PURPOSE: Matriderm(R) is a highly porous dermal substitute consisting of a collagen matrix (collagen type I, III, and V) cross-linked to an elastin hydrolysate. The 1 mm thickness Matriderm(R) is used in a one-stage procedure. On the other hand, 2 mm thickness Matriderm(R) has been used in two-stage procedures in combination with split thickness skin grafts (STSG) for reconstruction as dermal substitute. To the best our knowledge, there is no case that reports the single stage procedure with 2 mm thickness Matriderm(R). There are many expected advantages if a two-stage surgery could be performed by one-stage procedure as long as the result is guaranteed. The purpose of this study is to present capacity of 2 mm thickness Matriderm(R) as a dermal substitute in single stage skin grafting by the successful results of six cases. METHODS: We performed this one-stage procedure in five patients instead of soft tissue reconstruction. Those patients were required soft tissue reconstruction after trauma injuries or radial forearm harvest as a donor site in the period between 2011 and 2012. Five Patients were treated with a combination of STSG and 2 mm thickness Matriderm(R) solely. Three out of five patients who were injured by trauma got transplanted splint thickness skin that were range from 4/1000~8/1000 inches (Table 1). Patients' data were analyzed retrospectively by chart review and patients interviews. Each patient's chart was reviewed for age, gender, type of injury, complications, final outcome and successful rates. RESULTS: The patient group consisted of 4 men and 1 woman between ages of 5 and 70. The clinical results of these five treated patients concerning skin-quality and coverage of exposed soft tissue were very good. Using 2 mm thickness Matriderm(R) the wound could gain more dermal substitute compare to 1 mm thickness Matriderm(R). CONCLUSION: Matriderm(R) is a single-use three-dimensional matrix composed of native, structurally intact collagen fibrils and elastin for supporting dermal regeneration. In this study five patients with trauma injuries or radial forearm harvest as a donor site were treated with 2 mm thickness Matriderm(R) as a dermal substitute and STSG as a single-stage procedure to cover exposed structures. Compare to 1 mm Matriderm(R), 2 mm thickness Matriderm(R) provide more dermal collagen and enhance skin-elastisity. Achieving single stage STSG with 2 mm thickness Matriderm(R), patient's hospital days were reduced in half and infection chances were also decreased. In conclusion, single skin grafting with 2 mm thickness Matriderm(R) is feasible and it is time-effient and cost effective procedure.
Collagen ; Elastin ; Female ; Forearm ; Hand ; Humans ; Male ; Regeneration ; Retrospective Studies ; Skin Transplantation ; Skin* ; Splints ; Tissue Donors ; Transplants ; Wounds and Injuries

Background: During the early stages of lymphedema, active physiologic surgical treatment can be applied. However, lymphedema patients often have limited knowledge and misconceptions regarding lymphedema and surgical treatment. We analyzed the correlations between lymphedema severity and surgical technique according to patients’ awareness of surgical treatment for secondary upper extremity lymphedema (UEL). Methods: Patients with UEL diagnosed between December 2017 and December 2019 were retrospectively evaluated. At the time of their presentation to our hospital for the treatment of lymphedema, they were administered a questionnaire about lymphedema and lymphedema surgery. Based on the results, patients were classified as being aware or unaware of surgical treatment. Lymphedema severity was classified according to the arm dermal backflow (ADB) stage and the MD Anderson Cancer Center (MDACC) stage based on indocyanine green lymphography conducted at presentation. Surgical techniques were compared between the two groups. Results: Patients who were aware of surgical treatment had significantly lower initial ADB and MDACC stages (P<0.05) and more frequently underwent physiologic procedures than excisional procedures (P=0.003). Conclusions If patients are actively educated regarding surgical treatment of lymphedema, physiologic procedures may be performed during the early stages of UEL.

Background: During the early stages of lymphedema, active physiologic surgical treatment can be applied. However, lymphedema patients often have limited knowledge and misconceptions regarding lymphedema and surgical treatment. We analyzed the correlations between lymphedema severity and surgical technique according to patients’ awareness of surgical treatment for secondary upper extremity lymphedema (UEL). Methods: Patients with UEL diagnosed between December 2017 and December 2019 were retrospectively evaluated. At the time of their presentation to our hospital for the treatment of lymphedema, they were administered a questionnaire about lymphedema and lymphedema surgery. Based on the results, patients were classified as being aware or unaware of surgical treatment. Lymphedema severity was classified according to the arm dermal backflow (ADB) stage and the MD Anderson Cancer Center (MDACC) stage based on indocyanine green lymphography conducted at presentation. Surgical techniques were compared between the two groups. Results: Patients who were aware of surgical treatment had significantly lower initial ADB and MDACC stages (P<0.05) and more frequently underwent physiologic procedures than excisional procedures (P=0.003). Conclusions If patients are actively educated regarding surgical treatment of lymphedema, physiologic procedures may be performed during the early stages of UEL.

BACKGROUND: The authors sought to compare the use of the nonabsorbable polyvinyl alcohol sponge (PVA, Merocel) and absorbable synthetic polyurethane foam (SPF, Nasopore Forte plus) as intranasal splints after closed reduction of fractured nasal bones during the hospitalization period. METHODS: The medical records of 111 patients who underwent closed reduction for nasal bone fracture at Sanggye Paik Hospital, Inje University College of Medicine, from 2012 to 2013 were reviewed retrospectively. PVA (group A) or SPF (group B) was packed as an internal splint after closed reduction. The efficacy of the materials was compared and statistically analyzed. RESULTS: PVA was used in 82 patients, and SPF was used in 29 patients. The patients in group B complained significantly more of nasal pain on the first day after operation than the patients in group A. Headaches on the operation day were significantly more painful in group B than in group A. Bleeding on the fourth postoperative day was significantly reduced in group B as compared to group A. The patients in group B exhibited significantly more intensive nasal obstruction on the operation day and the following day than the patients in group A. However, on the third and fourth postoperative days, the nasal obstruction in group B was less than that in group A. The pain and bleeding related to the packing material was significantly reduced in group B as compared to group A. CONCLUSIONS: The use of SPF as an absorbable packing material is a reasonable substitute for the traditional nonabsorbable material.
Facial Bones ; Headache ; Hemorrhage ; Hospitalization ; Humans ; Medical Records ; Nasal Bone* ; Nasal Obstruction ; Polyurethanes ; Polyvinyl Alcohol ; Porifera ; Retrospective Studies ; Splints*

OBJECTIVE: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases METHODS: 11 hospitals participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. RESULTS: Between Apri1 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. Most of the HAVS cases came from shipbuilding, and 172 of them (92.7 %) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9 %). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6 %) and 4 (12.1 %) cases of occupational asthma, the agents included isocyanate and welding fume, respectively. 64.7 % of the cases of occupational skin diseases were contact dermatitis, and organic solvents and welding fume were the main agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10 (58.8 %) of the cases were diagnosed as squamous cell carcinoma and 5 (29.4 %) as adenoma. CONCLUSION: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.
Adenoma ; Asthma, Occupational ; Busan* ; Carcinoma, Squamous Cell ; Carpal Tunnel Syndrome ; Dermatitis, Contact ; Hand ; Hand-Arm Vibration Syndrome ; Lung Neoplasms ; Occupational Diseases* ; Occupational Medicine ; Prevalence ; Risk Factors ; Skin Diseases ; Solvents ; Specialization ; Ulsan* ; Welding