Purpose: This study identifies the optimal incision site by describing the relationship between McBurney’s point and the base of appendix using the coronal view of abdominal multi-detector computed tomography (MDCT) in patients with acute appendicitis. Methods: We reviewed the records of 206 patients with positive MDCT findings who were histologically diagnosed with acute appendicitis after appendectomy between January 2014 and September 2015. The outer 1/3 point between two points, the umbilicus and the right anterior superior iliac spine, was marked as McBurney’s point on the coronal view. The superoinferior, mediolateral and radial distances between the base of appendix and McBurney’s point were measured and recorded. Results: The average age was 35.1±20.3 years. There were 34 patients below the age of 15-years-old (children), and 172 patients over 15-years-old (adults). In 35.4% of patients, the base of appendix was located within a radius of 2 cm from the McBurney’s point, in 39.8% it was within 2∼4 cm, and in 24.8% was over 4 cm. The average center coordinate of the base of inflamed appendix in our patients is 9.32 mm, 8.31 mm and the distance between two points is 12.5 mm. Conclusion: The location of appendix has wide individual variability; therefore the McBurney’s point has limitations as an anatomic landmark. If we choose to customize appendectomy incisions considering the base of appendix by using an abdominal MDCT coronal view, additional incision site extension can be reduced.

Purpose: To assess the effects of whole-body computed tomography (WBCT) on severely injured trauma patients. Methods: After the installation of a WBCT scanner, we compared 48 patients who underwent the WBCT (WBCT cohort) with 40 patients prior to the WBCT (pre-WBCT cohort). We evaluated the number of CT, radiation exposure, time interval to decision and clinical outcomes such as length of intensive care unit stay, ventilation period, and acute kidney injury rates. Results: In the WBCT cohort, the number of CT scans was significantly less (3.5 times) than in the pre-WBCT cohort (5.5 times; p0.001). The radiation exposure was significantly lower in the WBCT cohort (24.5 mSv) than in the pre-WBCT cohort (31.3 mSv; p=0.040). The amount of radio-contrast used differed between the groups, but not significantly. Although there were fewer acute kidney injuries in the WBCT cohort (27.1%) than in pre-WBCT cohort (37.5%; p=0.296), especially severe injuries (stage 3 Acute Kidney Injury [AKI] Network: 17.5% in pre-WBCT vs. 6.3% in WBCT; p=0.059), the difference did not reach statistical significance. The hospital length of stay was significantly shorter in the WBCT cohort (21.42 days) than in the pre-WBCT cohort (32.38 days, p=0.019). However, there were no significant differences in the time interval to decision, intensive care unit stay, ventilation days, and mortality.

Purpose: Research comparing the effectiveness of different doses of antibiotics prior to surgery for preventing infection is sparse. This study examines whether a single dose of preoperative antibiotics suffices to treat uncomplicated appendicitis via laparoscopic appendectomy.\n\nMethods: This study retrospectively reviewed the medical records of 149 patients who underwent laparoscopic appendectomy from July 2013 to December 2014 in a single institution. The participants were divided into two groups; group A (n=99) was given a single dose of prophylactic antibiotics before surgery, and group B (n=50) was given both preoperative and postoperative antibiotics. Clinical factors and surgical outcomes were compared between two groups.\n\nResults: The mean length of hospital stay for group A (2.5 days) was shorter than for group B (3.2 days) (p<0.001). Average operation time was 58.7 minutes for group A, longer than for group B (52.2 minutes, p=0.027). There was no difference in pathologic results and postoperative complications, such as surgical site infection (SSI) between the two groups. In groups A and B, 4.0% of patients had superficial SSIs. One patient (2.0%) in group B had deep/organ SSI.\n\nConclusion: A single dose of prophylactic antibiotics administration to patients undergoing laparoscopic appendectomy is acceptable as a treatment in uncomplicated appendicitis.

Purpose: This study identifies risks for pressure ulcer in patients admitted to surgical intensive care units because of severe traumatic injuries with injury severity scores of 15 or higher. Methods: Data was collected from records of patients admitted from January 1, 2011, to December 31, 2013. The analysis addressed general characteristics, trauma-related characteristics, and treatment-related characteristics of pressure ulcers. Descriptive statistics include the raw numbers, percentages, and the standard deviations. Hypothesis tests including t-tests, chi-square tests, and multi-regression analyses were performed using SPSS ver.dow 12.0. Results: Two hundred and fifty-nine patients were admitted to surgical intensive care units with severe trauma injuries. Of those, 44 patients (17.0%) had a pressure ulcer. The mean pressure ulcer duration was 8.4 days. The most common pressure ulcer was the second phase ulcer at 51.9%. Risk factors were found to be age (p0.001), shock (p0.021), and the fixture device (p0.020).

복강내 감염이 동반된

Abdominal compartment syndrome is a state of intraabdominal pressure above 20mmHg, associated with new organ dysfunction or failure; It is not a disease, but a syndrome that can have many causes. Sometimes, the impact on end organ function and viability can be devastating, but research on this syndrome is still in its infancy.

복강 내 고압과 복강구획증후군은 많은 연구를 통해 임상적 중요성이 많이 알려지고 있다