• 한국산림과학회지
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• 제98권5호
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• pp.584-592
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• 2009

The objective of this study was to examine the impact of pruning intensity on the vigor and cambial growth of the treated trees, and on the closure of pruning wounds for one year after pruning treatment. Two tree species, Pinus strobus and Acer palmatum, planted broadly in the urban forest of Korea were selected for the experiment. Intensity of pruning, which was estimated by proportion of removed branches, was categorized into five levels with about 10% intervals from lowest 8% up to 46%. Following parameters were examined; cambial electrical resistance (CER) and the cambial growth of trunk at 30 cm above the ground for the years before and after pruning, the cambial growth of stem at 1.5 cm above the branch bark ridge (BBR) of the pruned branch, and closure of pruning wound for one year after pruning. Tree vigor inferred from CER had a tendency to be weakened as pruning intensity increased in P. strobus, while that of A. palmatum was not affected. The trunk growth decreased significantly when the pruning intensity was higher than 30% in both species. The closure of individual pruning wound was related more to the cambial growth of stem at 1.5 cm above BBR than to the pruning intensity. Comparing the closure rate of pruning wound for one year, P. strobus with 72.1% was faster than A. palmatum with 39.3%, which corresponded with the rate of cambial growth of the two species.

• The Journal of Korean Physical Therapy
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• 제22권3호
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• pp.87-92
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• 2010

Purpose: The purpose of this study was to investigate the effect of electrical stimulation (ES) on the wound closure rate, collagen deposition, and TGF-${\beta}$1 mRNA expression in skin wound of rat. Methods: Twenty male Sprague-Dawley rats (222~271 g) were randomly divided into ES (n=10) and control group (n=10). The ES group received a cathodal stimulation with 50 V at 100 pps for 30 minutes for 7 days, while the control group was not given electrical stimulation. The wound closure rate, collagen density and TGF-${\beta}$1 mRNA ratio were measured. Results: The mean wound closure rates in the ES and control groups were $83.79{\pm}16.35$% and $51.57{\pm}17.76$%, respectively (p<0.001). The collagen density in the ES and control groups were $46.67{\pm}10.68$% and $25.03{\pm}13.09$%, respectively (p<0.001). The TGF-${\beta}$1 mRNA ratio in the ES and control groups were $1.35{\pm}0.60$ and $0.63{\pm}0.30$, respectively at 6 hours post-wound (p<0.01) and $1.69{\pm}0.47$ and $1.32{\pm}0.28$, respectively, at 7 days post-wound (p<0.05). Conclusions: ES accelerated the wound closure rate of skin incision wounds and was accompanied by an increase in collagen deposition in the regenerating dermis. In addition, ES increased TGF-${\beta}$1 mRNA expression during wound healing process. These findings suggest that ES may activate TGF-${\beta}$1 expression, and may increase synthesis activities of fibroblasts in regenerating skin wounds in rats.

• Archives of Plastic Surgery
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• 제32권6호
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• pp.727-732
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• 2005

The treatment of wounds of the lower extremity caused by diabetes or vascular dysfunction remains a difficult problem for the plastic surgeon. The use of negative pressure in wound healing is a relatively new method to facilitate chronic wound healing by secondary healing. The use of vacuum-assisted closure(VAC) system is purposed to reduce local edema, increase regional blood flow, enhance epithelial migration, preserve a moist wound environment, reduce bacterial colonization, promote granulation tissue formation, and mechanically enhance wound closure. The VAC also can be used as a dressing for anchoring an applied split thickness skin graft. We reviewed the data from 20 consecutive patients with non-healing wound in lower extremity at Dong-A University from March 2002 to December 2004. We used the VAC in 20 patients and compared the results with the control group. In the VAC using group, mean application duration was about 3 weeks and dressing change was done every other day. The follow-up period of patients ranged from 3 months to 30 months with a mean of 17 months. The points of comparison with control group are wound size, granulation tissue proliferation rate, operation method, preoperative time, postoperative healing time, complication, and cost. With those points, we propose to approve the efficiency of the VAC in non-healing wound. As a result, the VAC used in non-healing wound decrease wound size, accelerate granulation tissue formation, do a wound closure with less invasive operation method, make less postoperative complication, can make operation time shorter. Therefore it is cost effect. Our results demonstrate the usefulness of VAC as an adjunct in management of chronic wounds with other extrinsic factors.

• Journal of Chest Surgery
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• 제56권3호
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• pp.206-212
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• 2023

Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

• 한국전문물리치료학회지
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• 제3권3호
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• pp.67-81
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• 1996

This study was performed to assess the efficacy of high voltage pulsed galvanic current for the healing of wounds in rabbits. Skin wounds were created laterally on the flank of 12 domestic rabbits($3{\times}3cm$). The wounds of each group were treated with an intensity of 170 V at a frequency of 70 pulses per second, which was applied for 30 minutes a day for 10 days. The experimental groups were randomly assigned to either EXP I (n=3), EXP II(n=3), EXP III(n=3) or control(n=3). Each group was stimulated under the following conditions : 1) EXP I (Negative polarity), 2) EXP II (Change in polarity, negative electrode stimulation during the first 3 days and then positive electrode stimulation from 4 to 10 days), 3) EXP III(Positive polarity), 4) control(No stimulation). An active electrode was placed over the wound and a dispersive electrode on the buttock. The rate of wound closure was compared with the original wound size, evaluated by a tracing film in each measurement period. Finally, on the wound in each group, skin tissue was excised for histological evaluation after treatment for 10 days. The results obtained are as follows : 1) It was found that the control group did not show a complete remodeling of epitherial layer and had a chronic inflammatory response. Judging from the irregularity of intercellular space and the loose alignment of connective tissue, these findings show that wound healing was delayed. 2) EXP I showed a significant bactericidal effect, but a moderate response of vasodilation. The rate of wound closure was slower when compared with EXP II, III. 3) EXP II showed a complete remodeling of epitherial layer and a positive repair of connective tissue. Its rate of wound closure was best when compared with the others. 4) EXP III had a slower rate of wound closure than EXP II, but judging from the greater proliferation of collagen fibers and the dense alignment of connective tissue, this positive electrode was very effective in the formation of neo - connective tissue.

• 한국산림과학회지
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• 제105권4호
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• pp.505-509
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• 2016

본 연구는 현재 수목관리 현장에서 사용 중인 상처도포제의 유효성을 확인하기 위해 실시하였다. 티오파네이트메틸 도포제(상표명: 톱신페스트)는 은행나무, 느티나무, 왕벚나무에서, 라놀린은 느티나무와 왕벚나무에서, 테부코나졸 도포제(상표명: 실바코)는 왕벚나무에서 각각 무처리구 대비 유의하게 높은 상처유합률을 나타냈다. 페트롤리움젤리(상표명: 바셀린)는 은행나무, 느티나무, 왕벚나무 등 소나무를 제외한 전 수종에서, 인체 무독성 접착제(상표명: 오공본드)는 느티나무에서 각각 무처리구보다 유의하게 낮은 상처유합률을 보였다. 특히 바셀린을 처리한 느티나무와 왕벚나무 상처부위에서는 형성층이 괴사되어 상처가 확대되는 피해가 발생하였다. 소나무는 수지 유출로 인해 상처도포제 처리효과가 나타나지 않았다.

• Journal of Chest Surgery
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• 제51권4호
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• pp.260-265
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• 2018

Background: A method of wound closure using knotless suture material in the chest tube site has been introduced at our center, and is now widely used as the primary method of closing chest tube wounds in video-assisted thoracic surgery (VATS) because it provides cosmetic benefits and causes less pain. Methods: We included 109 patients who underwent VATS pulmonary resection at Samsung Medical Center from October 1 to October 31, 2016. Eighty-five patients underwent VATS pulmonary resection with chest drain wound closure utilizing knotless suture material, and 24 patients underwent VATS pulmonary resection with chest drain wound closure by the conventional method. Complications related to the chest drain wound were compared between the 2 groups. Results: There were 2 cases of pneumothorax after chest tube removal in both groups (8.3% in the conventional group, 2.3% in the knotless suture group; p=0.172) and there was 1 case of wound discharge due to wound dehiscence in the knotless suture group (0% in the conventional group, 1.2% in the knotless suture group; p=0.453). There was no reported case of chest tube dislodgement in either group. The complication rates were non-significantly different between the 2 groups. Conclusion: The results for the complication rates of this new chest drain wound closure method suggest that this method is not inferior to the conventional method. Chest drain wound closure using knotless suture material is feasible based on the short-term results of the complication rate.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.121-126
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• 2011

Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

• Archives of Plastic Surgery
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• 제35권2호
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• pp.121-126
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• 2008

Purpose: Poly-N-acetyl glucosamine(PGlcNAc) nanofiber-based materials, produced by a marine microalga, have been characterized as effective hemostatic and angiogenic agents. The similarity between PGlcNAc patch and the natural extracellular matrix allows it to support new healthy tissue growth in an injured area and to encourage fluid absorption. In this study, we hypothesized that a poly-N-acetyl glucosamine fiber patch(PGlcNAc patch) may enhance wound healing in the db/db mouse. Methods: PGlcNAc patches were applied on one square centimeter, full-thickness, skin wounds in the db/db mouse model. Wounds(n=15 per group) were dressed with a PGlcNAc nanofiber patch for 1 hour(1 h), 24 hours(24 h) or left untreated(NT). After the application time, patches were removed and wounds were allowed to heal spontaneously. The rate of wound closure was evaluated by digital analysis of unclosed wound area in course of time. At day 10, wounds(n=7 per group) were harvested and quantified with immunohistochemical markers of proliferation(Ki-67) and vascularization (platelet endothelial cell adhesion molecule, PECAM-1). Results: Wounds dressed with PGlcNAc patches for 1 hour closed faster than control wounds, reaching 90% closure in 16.6 days, nine days faster than untreated wounds. Granulation tissue showed higher levels of proliferation and vascularization following 1 h treatment than the 24 h and NT groups. In addition to its hemostatic properties, the PGlcNAc material also appears to accelerate wound closure in healing-impaired genetically diabetic mice. Conclusion: This material, with its combination of hemostatic and wound healing properties, has the potential to be effective agent for the treatment of complicated wounds.

• Archives of Plastic Surgery
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• 제41권3호
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• pp.253-257
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• 2014

Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to $33.6kg/m^2$ (mean, $23.1{\pm}3.74kg/m^2$). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.