• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.27-31
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• 2021

A hemiarthroplasty with biologic resurfacing of the glenoid is one procedure that can be performed in young patients where total shoulder arthroplasty may be difficult. The authors introduced two cases in which this procedure was performed. This approach is one treatment option for young glenoid humeral arthritis patients that addresses some of the shortcomings of an isolated hemiarthroplasty.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.153-160
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• 2010

Purpose: The prevalence of skin cancers and cutaneous premalignant lesions are increasing recently. It is necessary to treat cutaneous premalignant lesions, because these can progress to invasive skin cancers. We conducted a retrospective study to evaluate the usefulness of $CO_2$ laser resurfacing in skin tumor surgery. Methods: From 2005 to 2008, 14 patients with skin cancers, photodamaged skin and cutaneous premalignant lesions were treated with skin cancer excision, immediate reconstruction, and $CO_2$ facial laser resurfacing. Mean average follow-up period was 15.6 months (5 months - 36 months). Biopsy and clinical photograph were taken preoperatively, intraoperatively and through follow-up period to assess the effectiveness of laser resurfacing. Recurrence and side effects were evaluated through follow-up period. Results: Histologic examination shows the abolition of actinic atypia, regeneration of epidermis and normalization of cellular differentiation after laser resurfacing. Clinical photographs shows elimination of keratoses and spots, and the homogeneous, smoothening change of skin surface, indicating healthy and younger faces. All patients had remained free of skin cancers and premalignant lesions in laser-treated field through follow-up period. Conclusion: $CO_2$ laser resurfacing in skin tumor surgery can treat not only premalignant lesions but also subclinical lesions of photodamaged skin. Moreover it may be helpful in prophylaxis against skin cancers and premalignant lesions, providing rejuvenation and cosmetic improvement.

• Medical Lasers
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• v.8 no.1
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• pp.13-18
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• 2019

Background and Objectives High-intensity focused ultrasound (HIFU) can produce small zones of thermal damage. A HIFU procedure is non-invasive and it can achieve rejuvenation of facial skin. Fractional CO₂ laser resurfacing delivers thermal damage to the pixilated columnar zone of the skin and so evoke collagen remodeling, the same as HIFU. In many cases, the patients who want rejuvenation with HIFU are also good candidates for cutaneous photorejuvenation such as can be accomplished via fractional CO₂ resurfacing. If patients are treated in a single session by remodeling both the superficial and deep compartments of skin by using both modalities, then improvement in rhytides and tightening of sagging skin will optimize the aesthetic result. Materials and Methods Between May 2014 and January 2018, a total of 44 patients were treated with combination HIFU and fractional CO₂ laser resurfacing according to our protocol. First, the HIFU was applied to the entire face with an average of 300 treatment lines. Immediately after HIFU treatment, the ultrasound gel was washed off and then fractional CO₂ laser resurfacing was performed. We evaluated the patients using 4-point grading scales. The clinician examined the skin for evidence of complications after the completion of treatment. Results All the patients' skin quality showed improvement. Further. the clinical results after duel modality treatment were substantially better than that after the use of either modality alone. The recovery times and the incidence of adverse events when quickly and consecutively performing both treatments were similar as compared to those with employing stepwise treatment. We encountered no complications whatsoever. Conclusion When compared with stepwise therapy, combination therapy with HIFU and fractional CO₂ resurfacing offers better, safer and more effective clinical results. Thus, for targeting multiple layers of aging facial skin, this combination therapy can be safely performed in a single treatment session.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.691-698
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• 2021

Background The reverse sural artery (RSA) flap is widely used for lower extremity reconstruction. However, patients sometimes suffer from donor site complications such as scar contracture and paresthesia, resulting in dissatisfaction with the aesthetic outcomes. This study investigated the characteristics of donor site morbidity associated with RSA flaps and described our experiences of dealing with complications by performing resurfacing surgery using thoracodorsal artery perforator (TDAP) flaps. Methods From April 2008 to August 2018, a total of 11 patients underwent contracture release and resurfacing surgery using TDAP flaps due to donor morbidity associated with RSA flaps. All affected donor sites were covered with a skin graft, the most common of which was a meshed split-thickness skin graft (six cases). Results Eight of the 11 patients (72.7%) suffered from pain and discomfort due to scar contracture, and seven (63.6%) complained of a depression scar. The donor sites were located 6.3±4.1 cm below the knee joint, and their average size was 140.1 cm². After resurfacing using TDAP flaps, significant improvements were found in the Lower Extremity Functional Scale (LEFS) scores and the active and passive ranges of motion (AROM and PROM) of the knee joint. The LEFS scores increased from 45.1 to 56.7 postoperatively (P=0.003), AROM increased from 108.2° to 118.6° (P=0.003), and PROM from 121.4° to 126.4° (P=0.021). Conclusions Planning of RSA flaps should take into account donor site morbidity. If complications occur at the donor site, resurfacing surgery using TDAP flaps achieves aesthetic and functional improvements.

• Hip & pelvis
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• v.34 no.4
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• pp.219-226
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• 2022

Purpose: The purpose of this study was to examine the clinical outcomes and efficacy of hip resurfacing arthroplasty (HRA) in patients with osteonecrosis of the femoral head after the failure of porous tantalum rod insertion without rod removal. Materials and Methods: Conversion to hip resurfacing arthroplasty was performed in 10 patients (11 hips) with a mean period of 14.9 months after the primary surgery. The mean follow-up period was 73.7 months. Analysis of pre and postoperative range of motion (ROM), University of California at Los Angeles (UCLA) activity score, modified Harris hip score, and visual analog scale (VAS) pain score was performed. Radiographic analysis of component loosening and osteolysis was performed. Results: The postoperative ROM showed significant improvement (P<0.05), excluding flexion contracture. The modified Harris hip score showed improvement from 65.82 to 96.18, the UCLA score showed improvement from 4.18 to 8.00, and the VAS pain score was reduced from 6.09 to 1.80. All scores showed statistically significant improvement (P<0.05). No component loosening or osteolysis was detected by radiographic analysis. Conclusion: Satisfactory results were obtained from conversion hip resurfacing arthroplasty after failure of porous tantalum rod insertion without rod removal. The findings of this study demonstrate the advantages of HRA, including no risk of trochanteric fracture and no bone loss around the tantalum rod. In addition, the remaining porous tantalum rod provided mechanical support, which reduced the potential risk of femoral neck fracture or loosening. This technique can be regarded as a favorable treatment option.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.408-411
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• 2019

Hairless scalp areas can occur due to trauma, tumors, or congenital disease. This aesthetically unpleasing condition can lead to psychosocial distress, and thin skin flaps may be prone to scarring. Treating the hairless scalp by simple excision is challenging because of skin tension. Tissue expanders are a good option for hairless scalp resurfacing. However, a single expansion may be inadequate to cover the entire defect. This report describes good results obtained using a serial resurfacing method involving re-expansion of the flap with a tissue expander to treat two patients with large lesions: one due to aplasia cutis congenital and another who underwent dermatofibrosarcoma protuberance resection. The results suggest that scalp resurfacing by serial tissue expansion using a tissue expander can be used for extensive lesions.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.11
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• pp.375-379
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• 1997

Pulsed Er:YAG and $CO_2$ lasers induced temperature rise of tissue are studied using axisymmetric, two-dimensional, and transient Pennes' bio-heat equation or the implications of skin resurfacing. Model results indicate that Er:YAG laser induced temperature has much higher but more shallow distribution in tissue than that of the $CO_2$ laser because of its higher absorption coefficient. The increase of repetition rate does not affect the temperature rise too much because these laser modalities have much shorter heat diffusion time than the temporal length of each off-pulse. This model works as a tool to understand the photothermal effect in the laser-tissue interaction.

• Medical Lasers
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• v.8 no.1
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• pp.7-12
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• 2019

Background and Objectives Skin and soft tissue defects can be treated according to a range of strategies, such as local flap, skin graft, biological dressing, or free flap. On the other hand, free tissue transfer usually leaves a distinct scar with an inconsistency of color or hypertrophy. This problem is highlighted if the defect is located on the face, which could have devastating effects on a patient's psychosocial health. Materials and Methods The authors used an erbium : yttrium-aluminum-garnet (Er:YAG) laser to resurface the free flap skin and match the color with the surrounding facial skin. This study evaluated the effectiveness of laser skin resurfacing on the harmonious color matching of transferred flap. Patients who had undergone laser resurfacing on facial flap skin between January 2014 and December 2018 were reviewed retrospectively. An ablative 2,940-nm fractional Er:YAG laser treatment was delivered to the entire flap skin at 21 J/cm² with the treatment end-point of pinpoint bleeding. Several months later, the clinical photographs were analyzed. The L^*a^*b^* color co-ordinates of both the flap and surrounding normal skin were measured using Adobe Photoshop. The L^*a^*b^* color difference (ΔE) for the scar and normal surrounding skin were calculated using the following equation: ${\Delta}E=\sqrt{({\Delta}L)^2+({\Delta}a)^2+({\Delta}b)^2}$ Results All five patients were satisfied with the more natural appearance of the flaps. The ΔE values decreased significantly from the pre-treatment mean value of 19.64 to the post-treatment mean value of 11.39 (Wilcoxon signed-rank test, p = 0.043). Conclusion Ablative laser resurfacing can improve the aesthetic outcome of free tissue transfer on the face.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.23-29
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• 1997

Freiberg's disease is a pathologic condition of the second or third metatarsal head, rarely the forth or fifth metatarsal head, and it becomes abnormally enlarge due to avascular necrosis of subchondral cancellous bone. From Nov. 1982 to Sep. 1994, we treated surgically 10 cases of the disease who complained the continuous symptoms inspite of proper conservative management. Metatarsal head excision was done in 8 cases and resurfacing of the cartilagenous portion of the metatarsal head in 2 cases. During the average follow up of 55 months, the pain was relieved in all patients who were underwent surgical intervention but the stiffness of the metatarsophalangeal joint was remained in most of cases. It seems to be a logical treatment of choice in younger and active patients that conservative management is the initial treatment but more ablative procedure is needed for the continued symptoms. We can propose the metatarsal head excision or resurfacing of the involved joint is effective treatment method with simple procedure and minimize morbid period than other procedures such as corrective osteotomy.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.110-113
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• 2000

The reconstruction of soft tissue defects of the sole requires to stand the force of weight bearing, provide sensation and adequacy for normal foot-wear. Although certain local flaps have been described and used for resurfacing the foot, extensive injury requires distant or free flaps for coverage. There is no doubt that the ideal tissue for resurfacing the sole is the plantar tissue itself. The specialized dermal-epidermal histology and fibrous septa of the subcutaneous layer gives its unique property to stand the pressure and to absorb the shock upon gait. This paper presents a case of reconstructing the sole that involves about 70% of the weight bearing portion. The combined medial plantar and dorsalis pedis chimeric free flap based on the medial plantar artery and medial plantar nerve adds another dimension in resurfacing the weight bearing sole of moderate to large sized defects.