• 대한족부족관절학회지
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• 제19권1호
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• pp.39-41
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• 2015

Swelling is a body's natural reaction to foot and ankle injury to mount a healing inflammatory response. To some degree, swelling is necessary for healing and is something that cannot be avoided following injury. However, post-traumatic swelling may have an adverse effect on wound healing and surgery can often be delayed due to preoperative swelling. We report on a unique technique of making multiple meshed stab incisions around the site of injury to reduce soft tissue swelling and promote wound healing.

• Journal of Chest Surgery
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• 제13권1호
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• pp.52-59
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• 1980

Twelve cases of traumatic diaphragmatic injuries were treated at the Chosun University Hospital from Feb. 1977 to Inn. 1980. The following results were obtained. l. Sex ratio incidence was 5:1, which male patients were predominant. 2. The age distribution at these cases, were ranged from 16 to 43 years of age, and average age was 27 years. 3. Left sided traumatic diaphragmatic injuries were far more common than right, which approximately incidence of 5:1 diaphragmatic injuries were due to blunt trauma [7 cases-traffic accident, 1 case-fall down], and stab wound [4 cases] in etiology. 4. Surgical repairs were done through only thoracotomy incision in blunt trauma cases, and through each thoracic and abdominal incision same time in 2 cases of stab wound. 5. 2 cases {16.7%] of blunt trauma were died before operation at emergency room, and no man died during or following operation. An overall mortality was 16.7%.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.773-778
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• 2009

Purpose: The authors propose the new classification of fatty - type gynecomastia(lipomastia) which can serve as a guide for modifying the periareolar technique. Methods: A retrospective analysis was made of 1000 cases of lipomastia operated on in the last 17 months. The extent of the clinical result, the technique employed, and the complications were observed. On the basis of this review the authors observed that at grade I(fat component < 50 ml, fibroglandular component < 3 g each breast), flattening of the thorax can be achieved by means of stab incision, ultrasound - assisted lipectomy(UAL), scavenging suction - assisted lipectomy(SAL) and tissue shaving. At grade II(50 < < 150 ml, 3 < < 5 g), stab incision, UAL, SAL and pull - out method(POM) using small curved scissors. At grade III(150 < < 300 ml, 5 < < 15 g and prominent inframammary fold(IMF)), minimal incision (5 - 6 mm), UAL, SAL and POM using small angulated scissors, and blunting IMF. At grade IV (300 < < 500 ml, 15 < < 30 g, and glandular ptosis), minimal incision (5 - 6 mm), UAL, SAL, fibroglandular excision using small angulated scissors, cutting IMF and fixation of nipple - areola complex(NAC) becomes necessary. At grade V (> 500 ml, > 30 g and ptosis), small incision (7 - 8 mm), UAL, SAL, fibroglandular excision using large angulated scissors, cutting IMF, upper repositioning of NAC and delayed circumareolar skin reduction or chest lifting becomes necessary. Results: The complications were minimal but there were hematoma (n = 7), infection (n = 3) and hypertrophic scar (n =13). Almost patients were satisfied with the outcome. Conclusion: This simple classification may help in choosing the most suitable treatment, thus avoiding insufficient or invasive treatments and undesirable scars.

• Archives of Plastic Surgery
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• 제32권1호
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• pp.124-130
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• 2005

In the microsurgical era, replantation with microvascular anastomosis is considered as the most superior method in aspects of texture, color, shape in case of nose amputation. There are some reported cases of replantation in nose amputation historically, but most of them are composite graft cases rather than microvascular anastomosis. Only a few cases of successful nasal replantation with microvascular anastomosis have been reported due to the reason that the size of vessels is usually very small and identifying suitable vessels for anastomosis is difficult. Microanastomosis of artery and microanastomosis of vein are ideal in replantation, but identifying suitable veins is often difficult. Without venous anastomosis, resolving the venous congestion remains to be a problem. We can carry out arteriovenous shunt if we can find two arteries in amputee. However, the smaller the size of amputee is, the more difficult it is to find two arteries. Instead of arteriovenous shunt, we can try external venous drainage(frequently swab, pin-prick, stab incision, IV or local heparin injection, dropping, apply of heparin-soaked gauze, use of medical leech). Here, we present three cases of replantation with microscopical arterial anastomosis (one angular artery, two dorsal nasal arteries) and external venous drainage (stab incision, application of medical leech and heparin-soaked gauze) even though the size of amputee may be as small as $1.5{\times}1.0cm$. In all cases, surgical outcomes were excellent in cosmetic and functional aspects. This report describes successful replantation by microvasular anastomosis in case that suitable veins are not found.

• 한국임상수의학회지
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• 제29권5호
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• pp.368-371
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• 2012

본 연구는 개흉술을 실시한 11 마리 개에서 수술 후 흉강 내 음압 형성을 위한 흉강 튜브 삽입방법으로 넓은 등근 아래 흉강 튜브 삽입 방법의 효과를 평가하기 위해 실시 하였다. 흉강 튜브 삽입을 위해 수술 창 뒤쪽으로 다섯 번째 늑간 늑골 위 피부와 넓은 등근에 작은 절개창을 형성하였다. 지혈겸자를 장착한 흉강 튜브를 근육 아래 터널을 통과하여 흉강 내로 삽입하였으며 튜브 장착 후 절개창 주위에 매트리스 봉합법을 이용하여 봉합사를 설치하였다. 수술 후 흉강 내 음압을 형성한 다음 흉강 튜브를 제거하였다. 튜브 관련 부작용을 확인 하기 위해 튜브 삽입 시 튜브 꺽임 현상과 수술 후 신체 검사 및 방사선 검사를 통한 기흉, 피하 기종, 호흡곤란 여부를 확인 하였다. 튜브 삽입 시 튜브 꺽임 현상과 수술 후 기흉 및 호흡 곤란 증상이 11 마리 개 모두에서 확인 되지 않았다. 신체 검사에서 튜브 삽입 주위 피하 기종이 한 마리에서 관찰 되었으나 별다른 치료 없이 3일 후에 사라졌음을 확인 할 수 있었다. 음압 형성 후 평균 (${\pm}SD$) 추적 기간은 $19{\pm}10$ 개월 이었다. 결론적으로 넓은 등근 아래 흉강 튜브 삽입 방법은 튜브가 흉강 내 유지 될 때와 튜브 제거 후 남게 되는 터널을 통한 흉강 내 공기 유입 차단에 효과적이며 흉강 튜브 장착 시 우선적으로 고려 되야 할 방법으로 사료 된다.

• Journal of Chest Surgery
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• 제11권4호
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• pp.378-384
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• 1978

Injuries to the major vessels in the thoracic inlet require early recognition and expedient operative approach. Delayed diagnosis difficulties encountered in the operative exposure of the region are the major factors limiting successful management. This report is a review of 13 patients with vascular injuries to the neck base who were managed at Busan National University Hospital from March 1975 to September 1978 about 3 years and 6 months. The important clinical problems are delineated with emphasis on the technical aspects of operative management. 1] Among 13 cases, 8 cases were male 5 cases were female. 2] Of 28 vascular injuries, subclavian axillary vascular injuries were 22 [78%]. Stab wound was the cause in 70% of these patients. 3] Without extension 7 cases[53.8%] were managed successfully with supraclavicular, and axillary incision. Posterolateral thoracotomy one of extending 4 cases, 2 cases were used right musculoskeletal flap for management of proximal part of the subclavian artery and innominate vessel, 2 cases were used left supraclavicular incision with anterolateral thoracotomy for management of left proximal subclavian artery. One Expired. 4] Repair of vascular injury was accomplished by lateral suture of debridement and end-to end anastomosis in 17[74%]. Autogenous vein was used one for interposition graft. Ligation was required 2 arterial, 6 venous injuries. Of 8 cases which were pulseless preoperatively, 5 cases were able to palpable distal pulse. 5] Post operative complications occurred 50%. Complication of vasular repair was rare. The majority was neurologic deficit (33.3%).

• Archives of Plastic Surgery
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• 제32권1호
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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.

• Journal of Chest Surgery
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• 제24권2호
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• pp.197-201
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• 1991

Twenty-three patients with traumatic diaphragmatic injuries treated at the Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center from Aug. 1978 to Nov. 1990 were reviewed. There were 19 male and 4 female patients. The age distribution was ranged from 1.5 to 72 years, with a mean age of 34.3 years. Sixteen patients had blunt trauma[traffic accident 14, fall down 2], and 7 had penetrating injuries[stab wound 6, broken glass 1]. Sixteen [70 percent]of the injuries occurred on the left side and 7[30 percent] on the right side. Fifteen patients were operated on during the acute phase, 5 patients during the latent phase, 2 patients during the obstructive phase. The surgical approach in 20 patients was through a thoracotomy; in 2 patients, a thoracoabdominal incision was necessary, and in 1 patient, a laparotomy was performed. Herniated organs in thorax included stomach[10], colon[5], small bowel[5], spleen[4], liver[2]. Postoperative complications included wound infection, empyema, pneumonia, hepatitis and respiratory failure. There were 3 postoperative deaths, 2 with cerebral dysfunction and 1 with sepsis.

• Journal of Chest Surgery
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• 제20권1호
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• pp.101-105
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• 1987

A clinical evaluation was performed on 17 cases of the cardiac and great vessel injuries above the subclavian vessel at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital from April, 1980 to September, 1986. The results were as follows: 1. Sex distribution were 13 cases in male and 4 cases in female. In age range, second and third decades occupied in about 65% of total cases. 2. Modes of injury were penetrating wound is 14 cases and nonpenetrating wound in 3 cases. The stab wounds by knife were most frequent. 3. Time interval from injury to operation was mean 103 minutes. 4. Surgical approaches were performed with thoracotomy in 9 cases, median sternotomy in 3 cases and direct incision above the wound. 5. Sites of injury were heart in 10 cases and great vessel in 7 cases. The right ventricular injury was most common as 7 cases. 6. Operative procedures were performed with simple closure, vascular graft anastomosis and ligation. There was no postoperative death.

• Korean Journal of Radiology
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• 제20권8호
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• pp.1247-1265
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• 2019

Abdominal aortic aneurysm (AAA) can be defined as an abnormal, progressive dilatation of the abdominal aorta, carrying a substantial risk for fatal aneurysmal rupture. Endovascular aneurysmal repair (EVAR) for AAA is a minimally invasive endovascular procedure that involves the placement of a bifurcated or tubular stent-graft over the AAA to exclude the aneurysm from arterial circulation. In contrast to open surgical repair, EVAR only requires a stab incision, shorter procedure time, and early recovery. Although EVAR seems to be an attractive solution with many advantages for AAA repair, there are detailed requirements and many important aspects should be understood before the procedure. In this comprehensive review, fundamental information regarding AAA and EVAR is presented.