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- The Experimental Study of Oxygen Supply on the Infected Wound
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Yeo Kyu Youn, Sung Hwan Bae, Jae Won Choi, Houng Rae Cho, Jin Pok Kim
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J Korean Soc Traumatol. 1988;1(2):108-221.
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Abstract
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- It is qenerally accepted that high oxygen tension in local wounds accelerate the activity of fibroblast which is an essential component for wound healing. In the present study. wound infection were made In rats using four standard inocular of streptococcus aureus (3.0X108) injected into subcutaneous wounds. The inoculation was done on the day of stripping, a 2X2 cm2 area of the dorsal skin from the rat. One uninoculated wound served as a control in each group. We directly measured the wound size by computer digitizer and the wound oxygen tension using Oxymeter, after applying a 1% povidone-iodone solution soaking (Group II), local TCDO applicafion (Group Ⅲ) fwice a day in each groups and using a hyperbaric chamber conditioned by 2.4 ATA for 90 minutes (Group Ⅳ). Also, we cultured the infected wounds and counted the colony numbers, after three day``s inoculation in each groups (×10(-2）). We found that the rate of wound healing and the tissue P02 in Group Ⅲ were very high, compared to the other groups The colony counts from the infected wound was high only in Group Ⅳ Also, culture counts were significantly low in the plasma with TCDO group .
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Summary
- Clinical Analysis of the Splenorrhaphy Using Omentum Meat Oall for the Traumatized Spleen
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Nam Kyu Kim, Hoon Sang Chi, Byong Ro Kim, Kyong Sik Lee
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J Korean Soc Traumatol. 1988;1(2):115-237.
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- Splenectomy had been unchallenged as the treatment of the splenic injury until 1919, when Morris and Bullock reported that asplenic patients would show an increased susceptibility to infection. Since following report of fatal postsplenectomy sepsis by King and Shmacher in 1952, splenectomy for the traumatized spleen has come under considerable criticism and reconsideration of the splenic injuries began to occur. Subsequently, postsplenectomy sepsis has been reported in all age group by many others. With expanding knowledge 01 immunologic and physiologic function recognition 01 the risk of OPSI(overwhelming postsplenctomy infection) has led surgeon to attempt splenic salvage procedures. Successful results with repair of traumatized spleen has been reported such as simple suture, partial splenectomy and splenorrhaphy using pedicle of omentum or hemostatic adhesives. Now, we have attempted 23 cases of splenorrhaphy using omentum meat ball, which previously had been unreported and successful results were obtained. 1. Among 23 patients undergoing successful splenorrhaphy, mean age was 27 year old. The youngest patient was II 4 year old and the eldest was 74 year of age. The 21 of 23 patients were male. 2. 20 of the injuries (87 96) were due to blunt trauma. while 3 (13 %) were iatrogenic. of the 20 traumatic injuries, 14(70%) resulted from motor vehicle accident and 4(20%) from falling down. 3. 10 patients with shock and hemopentoneum were immediately operated. In equivocal physical findings, diagnostic peritoneal lavage (8 patients) and paracentesis (2 patients) were performed 4. 15 of 23 injuries were parenchymal lacerations, which showed upper pole (7) lower pole (6) and longitudinal injury (2). 5 injuries were crack to hilus, not dividing vessels and 3 injuries of iatrogenic injury were capsular avulsion. 5. 18 had associated injuries, of these 18, 10 were rib and pelvic bone fracture and 4 were intraabdominal injuries including liver (3), renal contusion (1). 6. Splenorrhaphy was performed in 21 of the 23 patients with horizontal mattress suture using omentum meat ball. Only 2 of 23 patients, required partial splenectomy and also obtained secure hemostasis with omentum.
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Summary
- Wsefullness of Pediatric Trauma score and injury Severity score in Multiple injury Patients
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S. H. Choi, Y. U. Cho, H. S. Chi, H. D. Lee, B. R. Kim, E. H. Hwang, H. S. Lee
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J Korean Soc Traumatol. 1988;1(2):124-251.
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- Trauma is one of the most common causes of death in children. Recently, injury severity score (ISS) is widely used to evaluate and classify the patients with multiple injury. Pediatric trauma score (PTS) was developed as a means of providing rapid accurate assessment of the injured child. We analyzed the records of 130 consecutive trauma patients admitted to the Yonsei University Hospital from January, 1977 to December. 1986. PTS and ISS were collected from comprehensive initial evaluation. There were 8 persons who did following hospital admission. The most common cause of injury was motor vehicle accident (56.9 %) followed by falling down injury (24.1 ). This study demonstrated the inverse linear relationship between the PTS and f55. Patients with a PT5 of 8 and below have an increased potential for mortality as well as morbidity. Likewise, the patients with a ISS of 2 and above have a same tendency. The ISS was developed that correlates well with survival and provides a numerical description of the overall severity of injury for patients with multiple trauma. The PTS is simplified classify-cation system for pediatric age group. Use of the ISS or PTS facilitates comparison of the mortality experience of varied group of trauma patients.
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Summary
- Traumatic Duodenal Injury
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Kwang Soo Yoon, Kyung Soo Lim, Dae Sung Kim, Soo Young Yoo
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J Korean Soc Traumatol. 1988;1(2):129-264.
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- During the periord of 7 years from July 1981 to July 1988, the records of 35 patients with duodenal injury who were admitted and treated at Wonju Christian Hospital, Yonsei University Wonju College of Medicine. The reseults were follow: The ratio of male to female was 10:1. The most prevalent age group was in 4th decade. The most frequent clinical manifestation were abdominal pain, tenderness and rebound lender-ness, rigidity. The shorter the time from injury to operation, the lower the rate of complication & mortality after operation. The most common site of injury was the 2nd & 3rd portion (10 case. 28.6 %), followed by 1st portion and 4th portion. The type of duodenal injury were perforation (47.7 %), rupture (31.4 %), transection (22.8%). The 30 cases (85 %) were associated with other injuries. The most frequently associated injured organ was pancreas & Rt. . kidney, (each other 18.7 %). followed by large bowel. liver, biliary and small bowel. Operatire treatment was performed. The method of operative treatment was variable; primary closure & jejunal patch graft, primary closure & tube decompression, segmental resection and anastomosis, pyloric exclusion, duodenal diverticulization, Whipple``s operation, subtotal gastrectomy. Complications developed in 12 cases of the 35 patients (37.5 %) The most frequent complica-tion was wound infection and the other were enterocutaneous fistula, intraperitoneal or retr-operitoneal abscess and intestinal obstuction. The mortality rate was 17.1 %(6 cases of total 35 cases) and the most frequent causes of death was sepiticemia due to enterocutaneous fistula.
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Summary
- Treatment of the Shoulder Fractures
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Han Koo Lee, Sang Hoon Lee, Phil Hyun Chung, Suk Joo Lyu, Min Jong Park
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J Korean Soc Traumatol. 1989;2(1):1-12.
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- Sixty-two patients with fractures of the shoulder (22 clavicular fractures, 36 proximal humeral fractures and 4 scapular fractures) were treated at Department of Orthopedic Surgery, College of Medicine, Seoul National University between January, 1978 and October 1988. They were followed up between six months and three and half years with the aver-age of 1.2 years. Mean ages were 34.8 years in clavicular fractures, 52.9 years in proximal humeral fractures and 37.6 years in scapular fractures. Traffic accident was the most common cause of injury in all the shoulder fractures. In clavicular fractures, twelve were middle third and ten were lateral third fractures (four type I and six type II). Proximal humeral fractures were classified according to Neer``s classification, there were seven one-part(20%), seventeen two-part(41%), eight three-part(22%) and four four-part(11%) fractures or fracture-dislocations. In scapular fractures, there were two body fractures, one neck and one complex fractures involving the glenoid. Treatment and its results were as follows; 1. In clavicular fractures, middle third fractures were treated conservatively except two, which was unable to manually reduced. Type I lateral fractures were treated by closed method and type II by open method. 2. Complications of clavicular fractures were one nonunion, two malunion, one delayed union and one stiff joint in middle third fractures, and one broken pin, one loss of fix-ation in type II lateral third fractures. 3. In proximal humeral fractures, one-part and two-part fractures were treated conserva-tively except two old two-part fracture-dislocations. Three-part fractures were treated by open method except two with closed method and four-part fractures by two open method and two prosthesis. 4. Clinically, thirty-two(89%) proximal humeral fractures showed excellent or satisfac-tory tory results. 5. In scapular fractures, one glenoid fracture were treated by open method and others conservatively. All showed satisfactory union of fractures.
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Summary
- Necrotizing Fasciitis of Perineum
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Jae Moon Bae, Sung Han Bae, Yeo Kyu Youn, Sang Joon Kim, Jin Pok Kim
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J Korean Soc Traumatol. 1989;2(1):13-31.
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- Sixteen patients with necrotizing fasciitis of the perineum were treated at the Seoul National University Hospital from 1980 to 1988. Necrotizing fasciitis(N.F) occured predominantly in males(N : F= 14: 2), and the age of patients was even in distribution. These infections were caused by illicit injection for hemorrhoids, postoperative complica-tion, perianal abscess, fish bone impaction, bladder rupture due to traffic accident, and spontaneously in a half of patients. Necrotizing fasciitis is a rare disease that involves both superfical and deep fascia. It begins with fascial necrosis at onset and rapidly progresses to surrounding fascial planes, eventually involving overlying skin and underlying muscle. Escherichia coli was the most predominant organism cultured from the wounds in 12 patients. Other organism cultured were Pseudomonas enterococcus, streptococcus in orders of decreasing frequency. The accompanying disease was most commonly diabetes mellitus but perianal diseases such hemorrhoids and anal fistulas also occurred Its hospital course was quite long(mean : 60. 9 days) and showed high morbidity(6). The most definitive treatment was multiple incision and complete surgical removal of all necrotic tissue until the normal plane was reached. Reconstructive procedures such as skin graft and musculo cutaneous flap were necessary for 11 patients. None of the 16 patients died of the disease.
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Summary
- Double-Blind study of Effect of Elcation in Osteoporosis Patients with Low Back Pain
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Se Il Suk, Sang Hoon Lee, Kyung Hoi Koo
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J Korean Soc Traumatol. 1989;2(1):20-45.
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- Calcitonin, which prevents bone loss by inhibitory action on bone resorption, has been introduced in therapeutics for osteoporosis. While may studies revealed its analgesic effect on lumbago. whether or not calcitonin is capable of improving osteoporosis still remains to be investigated. The efficacy of calcitonin on lumbago and osteoporosis was evaluated with randomized double-blind. placebo controlled method in 56 patients with osteoporosis, who suffered lumbago. 10 unit elcatonin or placebo (lml saline) was injected intramuscularly, two times a week for 4 weeks. The patients were interviewed for evaluation of low back pain before treatment, 2weeks, 4weeks, 8weeks and 12weeks after beginning treatment. Also bone mass was measured with single photon absorptiometry, before and 12weeks after beginning treatment.
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Summary
- 교통사고 예방 및 대책에 대한 워크샵
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J Korean Soc Traumatol. 1989;2(1):27-55.
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Summary
- 우리나라 도로교통사고의 현황과 예방대책
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J Korean Soc Traumatol. 1989;2(1):30-64.
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- 도로교통사고환자(道路交通事故患者)의 응급의료대책(應急醫療對策)
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J Korean Soc Traumatol. 1989;2(1):36-76.
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- 교통사고의 재활문제
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J Korean Soc Traumatol. 1989;2(1):42-83.
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- 도로교통사고와 관련되는 보상문제
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J Korean Soc Traumatol. 1989;2(1):43-94.
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- 외상센타 설립의 필요성
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J Korean Soc Traumatol. 1990;3(1):1-3.
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- The Patient Outcome According to Transportation Time and Type in Multiple Trauma Patients
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Kyoung Soo Lim
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J Korean Soc Traumatol. 1990;3(1):4-15.
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- First aids on scene and field triage are required to multiple injured patients. So well tra-ined EMT(Emergency Medical Technician) and Emergency car equipped with emergent medical equipments are need for pre? hospital stabilization of patients. Especially in Kan-won-Do, there has been high incidence of traffic accident and relatively higher mortality in comparison to injury severity because of geographic characteristics. Over a 4-month period 1.083 multiple trauma patients admitted to the Wonju Christian HospitaJ were studied pro-spectively. The patients transported by car without emergency treatment were likely to show higher mortality (18/264) than those transported by ambulance after emergency treatment at regional hospital (36/819). And patients transported within 1 hour were lik-ely to show good result than those transported above 1 hour. Althogh the causes of death in severe injured patients (lSS≥16) are head injury, hemorrhage and chest injury, thoses in mild injured patients (ISS<16) are airway probl ms that were prevental death by rapid airway control on scene. I conclude that trauma triage system or EMS (Emergency Medical Serivces) systems would be oranized in recent time and trauma center with trauma team is need for multiple trauna patients.
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Summary
- The Value of Abdominal Trauma Index in Abdominal Trauma
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Youngmin Suh, Hoon Sang Chi, Byung Ro Kim
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J Korean Soc Traumatol. 1990;3(1):13-31.
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- The abdominal trauma index(ATI) is a method of quantifying the risk following abdominal trauma. The index is calculated by the sum of the individual organ scores which are calculated by assigning a risk factor to each organ injured and then multiplying this by a severity of injury estimate. We reviewed 103 patients undergoing laparotomy for abdominal trauma at the Yong Dong Severance Hospital from 1983 to 1988. This series were analyzed by scoring of ATI. The result of our study showed that, when the ATI was 25 or less the morbidity rate following abdominal trauma was 18%, whereas 50% of morbidity rate when the ATI exceded 25, and the mortality rates of each group were 3% and 20%, respectively. Thlis objective assessment of the risk of complication following abdominal trauma would assist the identification of high risk patient and appropriate allocation of operative and postoperative care. Moreover, as a field triage, ATI may assist in decision of transfer of patients to various medical care units. Using the ATl, comparison of the qualities of emergency systems would be justificably analyzed by the objective scoring system.
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