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Clinical Experience of Cleft Lip and/or Palate Repair in Complex Congenital Heart Disease (선천성 복잡심장병 환아의 구순 구개열의 치험례)

  • Koh, Kyung Suk;Lee, Sang Hyuk;Eom, Jin Sup
    • Archives of Plastic Surgery
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    • v.32 no.3
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    • pp.385-388
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    • 2005
  • In cleft lip and/or palate patients with the complex congenital heart diseases, surgical repair of the cleft lip and/or palate has been postponed after the open heart surgery because the heart problem of the patient might cause more complications associated with anesthesia and surgery. There has been little report about experiences in the surgical management of these patients and optimal time of surgical intervention. Authors are introducing the experiences of performing corrective surgery of cleft lip and/or palate in the patients with congenital heart diseases before and after the open heart surgery. We managed five patients from May 1992 to March 2004. Two patients were male and the rest were female. One of them had cleft lip alone and others had cleft lip and palate. Two of them underwent delayed cleft lip and/or palate surgery after open heart surgery, and the rest had immediate intervention for cleft lip and/or palate. There was no complication during the operation and postoperative period. There would be no need to delay the corrective surgery of the cleft lip and/or palate after the open heart surgery, if solid medical team approach was available with the pediatric cardiologist and the anesthesiologist.

Free Flap Transplantation in Open Tibial Fracture with Vessel Injury in the Elderly

  • Yu, Chang Eun;Yoo, Myung-Jae;Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.23 no.1
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    • pp.18-20
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    • 2014
  • Two aged patients who had open tibial fractures with arterial injury caused by high energy accidents underwent emergency arterial reconstruction using a greater saphenous vein and soft tissue repair using free flaps. In the patients, soft tissue necrosis developed and tibias were exposed at postoperative third week. Follow-up angiography through the superficial femoral artery showed occlusion of the anterior tibial artery. The anterior tibial artery was reconstructed using the contralateral greater saphenous vein graft and the latissimus dorsi myocutaneous and rectus abdominis muscle free flaps were transplanted for repair of necrotic soft tissue. The reconstructed arteries showed good perfusion to the new free flaps until union of the tibias occurred. The patients were followed-up for 21 years and 17 years postoperatively, respectively. In management of open comminuted fracture of the tibia, injury of the arterial system must be ruled out by angiography in addition to evaluation of the degree of soft tissue injury.

Successful treatment of a bowel fistula in the open abdomen by perforator flaps and an aponeurosis plug

  • Sashida, Yasunori;Kayo, Munefumi;Hachiman, Hironobu;Hori, Kazuki;Kanda, Yukihiro;Nagoya, Akihiro
    • Archives of Plastic Surgery
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    • v.45 no.4
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    • pp.375-378
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    • 2018
  • In this report, we present a case of successful treatment of a bowel fistula in the open abdomen by perforator flaps and an aponeurosis plug. A 70-year-old man underwent total gastrectomy and developed anastomotic leakage and dehiscence of the abdominal wound a week later. He was dependent upon extracorporeal membrane oxygenation, continuous hemodiafiltration, and a respirator. Bowel fluids contaminated the open abdomen. Two months after the gastric operation, a plastic surgery team, in consultation with general surgeons, performed perforator flaps on both sides and constructed, as it were, a bridge of skin sealing the orifice of the fistula. The aponeurosis of the external oblique muscle was elevated with the flap to be used as a plug. The perforators of the flaps were identified on preoperative and intraoperative ultrasonography. This modality allowed us to locate the perforators precisely and to evaluate the perforators by assessing their diameters and performing a waveform analysis. The contamination decreased dramatically afterwards. The bare areas were gradually covered by skin grafts. The fistula was closed completely 18 days after the perforator flap. An ultrasound-guided perforator flap with an aponeurosis plug can be an option for patients suffering from an open abdomen with a bowel fistula.

Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

  • Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.301-308
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    • 2012
  • In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.

Outcomes of Closed versus Open Rhinoplasty: A Systematic Review

  • Gupta, Rohun;John, Jithin;Ranganathan, Noopur;Stepanian, Rima;Gupta, Monik;Hart, Justin;Nossoni, Farideddin;Shaheen, Kenneth;Folbe, Adam;Chaiyasate, Kongkrit
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.569-579
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    • 2022
  • Open and closed rhinoplasty are two main approaches to perform nasal modifications. According to current literature, there is no current consensus among plastic surgeons and otolaryngologists on which technique is preferred in terms of aesthetic result, complications, and patient satisfaction. This study uses published research to determine whether open or closed rhinoplasty leads to superior patient outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed and a literature search was conducted in four databases based on our search strategy. Articles were then imported into COVIDENCE where they underwent primary screening and full-text review. Twenty articles were selected in this study after 243 articles were screened. There were 4 case series, 12 retrospective cohort studies, 1 prospective cohort study, 1 case-control, and 2 outcomes research. There were three cosmetic studies, eight functional studies, and nine studies that included both cosmetic and functional components. Sixteen studies utilized both open and closed rhinoplasty and four utilized open rhinoplasty. Both techniques demonstrated high patient and provider satisfaction and no advantage was found between techniques. Based on available studies, we cannot conclude if there is a preference between open or closed rhinoplasty in terms of which technique leads to better patient outcomes. Several studies determined that open rhinoplasty and closed rhinoplasty leads to comparative patient satisfaction. To make outcome reporting more reliable and uniform among studies, authors should look to utilize the Nasal Obstruction and Septoplasty Effectiveness scale and the Rhinoplasty Outcome Evaluation.

Digital Image Archiving Methodology on the Port of Busan: A Case Study Using an Open-Source Archiving Software (오픈소스를 이용한 부산항 사진 아카이브의 구축 방안)

  • Song, Jung-Sook;Heo, JeongSook;Lee, YeaLin
    • Journal of Korean Society of Archives and Records Management
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    • v.14 no.3
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    • pp.127-151
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    • 2014
  • This study aims to share a methodology for locality reproduction by concretely explaining the theoretical model, procedure, and practice of constructing the Port of Busan Image Digital Archive, based on the photographic and postcard images of the Port of Busan, the representative place of Busan. Among the open-source record management programs, Omeka was chosen in implementing the digital archive because of its suitability for image exhibition. After establishing the principles for archive implementation in accordance with the purpose of the archive, a basic investigation was conducted for the record collection. With the consent of the individuals and institutions that possess the related records on the Port of Busan, such as the National Archives of Korea, the Busan Museum, and the City of Busan, original image artifacts were thus collected. The collected artifacts were then described using the Dublin Core metadata and categorized by time period. The Port of Busan was classified through four distinctive spatial characteristics (transportation, historic, industrial, and living spaces). A total of 11 themes for the exhibition was then suggested. The Busan-Shimonoseki Ferry Boat was chosen as an example exhibition of transportation space.

Effect of Panax ginseng Extract on Passive Avoidance Retention in Old Rats

  • Jaenicke, Bernhard;Kim, Eun-Joo;Ahn, Jong-Woong;Lee, Hye-Sook
    • Archives of Pharmacal Research
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    • v.14 no.1
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    • pp.25-29
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    • 1991
  • Female rats of two groups (6 and 27 months) were tested in the passive avoidance test to investigate the age-dependency of the learning ability. The results showed a significantly better avoidance behavior in the young adult animals compared to the older ones. The influence of a 13-day treatment with Panax ginseng (30 mg/kg/d, oral) on 27 month old rats caused a considerably prolonging of the latency time in comparison to the untreated control group of the same age. In the open field the treated rats exhibited neither an altered locomotion nor exploration nor a changed emotional reactivity which could explain the improved avoidance reaction.

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Does Aging Matter? The Efficacy of Carpal Tunnel Release in the Elderly

  • Fung, Bettina Wai Yan;Tang, Chris Yuk Kwan;Fung, Boris Kwok Keung
    • Archives of Plastic Surgery
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    • v.42 no.3
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    • pp.278-281
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    • 2015
  • Open release remains the gold standard in the treatment of carpal tunnel syndrome in cases where conservative treatment fails. However, the efficacy of carpal tunnel release in the elderly has been debated in the literature throughout the years. This review aims to review the current evidence pertaining to the efficacy of carpal tunnel release in the elderly. Based on the current evidence, the outcome of carpal tunnel release is unpredictable in the elderly. Elderly patients are also less satisfied with the operation compared to younger patients. The authors recommend that these messages be conveyed to elderly patients before surgery. Moreover, open carpal tunnel release should be offered in the early stages of treatment whenever operative management is indicated.

Open reduction and internal fixation of metacarpal fractures using a thermoplastic splint as a surgical instrument

  • Papavasiliou, Theodora;Park, Paul Dain;Tejero, Ricardo;Allain, Niklaas;Uppal, Lauren
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.384-388
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    • 2021
  • Adequate positioning of the hand is a critical step in hand fracture operative repair that can impact both the clinical outcome and the efficiency of the operation. In this paper, we introduce the use of a thermoplastic splint with an added thumb stabilizing component as a means to increase the surgeon's autonomy and to streamline the patient care pathway. The thermoplastic splint is custom fabricated preoperatively by the specialist hand therapist. The splint is used prior, during, and post operation with minimal modification. The thumb component assists maintaining the forearm in a stable pronated position whilst drilling and affixing metal work. This is demonstrated in the video of removal of metal work and open reduction and internal fixation of a metacarpal fracture.