• 구강회복응용과학지
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• 제23권2호
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• pp.145-155
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• 2007

The advent of osseointegration and advances in biomaterials and techniques have contributed to increased application of dental implants in the restoration of maxillary partial edentulous patients. Often, in these patients, soft and hard tissue defects result from a variety of causes, such as infection, trauma, and tooth loss. These create an anatomically less favorable foundation for ideal implant placement. Reconstruction of the atrophic maxillary alveolar bone through a variety of regenerative surgical procedures has become predictable; it may be necessary prior to implant placement or simultaneously at the time of implant surgery to provide a restoration with a good long-term prognosis. Regenerative procedures are used for horizontal and vertical ridge augmentation. Many different techniques exist for effective bone augmentation. The approach is largely dependent on the extent of the defect and specific procedures to be performed for the implant reconstruction. It is most appropriate to use an evidenced-based approach when a treatment plan is being developed for bone augmentation cases. The cases presented in this article clinically demonstrate the efficacy of using a autogenous block graft, guided bone regeneration, ridge split, immediated implant placement technique on the atrophic maxillary area.

• Journal of Chest Surgery
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• 제31권2호
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• pp.190-193
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• 1998

본 강북삼성병원 흉부외과에서는 병적골절이 동반된 원발성 흉골결핵을 치험 하였다. 22세된 여자환자가 특별한 외상이없이 발생한 흉골부위의 통증 및 골절로 입원 하였다. 입원당시 시행한 흉부단순촬영 및 전산화단층촬영상 흉골의 괴사소견과 연부조직의 부종이 관찰되었다. 세침세포검사상 냉농양을 동반한 결핵성 골수염으로 진단되어 술전 항결핵 치료후 수술을 시행하였다. 수술시 흉골중앙부위의 골괴사 및 다발성 누공을 확인하였으며, 골괴사 부위를 제거한후 환자의 장골능을 골이식 하였다. 병리조직학적 결과는 결핵성 골수염의 소견 및 치즈양괴사를 보였다. 술후 경과는 양호 하였으며, 2개월동안의 추적검사상 흉골의 불안정은 관찰되지 않았다.

• Archives of Reconstructive Microsurgery
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• 제11권2호
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• pp.179-185
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• 2002

The wrist and forearm are a frequently damaged area in high tension electrical injury as an input or output of the current. Electrical burns affecting the wrist and forearm may produce full thickness necrosis of the skin and damage deep vital structures beneath the eschar, affecting the local tendons, nerves, even bones and joints which result in serious dysfunction of the hand. From January 1997 to December 2001, we had treated 20 patients with high tension electrical burn in the wrist and forearm using anterolateral thigh free flap. Average follow up period were 24 months and we get satisfactory results both in functional and aesthetic aspects. This flap is considered useful in one-stage reconstruction of wide and large soft tissue defect combined with arterial injuries.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.545-549
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• 2017

When foot reconstruction is performed in the pretibial area, the ankle, or the dorsum of the foot, the need for a reliable flap remains a challenge. We found that the superficial inferior epigastric artery (SIEA) free flap can be used as an alternative tool for this purpose, as it helps to solve the problems associated with other flaps. We describe 2 cases in which we reconstructed the foot using an SIEA free flap, which was pliable enough to fit the contours of the area. Postoperatively, the flaps were intact and showed excellent aesthetic results. Thus, the SIEA free flap can be an alternative tool for patients with a low body mass index who undergo reconstructive surgery involving the pretibial area, ankle, knee, or dorsum of the foot, all of which require a soft and flexible flap.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.68-73
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• 2004

Transverse rectus abdominis muscle (TRAM) free flap is widely used for breast reconstruction, however donor-site morbidities such as abdominal wall weakness, hernia, bulging are troublesome. For the purpose of minimizing donor-site morbidity, there has been a surge in interests in muscle sparing free TRAM flap preserving the anatomy of rectus abdominis muscle, fascia, and motor nerve. The purpose of this study is to investigate complication and morbidity after muscle sparing free TRAM flap. Between August, 1995 and May, 2003, there were 108 cases of muscle sparing free TRAM flap of breast reconstruction. There was no abdominal hernia. There were 4 cases of dog ear, 3 cases of marginal necrosis of apron flap, 2 cases of asymmetry of umbilicus. At 1 year after operation, most patients feel comfortness in physical exercise. Muscle sparing free TRAM flap provides ample amount of well vascularized soft tissue with small inclusion of rectus abdominis muscle and fascia. Also it minimizes donor-site morbidity with rapid recovery of abdominal strength.

• 대한기관식도과학회지
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• 제18권1호
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• pp.13-18
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• 2012

Objective This study was conducted to gather basic information of 3D CT in detecting and gaining information of esophageal foreign body (FB) models. Materials and Methods The chest model was made using PVC bottle, rubber balloon and plaster. Fish bone, Persimmon stone were used to mimic foreign bodies of esophageal model. The foreign body models were inserted into the balloon removing air from it and the balloon was sealed. The esophageal FB model was inserted into the chest model. The remaining space in the chest model was filled with fish paste and water to simulate soft tissue around esophagus. CT of chest model was reconstructed three-dimensionally by Rapidia software to make images of foreign body models. The axial CT, MPR image and VOI image were compared with real foreign body materials as to shape, size, location and orientation. Results Esophageal FB models were easily made. CT data gave good 3D images and showed realistic foreign body materials. Conclusion The results indicate the usefulness of 3D CT technique to help in diagnosis of esophageal foreign body models.

• Archives of Plastic Surgery
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• 제37권6호
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• pp.775-778
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• 2010

Purpose: Reconstruction of soft tissue defects with osteomyelitis in the lower third of the leg represents a challenge to plastic surgeons. Moreover, it is more arduous in multimorbid patients. One excellent option for reconstruction of these defects is to use a delayed distally based sural flap. Methods: We successfully used delayed distally based sural flap with a two-step procedure. During the first operation, radical debridement and elevation of flap were performed. The raised flap was fixed again at the donor site. The delay period ranged from seven to ten days. Between August 2008 and July 2009, we underwent operations for five patients using this technique. The size of flap varied from $10{\times}6\;cm$ to $12{\times}14\;cm$. Results: All flaps successfully survived. Partial skin loss of the grafted site was seen in two patients but no further surgical procedure was required for wound healing. Complaints of hypoesthesia on the lateral part of the foot was observed. In a three month follow-up period, hypoesthesia was resolved spontaneously. Conclusion: Delayed procedure improves the viability of distally based sural flap in high risk, critically multimorbid patients. We recommend that, if a two-stage operative approach is required, the delayed procedure should be considered.

• 대한두개안면성형외과학회지
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• 제20권5호
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• pp.319-323
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• 2019

Cochlear implant extrusion, which is a common complication of cochlear implants, is generally repaired by a well visualized soft-tissue flap. A 61-year-old female patient with a medical history of schizophrenia who had a skin ulcer that caused cochlear implant extrusion, but that would be a stronger statement was referred to our department for removal of the implant and reconstruction of the resultant scalp defect. Accordingly, the broad defect was covered via rotation of a temporoparietal fascia flap (TPFF) using the superficial temporal artery, with the pedicle in the preauricular region as the pivot point. Coverage of TPFF was achieved with a split-thickness skin graft using the scalp as the donor site, which led to a quick recovery after the operation and satisfactory results in terms of aesthetics. This case suggests that a TPFF might be used as a flexible flap with low donor site morbidity for reconstructing cases of cochlear implant extrusion accompanied by a large full-layer scalp defect.

• 대한두경부종양학회지
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• 제11권1호
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• pp.47-55
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• 1995

A large lateral facial defects especially a through and through defect of the cheek remains as challenging field of reconstruction for the head and neck surgeons. Closure of these wounds is technically troublesome due to the magnitude and location of the soft tissue and skin defect, functional and aesthetic consideration. optimal cancer surveillance, and desire for good nourishment. Most traditional methods dealing with these defects, including split-thickness skin graft, local and regional flaps as well as musculocutaneous flaps have their limitations. We applied four different methods for these reconstruction in four cases. We utilized temporal muscle flap, forearm free flap and secondary healing for repair of mucosal defects, and medial base cervicopectoral flap, pectoralis major myocutaneous flap and cervicofacial flap for the reconstruction of external skin defects. In one case, both sides were reconstructed with single forearm free flap. In our experiences, secondary healing could be one of the useful method for mucosal repair in the defect between upper and lower gingivobuccal sulcus. However, forearm free flap was thought to be more ideal for the cases with mandibulectomy. For the external repair, the regional skin flap was considered to be superior to pectoralis major myocutaneous flap or forearm free flap especially on color matching.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.137-142
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• 2001

This study evaluated the results of reconstructions of thumb web space in the patients with adduction contracture of thumb. Between February 1990 and April 2000, 28 patients with thumb web space adduction contracture were treated with various reconstruction methods. We divided the patients according to the severity; mild$(41^{\circ}{\sim}80^{\circ})$, moderate$(21^{\circ}{\sim}40^{\circ})$, severe$(20^{\circ}less)$ contracture. The number of patients with mild contracture was 5, moderate; 12, severe; 11. We performed Z-plasty in 15, free flap in 8, local flap in 3, abdominal flap in 1 and scar release only in 1 case. The mean follow-up period was 5.7 years, ranged from 1.5 to 11.2 years. The results of web reconstruction were evaulated by thumb web space angle. There were excellent in 9, good in 16, fair in 3 cases. Z-plasty was performed in the 5 cases with mild contracture, and all the results were excellent. Especially, free flap was performed in the 6 cases with severe contracture, and all the results were good or excellent. in the reconstruction of thumb web space contracture, we recommend Z-plasty for a mild contracture, and free flap for large soft tissue defect created by release of a severe contracture.