• 제목/요약/키워드: Scar Formation

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The Current Status of BCG Vaccination in Young Children in South Korea

  • Lee, Hye-Jon;Dockrell, Hazel M.;Kim, Deok-Ryun;Floyd, Sian;Oh, Sue-Yeon;Lee, Jin-Bum;Kim, Hee-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.4
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    • pp.374-380
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    • 2012
  • Background: Delivery of Bacille Calmette-Gur$\acute{e}$in (BCG) Tokyo vaccine, with the multipuncture device, has been much preferred over BCG Pasteur, with the intradermal method, possibly due to the easier manner of administration, a desire to avoid any trouble with scars, as well as side effects and higher profits to providers in South Korea. Methods: To determine BCG scar status in 0~6 year old children vaccinated with two BCG vaccines (Pasteur BCG vaccine with intradermal method and BCG Tokyo vaccine with percutaneous method), the data from the national BCG scar survey in 2006 was analyzed. Results: Based on the national survey, the high proportion that were vaccinated with BCG Tokyo vaccines with the multipuncture method (64.5%) was noted in 0~6 year old Korean children. From inspection of scar formation, as an indicator of vaccination, the median number of the visible pin scars from the percutaneous method was 16 (interquartile range, 12~18) in the Korean children, and pin scars decreased as the age of the children increased (p<0.001). Conclusion: The findings in this survey clearly showed a growing preference of parents for the BCG Tokyo vaccines by the multipuncture method in South Korea.

Donor-Site Morbidity Analysis of Thenar and Hypothenar Flap

  • Dong Chul Lee;Ho Hyung Lee;Sung Hoon Koh;Jin Soo Kim;Si Young Roh;Kyung Jin Lee
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.94-101
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    • 2024
  • Background For the small glabrous skin defect, Thenar and Hypothenar skin are useful donors and they have been used as a free flap. Because of similar skin characteristics, both flaps have same indications. We will conduct comparative study for the donor morbidity of the Free thenar flap and Hypothenar free flap. Methods From January 2011 to December 2021, demographic data, characteristics of each flap, and complications using retrospective chart review were obtained. Donor outcomes of the patient, who had been followed up for more than 6 months, were measured using photographic analysis and physical examination. General pain was assessed by Numeric Rating Scale (NRS) score, neuropathic pain was assessed by Douleur Neuropathique 4 Questions (DN4) score, scar appearance was assessed by modified Vancouver Scar Scale (mVSS), and patient satisfaction was assessed on a 3-point scale. Statistical analysis was performed on the outcomes. Results Out of the 39 survey respondents, 17 patients received Free thenar flaps, and 22 patients received Hypothenar free flaps. Thenar group had higher NRS, DN4, and mVSS (p < 0.05). The average scores for the Thenar and Hypothenar groups were 1.35 and 0.27 for NRS, 2.41 and 0.55 for DN4, and 3.12 and 1.59 for mVSS, respectively. Despite the Hypothenar group showing greater satisfaction on the 3-point scale (1.82) compared with the Thenar group (1.47), the difference was not significant (p = 0.085). Linear regression analysis indicated that flap width did not have a notable impact on the outcome measures, and multiple linear regression analysis revealed no significant interaction between flap width and each of the outcome measures. Conclusion Despite the limited number of participants, higher donor morbidity in general pain, neuropathic pain, and scar formation was noted in the Thenar free flap compared with the Hypothenar free flap. However, no difference in overall patient satisfaction was found between the two groups.

Lateral Canthoplasty Using Lateral Cantotomy and Y-V Advancement (외안각 절개술과 Y-V 피판술을 이용한 외안각 성형술)

  • Han, Byung Kee;Jung, Hyun Seok
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.641-646
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    • 2007
  • Purpose: Lateral canthoplasty is utilized in aesthetic surgery to lengthen the lateral palpebral fissure of the lateral canthal area. However, complication such as recurrence, contour deformity or hypertrophic scar make its results doubtful. Therefore, we developed lateral canthoplasty with lateral canthotomy and Y-V advancement to effectively lengthen the palpebral fissure without recurrence. Methods: A total number of 117 patients were reviewed from March 1991 to April 2005. The operative procedure was lateral canthoplasty with lateral canthotomy and Y-V advancement. To prevent recurrence, we dissected lateral conjunctiva of lower eyelid. The author believes that by this procedure, V flap would be able to advance laterally without tension. Results: We performed lateral canthoplasty in 117 patients. There were no recurrence and patients were satisfied with the results. There were 12 patients who presented with complication. Complication included hypertrophic scar in 4 patients, web formation in 3 patients and over-correction in 5 patients. Conclusion: Lateral canthoplasty with lateral canthotomy and simple Y-V advancement may be used as an effective method to lengthen palpebral fissure without recurrence.

The Three-Bite Technique: A Novel Method of Dog Ear Correction

  • Jaber, Omar;Vischio, Marta;Faga, Angela;Nicoletti, Giovanni
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.223-225
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    • 2015
  • The closure of any circular or asymmetric wound can result in puckering or an excess of tissue known as a 'dog ear'. Understanding the mechanism of dog ear formation is a fundamental requirement necessary to facilitate an appropriate treatment. Many solutions have been reported in the literature, but in all cases, the correction entails the extension of the scar and the sacrifice of the dermal plexus. Here, we propose a novel technique of dog ear correction by using a three-bite suture that sequentially pierces the deep fascial plane and each dog ear's margin, thus allowing for flattening the dog ear by anchoring the over-projecting tissue to the deep plane. The three-bite technique proved to be a fast, easy, and versatile method of immediate dog ear correction without extending the scar, while maintaining a full and complete local skin blood supply.

Preliminary Results of Topical Mitomycin Application in Laryngotracheal Stenosis (후두기관협착증에 있어서 mitomycin 국소 도포 : 예비결과)

  • 임상철;조형호
    • Korean Journal of Bronchoesophagology
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    • v.9 no.2
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    • pp.60-64
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    • 2003
  • Restenosis frequently develops with granulation and overgrowth of scar following surgical treatment for laryngotracheal stenosis. Various methods such as stenting or CO2 laser application have been used to prevent restenosis, but they were seldom unsatisfactory. Mitomycin is an antineoplastic antibiotics derived from Streptomyces caespitosus; it inhibits fibroblast proliferation and acts as an alkylating agent to inhibit DNA synthesis. This study was desinged to evaluate effectiveness and determine indications of usage of topical mitomycin for laryngotracheal stenosis as a nonsurgical means of reducing postoperative granulation and scar tissue formation. Patients and Method : A retrospective study was performed on eight cases of laryngotracheal stenosis with topical mitomycin application. The author analyzed clinical outcomes of operative treatment with topical mitomycin. Patients underwent laryngotracheal reconstruction, endoscopic granulation removal, or bronchoscopic bougienage followed by topical application of mitomycin (0.4 mg/$m{\ell}$, 4minuntes) on the lesion intraoperatively. Result : Overall success rate of decannulation was 38% ($\frac{3}{8}$). Successful decannulation was possible in 75% ($\frac{3}{4}$) of laryngeal stenosis patients, 75% ($\frac{3}{4}$) of children, 60% ($\frac{3}{5}$) of the patients without previous surgery, and 75% ($\frac{3}{4}$) of bronchoscopic bougienage. Conclusion : The topical application of mitomycin in laryngotracheal stenosis was effective in untreated pediatric laryngeal stenosis which underwent bronchoscopic bougienage. Our results show that the topical mitomycin application for laryngotracheal stenosis could be a effective adjuvant treatment.

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Tranilast-delivery surgical sutures to ameliorate wound healing by reducing scar formation through regulation of TGF-β expression and fibroblast recruitment

  • Choi, Sung Yoon;Kim, Byung Hwi;Huh, Beom Kang;Jeong, Woong;Park, Min;Park, Hyo Jin;Park, Ji-Ho;Heo, Chan Yeong;Choy, Young Bin
    • Journal of Industrial and Engineering Chemistry
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    • v.67
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    • pp.469-477
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    • 2018
  • We describe surgical sutures enabled with the local, sustained delivery of a TGF-${\beta}$ inhibitory drug, tranilast. To fabricate drug-delivery sutures, we separately prepared a tranilast-loaded strand using poly (lactic-co-glycolic acid), which was then physically braided with a surgical suture already in clinical use. By this method, the drug-delivery sutures maintained the mechanical strength and allowed the modulation of drug release profiles by simply altering the tranilast-loaded strand. The drug-delivery sutures herein released tranilast for up to 14 days. When applied to animal models, scarring was indeed reduced with diminished TGF-${\beta}$ expression and fibroblast numbers during the entire 21 day testing period.

The "Swing-Door" Regrafting of Donor Site: An Alternative Method for Split-Thickness Skin Graft in the Hand

  • Jin Soo Kim;Chan Ju Park;Sung Hoon Koh;Dong Chul Lee;Si Young Roh;Kyung Jin Lee
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.102-109
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    • 2024
  • Background Skin defects in the hands are common injuries, and autologous skin grafting is the ideal treatment. However, complications can occur at the donor and recipient sites. This study compares the "Swing-door" technique with conventional skin grafting. Methods From August 2019 to February 2023, 19 patients with skin defects of hand underwent the "Swing-door" split-thickness skin graft (STSG) technique. The thin epithelial layer was elevated with proximal part attached. Skin graft was harvested beneath. Donor site was then closed with epithelial flap like a "Swing-door". The outcomes were evaluated in terms of healing time, scar formation, and pain at the donor and recipient sites. The data were compared with the conventional STSG. Results The "Swing-door" group had lower graft take percentages, but complications did not significantly differ between the two groups. The "Swing-door" technique resulted in better cosmetic outcomes, as evidenced by lower Vancouver Scar Scale scores, faster donor site epithelialization, and reduced pain and discomfort during the early postoperative period, as measured by Visual Analog Scale. Conclusion The "Swing-door" STSG is a useful alternative for treating hand skin defects.

AN EXPERIMENTAL STUDY ON TISSUE REACTIONS OF ALLOGENEIC SCIATIC NERVE GRAFT IN RAT (백서 좌골신경의 동종이식후 조직반응에 관한 실험적 연구)

  • Chung, Hyung-Bai;Yim, Chang-Joon;Lee, Dong-Keun;Se, Jae-Deok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.203-216
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    • 1991
  • Nerve allografts as a bridge of regeneration is useful in the repair of peripheral nerve defect resulting from trauma, and leprosy. But immunological rejection and complicated scar formation is an unavoidable problem in the application of allogeneic nerves. This article is intended to study of the regeneration of allogeneic nerve grafts in rats with histopathologically, scanning electron microscopically. 24 adult male Sprague-Dawley rats were used as the experimental animals. A 2cm skin incision was made on the lateral aspects of limb, parallel to femur. Segments of sciatic nerve trunk taken from rats, 10mm was resected at the middle of the thigh, nerve graft was inserted between the ends of gaps with perineural and epineural suture method with 10-0 prolene. Obsrevation was made simultaneously at 3 day, 1, 2, 3, 4, 5, 6, 8 weeks after surgery. The results were as follows. 1. In light and electronic microscopic studies, marked degenerative change of the graft nerves were observed at 2 weeks after surgery. 2. After surgery, blood clot fromation was observed at 3 day, granualtion tissue formation was observed at 2 week, and fibrous tissue proliferation was observed at 3 week. 3. In change of nerve fiber, there were Wallerian degeneration at early stage, decrease in degeneration at 4 week but degeneration of myeline was continuded at 8 week. 4. At 4 week, schwann cells proliferate at its cut ends to join with the distal and proximal stump of the damaged nerve. 5. Fibrous scar tissues are formed at 2 weeks and increased progressively in 8 weeks, which was interrupted the regeneration of grafted nerve.

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STEP OSTEOTOMY TECHNIQUE THROUGH INTRAORAL APPROACH FOR MANDIBULAR DISTRACTION (Callus distraction method를 이용한 하악골 신장술;계단골절단술식의 적용)

  • Kim, Myung-Jin;Yun, Pill-Young;Shin, Dong-Joon;Kim, Soo-Kyung;Kim, Jong-Won;Kim, Kyoo-Sik
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.2
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    • pp.254-261
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    • 2000
  • Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regenerated bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1994 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

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Pathological Studies on the Esophagogastric Ulcers in Swine (돼지의 위궤양(胃潰瘍)에 관한 병리학적(病理學的) 연구(硏究))

  • Kang, Mun-Il;Rim, Bong-Ho;Lee, Chung-Gil
    • Korean Journal of Veterinary Research
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    • v.22 no.1
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    • pp.53-58
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    • 1982
  • Stomachs from 3,354 fattening pigs were examined at slaughter during the period from September 1980 to August 1981. Pigs of both sexes and $Landrace{\times}Hampshire$ crossbreds were included in the present studies, and they weighed about 60-120kg. Gross pathologic alterations of the stomach were classified as normal, epitnelial change, erosion, ulcer and scar formation. Representative tissue sections were taken from the stomach lesions at random and fixed in 10% buffered formalin. Cut sections were stained with hematoxylin and eosin, and examined histopathologically. The results obtained in the present studies were as follows. 1. In the seasonal prevalence of gastric ulceration, severe ulceration with erosion was shown during the Autumn and Winter, whereas mild ulceration was mainly shown during the Spring and Summer. 2. Of the 3,354 stomachs of the pigs, 20.8% were found to be normal. Of the rest, 40% had epithelial changes, followed by erosion (24.7%), ulcer (13.6%) and scar formation (0.9%), respectively. 3. In the prevalence of ulcers in the different regions of the stomach, the fundic region had the highest rate (61.6%) of ulceration, followed by cardiac (21.7%), esophageal (15.0%) and pyloric region (1.7%). 4. The principal gross changes were severe epithelial changes with keratotic proliferation in the esophageal region, and in the fundic region severe folding of the stomach wall was covered with bloody mucous exudates. 5. Main histopathological changes were inflammatory cell infiltrations in most cases, hemorrhages in acute ulcers and prominent proliferation of granulation tissues in chronic ulcers.

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