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Volume 1(2); December 1988
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Epidemiologic Study of Traumatic Accident Patients
Byung Yun Hwang, Yong Shik Shim, Soo Seong Chae
J Korean Soc Traumatol. 1988;1(2):81-169.
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Abrupt increase of the height transport and public traffics due to development of the domestic industry and the automation of the farming tools due to argicultural mechanization increased the traumatic patients annually. And, the loss of the life, working capacity, means and following direct and indirect enormous medical fee payment became a significant social problems. We have made a retrospective study of 726 cases of the traumatic patients who were visited to our department of Emergency Room of Chonbuk National University Hospital from Sep. 1987 to Aug. 1988 after traumatic accidents. It was considered necessary to find out some preventive measures whIch could obtained from the epidemiologic facts. In this study, we have find out such facts; 1. Second decade of age group showed the highest numbers of accident victims, as much as 22.2 % and children group showed 17.5 %. 2. Skull of the body showed the highest frequency of trauma involved region. as much as 36.8 % according to the regIonal distribution in the body and lower extremities showed 24.6 %. 3. On day, highest occurence was during evening (18 Hr-21 Hr) (21.3 %), and afternoon (I5 Hr-18 Hr) (17.8%) coinciding with the time for home bound traffic after work. 4. Casualities showed maximum occurence during the Autumn (34.7 %) and Spring (27 %) coinciding with picnic season. 5. In the kinds of vehicles, the private taxi showed the increased accident rate, as much as 22.3 % and farm machine group showed the 4.6 %.
Summary
A Statistical Analysis of Traffic Accident
Min Kyu Kang, Wan Hee Yoon, In Koo Kim, Ki Sub Son
J Korean Soc Traumatol. 1988;1(2):90-187.
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As a mean of transportation was developed and traffic volume was increased, the frequency of traffic accidents was increased and its scale became larger. The damage of property and loss of lives were enormous and death of traffic accidents became a main cause of death in a civilized community. The authors aurhors 493 cases of traffic accident treated at Chungam National University Hospital from January 1987 to December 1987, and the results were as follows: I) The age distribution was most prevalent between 25 and 44 years(45.6%), and the ratio of male to female was 2.8: I. 2) The most predominant monthly distribution was September(12.0%), and the least was February(5.7%). 3) Of 493 cases, 212 cases(43.0%) were associated with Orthopedic Surgery, Neurosurgery and General Surgery were 40.9 % and 7.9 % respectively. 4) In injury mechanism, motor vehicle accident was highest in incidence(36.9 %) and similar with pedestrian accident(36.1 %). 5) Most frequently injured body region was head and neck(64.9 %), and then extremity and pelvis was 43.3%, and abdomen was 7.5%. 6) The injured organs in 37 cases of abdominal injuries in order of frequency were sple-en(16.2%), small bowel(l6.2%), and liver(13.5%). 7) In elapsed time from arrival to death. 83.3% was died within first 24 hours and 66.7% was died within first 5 hours. 8) In mortality rate according to department, Neurosurgery was 55.6 % and General Surgery was 12.9%. The overall mortality rate was 11.0%. 9) Using a cutoff score of 6 or less, the Modified CRAMS scale identified the 15.2% 01 the trauma population which were critically ill as demonstrated by a 68.0 % mortality rate compared to a 0.7% overall mortality of those with a score of 7 or greater.
Summary
대구 경북지역 교통사고 환자 통계분석
J Korean Soc Traumatol. 1988;1(2):99-199.
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Summary
Clinical Analysis of the Traffic Accident Victims in Kang Won-DO
Kwang Soo Yoon, Kyung Soo Lim, Seong Joon Kang, Soo Yong Kim
J Korean Soc Traumatol. 1988;1(2):102-208.
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AbstractAbstract PDF
Pedestrian and Vehicle accidents are serious public health problem today. Prevention of pedestrian and vehicle injury can be approached through changes in the host, agent, environ-ment. or in their interaction with one another. Mortality rate from traffic accident victims have been shown 10 be significantly improved by rapid access 10 definitive care, but affected during initial phase of care. During the Iwo years from 1st. January. 1986 to 31 th. December. 1987, this report is a review and clinical analysis of 2,753 patients with traffic accident victims who were vistited the emergency room Wonju College of Medicine, Wonju christian Hospital.
Summary
The Experimental Study of Oxygen Supply on the Infected Wound
Yeo Kyu Youn, Sung Hwan Bae, Jae Won Choi, Houng Rae Cho, Jin Pok Kim
J Korean Soc Traumatol. 1988;1(2):108-221.
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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 .
Summary
Clinical Analysis of the Splenorrhaphy Using Omentum Meat Oall for the Traumatized Spleen
Nam Kyu Kim, Hoon Sang Chi, Byong Ro Kim, Kyong Sik Lee
J Korean Soc Traumatol. 1988;1(2):115-237.
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AbstractAbstract PDF
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.
Summary
Wsefullness of Pediatric Trauma score and injury Severity score in Multiple injury Patients
S. H. Choi, Y. U. Cho, H. S. Chi, H. D. Lee, B. R. Kim, E. H. Hwang, H. S. Lee
J Korean Soc Traumatol. 1988;1(2):124-251.
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AbstractAbstract PDF
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.
Summary
Traumatic Duodenal Injury
Kwang Soo Yoon, Kyung Soo Lim, Dae Sung Kim, Soo Young Yoo
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.
Summary

J Trauma Inj : Journal of Trauma and Injury