• Archives of Reconstructive Microsurgery
• /
• v.8 no.2
• /
• pp.115-119
• /
• 1999

In breast reconstruction with a free flap following mastectomy, the recipient vessels most widely used are in the axillary system, which limits flap movement and flexibility in breast shaping. In addition, scarring and fibrosis can make dissection of the vessels difficult. We have performed 43 breast reconstructions using a free transverse rectus abdominis myocutaneous(TRAM) flap. In 10 cases out of 20 delayed reconstruction, we anastomosed to the internal mammary vessels rather than subscapular system. There has been no flap failure. The surgical techniques, advantages and limitations of the internal mammary system are presented. The internal mammary vessel are compared with the axillary vessels as a recipient vascular system.

• Archives of Reconstructive Microsurgery
• /
• v.8 no.2
• /
• pp.149-153
• /
• 1999

Purpose : To investigate the complication of donor site in latissimus dorsi muscle flap. Materials and Methods : From April 1983 to March 1999, forty patients with latissimus dorsi muscle flap for reconstruction of extremity and with a follow-up period of more than 12 months were included. We analysed the complication, shoulder function, degree of shoulder muscle weakness, skin scar width after operation. Results After 1 year, skin scar widening in 12 cases(30%), limitation of shoulder motion in 9 cases(12.5%), muscle weakness in 14 cases(17.5%) were found. Conclusion. The rate of complication at donor site after latissimus dorsi flap operation is around 10%. To minimize the complication, avoiding axillary skin incision, minimal invasive harvesting by endoscopy, meticulous suturing of subcutaneous layer are needed.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1987.05a
• /
• pp.19.2-19
• /
• 1987

방사선치료후 재발성 또는 잔존성 두경부암의 수술후에 피부판의 괴사 및 slough, 감염, 누공, 부종과 경동맥 노출 심지어는 경동맥 파열 등의 술후 합병증이 빈발함으로 수술에 큰 어려움을 겪게 된다. Pectoralis major myocutaneous flap은 진행된 두경부암의 광범위한 절제후에 그 결손부를 보충해 주는 데 좋은 방법으로 사용할 수 있을 뿐아니라 방사선치료후에 생긴 합병증에도 이 flap을 이용하여 좋은 치료결과를 얻을 수 있다. 저자들은 수술 전에 방사선치료를 받고 심한 부종으로 후두조직의 괴사 및 기능이 손실된 환자와 방사선 치료후 재발된 상인두암환자의 경우에서 수술 후 생긴 pharyngocutaneous fistula와 피부판감염 및 경동맥노출 등으로 치유가 곤란하여 여기에 pectoralis major myocutaneous flap을 사용하여 pharyngostoma를 재건하고 노출된 경동맥부위를 보호하여 좋은 치료효과를 얻었기에 문헌을 고찰하여 보고하는 바이다.

• Journal of Aerospace System Engineering
• /
• v.4 no.4
• /
• pp.11-17
• /
• 2010

In this paper we make an flap actuator by using shape memory effects of SMA spring. We studied that the force and stroke what we need to design and the flap mechanism. The force and stroke was estimated through the analysis program which like a catia, matlab etc. We could design and make flap actuator. So The actuator which used SMA spring can apply to small aircraft.

• Archives of Craniofacial Surgery
• /
• v.15 no.3
• /
• pp.121-124
• /
• 2014

The use of the implantable Doppler device eases the burden of free flap monitoring, and allows caregivers to notify healthcare personnel of a potential vascular event. A 24-year-old female patient underwent anterolateral thigh adipofascial flap surgery to provide a buried flap on the left temporal area for a depressed and infected skull wound. The author was able to salvage the flap from two venous occlusions, which was made possible by early notifications from the caregiver who reported changes in the Doppler signal.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.39
• /
• pp.5.1-5.9
• /
• 2017

Many congenital and acquired defects occur in the maxillofacial area. The buccal fat pad flap (BFP) is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects. In this article, we have reviewed BFP and the associated anatomical background, surgical techniques, and clinical applications. The surgical procedure is simple and has shown a high success rate in various clinical applications (approximately 90%), including the closure of oroantral fistula, correction of congenital defect, treatment of jaw bone necrosis, and reconstruction of tumor defects. The control of etiologic factors, size of defect, anatomical location of defect, and general condition of patient could influence the prognosis after grafting. In conclusion, BFP is a reliable flap that can be applied to various clinical situations.

• Journal of International Society for Simulation Surgery
• /
• v.3 no.1
• /
• pp.12-15
• /
• 2016

Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.

• Korean Journal of Bronchoesophagology
• /
• v.3 no.2
• /
• pp.253-260
• /
• 1997

Successful regeneration of a cartilage framework using perichondrium has been reported by several authors but there are some arguments surrounding mucosal regeneration. Some authors report that regeneration of mucosa is completed by ingrowth from neighboring tissue but others insist that it occurs via metaplasia from the squamous epithelium. This study was designed to investigate the differences, especially in mucosal regeneration between nonvascularized and vascularized flaps via immunohistochemical study. A morphologic study was carried out to elucidate the characteristics o( the regenerated mucosa which was sutured on the vascularized perichondrium and fabricated in a rabbit ear. A nonvascularized perichondrial-mucosal composite flap with the same dimension was transferred in the control group. BrdU was labelled on both normal mucosa and grafted mucosa in the experimental group without my statistically significant differences. In cytokeratin stain, it was regarded that mucosal coverage of the control group occurred by ingrowth from the neighboring mucosa. It can be conceived that metaplasia of the grafted mucosa occurs in a vascularized composite flap transferred group.

• Archives of Plastic Surgery
• /
• v.46 no.1
• /
• pp.84-87
• /
• 2019

With the recent development in microsurgery, the use of a perforator flap has been widely implemented. If the length of the ALT flap pedicle is insufficient despite adequate preoperative planning, pedicle length extension is necessary. We planned for a reverse ALT free flap using the distal vessel of the descending branch for pedicle length extension in the case of ALT perforator branch originating from the proximal portion of the descending branch. For the management of venous congestion, the distal venae comitantes were anastomosed to the proximal venous stump in an antegrade manner, successfully resolving the venous congestion. Modified reverse-flow ALT free flap, wherein the venae comitantes are anastomosed to the proximal vein stump, is a good option that allows for relatively simple pedicle extension within the same operative field when securing an adequate pedicle length is difficult because of the origin of the perforator from the proximal descending branch, unlike the initial surgical plan.

• Journal of the Korean Burn Society
• /
• v.24 no.2
• /
• pp.53-59
• /
• 2021

High-voltage electrical burn injuries on the scalp often result in scalp and cranial bone necrosis. Repetitive debridements and rich-vascularized flap coverage of the cranium are required. However, despite successful flap coverage, chronic osteomyelitis of cranial bones may occur. Treatment of chronic osteomyelitis of cranial bones is surgical debridement of the necrotic bone with re-coverage by a well-vascularized flap. The latissimus dorsi musculocutaneous flap is suitable not only for coverage of the cranium after the burn injury, but also for treatment of chronic osteomyelitis of the skull.