• 제목/요약/키워드: Scar reduction

검색결과 69건 처리시간 0.021초

Reducing the donor site morbidity in radial forearm free flaps by utilizing a narrow radial forearm free flap

  • Shaikh, Safdar Ali;Bawa, Amber;Shahzad, Noman;Yousufzai, Zara;Ghani, Muhammad Shahab
    • Archives of Plastic Surgery
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    • 제45권4호
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    • pp.345-350
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    • 2018
  • Background The radial forearm free flap (RFFF) has remained a leading choice of many plastic surgeons as a fasciocutaneous flap due to its versatility, pedicle length, and simple elevation technique. However, donor site morbidity has led many reconstructive surgeons to limit their use of the RFFF and to use other flaps instead. We propose that using a narrow RFFF (nRFFF) decreases the aesthetic and functional morbidity of the donor site. Methods We report our experiences with the nRFFF from April 2012 through May 2015 at the Department of Plastic, Reconstructive, and Hand Surgery at Liaquat National Hospital, Karachi. The donor defects were closed primarily. The Stony Brook Scar Evaluation Scale and comparison with the contralateral hand were used to assess aesthetic and functional outcomes, respectively. Results A total of 24 patients underwent nRFFF procedures during the study period. The donor arm showed excellent motor function in 22 cases (91.7%), and very good function in the remaining two cases (8.3%). The aesthetic outcomes were excellent in four patients (16.6%), very good in eight patients (33.3%), good in 10 patients (41.6%), and fair in two patients (8.3%) who developed a hypertrophic scar. All flaps were successful and there were no cases of partial or complete loss. Conclusions For small to medium-sized soft tissue defects, the nRFFF had acceptable outcomes due to its thinness, pliability, and major reduction in donor site aesthetic and functional morbidity.

후하악부 절개를 통한 하악골 관절돌기 골절의 치료 후 임상경과에 대한 고찰 (Consideration of Clinical Progress after Open Reduction with Retromandibular Approach in Treatment of Mandibular Condyle Fractures)

  • 김한구;권남호;배태희;김우섭
    • 대한두개안면성형외과학회지
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    • 제9권1호
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    • pp.17-22
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    • 2008
  • Purpose: For several decades, open reduction has been a controversial issue in mandibular condyle fracture. The authors have successfully used the open reduction and internal fixation with retromandibular approach and have found it to be satisfactory for mandibular condyle fracture. Methods: A total of 10 patients with mandibular condyle fracture underwent open surgical treatment using retromandibular approach. The incision for the retromandibular approach was carried below the ear lobe and the facial nerve branches were identified. Dissection was continued until the fracture site was exposed and internal fixation was performed with miniplate following intermaxillary fixation. The average period of joint immobilization was 1 weeks and the arch bars were removed in 3 weeks on average. The preoperative and postoperative panoramic view and three-dimensional computed tomography were compared. During the follow up period, we evaluated the presence of malocclusion, chin deviation, trismus, pain, click sound, facial nerve palsy, hypertrophic scar and skin fistula. Results: According to the radiographic findings, the fractured condyle was reducted satisfactorily in all patients without any symptoms of facial palsy. During the follow up period ranged form 6 to 12 months, all clinical symptoms were improved except in one case with chin deviation and malocclusion. Conclusion: Using open reduction and internal fixation of mandibular condyle fracture with retromandibular approach, all results were satisfactory with good functional outcomes and minimal complication. We concluded that the open surgical treatment should be considered as the first choice for mandibular condyle fracture management.

광대뼈 축소술에 있어서 재배치와 고정 (Modified Approach in Reduction Malarplasty for Repositioning and Fixation)

  • 황소민;송제니퍼김;백세민;백롱민
    • Archives of Plastic Surgery
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    • 제38권3호
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    • pp.273-278
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    • 2011
  • Purpose: It has always been an aspiration for Asians to look more balanced and feminine, considering their facial features regarding relatively flat midface with marked prominences of the zygoma. Many studies have been dealt in this subject. However, the authors would like to emphasize the concept and introduce the technique of repositioning of the malar complex to a cosmetically beneficial point and stationing it on proper position by fixation on zygoma body and arch. Methods: From January 1998 to December 2007, this method was performed in 50 patients of mild to moderate prominence and malposition of the malar complex. A simplified technique of lateral orbital osteotomy and oblique osteotomy on zygomatic arch through intraoral and preauricular incision was developed. Then, liberal malar complex can be moved to a supero-posterior direction and repositioned to a more cosmetically beneficial point. To maintain the stationed position and to protect from vector affected by the attached masticating muscle to zygomatc bone, fixation was done on both zygoma body and arch. Results: We have obtained satisfactory results using this procedure without any observable complications. The advantages of this procedure are proper exposure, inconspicuous scar, safe, more natural contour, improved stability, and shorter healing time. Conclusion: The authors suggest that reduction malarplasty should be approached with underlying concept of repositioning and fixation. In mild moderate malar prominent cases, our technique will provide with maintenance of aesthetic concept, equal to the malar reduction performed under coronal approach and provide with more natural facial contour with stability even with less invasive surgical approach.

관상절개술을 통한 관골 복합골절 치료에 대한 환자의 만족도 조사 (A Survey of Patient Satisfaction after Treating Zygomatic Complex Fractures Using a Coronal Approach)

  • 김신락;박진형;한예식;예병진
    • 대한두개안면성형외과학회지
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    • 제12권1호
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    • pp.17-21
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    • 2011
  • Purpose: It is difficult to objectively evaluate the outcomes of plastic surgical procedures. The combination of aesthetic and medical factors makes outcome quantification difficult. In this study, fracture reduction accuracy was objectively evaluated in patients with zygomatic complex fractures. Patients satisfaction with the accuracy was also examined. In addition, the patients' overall satisfaction and discomfort due to complications were analyzed. Methods: Eighty-five patients who had surgeries via bicoronal incision for zygomatic complex fracture from March 2006 to December 2009 were included in this study. Two plastic surgeons evaluated the accuracy of the fracture reduction with postoperative computed tomography. A survey questionnaire was administered to evaluate the patients' overall satisfaction and the impact of symptoms associated with the procedure on the patients' daily lives. Results: The overall patient satisfaction rate was $82.1{\pm}10.9%$ (range, 45~100%). The level of deformation was $6.7{\pm}10.9%$, the levels of discomfort in daily life due to pain, paresthesia, scar, and facial palsy were $8.5{\pm}13.2%$, $5.8{\pm}8.9%$, $4.4{\pm}9.9%$, and $1.9{\pm}9.2%$, respectively. According to the visual analogue scale, paresthesia was found to be the most frequent symptom (43.5%), and pain was the most troublesome symptom. Conclusion: The use of bicoronal incision for treating zygomatic complex fractures can cause various complications due to wide incision and dissection. However, this technique can provide optimized reduction and rigid fixation. Most of these postoperative complications can cause significant discomfort in the patient. It is thought that the use of correct surgical technique and the accurate knowledge of craniofacial anatomy will result in a reduction of complications and significantly increase patient satisfaction.

학교급식효과(學校給食效果)에 관(關)한 연구(硏究) (A Study on the Effect of School-Feeding)

  • 성낙응
    • Journal of Nutrition and Health
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    • 제4권1호
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    • pp.41-48
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    • 1971
  • The effect of author's recipe of milk-substituting food was studied on 164 children of a primary school. Dividing the subjects into tow groups, A and B respectively, the former being fed with the author's food and the latter served as control, feeding was continued for 6 months daily at lunch hour, with the following results. (1) The effect of the author's milk-substituting food on the body-physique of the children could not be evaluated because of the short period of observation. (2) As observed clinically, various nutritional deficiency symptoms, such as anemia, angular scar glossitis, and hyperkeratosis, were far less frequently occurred in the fed group, while no such significant reduction of occurrence was noted in the control group. It was concluded from the above results that the well-balanced school feeding to the children Is necessary.

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'충전식 전기예초기' 혜드 부분의 개선 (Improvement of a Head Part of 'Chargable Electric Weeder')

  • 오세훈;심재현;남원기
    • 한국농업기계학회:학술대회논문집
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    • 한국농업기계학회 2006년도 동계 학술대회 논문집
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    • pp.31-34
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    • 2006
  • Purposes of this research are convenience of manufacture, quality sophistication and reduction of a/s' ratio by that improve several shortcomings of existing steel housing The Housing of head is changed existent steel housing to ABS (acrylonitrile butadiene styrene) copolymer housing and its shape is changed. It does not need that paint housing by paint. so We may not care scar at storage or manufacture. The fast work speed and A/S is possible by combining a safety plate and a housing by volt and spring washer. When disjoint head part, there is no damage of safety plate and housing. Noise is disappeared by resonance phenomenon in early rpm at motor moving. When neck part of housing and a middle pipe are connected by drill nasa, the work is easier Also, there is sense of security little more catching motor in housing The improvement accomplished much improvements including light weight of head part.

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Analysis for Forest Fire Damage Severity Map in Cheongyang

  • Jung Tae-Woong;Yoon Bo-Yeol;Yoo Jae-Wook;Kim Choen
    • 대한원격탐사학회:학술대회논문집
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    • 대한원격탐사학회 2004년도 Proceedings of ISRS 2004
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    • pp.537-540
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    • 2004
  • Space-borne multi-sensor data could provide fire scar and bum severity mapping. This paper will present detail mapping of burnt areas in Cheongyange Yesan of Korea with ETM+ image. Burn severity map based on ETM+ image was found to be affected by strong topographic illumination effects in mountainous forest area. Topographic effect is a factor which causes errors in classification of high spatial resolution image like IKONOS image. Minnaert constants J( in each band of ETM+ image is derived for reduction of mountainous terrain effects. Finally, this paper computes quantitative analysis of forest fire damage by each forest types.

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부분층 화상에 적용한 건조소양막과 동종배양표피세포의 치료효과 비교 (Comparison of Treatment Effect of the Dried Bovine Amniotic Membrane and the Cultured Allogenic Keratinocytes in the Partial Thickness Burn Management)

  • 여현정;김준형;정영진;손대구;한기환
    • Archives of Plastic Surgery
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    • 제36권4호
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    • pp.385-392
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    • 2009
  • Purpose: In the partial thickness burn management, despite of several advantages, the use of human amniotic membrane has been limited. The authors applied dried bovine amniotic membrane(DBAM) to overcome disadvantages of amniotic membrane for partial thickness burn and compared the effectiveness with cultured allogenic keratinocytes(CAK) that have been recently used for the management of burn. Methods: 16 patients with partial thickness burn, the mean age of 38 ranging 12 to 59 years, between August 2007 and May 2008 were assigned to this study. Either DBAM or CAK was applied, and the secondary dressing was removed on the following day. To compare treatment effect, time for epithelization, Vancouver scar scale and chromameteric results were evaluated. Results: The time for epithelization of DBAM was 10.1 days, that of CAK was 9.1 days, and they were shorter than the previous 2 - 3 weeks. At the follow up Vancouver scar scale was 2.8 for DBAM and 3.0 points for CAK and showed good results. The result of chromameter showed that the $L^*$, $a^*$, and $b^*$ values of the area applied DBAM were 60.1, 13.6, and 13.3, respectively, and the values of the area applied CAK were 60.1, 12.4, and 12.4, respectively. It was found that the skin color of the healed area after burn was darker, the redness was higher, and the yellowness was lower. After dressing, significant side effects were not observed, and in the cases of applying CAK, it was inconvenient as the moving area had to be fixed. Conclusion: With CAK, DBAM has several advantages such as the shortening of the epithelization period, reduction of scar and pigmentation, and convenient application, etc. Thus it is an effective method for the partial thickness burn management.

하악 매복치 발치 후 $CO_2$ laser 조사의 임상적 효과 분석 (ANALYSIS OF CLINICAL EFFECT OF $CO_2$ LASER ILLUMINATION AFTER SURGICAL EXTRACTION OF IMPACTED 3RD MOLAR)

  • 김인수;김영균
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제27권4호
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    • pp.349-352
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    • 2001
  • Dental laser provides many advantages to the clinicians. Those are excellent hemostatic effect, good operating sight, minimal adjacent tissue injury, reduction of postoperative swelling & pain, reduction of postoperative infection, reduction of scar tissue & contraction, etc. The purpose of this study is to observe how these advantages work after surgical extraction of impacted third molar. From march 2000 to july 2000, we have randomly divided the patients who had been surgically extracted unilateral impacted third molar into two groups. The first group comprised $CO_2$ laser illumination with 3 watts, defocusing & continuous mode, rotating motion for about 3 minutes after finishing of surgical extraction & suture. The other group patients were not irradiated. The medications in two groups were same. We measured pain, swelling and trismus three times(pre-operation, first day after operation, and 7th day after operation). The number of the patients who had measured three times all are 64, laser irradiated groups are 36 and non-irradiated groups are 28. The age ranged from 19 to 50, with a mean of 27.9 years. The operative time ranged from 3 minutes to 50 minutes, with a mean of 12.1 minutes. In the $CO_2$ laser group, the pain intensity of the 7th day after operation was still increased significantly comparing with that of the pre-operation and the distance which were measured for the swelling was different significantly. In the other group, the mouth opening limitation was still decreased significantly.

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Subbrow Approach as a Minimally Invasive Reduction Technique in the Management of Frontal Sinus Fractures

  • Lee, Yewon;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Kim, Soon Heum;Kim, Cheol Keun;Jo, Dong In
    • Archives of Plastic Surgery
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    • 제41권6호
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    • pp.679-685
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    • 2014
  • Background Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Methods Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws. Results Contour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed. Conclusions The subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.