Journal of Trauma and Injury

Biomechanics of stabbing knife attack for trauma surgeons in Korea: a narrative review: Kun Hwang, Chan Yong Park; J Trauma Inj. 2024;37(1):1-5. Published online January 15, 2024; DOI: https://doi.org/10.20408/jti.2023.0057

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Abstract PDF: The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.; Summary

A method of bedside urethrography before catheterization in pelvic trauma in Korea: a case report: Hojun Lee, Sung Yub Jeong, Kun Hwang; J Trauma Inj. 2023;36(4):451-453. Published online December 20, 2023; DOI: https://doi.org/10.20408/jti.2023.0047

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Abstract PDF: We introduce a convenient method of urethrography before catheterization for patients with pelvic trauma that can be used in a resuscitation area. A 10-mL syringe without a needle was used. X-ray contrast medium (Iohexol, 300 mg I/mL) was administered through the urethral orifice using a 10-mL syringe without needle and a simple pelvic anteroposterior film was taken (70 kilovolt [peak], 50 mAs). A 36-year-old soldier with a saddle injury from a gun barrel was taken to a trauma center. He had a pelvic fracture and complained of hematuria. Bedside urethrography above described was performed. The anterior urethra showed nonspecific findings, but dye leaked from the posterior urethra. Bedside Foley catheter insertion was attempted, but the catheter could not be advanced past the membranous urethra. Thereafter, suprapubic catheterization was performed. On the day of the injury, iliac artery embolization was carried out. The dislocated sacroiliac joint was also treated using open reduction and internal fixation. On hospital day 7, guidewire Foley insertion was performed. This bedside urethrography technique is simple and useful for pelvic fractures in which urethral injury is suspected.; Summary

Where the land ends and the sea begins: Kun Hwang; Received December 10, 2022 Accepted January 26, 2023 Published online June 9, 2023; DOI: https://doi.org/10.20408/jti.2022.0081 [Epub ahead of print]

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Penetrating trauma and “The Wound Man”: Kun Hwang; J Trauma Inj. 2023;36(1):1-2. Published online November 4, 2022; DOI: https://doi.org/10.20408/jti.2022.0035

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Development of variolation and its introduction to Joseon-era Korea: Kun Hwang; Received August 19, 2022 Accepted August 29, 2022 Published online October 26, 2022; DOI: https://doi.org/10.20408/jti.2022.0044 [Epub ahead of print]

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Near-death experiences in 19th century Korean tales: Kun Hwang; J Trauma Inj. 2023;36(2):75-77. Published online August 5, 2022; DOI: https://doi.org/10.20408/jti.2022.0020

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Writing papers: literary and scientific: Kun Hwang; J Trauma Inj. 2022;35(3):145-150. Published online June 29, 2022; DOI: https://doi.org/10.20408/jti.2022.0006

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Abstract PDF: This paper aims to summarize why I write, how to find a motif, and how to polish and finish a manuscript. For William Carlos Williams, practicing medicine and writing poetry were two parts of a single whole, not each of the other. The two complemented each other. Medicine stimulated Williams to become a poet, while poetry was also the driving force behind his role as a doctor. Alexander Pope, the 18th century English poet, wrote a poem entitled “The Epistle to Dr. Arbuthnot” that was dedicated to a friend who was both a poet and a physician. In this poem, we receive an answer to the questions of ‘‘Why do you write? Why do you publish?’’ Pope writes, “Happy my studies, when by these approv’d! / Happier their author, when by these belov’d! / From these the world will judge of men and books.” When I write, I first reflect on whether I only want to write something for its own sake, like “a dog chasing its own tail,’’ instead of making a more worthwhile contribution. When my colleagues ask me, “Why do you write essays as well as scientific papers?” I usually answer, “Writing is a process of healing for me—I cannot bear myself unless I write.” When the time comes to sit down and put pen to paper, I remind myself of the saying, festina lente (in German, Ohne Hast, aber ohne Rast, corresponding to the English proverb “more haste, less speed”). If I am utterly exhausted when I finish writing, then I know that I have had my vision.; Summary

Tactical field management of penetrating arrow injuries in ancient Asia: Kun Hwang; J Trauma Inj. 2022;35(4):229-231. Published online June 23, 2022; DOI: https://doi.org/10.20408/jti.2022.0018

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Medieval (arrow) weapon injuries in contemporary surgical practice: Impaled posterior thoracic wall arrowhead leading to haemo-thorax: Management protocols. Case report
Ahmed Shabhay, Zarina Shabhay, Fabian Anaclet Massaga, Amri Salim Mwami, Samwel Chugulu
International Journal of Surgery Case Reports.2023; 111: 108866. CrossRef

New horizons of Flaubert: from a barber-surgeon to a modern trauma surgeon: Kun Hwang; J Trauma Inj. 2022;35(Suppl 1):S1-S2. Published online May 30, 2022; DOI: https://doi.org/10.20408/jti.2021.0081

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Trauma Surgery and War: A Historical Perspective: Kun Hwang; J Trauma Inj. 2021;34(4):219-224. Published online September 7, 2021; DOI: https://doi.org/10.20408/jti.2021.0029

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The aim of this review is to introduce the progress in trauma surgery made during war. In the 16th century, Paré reintroduced ligature of arteries, which had been introduced by Celsus and Galen, instead of cauterization during amputation. Larrey, a surgeon in Napoleon’s military, adapted the “flying artillery” to serve as “flying ambulances” for rapid transport of the wounded. He established rules for the triage of war casualties, treating wounded soldiers according to the seriousness of their injuries and the urgency of medical care. To treat fractures and tuberculosis, Thomas created the “Thomas splint”, which was used to stabilize fractured femurs and prevent infection; in World War I (WWI), use of this splint reduced the mortality of compound femur fractures from 87% to less than 8%. During WWI, Cushing systematized the treatment of head injuries, reducing mortality among head injury patients. Gillies repaired facial injuries, and his experiences became the basis of craniofacial and aesthetic surgery. In WWII, McIndoe discovered that immersion in saline promoted burn healing and improved survival rates, and thus began saline baths and early grafting instead of using tannic acid. A high mortality rate in patients with acute renal failure was noted in WWII and the Korean War. In the Korean War, Teschan used the Kolff-Brigham dialyzer. The first use of medevac with helicopters was the evacuation of three British pilot combat casualties by the US Army in Burma during WWII. As a lotus blooms in the mud, military surgeons have contributed to trauma surgery during wartime.

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New horizons of Flaubert: from a barber-surgeon to a modern trauma surgeon
Kun Hwang
Journal of Trauma and Injury.2022; 35(Suppl 1): S1. CrossRef

Adam's apple and airway obstruction: Kun Hwang; J Trauma Inj. 2022;35(1):1-2. Published online September 1, 2021; DOI: https://doi.org/10.20408/jti.2021.0040

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Trauma Surgeons: Heroes of a Moment: Kun Hwang; J Trauma Inj. 2021;34(2):79-80. Published online June 1, 2021; DOI: https://doi.org/10.20408/jti.2021.0007

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Anatomy of the Soul, Psalm of the Anatomy: Kun Hwang; J Trauma Inj. 2021;34(1):1-2. Published online March 31, 2021; DOI: https://doi.org/10.20408/jti.2021.0006

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Keep Playing Tug-of-War Against Grim Reaper: Kun Hwang; J Trauma Inj. 2020;33(4):205-206. Published online December 31, 2020; DOI: https://doi.org/10.20408/jti.2020.0080

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Near-death experiences in 19th century Korean tales
Kun Hwang
Journal of Trauma and Injury.2023; 36(2): 75. CrossRef

Comments on “Case Series: Successful Resuscitation of Severe Facial Injuries Caused by a Chainsaw”: Kun Hwang; J Trauma Inj. 2019;32(4):258-259. Published online December 30, 2019; DOI: https://doi.org/10.20408/jti.2019.038

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