• Archives of Reconstructive Microsurgery
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• 제18권2호
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• pp.75-78
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• 2009

Purpose: Microsurgery is an essential technique in plastic and reconstructive surgery. However, microsurgical suturing and handling of the instrument are difficult for beginners, and who requires a steep learning curve. Therefore, methods for improving the technical skill are needed. The authors describe the value of a small stereoscopic microscope as a training tool. Materials and Methods: A small stereoscopic microscope was used to help improve the microsurgical skill. Monofilament 10-0 Nylon and a surgical rubber globe were used as a suture material and education material, respectively Result: Stereoscopic view of the operation field was obtained and basic microsurgical suture was possible. Conclusion: The stereoscopic microscope is an effective training tool for beginners of microsurgery with benefits in cost and usefulness in small place.

• 대한미세수술학회:학술대회논문집
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• 대한미세수술학회 1997년도 제17차 학술대회
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• pp.126.2-127
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• 1997

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.63-66
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• 2002

Microvascular anastomosis is too important to reduce the failure in operating room because of no choice in case of failure and prognosis of the failure would be more worse than any other success ones. Factors for microsurgery trainee influencing patency in microvascular anastomosis at the laboratory are numerous but three basic prerequisites are magnification, instruments and suture material and training. First Author trained microsurgical technique to the second author using femoral artery of the rat and patency of the anastomosis was evaluated by the milking test. Period which microsurgeon successes femoral arterial anastomosis in rat in both of 5 and 30 minutes was 7th week at the laboratory which has done 2 vessels a week under the supervise of the skilled first author.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.650-658
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• 2010

Purpose: In the case of repair for far distal parts of FDP (Flexor digitorum profundus) division, the method of either pull-out suture or fixation of tendon to the distal phalanx is preferred. In this paper, the results of a modified loop suture technique used for the complete division of FDP from both zone 1a and distal parts of zone 1b in Moiemen classification are presented. Methods: From July 2006 to July 2009, the modified loop suture technique was used for the 10 cases of FDP in complete division from zone 1a and distal parts of zone 1b, especially where insertion sites were less than 1 cm apart from a tendon of a stump. In a suture technique, a loop is applied to each distal and proximal parts of tendon respectively. Core suture of 2-strand and epitendinous suture are done with PDS 4-0. Out of 10 patients, the study was done on 6 patients who were available for the followup. The average age of the patients was 49.1 years (in the range from 26 to 67). 5 males and 1 female patients were involved in this study. There were 3 cases with zone 1a and distal parts of zone 1b. The average distance to the distal tendon end was 0.6 cm. There were 5 cases underwent microsurgical repair where both artery and nerve divided. One case of only tendon displacement was presented. The dorsal protective splint was kept for 5 weeks on average. The results of the following tests were measured: active & passive range of motion, grip strength test, key pinch and pulp pinch test. Results: The follow-up period on average was 11 months, in the range from 2 to 20 months. There was no case of re-rupture, but tenolysis was performed in 1 cases. In all 6 cases, the average active range of motion of distal interphalangeal joint was 50.8 degree. The grip strength (ipsilateral/contralateral) was measured as 88.7% and the pulp pinch test was 79.2% as those of contralateral side. Flexion contracture was presented in 2 cases (15 degree on average) and there was no quadrigia effect found. Conclusion: Despite short length of tendon from the insertion site in FDS rupture in zone 1a and distal parts of zone 1b, sufficient functional recovery could be expected with the tendon to tendon repair using the modified loop suture technique.

• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.82-92
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• 1993

A comparative study was undertaken to evaluate the contact Neo-dymium : yttrium aluminum garnet(Nd:YAG) laser system for vascular anastomosis of small caliber blood vessels(diameter 0.5-1.2 mm) in the animal model. In this study 40 femoral arteries and 40 femoral veins of Sprague-Dawley rats were anastomosed by contact laser assisted microvascular anastomosis(LAMA) utilizing 3 stay sutures which were placed 120 degrees apart and the intervals welded with contact Nd:YAG laser unit, conventionally sutured anastomosis(CSA) served as controls. The time needed for vascular anastomosis, patency rate(immediate postoperative, postoperative 2nd day, postoperative 1 week, postoperative 4 weeks), gross and microscopic evaluations were compared to conventional microsurgical suture technique. The results are as follows: 1. Postoperative patency rate was 82.5% for femoral artery and 75% for femoral vein by contact LAMA technique compared to 90% and 75% by CSA technique at postoperative 4 weeks. 2. Less time-consumed for arterial anastomosis by 6 minutes 23 seconds and venous anastomosis by 8 minutes 55 seconds with contact LAMA technique compared to CSA technique. 3. Grossly almost complete healing had taken place by postoperative 1 week by contact LAMA technique. 4. Aneurysm formation was 5% for femoral artery and 15% for femoral vein by contact LAMA technique compared to 5% and 10% respectively by CSA technique. 5. Microscopically, re-endothelization was complete by postoperative 7th day by contact LAMA technique. There was less medial hypertrophy and hyperplasia and also less inflammatory response compared to CSA.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.29-33
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• 2022

The application of minimal invasive mastectomy has allowed surgeons to perform nipples-paring mastectomy via a shorter, inconspicuous incision under clear vision and with more precise hemostasis. However, it poses new challenges in microsurgical breast reconstruction, such as vascular anastomosis and flap insetting, which are considerably more difficult to perform through the shorter incision on the lateral breast border. We propose an innovative technique of transcutaneous medial fixation sutures to help in flap insetting and creating and maintaining the medial breast border. The sutures are placed after mastectomy and before flap transfer. Three 4-0 nylon suture loops are placed transcutaneously and into the pocket at the markings of the preferred lower medial border of the reconstructed breast. After microvascular anastomosis and temporary shaping of the flap on top of the mastectomy skin, the three corresponding points for the sutures are identified. The three nylon loops are then sutured to the dermis of the corresponding medial point of the flap. The flap is placed into the pocket by a simultaneous gentle pull on the three sutures and a combined lateral push. The stitches are then tied and buried after completion of flap inset.