• Title/Summary/Keyword: Donor site

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Management of the Diabetic Foot Ulcer in Elderly Patients Using the Anterolateral Thigh Perforator Free Flap (고령의 당뇨병성 족부 궤양의 전외측 대퇴 천공지 유리 피판술을 이용한 치료)

  • Kim, J-Young;Lee, In-Mook;Na, Sang-Eun
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.59-65
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    • 2008
  • Purpose: To evaluate the results of anterolateral thigh perforator free flap for reconstruction of foot and ankle in old diabetic patients. Materials and Methods: Fifteen diabetic foot ulcer patients over the age of 55 were operated with anterolateral thigh perforator free flap. Hematological, hemodynamic, diabetic, bacteriologic and radiologic tests were checked with examination of blood vessel state in both the donor site and the recipient site. After surgery, serial check-up was performed at 6 week, 6 month, and 1 year postoperatively on the survival of transplantation tissue, condition of foot, and condition of walking. Results: There are one case of transplantation failure and four cases of partial tissue-necrosis. Delayed wound-healing was observed both recipient and donor tissue sites. At the final follow up, three cases of small ulcer were found at junction of flap and recipient tissue in plantar area. Fourteen out of fifteen patients could walk without any brace or walking aids. Conclusion: Reconstruction of foot and ankle region in old diabetic patients with the anterolateral thigh perforator free flap is a useful method which can prevent the amputation of foot and ankle.

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Lower Extremity Reconstruction of Soft Tissue Defects with Perforator Island Flap (하지의 연부조직 결손에 있어 천공지 도서형 피판술을 이용한 재건)

  • Lee, Tae Hoon;Choi, Jae Won;Lee, Jun Ho;Kim, Hyo Heon
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.435-440
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    • 2005
  • The reconstruction of deep soft tissue defects of lower extremities combined with bone exposure has been difficult problems. When it is impossible to raise local skin flap, we have been usually used the gastrocnemius musculocutaneous flap, cross leg flap or free flaps. However, In musculocutaneous flap, aesthetical appearance of the calf is not appropriate because of too bulky flap. Although the success rate of the free flap has improved, still failure of flap occurs in cases of the chronic ischemic state. As the concepts of perforator flap has recently developed and widely used due to its thin flap thickness. Between January 2002 to December 2004, we treated 7 patients with soft tissue defect in leg with chronic ischemic limbs with perforator island flap. Preoperative angiography were done in all case and we used 2 medial sural perforator flaps, 1 anterior tibial artery perforator flap, 1 posterior tibial artery perforator flap, 3 anterolateral thigh perforator flap. Partial necrosis of flap was seen in one patient but no further surgical procedure was required for wound healed spontaneously. Perforator island flaps are thin, reduce donor site morbidity, conceal donor site with primary closure and it is useful for resurfacing soft tissue defect of lower extremities.

Autotransplantation: A biological treatment alternative for a patient after traumatic dental injury

  • Vishwanath, Meenakshi;Janakiraman, Nandakumar;Vaziri, Hamed;Nanda, Ravindra;Uribe, Flavio
    • The korean journal of orthodontics
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    • v.48 no.2
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    • pp.125-130
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    • 2018
  • Traumatic dental injury is considered a public dental health problem because of a high childhood incidence, high treatment costs, and prolonged treatment time. Although management guidelines for traumatized teeth have been outlined, tooth loss following trauma is occasionally unavoidable. Here, we describe the successful interdisciplinary management of a traumatized central incisor in an 11-year old boy that was extracted because of a poor prognosis and restored by the autotransplantation of an immature donor tooth into the site. The patient underwent orthodontic treatment in order to close the donor site space and bring the autotransplanted tooth to an ideal position. Postorthodontic treatment radiographs and photographs revealed an esthetic and functional natural tooth replacing the lost tooth. The findings from this case suggest that autotransplantation offers unique advantages as a treatment modality for the restoration of missing teeth, particularly in growing children.

Soft Tissue Reconstruction of Extremity using Anteromedial Thigh Perforator Free Flap (전 내측 대퇴부 천공지 유리 피판술을 이용한 사지의 연부조직 재건)

  • Kong, Byeong-Seon;Lee, Sang-Hyun;Kim, Yong-Jin
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.24-30
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    • 2005
  • Thigh perforator flaps are used popularly, because they have a small thickness, a long vascular pedicle and a low rate of donor site morbidity. Among thigh perforator flaps, anterolateral thigh perforator flaps are generally used, but it is not easy to dissect the vastus lateralis muscle to find the vasuclar pedicle. The authors have planed 11 anteromedial thigh perforator flaps that have septocutaneous perforators. We were able to find anteromedial thigh perforators in 8 cases(72.7%). The perforators originated from the medial descending branch of the lateral circumflex femoral artery in 2 cases and a branch to the rectus femoris muscle in 6 cases. Of this type of surgery, 7 flaps survived. However, 1 flap failed because of arterial insufficiency. We believe the anteromedial thigh perforator flap is a good option when the thigh region is decided as a donor site, but surgeons should keep in mind that the perforator of anteromedial thigh flap may be absent.

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Reconstruction of the Finger Defect with Free Vascularized Reversed Radial Forearm Flap (유리 반전 전완피판술을 이용한 수지부 결손의 치료)

  • Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.122-128
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    • 1998
  • Radial forearm flap is one of the most useful skin flap in hand reconstructuion with distally based reverse pedicled or free vascularized fashion. Athors modified that flap into reverse pedicled and free vascularized flap which has advantages of both methods. The modification composed with harvesting flap on recipient side distal forearm just as free flap, than apply it as reverse distal pedicled flap fashion with microvascular anastomosis with distal vascular stump of donor radial vessels. We underwent this method in 5 cases in finger reconstruction from 1996, all of the cases had sucessful results. The advantages of this method are: 1. Thin flap which is compatible to finger skin can harvest from distal forearm with very long vascular pedicle that can be passed under the subcutaneous tunnel which avoid additional skin incisions on the hand. 2. The vessels of donor site and recipient site are same vessel in effected side of forearm, which can preserve contralateral side forearm and hand keep intact. 3. The flap can cover the defects on distal portion of the fingers which is difficult in conventional reversed radial forearm pedicled flap because of limited mobilization of flap due to limitation of pedicle length reach to tip of the fingers.

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Molecular Cloning and Expression of Bacillus pasteurii Urease Gene in Escherichia coli (B. pasteurii Urease 유전인자의 E. coli의 복제와 발현)

  • Kim, Sang-Dal;John Spizizen
    • Microbiology and Biotechnology Letters
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    • v.13 no.3
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    • pp.297-302
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    • 1985
  • The 7.1 Mdal Xbaf fragment of Bacillus pasteurii ATCC 11859 containing gene for urease was inserted into the Xbal site of bifunctional plasmid pGR71, and its urease gene was cloned and expressed in E. coil RRI. But the cloned gene was not expressed in Bacillus subtilis BR151 in consequence of deletion of inserted DNA fragment. The recombinant plasmid thus formed was named pGU66. The restriction map of the plasmid pGU66 was determined, and the size of the plasmid was estimated to be 12.6 Mdal by double digestion of restriction enzymes of the plasmid. The urease of the cloned strain was accumulated in periplasmic space and very similiar to that of donor strains in their enzymatic properties.

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Sensory Restoration of Abdomen after Free TRAM Flap for Breast Reconstruction

  • Sung, Kun Yong;Ahn, Hee Chang;Hwang, Weon Jung;Jo, Dong In
    • Archives of Plastic Surgery
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    • v.32 no.1
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    • pp.71-75
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    • 2005
  • The purpose of this study is to assess abdominal sensation after free TRAM flap for breast reconstruction. 74 patients underwent breast reconstruction with free TRAM flap by authors and were followed up to check the sensation on abdomen following the surgery at the out patient clinic. They are compared with 20 female volunteer controls. Abdomens were divided into 13 zones, and assessed for superficial touch, superficial pain, temperature, two-point discrimination, and vibration. For all five sensory modalities, subjects were found to have decreased sensation in the umbilical and infraumbilical regions. This was statistically significant compared with controls. Division following pedicle dissection showed more reduction of sensation than non-dissection side. Both Inguinal areas below the donor site closure also showed markedly decreased sensation. Sensation on most area of abdomen recovered in postoperative 1 year, however, there were remained hypoesthesia in umbilical and infraumbilical area after post operative 1 year. This study clearly demonstrates that there is a significant and persistent reduction in abdominal sensibility following free TRAM flap surgery.

Internal Mammary Artery Perforator Flap for Immediate Volume Replacement Following Wide Local Excision of Breast Cancer

  • van Huizum, Martine A.;Hage, J. Joris;Oldenburg, Hester A.;Hoornweg, Marije J.
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.502-508
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    • 2017
  • Background Breast-conserving therapy is defined as a breast-conserving wide local excision (WLE) of a mammary tumour combined with postoperative radiotherapy. Immediate restoration of the mammary shape by use of breast reduction techniques (volume displacement) or tissue replacement techniques (volume replacement) is gaining popularity to prevent breast malformation. Methods To date, using the internal mammary artery perforator (IMAP) flap has been suggested for immediate volume replacement after WLE, but has never been evaluated in a published study. Results We applied this flap in 12 women (mean age, 56.1 years) after WLE (mean specimen weight, 46.5 g) of the medial aspect of the breast. Over a median follow-up of 35.3 months (standard deviation, 1.2 months), 4 women needed repeated surgery for dog-ear correction of the donor site. Conclusions In our experience, the use of an IMAP flap was a reliable technique with good cosmetic outcomes after oncoplastic reconstruction. In this series, donor site revision often proved necessary initially, but we showed that this may easily be prevented.

반연속 흐름 2단 토양 컬럼에서의 사염화 에틸렌(PCE)의 혐기성 완전탈염소화 환원 생분해

  • Choi Jeong-Dong;Kim Yeong;Gwon Su-Yeol;Park Hu-Won;An Yeong-Ho
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2005.04a
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    • pp.131-134
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    • 2005
  • Anaerobic reductive dechlorination of tetrachloroethylene(PCE) to ethylene was investigated by performing laboratory experiments using semi-continuous flow two-in-series soil columns. The columns were packed with soils obtained from TCE-contaminated site in Korea. Site ground water containing lactate(as electron donor and/or carbon source) and PCE was pumped into the soil columns. During the first operation with a period of 50 days, injected mass ratio of lactate and PCE was 620:1 and incomplete reductive dechlorination of PCE to cis-DCE was observed in the columns. However, complete dechlorination of PCE to ethylene was observed when the mass ratio increased to 5,050:1 in the second operation, suggesting that the electron donor might be limited during the first operation period. During the degradation of cis-DCE to ethylene, the concentration of hydrogen was $22{\sim}29mM$. These positive results indicate that the TCE-contaminated groundwater investigated in this study could be remediated through biological anaerobic reductive dechlorination processes.

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Reconstruction of a scalp defect due to cochlear implant device extrusion using a temporoparietal fascia flap and a split-thickness skin graft from the scalp

  • Kang, Jae Kyoung;Lee, Jae Seong;Suh, Michelle;Lim, Gil Chae;Shin, Myoung Soo;Yun, Byung Min
    • Archives of Craniofacial Surgery
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    • v.20 no.5
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    • pp.319-323
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    • 2019
  • Cochlear implant extrusion, which is a common complication of cochlear implants, is generally repaired by a well visualized soft-tissue flap. A 61-year-old female patient with a medical history of schizophrenia who had a skin ulcer that caused cochlear implant extrusion, but that would be a stronger statement was referred to our department for removal of the implant and reconstruction of the resultant scalp defect. Accordingly, the broad defect was covered via rotation of a temporoparietal fascia flap (TPFF) using the superficial temporal artery, with the pedicle in the preauricular region as the pivot point. Coverage of TPFF was achieved with a split-thickness skin graft using the scalp as the donor site, which led to a quick recovery after the operation and satisfactory results in terms of aesthetics. This case suggests that a TPFF might be used as a flexible flap with low donor site morbidity for reconstructing cases of cochlear implant extrusion accompanied by a large full-layer scalp defect.