• Archives of Plastic Surgery
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• 제51권1호
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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.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.49-52
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• 2020

The specialized structure of the upper eyelid ensures complete closure of the eye and eyeball sealing. An upper eyelid injury can cause various symptoms associated with eyeball trauma, not just scar formation or eyelid deformity. In this report, we describe a case of lagophthalmos observed after wound repair in a patient with a crushing injury caused by a grinder. Several surgical techniques are used to treat lagophthalmos or scar contracture. In most cases, a releasing procedure is performed after 6 months of initial repair. However, if the patient has severe symptoms that are not relieved by conservative care, early revision is inevitable. We describe a case of early lagophthalmos successfully resolved with pentagonal wedge resection, fat redistribution, and full-thickness skin grafting. After the revisional surgery, we observed that the patient regained the ability to completely close the injured eyelid, with restoration of function and favorable cosmetic outcomes. Pentagonal wedge resection to release a retracted structure, fat redistribution to prevent readhesion, and full-thickness skin grafting for enough amount of skin to regain upper eyelid function is useful for scar release and lagophthalmos following crushing injuries of the upper eyelid.

• 한국임상수의학회지
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• 제24권2호
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• pp.276-279
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• 2007

A 2-year-old male, 3 kg body weight Japanese Chin was injured in the automobile accident three months ago. The dog became antebrachiocarpal joint instability, and performed pancarpal arthrodesis using 3 K-wires in localanimal hospital. But, the result was failure. Therefore the dog was referred to Chonbuk Animal Medical Center, Chonbuk National University. In physical examination, right carpal joint instability, knuckling sign and pain were evident. In radiography, sclerosis was observed on the 4th carpal bone. Complete blood count (CBC), serum chemistry and urinalysis finding were within reference ranges. Pancarpal arthrodesis was re-performed using 7-hole plate. However, mild skin and muscle defects was appeared by skin tension of extremity. We expected that granulation would fill the defect, but inflammation was continued on the lesions for 3 days. So, operation which is filling it was done by using the muscle flap and tubed skin flap. The donor muscles were flexor carpi radialis and superficial digital flexor muscles. After 7 days, the muscle flap was survived, but tubed skin flap was necrosed. After 20 days, the skin defect was substituted with granulation tissues. The flexor carpi radialis muscle and superficial digital flexor muscle transposition can be a useful procedure for reconstructing soft tissue defects in the carpal and metacarpal areas.

• 대한본초학회지
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• 제37권3호
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• pp.41-47
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• 2022

Objectives : Terminalia chebula (TC) has been used as a traditional remedy to treat gastrointestinal infectious and inflammatory diseases. However, its protective effects and mechanisms against skin inflammation have not been well-elucidated. Thus, the aim of this study is to evaluate the protective effects of the TC water extract and also to suggest a putative mechanism of TC against skin injury on human keratinocytes, HaCaT cells. Methods : HaCaT cells were pre-treated with TC for 1 h and then stimulated with tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ) (10 ng/mL each) to induce skin inflammation and injury. After 24 h, the cells were harvested to evaluate the expression of Th2 chemokines, such as C-C motif chemokine ligand 5 (CCL5, also known as RANTES), C-C chemokine ligand 17 (CCL17, also known as TARC) and C-C chemokine ligand 22 (CCL22, also known as MDC). To investigate the regulatory mechanisms of TC, we also assessed the phosphorylation of signal transducer and activator of transcription 1 (STAT1) signaling pathways in HaCaT cells. Results : Treatment of TC decreased the mRNA levels of RANTES, TARC and MDC with a concentration dependent manner against co-stimulation of TNF-α and IFN-γ. In addition, TC significantly reduced TNF-α and IFN-γ induced phosphorylation of STAT1. Conclusions : In summary, we propose that TC may be a promising candidate for anti-inflammatory skin protector through the inhibition of chemokines via STAT1 deactivation.

• Journal of Trauma and Injury
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• 제31권2호
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• pp.112-116
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• 2018

Calcaneal fractures are quite often seen in patients with axial loading injury. In the tongue-type of calcaneusal fractures or tuberosity avulsion fractures, bone fragments are often superiorly and posteriorly displaced, because of the insertion of the Achilles tendon and pull of the gastroc-soleus complex. The Ddisplaced bone fragment compresses the soft tissues, leading tothat makes skin necrosis. To prevent further soft tissue injury, early recognition of the injury by the emergency physician and immediate orthopedic consultation is needed.

• 대한의생명과학회지
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• 제9권2호
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• pp.75-84
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• 2003

To evaluate the influence of hepatic oxygen free radical systems on liver injury by topical p-phenylenediamine (PPD) application on rat skin, PPD (25 mg/16.5 $\textrm{cm}^2$) was topically applied to the abdominal region 5 times every other day and sacrificed. By PPD treatment, increasing rate of liver weight/body weight (%), serum activities of alanine aminotransferase and aspartate aminotransferase and decreasing rate of microsomal glucose-6-phosphatase activity were higher in the rats fed tungstate supplemented diet than those fed a standard diet. These findings indicate that group fed tungstate supplemented diet have more severe liver injury compared with group fed standard diet on topical PPD application. However, the activities of oxygen free radical generating enzymes such as xanthine oxidase (XO) and cytochrome P450 dependent aniline hydroxylase and those of oxygen free radical scavenging enzymes were not found to be different between these two animal groups. In the present study, a novel monitoring method to detect the generating of oxygen free radicals in liver extract was devised. Throughout this method, the oxidized PPD produced by oxygen free radicals was determined colorimetrically. The increasing rate of PPD oxidation by liver homogenate was higher in tungstate fed animals than in standard diet fed ones. Among the fractionations of liver extract, the mitochondrial and postmitochondrial fractions in the liver extract of tungstate fed animals led to a higher availability of PPD oxidation by PPD treatment compared with standard diet fed ones. In conclusion, these results suggest that an enhanced liver injury in tungstate fed animals treated with PPD may be due to oxygen free radicals produced in other systems except oxygen free radicals generating from cytosolic XO system. Especially, oxidative availability by PPD can be used for oxygen free radical detection in some tissue.

• 한국환경보건학회지
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• 제27권2호
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• pp.22-29
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• 2001

To evaluate the cutaneous injury in liver damaged rats by toluene application to the skin, toluene(35mg/㎤) was sequentially applied for 5 days to the dorsal skin of liver damaged rats with $CCl_4$ (6 times ever other day:0.1$m\ell$/100 g body weight-50% $CCl_4$in olive oil). The cutaneous ultrastructural changes were unexoectably not observed in liver from $CCl_4$-treated rats although necrotic liver damage appeared under light microscope. In these animals by the application of toluene to rat skin the cutaneous xanthine oxidase activity was significantly increased(p<0.05), but cytochrome P450 content was not different from that of the control or only $CCl_4$-treated rats. On the other hand, the cutaneous superoxide dismutase and catalase activities in liver damaged animals were significantly respectively(p<0.05, p<0.001), decreased by toluene application to the skin compared with control and especially the former enzyme activity was significantty decreased(p<0.01), compared with that of liver damaged rate rat but glutathione peroxidase, glutathione-S-transferase activities were not significantly different from those of the control or liver damaged rats. Futhermore, the reduced gluathione content of skin was also significantly decreased by toluene application to the liver damaged animals. In conclusion, the great deposits of cerrous peroxide and ultramorphological changes in skin tissue of liver damaged animals by toluene application may be responsible for the oxygen free radical.

• Journal of Radiation Protection and Research
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• 제40권1호
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• pp.65-72
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• 2015

방사선 노출에 따른 피부손상의 기본이론들은 정립되어 있지만, 정확한 기전에 관해서는 알려지지 않은 실정이다. 본 연구에서는 감마선 조사 후 용량 및 시간에 따라 돼지 피부의 장애를 육안 및 조직학적인 변화를 통해 평가하고 cyclooxygenase(COX)-2 발현 정도를 비교하고자 하였다. 미니돼지의 등 쪽 피부에 20-70 Gy 감마선을 국소조사 후 12 주 동안 육안적인 변화를 관찰하고 생검을 통해 조직학적인 변화를 관찰하였다. 방사선 조사 후 피부의 기저세포층에서의 세포자멸사와 표피층의 두께 변화를 평가하였고 COX-2 발현 정도를 면역염색을 통하여 비교하였다. 방사선 조사 후 피부 장애는 용량이 증가할수록 피부손상이 더욱 심하였으며 초기에 발적 소견을 보이다가 50 Gy 이상 조사군에서는 미란과 궤양으로 이어졌다. 조직학적인 변화는 육안적인 소견과 일치하였다. 방사선 조사 후 3일부터 기저세포에서 세포자멸사가 관찰되었으며 기저세포수의 감소가 유발되었으며 이러한 변화는 용량이 증가할수록 더욱 증가하였다. 방사선 조사 후 표피층의 두께는 3일 무렵에 일시적으로 증가하다가 점차 감소하였으며 20, 30, 40 Gy 조사 군에서는 다시 회복되는 소견이 관찰되었으나 50, 70 Gy 조사 군에서는 다시 회복되지 못하고 표피창의 두께 소실을 보였다. 방사선 조사 후 피부에서의 COX-2 발현은 피부손상정도와 일치하게 관찰되었다. 방사선 조사 후 COX-2 발현은 방사선의 용량이 증가할수록 발현이 증가하였고 시간이 증가할수록 증가하였다. 이러한 조직학적인 변화와 함께 방사선 손상을 일으키는 신호전달에 관여하는 COX-2 발현이 방사선조사 용량에 비례하여 증가하며 이러한 단백질의 발현은 피부손상과 관련성이 높은 것으로 사료된다.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.829-835
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• 2011

Purpose: The two major concerns in skin grafting are poor color match in the recipient site and the donor site morbidity. And, glabrous skin on the palmar aspect of the hands and plantar aspect of the feet attributes define the skin on the palm and fingers sole as functionally and aesthetically different from skin on other parts of the body. When there is a glabrous skin defect, it should be replaced with similar skin to restore function and aesthetics. The palmar crease areas were used to minimize these problems. The purpose of this study is to present the precise surgical technique of the full thickness skin graft using distal palmar and midpalmar creases for aesthetic better outcome for hand injuries. Methods: From May 2006 to April 2010, 10 patients with 11 defects underwent glabrous full thickness skin grafting of finger defects. Causes included seven machinery injuries, two secondary burn reconstructions, and one knife injury. Donor sites included ten glabrous full thickness skin graft from the distal palmar crease and one from the midpalmar crease. Results: Follow-up ranged from 3 months to 24 months. All glabrous skin grafts demonstrated complete taking the recipient sites and no incidence of the complete or partial loss. The donor site healed without complications, and there were no incidences of significant hypopigmantation, hyperpigmentation, or hypertrophic scarring. Conclusion: The important aspects of this method involve immediate return of glabrous skin to the defect site and restoration of the recipient site's crease by simple primary closure from adjacent skin. The glabrous skin of the palm provides the best tissue match for the reconstruction of the hands, but only a limited amount of tissue is available for this purpose. Full thickness skin grafting using palmar crease of the defects is the ideal way of reconstructing glabrous skin to restore both function and aesthetics and minimize donor site morbidity.

• Journal of Microbiology and Biotechnology
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• 제32권2호
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• pp.238-247
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• 2022

Since the skin covers most surfaces of the body, it is susceptible to damage, which can be fatal depending on the degree of injury to the skin because it defends against external attack and protects internal structures. Various types of artificial skin are being studied for transplantation to repair damaged skin, and recently, the production of replaceable skin using three-dimensional (3D) bioprinting technology has also been investigated. In this study, skin tissue was produced using a 3D bioprinter with human skin cell lines and cells extracted from mouse skin, and the printing conditions were optimized. Gelatin was used as a bioink, and fibrinogen and alginate were used for tissue hardening after printing. Printed skin tissue maintained a survival rate of 90% or more when cultured for 14 days. Culture conditions were established using 8 mM calcium chloride treatment and the skin tissue was exposed to air to optimize epidermal cell differentiation. The skin tissue was cultured for 14 days after differentiation induction by this optimized culture method, and immunofluorescent staining was performed using epidermal cell differentiation markers to investigate whether the epidermal cells had differentiated. After differentiation, loricrin, which is normally found in terminally differentiated epidermal cells, was observed in the cells at the tip of the epidermal layer, and cytokeratin 14 was expressed in the lower cells of the epidermis layer. Collectively, this study may provide optimized conditions for bioprinting and keratinization for three-dimensional skin production.