Subeschar culture using a punch instrument in unstageable wounds

Background@#A patient’s overall condition sometimes does not allow for the complete removal of a dead eschar or injured slough in cases involving a pressure-injury skin lesion. This frequently occurs in clinical practice, particularly in bedridden and older patients receiving home care or intensive care. Even after debridement, it is also difficult to manage open exudative wounds in these patients. Nevertheless, when a mature or immature eschar is treated without proper debridement, liquefaction necrosis underneath the eschar or slough tends to reveal a large, open wound with infectious exudates. We hypothesized that if the presence of any bacteria under the eschar can be evaluated and the progression of the presumed infection of the subeschar can be halted or delayed without creating an open wound, the final wound can be small, shallow, and uninfected. @*Methods@#Using a punch instrument, we performed 34 viable subeschar tissue cultures with a secure junction between the eschar and the normal skin. @*Results@#The bacterial study had 29 positive results. Based on these results and the patient’s status, appropriate antibiotics could be selected and administered. The use of suitable antibiotics led to relatively shallow and small exposed wounds. @*Conclusions@#This procedure could be used to detect potentially pathogenic bacteria hidden under black or yellow eschars. Since subeschar infections are often accompanied by multidrug-resistant bacteria, the early detection of hidden infections and the use of appropriate antibiotics are expected to be helpful to patients.

Comparison of eye measurements between young Korean women with inborn double eyelids and those with single eyelids

Background@#Eye measurements in Koreans have been studied extensively, but researchers have reported widely differing values, even for the same parameters. These discrepancies are likely due to inconsistencies in the proportions of subjects with double eyelids included in their studies. We retrospectively studied eye measurements according to the presence or absence of double eyelids, and compared the results to those of previous studies. @*Methods@#We conducted anthropometric measurements of eyes in young (20–29 years) Korean women with no congenital malformation, trauma, or surgery of the eyelids. The participants were dichotomized according to the presence of double eyelids, resulting in 116 eyes with single eyelids and 124 with double eyelids. We measured the palpebral fissure length (PFL), palpebral fissure height (PFH), margin reflex distance 1 (MRD1), intercanthal distance (ICD), interpupillary distance (IPD), outer canthal distance (OCD), and inclination of the palpebral fissure in each eye. @*Results@#The mean PFL was 24.1 mm in the single-eyelid group and 25.5 mm in the double-eyelid group. The other mean values for the two groups were as follows: PFH, 8.0 mm and 9.9 mm, respectively; MRD1, 2.8 mm and 4.1 mm, respectively; IPD, 61.6 mm and 62.8 mm, respectively; and OCD, 85.3 mm and 87.9 mm, respectively. @*Conclusions@#In the double-eyelid group, the horizontal and vertical length of the eye was greater than in the single-eyelid group, and the mean values of IPD, OCD, PFL, PFH, and MRD1 were statistically significantly higher.