• Title/Summary/Keyword: surgical wound

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Intraoperative Cerebrospinal Fluid Leak in Extradural Spinal Tumor Surgery

  • Ropper, Alexander E.;Huang, Kevin T.;Ho, Allen L.;Wong, Judith M.;Nalbach, Stephen V.;Chi, John H.
    • Neurospine
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    • v.15 no.4
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    • pp.338-347
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    • 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.

The treatment of lower extremity defects with severe proliferative tissue using an adjustable horizontal mattress suture in a Tosa dog

  • Heo, Suyoung;Kim, Namsoo
    • Korean Journal of Veterinary Research
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    • v.54 no.2
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    • pp.121-122
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    • 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.

The diathermy scratch pad: A cheap and efficient tool for chemical and explosion-related burns

  • Wong, Allen Wei-Jiat;Hong, Qi En;Hui, Cheryl Li Yu;Chong, Si Jack
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.88-91
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    • 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.

Galeal Tack-Up Sutures to Prevent Subgaleal Cerebrospinal Fluid Collection

  • Choi, Won Ho;Moon, Chang Taek;Koh, Young-Cho;Chun, Young Il;Cho, Joon;Song, Sang Woo
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.336-339
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    • 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.

Successful management of absent sternum in an infant using porcine acellular dermal matrix

  • Semlacher, Roy Alfred;Nuri, Muhammand A.K.
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.470-474
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    • 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.

Single-flap versus double-flap approach for periodontal pocket reduction in supraosseous defects: a comparative study

  • Mathala, Venkata Lakshmi;Konathala, Santosh Venkata Ramesh;Gottumukkala, Naga Venkata Satya Sruthima;Pasupuleti, Mohan Kumar;Bypalli, Vivek;Korukonda, Radharani
    • Journal of Periodontal and Implant Science
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    • v.51 no.4
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    • pp.239-253
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    • 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.

Effects of Danggwieumja on the Healing of Full-Thickness Skin Injury in Rat

  • Kim, Bum-Hoi
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.5
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    • pp.887-893
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    • 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.

Effect of High Voltage Pulsed Current Stimulation on Surgical Wound of Rat (고전압맥동전류자극이 흰쥐 창상 치유에 미치는 영향)

  • Choi, Eun-Young;Lee, Jae-Hyoung;JeKal, Seung-Joo
    • Journal of Korean Physical Therapy Science
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    • v.2 no.2
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    • pp.495-508
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    • 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.

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THE EFFECT OF SOFT LASER ON SOFT TISSUE WOUND HEALING PROCESS (SOFT LASER를 이용한 연조직 창상의 치료 효과)

  • Hong, Sang-Jin;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.116-123
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    • 2003
  • In children, they were presented pain and discomfort after surgical procedure. Some study has been suggested that Soft Laser promote healing process. So, the aim of the present study was to examine the effect of low power generating semiconductor laser on healing process after surgical procedure. DENS-BIO Laser applied to the wounds created by mesiodens extraction and lingual frenectomy. DENS-BIO Laser was irradiated on the wound with pulse 8(1000Hz) and 2mW, for 4 minutes. And then, healing process of surgical site was observed. The results from the present study can be summarized as follows : 1. In the irradiated wound, the healing process is more faster than not irradiation group. 2. Pain is less than not irradiation group.

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Evaluation of Post-Operative Residual Tumors Using $^{67}Ga$ Scintigram 1. Is the Blood Gallium Redistributed into the Surgical Wound? ($^{67}Ga$ 신티그램을 이용한 술후잔여종양의 평가 1. 혈중 $^{67}Ga$은 수술창상에 재분포하는가?)

  • Moon, Tae-Yong;Sol, Chang-Hyo;Kim, Yong-Ki;Wang, Soo-Geun;Han, Kook-Sang;Choi, Chang-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.355-359
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    • 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.

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