• Title/Summary/Keyword: Free Graft

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Two-Blade Guillotine Technique for Nipple Graft Harvest

  • Wong, Allen Wei-Jiat;Chew, Khong-Yik;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • 제44권5호
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    • pp.449-452
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    • 2017
  • The nipple-sharing technique for nipple reconstruction offers excellent tissue matching. The method used for nipple graft harvesting determines the quality of the graft and hence, the success of nipple sharing. Here, we described a guillotine technique wherein the nipple is first transfixed with 2 straight needles to stabilise it. Two No. 11 blades are then inserted in the center and simultaneously swept outwards to amputate the distal portion of the nipple. This technique provides good control, resulting in a very evenly cut base. The recipient bed is deepithelialized thinly, and the nipple graft is inset with interrupted 8-0 nylon sutures under magnification. Being a composite graft, it is protected with splint dressings for 6 weeks, and the dressing is regularly changed by the surgeon. The height of the nipple grafts ranges from 4 to 8 mm. This technique was performed in 9 patients with an average follow-up of 2.9 years (range, 1-4.5 years). Apposition between the nipple graft and its bed is crucial for the success of this technique. When correctly applied, we observed rapid revascularization of the graft.

흉부식도암의 근치적절제후 국소 재발에서의 유리공장 이식술 -1례- (Surgical Treatment in Local Recurrence of Esophageal Cancer with Free Jejunal Graft -A Case Report)

  • 이종목;임수빈
    • Journal of Chest Surgery
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    • 제30권4호
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    • pp.449-452
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    • 1997
  • 저자들은 흉부식도암의 근치적 절제후 국소재발을 보인 1례를 치험하였기에 보고하는 바이다. 환자는 식도아절제술후 후종격동 경로를 통한 경부식도-위 문합술을 시행받았었다. 수술 20개월후 환자는 연하곤란을 주소로 내원하였고 컴퓨터 단층촬영과 경피적 세침흡인 조직검사등을 통해 국소재발을 확인하였다. 환자는 경부식도절제, 위 분문부의 부분절제 및 후두절제를 시행하고 유리공장 이식 편을 이용하여 재건술을 시행하였다.

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각화조직 회복을 위한 근단변위 판막술과 유리치은 이식술에 관한 고찰 (Various considerations of apically positioned flap operation and free gingival graft)

  • 조인우
    • 대한치과의사협회지
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    • 제55권3호
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    • pp.240-248
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    • 2017
  • A keratinized gingiva is important to the natural teeth and it is more essential to the health of the peri-implant mucosa of the implants. There are various surgical methods to restore a keratinized gingiva. First, a clinician could utilize apically positioned flap operation. This flap operation technique could be used as a full or partial thickness. If there is little keratinized gingival tissue available for the apically positioned flap operation, free gingival grafting should be used. Its technique sensitivity is relatively high, but using various surgical techniques and disciplines makes it simple and have the good predictability. There have been many considerations for those surgical techniques. Clinicians who treat for periodontitis or operate implant surgeries have to know the considerations and surgical methods.

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경골에 시행한 유리 생 비골 및 피부편 이식 (Free Vascularized Osteocutaneous Fibular Graft to the Tibia)

  • 이광석;박종웅;하경환;한상석
    • Archives of Reconstructive Microsurgery
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    • 제6권1호
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    • pp.63-72
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    • 1997
  • We have evaluated the clinical results following the 46 cases of free vascularized osteocutaneous fibular flap transfer to the tibial defect combined with skin and soft tissue defect, which were performed from May 1982 to January 1997. Regarding to the operation, flap size, length of the grafted fibula, anastomosed vessels, ischemic time of the flap and total operation time were measured. After the operation, time to union of grafted fibula and the amount of hypertrophy of grafted fibula were periodically measured through the serial X-ray follow-up and also the complications and results of treatment were evaluated. In the 46 consecutive procedures of free vascularized osteocutaneous fibular flap transfer, initial bony union were obtained in the 43 grafted fibulas at average 3.75 months after the operation. There were 2 cases in delayed unions and 1 in nonunion. 44 cutaneous flaps among the 46 cases were survived but 2 cases were necrotized due to deep infection and venous insufficiency. One necrotized flap was treated with latissimus dorsi free flap transfer and the other was treated with soleus muscle rotational flap. Grafted fibulas have been hypertrophied during the follow-up periods. The fracture of grafted fibula(15 cases) was the most common complication and occurred at average 9.7 months after the operation. The fractured fibulas were treated with the cast immobilization or internal fixation with conventional cancellous bone graft. In the cases of tibia and fibula fracture at recipient site, the initial rigid fixation for the fibula fracture at recipient site could prevent the fracture of grafted fibula to the tibia.

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제거한 하안검 지방의 이식을 이용한 눈물받이 고랑의 교정 (Correction of the Tear Trough Using Orbital Fat Graft from the Lower Lid)

  • 유영천;임대원;양원용;박준
    • Archives of Plastic Surgery
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    • 제33권3호
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    • pp.335-340
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    • 2006
  • Lower palpebral bags and tear trough grooves are the common signs of aging. Weakness of the orbital septum, atrophy of the orbicularis oculi muscle, slackness and laxity of the lower lid skin are the main causes of these aging changes. Tear trough groove with skeletonization of the lower orbital rim can not be corrected easily by the conventional lower blepharoplasty, but the augmentation of the volume, can be an effective method. Lower lids provide a well vascularized recipient site, which is vital for proper grafting of fat to occur. We treated tear trough groove with free fat graft of surgically removed orbital fat. Surgical excision of the fat pad and septal reinforcement with free fat graft below the levator labii superioris alaeque nasi muscle were performed to correct tear trough groove. This technique was performed in 29 consecutive individuals from October, 2001 to January, 2005. Palpebral bags and tear trough groove were corrected concomitantly and obtained a youthful attractive midface with no secondary hollowness of lower lid and irregularity. The overall results obtained were satisfactory without any complications. Recurrence of tear trough deformity due to grafted fat absorption was not noted during the 7 months of the follow-up period. The authors conclude that the procedure is safe and effective in selected patients.

Comparative Study of Spiral Oblique Retinacular Ligament Reconstruction Techniques Using Either a Lateral Band or a Tendon Graft

  • Oh, Jae Yun;Kim, Jin Soo;Lee, Dong Chul;Yang, Jae Won;Ki, Sae Hwi;Jeon, Byung Joon;Roh, Si Young
    • Archives of Plastic Surgery
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    • 제40권6호
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    • pp.773-778
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    • 2013
  • Background In the management of mallet deformities, oblique retinacular ligament (ORL) reconstruction provides a mechanism for automatic distal interphalangeal (DIP) joint extension upon active proximal interphalangeal joint extension. The two variants of ORL reconstruction utilize either the lateral band or a free tendon graft. This study aims to compare these two surgical techniques and to assess any differences in functional outcome. As a secondary measure, the Mitek bone anchor and pull-in suture methods are compared. Methods A single-institutional retrospective review of ORL reconstruction was performed. The standard patient demographics, injury mechanism, type of ORL reconstruction, and pre/postoperative degree of extension lag were collected for the 27 cases identified. The cases were divided into lateral band (group A, n=15) and free tendon graft groups (group B, n=12). Group B was subdivided into the pull-in suture technique (B-I) and the Mitek bone anchor method (B-II). Results Overall, ORL reconstructions had improved the mean DIP extension lag by $10^{\circ}$ (P=0.027). Neither the reconstructive technique choice nor bone fixation method identified any statistically meaningful difference in functional outcome (P=0.51 and P=0.83, respectively). Soft-tissue injury was associated with $30.8^{\circ}$ of improvement in the extension lag. The most common complications were tendon adhesion and rupture. Conclusions The choice of the ORL reconstructive technique or the bone anchor method did not influence the primary functional outcome of extension lag in this study. Both lateral band and free tendon graft ORL reconstructions are valid treatment methods in the management of chronic mallet deformity.

개의 피부손상에 대한 전층망상식피술 증례 (Use of the Full-thickness Free Skin Mesh Graft for Reconstruction of Wound in a Dog)

  • 김주호;이종일;이해범;허수영;소경민;고재진;전승기;이철호;김남수
    • 한국임상수의학회지
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    • 제24권2호
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    • pp.280-283
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    • 2007
  • A 6-year-old male dog was referred to Animal Medical Center, Chonbuk National University with large distal extremity abrasion wound to the hind limb by automobile accident. The wound was reconstructed with an autogenous, full-thickness skin mesh graft. The graft was harvested from the ventrolateral abdominal wall and transplanted to the wound. The skin mesh graft survived successfully without any noticeable complications. Successful grafting requires asepsis, an adequately prepared recipient bed through the surgical debridement and lavage, proper harvesting and preparation of the graft. Full-thickness skin mesh graft has lesser skin contraction which prevents formation of scar. Meshing the graft provides more graft flexibility over uneven, convex and concave surfaces and allows adequate drainage. The full-thickness skin mesh graft can be successfully used for the treatment of large distal skin wounds in dogs.

유리 공장이식 술을 이용한 식도 질환의 외과적 치료 (Free Jejunal Transfer for Benign and Malignant Esophageal Disease -7 Cases Reports)

  • 신호승;옥창석
    • Journal of Chest Surgery
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    • 제29권12호
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    • pp.1392-1397
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    • 1996
  • 지난 2년동안 식도암 환자 6례, 식도협착 환자 1례에서 식도절제술후 유리공장 이식수술을 시행하였다. 환자들은 부분 식도절제술과 함께 기능적 경부청소술 또는 종격동 임파절 절개을 시행하였다. 유리공장이식술은 대개 경부식도 질환에서 경부혈관을 이용하여 시행되어 왔으나, 저자들은 늑간동정맥을 이용하여 3례 에서 공장이식을 하였다. 수술후유증은 이식괴사 1례, 문합부 누출 1례 였다. 유리공장이식술은7명의 환자중6명의 환자에서 성공하였가. 늑간동정 맥을 이용하면 흉부 식도 질환에서도 유리공장이식술을 할수 있으며, 5명의 환자는 현재 추적관찰 중이다.

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