Sosyo
Online ISSN : 1884-880X
ISSN-L : 1884-880X
Volume 5, Issue 1
Displaying 1-8 of 8 articles from this issue
Feature Articles : How to definite the term of acute, subacute and chronic wound
  • Yoshio Tanaka, Yusuke Hamamoto, Motoki Tamai, Tetsukuni Kogure, Satoko ...
    2014 Volume 5 Issue 1 Pages 1-9
    Published: 2014
    Released on J-STAGE: January 01, 2014
    JOURNAL FREE ACCESS
    The definition of wounds is unclear, causing confusion in medical practice. We investigated the possibility of defining wounds on the basis of combination and numerical values of barrier factors to wound healing. Barriers to wound healing were divided into DEFECT, CAUSE, and LOCAL factors, and relative and absolute factors were scored as 1 and 2, respectively. In the wound classification, the presence of only a DEFECT factor, a DEFECT factor with one of the other factors, and a DEFECT factor with both of the other factors was categorized as Classes I, II, and III, respectively. The presence of both CAUSE and LOCAL factors without a DEFECT factor was categorized as class II'. We applied this to 13 representative cases of wounds, and determined the total points and severity category. Clinically acute, sub-acute, and chronic wounds were categorized as Classes I (total points ≤ 3), II (total points ≤ 4), and II or III (total points ≥ 4), respectively. Class III, in which CAUSE and LOCAL factors remain after wound healing, may represent a non-healing ulcer. The definition of wounds based on the combination and numerical values of barrier factors to wound healing was thought to be useful, and may clarify the target of treatment and facilitate early healing.
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Original Articles
  • Takahiro Tokiyoshi, Yoriko Tsuji, Maki Nakayama, Hiroto Terashi
    2014 Volume 5 Issue 1 Pages 10-15
    Published: 2014
    Released on J-STAGE: January 01, 2014
    JOURNAL FREE ACCESS
    Infections of central plantar space affect the plantar vascular arch, leading to thrombosis of metatarsal arteries and to central toe necrosis. Such infections are critical and require proper drainage.
    We carried out central toe amputation and resection of the metatarsal head and the metatarsophalangeal joint capsule simultaneously in order to drain central plantar space and to control infection following diabetic foot infection from central toe gangrene. The problematic dead space after metatarsal head resection was kept open for treatment in secondary healing.
    Six patients underwent our procedure, and all wounds healed. No recurrences ensued and no additional amputations were needed. None of the patients demonstrated deformed plantar arches, and all were able to walk after wound healing by wearing an insole.
    In conclusion, our procedure is effective in the treatment of infections of central plantar space following diabetic foot infection from central toe gangrene.
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  • Takaharu Hatano, Toshiyuki Ozawa, Kuniyuki Morimoto, Daisuke Sakahara, ...
    2014 Volume 5 Issue 1 Pages 16-21
    Published: 2014
    Released on J-STAGE: January 01, 2014
    JOURNAL FREE ACCESS
    It is often difficult to determine the depth of burns correctly. In this study, we prepared models of superficial dermal burns (SDB) and deep dermal burns (DDB) in rats, determined the burn depth by using laser speckle flowgraphy (LSFG), and examined whether or not we could distinguish between SDB and DDB.
    Male Wistar rats aged 10 weeks were used and burns were created by the hot water method. Models of SDB and DDB were defined based on examination of specimens stained with hematoxylin-eosin. In these burn models, blood flow was measured over time using LSFG.
    Since LSFG measurements are relative values, the ratio of blood flow in the burned skin to that in the normal skin was calculated. This blood flow ratio determined by LSFG showed a significant difference between SDB and DDB.
    LSFG could be a useful method for the evaluation of wound blood flow in patients with burns.
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  • Kosuke Ishikawa, Toshiyuki Minamimoto, Kimihito Ichimura, Susumu Honda ...
    2014 Volume 5 Issue 1 Pages 22-26
    Published: 2014
    Released on J-STAGE: January 01, 2014
    JOURNAL FREE ACCESS
    The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was introduced as a tool for distinguishing necrotizing fasciitis from other soft tissue infections. We retrospectively analyzed 11 patients with necrotizing fasciitis and 110 patients with severe cellulitis between 2005 and 2012 to validate the usefulness of the LRINEC score. The LRINEC score was significantly higher in patients with necrotizing fasciitis (mean 9.2, range 6-12) than in those with severe cellulitis (mean 2.7, range 0-10). With a cut-off score of ≥ 6, the LRINEC score had a sensitivity of 100%, specificity of 85.5%, positive predictive value of 40.7%, and negative predictive value of 100% in distinguishing the patients with necrotizing fasciitis from those with severe cellulitis. Our results suggest the LRINEC score is a useful ancillary diagnostic tool for necrotizing fasciitis besides clinical and radiological findings.
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  • Shinobu Ayabe, Ayako Miki, Masayo Nagamatsu, Hisashi Motomura
    2014 Volume 5 Issue 1 Pages 27-33
    Published: 2014
    Released on J-STAGE: January 01, 2014
    JOURNAL FREE ACCESS
    Basal cell carcinoma (BCC) is the most common cutaneous cancer of the nose and is characterized by its local spreading and exceptionally rare tendency to metastasize. Surgical excision ensuring the highest chance of cure is frequently employed. Excision defects of the nose may be reconstructed with local flap, for which there are concerns regarding precise design and visible donor site scar.
    In covering such defects following excision of basal cell carcinomas, we favor the technique of dermis grafting, which is a de-epithelialized split-thickness skin graft. It was reported by Han et al. in 2007 to restore the epidermis portion of the recipient site by inducing epithelialization from adjacent skin. The color and texture of the dermis graft match well with the skin of the nose region; however, it has the problem that the graft is harvested from the loaded portion of the buttocks. Therefore, we modified the donor site from the gluteal area to the inguinal area.
    Using our method, modified dermis graft technique, a graft can be harvested in an unloaded portion without a precise design or visible donor site scar. Satisfactory results, both clinically and in patient appreciation, have been obtained in terms of both the reconstruction site and the appearance of the donor site in all patients.
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Case Reports
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