A Study of Partial Excision and Suvdermal Exicision in Surgical Treatment of Axillary Osmidrosis

There are 3 basic methods for surgical treatment of axillary osmidrosis; 1) method that removes only subcutaneous cellular tissue without removing skin 2) method that removes skin and subcutaneous cellular tissue en bloc, and 3) method that partially removes skin and subcutaneous cellular en bloc as well as removing the subcutaneous cellular tissue of the adjacent region. We studied the results of partial removal of the skin and subcutaneous cellular tissue en bloc, as well as the removal of subcutaneous cellular tissue of the adjacent region to compare the results of the bipedicled flap with the graft conversion method. There was no difference between two methods in results and complication rates. There are 3 advantage to this procedure. First, about 70-80% of apocrine glands were centrally distributed among the axillary hairbearing region therefore, resection of the central portion of axillary hair distribution area is important for good result. Second, the preservation of the subdermal plexus with careful excision of adjacent underlying subcutaneous tissue under the aid of the magnifying surgical loupe, is important for good wound healing. Third, the central excision of the axillary hair distribution area provides good exploration for undermining and defatting of the undersurface of the adjacent area, therefore it tooks a shorter operation time.

A comparisin of the Operative Results and Costs Between Interosseous Wiring and Miniplate Fixation in Open Reduction of Mandible Fracture

Mandible fractures have recently been managed by rigid internal fixation with miniplate and screws more often than by traditional interosseous wiring methods. The purpose of this paper was to compare traditional interosseous wiring with miniplate fixation in open reduction of mandible fracture, especKweonially in operative results and costs. From June of 1989 to June of 1998, there were 142 patients, admitted to the department of Plastic and Reconstructive Surgery, Chun-Cheon Sacred Heart Hospital, Hallym University. Of those, 101 patients were managed by open reduction, and among them, 83 patients were treated with miniplate fixation, but 18 patients had recently been treated with interosseous wiring methods. No significant difference was noted between the two groups in terms of complications, but the overall cost of miniplate and screws was higher than interosseous wiring, while the mean operative time was longer in the group treated with miniplate fiation. The authors recommend interosseous wiring technique for patients with mandible fractures requiring open reduction and fixation, except for absolute indications of rigid internal fixation.

Reconstruction of the alveolar cleft with gingivo-vestibular-mucoperiosteal flap

The maxillary alveolar ridge separates the palate from the lip and clefts of the primary palate have a cleft of the alveolus as well. In the most common clefts of the primary palate, the alveolar portion of the cleft is located between the lateral incisor, if present, and the canine. The cleft may also pass between the central incisor and the lateral incisor, rarer forms of clefts may pass between the central incisor or more distally on the maxillary arch. There are still considerable differences of opinion as to the optimal time for closure of alveolar defects, with or without concomitant bone grafting. But the preferred time for the operation with bone graft is between age 9 and 11 before the canine teeth have fully erupted. As an alternative to primary bone grafting, Skoog developed the periosteoplasty, or "boneless bone graft" technique, in which periosteal continuity was established between maxillary segments by the transfer of local periosteal flaps from the anterior maxillary wall. this procedure, which takes advantage of the propensity of periosteum to form bone in young children, leads to the formation of new bone within the alveolar cleft in spite of the fact that no bone graft is used.This study attempts to defin the effectiveness of early alveolar cleft repair with gingivo-vestibular-mucoperiosteal flap.The results in 6 unilateral alveolar clefts and 1 bilateral alveolar cleft, which is corrected early by gingivo-vestibular-mucoperiosteal flap, have been satisfactory alveolar arch continuity and alveolar bone formation with tooth eruption.

Clinical Experience of Gentian Violet Dressing for Local Treatment of Wound Infection with MRSA / 병원감염관리

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is hardly controllable organism among the pathogen of nosocomial infection, because it is resistant to most antibiotics except vancomycin and local treatment with most antiseptics are not effective to eradicate MRSA from the infected wounds. There is increasing fear that MRSA infection can be spread widely in the hospitals. The effectiveness of Gentian Violet against MRSA was reported by Saji et al in 1992 for the first time. We tried Gentian Violet dressing on MRSA infected wounds to evaluate whether at not the Gentian Violet is effective to eradicate 11RSA which existed in the open wound. METHODS: 24 patients were treated by wet dressing with 0.1%Gentian Violet soaked gauze twice daily. They included 10 cases of sacral and trochanteric pressure sore, 6 cases of postoperative wound infectious, 3 cases of posttraumatic skin defects, 2 cases of DM foot, 1 case of post infectious skin defect and 2 cases of electrical burn, The wound culture was evaluated for elimination of MRSA infection twice weekly. RESULTS: The clinical results revealed that MRSA was not detected in all cases within 34days (average 13.5 days) after topical administration 0.1% Gentian Violet. CONCLUSION: There is no evidence of tissue irritation with Gentian Violet dressing on open wound or wound margin. After negative conversion of MRSA with Gentian Violet dressing, gram (-) organism was isolated in a half of the cases. 0.1% Gentian Violet topical administration is a useful treatment method of wound infection with MRSA.

CLINICAL EXPERIENCE OF GENTIAN VIOLET DRESSING FOR LOCAL TREATMENT OF MRSA INFECTED WOUND

No abstract available.