• 제목/요약/키워드: skin wound

검색결과 742건 처리시간 0.02초

소아 장루의 합병증 (Stomal Complications in Children)

  • 박중재;이주홍;정종도;최영철;정우식;전시열
    • Advances in pediatric surgery
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    • 제8권1호
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    • pp.11-15
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    • 2002
  • This is a 20 year analysis of the problems associated with enterostomy formation, and closure. Forty-three stomas were established in 43 patients: 23 for anorectal malformations, 11 for Hirschsprung's diseases, 4 for necrotizing enterocolitis, 3 for multiple ileal atresias, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. Thirty boys and 13 girls were included (mean age 4.8 months). Stoma complications were encountered in 13 patients (30.2 %): stomal prolapse, stenosis, obstruction, paracolic hernia, retraction, dysfunction, and skin excoriation, Four patients (9.3 %) required stomal revision. Occurrence of complications was not related to age and primary disease, but sigmoid colostomy showed lower complication rate than transverse colostomy (20.0 % vs 42.9 %, p<0.05). There were five deaths but, only one (2.3 %) was directly related to the enterostomy complication. Twenty-one stomas were closed in our hospital and complications occurred in seven patients (33.3 %). The most common complication was wound sepsis in 5 children. In conclusion, because the significant morbidity of stomal formation still exists, refinements of the surgical technique seem to be required, Sigmoid loop colostomy is preferred whenever possible.

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Reconstruction of a long defect of the median nerve with a free nerve conduit flap

  • Campodonico, Andrea;Pangrazi, Pier Paolo;De Francesco, Francesco;Riccio, Michele
    • Archives of Plastic Surgery
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    • 제47권2호
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    • pp.187-193
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    • 2020
  • Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma.

고압산소 치료에 대한 일개 권역 응급센터의 최근 10년 경험 및 제언 (Recent 10-Year Experience of One Regional Emergency Center and Recommendation for Hyperbaric Oxygen Therapy (HBOT))

  • 윤정훈;김기운;정윤석;한철수;민영기;조준필;최상천
    • 대한임상독성학회지
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    • 제11권2호
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    • pp.81-88
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    • 2013
  • Purpose: The aim of this study is to investigate current status, indications, and complications of hyperbaric oxygen therapy. Methods: A retrospective investigation of patients who underwent hyperbaric oxygen therapy at a university medical center from September 2004 to August 2013 was conducted based on patients' medical records and results of an email survey for 99 emergency centers. Results: During the study period, a total of 233 patients underwent hyperbaric oxygen therapy. Indications for hyperbaric oxygen treatment of illness or injury were as follows: 1) 151 cases of acute carbon monoxide poisoning(65.4%), 2) flap wound management, including 42 cases(18.2%), 3) skin care transplanted, including 23 cases(10.4%), 4) Burger's disease, including 5 five cases(2.1%), respectively. Total application time$^*$ frequency was 1,088 and total time was 1,239 hours. Among 233 patients who underwent hyperbaric oxygen therapy, 32 patients(13.7%) had complications: 1) otalgia in 21 cases(9.0%), 2) mastoiditis?in six cases(2.6%), 3) hemotympanum in five cases(2.1%), respectively. There were only 8 emergency centers that currently had an operational hyperbaric oxygen chamber in 77 emergency centers(10.4%). Conclusion: Indications identified through this study showed difference from current indications worldwide. It seems necessary that physicians' perception regarding application of hyperbaric oxygen therapy for more indications be changed and improved. A hyperbaric chamber capable of providing respiratory assistance and intensive care is also needed. A good network for sharing treatment experiences and a specialized team for administration of hyperbaric oxygen therapy is also required.

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Suppressive Effect of Fermented Angelica tenuissima Root Extract against Photoaging: Possible Involvement of Hemeoxygenase-1

  • Park, Yun-A;Lee, Sung Ryul;Lee, Jin Woo;Koo, Hyun Jung;Jang, Seon-A;Yun, Seung-Won;Kim, Hyun Ju;Woo, Jeong Suk;Park, Myung Rye;Kang, Se Chan;Kim, Youn Kyu;Sohn, Eun-Hwa
    • Journal of Microbiology and Biotechnology
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    • 제28권8호
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    • pp.1391-1400
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    • 2018
  • Angelica tenuissima root has historically been used as a traditional medicine in Korea. Previous studies have identified the anti-melanogenic effects of the extract of A. tenuissima root fermented by Aspergillus oryzae (FAT). This study investigated the protective effects of FAT against ultraviolet light B exposure (UVB; $30mJ/cm^2$) in HaCaT (human keratinocyte) or Hs68 (human foreskin fibroblast) skin cells. FAT treatment was able to stimulate wound healing rate at the basal condition. FAT also favored the maintenance and/or improvement of extracellular matrix impairment caused by UVB irradiation through: 1) upregulation of procollagen Type-1 synthesis and secretion; 2) suppression of MMP-1 and elastase expression. FAT was able to play a role in the attenuation of inflammatory responses caused by UVB irradiation via upregulation of photo-protective hemeoxygease-1 and suppression of proinflammatory cyclooxygenase-2 expression. After further verification of the anti-photoaging potential of FAT, it could be utilized as an effective ingredient in anti-aging and anti-wrinkle cosmetics.

대학의 안전교육 현황 및 대학생의 안전사고 대처방법 인식에 관한 연구 (A Study on Situations of Safety Education in Universities and University Students' Awareness of Coping Methods for Safety Accidents)

  • 정성일;오재연
    • 한국콘텐츠학회논문지
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    • 제16권12호
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    • pp.518-529
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    • 2016
  • 본 연구는 예비사회인을 배출하는 대학의 안전교육 현황과 대학생들의 안전사고 대처방법에 대한 인식을 조사하고자 연구되었다. 이를 위하여 광주와 대전 지역의 대학생 411명을 대상으로 설문조사를 실시하였다. 그 결과를 보면, "안전교육에 참여할 의향이 있다"고 응답한 대학생의 계열별 비중이 기타(공학, 예체능), 교육계열, 인문계열, 사회 자연계열, 의학계열 순으로 나타났으며, 안전교육의 내용으로서는 "응급처치 교육을 가장 선호"하는 것으로 조사되었다. 안전사고 대처방법에 대한 대학생들의 인식을 살펴본 결과, 모든 계열의 대학생들이 "안전교육을 받은 경험은 있으나, 실제 안전사고가 일어난다면 당황할 것 같다"고 응답하였으며, 대학생들이 주변에서 이미 경험한 적이 있는 안전사고 유형 중에서는 "피부에 상처가 나는 안전사고를 많이 경험"한 것으로 밝혀졌다. 이러한 결과는, 대학생의 안전의식과 안전역량을 향상시키기 위해서는 대학생 스스로가 위험요소를 사전에 예측하고 대응할 수 있는 습관을 기르도록 하는 안전교육을 대학의 교육과정 안에서 실시되어야 한다고 본다.

Ovadia와 Beals 제2형 또는 3형 경골 천정 골절의 제한적 내고정술을 이용한 치료 (Limited internal fixation for the treatment of the Ovadia and Beals type II or III Pilon fracture)

  • 김형천;김광열;임문섭;김진형;권준형
    • 대한족부족관절학회지
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    • 제7권2호
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    • pp.250-257
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    • 2003
  • Purpose: Pilon fracture is caused by high energy and axial compression forces, and it is often associated with severe comminution and soft tissue injury. Recently, limited internal fixation of this fracture may avoid the soft tissue complications associated with formal open reduction and internal fixation and avoid incongruity of joint margin associated with conservative treatment. We have treated Ovadia and Beals type II or III pilon fracture with limited internal fixation and the results were satisfactory. Materials and Methods: We analyzed 15 cases of Ovadia and Beals type II or III fractures who were treated by limited internal fixation(K-wire or screw fixation) from January 1995 to December 2000. The average follow up period was 20 months(range, 12 to 38 months). According to the Ovadia and Beals classification, seven cases were type II, and eight cases were type III. Radiographic results were assessed by Ovadia and Beals criteria. We also assessed the functional results by Mast and Teipner criteria. Results: Radiographic results showed good in 67% and fair in 33% of cases. Clinical results showed good in 73% and fair in 27% of cases. There were no complications such as wound infection and skin necrosis, but traumatic arthritis were 2 cases. Conclusion: Pilon fractures are high energy injuries with significantly associated soft tissue damage and traumatic arthritis. Limited internal fixation offers good solution to Ovadia and Beals type II or III fracture.

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가토의 비후성 반흔에서 세포외 알칼리성 인산효소 발현의 변화 (THE CHANGE OF EXTRACELLUAR ALKALINE PHOSPHATASE EXPRESSION IN HYPERTROPHIC SCAR IN RABBITS)

  • 조용기;유선열
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제21권1호
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    • pp.23-28
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    • 1999
  • ALP (alkaline phosphatase) is a membrane-bound metalloenzyme that is expressed in osteoblasts, hepatocytes, lung, kidney, endothelial cells, leukocytes and other cells. Normal soft tissue and skin show little tissue nonspecific ALP (TN-AP), However, scar tissue contains high levels of TN-AP activity, and in fact, TN-AP is expressed intensely in regenerating connective tissue after the wounding. The purpose of this study was to evaluate the change of ALP expression in hypertrophic scar model in rabbits and the effect of triamcinonolone on ALP expression. Adult male New Zealand white rabbits, weighing about 2.5 kg, were used. After full-thickeness wounding over the ventral surface of each ear, either saline (control ear) or triamcinolone (contralateral ear) was injected on day 16. Rabbits were sacrificed on day 3, 7, 15, 17, 19, 23, and the specimens were retrieved en bloc. Histologic and immunohistochemical examinations of tissue samples were done. The results obtained were as follows: On day 3, ALP reaction was observed on fibroblasts and inflammatory cells in wound margin. On day 7, ALP reaction was more intense than day p in capillaries, inflammtory cells, and fibroblasts behind newly formed epithelium. On day 15, ALP reaction was lessened in both groups and appeared mainly in subepidermal capillary network, Since day 17, ALP reaction was lessened in both groups and weaker in triamcinolone-injected group than in saline-injected group. These results suggest that ALP reaction isn't increased in triamcinolone-injected scar and triamcinolone reduces scar not by increasing TN-AP expression but other mechanism.

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Cryosurgery를 이용(利用)한 Keloid의 치료(治療) (Cryosurgery in the Treatment of Keloids)

  • 정영식;최시호;설정현;이태숙
    • Journal of Yeungnam Medical Science
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    • 제2권1호
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    • pp.23-30
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    • 1985
  • Keloids are abnormally healed skin wounds that develop in the subpapillary layer of the dermis. They are a lesion with wide, raised and deep scars. They exceed the original dimensions of the wound and grow mounds upon mounds of collagen in a pseudotumor fashion. Their treatment may take several forms such as surgery, intralesional injection of steroid, compression, superficial irradiation, and combination therapy. However, absolute method is nothing until now. Recently, the cryosurgery shows relatively good effect in treatment, so we tried the clinical experience with cryosurgery in the treatment of keloids. Material and methods: During the past 2 years, we treated 20 individuals of the keloids with severe itching and pain. The age ranged from 5 to 45 years old. Only 6 cases were biopsied before and after cryotherapy. The cryosurgery set we used was Toitu model CR 201 $N_2O$ gas (tip temperature is $-80^{\circ}C$) and was applied directly on the lesion about 4 to 5 minutes with slight compression. After cryosurgery in keloids, the following results were obtained: 1. It is both quick and easy method. 2. It causes little or no pain and no loss of blood. 3. Integumentary normalization is rapid. The new scar tissue is smaller, and more elastic and soft. 4. The pain, itching and paresthesia commonly associated with keloid is usually disappeared. 5. Other treatment can be used after cryosurgery. 6. Histologic picture after cryosurgery is similar with the result of steroid injection. 7. The mechanism of the cryosurgery in keloids is the result of the direct tissue destroying action and cryoimmunologic reaction.

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농촌주부(農村主婦)들의 의료(醫療)와 항생제(抗生劑)에 대(對)한 지식(知識)과 태도(態度)에 관(關)한 조사(調査) (A Study on Knowledge and Attitude of Housewives toward Health Care and Antibiotics in a Rural Area)

  • 김순기
    • Journal of Preventive Medicine and Public Health
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    • 제9권1호
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    • pp.147-151
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    • 1976
  • A study was conducted during the period of August 13 to August 18, 1974 to obtain information on knowledge and attitude of the rural area housewife toward health care and antibiotics using. Interviewed 242 housewives dwelling in Soodong and Hwado Myun, Yangju Gun, Kyunggi Do, a typical rural area in Korea and the following results are obtained: 1. Of 242 housewives interviewed, 20.2% were illiteracy, 68.2% was graduated from primary school, 9.1% from middle school and 2.5% from high school. 2. Of those interviewed, 8.7% were Christian, 5.0% Bueldist, 2.9% Confucianism, and 83.4% of those were no religious preference. 3. Utility rate according with the kind of mass media in home was 85.1% of respondants possessed radio, 16.1% of magazine, 12.8% of newspaper, and 4.1% of television. 4. In the case of patients occure in a family, 13.0% out of 242 respondants had chosen physician's clinics for inicial medical care place, 58.4% drug stores, 0.9% herb medicine and 27.7% of those had chosen folk medicine at home. 5. Antibiotics effective complaints listed by the respondants were skin diseases with 43.8%, suppurated wound 30.0%, URI like symptoms 18.2%, diarrhea 14.5%, low back pain 12.9%, fever 6.2%, loss of appetite 3.3%, all kind of diseases 2.5%, urethral discharge 2.1% and tuberculosis 0.8% respectively. 6. Only 14.7% of respondants had obtained antibiotics for medical care from physician's clinics and 85.3% of the respondants had obtained antibioties from drug store (70.7%), village shop (10.4%), and salesmen in street market without any physician's prescription. 7. Eighty-nine percent of the respondants were understanding on patient care activity as the local health subcenter but only 11.0% of those on M.C.H., 29.0% of those on family planning, 21% on vaccination, and only 6.6% on tuberculosis control activity. 8. Utility rate of the local health subcenter was 71.9% out of the patients indicated medical care of medical facilities.

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종골 골절후 외상성 관절염에 대한 삼중 관절 고정술의 임상적 결과 (Clinical Outcome of Triple Arthrodesis for Posttraumatic Arthritis after Calcaneal Fractures)

  • 정성택;노성만;정재윤;송은규;이근배
    • 대한족부족관절학회지
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    • 제6권2호
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    • pp.156-160
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    • 2002
  • Purpose: To analyze the clinical outcome of triple arthrodesis for the posttraumatic arthritis after calcaneal fractures. Materials and Methods: We retrospectively reviewed 22 posttraumatic arthritis patients who underwent a triple arthrodesis from March 1991 to May 1998. The mean duration of follow up was 74 months(range, 36-123 months). The pain, function and alignment were evaluated by the modified ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society(AOFAS) clinically and the union rate, the duration of union and the degenerative change of adjacent joints radiographically were evaluated. Results: The mean duration from injury to arthrodesis was 33 months (range, 12-132 months). The AOFAS score improved from 36.4 points(range, 14-64) preoperatively to 67.6(range, 25-90) postoperatively. The union rate was 90.1% radiographically, the mean duration of union was 14.3 weeks(range, 12-21 weeks) and the degenerative change in the adjacent joint was showed in 12 patients(54.5%). There were 2 cases of talonavicular nonunion, one superficial wound infection and one partial skin necrosis. Conclusion: Triple arthrodesis for posttraumatic arthritis after calcaneal fractures is a useful method for relief of pain and correction of posttraumatic hindfoot deformity, as an evidenced by the satisfactory clinical outcome. Although a high prevalence of subsequent arthritis of the ankle and midtarsal joint was noted radiographically, we found that it was not clinically relevant.

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