Wounds and Injuries/*mortality

No abstract available.
*Hospital Mortality ; Humans ; Wounds and Injuries/*mortality

The management of malignant left colon obstruction remains a difficult problem. Conventional surgical treatment is muti-staged and each stage carries its own morbidity and mortality. The purpose of this study is to identify the feasibility and safety of one stage operation in patients presenting with acute obstruction of the left colon. From January 1991 to June 1996, 29 patients received one stage resection for acutely obstructed carcinoma of the left colon at Soonchunhyang University Chunan Hospital. Subtotal colectomies were performed in 9 patients(31.0%), left hemicolectomies in 6(20.7%), low anterior resection in 6(20.7%), sigmoid colectomy in 4(13.8%), anterior resection in 4 patients(13.8%). Subtotal colectomy was performed in patients with massively distended colon of dubious viability and to contain ischemic lesions at proximal colon. Total operative mortality was 6.9%: 5% in the immediate resection with anastomosis group, 11.1% in subtotal colectomy group. Complications included wound infection(4), fecal incontinence(2), intestinal obstruction(2), anastomotic leakage(1), upper G-I bleeding(1), postoperative bleeding(1), pulmonary complication(1). Our results suggest that resection and primary anastomosis can be performed with acceptable morbidity and mortality in patients with acute malignant obstruction of the left colon.
Chungcheongnam-do ; Colectomy ; Colon* ; Colon, Sigmoid ; Humans ; Mortality ; Wounds and Injuries

A series of 70 lumboperitoneal shunt performed at Yonsei university Severance hospital was reviewed. The clinical indications for this procdures were communicating hydrocephalus, CSF fistulas, benign intracranial hypertension and bulging craniectomy site. There were several complications such as shunt migration, obstruction, infection and nonfunctioning. Wound dehiscence, epidural hematoma and ingumal hernia were also observed after shunting. This procedure is completely extracranial and diminished intracranial complications, thereby significantly reducing morbidity and mortality. Good results were reported due to easy insertion, short operation time and reduced complications. This report documented the efficacy of lumbopertoneal shunt and literatures were reviewed.
Fistula ; Hematoma ; Hernia ; Hydrocephalus ; Mortality ; Pseudotumor Cerebri ; Wounds and Injuries

PURPOSE: Though the nonoperative management of liver injury (NOMLI) has frequently been employed for traumatic liver injuries, the indications for NOMLI for grade IV liver injuries are still controversial. To determine the usefulness of the NOMLI in grade IV liver injuries, the clinical features of an operative management (n=26) and a NOMLI group (n=20) were compared. METHODS: For the 10 years up until Feb. 2004, 46 grade IV liver injury cases, according to the AAST liver injury scale, at the Kyung Pook National University Hospital, were selected for this study. The clinical features, grade of liver injury and outcomes of treatments were reviewed retrospectively. RESULTS: Of the 46 cases 40 (87%) and 6 (13%) were male and female, respectively. The mean ages of the male and female cases were 37.6 (15.2 and 34.5 (16.7 years, respectively. The causes of liver trauma were vehicle accident (71.7%, 33/46), industry accident (26.1%, 12/46) and violence (2.2%, 1/46). The accompanying abdominal injury was not present in the NOMLI group compared to 30.8% (8/26) in the operative management group. NOMLI was more than 2 times more frequently indicated after Feb. 1999. The mortality in operative management group was 11.5% (3/26) compared with none in the NOMLI group. 20% (4/20) of NOMLI group failed due to delayed bleeding and eventually had to undergo operations and the 80% (16/20) of NOMLI group was successful. The morbidity in successful NOMLI group was bile collection (6.25%, 1/16) and empyema (6.25%, 1/16). CONCLUSION: Nonoperative management for grade IV liver injury in hemodynamically stable patients without accompanying abdominal injury was successful. However, continuous monitoring and immediate operative management should be prepared for the delayed bleeding.
Abdominal Injuries ; Bile ; Empyema ; Female ; Hemorrhage ; Humans ; Liver* ; Male ; Mortality ; Retrospective Studies ; Violence ; Wounds and Injuries

OBJECTIVETo analyze and summarize the secular trend and influencing factors of road traffic injuries(RTI) in China, so as to provide evidence for the management of traffic safety.

METHODSIndexes as fatalities per 10,000 vehicles, fatalities per 100,000 population, fatalities per 10,000 kilometers, motorization(number of vehicles per 1000 population) and mortal coefficient were used. Clustering analysis and ranking correlation were used to analyze the relative factors.

RESULTSThe number of casualties of RTI had doubled every decade before the year of 2000. One hundred thousand people were killed in RTI every year since 2000. Facts as: Gross National Product(GNP) of China exceeded 1000 USD in 2002, number of motor vehicles reached 1.3 million in 2005, had both influenced the rates of road traffic fatality, mileage fatality and mortal coefficient which causing them to drop since 2002. In China, RTI happened in the underdeveloped districts in the western part of the country including Tibet, Ningxia, Xinjiang, Qinghai, and in some coastal areas as Zhejiang and Guangdong provinces. Men seemed to be more at risk than women in RTI, and accounted for three-quarters of the victims. Majority of fatalities happened in 21-50 year olds and the fatalities among those over 65 year olds had risen every year. The vulnerable populations in road-user category were pedestrians, passengers, motorcyclists and bicyclists. Under most situations, drivers were responsible for RTI and over half of them were professionals. Bad behaviors were the major causes of RTI, including exceeding the speed limit, handle misfeasance, breaking traffic rules and regulation, having taken alcohol or driving with fatigue etc. Exceeding the speed limit was the most risky factor which causing 75% of the RTI and the traffic deaths increased between 2002 to 2004. A positive correlation was discovered between population fatality rate and the factors as the number of vehicles, volume of road haulage, volume of passengers and the degree of highway etc. with correlation coefficients as r1 = 0.986, r2 = 0.986, r3 = 0.987, r4 = 0.985, P = 0.001, respectively.

CONCLUSIONSince 1951, the population fatality rate of RTI had been going up continuously until it began to fall in 2003.

Accidents, Traffic ; mortality ; statistics & numerical data ; China ; epidemiology ; Female ; Humans ; Male ; Wounds and Injuries ; mortality

Surveillance for Vibrio vulnificus infections was performed by Korea National Institute of Health to investigate the epidemiological characteristics of recent occurence and to provide basic information for V. vulificus infection control. In 1998, a total of 44 cases of V. vulnificus infections were confirmed bacteriologically. The age groups of the patients ranged from thirties to seventies and 13 (29.5%) patients were in their fifties. Thirty-six (81.8%) patients had chronic liver diseases. Twenty-five (56.8%) had drinking habits. Eating uncooked seafood (fish, shrimp, and small octopus) produced in tideland was the main suspected source of infections and 32 (72.8%) cases were associated with raw seafood consumption. Two cases were associated with contaminated chopping board and 5 were infected through the wound. The incubation period ranged from less than 1 day to 7 days (median 2 days). The case fatality rate was 48%. In conclusion, V. vulnificus infection, a highly fatal disease, is not rare in Korea. Therefore, attention should be given to prevent V. vulnificus infections.
Drinking ; Eating ; Humans ; Infection Control ; Korea ; Liver Diseases ; Mortality ; Seafood ; Vibrio vulnificus* ; Vibrio* ; Wounds and Injuries

BACKGROUND: Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. METHODS: Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. RESULTS: Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068). CONCLUSION: The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.
Hemorrhage ; Humans ; Mediastinitis ; Mortality ; Propensity Score ; Retrospective Studies ; Stainless Steel ; Steel ; Thoracic Surgery* ; Wounds and Injuries

BACKGROUND: After an esophageal resection for an esophageal disease, the stomach becomes the most common organ for a substitute. The stomach has the advantages of being simple with fewer complications when used properly. The complications of an esophageal reconstruction using the stomach as the substitute are assessed and discussed. MATERIAL AND METHOD: Between 1990 and 1998, 44 patients who underwent esophagogastric anastomosis were treated in the department of Thoracic and Cardiovascular Surgery of Yongdong Severance Hospital, Seoul, Korea. RESULT: The rate of postoperative complications and mortality in these 44 patients were 70.5% and 13.6%, respectively. The major complications in our series involved the stricture of anastomosis(13.6%), pneumonia(11.4%), and wound infection(9.1%). The most frequent causes of postoperative deaths were pulmonary complications and sepsis(6.8%). CONCLUSION: Anastomotic leakage is no longer a major complication of an esophagogastrostomy. Most postoperative stricture can be overcome with frequent esophageal dilations. Postoperative pulmonary infection, nutrition, and physiotherapy are very important in reducing the rate of pulmonary morbidity and mortality.
Anastomotic Leak ; Constriction, Pathologic ; Esophageal Diseases ; Humans ; Korea ; Mortality* ; Postoperative Complications ; Seoul ; Stomach ; Wounds and Injuries

PURPOSE: Surgical wound complications remain a cause of morbidity and mortality among postoperative patients, and the cost of caring for patients with a surgical wound complication is substantial. The purpose of this study was to evaluate the ability of a vinyl wound protector to reduce the rate of wound complications when used in clean-contaminated surgery. MATERIALS AND METHODS: Between May 2006 and September 2006, 295 patients with a gastric cancer that underwent gastric surgery were studied prospectively, and the patients were randomized into one of two groups: the no wound protector group (n=137) or the polyethylene protector group (n=132). RESULTS: The demographics and operation type and operation time were similar for patients in both groups. The rate of wound complication was different between patients in the no protector group (n=42) and the polyethylene protector group (n=12) (P=0.001) and the rates of seroma (P=0.001), infection (P=0.030) and dehiscence (P=0.282) were different for the two groups. The postoperative hospital stay was significantly shorter in the polyethylene protector group of patients (P=0.040). CONCLUSION: The use of a polyethylene protector resulted in a reduction of the surgical wound complication rate, and the cost of caring for patients, and morbidity and mortality among postoperative patients could be reduced.
Demography ; Humans ; Length of Stay ; Mortality ; Polyethylene ; Prospective Studies ; Seroma ; Stomach Neoplasms ; Wounds and Injuries*