• Archives of Plastic Surgery
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• v.47 no.6
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• pp.528-534
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• 2020

Split-thickness skin grafting (STSG) is the gold standard for coverage of acute burns and reconstructive wounds. However, the choice of the donor site for STSG varies among surgeons, and the scalp represents a relatively under-utilized donor site. Understanding the validity of potential risks will assist in optimizing wound management. A comprehensive literature search was conducted of the PubMed database to identify studies evaluating scalp skin grafting in human subjects published between January 1, 1964 and December 31, 2019. Data were collected on early and late complications at the scalp donor site. In total, 27 articles comparing scalp donor site complications were included. The selected studies included analyses of acute burn patients only (21 of 27 articles), mean total body surface area (20 of 27), age distribution (22 of 27), sex (12 of 27), ethnicity (5 of 27), tumescent technique (21 of 27), depth setting of the dermatome (24 of 27), number of harvests (20 of 27), mean days of epithelization (18 of 27), and early and late complications (27 of 27). The total rate of early complications was 3.82% (117 of 3,062 patients). The total rate of late complications was 5.19% (159 of 3,062 patients). The literature on scalp skin grafting has not yet identified an ideal surgical technique for preventing donor site complications. Although scalp skin grafting provided superior outcomes with fewer donor site complications, there continues to be a lack of standardization. The use of scalp donor sites for STSG can prevent early and late complications if proper surgical planning, procedures, and postoperative care are performed.

• YAKHAK HOEJI
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• v.40 no.6
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• pp.646-652
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• 1996

Epidermal Growth Factor (EGF), discovered by Stanley Cohen in 1960, has a potential healing effect for wounds and bums. Considering wound care, in order to avoid physical stress at the wound surface and efficiently apply EGF, the need for viscous spraying solutions was essential. Viscous spraying solutions containing EGF were prepared by utilizing viscosity-building polymer, poloxamer 407, and by introducing liposome systems. On the other hand, EGF is purified on reverse HPLC gradient program with the mobile solvent of acetonitrile. It is necessary to observe liposomal EGF changes as the acetonitrile contents varied in order to introduce liposome systems at the step of EGF solution (at the time of EGF purifying). By evaluating the size distribution and entrapment efficiency of EGF liposome, it was possible to detemine the limit contents of acetonitrile and establish the optimal conditions for solution formulations. It has been revealed that, as the acetonitrile content increases, mean diameter of EGF liposomes increased and the width of size distribution tends to decrease. The limit contents of acetonitrile were 10%, since there was little difference to the acetonitrile free liposomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.224-227
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• 2000

Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

• Health Policy and Management
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• v.15 no.4
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• pp.26-45
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• 2005

The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

• The Journal of Korean Physical Therapy
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• v.7 no.1
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• pp.61-67
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• 1995

The silver cation has broad-spectrum antibiotic activity toward Gram-positive, Gram-negative, fungal. aerobic and anerobic micro-organisms. Silver has been used to care of infected wound. pyogenic arthritis, and chronic osteomyelitis. The purpose of this study was to determine whether pure silver wire iontophoresis using milliamperage direct current has an inhibitory effect on growth in vitro of 3 different species of bacteria-Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Using agarose based media, silver iontophoresis performed at 0, 1, 2, 4, 8 mA for 15 minutes. All experiments were performed in triplicate. Following iontophoresis, inhibition zone width of bacterial growth was measured with calliper. The inhibition of bacterial growth occured at the anodal silver electrode. Inhibition zone width of bacterial growth was significantly increased in all three bacterial species (p<0.05). Between bacterial species, inhibition zone width was not significantly different. Inhibition gone and amperage showed a highly significant positive linear relationship (p<0.001). The result of this study showed that pure silver wire iontophoresis with milliamperage direct current, as well as microamperage direct current, can inhibit bacterial growth in vivo.

• Archives of Craniofacial Surgery
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• v.22 no.1
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• pp.52-55
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• 2021

Complete surgical excision within a margin of normal healthy bone is the treatment of choice for intraosseous hemangioma. A 56-year-old man visited with complaints of a firm, mildly tender, immovable, and palpable mass on the right forehead (size: 1.5×1.5 cm). Non-contrast brain computed tomography performed preoperatively revealed a 1.5 cm heterogenous osteolytic lesion with suspected internal trabeculation in the right frontal bone. Under general anesthesia, a 2 cm transverse incision was made on the forehead skin rather than bicoronal incision. Full-thickness en bloc resection of the frontal bone including the mass was performed. The frontal bone was removed with care taken not to damage the frontal sinus mucosa. The frontal sinus was sealed with a collagen patch (Tachocomb) and a cranioplasty was performed using bone cement. At 6 months postoperative, a clean wound was confirmed without any complications, and there was no local recurrence. Surgical excision of intraosseous hemangioma in the frontal sinus bone can be performed via direct incision or the bicoronal approach. In this case, the direct incision approach was used to achieve smaller scars and faster recovery than the bicoronal approach.

• Journal of Biomedical Engineering Research
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• v.44 no.1
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• pp.64-72
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• 2023

Initial burn wound care is one of the important factors in the outcome of burn treatment. In this study, we tried to develop spray-type alginate hydrogel dressing with advantages such as promoting wound healing, reducing pain, and increasing ease of use for emergency burn treatment. Spray implementation, physical properties, and cytotoxicity of the newly developed spray-type alginate hydrogel dressing were evaluated. As a result, a new functional spray-type hydrogel dressing with excellent physical properties and biocompatibility was developed along with the development of spray able containers, and it was confirmed that it could be applied as a treatment for skin regeneration in the future.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.1-5
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• 2024

The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.2
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• pp.189-195
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• 2010

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal & gastric aspiration and hypovolemic shock. Therefore, the rapid & correct bleeding control is very important for life-saving in the medical emergency room. In spite of the bleeding control methods of the wound suture & direct pressure, the postoperative bleeding can be occurred, because of the presence of various bleeding disorders & postoperative delayed wound infections. The proper care of bleeding disorders & wound infections are very important for the control of the delayed postoperative rebleeding. In spite of these methods, active oral bleeding can be presented by the other causes of head injury. A rare but particularly dangerous sort of bleeding that may have an especial importance to the patient with severe basal skull fracture that damage large vessels and even the cavernous sinus. The occurrence of profuse nasal or oropharyngeal bleeding may arise from damage to the anterior and posterior ethmoidal vessels, but when mixed with brain tissue it is evidence of mortal damage. In this condition, rapid entire oropharyngeal packing is essential for the control of active oral bleeding. This is a case report of rapid rational bleeding control method by much amount of wet gauze packings, in a 44-years-old male patient with active oropharyngeal bleeding by basal skull fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.560-564
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• 2001

The experienced surgeon can be surprised & challenged by the hazards of active bleeding during oral & maxillofacial surgical procedure, because of alterations in the surgical anatomy, bleeding disorders and surgical intervention of infected tissues. This is a report of two cases of active bleeding during surgical extraction of mandibular third molar, that had the pericoronitis, osteitis and adjacent neurovascular bundle in its apex. When the abrupt active bleeding was occurred during surgical extraction of mandibular third molar, pressure packing by hemostatie agent(bone wax) & wet gauze biting were applied into the extraction socket during 30 minutes. After 30 minutes, the wound was explored about the bleeding and active bleeding was then continued. In spite of repeated bleeding control method of the pressure dressing, the marked hemorrhage was generated continuously. Therefore, the author decised the bleeding as immediately uncontrollable hemorrhage and the pressure dressing was again applied for the more longer duration without wound closure. After 3 days, the pressure dressing was removed and iodoform gauze drainge was then established without the bleeding. The drain was changed as the interval of 3~5 days for prevention of infection & secondary hemorrhage and relatively good wound healing was then resulted in 6 weeks.