• Journal of Chest Surgery
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• 제15권1호
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• pp.3-12
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• 1982

Although most patients with penetrating injuries can be managed successfully with early tube thoracotomy, blood volume replacement & close observation, the remainder can be saved only by an aggressive operative intervention. From January 1959, to August 1980, 176 cases with penetrating injuries had been treated at the Department of Cardiothoracic Surgery, National Medical Center. The ratio of male to female patient of penetrating chest wounds was 4.3:1 in male predominance and age from 10 to 40 occupied 76.7% of the total cases. Stab wounds was the most common penetrating injuries and followed by gunshot & glass wounds. To prevent early complications of penetrating chest injuries, thoracentesis were done in 29 cases [16%], and closed thoractomy in 40 cases [22.7%]. Open thoractomy, however, had to be done in 37 cases [21%] because of massive bleeding, hemopericardium, foreign body.

• Journal of Trauma and Injury
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• 제37권1호
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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.

• Journal of Trauma and Injury
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• 제37권2호
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• pp.166-169
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• 2024

Stab wounds, particularly those affecting multiple body regions, present considerable challenges in trauma care. This report describes a case of sustained self-inflicted stab injuries to the abdomen and thighs of a 23-year-old male patient. Although the patient's vital signs were stable and bleeding was minimal from thigh wounds without overt signs of vascular injury, the patient experienced a sudden, profound hemorrhage from the right thigh, leading to cardiac arrest. Successful resuscitation was followed by surgical repair of a right superficial femoral arterial injury accompanying a resuscitative endovascular balloon of the aorta. Subsequent lower extremity computed tomography angiography revealed no additional vascular abnormalities. The patient was discharged in stable condition on the 12th postoperative day. This case underscores the unpredictability of stab wound trajectories and the potential for hidden vascular injuries, even in the absence of immediate life-threatening signs. It also emphasizes the critical role of advanced imaging modalities, such as computed tomography angiography, in identifying concealed injuries, and the importance of strategic intraoperative techniques, including resuscitative endovascular balloon occlusion of the aorta, in achieving favorable patient outcomes.

• Archives of Plastic Surgery
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• 제40권6호
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• pp.705-710
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• 2013

Background Mammalian bite injuries create a public health problem because of their frequency, potential severity, and increasing number. Some researchers have performed fragmentary analyses of bite wounds caused by certain mammalian species. However, little practical information is available concerning serious mammalian bite wounds that require hospitalization and intensive wound management. Therefore, the purpose of this study was to perform a general review of serious mammalian bite wounds. Methods We performed a retrospective review of the medical charts of 68 patients who were referred to our plastic surgery department for the treatment of bite wounds between January 2003 and October 2012. The cases were analyzed according to the species, patient demographics, environmental factors, injury characteristics, and clinical course. Results Among the 68 cases of mammalian bite injury, 58 (85%) were caused by dogs, 8 by humans, and 2 by cats. Most of those bitten by a human and both of those bitten by cats were male. Only one-third of all the patients were children or adolescents. The most frequent site of injury was the face, with 40 cases, followed by the hand, with 16 cases. Of the 68 patients, 7 were treated with secondary intention healing. Sixty-one patients underwent delayed procedures, including delayed direct closure, skin graft, composite graft, and local flap. Conclusions Based on overall findings from our review of the 68 cases of mammalian bites, we suggest practical guidelines for the management of mammalian bite injuries, which could be useful in the treatment of serious mammalian bite wounds.

• Medical Lasers
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• 제8권2호
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• pp.94-96
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• 2019

Burns are one of the most extensive injuries of soft tissues as well as skin, occasionally resulting in extensive, deep wounds and death. Burn wounds can lead to severe physical and psychological distress because of excessive scarring and skin contractures. Treatment of burn wounds has always been a challenging problem and many different methods have been used to treat such injuries. We report here on treating a patient with a burn wound using 830-nm light emitting diode (LED) phototherapy combined with epidermal growth factor (EGF) solution. After five daily sessions of LED with EGF solution treatment, the patient demonstrated nearly complete improvement with no remarkable side effects. We suggest that LED phototherapy combined with EGF solution could be an effective and safe treatment option for treating burn wounds.

• Journal of Korean Neurosurgical Society
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• 제41권1호
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• pp.16-21
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• 2007

Objective : Civilian gunshot injuries to the brain are relatively rare and study of these injuries has been neglected in South Korea. We present our experience with penetrating gunshot injuries to the brain and review the outcome of surgical management, as well as other clinical predictors influencing the prognosis. Methods : We present a retrospective analysis of 13 patients with penetrating gunshot injuries to the brain who were treated at our hospital over a period of 22 years. Results : The Glasgow Coma Scale[GCS] score on admission was recorded to be : 3-5 in 1 patient, 6-8 in 3 patients, 9-12 in 2 patients and 13-15 in 7 patients. There were 11 patients who underwent surgical treatment, and the surgical mortality rate was 0%. The admission GCS score was the most valuable prognostic factor. The best results were found to be in patients admitted with an initial GCS higher than 13. There were no favorable outcomes in patients admitted with a GCS of 8 or lower. There was a correlation between the presence of a transventricular or bihemispheric trajectory and poor outcome. The patients admitted with unilobar wounds resulted in better outcome than those with bilobar or multilobar wounds. Retained deep intracranial bone or metal fragments were the most common postoperative complication. However, retained fragments did not increase the risk of infection or seizure. Conclusion : Our results suggest that a less aggressive approach, consisting of minimal local debridement and removal of the bone and metal fragments that are easily accessible, can be successfully used in civilian gunshot wounds to the brain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권1호
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• pp.60-63
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• 2003

Gunshot injuries can range from the most minor to the life-threatening. Multidisciplinary care is required for successful management of patients, In the acute phase, care may involve emergency surgeons, anaesthesists, neurosurgeons, ophthalmic surgeons, vascular surgeons, ENT specialist in addition to the oral and maxillofacial surgeons. Afterwards, definitive treatment of facial gunshot injuries depends ultimately on the abilities and skills of the oral and maxillofacial surgeons, and their appreciation of such injuries. The timing and sequence of the surgical procedures used for reconstruction and rehabilitation of maxillofacial gunshot injuries are crucial to a successful outcome and aesthetic result. If incorrect, they may lead indefinitely to infection, graft rejection, wound dehiscence with consequent multiple revisional operations and complication which will prolong hospital stay and increase treatment costs and morbidity on those patients. We present a gunshot case of a 46-year-old man who tried to commit sucide, and have avulsive and penerating wounds on the face and the neck. We removed the scattered bullets and fragments successfully and the wounds were closed primarily.

• Journal of Chest Surgery
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• 제19권2호
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• pp.288-294
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• 1986

During the period from Mar. 1983 to Feb. 1986, 22 patients with vascular trauma were treated at Capital Armed General Hospital. 1] 11 patients had arterial injury alone, 6 patients had venous injury alone, and 5 patients had both arterial and venous injuries. 2] The mechanism of injury in these 22 patients was 7 penetrating non-gun shot wounds, 5 blast fragments injuries, 4 iatrogenic injuries, 4 blunt injuries, 2 gun shot wounds. 3] The method of 16 arterial repair was 5 autogenous saphenous vein graft, 8 synthetic vascular graft, 1 end to end anastomosis, 2 lateral suture. Midterm patency of 16 repairs was 100% within 1 months. 4] The method of 11 venous repair was 1 autogenous saphenous vein graft, 2 onlay vein patch, 2 ligation, 1 lateral suture. The thrombotic obstructions occurred in 4 repairs [36.4%], but they were resolved somewhat with heparinization. 5] Uncommon cases of false aneurysm of internal carotid artery and laceration of retrohepatic inferior vena cava were summarized.

• Journal of Medicine and Life Science
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• 제15권2호
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• pp.56-61
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• 2018

NPWT는 90년대 이후 많은 연구가 이루어지며 발전해왔다. 이 기술은 사용하기에 간단하고 다양한 상처에 적용할 수 있고 효용성과 비용-효과가 뛰어나며 부작용이 적다. 따라서 NPWT를 일반적인 드레싱 대신에 사용하면 육아조직의 빠른 성장과 상처 수축을 통해 피부 이식이나 피판이 필요한 부위를 줄일 수 있고 봉합이 불가했던 부위를 가능하게 하므로 창상 환자에 대한 의료 비용을 감소시키고 만성 창상 환자가 입원하지 않고 움직이면서 창상 관리가 가능하도록 할 수 있는 유용한 방법이다.

• Journal of Trauma and Injury
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• 제22권2호
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• pp.233-241
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• 2009

Purpose: Alcohol is a major risk factor for injuries, but little is known about the relationship between chronic drinking pattern and injuries. The purpose of this study was to evaluate the incidence of alcohol-related injuries and the differences in the characteristics of the injuries between Alcohol Use Disorder Identification Test (AUDIT) categories. Methods: Among a representative sample of the third Korea National Health and Nutrition Examination Survey. 7,697 adults answered questions about injuries, drinking patterns, and socioeconomic status. Incidences of alcohol-related injuries and of non-alcohol-related injuries were calculated, and the relative ratio of injuries between AUDIT categories was analyzed. Results: The incidences of all injuries and alcohol-related injuries were 69.2 and 6.8 per 1000 person-year. After adjustment, the incidences of non-alcohol-related injuries showed no differences between AUDIT categories. But the adjusted relative ratios (RRs) of alcohol-related injuries were 3.73 (95% CI: 1.54~8.99) and 7.70 (95% CI: 3.61~16.44) for risk drinkers and for alcohol-dependent drinkers respectively. No specific body part could be identified as being frequently injured in cases of risk drinkers and alcohol-dependent drinkers. In contrast, the adjusted RRs of fractures, bruises, and open wounds were 1.76 (95% CI: 1.03~3.02), 1.73 (95% CI: 1.15~2.61), and 1.85 (95% CI: 1.17~2.93) for alcohol-dependent drinkers. Assaults occurred 4.66 times more frequently in alcohol-dependent drinkers. Conclusion: Alcohol-related injuries occur more frequently as the person becomes more dependent on alcohol. Fractures, Bruises, open wounds, and assaults occur more frequently in alcohol-dependent drinker. This study suggests that efforts should be carried out in the ED to screen and treat alcohol-use disorders associated with patients injured after drinking.