• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.93-98
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• 2001

Purpose : This describes our experience with a tenocutaneous free flap from the dorsum of the foot or radial forearm to reconstruct the dorsal skin and extensor tendons of the hand. Material and Methods : Between february 1987 and July 1998, we treated 9 patients with composite tissue loss on the dorsal hand caused by crushing injury. Nine men had an average age of 26.4 years(range, $19{\sim}47$). We treated 5 patients with the free dorsalis pedis flap including the extensor tendons and the superficial peroneal nerve and 4 patients with reverse forearm flap including the brachioradialis tendon and/or superficial radial nerve. Flap size was average 4.4(3,2cm. Evaluation of the results was based on the survived flap rate, the recovery rates for range of motion of the metacarpophalageal joints in the operated fingers. two-point discrimination. Results : All flaps were well vascularized and survived completely. Recovery rates for range of motion of the metacarpophalageal joints in operated fingers range from $78%{\sim}99%$(average, 90%). Two-point discrimination of the transferred flaps in 5 patients average $20{\pm}3.5mm$. Conclusion : The advantages of this procedure are mass action reconstruction with tendon, one-stage operation, faster healing with less adhesion formation, and early mobilization.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.345-348
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• 2008

Purpose: Fracture of the frontal sinus accounts for 5-15% of all facial fractures. Only anterior table fracture occupies one third of the frontal sinus fracture. Conventional coronal approach is the standard treatment, but this method is very aggressive, especially in patient with simple, depressed, anterior frontal sinus wall fracture. We introduce new, simple technique for these patients, using small incision and Dual-top screws. Methods: A 27-year-old male patient was introduced to our department under the impression of fracture of frontal sinus, involving only anterior table. Under general anesthesia, 1.5 cm-sized, small incision was made on the suprabrow area. We reduced fractured fragment with two dual-top screws and 25G wires. Fixation was not necessary Results: The operation took about forty minutes, and the patient discharged 2 days after the operation. Postoperative 2 months follow up CT shows maintenance of reduction site. Gross depression of the forehead and visible scar was not observed. Conclusion: Although the indication of this procedure is limited, less aggressive, simple and very effective to the patient with simple. depressed, anterior frontal sinus fracture.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.639-643
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• 2010

Purpose: Cryptotia is a congenital deformity in which the upper third of the auricle is buried under the temporal skin. It is rare in Caucasians, yet it is more common in Asians. Although a variety of methods to treat cryptotia have been introduced, there is still no acceptable single procedure that can successfully manage this deformity in its entity. We present a triangular V-Y advancement flap and rhomboid flap for correcting cryptotia that can overcome the diverse shortcomings of the conventional methods. Methods: This operative method was used to correct 18 auricles in patients ranging in age from 4 to 33 years. A triangular flap was prepared over the auricle by making a skin incision according to Ohmori's method. Then a rhomboid flap with a side length of about 8 to 10 mm that sets the lower portion as a pedicle in the anterior region was prepared to supplement the contracted portion of the helix. The cartilage deformity was corrected by the banner flap or the radiating cartilage incisions with cartilage graft or high density polyethylene graft. Results: We have treated 16 patients with severe cryptotia using this method and have obtained good aesthetic results. All cases showed widened scaphoid fossa and smooth triangular fossa of antihelix. There were no major postoperative complications, such as necrosis or infection of the flaps. Conclusion: Correction of cryptotia using the triangular V-Y advancement flap and rhomboid flap is useful a method for certain conditions, when a severe contraction of the helix is present.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.65-69
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• 2006

Purpose: We performed vastus lateralis (VL) muslce or myocutaneous flap for close of the trochanteric skin defect usually happened in paraplegia and report our 6 cases. Materials and Methods: Between March 2004 and August 2005 we performed 4 cases of VL muscule flap with skin graft and 2 cases of VL myocutaneous flap for close of the trochanteric skin defect in 6 paraplegia patients. There were 5 men and 1 woman and mean age was 52.2 years and mean diameters of skin defect was $8.3{\times}8.3\;cm$. The mean follow up period was 18 months. The survival of flap, complications, healing time and patient's satisfaction were evaluated. Results: All flaps were survived except 1 case of margin necrosis. In 2 cases, blood-serous discharges were continued after operation which might be due to dead space and treated with $2{\sim}3$ times debridement and delayed close. Mean time to heal the skin defect was 7.6 weeks. No infection and recurrence in follow up periods. Cosmetic results judged by patients are that 3 cases are good and 3 cases are fair. Conclusion: VL muscle and myocutaneous flap is good treatment method among the numerous methods in treatment-failed cases of trochanteric skin defects of paraplegia patients. This surgical procedure is simple, constant blood supply, good pliability, cosmetic results and also appliable to other skin defect of pelvis girdle like sacrum and ischium.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.306-310
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• 2009

Purpose: Owing to improvement of microscope, microsurgery implements, and microsuture, finger replantation has shown much development. With high success rate of microsurgery in children, positive results have been reported ever from distal amputation. Here, we report the patients demographics, methods, and results of the microsurgery performed in children in our hospital for the last 8 years. Methods: From the medical records of 21 patients who had given the treatment in our hospital from January 2000 to December 2007, we analyzed patients' sex, age, operative method, and complication retrospectively. Results: The number of male patients was twice as many as female, where most patients belong to the ages of five to ten years. Operative methods performed in this study included end - to - end anastomosis of artery and vein, vein graft, and epineurial suture. As a result, 19 out of 21 cases were successfully accomplished, and four of them went through the debridement of necrotic tissue due to the partial necrosis of the lesion. A one - year follow - up observation was done after surgery and most of them were almost fully recovered like in their previous state. Conclusion: The success rate of finger replantaion in children is continuously improving despite the difficulty of vessel anastomotic procedure, rehabilitation treatment and management after surgery. We report the satisfactory results of pediatric finger replantation technically and aesthetically.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.569-573
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• 2008

Purpose: Surgical excision of the subcutaneous tissues, with or without skin excision in the axillary hair-bearing area, has been the treatment of choice in treating osmidrosis for several decades. However, long periods of postoperative immobilization of a shoulder joint, partial necrosis of skin flaps or the possibility of hematoma and scars have occurred frequently. So we used $XPS^{(R)}$ microresector(Shaver) in procedure which requires removal of soft tissue for comparing results between surgical excision and the laters. Methods: From January 2007 to February 2008, a total of 20 patients(8 male and 12 female) underwent $XPS^{(R)}$ microresector(Shaver) assisted aspiration for treating osmidrosis. The mean age of the subjects was 21.9, and we tried to analyze some advantages of $XPS^{(R)}$ microresector(Shaver). Results: The average operation time was 61.6 minutes. This results can show that the patients who received $XPS^{(R)}$ microresector(Shaver) assisted aspiration can accomplish better outcomes than any other procedures in terms of operation time at least. Moreover, no significant postoperative complications occurred in our studies. Subjects have been followed up from 2 months to 1 year and among these patients, no one suffered from critical complications. Conclusion: In brief, $XPS^{(R)}$ microresector(Shaver) is able to shorten the time of operation and simplify the procedures relatively and this device has more superiorities in wound healing by maintaining of vascularized dermal skin flaps. It means that $XPS^{(R)}$ microresector (Shaver) can prevent flap necrosis, axillary hair loss and minimalize scarring and bleeding. Thus, we expect that these advantages can lead to better patient's comfort and self-confidence than several previous procedures.

• Archives of Plastic Surgery
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• 제43권2호
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• pp.181-188
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• 2016

Background Major problems with cervicoplasty by direct skin excision include the subjective nature of skin markings preoperatively and the confusing array of procedures offered. This technique incorporates curved incisions, resulting in a wave-like scar, which is why the procedure is called a "wave-plasty". Methods This prospective study includes 37 patients who underwent wave-plasty procedures from 2004 to 2015. Skin pinching technique was used to mark the anterior neck preoperatively in a reproducible fashion. Intra-operatively, redundant skin was excised, along with excess fat when necessary, and closed to form a wave-shaped scar. Patients were asked to follow up at 1 week, 6 weeks, and 6 months after surgery. Results The mean operation time was 70.8 minutes. The majority (81.3%) was satisfied with their progress. On a scale of 1 to 10 (1 being the worst, and 10 being the best), the scars were objectively graded on average 5.5 when viewed from the front and 7.3 when seen from the side 6 months after surgery. Complications consisted of one partial wound dehiscence (2.3%), one incidence of hypertrophic scarring (2.3%), and two cases of under-resection requiring revision (5.4%). Conclusions In select patients, surgical rejuvenation of the neck may be obtained through wave-like incisions to remove redundant cervical skin when other options are not available. The technique is reproducible, easily teachable and carries low morbidity and high patient satisfaction in carefully chosen patients.

• Journal of Chest Surgery
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• 제30권3호
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• pp.348-348
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• 1997

48세 남자 환자의 전종격동을 깊게 침범하며 흉골에서 발생한 거대한 연골육종을 치료하였다. 환자는 흉골의 연골육종과 주변의 정상변연 4cm을 포함하여 광범 위 절제술을 받았으며 그 종양 자체 는 양측의 쇄골과제 1,2,3늑연골을 포함하는 15× 16X10cm크기였다. 종양의 광범위 절제술후 남은 결손 부위는 매우 컸으며 흉벽 재건술을 Marled mesh와 methylmethacrylate와 wire steels로 겹싸는 sandwich식의 방법으로 시행하였고 연부조직의 재건술 또한 대흉근을 이용한 근피 판 치환술을 시행하 였다. 그러나 환자는 수술후 결핵성 종격동염이 발생되었고 다량의 농이 배출되었다. 재수술은 흉벽 재건술시의 사용되었던 이물질 모두를 제거하고 괴사성 조직의 소파술과 배농술을 시행하였다. 환자는 1 년간 항결핵제요법을 시행하였으며 완치되었기에 문헌고찰과 보고하는 바이다.

• Journal of Chest Surgery
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• 제30권3호
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• pp.248-252
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• 1997

48세 남자 환자의 전종격동을 깊게 침범하며 흉골에서 발생한 거대한 연골육종을 치료하였다. 환자는 흉골의 연골육종과 주변의 정상변연 4cm을 포함하여 광범 위 절제술을 받았으며 그 종양 자체 는 양측의 쇄골과제 1,2,3늑연골을 포함하는 15$\times$ 16X10cm크기였다. 종양의 광범위 절제술후 남은 결손 부위는 매우 컸으며 흉벽 재건술을 Marled mesh와 methylmethacrylate와 wire steels로 겹싸는 sandwich식의 방법으로 시행하였고 연부조직의 재건술 또한 대흉근을 이용한 근피 판 치환술을 시행하 였다. 그러나 환자는 수술후 결핵성 종격동염이 발생되었고 다량의 농이 배출되었다. 재수술은 흉벽 재건술시의 사용되었던 이물질 모두를 제거하고 괴사성 조직의 소파술과 배농술을 시행하였다. 환자는 1 년간 항결핵제요법을 시행하였으며 완치되었기에 문헌고찰과 보고하는 바이다.

• Archives of Plastic Surgery
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• 제47권6호
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• pp.542-550
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• 2020

Background This study aimed to identify the initial diagnostic characteristics and treatment status of children with submucous cleft palate (SMCP) and to examine the relationship between the timing of surgical correction and the degree of articulation and resonance improvement. Methods This retrospective study included 72 children diagnosed with SMCP between 2008 and 2016. The evaluation criteria were the age of the initial visit, total number of visits, age at the end of treatment, speech problems, resonance problems, and speech therapy. Results Children with SMCP first visited the hospital at an average age of 34.32 months, and speech problems were identified at an average age of 48.53 months. Out of 72 children, 46 underwent surgery at an average age of 49.74 months. Four of these children required secondary surgery at an average age of 83.5 months. Among the children who underwent surgery before 3 years of age, 70% exhibited articulation improvements, with mild-to-moderate hypernasality. Articulation improvements showed no statistically significant differences according to age at the time of surgery. However, children who underwent surgery before 4 years had a better hypernasality rating than those who underwent surgery after 4 years of age. Conclusions Children with SMCP tend to undergo delayed treatment because the anatomical symptoms in some children with SMCP are unclear, and surgical interventions are considered only after speech problems are clarified. Starting interventions as early as possible reduces the likelihood of receiving secondary surgery and speech therapy, while increasing expectations for positive speech function at the end.