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RISS 인기검색어
- 검색키워드
- 저자 : Eun Choang Cha (검색결과 3 건)
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범진식,Eun Choang Cha,박준 대한창상학회 2024 Journal of Wound Management and Research Vol.20 No.1
Background: The en bloc sliding gluteus maximus myocutaneous flap was introduced to preserve the vasculature, muscular integrity, sensory innervation, and normal gluteal contour with a midline scar in sacrococcygeal pressure ulcer reconstruction. However, its critical disadvantages include incomplete detachment of the origin of the gluteus maximus and central tension of the closed wound due to round ulcer excision. Therefore, we reviewed the surgical anatomy and applied modifications to achieve sufficient flap mobilization and to decrease complications.Methods: After fusiform or rocket-shaped ulcer excision, submuscular flap elevation was initiated by completely detaching the origin of the gluteus maximus, including the posterior iliac crest, followed by comprehensive lateral submuscular dissection in the gluteal space while preserving the neurovascular pedicles. Bony protrusions were tangentially resected from the lower sacrum and upper coccyx. After en bloc medial advancement of the bilateral flaps, defects were closed in layers, with muscle ligament fixation at the midline.Results: Twenty-nine patients underwent surgery for sacrococcygeal pressure ulcers (primary, n=22; recurrent, n=7). Transverse width of the excised ulcers was 5–12 cm (final defect, 7–15 cm). During the follow-up period (6 months to 7 years), no early postoperative complications or late aesthetic or functional discomfort occurred; however, intermittent skin sloughing occurred in four cases and one coccygeal sore recurrence occurred. The recurrent ulcer was treated using the same surgical method, with no recurrence after 2 years.Conclusion: This modification can be successfully used for the reconstruction of primary and recurrent sacrococcygeal pressure ulcers.
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Key Day Lee,Eun Choang Cha,Lee Jimin,강상윤,범진식,Cho Jaeyoung 대한창상학회 2023 Journal of Wound Management and Research Vol.19 No.1
Background: Cultured allogenic keratinocyte (CAK) and epidermal growth factor (EGF) are commonly used biological treatments for partial-thickness burn wounds. A comparative study was conducted on whether the combination therapy of CAK and EGF promotes partial-thickness burn wound healing.Methods: From January 2020 to March 2021, 73 patients who visited the hospital with partial-thickness burns were enrolled in the study. Patients were treated with CAK (Kaloderm) (n=20), EGF (Easyef) (n=17), and CAK+EGF (n=24). Wound healing rate, time to heal, factors affecting wound healing (age, sex, underlying disease, mode of injury, location of injury, initial wound size), and scarring were comparatively analyzed.Results: The wound healing rate for 20 days was 85% (17/20) in the CAK group, 88% (15/17) in the EGF group, and 92% (22/24) in the CAK+EGF group. The average healing time was 11.0±6.0 days, with the CAK group taking 12.6±5.5 days, EGF group taking 11.5±6.0 days, and CAK+EGF group taking 9.0±6.3 days. The patients who received CAK+EGF treatment had higher hazard than the patients without CAK+EGF treatment (hazard ratio, 2.078; 95% confidence interval, 1.021–4.228). Smaller wound size <5 cm2 (hazard ratio, 2.869; 95% confidence interval, 1.426–5.773) was associated with complete wound healing. Though statistically insignificant (P=0.218), less scars occurred in the CAK+EGF group.Conclusion: Combination therapy of CAK and EGF promotes wound healing in partial-thickness burn wounds.
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The Effect of Topical Normobaric Oxygen Therapy on Composite Graft Survival in Fingertip Amputation
Key Day Lee,Eun Choang Cha,Lee Jimin,윤시현,최영웅,Cho Jaeyoung 대한창상학회 2023 Journal of Wound Management and Research Vol.19 No.1
Background: Though composite grafting is an easy, simple treatment for fingertip amputation, it is known to have a low survival rate. To increase the likelihood of composite graft survival, various adjuvant therapies such as hyperbaric oxygen therapy, ice-cooling, or vasodilator agents have been used. In this study, we attempted to validate the hypothesis that topical normobaric oxygen therapy (tNBO) could improve composite graft survival in fingertip amputation.Methods: Patients who sustained fingertip amputations and who were treated with composite grafting between January 2015 and July 2020 were included. The patients (n=154) were divided into two groups: those who received tNBO (n=102) and those who had not (n=52). The effect of tNBO on graft survival, survival rate by level of amputation, and risk factors of graft survival (age, smoking, time to surgery, diabetes mellitus, and crush-avulsion injury type) were examined.Results: tNBO significantly increased composite graft survival (75.3% vs. 50%, P<0.001) in amputations distal to the nail base area. Among risk factors, time to surgery >5 hours (odds ratio, 48.6; P=0.001) and crush-avulsion injury type (odds ratio, 10.1; P<0.001) significantly decreased graft survival in both groups. Smoking decreased graft survival only in the non-tNBO group (odds ratio, 28; P=0.015), not in the tNBO-treated group.Conclusion: tNBO increased composite graft survival in fingertip amputation distal to the nail base area. It can be helpful for composite graft survival in smokers.
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