• Neurospine
• /
• 제15권4호
• /
• pp.338-347
• /
• 2018

Objective: Patients with extradural spine tumors are at an increased risk for intraoperative cerebrospinal fluid (CSF) leaks and postoperative wound dehiscence due to radiotherapy and other comorbidities related to systemic cancer treatment. In this case series, we discuss our experience with the management of intraoperative durotomies and wound closure strategies for this complex surgical patient population. Methods: We reviewed our recent single-center experience with spine surgery for primarily extradural tumors, with attention to intraoperative durotomy occurrence and postoperative wound-related complications. Results: A total of 105 patients underwent tumor resection and spinal reconstruction with instrumented fusion for a multitude of pathologies. Twelve of the 105 patients (11.4%) reviewed had intraoperative durotomies. Of these, 3 underwent reoperation for a delayed complication, including 1 epidural hematoma, 1 retained drain, and 1 wound infection. Of the 93 uncomplicated index operations, there were a total of 9 reoperations: 2 for epidural hematoma, 3 for wound infection, 2 for wound dehiscence, and 2 for recurrent primary disease. One patient was readmitted for a delayed spinal fluid leak. The average length of stay for patients with and without intraoperative durotomy was 7.3 and 5.9 days, respectively, with a nonsignificant trend for an increased length of stay in the durotomy cases (p=0.098). Conclusion: Surgery for extradural tumor resections can be complicated by CSF leaks due to the proximity of the tumor to the dura. When encountered, a variety of strategies may be employed to minimize subsequent morbidity.

• 대한수의학회지
• /
• 제54권2호
• /
• pp.121-122
• /
• 2014

A 2-year-old male Tosa was admitted for treatment of a non-healing wound on the right forelimb. Skin tests were unremarkable; however, the lesion contained severe proliferative tissue. Surgical treatment was conducted due to the extensive skin defect and granulation tissue present. Following removal of the proliferative tissue, the wound was closed using the adjustable horizontal mattress suture method with multiple punctate relaxing incisions. The proliferative tissue healed completely after the surgical treatment. This technique can be considered an alternative treatment for the proliferative tissue when conditions require a skin graft or flap after surgical treatment.

• Archives of Plastic Surgery
• /
• 제46권1호
• /
• pp.88-91
• /
• 2019

The burn center in our hospital is a national and regional (Southeast Asia) center. Of all admissions, 10% are related to blast explosions, and 8% due to chemical burns. In the acute burn management protocol of Singapore General Hospital, early surgical debridement is advocated for all acute partial-thickness burns. The aim of early surgical debridement is to remove all debris and unhealthy tissue, preventing wound infection and thereby expediting wound healing. In chemical burns, there can be stubborn eschars that are resistant to traditional debridement. We would like to present a novel technique using the diathermy scratch pad as a cheap and efficient tool for the dual purpose of surgical debridement and dermabrasion.

• Journal of Korean Neurosurgical Society
• /
• 제54권4호
• /
• pp.336-339
• /
• 2013

Objective : Postoperative subgaleal cerebrospinal fluid (CSF) collection is considered as one of the common minor surgical complication which can lead to prolonged hospitalization. We introduce "galeal tack-up suture" to prevent postoperative subgaleal CSF collection. Methods : Galeal tack-up suture consists of various surgical techniques which aim to fix galea to cranium in order to prevent CSF pooling in subgaleal space. A total of 87 patients who underwent craniotomy were divided into two groups while closing the wound : group A with galeal tack-up suture and group B with routine wound closure without galeal tack-up suture. The patients were observed for postoperative subgaleal CSF collection. Results : Among 87 cranitomy cases, galeal tack-up suture was performed in 32 cases and routine wound closure was done in 55 cases. Postoperative subgaleal CSF collection occurred in 13 cases (15%) in which 12 cases occurred in group B patients and 1 case occurred in group A patients (p=0.026). Conclusion : Galeal tack-up suture is an easy and effective technique in wound closure to prevent postoperative CSF collection.

• Archives of Plastic Surgery
• /
• 제46권5호
• /
• pp.470-474
• /
• 2019

Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

• Journal of Periodontal and Implant Science
• /
• 제51권4호
• /
• pp.239-253
• /
• 2021

Purpose: The single-flap approach (SFA) is a minimally invasive technique with limited mucoperiosteal flap elevation to gain access to the buccal/palatal aspects, thus limiting post-surgical complications. The purpose of the present study was to gain insights into the impact of the SFA over the double-flap approach (DFA) on periodontal flap treatment outcomes and patient compliance in terms of discomfort and time taken for surgical procedures. Methods: Twenty patients with persistent probing pocket depths of ≥5 mm were scheduled for the SFA (test site) and for the DFA (control site). All the clinical periodontal parameters were recorded at baseline, 3 months, and 6 months. Radiographic bone level (cone-beam computed tomography) was evaluated at baseline and 6 months. Patients' postoperative pain perception and wound healing were also assessed. Results: The SFA showed a significant reduction in periodontal pocket depth, gain in clinical attachment level (CAL), and gain in bone level when compared with the DFA. The SFA substantially improved wound healing and induced less postoperative pain than the DFA. Conclusions: The SFA resulted in substantial improvement in the composite outcome measures, as shown by a reduction in pocket depth with minimal gingival recession, gain in CAL, early wound healing, less postoperative discomfort, and better patient-centered outcomes.

• 동의생리병리학회지
• /
• 제25권5호
• /
• pp.887-893
• /
• 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.

• 대한물리치료과학회지
• /
• 제2권2호
• /
• pp.495-508
• /
• 1995

The purpose of this study was to determine the effects of high voltage pulsed current (HVPC) stimulation on wound healing. Thirty-four Sprague-Dawley adult female rats were assigned to experimental and control groups. Each rats were anesthetized with pentotal sodium, and a 10 mm full-thickness incision was made on the back. From 24 hours after surgery, the rats of experimental groups were stimulated with HVPC, $140{\mu}s$, 120 pps, 30-40 V for 30 minutes, daily. The rats were sacrified 2 days, 4 days and 6 days after stimulation, respectively. The skin was removed, and processed for light microscopic examination. The length of incisional wounds were measured by microcaliper, and nucleolar organizer regions were counted under light microscope. For the histological observations the specimens were stained with Hematoxylin and Eosin, Masson Trichrome, Gomori Reticulum and Ag-NOR. There was a significant decrease in the length of incisional wound in experimental group compared with control group at 6 days HVPC stimuation (p<0.05). In experimental group, wound were significant difference (p<0.01) between the duration of post surgery. The mean numbers of nucleolar organizer regions per nucleus were significantly increased in the experimental group at 6 days HVPC stimulation (p<0.05), and were significantly difference (p<0.01) between the duration of post surgery in experimental group. Histological examination of the wound site suggested a more rapid of epithelialization and collagen formation between experimental groups compared with control groups. The result may indicated that the HVPC with $140{\mu}s$, 120 pps, 30-40 V for 30 minutes promoted surgical wound healing in the rat.

• 대한소아치과학회지
• /
• 제30권1호
• /
• pp.116-123
• /
• 2003

소아 환자에서 외과적 처치 후 많은 불편감과 동통이 존재한다. 최근 몇몇의 연구에서 저출력 레이저의 조사로 구강내 창상의 치유 과정이 촉진된다는 보고가 있다. 이에 본 증례에서는 외과적 처치 후 저출력 레이저조사가 연조직의 치유 과정에 미치는 영향을 알아보고자 과잉치 발거와 설소대 절단술을 시행하고, 저출력 레이저(DENS-BIO Laser)를 pulse 8(1000Hz), 2mW의 조사조건으로 4분간 조사 후 그 연조직 창상 치유 양상을 관찰하여 다음과 같은 결과를 얻을 수 있었다. 1. 레이저를 조사한 부위가 레이저를 조사하지 않은 부위보다 빠르게 치유되었다. 2. 레이저 조사한 경우 환자는 술 후 동통을 덜 호소하였다.

• 대한핵의학회지
• /
• 제26권2호
• /
• pp.355-359
• /
• 1992

The $^{67}Ga$ has somewhat long physical and biological half livies with 78 hours and 600 hours respectively, so we can get $^{67}Ga-scan$ images for 3 or more days after once injection of $^{67}Ga$. Furthermore $^{67}Ga$ scan would be useful to search some residual tumors after surgical removal of the tumors trapped with $^{67}Ga$. However $^{67}Ga$ bound with plasma proteins would be delayed in plasma clearance as approximately 10% of the dose remains in the plasma at 24 hours. If the remained $^{67}Ga$ in the plasma is redistributed into the surgical wound, we wouldn't evaluate the degree of the tumor remained after surgery. So the authors examined the amounts of the remained blood $^{67}Ga$ and the redistribution of the blood $^{67}Ga$ into the artificial wound with S or more centimeters in the diameter at the neck and chest of the rabbits. The results were as follows; 1) The $^{67}Ga$ remained in the plasma were 12%, 5.7%, 4.2% at 24, 48 and 72 hours after $^{67}Ga$ injection respectively. 2) The blood $^{67}Ga$ were redistributed into the artificial wound with 5.9% at 48 hours and 6.9% at 72 hours after $^{67}Ga$ injection.