• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.7.1-7.5
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• 2018

Background: Oroantral communicating defects, characterized by a connection between the maxillary sinus and the oral cavity, are often induced by tooth extraction, removal of cysts and benign tumors, and resection of malignant tumors. The surgical defect may develop into an oroantral fistula, with resultant patient discomfort and chronic maxillary sinusitis. Small defects may close spontaneously; however, large oroantral defects generally require reconstruction. These large defects can be reconstructed with skin grafts and vascularized free flaps with or without bone graft. However, such surgical techniques are complex and technically difficult. A buccal fat pad is an effective, reliable, and straightforward material for reconstruction. Case presentation: This report describes three cases of reconstruction of large oroantral defects, all of which were covered by a pedicled buccal fat pad. Follow-up photography and radiologic imaging showed successful closure of the oroantral defects. Furthermore, there were no operative site complications, and no patient reported postsurgical discomfort. Conclusion: In conclusion, the use of the pedicled buccal fat pad is a reliable, safe, and successful method for the reconstruction of large oroantral defects.

• Archives of Reconstructive Microsurgery
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• v.26 no.1
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• pp.14-17
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• 2017

The superior gluteal artery perforator flap technique has increasingly been used for soft tissue defects in the sacral area following its introduction nearly 25 years ago. Advantages in covering sacral defects include muscle sparing, versatility in design, and low donor side morbidity. The bilateral superior gluteal artery perforator flap procedure is planned in cases of large sacral defects that cannot be covered with the unilateral superior gluteal artery perforator flap. Here, we report two cases of large sacral defects in which patient factors of poor general health, such as old age, pneumonia, and previous operation scar, led to use of a large unilateral superior gluteal artery perforator super-flap with parasacral perforator. The approach was utilized to reduce the operation time and prevent unpredictable flap failure due to the large flap size. Even though the parasacral perforator was included, the versatility of the large superior gluteal artery perforator flap was preserved because sufficient perforator length was acquired after adequate dissection.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.319-323
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• 2017

Background Free-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the authors examined outcomes of large facial defect reconstruction using multiple flaps. Methods Among patients undergoing MMS for skin cancer at Pusan National University Hospital between January 2013 and December 2015, we evaluated 7 patients (2 males, 5 females; average age, 73.14 years) treated for large facial defects from basal cell carcinoma. Based on operative and follow-up records, we investigated the number and type of flaps used, postsurgical complications, and patients' post-surgical satisfaction. Results Two and 3 types of flaps were used for 5 and 2 patients, respectively. Most frequently used were nasolabial flaps (7 times in 6 patients) and forehead flaps (once in each of 4 patients). The average follow-up period was 14 months, with no complications-including necrosis, hematoma, or wound dehiscence-observed. Post-surgical satisfaction averaged 4.4 out of a maximum of 5 points. Conclusions Reconstruction using two or more flaps for large facial defects after skin cancer removal using MMS produced satisfactory outcomes while preventing aesthetic problems. Practitioners should consider using multiple flaps when choosing a reconstruction method for large facial defects following skin cancer removal.

• Journal of the Semiconductor & Display Technology
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• v.3 no.4
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• pp.45-49
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• 2004

We examined large particles and filter size effects of Central Chemical Supplying (CCS) system for STI-CMP on Light Point Defects (LPDs) after polishing. As manufacturing process recently gets thinner below 0.1 um line width, it is very important to keep down post-CMP micro-scratch and LPDs in case of STI-CMP. Therefore, we must control the size distribution of large particles in a slurry. With optimization of final filter size, CCS system is one of the solutions for this issue. The oxide and nitride CMP tests were accomplished using nano-ceria slurries made by ourselves. The number of large particles in a slurry and the number of LPDs on the wafer surface after CMP were reduced with decrease of the final filter size. Oxide removal rates slightly changed according to the final filter size, showing the good performance of self-made nano ceria slurries.

• Archives of Plastic Surgery
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• v.43 no.5
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• pp.446-450
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• 2016

Background Perineal defects are commonly encountered during the treatment of conditions such as malignancy, infectious disease, and trauma. Covering large defects in the perineal area is challenging due to its complicated anatomy and the need for functional preservation. Methods Fourteen patients who underwent reconstructive surgery with multiple perforator flaps for defects >$100cm^2$ in the perineal area were included in this retrospective cohort study. Characteristics of the perforator flap operation and postoperative outcomes were reviewed. Results Reconstruction was performed using 2 perforator flaps for 13 patients and 3 perforator flaps for 1 patient. Internal pudendal artery perforator flaps were mainly used for covering the defects. The average defect size was $176.3{\pm}61.8cm^2$ and the average size of each flap was $95.7{\pm}31.9cm^2$. Six patients had minor complications, such as wound dehiscence and partial necrosis of the flap margin, which were corrected with simple revision procedures. Conclusions Multiple perforator flaps can be used to achieve successful reconstructions of large perineal defects that are difficult to reconstruct with other coverage methods.

• Archives of Plastic Surgery
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• v.47 no.4
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• pp.340-346
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• 2020

Background Adipofascial flaps covered with a skin graft address the challenges involved in reconstructing dorsal foot defects. The purpose of this study was to describe a large adipofascial flap based on the perforators of the dorsalis pedis artery for large foot defects. Methods Twelve patients aged 5-18 years with large soft tissue defects of the dorsal foot due to trauma were treated with an extended dorsalis pedis adipofascial flap from May 2016 to December 2018. The flap was elevated from the non-injured half of the dorsum of the foot. Its length was increased by fascial extension from the medial or lateral foot fascia to the plantar fascia to cover the defect. All perforators of the dorsalis pedis artery were preserved to increase flap viability. The dorsalis pedis artery and its branches were kept intact. Results The right foot was affected in 10 patients, and the left foot in two patients. All flaps survived, providing an adequate contour and durable coverage with a thin flap. Follow-up lasted up to 2 years, and patients were satisfied with the results. They were able to wear shoes. Donor-site morbidity was negligible. Two cases each of partial skin graft loss and superficial necrosis at the tip of the donor cutaneous flap occurred and were healed by a dressing. Conclusions The hinged multiperforator-based extended dorsalis pedis adipofascial flap described herein is a suitable method for reconstructing dorsal foot defects, as it provides optimal functional and aesthetic outcomes with minimal donor site morbidity.

• Journal of the Korean institute of surface engineering
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• v.53 no.2
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• pp.80-86
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• 2020

This paper is concerned with type of imperfections present within the anodic oxide films on AA2024 and surface hardness of the anodic film measured after ink-impregnation. The anodic oxide films were formed for 25 min at 40 mA/㎠ and 15±0.5℃ and 300 rpm of magnet stirring rate in 20% sulfuric acid solution. The ink-impregnation allows clear observations of not only the imperfections within the anodic oxide films but also an indentation mark on the oxide film surface made by a pyramidal-diamond penetrator for the hardness measurement. There were observed four different regions in the anodic oxide films on AA2024 and the surface hardness of the anodic oxide films appeared to be crucially dependent on the type of defects, showing 60~100 H_v on the oxide surface region I with large size black defect, 100~140 H_v on the oxide surface region II with large size grey defect, 140~170 H_v on the oxide surface region III with mall size black and/or grey defects and 170~190 H_v on the oxide surface region IV without defects. The pyramidal indentation marks were observed to be distorted in the regions with a large size black and grey defects, while no distortion of the indentation mark was observed in the regions with small size defects and without visible defects.

• Archives of Plastic Surgery
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• v.48 no.3
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• pp.261-268
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• 2021

Background Various methods have been described to close large meningomyelocele defects, but no technique has been proven superior to others. This study presents cases of meningomyelocele defect closure with a keystone-design perforator island flap. Methods A retrospective study was performed on 14 patients with meningomyelocele defects closed using various types of keystone flaps. Results The median age of the patients at surgery was 10.5 days (range, 1-369 days) and the average defect size was 22.5 cm² (range, 7.1-55.0 cm²). The average operative time for defect closure was 89.6 minutes (range, 45-120 minutes). Type IV bilateral keystone flaps were used for four defects, type IV unilateral flaps for six defects, type IIA flaps for two defects, and type III flaps for two defects. Conclusions All the defects healed completely with no major complications. The keystone-design perforator island flap is a reliable, easy, and fast technique to close large meningomyelocele defects.

• Archives of Craniofacial Surgery
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• v.23 no.1
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• pp.17-22
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• 2022

Background: Reconstruction of large facial defects is challenging as both functional and cosmetic results must be considered. Reconstruction with forehead flaps on the face is advantageous; nonetheless, reconstruction of large defects with forehead flaps alone results in extensive scarring on the donor site. In our study, the results of reconstruction using a combination of forehead flaps and other techniques for large facial defects were evaluated. Methods: A total of 63 patients underwent reconstructive surgery using forehead flaps between February 2005 and June 2020 at our institution. Reconstruction of a large defect with forehead flaps alone has limitations; because of this, 22 patients underwent a combination of procedures and were selected as the subjects of this study. This study was retrospectively conducted by reviewing the patients' medical records. Additional procedures included orbicularis oculi musculocutaneous (OOMC) V-Y advancement flap, cheek advancement flap, nasolabial V-Y advancement flap, grafting, and simultaneous application of two different techniques. Flap survival, complications, and recurrence of skin cancer were analyzed. Patient satisfaction was evaluated using questionnaires. Results: Along with reconstructive surgery using forehead flaps, nasolabial V-Y advancement flap was performed in nine patients, local advancement flap in three, OOMC V-Y advancement flap in two, grafting in five, and two different techniques in three patients. No patient developed flap loss; however, cancer recurred in two patients. The overall patient satisfaction was high. Conclusion: Reconstruction with a combination of forehead flaps and other techniques for large facial defects can be considered as both functionally and cosmetically reliable.

• Proceedings of the Korean Institute of Building Construction Conference
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• 2021.11a
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• pp.56-57
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• 2021

Apartments, an intensive residential type, exist and are supplied in large quantities regardless of the size of the city. The value of an apartment is affected not only by the surrounding infrastructure, but also in terms of maintenance. Defects that occur in apartments come in various forms, and mainly poor finishing accounts for 60% of the defects. Among them, tile defects accounted for a large proportion and were found to be caused by several factors. This paper analyzed the influence of each factor considering the coefficient of thermal expansion affecting tile defects according to the domestic seasonal climate.