• Archives of Plastic Surgery
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• 제43권3호
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• pp.265-271
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• 2016

Background Reconstruction of orofacial soft tissue defects is often challenging due to functional and aesthetic demands. Despite advances in orofacial soft tissue defect reconstruction using free flaps, locoregional flaps still remain an important option, especially in health resource-depleted environments. This retrospective study highlights our experiences in oral and maxillofacial soft tissue reconstruction using locoregional flaps. Methods A twenty-three years retrospective analysis of all patients managed in our department was undertaken. Information was sourced from patients' case notes and operating theater records. Data was analyzed using SPSS ver. 16 (SPSS Inc.) and Microsoft Excel 2007 (Microsoft). Results A total of 77 patients underwent orofacial soft tissue defect reconstruction within the years reviewed. Males accounted for 55 (71.4%) cases and trauma was the main etiological factor in 45 (58.4%) of the patients treated. When sites of defect were considered, the lip, 27 (32.1%), was the most frequent site followed by the nose, 17 (20.2%). Forehead flap, 51 (59.3%), was the most commonly used flap. Complications noted were tumor recurrences at the recipient bed in 3 (3.9%) cases, tumor occurrence at the donor site in 1 (1.3%) case and postoperative infection in 11 (14.3%) cases. Conclusions Locoregional flaps still have an important role in the rehabilitation of patients with orofacial soft tissue defects. They remain a vital tool in the armamentarium of the reconstructive surgeon, especially in health resource-depleted environments where advanced reconstructive techniques may not be feasible.

• 대한족부족관절학회지
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• 제21권4호
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• pp.165-169
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• 2017

Secondary soft tissue injuries can occur from the pressure of the displaced fragment of posterior calcaneal tuberosity in calcaneal tongue-type fractures and calcaneal tuberosity avulsion fractures. The soft tissue injury can be prevented by immediate reduction of the displaced fragments. Various techniques can be used to fix the fracture fragments, but the stability of fixation and minimal invasiveness to soft tissue should be considered. This paper reports the successful outcomes of patients with soft tissue compromises in calcaneal tongue-type fractures and calcaneal tuberosity avulsion fractures. The fixation technique of a large cannulated screw and simple cerclage wiring is believed to be a useful surgical option for the treatment of secondary soft tissue compromised calcaneal fractures.

• Journal of Korean Neurosurgical Society
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• 제42권2호
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• pp.97-102
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• 2007

Objective : The authors attempted to evaluate the pattern of the airway narrowing due to prevertebral soft tissue swelling after surgery of the anterior cervical spine and their clinical significances using plain cervical X-ray images. Methods : Twenty-four patients undergoing anterior cervical spine surgery were reviewed from January 2004 to December 2005. Postoperatively, in daily basis, lateral radiograph of the neck was obtained in neutral position. We measured the upper airway diameter above and below the epiglottis level and prevertebral soft tissue diameter every day for a week and finally 2 weeks after surgery using their simple lateral cervical X-ray films. Results : Both airway narrowing and prevertebral soft tissue swelling were maximum in postoperative 2 days, and decreased rapidly in postoperative 7 days. Airway narrowing was aggravated postoperatively but slowly decreased as prevertebral soft tissue swelling diminished. But, the severity of airway narrowing showed no clinical correlations with clinical symptom and radiologic severity. Conclusion : Not all patients who show severe airway narrowing and prevertebral soft tissue swelling on their plain cervical X-ray film complain respiratory insufficiency. But, the patients with undergoing anterior cervical spine surgery should be monitored carefully for respiratory insufficiency, especially during several days following operation because both airway narrowing and prevertebral soft tissue swelling become peak at postoperative 2-3 days.

• Archives of Reconstructive Microsurgery
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• 제23권2호
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• pp.65-69
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• 2014

Purpose: Soft tissue reconstruction is essential for recovery of finger function and aesthetics in any traumatic defect. The authors applied a reverse homodigital artery island flap for soft tissue defect on distal part of digits. The aim of this study is to evaluate the efficacy of the procedure. Materials and Methods: Seven cases of soft tissue defects of finger tip were included in this study. There were six male and one female, mean age was 43 years and mean follow-up period was 38 months. The length of flaps ranged from 2.0 to 2.5 cm and width ranged from 1.0 to 2.0 cm. Flap survival, postoperative complications were evaluated. Results: All flaps survived without loss. Donor sites were repaired with primary closure in five cases and skin graft in two cases. None of the patients showed significant complications and their average finger motion was $255^{\circ}$ in total active motion at the last follow-up. Conclusion: The authors suggest that the reverse homodigital artery island flap could be a versatile treatment option for the soft tissue defect on distal part of digits.

• Archives of Reconstructive Microsurgery
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• 제23권1호
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• pp.13-17
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• 2014

Purpose: Soft tissue defect on foot and ankle is vulnerable and requires a thin flap for improvement of aesthetic and functional results. Lateral supramalleolar flap is a simple and fast procedure, which can preserve and supply reliable constant blood flow, and causes fewer donor site complications. The authors reviewed our cases and report the clinical results. Materials and Methods: Ten cases of soft tissue defects on the lower leg, around the ankle were treated with lateral supramalleolar flap. There were seven males and three females with a mean age of 54.8 years. The mean size of flaps was $5.9{\times}6.3$ cm and the mean follow-up period was 23 months. Flap survival and postoperative complications were evaluated. Results: Nine flaps survived completely without loss of flap. There was one case of partial wound dehiscence requiring debridement and repair, and another case of necrotic flap change requiring partial bone resection and closure. All patients were capable of weight bearing ambulation at the last follow up. Conclusion: The authors suggest that the lateral supramalleolar flap could be a useful option for treatment of soft tissue defect around the ankle joint.

• Archives of Plastic Surgery
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• 제42권4호
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• pp.419-423
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• 2015

Background Orthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery). Methods Twenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared. Results The mean horizontal advancement of the maxilla (point A) was 6.12 mm, while that of the mandible (point B) was -5.19 mm. The mean point A-nasion-point B angle was $-4.1^{\circ}$ before surgery, and increased to $2.5^{\circ}$ after surgery. The mean nasolabial angle was $72.7^{\circ}$ before surgery, and increased to $88.7^{\circ}$ after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'. Conclusions Patients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A') was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.

• 대한족부족관절학회지
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• 제10권1호
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• pp.105-108
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• 2006

Open calcaneal fractures are potentially devastating hindfoot injuries, in which the status of soft tissue envelope is very important. The reversed adipofascial flap has a merit of simplicity and minimal complication compared to free tissue transfer. We report of a case of open calcaneal fracture with soft tissue defect of hindfoot, which was successfully treated with reversed adipofascial flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.21-26
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• 2006

Considering the skeletal class III malocclusion that complains of mandibular prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.369-375
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• 2023

Purpose: The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods: This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results: There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm², and extensive defects as large as 16 cm×14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm², and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions: The proximally based sural fasciocutaneous flap serves as the primary method for reconstructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications.

• Journal of Trauma and Injury
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• 제28권1호
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• pp.27-30
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• 2015

A child sustained a car tire friction injury and had multiple soft tissue wounds. She had a severe soft tissue defect in the medial foot and ankle aspect which requiring flap coverage. We performed an adipoafscial flap with upside-down pattern for the treatment of the medial foot and ankle soft tissue posttraumatic defect. The flap is based on the perforator artery from the posterior tibial artery. Because it gave a thin coverage for the foot, the patient could walk with normal foot wear.