• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.174-177
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• 2013

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a disease characterized by jaw necrosis and delayed wound healing in patients who had received bisphosphonates. Buccal fat pad (BFP) can be used as a pedicled flap in the posterior region of the oral cavity. BFP pedicle flap needs simple surgical technique and it shows less donor site morbidity and aesthetic problem than other vascularized flap. BFP pedicled flap was fed by 3 arteries-facial, internal maxillary, and transverse facial artery. Osteomyelitis was generally related with poor blood supply. Thus, rich blood supply of BFP pedicle flap can have a potential advantage to BRONJ patients. In this case report, we presented 3 BRONJ patients treated by BFP pedicle flap after sequestrectomy.

• Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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• 2013.04a
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• pp.347-352
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• 2013

Seoul National University Flap (SNUF) blade is a small-scaled rotor blade incorporating a small trailing-edge flap control surface driven by piezoelectric actuators at higher harmonics for vibration attenuation. Initially, the blade was designed using two-dimensional cross-section analysis and a geometrically exact one-dimensional beam analysis, and material configuration was finalized. Flap deflection angle of ${\pm}45^{\circ}$ was established as the criterion for better vibration reduction performance based on an earlier simulation. Flap linkage mechanism design is carried out and static bench tests are conducted to verify the flap actuation mechanism performance. Different versions of test beds are developed and tested with the flap and chosen APA 200M piezoelectric actuators. Through significant improvements, a maximum deflection of ${\pm}3.7^{\circ}$ was achieved. High frequency experiments are conducted to evaluate the performance and transfer function of the test bed is determined experimentally. As the static tests are almost completed, rotor power required for testing the blade in whirl tower (centrifugal environment) is calculated and further preparations are under way.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.257-260
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• 2012

This report describes the use of a tubularized random flap for the curative treatment of recurrent anterior urethral stricture. Under the condition of pendulous lithotomy and suprapubic cystostomy, the urethral stricture was removed via a midline ventral penile incision followed by elevation of the flap and insertion of an 18-Fr catheter. Subcutaneous buried interrupted sutures were used to reapproximate the waterproof tubularized neourethra and to coapt with the neourethra and each stump of the urethra, first proximally and then distally. The defect of the penile shaft was covered by advancement of the surrounding scrotal flap. The indwelling catheter was maintained for 21 days. A 9 month postoperative cystoscopy showed no flap necrosis, no mechanical stricture, and no hair growth on the lumen of the neourethra. The patient showed no voiding discomfort 6 months after the operation. The advantages of this procedure are the lack of need for microsurgery, shortening of admission, the use of only spinal anesthesia (no general anesthesia), and a relatively short operative time. The tubularized unilateral penile fasciocutaneous flap should be considered an option for initial flap urethroplasty as a curative technique.

• Archives of Reconstructive Microsurgery
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• v.8 no.2
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• pp.184-191
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• 1999

Reconstruction of soft tissue defect of the foot, ankle and distal tibial area has been and remains a challenging problem for reconstructive surgeons. We treated 19 patients who showed soft tissue defect in these area with distally based superficial sural artery flaps, including four adipofascial flaps, two sensate flaps. The size of the soft tissue defect was from $4{\times}5cm\;to\;8{\times}10cm$. In nine cases, we preserved sural nerve. Seventeen flaps survived completely, but one flap failed and another flap showed partial skin necrosis at the distal half. In failed cases, lesser saphenous vein was ruptured at initial injury. The advantage of this flap is a constant and reliable blood supply without sacrifice of major artery or sensory nerve. Elevation of the flap is technically easy and quick. The pedicle is long and the island flap can be transffered as far as to the instep area. It also has the potential for sensate flap, innervated by the lateral sural cutaneous nerve. But for appropriate venous drainage small saphenous vein must be preserved.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.226-231
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• 1999

Objectives: Visor flap is one of the useful surgical approach to the oral cavity cancer, but the report on its specific indications, advantages and disadvantages is lacking. Material and Methods: Seven patients treated with visor flap for oral cavity and oropharyngeal cancer were reviewed. Result: Visor flap provided excellent visual field to anterior oral cavity without splitting the lip and chin skin. Postoperative cosmesis was satisfactory. One complication associating with this flap was salivary leak through gingivo-labial and gingivo-buccal suture which was successfully repaired. Conclusion: Visor flap is an excellent approach on extirpation of the oral cavity and oropharyngeal cancer in case of combining with segmental mandibulectomy. Especially it was useful for the approach to the anterior floor of the mouth and oral tongue lesion. But, it has no actual advantage over the other approaches in cases without mandibulectomy.

• Archives of Reconstructive Microsurgery
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• v.13 no.1
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• pp.68-73
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• 2004

Transverse rectus abdominis muscle (TRAM) free flap is widely used for breast reconstruction, however donor-site morbidities such as abdominal wall weakness, hernia, bulging are troublesome. For the purpose of minimizing donor-site morbidity, there has been a surge in interests in muscle sparing free TRAM flap preserving the anatomy of rectus abdominis muscle, fascia, and motor nerve. The purpose of this study is to investigate complication and morbidity after muscle sparing free TRAM flap. Between August, 1995 and May, 2003, there were 108 cases of muscle sparing free TRAM flap of breast reconstruction. There was no abdominal hernia. There were 4 cases of dog ear, 3 cases of marginal necrosis of apron flap, 2 cases of asymmetry of umbilicus. At 1 year after operation, most patients feel comfortness in physical exercise. Muscle sparing free TRAM flap provides ample amount of well vascularized soft tissue with small inclusion of rectus abdominis muscle and fascia. Also it minimizes donor-site morbidity with rapid recovery of abdominal strength.

• Archives of Reconstructive Microsurgery
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• v.17 no.2
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• pp.61-67
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• 2008

Introduction: The purpose of this study is to evaluate the necessity of distant pedicled flap in the treatment of soft tissue defects in the hand. Materials and Methods: Distant pedicled flap was performed in the 25 hands of 25 patients from 2000 to 2004. There were 20 males and 5 females and mean age was 34 years. The surgery was done for electrical burns in 13 patients, flame burns in 8 patients and crushing injuies in 4 patients. Results: We have performed 25 distant pedicled flaps for the coverage of soft tissue defects in the hands when local and free flaps were unavailable. Soft tissue coverages by distant pedicled flap were completely successful in all the 25 hands. No complication such as total flap loss, marginal flap loss and infection occurred. Conclusion: Distant pedicled flaps were very useful alternative method in the treatment of soft tissue defect in the hand.

• Archives of Reconstructive Microsurgery
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• v.22 no.1
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• pp.38-41
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• 2013

A 31-year-old female patient presented with a skin and soft tissue defect measuring $8{\times}6cm$ in size with exposure of the extensor hallucis longus tendon and the first metatarsal bone after metatarsal lengthening for brachymetatarsia. The defect was covered with a distally based dorsalis pedis flap based on the distal communicating branch of the dorsalis pedis artery. Secondary defect was covered by a split thickness skin graft. There was congestion of the flap tip after the operation; however, it was resolved using medical leeches and anti-coagulants. No necrosis or infection was encountered and the contour of the flap was satisfactory. There was no donor site morbidity. Reverse dorsalis pedis flap has not been commonly used due to the anatomical variation and uncertainty, which is different from the reverse radial forearm flap. However, when faced with the challenge of a moderate soft tissue defect of the distal forefoot, we believe that the reverse dorsalis pedis flap offers a good option with various advantages.

• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.186-190
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• 2017

We report a case of free flap deterioration which may have been induced by pressure gradient resulting from cranial defect overlying a ventriculoperitoneal shunt (VP shunt). The patient, male and aged 78, had a VP shunt operation for progressive hydrocephalus. Afterwards, the scalp skin flap surrounding the VP shunt collapsed and showed signs of necrosis, exposing part of the shunt catheter. After covering the defect with a radial forearm free flap, the free flap site showed signs of gradual sinking while the vascularity of the flap remained unimpaired. An agreement was reached to remove the shunt device and observe the patient for any neurological symptoms, and after the shunt was removed and the previous cranial opening filled with fibrin glue by Neurosurgery, we debrided the deteriorated flap and provided coverage with 2 large opposing rotational flaps. During 2 months' outpatient follow-up no neurological symptoms appeared, and the new scalp flap displayed slight depression but remained intact. The patient has declined from any further follow-up since.

• Korean Journal of Cleft Lip And Palate
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• v.13 no.2
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• pp.77-84
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• 2010

Vomer flap is used to repair anterior hard palate in complete cleft lip and palate patients. As the midline structure located in between the two cleft segments of hard palate, the vomer flap is very useful because of its vicinity to cleft site and their ease of execution when it is done with primary cheiloplasty simultaneously. In addition, the quality of tissue is very similar to that of the nasal mucosa with good vascularity. In cases of simultaneous repair of cleft lip with anterior palate using vomer flap, the hard palate can be repaired at the same time with primary cheiloplasty which is earlier period than other techniques. With simultaneous close of cleft lip and cleft hard palate by vomer flap, subsequent palatoplasty does not require wide dissection, and consequently chance of oronasal fistula formation will be minimized. Additionally, surgical time will be reduced and, the harmful effects on mid-facial growth will be diminished. In this article, we will introduce the comprehensive vomer flap technique with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with vomer flap.