wound size decreased in all treated groups as compared with the control group. However, there was no statistical difference. Gentamicin solution group was showed the lowest bacterial colony count and statistically significant difference compared with the control group(p=0.032). Other treated groups were also effective against Pseudomonas aeruginosa, but not different statistically. Histologic findings revealed that epithelialization, granulation tissue formation and microvessel proliferation were increased and necrosis and inflammation were decreased in all treated groups compared to the control group, but not different statistically. Betadine group significantly increased granulation tissue formation compared to the control group (p= 0.041). Conclusion: There is no universal topical agent that enhances most aspects of wound healing while simultaneously decreasing the bacterial concentration. However, Gentamicin solution may be an optimal topical agent for Pseudomonas aeruginosa infected wound. Further study should experiment on human with Gentamicin solution to confirm a effect on Pseudomonas aeruginosa infected wound for clinical applications.

• Archives of Plastic Surgery
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• v.45 no.6
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• pp.564-571
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• 2018

Background Chronic wounds occur due to failure of the normal healing process, associated with a lack of deposition of cellular components and a suitable microenvironment such as the extracellular matrix (ECM). Acellular dermal matrix (ADM) is viewed as an ECM substitute, and a paste-type ADM has recently been introduced. We hypothesized that CGPaste, an injectable paste-type ADM, could serve as a scaffold and promote wound healing. Methods We retrospectively studied seven patients in whom CGPaste was applied between 2017 and 2018, who had pressure ulcers, necrotizing fasciitis, diabetic foot ulcers, traumatic defects, and osteomyelitis. The goal of applying CGPaste was to achieve complete wound healing with re-epithelialization or growth of granulation tissue, depending upon the wound bed status. CGPaste was injected based on the wound size along with the application of a dressing. Results Four of the seven patients showed granulation tissue on their wound bed, while the other three patients had a bony wound bed. The mean wound area was $453.57mm^2$ and the depth was 10.71 mm. Wound healing occurred in five of the seven patients (71.43%). The mean duration of complete healing was 2.4 weeks. Two patients showed failure due to paste absorption (29.57%); these patients had wound beds comprising bone with relatively large and deep wounds ($40{\times}30$ and $30{\times}20mm^2$ in area and 15 and 10 mm in depth). Conclusions CGPaste is an effective option for coverage of small and deep chronic wounds for which a flap operation or skin grafting is unfeasible.