다발성 전신질환 장애환자에서 진행성 치성감염에 의한 측두간극농양 절개 배농시 창상주위 봉합과 배농술에 의한 과도한 출혈조절 - 증례보고
BLEEDING CONTROL BY THE CIRCUMFERENTIAL SUTURE & DRAINAGE ON ACTIVEBLEEDING INCISION & DRAINAGE SITE OF TEMPORAL SPACE ABSCESS DUE TO ADVANCEDODONTOGENIC INFECTION IN A MULTIPLE MEDICALLY COMPROMISED DISABLED PATIENT - REPORT OF A CASE -
손정석, 오지현, 유재하,
소속 상세정보
손정석 ( Son Jeong-Seog ) - 연세대학교 치과대학 구강악안면외과학교실
오지현 ( Oh Ji-Hyeon ) - 연세대학교 치과대학 구강악안면외과학교실
유재하 ( Yoo Jae-Ha ) - 연세대학교 치과대학 구강악안면외과학교실
KMID : 1144020130090010030
Abstract
The four principles of treatment of odontogenic infection are as follows : (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including proper rest and nutrition.
A separate incision is required to establish drainage, especially in the case of extensive fascial space -infections. There are four principle causes for active bleeding in the immediate incision & drainage phase; (1) vascular wall alteration (infection, scurvy, chemicals), (2) disorder of platelet function, (3) thrombocytopenic purpuras, (4) disorders of coagulation (liver disease, anticoagulation drug).
If the hemorrhage from incision & drainage site is aggressive, the site must be packed with proper wet gauze and wound closure & drainage dressing are applied. The specific causes of bleeding may be associated with hypoxia, changes in the pH of blood & chemical changes affecting vascular contractility and blood clotting.
This is a case report of bleeding control by the circumferential suture & drainage on active bleeding incision & drainage site of temporal space abscess due to advanced odontogenic infection in a multiple medically compromised disabled patient.
키워드
Active bleeding; Incision & drainage; Temporal space abscess; Medically compromised patient
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