• Title/Summary/Keyword: 조직 결손

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Bone reaction to bovine hydroxyapatite grafted in the mandibular defects of beagle dogs. (성견의 하악 골 결손부에 이식한 생체 유래 골 이식재 (OCS-B)에 대한 치조골의 반응)

  • Byun, Yu-Kyung;Park, Jun-Beom;Kim, Tea-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Lee, Hye-Ja;Chung, Chong-Pyoung;Han, Soo-Boo;Rhyu, In-Chul
    • Journal of Periodontal and Implant Science
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    • v.36 no.1
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    • pp.39-49
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    • 2006

  • 1. 목 적 이 연구의 목적은 성견의 하악 골 결손부에 이식한 생체 유래 골 이식재에 대한 치조골의 반응을 알아보는 것이다. 2. 연구방법 및 재료 생후 1년 이상 된 성견 4마리의 하악 제2소구치 및 제 4 소구치를 발거하고 발치와에 금원심 폭경 8mm, 협설 폭경 5mm, 치조정에서의 깊이 6mm인 결손부를 형성하였다. 4주간의 자연 치유 후 판막을 형성하여 결손부의 크기를 확인하였다. 각각의 결손부 크기가 일정하도록 수정한 후 '이식재+차폐막'군에는 OCS-B을 이식하고 Bio-gide을 차단막으로 사용한 후 봉합하고 '이식재군'은 OCS-B 이식 후 차폐막 없이 봉합하였으며 '비이식'군은 아무런 처치없이 일차봉합하였다. 수술 4, 6주에 실험동물을 각각 희생시켜 실험부위를 적출하고 비탈회 연마 표본을 제작하여 골 치유 양성을 조직학적 및 조직계측학적으로 관찰하였다. 3. 연구결과 이식재 비이식군 및 이식군 모돼서 별다른 부작용없이 잘 치유되었다. 세 실험군 모두에서 술후 4주에 비교하여 술 후 6주에서의 결손부 산생골 형성량이 증가하였다. 술후 4주 소견에서 비이식군은 결손부 주변부위에서 골이 생성되어 나오는 양상을 보였으며 이식군은 이식재 주변으로 골침착 시작되는 것을 관찰할 수 있었다. 술후 6주 소견에서 비이식군은 결손부 경계부로부터의 지속적인 골 생성을 관찰할 수 있었으며 이식군은 이식재 주변으로 침착된 골의 양이 많아지고 신생골이 가교를 형성하는 것을 관찰할 수 있었다. 4. 결 론 차폐막 유무와 상관없이 OCS-B는 염증반응을 전혀 일으키지 않았으며 우수한 골 전도성을 보였다. 또한 결손부의 형태를 잘 유지하여 골재생을 위한 공간을 확보할 수 있었다. 이는 OCS-B가 골이식재로서의 필요조건을 갖추었음을 확인한 결과이며 보다 장기적인 관찰에서 OCS-B의 흡수 가능성을 확인하는 것이 필요할 것으로 보인다.

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Tracheal Reconstruction with Perichondrial Graft - An Experimental Study in Rabbits - (연골피막편 이식후 기관 결손부위의 재생에 관한 실험적 연구(제 1 보))

  • 이원상;서장수;이성은;홍원표;박찬일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.10.3-11
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    • 1982

  • Recently through the advancement of medical and surgical managements and the development of low pressure cuffed endotracheal tube, incidence of tracheal stenosis was decreased significantly. Though its incidence was decreased markedly, stenosis was developted unfortunately in the situations such as long term use of respirator, heavy infection, trauma of the trachea and long term intubation etc. Tracheal stenosis had been handled with various methods such as mechanical dilatation, tissue graft techniques, luminal augumentation and end to end anastomosis due to their individual advantages but their effects were not satisfactory. In 1959 Lester had been found the regenerated cartilage from the perichondrium of the rib incidentaly. Since then Skoog, Sohn and Ohlsen were reported chondrogenic potential of perichondrium through the animal experiments. Though many different materials have been tried to rebuild stenosis and gaping defect of trachea, tracheal reconstruction has been a perplexing clinical problems. We choose the perichondrium as the graft material because cartilage is the normal supporting matrix of that structure and it will be an obvious advantage to be able to position perichondrium over a defect and obtain new cartilage there. The young rabbits, which were selected as our experimental animals, were sacrified from two to eight weeks after surgery. The results of our experiment were as follows; 1) In control group, the defect site of trachea was covered with fibrosis and vessels but graft site was covered with hypertrophied perichondrium and vessels. 2) Respiratory mucosa was completely regenerated in defect sites both control and grafted groups. 3) The histologic changes of the grafted sites were as follows: 2 weeks- microvessel dilatation, inflammatory reaction, initiation of fibrosis 4 weeks- decreased microvessel engorgement, submucosal fibrosis, decreased inflammatory reaction immatured cartilage island was noted in the grafted perichondrium (one specimen) 6 weeks- mild degree vascular engorgement submucosal fibrosis. chronic inflamatory reaction cartilage island and endochondrial ossification was noted in the grafted perichondrium (Two specimens) 8 weeks- minute vascular engorgement dense submucosal fibrosis. loss of inflammatory reaction. cartilage island was noted in the grafted perichondrium (two specimens) 4) There was no significant differences in regeneration between active surface in and out groups. 5) We observed immatured cartilage islands and endochondrial ossification in the perichondrial grafted groups where as such findings were not noted in control groups except fibrosis. We concluded that perichondrium was the adequate material for the reconstruction of defected trachea but our results was not sufficient in the aspect of chondrogenic potential of perichondrium. So further research has indicated possibility of chondrogenic potential of perichondrium.

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Reverse Superficial Sural Artery Flap for the Reconstruction of Soft Tissue Defect Accompanied by Fracture of the Lower Extremity (하지 골절과 동반된 연부조직 결손 재건을 위한 역행성 비복동맥 피판술)

  • Han, Soo-Hong;Hong, In-Tae;Choi, SeongJu;Kim, Minwook
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.253-260
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    • 2020

  • Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

  • https://doi.org/10.4055/jkoa.2020.55.3.253 인용