• Journal of Chest Surgery
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• v.22 no.1
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• pp.155-157
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• 1989

Median sternotomy is the incision of choice to allow access to the anterior mediastinum, heart, or both lungs. The vertical skin incision generally gives a poor cosmetic result. In certain patients particularly those who are asymptomatic and undergoing short, low risk procedures, cosmetic considerations are of relatively greater importance. A bilateral horizontal submammary skin incision with dissection of a flap including the subcutaneous tissue and breast allows exposure of the sternum so that a median sternotomy can be performed. We have performed this incision in 12 patients undergoing open heart surgery. Although obtaining the usual midsternal exposure takes some extra time, results have shown the va1ue of this approach and its benefit to the patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.2
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• pp.82-87
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• 1990

There are some methods of approach to the temporomandibular joint. The preauricular, the endaural and the postauricular incision are frequently used among those. The preauricular incision necessiates a preauricular scar, possible postopertive facial nerve damage and is the least cosmetically desirable incision. The endaural incision is more esthetic than preauricular incision, but it is not sufficient. The postauricular approach allows adequate exposure with decreased occurence of injury to facial nerve and excellent cosmetic results. The purpose of this report is to discuss the surgical approach of postauricular incision to the cases of TMJ ankyloses, internal derangement and condylar fracture of mandible.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.516-518
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• 2009

Purpose: To retrieve the retracted flexor tendon, additional incision and wide dissection are conventionally required. We introduce minimal - incision tenorrhaphy using 1 cm - length incision and minimal dissection. Methods: Transverse incision about 1 cm - length is made over the level of retracted tendon. Nelaton's catheter is advanced into tendon sheath from distal primary laceration wound to emerge proximally through the incisional wound. Catheter is sutured to proximal tendon in end - to - end fashion. By gently pulling the catheter, retracted tendon is delivered to distal wound. Tenorrhaphy with core suture and epitendinous suture is then carried out. Results: This retrieving technique provides minimal incision, minimal dissection, minimal bleeding, minimal injury to tendon end, and shorter operation time with preservation of vincula tendinum and pulley system. Conclusion: In case of flexor tendon rupture with retraction, this operative method is believed to allow reliable and effective tenorrhaphy and excellent postoperative outcomes.

• Journal of Veterinary Clinics
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• v.30 no.4
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• pp.247-252
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• 2013

We compared wound healing with $CO_2$ laser incision and scalpel incision by measuring the extent of bleeding, the ease of incision, time, degrees of adhesion and histological observation in pig's stomach. Eight healthy pigs were used. Two symmetrical incisions were made in ventral aspect of the stomach between the greater curvature and lesser curvature were made with scalpel and 2 mm spot diameter $CO_2$ laser (8W, continuous wave) in eight pigs. And then each wound was closed with absorbable suture in a two-layer inverting seromuscular pattern. At 7 and 14 days after initial wounding, each wound was taken for histological observation. On surgery, the extent of bleeding, the ease of incision and incision time showed significant differences between the two groups. The $CO_2$ laser provided better hemostasis (p < 0.01) and smaller postoperative adhesion compared with the scalpel. However, the scalpel produced faster speed of incision and was easier to handle than the $CO_2$ laser group (p < 0.01). There was no considerable difference between the two groups in histological observation.

• Journal of Korean Foot and Ankle Society
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• v.16 no.3
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• pp.181-189
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• 2012

Purpose: The purpose of this study was to compare and analyse the clinical outcomes of minimal incision repair and open repair in ruptured Achilles tendon. Materials and Methods: We retrospectively analyzed the outcomes of 10 patients with minimal incision repair (group 1) and 19 patients with open repair (group 2) from February 2007 to June 2011. The postoperative clinical evaluations were done by Arner-Lindholm scale, AOFAS score, overall patient's satisfaction and cosmetic satisfaction of scar. Results: There was no statistical difference between two groups in Arner-Lindholm scale, AOFAS score, overall patient's satisfaction (p=1.21, 0.87, 1.07). There was statistically high rate of cosmetic satisfaction in group 1(p<0.001). There were no complications in group 1. Complications occurred in three patients (deep infection, rerupture, deep vein thrombosis) of group 2. Conclusion: Treatment of minimal incision repair in Achilles's tendon ruptures showed high rate of cosmetic satisfaction and low rate of complication's, but there were no significant differences with open repair in other clinical outcomes. The minimal incision repair could be recommended as one of the effective treatment for the Achilles's tendon ruptures.

• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.33-39
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• 1998

This study was done to compare the results of the one-incision technique and the conventional two incision technique for the arthroscopic treatment of the posterior cruciate ligament injury. Fifty-five patients with the posterior cruciate ligament injury underwent the arthroscopic posterior cruciate ligament reconstruction using bone-patellar tendon-bone(BTB) graft. Patients with combined ligament injuries requiring concomitant operative treatment were excluded in this study. The conventional two-incision technique was performed in ten patients(Group I) and the one-incision technique in forty-five patients(Group II). The average duration of follow-up was 45 months in Group I(range, 40 to 50 months) and 36 months in Group II(range, 24 to 68 months). Auto BTB grafts were utilized for all patients in Group I. In Group II, 34 BTB autografts and 11 BTB allografts were utilized. The functional results were evaluated according to the Lysholm Knee Scoring scale and the Hospital for Special Surgery(HSS) knee ligament rating form. The postoperative posterior laxity was measured with a KT 1000 or 2000 arthrometer. Lysholm postoperative mean values were 90.0 in Group I and 90.6 in Group II. HSS mean values were 87.7 in Group I and 92.6 in Group II. HSS postoperative mean value showed better results in Group II(p=0.037). The average side-to-side difference of the posterior translation measured by the KT 2000 arthrometer were 2.10 mm(range, 1 to 4 mm) in Group I and 2.38 mm(range, 0 to 5 mm) in Group II. But there was no statistically significant difference. In Group II, the results of the autograft and allograft showed no significant difference. The arthroscopic posterior cruciate ligament reconstruction using one-incision technique showed good results comparable to the conventional two-incision technique. This technique minimizes potential injury to the extensor mechanism, especially vastus medialis obliquus, and scar formation over the medial femoral condyle. The operation can be finished within one tourniquet time by using only one-incision.

• Korean Journal of Head & Neck Oncology
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• v.28 no.2
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• pp.114-117
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• 2012

Background and Objectives : To assure the surgical completeness of the gasless endoscopic thyroidectomy via single incision axillary approach using flexible videoscope which provide wide angle and working space, we compared single incision axillary approach and axillo-areolar approach by means of clinical, surgical outcomes. Materials and Methods : From March 2011 to July 2012, 24 patients who had underwent endoscopic thyroidectomy via transaxillary approach were enrolled. Of total, 17 patients underwent single incision axillary approach(group I) and the other 7 underwent axillo-areolar approach(group II). Results : Patient demographics, surgical indications were similar between the two groups. The operating time(group I 144.6min, group II 153.6 min ; p=.29), blood loss(group I : 55.4cc, group II : 35.7cc : p=.64), hospital stay(group I : 4.2days, group II : 4.4 days ; p=.65) were similar in the two groups. Overall, two patients in group I(2/17, 11.8%) experienced postoperative complications, including one hematoma and one seroma. Due to narrow working space, one patient was change to axillo-areolar approach during single incision axillary approach with $30^{\circ}$ rigid endoscope. Conclusion：Single incision axillary approach is safe and effective similar to other endoscopic thyroidectomy methods using flexible videoscope. Different with $30^{\circ}$ rigid endoscope, 10-mm flexible videoscope can put inside the axillary inicision site in different axis with endoscopic instruments. This difference in endoscopic axis help to prevent crash with endoscopic instrument.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.325-332
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• 2018

Background Zygomaticomaxillary complex (ZMC) fractures mostly occur in the form of tripod fractures. The surgical field is accessed using a combination of three classic approaches. However, the subciliary incision may have unfavorable aesthetic results. Herein, the authors report the advantages of the extended transconjunctival approach (ETA) combined with T-bar screw reduction in minimizing scarring and complications for the treatment of ZMC fractures. Methods A total of 26 patients underwent ZMC reduction through the ETA and intraoral approach. A skin incision measuring roughly 5 to 8 mm in length was placed following the lateral canthal skin crease. After releasing the inferior crus of the lateral canthal tendon for canthotomy, the medial periosteum of the lateral orbital rim was preserved for canthal reattachment. A limited subperiosteal dissection and partial relaxing incision of the orbicularis oculi were performed to expose the fracture line of the inferior orbital rim and zygomaticofrontal suture. Reduction was performed using a T-bar screw through the transconjunctival incision and an elevator through the intraoral incision. Results The aesthetic and functional results were excellent. Successful reduction was achieved and the skin incision was less than 8 mm in 20 cases (76.9%). Only six patients had an additional skin incision (less than 5 mm) to achieve reduction. No cases of ectropion, entropion, or excessive scarring were noted. Conclusions The ETA using a T-bar screw is a useful method for maximizing aesthetic results in ZMC fractures, with the advantages of minimal scarring, faster recovery, and maintenance of pretarsal fullness.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.340-344
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• 2018

Background In performing extended latissimus dorsi (ELD) flap procedures, a skin paddle design on the bra line helps reduce visible scarring. This improves the patient's satisfaction with the outcome. However, such a design leads to a longer operation time and increased fatigue of the surgeon due to the narrow operative field. In this study, the authors propose a method that elongates the axillary incision line posteriorly by 1.5 cm from the lateral border of the latissimus dorsi muscle. We examined whether this method could shorten the operation time and compared the incidence of complications between patients who underwent this novel procedure and patients who underwent the traditional procedure. Methods In this study of patients who underwent ELD flap procedures for immediate breast reconstruction, 89 underwent surgery with the elongated axillary incision and 45 underwent surgery without the elongated incision. The total operation time and complications were retrospectively examined based on the patients' medical records, and we examined whether there was any statistically significant difference in the total operation time. Results In the experimental group with the elongated axillary incision, the operation time ranged from 125 to 255 minutes (median, 175 minutes). In contrast, in the control group without the elongated axillary incision, the operation time ranged from 142 and 340 minutes (median, 205 minutes). The operation time was statistically significantly different between the two groups, and no significant complications were observed in the experimental group. Conclusions Elongation of the axillary incision alone may shorten the operation time of the ELD flap procedure without causing additional complications.

• Korean Journal of Veterinary Research
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• v.50 no.2
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• pp.155-160
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• 2010

The objective of this study was to compare wound healing in stomach with $CO_{2}$ laser and scalpel incision by measuring the extent of bleeding, the ease of gastric incision, incision time, degree of adhesion and wound healing degree in dogs. Sixteen healthy dogs were used. Two symmetrical incisions were made in ventral aspect of the stomach between the greater and lesser curvatures were made with scalpel and 0.2 mm spot diameter $CO_{2}$ laser (8W, continuous wave) in sixteen dogs. And then each wound was closed with absorbable suture in a two-layer inverting seromuscular pattern. At 3, 7, 14 and 21 days after initial wounding, each wound was taken for histological observation. On surgery, the extent of bleeding, the ease of incision and incision time showed significant differences between the groups. The $CO_{2}$ laser provided better hemostasis (p < 0.05) and smaller postoperative adhesion compared with the scalpel. However, the scalpel produced faster speed of incision and was easier to handle than the $CO_{2}$ laser (p < 0.05). Although there was no considerable difference between the two groups in histological observation, necrosis and calcium deposit tended to be larger in the $CO_{2}$ laser than in the scalpel.