• Journal of Yeungnam Medical Science
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• 제38권1호
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• pp.74-77
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• 2021

Lymphorrhea is a rare but potentially severe complication that occurs after various surgical procedures. Untreated lymphorrhea may lead to wound dehiscence, infection, and prolonged hospital stay. Currently, there is no standard effective treatment. Early management usually includes leg elevation, drainage, and pressure dressing. However, these methods are associated with prolonged recovery and high recurrence rates. We report a case of lymphorrhea from a calf wound after endoscopic great saphenous vein (GSV) harvesting for coronary artery bypass grafting (CABG). The patient presented with intractable oozing from the postoperative wound on the right calf. Lymphorrhea persisted for 6 weeks despite negative-pressure wound therapy with a long-acting somatostatin. We performed unilateral pedal lymphangiography that confirmed wound lymphorrhea, followed by glue embolization. No recurrence was observed after 8 months of follow-up. This case report demonstrates the successful use of lymphangiography with glue embolization in the control of lymphorrhea after GSV harvesting for CABG.

• 한국동물위생학회지
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• 제33권3호
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• pp.313-317
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• 2010

This study was conducted in the saltwater crocodile (Crocodylus porosus) for the occurrence of various surgical affections with their clinical management. During the period of January 2006 to June 2008, a total of 68 adult crocodiles were considered as reference population from the Reptiles Farm Ltd. at Bhaluka, Mymensingh. The occurrence of surgical affections of adult female (88.9%) was significantly (P<0.01) higher than male (11.1%). Prevalence of common surgical affections were wound: 72.2%, fibroma: 11.1% abscess: 5.6%, fracture: 5.6%, tail necrosis: 2.8%, myiasis: 2.8%. Wound was the highest among the affections. Among the identified wounds, biting wound was higher. In summer (57.7%) the occurrence of wound was higher compared to other seasons. In winter season (7.7%) the occurrence of abscess, myiasis, fibroma were higher compared to other seasons. Wounds and fibroma are the major surgical affections in salt water crocodile. The most common site of surgical affection was recorded in crocodile's tail (30.6%). It was suggested that minimal stress, allowing constant and easy access to water, removal of roots of the tree in the basking land of crocodiles pen, basking land of the pen is better filling up by sand, clinical surgical managements are essential for better health and production.

• Archives of Plastic Surgery
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• 제48권6호
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• pp.599-606
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• 2021

Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol. Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing. Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4-23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar. Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7765-7768
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• 2015

This study was conducted to determine the incidence of wound complications after laparotomy for endometrial cancer and significant predictors of risks. Medical records of patients with endometrial cancer undergoing laparotomy for surgical staging at Srinagarind Hospital, Khon Kaen University between January 2007 and December 2013 were reviewed. Intravenous antibiotic prophylaxis was routinely given 30 minutes before surgery. The primary endpoint was wound complications (including seroma, hematoma, separation, or infection) requiring additional medical and/or surgical management within 4 weeks of laparotomy. During the study period, 357 patients with complete medical records were reviewed. The mean age was 56.9 years. Wound complications were observed in 28 patients (7.84%, 95% CI, 5.27% to 11.14%). Body mass index (BMI) ${\geq}30kg/m^2$, diabetes mellitus (DM), and prior abdominal surgery were observed as significant independent factors predicting an increased risk of wound complications with adjusted odds ratios (95% CIs) of 2.96 (1.23-7.16), 2.43 (1.06-5.54), and 3.05 (1.03-8.98), respectively. In conclusion, the incidence of wound complications after laparotomy for endometrial cancer was 7.8%. Significant independent predictors of risk included BMI, DM and prior abdominal surgery.

• Neurospine
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• 제15권4호
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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.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.335-342
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• 2023

Diabetic foot ulcers (DFUs) are among the most serious complications of diabetes and are a source of reduced quality of life and financial burden for the people involved. For effective DFU management, an evidence-based treatment strategy that considers the patient's clinical context and wound condition is required. This treatment strategy should include conventional practices (surgical debridement, antibiotics, vascular assessment, offloading, and amputation) coordinated by interdisciplinary DFU experts. In addition, several adjuvant therapies can be considered for nonhealing wounds. In this narrative review, we aim to highlight the current trends in DFU management and review the up-to-date guidelines.

• 임상간호연구
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• 제20권1호
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• pp.40-52
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• 2014

Purpose: This study was done to develop an evidence-based nursing clinical practice guideline (PU CPG) for pressure ulcer prevention and management in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by Gu et al. (2012) which consists of three main phases and 9 modules including a total of 24 steps. Results: The newly developed PU CPG included the introduction, pressure ulcers, summary of recommendations, recommendations, references, appendices, and glossary. The total number of recommendations was 148 in 4 sections (organizational policy, assessment, pressure ulcer prevention and management, and education) and 16 domains. Of the recommendations 4.7% were graded A, 16.9%, B, and 78.4%, C. Conclusion: Results indicate that this new PU CPG is an evidence-based practice guidance for pressure ulcer prevention and management and can be recommended for dissemination and utilization by nurses nationwide to improve the quality of pressure ulcer prevention and management. Regular revision is recommended.

• Journal of Chest Surgery
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• 제28권6호
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• pp.630-632
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• 1995

Bichamber cardiac rupture is less frequent compared to unichamber cardiac rupture. We report a patient who was successfully treated after the diagnosis of penetrating stab wound of both ventricles. The key to improved outcome of management of cardiac trauma lies in the rapid transportation to a general hospital where cardiac surgery is available. Aggressive primary intervention and immediate operation are also major factors.

• 대한치과의사협회지
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• 제54권10호
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• pp.790-798
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• 2016

The maxillofacial soft tissue trauma is one of the major causes to visit the emergency room. For the past few decades, however, the basic concept of the repairing the soft tissue wound have not been changed. Therefore, it could be worthwhile to remind the fundamental concepts and practical information belong to the soft tissue injury management. Among the many types of soft tissue trauma, laceration wound which is most frequently met in the clinic will be discussed in this review.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.213-219
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• 2010

Purpose: Iodine has been used for the prevention or management of wound infection as a topical agent. Although iodine was widely used mainly by Betadine$^{(R)}$ and cadexomer iodine, there was no comparative study on the efficacies of dressing methods of iodine. And also it's wound healing effect was not yet clear. The purpose of this study is to compare antibacterial effects and wound healing effects associated with various dressing methods of iodine on infected full thickness skin defect in the mouse. Methods: One full thickness skin defects in the mice (n=60) were developed on the back and left open for twenty-four hours. Sixty mice were divided into four groups : group S (dressing with Betadine$^{(R)}$ soaking, n=15), group T (dressing with Betadine$^{(R)}$ topping, n=15), group I (dressing with Iodosorb$^{(R)}$, n=15), group G (control group, dressing with dry gauze, n=15). The size of the wound defects and the grades of wound healing were evaluated in 4, 7, 10 days, and antibacterial effect was evaluated with restricted zone in Mueller Hinton agar by disk diffusion method. Results: After the wound was left open for twenty-four hours, many Staphylococcus aureus were cultured. The wound defect size was decreased in order of Betadine$^{(R)}$ soaking, Iodosorb$^{(R)}$, Betadine$^{(R)}$ topping and gauze dressing group in all days, but difference among experimental groups was not statistically significant. The grade score of wound healing was increased in order of Betadine$^{(R)}$ soaking, Iodosorb$^{(R)}$, Betadine$^{(R)}$ topping and gauze dressing group, and the difference was statistically significant. Antibacterial effect for S. aureus was increased in order of Iodosorb$^{(R)}$, Betadine$^{(R)}$ soaking, Betadine$^{(R)}$ topping and gauze dressing group, and the difference was statistically significant. Conclusion: Selection of the effective dressing method of iodine for infected wounds remains a controversial decision. According to this study, Iodosorb$^{(R)}$ may be most effective method for antibacterial effect and Betadine$^{(R)}$ soaking may be most effective method for infected wound healing. However, further study is necessary to evaluate the clinical efficacy of dressing methods of iodine and to search for the mechanisms that explain their effects.