• Title/Summary/Keyword: surgical debridement

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The "Sombrero-Shape" Super-Thin Pedicled ALT Flap for Complete Scrotal Reconstruction Following Fournier's Gangrene

  • Sapino, Gianluca;Gonvers, Stephanie;Cherubino, Mario;di Summa, Pietro G.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.453-456
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    • 2022
  • When the scrotal sac is entirely debrided following a Fournier gangrene, testes exposure poses unique challenges for the reconstructive surgeon. Despite the anterolateral thigh (ALT) flap is considered a workhorse in such context, aesthetic results are often suboptimal because of the lack of natural ptosis and patchwork appearance. We describe the use of a super-thin pedicled ALT flap for total scrotal reconstruction, modified according to a peculiar flap design and inset technique. A 42-year-old man was referred to our department for delayed total scrotal reconstruction 8 months after a Fournier gangrene extensive debridement. A super-thin pedicled ALT flap from the right thigh was designed: in the central portion of the ALT, a lateral skin paddle extension was marked to guarantee adequate posterior anchorage during insetting and ptosis of the scrotal sac. This particular flap arrangement has inspired the name "sombrero" as the shape is akin to the famous hat. No secondary refinements were needed, and the patient showed satisfying aesthetic and functional results at 12 months' follow-up. The ALT flap design "sombrero" modification proposed in this article can improve scrotum cosmesis and patient satisfaction in a single-stage single-flap procedure.

Irrigation-suction System for Management of Deep Sternal Wound Infection after Open Heart Surgery -Four cases- (개심술 후 발생한 심부 흉골 창상감염의 세척-흡입법을 이용한 치험 -4예 보고-)

  • 김상익;오상준
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.431-435
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    • 2003
  • Deep sternal wound infection (with or without acute mediastinitis) is a serious complication of open heart surgery, with high rates of associated morbidity and mortality, and prolonged hospitallization. The result of treatment largely depends on timely diagnosis and appropriate surgical management. Postoperative deep sternal wound infections in 4 cases were successfully treated with extensive debridement, pressurized jet irrigation with antibiotic solution, sternal refixation by Robicsek method, and dilute antibiotic irrigation via irrigation-suction system. We report 4 cases with review of articles.

Spontaneous Achilles Tendon Rupture After Repeated Local Steroid Injention - A Case Report - (국소 스테로이드 반복 주사후 발생한 자발적 아킬레스건 파열 -증례 보고-)

  • Chung, Hyung-Jin;Choi, Jung-Yun
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.218-220
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    • 2004
  • It is known that steroids increase the risk for tendon ruptures. Despite this local steroids are still used in the treatment of achilles tendinitis. 46-year-old women had occurred achilles tendon rupture after repeated local steroid injection. Intraoperatively, necrotic change were seen at both side of ruptured end. Like this, tendon rupture after repeated steroid injection often result in a large defect, which needed surgical repair. After debridement of ruptured end, tenorrhaphy with single Krackow method and plantaris tendon augmentation was done. The patient showed favorable result with return to range in a degree of activity levels.

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Autogenous Osteochondral Graft for Freiberg's Disease (A Case Report) (자가 골연골 이식술을 이용한 Freiberg 병의 치료(1예 보고))

  • Kim, Hyong-Nyun;Eom, Sang-Wha;Suh, Dong-Hyun;Park, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.223-226
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    • 2009
  • Freiberg disease is a osteochondrosis of the lesser metatarsal heads. Various surgical treatment have been recommanded including joint debridement and metatarsal head reshaping, metatarsal dorsal wedge osteotomy, metatarsal head excision and joint arthroplasty. Autogenous osteochondral graft for the treatment of Freiberg disease is an effective restorative procedure that provides early range of motion exercise, weight bearing, and reduces other morbidity. We report a case of late stage Freiberg disease treated with arthrotomy, removal of loose body and autogenous osteochondral graft.

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Physical therapy and Occupational therapy on the hand infections (수부 감염에 대한 물리치료와 작업치료)

  • Jung, Seok;Kim, Jeong-Ja
    • Journal of Korean Physical Therapy Science
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    • v.6 no.1
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    • pp.861-877
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    • 1999
  • The hand is a very specialized organ that functions to obtain information and to execute motor acts essential to human interaction with the environment. Loss of hand function through infections affects the mechanical tasks that the hand performs and psychological adjustments to their disability. Infection is a disastrous complication of hand injuries and adequacy of circulation is of greatest importance to prevention of infection. Careful debridement, incision, and adequate drainage and antibacterial treatment are of great importance. Optimal care of the infected hand demands that carefully surgical care, early postoperative exercises and other therapy. Hand rehabilitation has grown as a specialty area of both physical and occupational therapy. It is essential that the surgeon and therapist work together, and communicate freely-all of which generally require daily contact. Treating the psychological loss suffered by the patient with a hand infections is an integral part of the rehabilitation therapy as well. Treatment techniques, Whether thermal modalities or specifically designed exercises, are used as a bridge to reach a further goal of returning to functional performance.

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Chronic suppurative osteomyelitis with proliferative periostitis related to a fully impacted third molar germ: a report of two cases

  • Park, Joonhyoung;Myoung, Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.4
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    • pp.215-220
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    • 2016
  • In prolonged chronic osteomyelitis, chronic inflammation and low-grade infections can result in new periosteal bone formation. Chronic osteomyelitis with proliferative periostitis (traditionally termed $Garr{\acute{e}^{\prime}s$ sclerosing osteomyelitis) mainly affects children and young adults. Here, we present two rare cases of an 11-year-old and a 12-year-old patient with suppurative chronic osteomyelitis with proliferative periostitis without any definitive infection source, such as dental caries or periodontitis. The source of infection was likely to be related to the development of a lower right third molar germ with follicular space widening. Management involved antibiotics and the removal of the third molar germ and surgical debridement. Disease remission and a normal appearance was observed at the six-month follow-up visit.

Esophageal Injury Following Anterior Cervical Plate Fixation

  • Park, Jae-Sung;Kim, Young-Baeg;Hong, Hyun-Jong;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.141-145
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    • 2005
  • We report five patients of esophageal injuries confirmed by clinical signs and radiological evidences. They include a partial tear and a perforation which were not noticed during the operation, a perforation which was primarily repaired during the operation, and two perforations which occurred during the reoperations for the removal of mal-positioned screws or plate. The partial tear was not repaired. The perforation which occurred during the operation was primarily sutured and didn't receive further treatment. Two perforations which occurred during the reoperations were treated by irrigation, debridement with surgical drainage, and systemic antiobiotics. One who was diagnosed later after the operation showed the poorest outcome and required longest hospital days among our series. Early detection and appropriate treatment of esophageal injury following anterior spinal surgery can only improve the prognosis by preventing secondary complications.

Implant failure associated with oral bisphosphonate-related osteonecrosis of the jaw

  • Shin, Eun-Young;Kwon, Young-Hyuk;Herr, Yeek;Shin, Seung-Il;Chung, Jong-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.40 no.2
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    • pp.90-95
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    • 2010
  • Purpose: The aim of this study is to report a case of oral bisphosphonate-related osteonecrosis of the jaw (BRONJ) resulting in implant failure. Methods: A patient suspected of having BRONJ was referred to the Department of Periodontology, Kyung Hee University School of Dentistry for the evaluation and treatment of exposed bone around implants. Results: The patient, who had been taking oral bisphosphonates (BPs) for about a year, was successfully treated with systemic antibiotics, chlorhexidine mouth rinse, explantation, and surgical debridement of necrotic bone. Conclusions: The results of this case suggest that a patient taking BPs orally should be treated cautiously. Appropriate management including cessation of BPs and respective dental treatment may reduce the development of BRONJ.

Multiple Ascending Aortic Mural Thrombi and Acute Necrotizing Mediastinitis Secondary to Acute Pancreatitis

  • Chong, Byung Kwon;Yun, Jae Kwang;Kim, Joon Bum;Park, Do Hyun
    • Journal of Chest Surgery
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    • v.49 no.5
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    • pp.401-404
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    • 2016
  • The formation of aortic thrombi is an extremely rare complication of acute pancreatitis. Here we report a case of acute pancreatitis complicated by a paraesophageal pseudocyst, necrotizing mediastinitis, and the formation of multiple thrombi in the ascending aorta. The patient was successfully treated by surgical therapy, which included extensive debridement of the mediastinum and removal of the aortic thrombi under cardiopulmonary bypass. Although esophageal resection was not carried out concomitantly, the lesions were resolved and the patient remained free of complications over 2 years of follow-up care.

Massive Necrotizing Fasciitis of the Chest Wall: A Very Rare Case Report of a Closed Thoracostomy Complication

  • Chun, Sangwook;Lee, Gyeongho;Ryu, Kyoung Min
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.404-407
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    • 2021
  • We present a case study of necrotizing fasciitis (NF), a very rare but dangerous complication of chest tube management. A 69-year-old man with shortness of breath underwent thoracostomy for chest tube placement and drainage with antibiotic treatment, followed by a computed tomography scan. He was diagnosed with thoracic empyema. Initially, a non-cardiovascular and thoracic surgeon managed the drainage, but the management was inappropriate. The patient developed NF at the tube site on the chest wall, requiring emergency fasciotomy and extensive surgical debridement. He was discharged without any complications after successful control of NF. A thoracic surgeon can perform both tube thoracostomy and tube management directly to avoid complications, as delayed drainage might result in severe complications.