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RISS 인기검색어
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- 저자 : 박경남 ( Koung Nam Bark ) (검색결과 2 건)
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응급실 얼굴 열상 환자에서 Modified Hollander 점수에 의한 조직 접착제 사용과 봉합사를 이용한 봉합 후 결과 비교
홍석호 ( Suk Ho Hong ),양영모 ( Young Mo Yang ),이장영 ( Jang Young Lee ),이원석 ( Won Suk Lee ),박경남 ( Koung Nam Bark ),양희범 ( Hee Bum Yang ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.2
Purpose: The object of this study is to compare the patient satisfaction in the view of scarring, cost, and hospital stay between the conventional suture method and a method using Histoacryl® (2-N-butylcyanoacrylate) adhesive for treating facial lacerations in the emergency department. Methods: This study is a randomized prospective trial, which was conducted from December 2009 to January 2010. The participants include 109 patients who visited the emergency room in Deajon Eulji Medical Center. The ages ranged from 1 to 59 (mean age of 18.7), and all had facial lacerations of less than 3 cm. In order to treat the facial lacerations, an emergency medicine doctor used tissue adhesive (2-N-butylcyanoacrylate, Histoacryl®) for 41 patients in the experimental group, and a plastic surgeon performed conventional suturing for 68 patients in the control group. The ER-stay and the primary treatment fee were compared in the two groups, and the scarring was evaluated 10 to 11 months from suturing by using the Modified Hollander Method and the 10-cm scaled VAS (visual analogue scale: score 0=no scar, score 10=very severe scar) Results: The ER stay was 76 minutes for the experimental group and 107 minutes for the control group, showing that statistically significantly less time of 31 minutes was taken in the experimental group. The cost of the experimental group was 40000 won (50.1%) more expensive than the control group, with an average cost of 121900 won for the experimental group and 81200 won for the control group. As for scar evaluation, 10.56 months after suturing, the experimental group showed a better result with a score of 2.6 compared to a score of 3.4 in the control group; however, this difference was not statistically significant (p<0.05). As to a detailed evaluation of scar characteristics, the experimental group had a statistically significantly better result in scar elevation, with a score of 0.6 compared to a score of 1.65 for the control group. Conclusion: If appropriate patients are selected, the method using tissue adhesive directly applied by an EM doctor not only decreases ER stay but also creates similar patients satisfaction, with statistically better result in scar elevation, compared to the conventional suture method; thus, ultimately general patient satisfaction is increased.
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김용환 ( Yong Hwan Kim ),양영모 ( Young Mo Yang ),이장영 ( Jang Young Lee ),이원석 ( Won Suk Lee ),성원영 ( Won Young Sung ),박경남 ( Koung Nam Bark ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.3
Purpose: This hospital has operated a trauma system of the inclusive trauma system under the sponsorship of this hospital and with financial support from the government from 2011, and it has been designated as a specialized trauma center (candidate) since November 2008. Therefore, this emergency medical center evaluated the influence of the inclusive trauma system on the course of healing and on the results for trauma patients within the region. Methods: The medical records of all patients who were registered as trauma patients from among those who visited the emergency medical center of this hospital from April 2009 to May 2012 were retrospectively reviewed. The monthly and the annual averages of important indices, such as the time in the emergency room and preventable mortalities, were calculated, and patterns of change were sought. The preventable mortality rate was calculated by using the Trauma Injury Severity Score (TRISS) for each patient. Results: The total number of patients registered from April 2009 to May 2012 was 601, and male patients accounted for a larger proportion(432 males(71.88%) vs. 169 females(28.12%)). Their average age was 46.2 years, the average Revised Trauma Score (RTS) was 5.74 points, and the average Injury Severity Score (ISS) was 26.99 points. The preventable mortality rate during the entire period, which was calculated using the TRISS, appeared lower than the preventable mortality rates reported in past studies in the Republic of Korea. Conclusion: These results for the operation of a new trauma system are limited in that they are only for a local private university hospital. However, results show greater changes and developments in and out of the hospital due to multilateral endeavors by the trauma team and the hospital. These endeavors include increased communications among the departments and development of a complementary patient registration system.
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