• 제목/요약/키워드: wound care

검색결과 269건 처리시간 0.026초

기관지확장증의 외과적 치료 (Surgical Observation of Bronchiectasis)

  • 이동준;김찬용
    • Journal of Chest Surgery
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    • 제11권3호
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    • pp.260-264
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    • 1978
  • Sixty-one bronchiectatic patients were reviewed who were treated by surgical intervention in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital during the recent 14 years from January of 1965 to August of 1978. 1. Various pulmonary resection was performed; lobectomy was 55.5%, lobectomy and segmental resection 20.6%, bilobectomy 13.1%, lobectomy, segmental resection and thoracoplasty 4.9% and pneumonectomy was 3. 2%. 2. The most common associated disease was pulmonary Tbc, its frequency was 47.5% and next was chronic bronchitis [31%]. 3. The postoperative complication was observed in 19.6% [12 cases] and the most common was wound infection. 4. The possibility of recurrence was relatively high in the cases of residual lesion and it needs more intensive medical care. 5. The surgical result was satisfactory in 86.9% (53 cases), slight improvement in 4.9% (3 cases) and the mortality rate was 1.6% (1 case).

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말기 암성통증을 위한 Totally Implanted Port System; 문제점과 합병증 (Totally Implanted Port System for Terminal Cancer Pain; Problems and Complications)

  • 홍기혁
    • The Korean Journal of Pain
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    • 제5권1호
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    • pp.23-28
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    • 1992
  • The use of epidural narcotics to treat cancer pain was first described by Behar et al in 1979. More recently, a variety of implantable INDSs have been described for long-term intraspinal narcotic administration. Especially, among these systems INDS typeIII which is designed by Poletti et al is relatively low cost and less risk of infection, therefore this system has been widely accepted but the clinical experience is insufficient yet. 1, Problems, 1) thorough education of patients and care-givers about this system the method of drug delivery and the situations could be happen in using this system. 2) high cost of continuous drug delivery system 3) legal problems about morphine carry-out in the case of bolus infusion by syringe 1. Complications; 1) by morphine; Significant respiratory depression was not found in all 21cases. other morphine-related complications were occurred occasionally but improved within a few days by appropriate treatment. 2) by system, Blockage or leakage of catheter was occurred in 2cases and wound infection was occurred in 2cases and so reimplantation was done.

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Necrotizing fasciitis of the head and neck: a case report

  • Choi, Moon-Gi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권2호
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    • pp.90-96
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    • 2015
  • Necrotizing fasciitis (NF) is an infection that spreads along the fascial planes, causing subcutaneous tissue death characterized by rapid progression, systemic toxicity, and even death. NF often appears as a red, hot, painful, and swollen wound with an ill-defined border. As the infective process continues, local pain is replaced by numbness or analgesia. As the disease process continues, the skin initially becomes pale, then mottled and purple, and finally, gangrenous. The ability of NF to move rapidly along fascial planes and cause tissue necrosis is secondary to its polymicrobial composition and the synergistic effect of the enzymes produced by the bacteria. Treatment involves securing the airway, broad-spectrum antimicrobial therapy, intensive care support, and prompt surgical debridement, repeated as needed. Reducing mortality rests on early diagnosis and prompt aggressive treatment.

Reconstruction of a Large Infected Midline Abdominal Wall Defect Using a Latissimus Dorsi Free Flap

  • Cha, Han Gyu;Kim, Eun Key;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • 제31권2호
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    • pp.91-95
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    • 2018
  • Managing large infected midline abdominal defects are clinically challenging and technically demanding. The alloplastic materials, regional flaps, and component separation are usually infeasible because of the size, location, depth, and state of the defects. In these cases, the free flap is the only option with a large well-vascularized tissue that is free to inset regardless of the location. Herein, we report a case of 44-year-old man with a large infected midline abdominal wall defect who was completely treated with a latissimus dorsi myocutaeous free flap followed by negative pressure wound therapy.

악골에 발생된 방사선골괴사 (Osteoradionecrosis of the jaws)

  • 안현숙;고광준
    • Imaging Science in Dentistry
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    • 제31권1호
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    • pp.57-65
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    • 2001
  • Osteoradionecrosis is one of the most serious complication after heavy irradiation of bone and most particularly following treatment of cancers within the head and neck. The irradiated bone has the decreased vascularity and is easily infected. As a result, the spread of infection may cause a nonhealing wound that is very difficult to be treated. A comprehensive prophylactic dental care as well as proper blocking of the radiation field before radiotherapy must be considered to reduce the risk of osteoradionecrosis. We present three cases of osteoradionecrosis which developed after extraction of teeth in irradiated patients.

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Ventricular Septal Defect Closure in a Neonate with Osteogenesis Imperfecta

  • Jang, Woo Sung;Choi, Hee Jeong;Kim, Jae Bum;Kim, Jae Hyun
    • Journal of Chest Surgery
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    • 제52권3호
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    • pp.162-164
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    • 2019
  • A male patient weighing 2.5 kg was admitted for respiratory difficulty, and a large ventricular septal defect (VSD) was diagnosed. During care, sudden right leg swelling with a femur shaft fracture occurred. The patient's father had a history of recurrent lower extremity fractures; thus, osteogenesis imperfecta was considered. The patient's respiratory difficulty became aggravated, and VSD repair in the neonatal period was therefore performed with gentle sternal traction and great vessel manipulation under total intravenous anesthesia to prevent malignant hyperthermia. The patient was discharged without notable problems, except minor wound dehiscence. Outpatient genetic testing revealed that the patient had a COL1A1/COL1A2 mutation.

Leukocyte Adhesion Deficiency Associated with Neonatal Septic Hip in a Late Preterm Infant

  • Kim, Hye-Eun;Kim, Do Hee;Chung, Sung-Hoon;Bae, Chong-Woo;Choi, Yong-Sung
    • Neonatal Medicine
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    • 제25권4호
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    • pp.191-195
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    • 2018
  • Leukocyte adhesion deficiency is a rare primary immunodeficiency and autosomal recessive disorder caused by a mutation in the gene encoding CD18, which is a constituent of leukocyte integrins. Clinical features usually begin with a delay in the separation of the umbilical cord in the neonatal period, and are characterized by marked leukocytosis with infection, delayed wound healing, and repeated bacterial and fungal infections. We experienced a case of leukocyte adhesion deficiency diagnosed in the neonatal period, in which a late preterm infant admitted to neonatal intensive care unit presented with a septic hip. Flow cytometry analysis of whole blood showed a decrease in the expression of CD11b/CD18. This is the first case of leukocyte adhesion deficiency with neonatal septic hip diagnosed in Korea.

두경부 악성 종양환자에서 조기 방사선치료를 위한 구강관리법에 대한 임상적 연구 (The clinical study of oral care for early radiation therapy in the head and neck cancer patients)

  • 문원규;유재하;차인호;김형준;정영수;이천의;이종영;유미현
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권6호
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    • pp.473-480
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    • 2010
  • Introduction: Tooth requiring extraction before radiotherapy in head and neck cancer patients should be performed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it is not uncommon for the radiotherapist and cancer patient to feel an urgent need to proceed with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy were considered and applied based on a literature review Materials and Methods: The clinical study involved 120 head and neck cancer patients who were treated at Wonju Christian Hospital, Wonju College of Medicine, Yonsei University, from January 1995 to December 2004. Results: In the clinical study, there were no specific complications, such as, post-extraction wound infections, radiation osteitis and osteoradionecrosis over the recent 10 years despite the early radiotherapy. Conclusion: Based on the clinical study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for early radiotherapy in head and neck cancer patients.

중증외상환자의 치료경과 시간과 활력징후에 따른 응급처치 및 간호활동 (Emergency Treatment and Nursing Activities of Severe Trauma Patients according to Elapsed Time and Vital Signs)

  • 김명희;박정하;김명희;구지은
    • Journal of Korean Biological Nursing Science
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    • 제16권3호
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    • pp.182-191
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    • 2014
  • Purpose: The aim of this study was to identify necessary emergency treatment and nursing activities for severe trauma patients according to elapsed time and vital signs. Methods: A survey was conducted with 121 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. Collected data were analyzed with descriptive statistics, applying McNemar's test using SPSS 12.0. Results: Almost all of the subjects were men and the mean age was 46.9. Run-time for primary diagnosis, treatment decision, and leaving for the hospital room was 0.19, 4.36, and 4.21 hours, respectively, and stayover time was 9 hours. Regardless of vital signs, emergency treatments involving ambu-bagging, intubation, ventilator, and central vein catheterization insertion were offered within an hour. Central venous pressure, Foley catheter/Levin tube preparation and maintenance were performed in cases of unstable vital sign patients within an hour. Unrelated to vital signs, nursing activities for consciousness assessment, skin assesment and wound care, bed sore/fall down assesment and care, intravenous injection insertion and maintenance were conducted for all severe trauma patients within an hour. Foley catheter/Levin tube drainage care was performed for patients who had unstable vital signs within an hour. Conclusion: Emergency treatment and nursing activities for severe trauma patients were specific according to elapsed time and vital signs.

Comparison of Standardized Peristomal Skin Care and Crusting Technique in Prevention of Peristomal Skin Problems in Ostomy Patients

  • Park, Seung-Mi;Lee, Yun-Jin;Oh, Doo-Nam;Kim, Ji-Yun
    • 대한간호학회지
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    • 제41권6호
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    • pp.814-820
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    • 2011
  • Purpose: This study was performed to compare the effects of standardized peristomal skin care (SPSC) and crusting technique (CT) on the peristomal skin of ostomates. SPSC was developed by a consensus among the expert group based on a comprehensive review of the relevant literature and hospital protocols. Methods: A randomized controlled pilot trial with 2 parallel arms was used. A total of 81 ostomates, who were recruited from a tertiary hospital, completed the baseline, 1-month, 2-month, and 3-month follow-up (SPSC group, n=45; CT group, n=36). SPSC consisted of water cleansing and direct application of ostomy appliances. CT involved crusting hydrocolloid powder and patting with water sponge or protective barrier liquid film. The outcomes of the study were assessed by skin problems, such as discoloration, erosion and tissue overgrowth; the domains of the evaluation tool used in examining the peristomal skin. A generalized estimating equation model was used to examine the effects according to time and group. Results: In both SPSC and CT groups, the likelihood of occurrence of discoloration (OR, 1.99; 95% CI, 1.61-2.46), erosion (OR, 1.87; 95% CI, 1.55-2.25) and tissue enlargement (OR, 1.94; 95% CI, 1.36-2.77) increased with time. There was no significant difference in discoloration between the groups, whereas the probability of erosion (OR, 0.38; 95% CI, 0.16-0.89) and tissue overgrowth (OR, 0.09; 95% CI, 0.02-0.55) was lower in the SPSC group than in CT group. Conclusion: SPSC was sufficient in preventing peristomal skin problems of ostomates compared to the CT.