• Title/Summary/Keyword: surgical plan

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Applying Principles of OPT by Soft-Tissue Lesions Stages (연부조직 병변의 회복단계별 정형 물리치료적 적용원리)

  • Park, Ji-Whan
    • Journal of Korean Physical Therapy Science
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    • v.1 no.2
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    • pp.313-320
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    • 1994
  • This article provids background information necessary to design orthopaedic physical therapy programs based on a patient's level of orthopaedic involvement during the acute, subacute, or chronic stage of soft-tissue healing. This approach was used whether the problem involved injury from trauma, insult from overuse, disease, surgical intervention. Soft-tissue lesions and clinical conditions were defined ; the stages of inflammation and repair were described with emphasis on how to manage soft tissues and joints with therapeutic exercise during each stage. A problem list with goals and plan of care was outlined to summarize each clinical situation. A list of clinical problems will be used as the foundation for designing exercise problems for each region of the body.

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Real-Time Pleural Elastography: Potential Usefulness in Nonintubated Video-Assisted Thoracic Surgery

  • Tacconi, Federico;Chegai, Fabrizio;Perretta, Tommaso;Ambrogi, Vincenzo
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.433-435
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    • 2021
  • Pleural adhesions are a major challenge in standard and nonintubated video-assisted thoracic surgery. The currently available imaging techniques help to assess the presence and extent of pleural adhesions, but do not provide information on tissue deformability, which is crucial for intraoperative management. In this report, we describe the utilization of real-time elastography mapping of pleural adhesions. This technique enabled us to detect areas with softer adhesions, and helped establish the surgical plan in a difficult case of a patient scheduled for nonintubated video-assisted thoracic surgery.

Residual Pain after Operative Treatment for Chronic Ankle Instability (만성 발목 불안정증 수술 후의 지속적인 발목 통증)

  • Cho, Byung-Ki;Ahn, Byung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.32-37
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    • 2021
  • Patients with chronic lateral ankle instability often experience a range of associated injuries. The well-known comorbidities include intra-articular pathologies (osteochondral lesion, soft tissue or bony impingement, and loose body), peroneal tendon pathologies, neural injuries, and other extra-articular pathologies. Surgeons should have a high index of suspicion for these associated pathologies before operative intervention, correlate the clinical findings, and plan the treatment. Despite the restoration of ankle stability following ligament repair or reconstruction surgery, a high prevalence (13%~35%) of postoperative residual pain has been reported. This pain can negatively affect the clinical outcomes and patient satisfaction. This study examined the causes of persistent pain after surgical treatments for chronic ankle instability.

Congenital epulis in a newborn

  • Min-Jun, Kang;Sang-Hoon, Kang
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.6
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    • pp.382-385
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    • 2022
  • Congenital epulis (CE) is an extremely rare benign tumor of the gingiva that is found on the alveolar ridge of newborns, and the main treatment option is simple excision. Postoperative prognosis is very good, and spontaneous regression may occur despite incomplete excision. This report presented a rare case of CE and its healing process after surgery under local anesthesia. The treatment plan was decided upon through consultation between a medical team and the patient's family, with surgical excision for the main lesion, which benefitted from surgery, and follow-up for a very small-sized lesion, which was thought to be appropriate for a newborn. No recurrence was found after its removal, and favorable healing was observed.

Immediate Partial Breast and Nipple-Areola Complex Reconstruction Using a Superficial Circumflex Iliac Artery Perforator Flap

  • Gemma Pons;Lucia Sisternas;Jaume Masia
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.150-155
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    • 2024
  • The superficial circumflex iliac artery perforator (SCIP) flap is a versatile flap that has been described for various applications, mostly for lower extremity coverage and head and neck reconstructions. However, there are few publications reporting its use for breast reconstruction, mainly because of its low volume availability. In this article, we present the case of a patient who successfully underwent a partial breast and immediate nipple-areola complex (NAC) reconstruction with an SCIP flap. She had been previously reconstructed with an implant after a nipple-sparing mastectomy, but the NAC turned out to be involved with cancer needing further resection. Our goal with this article, is to introduce a novel concept for addressing partial breast and NAC reconstruction and mostly, to illustrate the importance of an adaptable surgical plan based on every individual case emphasizing the versality of microsurgery for breast cancer reconstruction.

Strategic surgical-combined orthodontic treatment planning of patient with missing incisors on maxilla: a case report (상악 전치부 결손 환자의 수술을 동반한 전략적 교정치료 증례)

  • Park, Je-Hyeok;Jeon, Jin;Zhao, Sen;Jeon, Young-Mi;Kim, Jong Ghee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.4
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    • pp.244-252
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    • 2019
  • Proper positioning of maxillary incisors is key to success of surgery combined treatment. Establishing surgery plan would be a difficult job if maxillary incisors are lost. Patient who lost all of her maxillary incisors due to accident came for orthodontic treatment. Through careful modification of maxillary archform, pre-surgical orthodontic treatment was conducted with four prosthetic space consolidation. Position of incisors was decided by help of 3D prosthetic set-up, and 1-jaw surgery was planned. After relative short treatment period of 28 months, final prosthesis was done. When alveolar bone loss happens, harmonious prosthesis of upper incisors is difficult. Utilizing mandibular set-back surgery and incisor positioning using 3D set-up could make a better environment for treatment outcome. Strategic pre-surgical orthodontic treatment can allow shorter time and less number of prosthetics.

The Vertical Changes of Lip and Perioral Soft Tissue Following Orthognathic Surgery in Skeletal Class III Patients by a Cephalometric Analysis of Cone Beam Computed Tomography (Cone Beam Computed Tomography의 두부계측분석을 통한 골격성 제3급 부정교합 환자에서 악교정 수술 후 입술과 주위 연조직의 수직적 변화)

  • Lee, Jong-Min;Kang, Joo-Wan;Lee, Jong-Ho;Kim, Chang-Hyen;Park, Je Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.311-319
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    • 2012
  • Purpose: The aim of this study is to evaluate the vertical changes of the lip and perioral soft tissue, following orthognathic surgery in skeletal class III patients by a cephalometric analysis of a cone beam computed tomography (CBCT). Methods: A total of 20 skeletal class III patients, who had bimaxillary surgery with Le Fort 1 osteotomy and bilateral sagittal split ramus osteotomy, were included in this study. The surgical plan for maxilla was posterosuperior impaction with the anterior nasal spine, as the rotation center. Further, the surgical plan for mandible was also posterosuperior movement. The soft tissue changes between lateral cephalogram and CBCT were compared. And the correlations between independent variables and dependent variables were evaluated. Results: There were no significant differences of the soft tissues changes between lateral cephalogram and CBCT. Upper lip philtrum length (SnLs), nasolabial angle increased and upper lip vermilion length (LsStms), lower lip length (StmiB'), lower lip vermilion length (StmiLi), lower lip philtrum length (LiB') and soft tissue lower facial height (SnMe') decreased after surgery. Change of SnLs (${\Delta}$SnLs) was influenced by vertical change of menton (${\Delta}$MeV), and change of LsStms (${\Delta}$LsStms) was influenced by upper lip thickness (ULT). Change of StmiLi' (${\Delta}$StmiLi') were influenced by preoperative overjet. Change of StmiB' (${\Delta}$StmiB') were influenced by preoperative overjet, vertical change of lower incisor (${\Delta}$L1V) and horizontal change of posterior nasal spine (${\Delta}$PNSH). Change of LiB' (${\Delta}$LiB') was influenced by ${\Delta}$L1V and ${\Delta}$PNSH. Change of SnMe' (${\Delta}$SnMe') was influenced by ${\Delta}$MeV, horizontal change of upper incisor (${\Delta}$U1H) and horizontal change of lower incisor (${\Delta}$L1H). ${\Delta}$Nasolabial angle was influenced by change of ULT (${\Delta}$ULT). Conclusion: Both soft tissues and hard tissues can be evaluated by CBCT. Posterosuperior rotation of maxillomandibular complex resulted in increase of upper lip philtrum length and nasolabial angle, while the upper lip vermilion length, lower lip philtrum length, lower lip vermilion length, and soft tissue lower facial height showed a decrease.

Effects of Preoperative Psychological fare on Postoperative Recovery - An Exploratory Experiment - (수술 전 심리간호가 회복에 미치는 효과에 관한 실험적 연구)

  • 김조자
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.97-113
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    • 1971
  • The purpose of this study was to investigate the preoperative anxiety of surgical patients and to observe the effects of an experimental nursing process on the incidence of vomiting, the number of analgesics used and the voiding ability of surgical patients within a 48 hour postoperative period and also the number of postoperative days in the hospital. This study me based on a sample of 51 patients who were scheduled for abdominal surgery. They were assigned alternately to experimental and control groups. Patients assigned to the experimental group were given nursing care by the writer, using an experimental nursing process. This is a process directed toward helping the patient obtain a suitable psychological state for surgery. This process was performed by use of the following steps: 1. The nurse approached the patient with interest and concern, and observed the patient's behavior to determine the presence of anxiety. 2. The nurse explored further to find out what was causing the anxiety and what was needed too relieve it. 3. The nurse listened carefully lo the patient. 4. The nurse gave an opportunity for expression of individuality. 5. The nurse showed friendliness and reassured the patient 6. The nurse gave instruction about deep berating, turing and coughing and gave an explanation of routine preoperative preparation which decreased the unknown and so decreased the patient's anxiety- The findings of this study are as follows: 7. The investigation of preoperative anxiety through observing and interviewing revealed patients were concerned about the following: a. Length of stay in the hospital 69.7% (31 cases) b. Condition unimproved o. worse 48.,8% (30 cases) c. Postoperative pain and discomfort .56.8% (29 cases) 2. The results of the study regarding the four hypothesis were as follows: a. Preoperative psychological care not reduce the number of analysis needed during the 48 hour period following surgery. b. Preoperative psychological care did not reduce the Postoperative incidence of vomiting c. Preoperative psychological care had no influence on voiding ability following surgery. d. Preoperative psychological care significantly reduced the number of postoperative days in tile hospital. The experimental nursing process proved to be successful in decreasing the length of postoperative hospitalization (improving rate of healing). This study has demonstrated further that the relief of anxiety (emotional distress) is part of the nurse's professional role. In order to be sure psychological care is given it is important to make a nursing care plan which .includes a plan for the psychological care needed by the patient. As this care is given it can be charted off by each nurse just as medication and treatments are checked after they are given.

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Influence of implant misplacement on the success of the final prosthesis: Subjective evaluation by a prosthodontist of dental implants placed by an oral and maxillofacial surgeon (임프란트 식립오류가 최종 보철물의 성공에 미치는 영향: 구강악안면외과의사에 의해 식립된 치과임프란트에 대한 보철의사의 주관적 평가)

  • Kim, Young-Kyun;Hwang, Jung-Won;Lee, Hyo-Jung;Yeo, In-Sung;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.437-441
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    • 2009
  • Purpose: In many cases, the erroneous placement of a dental implant brings about undesirable results. Here, the effect of dental implant placement on the success of the final prosthesis was evaluated from the point of view of the prosthodontist. Materials and Methods: All surgical operations were performed by the same oral surgeon with the same surgical protocol and all prosthodontic procedures were performed by the same prosthodontist. The problems faced by the prosthodontist, their causes, and their effect on prosthesis success were identified. The success of the final prostheses was evaluated by the same prosthodontist. Results: Only 53% (238 implants in 105 patients) of dental implants were not associated with prosthodontic problems. Multiple implant placement (more than three implants) was associated more frequently with prosthodontic problems. Conclusions: The data indicate that the satisfactory construction of a prosthesis is highly dependent on the placement of the dental implant in the best possible position. It is strongly recommended that the oral surgeon and the prosthodontist engage in pre-operative discussions to establish a top-down treatment plan, as this will improve implant placement and ultimately the success of the prosthesis.

A 3D-printing Bone Model for Surgical Planning of Total Hip Replacement after Failed Triple Pelvic Osteotomy

  • Han, Kyungjin;Park, Jiyoung;Yoon, Jangwon;Lee, Young-Won;Choi, Ho-Jung;Jeong, SeongMok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.463-466
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    • 2017
  • A 3-year-old, 26 kg, castrated male Chow Chow was presented for assessment of weight-bearing lameness of the left hind limb. The patient had a history of triple pelvic osteotomy on the left side to correct hip dysplasia 2 years prior to his presentation of clinical signs and underwent total hip replacement on the right coxofemoral joint 1 year later. Upon physical examination, pain and crepitus were noted on the left hip joint during extension. Radiological examination revealed coxofemoral joint subluxation and moderate degenerative bone changes on the left hip joint and pelvic axis, which relates to acetabular angles that were changed after triple pelvic osteotomy (TPO). Preoperative computed tomography was used for 3-dimensional printing to establish an accurate surgical plan. The changed angles of the acetabulum after TPO were evaluated, and rehearsal surgery was performed using a 3-demensional printing bone model. Three months after the THR surgery, the function of the affected limb had improved, with no lameness. Complications, such as luxation and implant failure, were not observed until 6 months after the operation. Accurate evaluation of acetabulum angles and rehearsal surgery using a 3D-printed bone model is effective for total hip replacement after unsuccessful TPO.