• 대한두개안면성형외과학회지
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• 제18권3호
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• pp.214-217
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• 2017

The reconstruction of the mandibulofacial defects is a difficult task when there are full-thickness cheek defects involving mandible, inner mucosa and outer skin. There are several reconstructive options for the coverage of large defects, but most of the methods are complicated, and time- and effort-consuming. We hereby present a case of fibula osteocutaneous flap based on a single peroneal artery perforator in the reconstruction of a three-dimensional mandibulofacial defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권3호
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• pp.209-213
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• 1995

Various cutaneous as well as myocutaneous flaps have been designed for the reconstruction of tissue defects caused by the excision of oral cancer. Among these flaps, cervical island skin flap have been introduced by Farr et al and more have developed by Tashiro et al. This flap has many advantages. The flap minimizes donor size by use of cervical operation wound, flap size available is adequate for most oral defects and the procedure is relatively simple and time saving. However, this flap is not applicable in patients where there are large tissue defects and metastasis is suspected. We used this flap for it's rapid, simple, and effective, primary closure of oral defects after cancer ablation and we have found this flap very useful for the reconstruction of relatively small oral defects.

• Archives of Plastic Surgery
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• 제49권6호
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• pp.724-728
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• 2022

Various flaps are used to reconstruct skin and soft tissue defects of the vulva following resection of malignancies. Whenever possible, reconstruction using local flaps is the standard treatment. Here, we describe vulvar defect reconstruction using keystone flaps. Standard keystone flaps are based on randomly located vascular perforators. However, we designed a keystone flap that includes perforators of three named arteries (the anterior labial artery of the external pudendal artery, cutaneous branches of the obturator artery, and posterior labial artery of the internal pudendal artery) and the pudendal nerve, which accompanies the internal pudendal artery. Four patients with squamous cell carcinoma and extramammary Paget's disease of the vulva underwent radical vulvectomy and keystone flaps including perforators of three arteries. Depending on the morphology of the defects, keystone flaps were used with different designs. For elliptical and unilateral vulvar defects, a standard keystone flap was designed, and for defects on both sides of the vulva, a double opposing keystone flap was used. For oval defects, the omega variant keystone flap was designed, and when the morphology of the defect needed rotation of the flap, a rotational keystone flap was designed. All the patients showed good function and sensation, with an acceptable cosmetic appearance.

• Archives of Plastic Surgery
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• 제43권5호
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• pp.418-423
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• 2016

Background Skin grafting is a relatively simple and thus widely used procedure. However, the elastic and structural quality of grafted skin is poor. Recently, various dermal substitutes have been developed to overcome this disadvantage of split-thickness skin grafts. The present study aims to determine the feasibility of RapiGraft as a new dermal substitute. Methods This prospective study included 20 patients with partial- or full-thickness skin defects; the patients were enrolled between January 2013 and March 2014. After skin defect debridement, the wound was divided into two parts by an imaginary line. Split-thickness skin grafting alone was performed on one side (group A), and RapiGraft and split-thickness skin grafting were used on the other side (group B). All patients were evaluated using photographs and self-questionnaires. The Manchester scar scale (MSS), a chromameter, and a durometer were used for the scar evaluation. The average follow-up period was 6 months. Results The skin graft take rates were 93% in group A and 89% in group B, a non-significant difference (P=0.082). Statistically, group B had significantly lower MSS, vascularity, and pigmentation results than group A (P<0.05 for all). However, the groups did not differ significantly in pliability (P=0.155). Conclusions The present study indicates that a simultaneous application of RapiGraft and a split-thickness skin graft is safe and yields improved results. Therefore, we conclude that the use of RapiGraft along with skin grafting will be beneficial for patients requiring reconstructive surgery.

• 대한두경부종양학회지
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• 제20권1호
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• pp.41-43
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• 2004

An advanced maxillary sinus cancer requires an extensive ablation that results an extensive facial deformity, including a skin defect. Reconstruction has to be considered in a radical maxillectomy, especially with skin defect may be accomplished in one stage with a microsurgical free transfer of a latissimus dorsi flap. A man of right maxillary sinus cancer, squamous cell carcinoma, 47 years old of age, had soft tissue invasion of the cheek region. He underwent a radical maxillectomy with extensive skin excision. The maxillectomy and skin defects were reconstructed with the double skin island latissimus dorsi myocutaneous free flap. The cosmetic result and the functional outcome of the nose were thought to be considerably satisfied.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.86-90
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• 2022

Performing a skin graft is not feasible for tendon-exposed defect reconstruction because tendons are fibrous connective tissues with relatively poor blood supply. This study proposes a method to effectively perform skin graft surgery in tendon-exposed wounds. A 48-year-old male patient with diabetes mellitus had a very large left dorsal foot defect (8×8 cm). The wound bed had healthy granular tissue, with tendon exposure. The tendons were turned over so that the posterior side would behave as the anterior side. The edge of the paratenon was then fixed together to the surrounding granulation tissue or dense remnant fascia using absorbable sutures, and the close granulation tissue was approximated and buried. A split-thickness skin graft was performed after 1 week. The graft site was stably taken on postoperative day 3. A small disruption was then observed at the graft site within 1 week postoperatively, but conservative treatment was continued for 1 month, after which the defect site was completely restored. This technique can increase the success rate of skin grafts for defects with tendon exposure.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.149-153
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• 2001

Various types of flaps including local flaps, pedicle flaps and free flap have been used to reconstruct hand soft tissue defects, but each flaps have some limitation and disadvantages. The reverse posterior interosseous artery flap described by Zancolli and Angrigiani have some advantages : preserving the major artery of the hand, minimal donor site morbidity and thin skin. From May 1999 to May 2001, we reconstructed 18 cases of hand defects in industrial injury with reverse posterior interosseous artery flaps and partial distal part necrosis of flaps due to infection developed in a case but other 17 cases survived completely without any specific complication.

• 한국임상수의학회지
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• 제9권1호
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• pp.277-281
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• 1992

To investigate the effect of chlorhexidine gluconate and povidone iodine on wound healing, their antimicrobial activity and their effects on wound contraction in rabbits were studied. Staphyococcus aureus (1${\times}$10$\^$7/) was inoculated on the full thickness skin defects (2${\times}$2cm) on the back. Antiseptics were applied on the defects 2 hours after Inoculation. The defects were swabbed for bacterial culture 24 and 48 hours after the application of antiseptics. Percentage of wound contraction, based on wound area measured on the day of surgery was calculated for each wound on days 1,7 and 14. The 0.5% chlorhexidine gluconate solution had more effective antimicrobial activity against Staphyococcus aureus in wounds than 0.05% chlorhexidine gluconate solution (p<0.05), and povidone iodine solution and saline (p<0.01). Percentages of wound contraction were not significantly different among different dilutions of the antiseptics and saline. Present study indicated that the antimicrobial activity of chlorhexidine gluconate in wound was superior to that of povidone iodine.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2001년도 춘계학술대회 논문집 전기기기 및 에너지변환시스템부문
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• pp.102-104
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• 2001

This paper presents a numerical analysis of the eddy current testing for pipe with axi-symmetric defect according to frequency changes using the finite element method(FEM). The defects used in this analysis are inner and outer axi-symmetric type. In order to obtain the behaviors of the signals by changing the frequency, the defects with different depths are modeled and analyzed using FEM. It is important to choose proper frequency because of the effect of skin depth in eddy current testing. This paper describes signal characteristics of each defects as frequency is changed.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.469-472
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• 2010

Purpose: Aplasia Cutis Congenita (ACC) is a rare disease characterized by the focal defect of the skin at birth, frequently involving scalp, but it may affect any region of the body. There are no etiology known but some conditions such as intrauterine vascular ischemia, amniotic adherences and viral infections are associated. The ideal treatment for the ACC is not known. Superficial and relatively small sized defects (< $3{\times}5\;cm$) may heal spontaneously and large defects related with risks of infection and bleeding may require aggressive surgical treatment. Hyalomatrix$^{(R)}$ is a bilayer of an esterified hyaluronan scaffold beneath a silicone membrane. It has been used as a temporary dermal substitute to cover deep thickness skin defect and has physiological functions derive from the structural role in extracellular matrix and interaction with cell surface receptor. This material has been used for the wound bed pre-treatment for skin graft to follow and especially in uncooperative patient, like a newborn, this could be a efficient and aseptic way of promoting granulation without daily irritative wound care. For this reason, using Hyalomatrix$^{(R)}$ for the treatment of ACC was preferred in this paper. Methods: We report a case of a newborn with ACC of the vertex scalp and non-ossified partial skull defect. The large sized skin and skull defect ($6{\times}6\;cm$) was found with intact dura mater. No other complications such as bleeding or abnormal neurologic sign were accompanied. Escharectomy was performed and Hyalomatrix$^{(R)}$ was applied for the protection and the induction of acute wound healing for 3 months before the split-thickness skin graft. During the 3 months period, the dressing was renewed in aseptic technique for every 3 weeks. The skin graft was achieved on the healthy granulation bed. Results: The operative procedure was uneventful without necessity of blood transfusion. Postoperative physical examination revealed no additional abnormalities. Regular wound management was performed in out-patient clinic and the grafted skin was taken completely. No other problems developed during follow-up. Conclusion: Hyalomatrix$^{(R)}$ provides protective and favorable environment for wound healing. The combination of the use of Hyalomatrix$^{(R)}$ and the skin graft will be a good alternative for the ACC patients with relatively large defect on vertex.