• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권4호
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• pp.222-226
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• 2024

The upper lip is a functionally and aesthetically important area of the face. Therefore, reconstruction of an upper lip defect needs sufficient consideration to ensure functional and aesthetic recovery. Several methods, such as wedge resection, rotation flaps, advancement flaps, and myomucosal advancement flaps, have been used to reconstruct vermilion defects. However, it is challenging to reconstruct a vermilion defect because of the possibility of residual asymmetry or scars and restrictions to normal lip movement after the reconstruction. We present the case of a 51-year-old female that had an upper lip vermilion defect caused by a dog bite. The lip defect was reconstructed using a mucosal V-Y advancement flap. This mucosal flap was based on the orbicularis oris muscle with a branch of the superior labial artery to ensure sufficient blood supply. Therefore, flap survival was excellent, and there was no constriction of the flaps. Moreover, the color and contour were matched to the adjacent lip tissue, and re-establishment of the white roll and adequate lip volume were achieved. This mucosal V-Y advancement flap technique represents a reliable method to repair mucosal defects without vascular compromise of the flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권1호
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• pp.210-214
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• 1990

외상에 의한 안면부의 반흔 및 안면 종양에 의한 결손은, 사회적 적응면에서 고찰할 때, 환자 자신에 대한 심리적 부담 및 타인에 대한 혐오감을 유발시킨다. 그러므로 안면부의 반흔 구축 및 결선 수복은 환자의 사회적 적응을 쉽게 유도해야 하며 방법적인 면을 고려할 때, 보다 심미적인 결과를 추구해야 한다. 일반적으로 안면 반흔의 구축 및 결손의 수복 방법에는 피부 이식 또는 피판 이식이 이용되고 있으나, 원거리 피부 의식의 결과, 안면부의 피부와 상이한 양태를 나타내고 있어 심미적이지 못하며, 안면부에서의 피판 이식은 수복할 수 있는 반흔 및 결손의 범위가 제한되어 있는 결점이 있다. 경안 피판에 의한 반흔 구축 및 결손 수복은 와반증을 동반할 수 있는 단점이 있으나, 혈류 공급이 우수하고, 봉합후 반흔이 적으며, 보다 광범위한 반흔 및 결손을 수복할 수 있고, 안면부 피부와 성상이 유사하여 보다 심미적이다. 본 교실에서는 화상에 의한 안면부 반흔과 혈관종 절제술에 의한 결손 수복에 경안 피판을 이용하여 심미적으로 우수한 결과를 얻었기에 저자등은 문헌 고찰과 함께 증례 보고를 하는 바이다.

• 한방안이비인후피부과학회지
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• 제22권3호
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• pp.228-236
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• 2009

Objectives : Acne, one of the most common disorders in dermatology clinic, is a chronic inflammatory disease which has the symptoms of comedones, papules, pustules, cysts, nodules and scars mainly on the face. Although some of pathologic findings are suggested, but the exact causes and mechanisms are not yet known in Western Medicine. Hwangryeonhaedok-Tang(HRHDT) is an antiinflammatory, antipyretic and detoxifying herb decoction. In this report, we would like to share our experience of acne treatment with HRHDT. Methods : We had treated several patients with acne, facial flushing and uprising febrile sensation on face using oral administration and external application of HRHDT. HRHDT is basically made up with Scutellariae Radix, Coptidis Rhizoma, Phellodendri Cortex and Gardeniae Fructus. In this trial, several other herbs were added according to the individual patient's accompanying symptoms. After the decoction of herbs in amount for 10 days, $Yogourmet^{(R)}$ Kefir Starter 10 g was added to the herbal solution that was then fermented in an incubator at $25^{\circ}C$ for 72 hours, and divided into 30 doses. Results : Photographies were taken before and after the treatment. The severities of acne were evaluated with these photos according to the Korean Acne Grading System(KAGS). As results, we observed dramatic clinical improvements and the decreases of KAGS grades after the average treatment period of 8 weeks. The medication was orally administered 3 times a day and the external treatment was applied average twice a week during the whole treatment period. Conclusions : From these results, HRHDT may be considered as a good prescription for the febrile and toxic type of acne patients.

• Archives of Plastic Surgery
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• 제41권2호
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• pp.158-162
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• 2014

Background Loss of nipple projection is a common problem following nipple reconstruction. The aim of this study was to demonstrate that the use of a tightly rolled dermal graft is effective in the long-term maintenance of nipple projection. Methods Nipple reconstruction was performed using the C-V flap technique. A dermal graft was harvested from the dog-ear portion of previous scars. The graft was rolled tightly into a compact cylinder and used to augment the nipple reconstruction. Postoperatively, stacked Allevyn dressing was used for protecting the nipple from compression for a minimum of two months. Nipple projection was measured at the time of surgery and at 12 months postoperatively. Results Forty nipple reconstructions were performed using this technique. There were 19 transverse rectus abdominis musculocutaneous (TRAM) flaps, 10 latissimus dorsi (LD) flaps, and 11 tissue-expanded breast mounds. At one year, the mean projection was 0.80 cm (range, 0.62-1.22 cm). The twelve-month average maintenance of nipple projection was 70.2% for the TRAM flap group, 76.3% for the LD flap group, and 61.8% for the tissue-expanded group. In two patients with previous irradiation of the reconstructed breasts, relatively poor maintenance of nipple projection was noted (45.7%). No complications were noted, and all of the donor sites healed well primarily. Conclusions Our results demonstrated that the use of a C-V flap with a tightly rolled dermal graft for nipple reconstruction improves the long-term maintenance of nipple projection. Its advantages include reproducibility, technical simplicity, cost-effectiveness, and minimal donor site morbidity.

• 대한두개안면성형외과학회지
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• 제10권2호
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• pp.120-126
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• 2009

Purpose: Autogenous cartilage is generally first choice in rhinoplasty because of its biocompatibility and resistance to infection. On the other hand, allogeneous cartilage graft might preferred over an autogenous graft to avoid additional donor site scars, morbidity and lengthened operating time. Allogenous costal cartilage ($Tutoplast^{(R)}$) not only have the advantage of averting donor site morbidity but also are resistant to infection, resembling autogenous cartilage graft. We report here a technique for rhinoplasty by using allogenous costal cartilage graft. Methods: Through open rhinoplastic approach, alar cartilage is released from upper lateral cartilage and relocated caudally. After relocation of alar cartilage, allogenous costal cartilage is immobilized by nonabsorbable suture material at caudal aspect of septal cartilage. Caudal end of allogenous costal cartilage is sutured between medial crura of alar cartilage. Tip projection is improved by using interdormal suture, transdormal suture and shield-shape cartilage graft which is harvested from concha Results: No significant resorption and infection was detected in any of patients. Aesthetic and functional results were satisfactory. Conclusion: The low incidence of major complication and versatility of allogeneous costal cartilage graft make safe and reliable source of cartilage graft in rhinoplasty.

• 한국사회복지학
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• 제61권3호
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• pp.229-253
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• 2009

본 연구의 목적은 아동양육시설 퇴소생의 퇴소 후 생활경험을 이해하고자 하는 것이다. 이러한 목적을 달성하기 위해 본 연구에서는 아동양육시설에서 퇴소한 지 5년 이상된 퇴소생들을 대상으로 심층면접을 실시하여 자료를 수집하고 질적 접근으로 분석하였다. 분석결과, 주제는 "고립무원", "발목을 잡힘", "미래를 향해 달려감"으로 나타났다. 고립무원은 '진짜 고아가 됨'과 '고군분투'로 구성되었다. 발목을 잡힘은 '시설, 떠나야 할 고향', '시설 출신이라는 딱지', '가족이 준 상처와 흔적'으로 구성되었다. 미래를 향해 달려감은 '시설에서 얻은 것', '함께 일어서기', '미래를 바라봄', '현실을 박차고 달려나감'으로 구성되었다. 연구결과에 근거하여 시설 퇴소생들의 생활을 지원하기 위한 정책과 실천지침들을 제언하였다.

• Archives of Plastic Surgery
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• 제42권4호
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• pp.446-452
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• 2015

Background Various techniques are used for performing breast reduction. Wise-pattern and vertical scar techniques are the most commonly employed approaches. However, a vertical scar in the mid-lower breast is prominent and aesthetically less pleasant. In contrast, a semicircular horizontal approach does not leave a vertical scar in the mid breast and transverse scars can be hidden in the inframammary fold. In this paper, we describe the experiences and results of semicircular horizontal breast reductions performed by a single surgeon. Methods Between September 1996 and October 2013, our senior author used this technique in 38 cases in the US and at our institution. We used a superiorly based semicircular incision, where the upper skin paddle was pulled down to the inframammary fold with the nipple-areola complex pulled through the keyhole. Results The average total reduction per breast was 584 g, ranging from 286 to 794 g. The inferior longitudinal pedicle was used in all the cases. The average reduction of the distance from the sternal notch to the nipple was 13 cm (range, 11-15 cm). The mean decrease in the bra cup size was 1.7 cup sizes (range, a decrease of 1 to 3). We obtained very satisfactory results with a less noticeable scar, no complication such as necrosis of the nipple or the skin flap, wound infection, aseptic necrosis of the breast tissue, or wound dehiscence. One patient had a small hematoma that resolved spontaneously. Conclusions This technique is straightforward and easy to learn, and offers a safe, effective, and predictable way for treating mammary hypertrophy.

• Archives of Plastic Surgery
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• 제44권3호
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• pp.228-233
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• 2017

Background Hidradenitis suppurativa (HS) is a chronic skin condition that can affect any area with apocrine sweat glands and has the potential to involve multiple sites concurrently. Commonly affected sites include the axilla, groin, perineum and perianal areas. In this study we performed a literature review on the surgical methods for HS and describe an innovative technique for reconstructing axilla HS using an inner-arm transposition flap. Methods We reviewed all cases (5 cases from 4 patients) of transposition flap reconstruction performed by the senior author at a single London tertiary hospital from 2008-2013. Patient related outcome measures were collected using the Derriford appearance scale (DAS 24) and a study specific questionnaire. Results All patients were satisfied with their final result. One out of five cases had a complication but did not result in flap failure. There is no disease recurrence to date. DAS 24 scores collected demonstrated acceptable postoperative distress that did not deviate far from the norm tables while study specific questionnaire reveal desirable outcomes. Conclusions We have managed to achieve our aim through the use of the innovative inner-arm transposition flap. Our study hopes to provide an additional technique for axillary reconstruction. This technique offers the effective concealment of scars with the benefit of tightening of the arm tissue producing 'brachioplasty like' effects. All things considered it would be reasonable to conclude the innovative flap technique is a reliable, effective, and simple method that results in multiple benefits.

• 성인간호학회지
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• 제14권1호
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• pp.34-43
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• 2002

More and more non-injured operations are being implemented these days, thanks to the development of medical technology. Still, however, most operations leave direct scars on patient' bodies, as well as accompanying pain. The massage as an independent nursing intervention can stimulate the circulation of the blood of tissue and muscle and increase the relationship between a patient and a nurse. The purpose of this study is to investigate the effect of foot massage on pain in post abdominal operative patients. The nonequivalent control group, pre-post test design is used for this study. From July 7, 2000 to February 20, 2001, the 40 patients who were operated under general anesthesia in a university hospital in Seoul were studied. They were divided into two groups ; 20 patients were part of the experimental group, and the others, in the control group. In order to evaluate the effect of foot massage, severity of pain was checked with the VAS (Visual Analog Scale) and also each patients' vital signs were measured with pulse rate, systolic blood pressure and diastolic blood pressure. The collected datas were processed by SAS version 6.12 program and analyzed by the Chi-square, Fisher's exact test, t-test and repeated measures ANOVA. The results of this study were as follows. 1. The severity of pain decreased significantly in the experimental group as compared to the control group following foot massage (t=-3.317, p= .002). 2. Measured vital signs in the experimental group had more reduction of that than in the control group following foot massage. - The pulse rate in the experimental group was lower than that in the control group following foot massage (F=7.73, p=.008). - The systolic blood pressure in the experimental group was lower than that in the control group following foot massage (F=25.75, p=.000). - The diastolic blood pressure in the experimental group was lower than that in the control group following foot massage (F=15.27, p=.000). In conclusion, foot massage is an effective dependent nursing intervention for pain control of post abdominal operative patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.406-415
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• 2010

Purpose: The secondary correction of cleft lip nasal deformity still presents a difficult surgical problems. The present study was aimed to investigate the usefulness of Bardach's technique for secondary correction of cleft lip nasal deformity. Materials and Methods: The subjects were eight patients with unilateral and bilateral cleft lip nasal deformity, who had secondary correction by using Bardach's rhinoplasty technique. Age range was from 2 to 21 years and mean age was 10.6 years. There were 3 boys and 5 girls. Six patients had bilateral and two patients had unilateral cleft lip. Facial photographs were taken before and twenty days after the operation. By using Adobe photoshop, the columella height and the nostril width were measured from the facial frontal photograph and Worm's eye view. The degree of improvement was calculated and statistically analyzed. Results: The degree of improvement of the columella length and the nostril width after Bardach's technique was $70.39{\pm}50.14%$ and $-22.93{\pm}0.15%$ respectively. Bardach's technique resulted in projecting the nasal tip, lengthening the columella, medially advancing the alar bases, restructuring the lower lateral cartilages, and changing orientation of the nostrils from horizontal to oblique. The profile view shows projection of the nasal tip, lengthening of the columella, and the change in the nasolabial angle. The scars remained at the philtrum were matter little in compared with improvement of the nasal appearance. Conclusion: These results indicate that Bardach's technique is an useful surgical technique for secondary correction of cleft lip nasal deformity.