• Title/Summary/Keyword: 국소피판

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A Case Report of Head and Neck Neurofibroma Cured with Transitional Flap (국소피판으로 치료한 $6{\times}7cm$ 크기의 두경부 신경섬유종 1례)

  • Do Jae-Woon;Park Sang-Woo;Jeong Joon-Hun;Kang Tae-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.1
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    • pp.36-39
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    • 2006
  • The Neurofibroma is a benign neoplasm originating from neural tissue such as Schwann cell, fibroblast and peripheral fibroblast, which rarely converts to malignancy. About 25-45% of neurofibroma are located in head and neck, and the most common sites are lateral cervical region and mouth. Because of its high vascularity and invasion to the adjacent organs, surgical resection may be confronted and limited, moreover large neurofibroma can cause large defect that needs various kinds of flap. The factors related to clinically suspected malignancy are painlessness, abrupt increase in size, firm fixation, and central ulceration, although the malignancy rate of neurofibroma is low. The complete resection was failed several times at local clinic, the patient was transferred to our hospital. We have successfully removed the retroauricular neurofibroma using transposition flap & free skin graft on its large defects.

Reconstruction after Wide Excision of Malignant Soft Tissue Tumor in Ankle and Foot (족관절 및 족부에 발생한 연부 조직 악성 종양의 광범위 절제술 후 재건술)

  • Kwon, Young-Ho;Cho, Yool;Kim, Jae-Do;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.33-43
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    • 2008
  • Purpose: To evaluate the clinical usability of reconstructive methods, and how to select flap after wide excision of malignant soft tissue tumor in ankle and foot. Materials and Methods: The 15 cases shown in the 14 patients (In case of a male patient, reconstruction was performed two times due to local recurrence.) with malignant soft tissue tumor in ankle and foot, who underwent reconstruction after wide excision from March 2000 until March 2007. Oncologic, surgical and functional results were evaluated. Results: The method of reconstruction used were anterolateral thigh perforator flap (5cases), Reversed superficial sural artery flap (4 cases), dorsalis pedis flap (3 cases), local flap (3cases). The defect, mean size was $5.5{\times}5.7\;cm$, was reconstructed with rotation flap or free flap, mean size was $5.9{\times}6.0\;cm$, skin graft for remnant. The mean operation time was 310 minutes (120~540 minutes); it took 256 minutes to reconstruct by rotation flap, and 420 minutes by free flap. As oncologic results, 7 patients were no evidence of disease, 6 patients were alive with disease and 1 patient was expired by pulmonary metastasis at the time of the last follow-up. 4 patients had local recurrence and 4 pateints had distant metastases. As functional results, 14 patients were evaluated with average score of 68.8% using the system of the Musculoskeletal Tumor Society. Conclusion: The dorsalis pedis and reverse superficial sural artery rotation flap which is easy procedure, has less complication and takes short operation time, can be primarily considered to reconstruct a small defect. And the anterolateral thigh perforator flap is suitable for coverage of a large defects after wide excision of malignant soft tissue tumor in ankle and foot.

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Reconstruction of a Circumferential Penile Shaft Defect Using Bilateral Superficial External Pudendal Artery Perforator Flaps (양측 천외음부동맥 천공지 피판을 이용한 음경둘레 연조직 결손의 재건)

  • Park, Jongohk;Shin, Donghyeok;Choi, Hyungon;Kim, Jeenam;Lee, Myungchul
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.296-300
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    • 2018
  • Penile shaft reconstruction requires adequate soft tissue characteristics as well as constant vascular pedicles when considering a perforator flap. The free flap technique using various donor sites and regional conventional and perforator flaps have been utilized for penile shaft reconstruction. Still, the free flap techniques include challenging surgical procedures in addition to postoperative management. The regional flap can be applied to limited defects due to the size and shape. We performed the bilateral superficial external pudendal artery (SEPA) perforator flaps in order to reconstruct a circumferential penile shaft defect. The circumferential wound has noted necrotic tissue involving superficial (Dartos) fascia. We underwent debridement, preserving deep (Buck's) fascia and corpus spongiosum. Thereafter, the soft tissue defect was covered with bilateral SEPA perforator flaps. The patient has been observed for 27 months, showing penile resilience without deformity or wound-related problems.

영구 기공협착(tracheal stenosis)의 치료

  • 최종욱;김혜정;석윤식;박호정
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1995.04a
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    • pp.91.1-91
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    • 1995
  • 후두 또는 하인두 암종에 대한 광범위 절제 후 효율적인 호흡을 위하여 영구기공(permanant tracheostome)을 만들어 주게 되는데, 여러 가지 원인에 의하여 기공 협착이 발생하면 가피형성, 혈담, 호흡곤란 등을 초래하게 된다. 현재까지 기공협착의 치료는 Z형 성형술, 국소 스테로이드요법, 스텐트 삽입법 등 다양하게 이용되고 있으나 만족할 만한 결과를 얻는데 한계가 많았다. 이러한 기공협착의 치료에 도움을 얻고자, 저자들이 경험한 12례의 기공협착 환자에 대하여 기관전진점막피판(tracheal advancement flap)을 이용하여 성공적으로 치료하였기에 요약 보고하고자 한다.

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The Treatment of Congenital Cutis Aplasia (선천성 피부결손증의 치험 1례)

  • Kim, Young-Ha;Cha, Gyu-Ho;Jung, Jae-Ho;Lee, Kyung-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.422-426
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    • 1992
  • One case of Congenital Cutis Aplasia is presented. The defect involved includes full-thickness skin defect of scalp and cranium. The patient was treated with debridement of dirty necrosed crust which covered exposed dura mater and with double opposing rotation flap including pericranium for bone regneration. The donor site was covered with skin graft from right thigh. During operation, the superficial temporal arterty was found to be short and weak. And after operation, the margin of flap were congested and finally necrotized. The necrotic wound was treated with conservative management. The vascular impairment is thought to be main course of Congenital Cutis Aplasia. So we conclude that the treatment of choice is conservative management or careful flap surgery for coverage of defect area.

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EFFECT OF APF GEL ON THE SURFACE OF COMPOSITE RESIN (복합레진 표면에 대한 APF gel의 영향)

  • Yuk, Gun-Yeung;Yang, Kyu-Ho;Kim, Seon-Mi;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.1
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    • pp.43-52
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    • 2006
  • Topical fluoride application for children is a widely peformed procedure in the field of pediatric dentistry to prevent dental caries. However, it is recently recognized as having some unwanted effects on several esthetic restorative materials as it roughens the surface of the restorative materials. The aim of this study was to evaluate the surface changes in composite resins to topical fluoride. Composite resins(Z $250^{(R)}$, Ultraseal $XT^{(R)}$ Filtek $flow^{(R)}$ $Revolution^{(R)}$, $Denfil^{(R)}$) in topical fluoride agents were immersed and their surface roughness, weight loss and SEM were evaluated. The results were as follows : 1. The 4 minutes-immersion groups showed more roughened surface than 1 minute-immersion groups and the control groups showed the smoothest surface among all the materials, and there was statistically significant difference except the revolution between the groups. 2. There was no significant difference between the 1 minute-immersion groups and 4 minutes-immersion groups in weight loss. 3. The experimental group treated with topical fluoride gel showed the generally mere roughened surface than control group in the SEM findings.

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Resurfacing the Large Penoscrotal Defects with Various Local Flaps after Ablation of Extramammary Paget's Disease (유방외 파제트병의 제거 후 발생한 음경-음낭부 결손의 다양한 국소피판을 이용한 재건)

  • Lee, Seung Ryul;Kang, Nak Heon;Oh, Sang Ha
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.753-758
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    • 2007
  • Purpose: Penoscrotal extramammary Paget's disease is a rare cutaneous malignancy that primarily affects the elderly. To prevent local recurrence, adequate surgical excision with its intraoperative frozen section, proper reconstruction, and careful follow-ups are required. The present study describes the treatment of patients with penoscrotal extramammary Paget's disease, focusing on the reconstruction after the ablation of lesion. Methods: Nine patients were selected who had undergone a local pedicle flap procedure due to the large defects after ablation of extramammary Paget's disease of the penoscrotal area, during the period of 1999 to 2005. Wide excision combined with intraoperative frozen sectioning was performed, and the penoscrotal wound was reconstructed with a local skin flap. Three flaps were chosen depending on the size of the defect. If the defect size was small and the scrotal tissue was adequate, scrotal flap(n=5) was enough for its reconstruction. However, as there were large defects with insufficient remnant scrotal tissue, a groin flap(n=2) or an anterolateral thigh flap(n=2) were performed. Results: There were no complications with the postoperative wound. Furthermore, no local recurrence was noted during two to six years of follow-up period (mean average 3.7 years). Conclusion: For the resurfacing the penoscrotum at large defects after ablation of extramammary Paget's disease, we performed reconstruction with a local flap. In the aspect of both function and cosmetic concerns, the results were satisfactory. 

A Case of the Soft Palate Reconstruction Using the Bilateral Palatal Mucomuscular Flap and Pharyngeal Flap after Wide Resection (연구개 및 구개수 암종의 광범위 절제 및 국소 점막근 피판 재건술 1예)

  • Gu, Ga Young;Lee, Hye Ran;Jang, Jeon Yeob
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.31-35
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    • 2022
  • The soft palate of carcinoma limited to the uvular region is infrequent among oropharyngeal cancers. The oropharynx regulates swallowing and speech through dynamic motions. Failure to reconstruct after surgical resection of the oropharynx structure can lead to permanent velopharyngeal insufficiency. Therefore, suitable reconstruction is important in establishing proper functional outcomes while maintaining oncological safety. We present a case of a 66-year-old male who was diagnosed with oropharynx cancer limited in the uvula accompanied by lymph node metastasis. After surgical resection, reconstruction was performed with the united arrangement of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap. There was no aspiration or reflux after feeding and epithelialization completely occurred after 1 month postoperatively. We report a successful case that the reconstruction with the local flap described above could preserve proper oropharyngeal function after primary surgery in small-sized oropharyngeal cancer.

Palliative Surgery in Two Dogs with Non-Curative Palatal Tumors (두 마리 개에서 완치가 어려운 구개 종양의 완화 수술 적용 증례)

  • Yoon, Hun-Young;Lee, Jung-Ha;Shin, Dong-Wook;Park, Hee-Myung;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.425-429
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    • 2014
  • Two dogs were presented with a history of anorexia, respiratory distress, or epistaxis. On physical examination, the dogs showed difficulty breathing and open-mouth breathing and large masses were found on the hard palate and soft palate. Cardiac arrest happened in case 2 and the dog was stabilized with cardiopulmonary resuscitation and oxygen therapy. Computed tomography demonstrated that the mass occupied the oropharynx, intrapharyngeal ostium, and laryngopharynx including the hard palate and soft palate in case 1. Palliative surgery was decided to improve swallowing and breathing with owner's consent in two dogs. Buccal mucosal flaps were performed for reconstruction of defects using rotational and single-pedicle advancement flaps and bilateral 90 degree transposition flaps in cases 1 and 2, respectively. Histopathology results described the oral masses as amelanotic melanoma in two dogs. The owners reported that there was normal swallowing and breathing at 7 days postoperatively in two dogs. In case 1, recurrent tumor was identified caudal to the hard palate 4 weeks after surgery. The owner did not allow further treatment and the dog became lost to follow-up at 2 months postoperatively. In case 2, there was no clinical or radiographic evidence of a local recurrence or distant metastasis at 3 weeks after surgery. The owner informed that the dog died suddenly with no signs of anything particularly wrong at 7 weeks after surgery.

The Effect of Topical Application of Heparin with Microneedling on Skin Flap Survival (미세바늘을 이용한 헤파린의 국소 도포가 피부 피판 생존에 미치는 영향)

  • Yang, Eunjung;Kim, Sugwon
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.254-261
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    • 2009
  • Purpose: The objective of this study was to evaluate the heparin effect for a viability of random - pattern dorsal flap in hairless mouse. Methods: A caudally - based random dorsal flap, measuring $1.5{\times}5cm$, was designed and heparin was applied topically after microneeding. Twenty five male hairless mice were randomly divided into control (Group1, n=5); received only microneedling (Group 2, n=5), only heparin(Group3, n=5), microneedling with saline(Group 4, n=5), and microneedling with heparin group(group5,n=5) to the flap during 7 days. The number of the capillaries were compared between the experimental groups and control group with respect to neovascularization after heparin application using imaging analysis program under hematoxylin - eosin stain. The capillary blood flow was measured by laser Doppler flowmetry. After seven days each animal was evaluated for the percentage area of the flap survival. Mann - Whitnety U test and Kruskal - Wallis statistical analysis of survival relationships was performed. Results: It can be observed increased number of the blood vessels in the experimental groups however it was not statistically significant. Blood flow of the haparin with microneedling group maintained higher than other experimental groups. Treated microneeding and heparin mice were significantly better flap viability than in controls (flap survival 67% and $54.4mm^2$ respectively; p<.01). Positive correlation was shown between flap survival rate and laser Doppler flux value only at first day after surgery. Conclusion: Heparin has a beneficial effect on capillary flow and improve peripheral circulatory disturbances in random pattern flaps.