• Title/Summary/Keyword: Partial-drainage

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Soft Tissue Reconstruction Using Perforator Flap in Patients with Infected Knee Prosthesis

  • Lee, Jin Won;Kim, Sung Hoon;Yoo, Jun Ho;Roh, Si Gyun;Lee, Nae Ho;Yang, Kyoung Moo
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.70-75
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    • 2014
  • Purpose: Soft-tissue reconstruction in the knee area requires thin, pliable, and tough skin. The range of motion of the knee also acts as a limitation in using only local flaps for coverage. The author has successfully used various perforator flaps for soft tissue reconstruction around the knee while preserving its functional and cosmetic characteristics. Materials and Methods: Out of the twenty patients assessed from April 2009 to March 2011, seven received anterolateral thigh perforator flaps, four received medial sural perforator island flaps, four received lateral supragenicular perforaor perforator flaps, and five received medial genicular artery flaps. The age of the patients ranged from 44 to 79 and the size of the defects ranged from $4{\times}5cm$ to $17{\times}11cm$. Fifteen of the twenty patients had histories of total knee replacement (TKR) surgery. Results: There were no flap losses in any of the twenty patients assessed. Two patients showed partial losses in the distal area of the flap, but were treated through careful wound care. One patient presented with pedicle adhesion at the drainage site from a past TKR, but it did not hinder the flap survival. Primary closure at the donor site was possible in nine patients, while split skin graft was necessary for the other 13. Conclusion: In soft tissue reconstruction of the knee, various perforator flaps can be used depending on the condition of the preoperation scar, wound site, and size. It also proved to provide better functional and cosmetic results than in primary wound closure or skin grafts.

Formulation of Fully Coupled THM Behavior in Unsaturated Soil (불포화지반에 대한 열-수리-역학 거동의 수식화)

  • Shin, Ho-Sung
    • Journal of the Korean Geotechnical Society
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    • v.27 no.3
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    • pp.75-83
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    • 2011
  • Emerging issues related with fully coupled Thermo-Hydro-Mechanical (THM) behavior of unsaturated soil demand the development of a numerical tool in diverse geo-mechanical and geo-environmental areas. This paper presents general governing equations for coupled THM processes in unsaturated porous media. Coupled partial differential equations are derived from three mass balances equations (solid, water, and air), energy balance equation, and force equilibrium equation. With Galerkin formulation and time integration of these governing equations, finite element code is developed to find nonlinear solution of four main variables (displacement-u, gas pressure-$P_g$), liquid pressure-$P_1$), and temperature-T) using Newton's iterative scheme. Three cases of numerical simulations are conducted and discussed: one-dimensional drainage experiments (u-$P_g-P_1$), thermal consolidation (u-$P_1$-T), and effect of pile on surrounding soil due to surface temperature variation (u-$P_1$-T).

Reconstruction of the Soft Tissue Defect of the Finger Using Digital Island Flap with Supercharged Vein (손가락섬피판으로 손가락 연조직 재건시 과급정맥문합)

  • Choi, Hwan Jun;Kim, Nam Joong;Choi, Chang Yong
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.153-160
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    • 2009
  • Purpose: The heterodigital or homodigital artery island flap is a popular method of reconstruction for finger defects. Sometimes, digital artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. However, we could decrease these disadvantages by means of venous superdrainage. The aim of this study is to report usefulness and postoperative results of venous supercharging digital artery island flaps for finger reconstruction. Methods: From March of 2005 to March of 2008, a total of eight patients with soft tissue defects of the finger underwent venous supercharging digital island flap transfer. Briefly, the flap is harvested along with dorsal vein that is then anastomosed to a recipient vein in an end - to - end fashion, after flap transfer and insetting. Using this technique, eight patients were operated on, ranging in age 23 to 52 years. Results: All the flaps survived with a success rate of 100 percent, thus fully satisfying the reconstructive requirements. No postoperative flap congestion was recognized, obviating the need to take any measures for venous engorgement, such as suture removal. Among 8 cases, it was possible to make an long - term and follow - up observation more than 6 months. In these cases, the fact that light touches and temperature sensations can be detected in all the flaps. Cold intolerance and hyperesthesia were not seen in our series. Conclusion: Providing good harmony with conventional methods and microsurgery, inclusion of a vein with the heterodigital and homodigital artery island flap allows a more reliable and safer reconstructive choice for finger defects. The venous supercharged island flap is a reliable flap with a consistent arterial structure, and with its augmented venous drainage, it is more reliable, providing single - stage reconstruction of adjacent finger defects, including the fingertip.

Clinical Experience of Finger Tip Amputation of Small Finger in 12-Months-Old: Use of the Technique of Artery-Only Anastomosis (단일동맥연결을 통한 유아 새끼 손가락끝 재접합 경험)

  • Kim, Sun-Joo;Choi, Hwan-Jun;Lee, Young-Man;Kim, Yong-Bae
    • Archives of Reconstructive Microsurgery
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    • v.18 no.1
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    • pp.27-30
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    • 2009
  • Purpose: Recently, replantation of fingertip amputation, Zone I by Yamano classification, is still difficult because digital arteries branch into small arteries and also digital veins are hard to separate from the immobile soft tissue. However the replantation of fingertip in adults is a well-established procedure, but the replantation in infant or child is still uncommon. Therefore we present one case of replantation of the fingertip of the small finger in 12-months-old patient. Methods: We experienced a 12-months-old male amputation of small finger. It had been amputated completely at the level of Zone I by Yamano classification. Replantation was performed using the arteryonly technique with neither vein nor nerve repair. Because the artery has been damaged, it is still possible to make a direct suture by transposing the arterial arch in an inverted Y to I arterial configuration. Venous drainage was provided by an external bleeding method with partial nail excision and repaired margin for approximately 7 days. Results: We were performed replantation in infant with only-arterial anastomosis successfully, result in good recovery of aesthetic and functional outcome. Conclusion: In conclusion, although fingertip injury was difficult to replantation in infant and child, we must try it. Because of its functional and cosmetic advantage.

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Case Report of Avulsion Amputation of Multiple Digits: Use of Rerouting the Transverse Digital Palmar Arch (가로손가락손바닥활을 이용한 다발성 벗겨짐 손상 손가락 재접합술 - 증례보고 -)

  • Kim, Jae-In;Choi, Hwan-Jun;Kim, Jun-Hyuk;Tark, Min-Seong;Kim, Yong-Bae
    • Archives of Reconstructive Microsurgery
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    • v.18 no.2
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    • pp.79-83
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    • 2009
  • Purpose: Avulsion injuries of digits have been presented for a long time as complex management problems. Despite of microsurgical advances, it is difficult to achieve good functional results and their management remains somewhat controversial. However, in a finger there are three transverse digital palmar arches. The middle and distal transverse digital palmar arches are consistently large(almost 1 mm) and may be used for arterial vessel repairs either proximally or distally, depending on the length and direction needed. 39-year-old man presented with avulsion amputation of the ulnar three digits, was operated using only arterial anastomosis with rerouting the transverse digital palmar arches. Methods: Replantation was performed using the artery-only technique. Because the digital arteries had been damaged, we did that the transverse digital palmar arches were transposed in an inverted Y to I configuration and were lengthened with rerouting them for the purpose of direct anastomosis of the digital artery. Venous drainage was provided by an external bleeding method with partial nail excision and external heparin irrigation. Results: The authors conclude that complete avulsion amputations with only soft tissue at the distal to insertion of the flexor digitorum superficialis tendon were salvageable with acceptable functional results. All three fingers survived. Conclusion: With technical advancements, the transverse digital palmar arches play an important role for finger amputation. Three digital palmar arches give us additional treatment option for the finger amputation. In this case, replantation with only-arterial anastomosis was successful and we obtained good aesthetic and functional outcome.

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Determination of Horizontal Coefficient of Consolidation from the Self-boring Pressuremeter Holding Test by Considering Pore Pressure Dissipation Trend (간극수압 소산경향을 고려한 자가굴착식 프레셔메터로부터의 수평압밀계수 결정법)

  • 김영상
    • Journal of the Korean Geotechnical Society
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    • v.20 no.3
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    • pp.151-159
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    • 2004
  • This paper describes a systematic way of identifying the horizontal coefficient of consolidation of clayey soil by applying an optimization technique to the early part of dissipation data measured from the self-boring pressuremeter strain holding test. An analytical solution developed by Randolph & Wroth (1979) was implemented in normalized form to express the build-up of excess pore pressures as a function of the rigidity index and subsequent dissipation of excess pore pressures around a pressuremeter Horizontal coefficient of consolidation was determined by minimizing the differences between theoretical and measured excess pore pressure curves over 50% degree of dissipation range using optimization technique. The effectiveness of the proposed back-analysis method was examined against the real fled performances obtained from pressuremeter strain holding tests at Gimje and Yangsan site. It is shown that the proposed back-analysis method can evaluates the rational horizontal coefficient of consolidation, which is similar to those obtained from the piezocone dissipation test. Furthermore, proposed method can evaluate appropriate coefficient of consolidation for soil under partially drained condition.

Levoatriocardinal Vein Combined with Pulmonary Venous Varix Mimicking Arteriovenous Malformations: A Case Report (동정맥기형으로 오인되었던 폐정맥정맥류를 동반한 Levoatriocardinal 정맥: 증례 보고)

  • Joo Hee Jeun;Eun-Ju Kang;Jeong-Hyun Jo;Ki-Nam Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.440-446
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    • 2021
  • The levoatriocardinal vein is an uncommon pulmonary venous abnormality that connects the left atrium or pulmonary vein with the systemic vein. It is distinct from partial anomalous pulmonary venous return in that the former forms a connection with the left atrium through the normal pulmonary vein whereas the latter involves pulmonary venous drainage to the systemic vein. Herein, we describe a case of the levoatriocardinal vein initially misdiagnosed as a pulmonary arteriovenous malformation using chest radiography and chest CT. The levoatriocardinal vein combined with pulmonary venous varix was confirmed using pulmonary angiography. To the best of our knowledge, this unusual coexistence of the levoatriocardinal vein and pulmonary venous varix has not been reported in English literature.

Nonvital Pulp Therapy of Elongation of Roots of Mandibular Cheek Teeth in Pet Rabbits (애완토끼에서 과잉성장된 하악치아의치신경치료 연구)

  • Park, Cheon-Sik;Cha, Se-Yeoun;Kang, Min;Kim, Jury;Jeong, Soon-Wuk;Jang, Hyung-Kwan
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.474-482
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    • 2012
  • Elongation of cheek teeth roots in pet rabbits is very common, and is associated with malocclusion followed by reduced appetite, salivation, periapical abscess, and epiphora. Conservative methods including medication, drainage, irrigation, tooth trimming, intraoral and extraoral extraction, surgical treatment of periapical abscessation, and diet control have been adapted as the only treatments to resolve elongation of teeth roots. However, remaining challenges include the long-term period of cure and recurrence. This study was performed to investigate the possibility of nonvital pulp therapy on elongation of the mandibular cheek teeth roots in pet rabbits. Thirty-one pet rabbits with dental problems due to root elongation were submitted. Ten pet rabbits among them were treated by nonvital pulp therapy procedures (group A), while the others were treated by conservative methods (group B). Appetite improved within 1-5 days after nonvital pulp therapy and the treatment was discontinued 1 month postoperatively in group A. Abscess occurred in another site not treated with nonvital pulp therapy in only two rabbits. Growth of the mandibular cheek teeth treated with nonvital pulp therapy stopped, resulting in malocclusion, intraoral inflammation from the enamel spur, and abscess of the teeth roots. In the group B rabbits treated with conservative therapy, partial drainage, long term medication, recurrent oral trimming and control of repeated oral inflammation occurred. Consequently, buccotomy or tooth extraction was performed in group B. Owners were satisfied with nonvital pulp therapy preventing dental root abscess and repeated troubles including inflammation and malocclusion and reduction of the treatment period. These results suggest that nonvital pulp therapy can be performed on pet rabbits with elongation of mandibular cheek teeth roots.

A Study on the Horizontal Drainage Method Using Plastic Drain Board (플라스틱 배수재를 이용한 수평배수공법에 관한 연구)

  • 황정규;김홍택;김석열;강인규;김승욱
    • Geotechnical Engineering
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    • v.14 no.6
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    • pp.93-112
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    • 1998
  • In the present study, 2-D consolidation theory of the dredged clay by means of the horizontal drain method is proposed. The horizontal drain method to install the drains such as plastic drain board within the dredged clay is a soil improvement method to accelerate the consolidation by expelling pore water in the vertical direction along the horizontal drains. Based on the finite strain consolidation theory by Gibson et al., the partial differential equation of 2-D consolidation due to the horizontal drain is derived. The consolidation due to the horizontal drain can be illustrated from combined self-weight consolidation effect and consolidation effect by horizontal drains. For the prediction of consolidation settlement and degree of consolidation numerical analysis is suggested on the basis of Dufort-Frankel finite differential algorithm. Also, the analytical procedures proposed in this study are verified by the model tests, and the predictions of the consolidation settlement and degree of consolidation are compared with the results obtained from the tests for the dredged clay gathering at Siwha site in Ansan, Korea. For the predictions, the relationship void ratio vs effective stress and the relationship permeability vs void ratio of the dredged clay are obtained from the odometer tests. Additionally, the parametric study for consolidation settlement by variations of design parameters related with horizontal drain method is carried out. Based on the results of the parametric study, design .charts for the preliminary design are also proposed.

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Reconstruction of the Finger using Rerouting the Transverse Digital Palmar Arch in the Crushing or Avulsion Injured Finger (짓니긴 및 벗겨진 손상에서 가로손가락손바닥활을 이용한 손가락 재건)

  • Choi, Hwan-Jun;Lee, In-Soo;Choi, Chang-Yong;Kim, Mi-Sun;Kim, Jun-Hyuk
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.59-66
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    • 2010
  • Purpose: In the finger, there are three major palmar arches in the arterial system. The location of this arches are constant. The middle and distal transverse arches are consistently large (almost 1 mm) and may be used for arterial vessel repairs either proximally or distally, depending on the length and direction needed. This paper describes our experiences in reconstruction and replantation of the finger using rerouting the transverse digital palmar arch. Methods: 31 patients with injuries according to our classification were treated from March of 2005 to October of 2008. In this study the authors subdivided injuries into those with amputation distal to the insertion of the flexor digitorum profundus (Class I, 31 fingers); those with amputation distal to the insertion of the flexor digitorum superficialis (Class II, 4 fingers). Replantation was performed using the artery-only technique with neither vein nor nerve repair. Because the artery has been damaged, it is still possible to make a direct suture by transposing the arterial arch in an inverted Y to I arterial configuration or converting the arch. Venous drainage was provided by an external bleeding method with partial nail excision, medical leech, and repaired margin. Results: The success rate was 87% (n=27) in class I and 75% (n=4) in class II. The authors conclude that crushing and complete avulsion injuries & amputations are salvageable, with acceptable functional results in select patients, especially those with amputation distal to the insertion of the flexor digitorum superficialis. Conclusion: We performed replantation and reconstruction with only-arterial transposing anastomosis successfully, resulting in good recovery of aesthetic and functional outcome. Three major digital palmar arches, especially distal two branches, give us additional treatment options. In the finger replantation and reconstructive techniques using rerouting healthy the transverse digital palmar arch increase the survival rate of the finger.