• Title/Summary/Keyword: defect cases

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Clinical Studies of Congenital Atrial Septal Defects - A Case Report - (심방중격 결손증에 대한 임상적 고찰)

  • Jo, Yong-Jun;O, Bong-Seok;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.25 no.4
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    • pp.383-390
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    • 1992
  • From Oct. 1983 to Dec. 1991, 135 cases of atrial septal defect which were operated at the department of Thoracic and Cardiovascualr Surgery, Chonnam National University Hospital, were analysed retrospectively. They were 23.7% of all congenital heart diseases operated in the same period. Among the 135 cases, 62 cases were male and 73 cases were female. Their ages were ranged from 2 to 54 years and the mean was 18 years old. Main symptoms at admission were exertional dyspnea[70.37%], frequent URI[49.12%] and palpitation[32.59%], but 12 cases[8.88%] were asymptomatic. Electrocardiographic findings wer regular sinus rhythm in 96.99%, RVH in 64.66%, incomplete RBBB in 27.06%, complete RBBB in 42.10%, and first degree AV block in 9.02% All 135 cases were operated under the direct vision with cardiopulmonary bypass. Anatomically, most frequent type was fossa ovalis defect with complete septal rim[78.52%]. 117 of 135 ASD patients were repaired with pathch closure[86.66%] and 14 patients were repaired with direct closure[10.37%] and 4 patients in mutiple ASD were repaired with patch and direct closure[2.96%]. Postoperative complications were occured in 21 cases[15.56%], and they were wound infection, pleural effusion, postoperative bleeding, urinary tract infection, and heart failure mainly. One case died due to epidural hematoma and operative mortality was 0.74%.

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Vascular Anatomy of Peroneal Perforator Flap (비골 동맥 천공지 피판의 혈관 해부학)

  • Chung, Duke Whan;Han, Chung Soo;Hwang, Joon Sung
    • Archives of Reconstructive Microsurgery
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    • v.13 no.1
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    • pp.36-42
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    • 2004
  • Materials and Methods: We studied 50 cases of peroneal perforating branch about branching pattern, course, length of vascular pedicle, and perforating level of the perforating cutaneous branches from Oct. 1985 to November 2003 by doppler flow meter and intraoperative findings. Results: 1) The perforating cutaneous branches were classified into four types, the Straight Branch (27cases), the Proximal Oblique Branch (11cases), the Branch from Muscular Artery (10cases), the Distal Oblique Branch(2 cases) respectively. The most common patten was Straight Branch, that was 54%. 2) There were 3 pathways of these branches, the most common one passed between the Soleus and Peroneus muscles(34 cases, 68%) 3) The length of vascular pedicle in Buoy Flap was variable from from 3 cm to 15 cm, but 32 cases(64%) were distributed between 5 cm and 6 cm. 4) The perforating level of branches were 5.9 cm in average from fibular neck to subcutaneous perforator artery 5) Peroneal Buoy Flap in possible to reconstruct both seperated bone and skin defect in some distance by One-Stage Operation and we can harvest maximal $8{\times}16cm$ sized flap in one perforating artery. If we include more two perforating artery, we get more wide flap which can cover large defect.

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Ventricular Septal Defect in Twin -Report of Two Case- (쌍동이에서의 심실중격결손증)

  • 안광필
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.140-142
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    • 1977
  • Total of 52 patients having ventricular septal defect were operated on using extracorporeal circulation in the 8 years period between 1969 and 1977. Of these, the very rare and interesting were the cases of ventricular septal defect seen in twin boys. Their defects were Type II and Type III in each which had been closed with Teflon felt patch in one and with primary suture in the other. Their postoperative courses were uneventful without complications of any.

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Reconstruction of the Limb Using Latissimus Dorsi Free Flap (광배근 유리 피판술을 이용한 사지 재건술)

  • Kim, Joo-Sung;Jung, Jun-Mo;Baek, Goo-Hyun;Chung, Moon-Sang
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.56-62
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    • 1997
  • Latissimus dorsi(LD) muscle is the largest transplantable block of vascularized tissue. Since LD free flap was introduced in 1970's, this flap has been widely used for the reconstruction of large soft tissue defect of the limb. From 1981 to 1996, we had experienced 37 cases of LD free flap. Serratus anterior muscle was combined with LD in three of them whose defects were very large. The average age of the patients was 31 years(range : 4-74 years), and thirty one patients were male. Trauma was cause of the defect in every case. For the recipient sites, the foot and ankle was the most common(22 cases); and the knee and lower leg(11 cases), the elbow and forearm(2 cases), the hand(2 cases) were the next. The duration of follow-up was averaged as 16 months(range: 6 months-12 years). Thirty one cases(84%) out of 37 were successful transplantations. In one case the failure of the flap was due to heart attack and subsequent death of the patient. One failure was caused by sudden violent seizure of the patient who had organic brain damage. Immediate reexploration of the flap was performed in 4 patients, and the flap survived in three of them. There was one necrosis of the grafted split-thickness skin on the survived LD flap. LD free flap was considered as one of the good methods, for the reconstruction of the large soft tissue defect of the limb.

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A Modified Free Thenar Flap with Constant Innervations and Its Clinical Application (일관된 신경 지배를 위한 유리 무지구피판의 수정과 그의 임상 적용)

  • Han, Seung-Kyu;Yang, Jae-Won;Kim, Jin-Soo;Lee, Dong-Chul;Ki, Sae-Hwi;Roh, Si-Young
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.663-668
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    • 2011
  • Purpose: A modified free thenar flap was designed for coverage of volar finger defect with constant innervation using the palmar cutaneous branch of the median nerve. After clinical application of this flap, sensory results were evaluated in 6 cases. Methods: Patients were selected who have volar soft tissue defect with or without fingertip defect. The six cases of the innervated free thenar flap were performed since September 2009, and sensory outcomes were evaluated by the Semmes-Weinstein monofilament and two-point discriminator at four and half month after the surgery. Results: The Semmes-Weinstein Monofilament test revealed 3 cases showed 2.83, 1 case showed 3.61, 1 case showed 4.31 and 1 case showed 4.56. The static two-point discrimination test revealed 1 case showed 4 mm, 1 case showed 6 mm, 2 cases showed 9 mm, and 2 cases showed over 15 mm. The moving two-point discrimination test revealed 1 case showed 3 mm, 1 case showed 4 mm, 1 case showed 5 mm, 1 case showed 7 mm, and 2 cases showed over 15 mm. The donor sites showed no significant limitation of the thumb and neuroma formation. Conclusion: The innervated free thenar flap showed good sensory outcomes as a sensate free flap in a short time after surgery. It can be an option for coverage of volar finger defects that requires sensation.

THE RECONSTRUCTION OF THE MAXILLARY WALL DEFECT USING MICRO-TITANIUM MESH (Micro-titanium mesh를 이용한 상악골 결손부의 재건술에 관한 연구)

  • Kim, Seong-Gon;Choi, You-Sung;Choung, Pill-Hoon;Lee, Hee-Chul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.197-203
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    • 2000
  • Maxillary defect may be induced by trauma, inflammation, cyst, tumor and surgical procedure. In case of limited wall defect, free bone graft has been preferred. But it has some problems such as postoperative bone resorption and soft tissue inclusion to recipient site. And we can not use free bone in the case who has inflammation in the donor site. So we used the micro-titanium mesh as reconstructive material for the maxillary wall defect. We had operated 8 patients who were diagnosed as maxillary partial defects from June 1997 to September 1998 in the Chin-Hae military hospital. They were 1 case of antral wall defect, 1 case of palatal wall defect, 5 cases of infra-orbital wall defects and 1 case of oroantral fistula case. As a result, the micro-titanium mesh has shown the morphological stability and biocompatibility and it could be used in case who has infection. And mesh structure could prevent soft tissue ingrowth to bony defect area. Thus it can be used to the case of maxillary partial defect successfully.

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The Rastelli operation for tetralogy of Fallot (Rastelli 수술법을 이용한 활로씨 4 증후군-치험 4예-)

  • 임승균
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.394-401
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    • 1982
  • Recently, 4 cases underwent successful surgical correction of tetralogy of Fallot combined with pulmonary atresia in 2 cases, with abnormal coronary artery in another 2 cases. The operation consisted of a patch repair to the ventricular septal defect. The pulmonary atresia and stenosis were corrected with the method of external connection, from the right ventricle to the pulmonary artery using the valved conduits.

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Reconstruction of the Lower Extremities with the Large Latissimus Dorsi Myocutaneous Free Flap (넓은 유리 광 배 근피부 판을 이용한 하지 재건술)

  • Lee, Jun-Mo;Huh, Dal-Young
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.80-87
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    • 2000
  • Acute high speed accidents that results in full thickness skin defect and exposure of tendon, nerve, vessel and periosteum over denuded bone demands soft tissue coverage. Exposed bone often ensues chronic infection and requires free flap transplantation which surely covers defects in one stage operation and enhances transport of oxygen-rich blood and converts a non-osteogenic or partially osteogenic site into a highly osteogenic site, but exposed bone which had performed free flap transplantation sometimes necroses and needs secondary bone procedure. Scar contracture limits joint motion should be excised and covered with normal soft tissue to restore normal range of motion. Authors have performed the large latissimus dorsi myocutaneous free flap in 8 cases of extensive soft tissue defect and exposed bone lesion in the leg and 1 case of the flap was failed. The secondary ilizarov bone procedure was performed in 3 of 8 cases. 2 cases of large burn scar contracture and 1 case of posttraumatic scar contracture in lower extremity were restored with the large latissimus dorsi myocutaneous free flap. Authors concluded that large latissimus dorsi myocutaneous free flap is the most acceptable microvascular procedure in large soft tissue defect combined with exposed periosteum and bone requiring secondary bone procedure and in large burn scar contracture limiting knee joint motion.

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Reconstruction of Distal Phalangeal Soft Tissue Defects with Reverse Homodigital Artery Island Flap

  • Kim, Byung-Gook;Han, Soo-Hong;Lee, Ho-Jae;Lee, Soo-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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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.

Combined Rotation and Advancement Flap Reconstruction for a Defect of the Upper Lip: 2 Cases

  • Lee, Jun-Sang;Oh, Suk-Joon;Jung, Sung-Won;Koh, Sung-Hoon
    • Archives of Plastic Surgery
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    • v.39 no.3
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    • pp.244-248
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    • 2012
  • Many types of upper lip reconstruction have been introduced to treat defects after a tumor excision or trauma. The authors treated two cases of upper lip defects. A 35-year-old woman presented with a squamous cell carcinoma of the left upper lip that had invaded the corner of the mouth. After resecting the tumor, the defect was $3.7{\times}3.5cm$ in size. A 52-year-old woman presented with a dog bite of the right upper lip. The defect measured $4.0{\times}2.2cm$ in size. The two cases were reconstructed by combined rotation and advancement of a cheek flap. This technique produced a good functional outcome that allowed for oral competence and created an opening of adequate size. A combination of rotation and an advancement flap can be used to treat upper lip defects in a single-stage procedure. This approach produces a good functional and cosmetic outcome.