Kim, Hyoung-Min;Jeong, Chang-Hoon;Lee, Gee-Heng;Koh, Young-Seok
Archives of Reconstructive Microsurgery
/
v.7
no.1
/
pp.68-72
/
1998
With the advent of microvascular free-tissue transfer, this single stage resurfacing method for large scar and soft tissue defects around the wrist in the patients of electrical burn has distinctive advantage over the conventional multistage pedicle-flap transfer. Between 1992 and 1996, we treated 9 cases of 8 patients who had large scar around the wrist due to old electrical burn with free flaps as a preparation of staged tendon graft. Mean age was 30.3 years and average scar area was $6{\times}11cm$. The length of time the injury and free flaps was 9 months on an average. Prior to the free flap, we performed the angiography to all patients in order to evaluate the circulation of the forearm and hand and to choose the recipient vessel. In all cases, proximal ulnar arteries in the forearm remained intact and all radial arteries remained intact in 8 of 9 cases on angiogram. The interosseous arteries were well visualized in all cases. We used the ulnar arteries as a recipient artery. The types of flaps used were f scapular cutaneous flaps, 2 dorsalis pedis flaps and a radial forearm flap. Flap survial was 100 percents with satisfactory functional and cosmetic results. Free flaps using ulnar artery as a recipient artery is one of the useful reconstruction methods for the resurfacing of large scar around the wrist in the patients of old electrical burn.
Lee, Young Jin;Ahn, Hee Chang;Choi, Methew Seung Suk;Hwang, Weon Joong
Archives of Plastic Surgery
/
v.32
no.1
/
pp.100-104
/
2005
A soft tissue defect of the lower leg or foot presents a challenging problem. Reconstructive surgeon should be armed at all points of wound site, tendon and bone exposure, injury of major vessel and so on in the lower limb. We reconstructed the defects of lower legs and feet of 25 patients between February, 1997 and December, 2003. Applying reversed adipofascial flap with skin graft on a soft tissue defect of the lower leg or foot is challenging. We did a comparative study of 25 reversed adipofascial flaps with 51 free flaps. All 25 cases of reverse adpofascial flap reconstruction were successful except for a partial loss of skin graft in 3 occasions. The reversed adipofascial flap had a merit of a short operation time and hositalization, a high success rate and minimum complications. Besides major vessels in the lower leg are better preserved and donor morbidity is minimal. However, the flap is unmerited in reconstructing a hug hallowed defect and in the leg with poor blood circulation and once previous surgery. The operators may consider the feasible substitution of reversed adipofascial flap for free flap before applying in the lower leg.
Park, Il Ho;Chung, Chul Hoon;Chang, Yong Joon;Kim, Jae Hyun
Archives of Plastic Surgery
/
v.43
no.5
/
pp.438-445
/
2016
Background The goal of reconstruction is to provide coverage of exposed vital structures with well-vascularized tissue for optimal restoration of form and function. Here, we present our clinical experience with the use of the scapular fascial free flap to correct facial asymmetry and to reconstruct soft tissue defects of the extremities. Methods We used a scapular fascial free flap in 12 cases for soft tissue coverage of the extremities or facial soft tissue augmentation. Results The flaps ranged in size from $3{\times}12$ to $13{\times}23$ cm. No cases of total loss of the flap occurred. Partial loss of the flap occurred in 1 patient, who was treated with a turnover flap using the adjacent scapular fascial flap and a skin graft. Partial loss of the skin graft occurred in 4 patients due to infection or hematoma beneath the graft, and these patients underwent another skin graft. Four cases of seroma at the donor site occurred, and these cases were treated with conservative management or capsulectomy and quilting sutures. Conclusions The scapular fascial free flap has many advantages, including a durable surface for restoration of form and contours, a large size with a constant pedicle, adequate surface for tendon gliding, and minimal donor-site scarring. We conclude that despite the occurrence of a small number of complications, the scapular fascial free flap should be considered to be a viable option for soft tissue coverage of the extremities and facial soft tissue augmentation.
Lee, Jang Hyun;Jang, Soo Won;Kim, Cheol Hann;Ahn, Hee Chang;Choi, Matthew Seung Suk
Archives of Plastic Surgery
/
v.36
no.5
/
pp.605-610
/
2009
Purpose: Substantial tissue necrosis after snake bites requiring coverage with flap surgery is extremely rare. In this article, we report 7 cases of soft tissue defects in the upper and the lower extremities caused by snake bites, which needed to be covered with flaps. Among the vast mass of publications on snake bites there has been no report that focuses on flap coverage of soft tissue defects due to snake bite sequelae. Methods: Seven cases of soft tissue defects with tendon, ligament, or bone exposure after snake bites were included. All patients were males without comorbidities, the average age was 35 years. All of them required coverage with a flap. In 6 cases, the defect was localized on the upper extremity, in one case the lesion was on the lower extremity. Local flaps were used in 6 cases, one case was covered with a free flap. The surgical procedures included one kite flap, one cross finger flap and digital nerve reconstruction with a sural nerve graft, one reverse proximal phalanx island flap, one groin flap, one adipofascial flap, one neurovascular island flap, and one anterolateral thigh free flap. The average interval from injury to flap surgery was 23.7 days. Results: All flaps survived without complication. All patients regained a good range of motion in the affected extremity. Donor site morbidities were not observed. The case with digital nerve reconstruction recovered a static two point discrimination of 7 mm. The patient with foot reconstruction can wear normal shoes without a debulking procedure. Conclusion: The majority of soft tissue affection after snake bites can be treated conservatively. Some severe cases, however, may require the coverage with flap surgery after radical debridement, especially, if there is exposure of tendon, bone or neurovascular structures. There is no doubt that definite coverage should be performed as soon as possible. But we also want to point out that this principle must not lead to a premature coverage. If the surgeon is not certain that the wound is free of necrotic tissue or remnants of venom, it is better to take enough time to get a proper wound before flap surgery in order to obtain a good functional and cosmetic result.
Chui, Christopher Hoe-Kong;Wong, Chin-Ho;Chew, Winston Y.;Low, Mun-Hon;Tan, Bien-Keem
Archives of Plastic Surgery
/
v.39
no.2
/
pp.130-136
/
2012
Background : Complex elbow injuries with associated nerve, muscle, or joint injury commonly develop post-inury stiffness. In order to preserve function, joint congruency, elbow stability and durable wound coverage must be achieved in a timely manner. Methods : A retrospective review of patients who underwent orthopaedic fixation followed by free anterolateral thigh (ALT) flap soft tissue coverage was performed. Five patients were identified and included in this study. Results : We present a series of 5 cases managed with this principle. Soft tissue defects ranged in size from $4{\times}9cm$ ($36cm^2$) to $15{\times}30cm$ ($450cm^2$) and were located either posteriorly (n=4) or anteriorly (n=1). Associated injuries included open fractures (n=3) and motor nerve transection (n=2). Wound coverage was achieved in a mean duration of 18.8 days (range, 11 to 42 day). There were no flap failures and no major complications. The mean postoperative active elbow motion was $102^{\circ}$ (range, $45^{\circ}$ to $140^{\circ}$). Conclusions : In our small series we have highlighted the safety and utility of using the free ALT flap in complex elbow injuries. The ALT flap has many advantages which include abundant skin and subcutaneous tissue; vascularised vastus lateralis muscle that was used in our series to obliterate dead space, provide a vascular bed for nerve grafts and combat infection; and, access to fascia lata grafts for reconstruction of the triceps tendon.
The purpose of this study was to present the clinical analysis of the results of lateral arm free flap for small sized and infected diabetic foot ulcer around toes. From May 2006 to December 2007, Seven patients were included in our study. Average age was 52.8 years, six were males and one was female. All had infected diabetic foot ulcer and had exposures of bone or tendon structures. Ulcers were located around great toe in four patients, 4th toe in one and 5th toe in two. Three patients had osteomyelitis of metatarsal or phalanx. After appropriate control of infection by serial wound debridement and intravenous antibiotics, lateral arm flap was applied to cover remained soft tissue defects. Posterior radial collateral artery of lateral arm flap was reanastomosed to dorsalis pedis artery of recipient foot by end to side technique in all cases in order to preserve already compromised artery of diabetic foot. All flaps were designed over lateral epicondyle to get longer pedicle and averaged pedicle length was 8 cm. Two cases were used as a sensate flap to achieve protective sensation of foot. All flaps survived and provided satisfactory coverage of soft tissue defects on diabetc foot ulcers. All patients could achieve full weight-bearing ambulation. No patients has had recurrence of infection, ulceration and further toe amputations. There were three complications, a delayed wound healing of flap with surrounding tissue, a partial peripheral loss of flap and a numbness of forearm below donor site. All patients were satisfied with their clinical results, especially preserving their toes and could return to the previous activity levels. Lateral arm free flap could be recommend for infected diabetic foot ulcers around toes, to preserve toes, coverage of soft tissue defect and control of infection with low donor site morbidity.
Kim, Sukhan;Hyon, Wonsok;Lee, Jihyuck;Mun, Goohyun;Bang, Saik;Oh, Kapsung
Archives of Reconstructive Microsurgery
/
v.13
no.1
/
pp.63-67
/
2004
Because traumatic tissue damage on hands and feet often lead to loss of function, permanent deformity, prompt and adequate reconstruction is essential. For children, future growth, as well as function and esthetics, must be taken into account. Several techniques have been employed to reconstruct hand and foot dorsum defects of children. However, skin graft and muscle free flap with skin graft cannot prevent contracture and will interfere with normal growth. Fasciocutaneous free flap reduces contracture and enables early physical therapy, decreasing the need for additional surgical intervention. Parascapular flap is particularly suitable because it has reliable pedicle and is relatively thin. There is little functional loss in the donor site, and also simultaneous extensor tendon reconstruction of hand and foot is possible. The disadvantage of this technique is that postoperative defatting is needed to adjust volume. Our department has achieved satisfactory results using this approach, and would like to report 13 cases of hand and foot reconstruction using parascapular flap in patients under the age of 15 (from March, 1998 to May, 2003).
Ahn, Deok Ki;Lew, Dae Hyun;Roh, Tai Suk;Lee, Won Jai
Archives of Plastic Surgery
/
v.42
no.5
/
pp.619-625
/
2015
Background The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions. Methods From July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review. Results The mean age of the patients was 52.4 years. The size of the flaps ranged from $5{\times}4$ to $20{\times}8cm^2$. The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities. Conclusions Peroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.
Purpose: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. Methods: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. Results: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. Conclusion: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.
Journal of the Earthquake Engineering Society of Korea
/
v.23
no.3
/
pp.159-167
/
2019
2016 Gyeongju and 2017 Pohang earthquakes led Koreans to acknowledge that the Korean peninsula is not an earthquake-free zone anymore. Among various buildings crucial to after-shock recovery, general hospital buildings, especially existing old ones, are very significant so seismic retrofitting of those must be an important issue. Self-centering energy dissipative(SCED) brace is one of retrofitting methods, which consists of tendon with restoring force and friction device capable of dissipating seismic energy. The strength of the SCED brace is that the tendon forces a structure to go back to the original position, which means residual drift can be negligible. The residual drift is a very important parameter to determine usableness of general hospitals after shock. To the contrary, buckling-restrained braces(BRB) are also a very effective way to retrofit because they can resist both compressive and tensile, but residual drift may exist when the steel core yields. On this background, the seismic retrofitting effect of general hospitals reinforced with SCED braces was investigated and compared to that of the BRD in this study. As a result, although the floor acceleration cannot be reduced, the story drift and residual drift, and the shear demand of walls significantly decreased. Consequently, seismic retrofitting by SCED braces are very effective for domestic low-rise general hospitals.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.