• The Journal of the Korean dental association
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• v.15 no.2
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• pp.115-120
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• 1977

Extensive avulsion of the scalp, or stripping of a large area of soft tissue from the skull, is a serious accidnet. The avulsed scalp is often injured otherwise, such as by crushing, tearing, or from multiple laceration. The surrounding skin may be devitalized. Replacement of the scalp is usually followed by necrosis and sloughing within a short time. In such instances, the outer table of the cranium may become sucessively exposed. dry, dead, and affected by osteomyelitis. Hence the securing of early healing to prevent these is of the utmost importance. The successful case of reimplantation of the completely avulsed scalp, which is exposured to air for about 14 hours, is reported, in which there was partial growth of hair afterwards. The avulsed scalp caused by her long hair being caught in a grain belt was contaminated with hairs & dust. Authors treated this 19-year old female patient by split thickness skin graft, intermediate skin graft, full thickness skin graft from her own avulsed scalp.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.383-387
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• 2007

Purpose: A necrotizing fasciitis is a rare, but insidiously advancing fatal soft tissue infection characterized by extensive fascial necrosis. Diagnosis & treatment of this disease are difficult. Necrotizing fasciitis tend to begin with constitutional symptoms of fever and chills. Quite a many lab studies and imaging studies such as standard radiography, computerized tomography can be used, but nothing can confine the extent of affected tissue. Aggressive surgical interventions are often required because of large skin and soft tissue deformity. However, many patients with necrotizing fasciitis are not healthy enough to overcome aggressive surgical intervention. Methods: Since 2000, we treated 10 patients with necrotizing fasciitis. In 4 patients, we used magnetic resonance imaging(MRI) as a tool for diagnosis as soon as necrotizing fascitiis was doubted. We treated patients with delayed coverage with Alloderm$^{(R)}$ & split thickness skin graft or delayed wound closure in as many cases as possible. Results: In 4 patients using preoperative MRI, diagnosis could be made in earlier stage of the disease compared to other patients. Our treatment modality was debridement and coverage with Alloderm$^{(R)}$ & split thickness skin graft. We could reconstruct deformities without significant limitation of movement in 7 cases. Conclusion: We diagnosed and treated 10 necrotizing fasciitis with MRI and Alloderm$^{(R)}$ graft, and results were good.

• Archives of Plastic Surgery
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• v.41 no.4
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• pp.330-336
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• 2014

Background For patients with full thickness skin defects, autologous Split-thickness skin grafts (STSG) are generally regarded as the mainstay of treatment. However, skin grafts have some limitations, including undesirable outcomes resulting from scars, poor elasticity, and limitations in joint movement due to contractures. In this study, we present outcomes of Matriderm grafts used for various skin tissue defects whether it improves on these drawbacks. Methods From January 2010 to March 2012, a retrospective review of patients who had undergone autologous STSG with Matriderm was performed. We assessed graft survival to evaluate the effectiveness of Matriderm. We also evaluated skin quality using a Cutometer, Corneometer, Tewameter, or Mexameter, approximately 12 months after surgery. Results A total of 31 patients underwent STSG with Matriderm during the study period. The success rate of skin grafting was 96.7%. The elasticity value of the portion on which Matriderm was applied was 0.765 (range, 0.635-0.800), the value of the trans-epidermal water loss (TEWL) was 10.0 (range, 8.15-11.00)$g/hr/m^2$, and the humidification value was 24.0 (range, 15.5-30.0). The levels of erythema and melanin were 352.0 arbitrary unit (AU) (range, 299.25-402.75 AU) and 211.0 AU (range, 158.25-297.00 AU), respectively. When comparing the values of elasticity and TEWL of the skin treated with Matriderm to the values of the surrounding skin, there was no statistically significant difference between the groups. Conclusions The results of this study demonstrate that a dermal substitute (Matriderm) with STSG was adopted stably and with minimal complications. Furthermore, comparing Matriderm grafted skin to normal skin using Cutometer, Matriderm proved valuable in restoring skin elasticity and the skin barrier.

• Archives of Craniofacial Surgery
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• v.18 no.1
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• pp.50-53
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• 2017

Trichilemmal cysts are common fluid-filled growths that arise from the isthmus of the hair follicle. They can form rapidly multiplying trichilemmal tumors-, also called proliferating trichilemmal cysts, which are typically benign. Rarely, proliferating trichilemmal cysts can become cancerous. Here we report the case of a patient who experienced this series of changes. The 27-year-old male patient had been observed to have a $1{\times}1cm$ cyst 7 years ago. Eight months prior to presentation at our institution, incision and drainage was performed at his local clinic. However, the size of the mass had gradually increased. At our clinic, he presented with a $5{\times}4cm$ hard mass that had recurred on the posterior side of his neck. The tumor was removed without safety margin, and the skin defect was covered with a split-thickness skin graft. The pathologic diagnosis was a benign proliferating trichilemmal cyst. The mass recurred after 4months, at which point, a wide excision (1.3-cm safety margin) and split-thickness skin graft were performed. The biopsy revealed a trichilemmal carcinoma arising from a proliferating trichilemmal cyst. This clinical experience suggests that clinicians should consider the possibility of malignant changes when diagnosing and treating trichilemmal cysts.

• Archives of Craniofacial Surgery
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• v.9 no.1
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• pp.27-30
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• 2008

Purpose: It's difficult to treat port wine stain with nodular change in Laser therapy, and many patients with port wine stain suffer from restriction in social activity in case that port wine stain located on face. We present our experience in excision of port wine stain and skin graft in two patients who had port wine stain with nodular change on their faces. Methods: After excision of discolorized skin and nodular changed lesion of port wine stain, thick split thickness skin graft was done. Results: There was no recurred nodular hypertrophy for 3 months and 3 years of follow up periods. Conclusion: Surgical treatments of port wine stain with nodular change can lead significant improvement of lesion and social intercourse.

• The Journal of Advanced Prosthodontics
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• v.5 no.1
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• pp.67-72
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• 2013

Traumatic defects are mostly accompanied by hard and soft tissue loss. This report describes the surgical and prosthetic treatment of a patient with post-traumatic mandibular defect. A split-thickness skin graft was performed prior to implant placement and prefabricated acrylic stent was placed to hold the graft in place. The esthetic and functional demands of the patient were fulfilled by implant-supported screw-retained fixed prosthesis using CAD-CAM technology.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.243-247
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• 2008

Purpose: For a proper wound care, the correct evaluation of wound is very important. Usually the evaluation of wound was subjective, and as a result, wound care was empirical. There were many attempts to objectify the wound evaluation, and one of them was measurement of the wound pH. The purpose of this study is to observe the wound pH changes during wound healing phase. Methods: From 2005 to 2007, we measured the pH values of 6 acute wounds, which were split thickness skin graft donor sites. In addition, we measured the pH values of 18 chronic wounds, which were 17 pressure sores and 1 tuberculosis ulcer. After pH meter ($SkinCheck1^{(R)}$, Hanna Instruments, Italy) was calibrated, wound pH was checked. Wound was cleansed with saline gauze and dressed with polyurethane foam dressing($Medifoam^{(R)}$, Biopol, Korea). Results: In split thickness skin graft donor sites, the pH raised(mean pH value: $7.45{\rightarrow}7.62$) when the wound was on the process of healing(*p=0.027, analysis of Wilcoxon signed-rank test). If wound became re-epithelialised, the pH value dropped to that of normal skin. However, we could not find a relation between time and the pH values in chronic wound. Conclusion: We could observe the consistent wound pH changes during wound healing phase in acute wound.

• Archives of Reconstructive Microsurgery
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• v.25 no.1
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• pp.15-18
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• 2016

Any types of burn injury that involve more than deep dermis often require reconstructive treatment. In gluteal region, V-Y fasciocutaneous advancement flap is frequently used to cover the defect. However, in case of large burn wounds, this kind of flap cannot provide adequate coverage because of the lack of normal surrounding tissues. We suggest V-Y adipofascial flap using the surrounding superficially damaged tissue. We present the case of a patient who was referred for full-thickness burn on gluteal region. We performed serial debridement and applied vacuum-assisted closure device to defective area as wound preparation for coverage. When healthy granulation tissue grew adequately, we covered the defect with surrounding V-Y adipofascial flap and the raw surface of the flap was then covered with split-thickness skin graft. We think the use of subcutaneous fat as an adipofascial flap to cover the deeper defect adjacent to the flap is an excellent alternative especially in huge defect with uneven depth varying from subcutaneous fat to bone exposure in terms of minimal donor site morbidity and reliability of the flap. Even if the flap was not intact, it was reuse of the adjacent tissue of the injured area, so it is relatively safe and applicable.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.117-123
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• 2005

The reconstructive modalities for vaginal reconstruction include simple dilatation, skin graft, use of intestinal segments and various methods using flaps. However, skin grafting procedure is the most commonly used technique and the McIndoe procedure is a representative technique among skin grafting procedures. McIndoe procedure is easier, faster and has a lower morbidity compared to other techniques. However the conventional McIndoe procedure has several problems such as incomplete vestibule formation, excessive bleeding during dissection, possibility of recto-vaginal or urethro-vaginal fistula formation, late vaginal contracture and discomfort in wearing hard plastic mold for a long time after operation. To solve these problems, the authors modified the conventional McIndoe procedure in several perspectives. The undeveloped vestibule was incised with X-shaped mucosal incision between the urethral opening and posterior margin of the vestibule and deepened by blunt finger dissection to provide a sufficient diameter & length of the neovagina and to minimize bleeding. A sizable medium thickness split skin graft was harvested and wrapped over a roll gauze-filled condom mold. Applying multiple stab incision on the skin grafted condom mold, it was inserted into the prepared neovaginal canal. Distal margin of the skin graft was secured with tips of the mucosal flaps created by X-shaped vestibular incision to prevent accidental extrusion of the skin grafted mold. During last 15 years, we applied this modification to 20 vaginal agenesis patients and investigated results of the 12 patients who could be followed up serially including hematoma formation and skin graft survival rate, size, depth, presence of late contracture, appearance, comfortness, and hygiene of the neovagina. And they were compared with 8 patients of 20 patients who underwent conventional McIndoe procedures. The modified McIndoe procedure revealed lower complication rate, higher patient satisfaction and better functional results.

• The Journal of the Korean dental association
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• v.17 no.8 s.123
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• pp.623-626
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• 1979

The patient, a 20 years old Korean female, have been injuried by thermal burn involving scalp. She was treated bur holes for rapid formation of the granulation tissue of exposed and devitalized bone of skull, over which thin split thickness skin graft performed. With the bald skin graft was covered by a wig, she presented a satisfactory appearance.