Satoko Iwai’s scientific contributions

We report a case of a gun shot wound treated at our hospital. A 59-year-old man was accidentally injured by a rifle bullet fired by a fellow hunter. The entrance wound was located on the medial side of the left leg, and the bullet exited on the lateral side of the same leg; the wound was approximately 20×15 cm in width. A comminuted left tibial fracture and left fibular epiphyseal fracture were detected. The sense of touch was impaired in the dermatome supplied by the deep peroneal nerve. Although there was plantar flexion in his left toes, he could not make dorsal flexion movements. The dorsal artery of the left foot showed a strong and steady pulse. He underwent seven surgeries under general anesthesia for wound cleaning, skin grafts, bone grafts, and a muscle flap. He was discharged from the hospital 371 days after the injury. Presumably,the three key points suggestive of the extent of injury to the patient and the treatment plan are the type of firearm, quality and quantity of the bullets, and strike points. We think that these three points are important when checking gunshot wounds.

Necrotizing fasciitis (NF) is a rare infection of the deeper layers of skin and subcutaneous tissues, early spreading across the fascia plane within the subcutaneous tissues. We have experienced 29 patients, 20 are males and 9 are females, who have diagnosed as «NF» or «Fournier’s gangrene» which is recognized as groin NF during the period from January 2003 to June 2012. We have studied about patients’ specific data, clinical data and our treatment. Patient’s specific data includes age, sex, main complaint and complications. Clinical datas are bacterial cultures, blood chemistry analysis and radiodiagnosis. Our treatments contain operations and antibiotics which we used for these patients. We studied their clinical courses. We report about our cases and studies.

A 50-year-old woman suffering from schizophrenia self-inflicted a laceration on her head and peeled off a wide area of her scalp by inserting her fingers into the wound. The peeled area of her scalp was divided into a large skin flap and a small piece of free skin. Under general anesthesia, we repositioned the two parts. The large flap of skin was engrafted successfully; however, hair loss was observed in the area of engrafted free skin. We have been following up this patient to observe the progress of hair regrowth.