• Archives of Plastic Surgery
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• 제35권2호
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• pp.169-173
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• 2008

Purpose: Sacrococcygeal pilonidal sinus is a chronic inflammatory disease that mostly affects young people, which warrants surgical intervention. Although many surgical methods have been suggested, an optimal surgical method remains controversial because of high recurrence rates and postoperative complications. The objective of this study is to evaluate the results of wide excision and coverage with fasciocutaneous advancement flap for the treatment of sacrococcygeal pilonidal sinus, and to assess the usefulness of this method Methods: From May 1995 to October 2006, the authors treated 19 patients with the use of coverage with fasciocutaneous flap after wide excision. The results were evaluated regarding recurrence rates, complications, and the change in sensitivity of the gluteal region after surgery. The follow-up period was 7 to 142 months (mean, 76 months). All patients were male. Results: Postoperative complications were wound infection at the suction drain insertion site and skin necrosis around the suture margin in one case, respectively. During the follow up period, only one recurrence (5.3%) was seen in fifth postoperative month, which was successfully treated by the same operative procedure. There was no other complications such as seroma, hematoma, wound dehiscence and flap loss. Extensive scarring and anatomic distortion did not occur in the reconstructed area. In addition, sensitivity of the gluteal region did not diminish. The aesthetic results were satisfactory for all patients as well. Conclusion: The authors advocate that fasciocutaneous flap closure be a good alternative method to cover defects after the excision of sacrococcygeal pilonidal sinus.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.516-522
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• 2017

Background Implant-based breast reconstruction is being performed more frequently, and implants are associated with an increased risk of infection. We reviewed the clinical features of cases of implant infection and investigated the risk factors for breast device salvage failure. Methods We retrospectively analyzed 771 patients who underwent implant-based breast reconstruction between January 2010 and December 2016. Age, body mass index, chemotherapy history, radiation exposure, and smoking history were assessed as potential risk factors for postoperative infection. We also evaluated the presence and onset of infection symptoms, wound culture pathogens, and other complications, including seroma, hematoma, and mastectomy skin necrosis. Additionally, we examined the mastectomy type, the use of acellular dermal matrix, the presence of an underlying disease such as hypertension or diabetes, and axillary node dissection. Results The total infection rate was 4.99% (58 of 1,163 cases) and the total salvage rate was 58.6% (34 of 58). The postoperative duration to closed suction drain removal was significantly different between the cellulitis and implant removal groups. Staphylococcus aureus infection was most frequently found, with methicillin resistance in 37.5% of the cases of explantation. Explantation after infection was performed more often in patients who had undergone 2-stage expander/implant reconstruction than in those who had undergone direct-to-implant reconstruction. Conclusions Preventing infection is essential in implant-based breast reconstruction. The high salvage rate argues against early implant removal. However, when infection is due to methicillin-resistant S. aureus and the patient's clinical symptoms do not improve, surgeons should consider implant removal.

• 토지주택연구
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• 제2권2호
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• pp.163-170
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• 2011

개별진공압공법은 지반에 타설된 연직배수재에 진공압을 직접 가하여 간극수를 배출하여 일정한 전응력 상태에서 유효응력이 증가함에 따라 압밀을 촉진 시키는 공법이다. 연약지반 개량에 일반적으로 사용되는 공법인 성토재하공법(preloading)과는 다르게 성토하중이 필요로 하지 않기 때문에 성토재료의 확보 문제와 지반의 국부적인 전단파괴에 대해 이점을 가지고 있다. 또한 기존의 진공압밀 공법에서의 문제점인 펌프효율의 감소, 고가의 기밀시트에 소요되는 비용, 그리고 기밀시트의 잦은 파손의 문제 등을 직접적으로 배수재에 진공압을 가함으로서 개선시킨 공법이다. 그러나 개별진 공압공법은 직접 고압의 진공압을 직접 배수재에 가함으로써 배수재 주변의 투수계수가 감소하며 경화되는 영역(hardening zone)과 필터재료의 막힘현상(clogging)에 의해서 간극수의 배출이 줄어들게 되어 지반개량의 효율이 크게 감소하게 된다. 따라서 본 연구에서는 높은 지반개량 효과를 얻을 수 있는 진공압의 적용기간을 찾기 위해서 단계진공압(-20, -40, -60, -80KPa) 적용기간을 각각 다르게 적용하였다. 실험을 진행하는 동안 각 조건에 따라 개량 시간에 따른 침하량을 측정하였으며, 실험 종료 후 최종침하량, 함수비, 콘저항치를 측정하였다. 파악된 데이터를 비교/분석하여 개별진공압공법에 적합한 단계진공압 적용기간을 도출한 후 수치해석을 실시하여 제안된 단계진공압 적용에 따른 침하량을 예측하였다.