• Journal of Trauma and Injury
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• v.21 no.2
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• pp.140-143
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• 2008

Degloving injuries result from the tangential force against the skin surface, with resultant separation of the skin and the subcutaneous tissue from the rigid underlying muscle and fascia. These injuries are associated with extensive soft tissue loss and occasionally with exposure of bone, and they require reconstructive modality for resurfacing and successful rehabilitation that considers the vascular anatomy and the timing of the operation. A 19-year-old male patient was transferred to our facility with degloving injury extending from the lower third of the right thigh to the malleolar area. The tibial bone was exposed to a size of $2{\times}3.5cm^2$ on the upper third of the lower leg at the posttraumatic third day. The exposed soft tissue was healthy, and the patient did not have any other associated disease. At the posttraumatic sixth day, one-stage resurfacing was performed with a medial gastrocnemius muscle flap transposition for the denuded bone and a split-thickness skin graft for the entire raw surface. The transposed gastrocnemius muscle attained its anatomical shape quickly, and the operating time was relatively short. No transfusion was needed. This early reconstruction prevented the accumulation of chronic granulation tissue, which leads to contracture of the wound and joint. The early correction of the gastrocnemius muscle flap transposition made early rehabilitation possible, and the patient recovered a nearly full range of motion at the injured knee joint. The leg contour was almost symmetric at one month postoperatively.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.647-651
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• 2010

The advantages of the $CO_2$ laser are offset by the delay in laser wound healing secondary to thermal damage. To minimize the undesirable thermal damage of the $CO_2$ laser, investigators have developed technical advances in the delivery system of the laser energy. This study compared tissue healing of the continuous and the pulsed modes $CO_2$ laser wounds in an animal surgery model. Five healthy Landrace and Yorkshire mixed breeds of both genders were used (45-51 kg, 4-6 months old, three males and two females). A full thickness wound of skin ($2{\times}2{\times}2cm^2$) was made over on the each pig's both sides of dorsal midline at 0, 7, 14, and 18 days. The wounds created at 18, 14, 7 and 0 days were named post-wounding day (PWD) 3, 7, 14 and 21, respectively. In each pig, one wound (left side) was treated pulsed $CO_2$ laser and the other wound (right side) was treated continuous wave $CO_2$ laser. Each wound was closed with two interrupted suture of 3-0 sutures. At 21 days after initial wounding, each wound was taken for histological evaluations. The degrees of reepithelialization were performed more prominently in the pulsed mode group than in the continuous mode group. The degrees of granulation were greater significantly in pulsed mode group than those in the continuous mode on PWD 3 (p < 0.05). The degrees of fibroblasts in the pulsed mode group were greater significantly in comparison to those in the continuous mode group on PWD 7, (p < 0.05). In conclusion, reepithelialization, granulation and fibroblasts in the pulsed mode group were greater markedly in comparison to those in the continuous mode group. It was considered that pulsed mode $CO_2$ laser was more suitable for the skin incision than the continuous mode $CO_2$ laser.

• The Journal of Korean Physical Therapy
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• v.9 no.1
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• pp.1-18
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• 1997

The purpose of this study is to investigate the effects of the low power Helium Neon-Infra Red(HeNe-IR) laser and the special electromagnetic therapeutic apparatus stimulation, which is usually designated as TDP by using the initial of Tending Diancibo Pu which is the Chinese inscribed with English, on wound healing in rat. The seventy-five Sprague-Dawley adult female and male rats were assigned to the experimental and control groups. Each rat was anesthetized with pentobarbital sodium, and three full-thickness incisions with 12mm length wert made on the back of the half cf the rats and three deep second degree burns were made on the back of the remainder of the rats. From 34 hours after being injured, the rats of the experimental laser group were irradiated with the 157mW electric power HeNe-IR laser for 2 minutes every day and the rats of the experimental TDP group were stimulated with TDP irradiation with the 4km spot distance for 20 minutes every day during the 17 days. The rats were sacrificed and the wound parts of its were incised on the first day, 4th day, 7th day, 10th day and 17th day respectively after the beginning of wound treatment with laser and TDP irradiation. The incised wound parts were processed appropriately for the light microscopic and electron microscopic examination. The length of incised wound was measured with microcaliper before the wound part was incised. There was a significant decrease in the length of the incised wound of the experimental laser and TDP group, compared with that of control group at 4th day, 7th day and 10th day(p<0.01) after surgery. Through the histological examination of the wound site, the more rapid epithelialization and collagen formation in experimental groups were showed, compared with control group. The histological results were analyzed and summarized as the follows; The epidermis begins to be regenerated and the granulation tissue begins to be changed to the mature pattern in the H-E stained incised skin of the laser and TDP treatment group on the 4th day. The epidermis shows the complete regeneration and the granulation tissue in the dermis in mostly to be matured in the laser and TDP treatment group on the 7th day, compared with control group. The chronic inflammatory cells are oberved and the necrosis of the collagen fibers are partially observed in control group on the 10th day. The dermis of the laser and TOP treatment group reveals relatively compactly arranged collgen bundles with the mature collagen fibers on the 10th day. The epidermis and dennis of the laser and TDP group are repaired normally and the hair follicles are well regenerated on the 17th day. The mild edema and the granulation tissue is observed in the dermis of the control groups and the delayed treatment process is observed on the 17th day. The Most of proliferated collagen fibrils are found to be compact and regular in electron micrograph of burn skin of the laser treatment group on the 10th day hut the interstitial eadema and some inflammatory cells are found in the control group. The above results suggest that through the visual and histological examination the epithelized epithelium and the proliferation of the collagen liters in the dermis occur very effectively with the low power laser treatment and the TDP treatment in the incised wound healing and the burn wound healing.

• Applied Microscopy
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• v.28 no.3
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• pp.307-314
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• 1998

The author has undertaken this study for demonstrating the relationship between keratinization and proliferation as well as remodeling of epidermis. Healthy ICR strain male mice, weighing about $20\sim25gm$, were used as experimental animals. Under the general anesthesia with ether the skins of experimental animals were subjected to a dorsal, transverse, full-thickness incision with 0.5cm in length, and removed them on 3rd day, 7th day and 2nd week after operation Specimens were prepared for electron microscopic study. The results obtained were as follows: The epidermis of 3rd day group is made up of $7\sim8$ keratinocytes. The new epidermal cells are grown beneath the necrotic tissue. Keratohyaline granules (KHGs) are visible in some granular cells. Various sited-KHGs are seen in granular layer cell, and in spinous cell ribosomes, tonofilaments and lamellar granules are seen. The epidermis of 7th day group is made up of $7\sim8$ keratinocytes. Numerous KHGs are seen in granular layer cells. KHGs are located in granular layer cells as well as spinous layer cells. The epidermis of End week group is composed of one-layered basal cell and $1\sim2$ layered superficial cells. Various sized-KHGs are observed in granular layer cells. The results of the present study suggest that as the epidermis should be keratinized during proliferation and remodeling process, so keratinization of the epidermis would play a major role of wound healing process.

• Archives of Plastic Surgery
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• v.41 no.4
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• pp.317-324
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• 2014

Background Burn infliction techniques are poorly described in rat models. An accurate study can only be achieved with wounds that are uniform in size and depth. We describe a simple reproducible method for creating consistent burn wounds in rats. Methods Ten male Sprague-Dawley rats were anesthetized and dorsum shaved. A 100 g cylindrical stainless-steel rod (1 cm diameter) was heated to $100^{\circ}C$ in boiling water. Temperature was monitored using a thermocouple. We performed two consecutive toe-pinch tests on different limbs to assess the depth of sedation. Burn infliction was limited to the loin. The skin was pulled upwards, away from the underlying viscera, creating a flat surface. The rod rested on its own weight for 5, 10, and 20 seconds at three different sites on each rat. Wounds were evaluated for size, morphology and depth. Results Average wound size was $0.9957cm^2$ (standard deviation [SD] 0.1845) (n=30). Wounds created with duration of 5 seconds were pale, with an indistinct margin of erythema. Wounds of 10 and 20 seconds were well-defined, uniformly brown with a rim of erythema. Average depths of tissue damage were 1.30 mm (SD 0.424), 2.35 mm (SD 0.071), and 2.60 mm (SD 0.283) for duration of 5, 10, 20 seconds respectively. Burn duration of 5 seconds resulted in full-thickness damage. Burn duration of 10 seconds and 20 seconds resulted in full-thickness damage, involving subjacent skeletal muscle. Conclusions This is a simple reproducible method for creating burn wounds consistent in size and depth in a rat burn model.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.601-605
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• 2012

Background Cryptotia is a congenital ear deformity in which the upper pole appears buried beneath the mastoid skin. Cryptotia is a common auricular malformation among Asians. The aim of this paper is to examine the surgical techniques for and complications of 34 cryptotic patients. Methods Surgery was performed for 34 cryptotic deformities (January 2005 to January 2012). Twenty-two patients (64.7%) were classified as having type I cryptotia, and 12 patients (37.5%) type II cryptotia. Among the type I cryptotia patients, 8 patients had mild deformity and 14 severe deformity. Among the type II cryptotia patients, 10 patients had mild deformity and 2 severe deformity. Results The mild deformities were corrected via Z-plasty, V-Y plasty, full-thickness skin graft, and transposition flap, while the severe deformities were corrected via cartilage graft or Medporfor the spread of cartilage adhesion of antihelix. There were two cases of reinvagination in the autologous cartilage graft group. Implant exposure occurred with Medpor (two cases). There were two cases of hypertrophic scar on the previous surgical wound with Medpor. There were no complications in the 18 patients who had mild deformities. Conclusions The type I cryptotia patients had more severe deformities than the type II cryptotia patients. As most of the type II cryptotia patients had only mild deformities, their deformities were corrected without using autologous conchal cartilage graft or Medpor, except for two patients. Through more case analyses, researchers should make an effort to identify methods for recurrence and prevention of complication.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.92-100
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• 2006

Radial forearm free flap (RFFF) has been established itself as a versatile and widely used method for reconstruction of the head and neck, although it is still criticized for high mortality of donor site. Delayed wound healing, cosmetic deformity, vascular compromise and potentially reduced wrist function have many plastic surgeons hesitate to adapt it as a first choice in micro-reconstruction. To overcome these drawbacks, some techniques for donor-site repair such as V-Y advancement with full thickness skin graft (FTSG), application of artificial dermis ($Terudermis^{(R)}$) or acellular dermal matrix ($AlloDerm^{(R)}$), and double-opposing rhomboid transposition flap have been reported. Authors performed 4 cases of RFFF in old-aged patients of the head and neck cancer from April 2005 to February 2006. We compared the outcomes of donor site of RFFF which were resurfaced with split thickness skin graft (STSG) only and STSG overlying an $AlloDerm^{(R)}$. Patients were all males ranging from 59 to 74 years old (mean, 67.5). Three of them had tongue cancers, and the other showed hypopharyngeal cancer. All cases were pathologically confirmed as squamous cell carcinomas. We included the deep fascia into the flap, so called subfascially elevated RFFF in three cases, and in the other one, we dissected the RFFF suprafascially leaving the fascia intact. The donor site of the suprafascially elevated RFFF was resurfaced with STSG only. Among three of subfascially elevated RFFFs, donor-sites were covered with thin STSG only in one case, and STSG overlying $AlloDerm^{(R)}$ in two cases. All RFFFs were survived completely without any complication. The donor site of the suprafascially elevated RFFF was taken well with STSG only. But, the partial graft loss exposing brachioradialis and flexor carpi radialis muscle was unavoidable in all the subfascially elevated RFFFs irregardless of $AlloDerm^{(R)}$ application. Considering that many patients of the head and neck cancer are in old ages, we believe the RFFF is still a useful and versatile choice for resurfacing the head and neck region after cancer ablation. Its reliability and functional characteristics could override its criticism for donor site in old-aged cancer patients.

• Journal of Veterinary Clinics
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• v.24 no.4
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• pp.550-556
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• 2007

The purpose of this study is to assess healing effect of the green tea on Staphylococcus contaminated wound. On the back of 7 dogs, 6 full-thickness skin wounds($2cm{\times}2cm$) were made and Staphylococcus intermedius was inoculated. Each wound was applied with the 2%(experimental group I), 1%(experimental group II) extract of green tea and normal saline(control group I) after inoculation. The wound contraction rate of the experimental group I and II was higher than that of the control group in entire period. And from the $6^{th}\;to\;22^{nd}$ day, the wound contraction rate of the experimental group I and II was significantly higher than that of the control group(p<0.05). The occupation rate of wound healing in the experimental group I was higher than that of the control group from $0\;to\;9^{th}$ day except from $1^{st}\;to\;2^{nd}$ day and also higher than that of the experimental group II from $0\;to\;3^{rd}$ day except from $1^{st}\;to\;2^{nd}$ day. And the occupation rate of wound healing in the experimental group II was higher than that of the control group from $1^{st}\;to\;8^{th}$ day except from $2^{nd}\;to\;3^{rd}$ day. According to concentration of green tea extract increased, the wound contracted more vigorously in earlier period. The tensile strength of the experimental group I and II was significantly higher than that of the control group(p<0.05). And that of the experimental group I was also higher than in the experimental group II(p<0.05). The number of S. intermedius in the experimental group I and II was decreased more rapidly than that of the control group. From the $4^{th}$ to the $11^{th}$ day, the number of S. intermedius in the experimental group I was significantly lower than that of the experimental group II and the control group. And from the $4^{th}$ to the $7^{th}$ day, the number of S. intermedius in the experimental group was significantly lower than that of the control group. The histopathological findings of the experimental group I and II were similar to those of the control group on the $1^{st}\;and\;4^{th}$ day. On $14^{th}$ day, reepithelialization was completed in the experimental group I and II except the control group. Higher wound contraction rate, better bacteriocidal action, higher tensile strength and better histopathological findings were observed in the experimental group I and II than in the control group. These results suggest that the topical application of green tea extract can promote contaminated wound healing in dogs.

• Archives of Plastic Surgery
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• v.35 no.1
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• pp.67-72
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• 2008

Purpose: The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Electrical burn affecting the hand may produce full thickness necrosis of the skin and damage deep structures beneath the eschar, affecting the tendon, nerve, vessel, even bone which result in serious dysfunction of the hand. As promising methods for the reconstruction of the hand defects in electrical burn patients, we have used the peroneal perforator free flaps. Methods: From March 2005 to June 2006, we applied peroneal perforator free flap to five patients with high tension electrical burn in the hand. Vascular pedicle ranged from 4cm to 5cm and flap size was from $4{\times}2.5cm$ to $7{\times}4cm$. Donor site was closed primarily.Results: All flaps survived completely. There was no need to sacrifice any main artery in the lower leg, and there was minimal morbidity at donor site. During the follow-ups, we got satisfactory results both in hand function and in aesthetic aspects.Conclusion: The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized wound defect, especially hand with electrical burn injury.

• Archives of Craniofacial Surgery
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• v.24 no.1
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• pp.37-40
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• 2023

Penetrating wounds to the face are cosmetically devastating and can be life-threatening. If the foreign body causing the penetrating wound is a piece of wood, small remnants might be left behind after the initial treatment. A 33-year-old male patient presented to the emergency center after a piece of lumber pierced his face as a passenger in a traffic accident. The patient's vital signs were stable, and emergency surgery was performed to remove the foreign body and repair the soft tissue. No noteworthy complications were seen after open reduction and internal fixation of the facial bone fractures. Seven months after the accident, the patient underwent scar revision along with full-thickness skin grafting for post-traumatic scars. After the surgery, pus-like discharge which was not previously present was observed, and the graft did not take well. A residual foreign body, which was the cause of graft failure, was found on computed tomography and the remaining foreign body was removed through revision surgery. The patient is receiving outpatient follow-up without any complications 6 months after surgery. This case demonstrates the importance of performing a careful evaluation to avoid missing a residual foreign body, especially if it is of wooden nature.