• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.124-130
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• 2001

Both of latissimus dorsi and rectus abdominis muscles are workhorse for various reconstructive surgeries. These muscle flaps have been used widely for soft tissue coverage, tissue augmentation, and functional muscle transfer. However, the traditional method for muscle harvest requires a long incision that often results in an unsightly scar and becomes the main concern of the patient. The purpose of this study is to introduce our clinical experience of endoscopic harvest of latissimus dorsi muscle and rectus abdominis muscle, and to make comparison with traditional harvest of these two muscle flaps. Of the 13 rectus abdominis muscles free flaps, 6 muscles were harvested traditionally and 7 muscles were harvested with endoscopic assistance. Of the 21 latissimus dorsi muscle free flaps, 12 muscles were harvested traditionally and 9 muscles were harvested with endoscopic assistence. Follow up period was between 6 months and 24 months. The patients age ranged from 7 to 70 years old. The result revealed no statistically significant differences in the amount of intraoperative bleeding, incidence of postoperative hematoma and seroma, and the incidence of donor-site wound infection. However, patients feel less pain and start earlier and better movement after the operation with endoscopically assisted harvest. This technique is easy to learn, is safe, and can reduce substantially the donor site morbidity comparing traditional harvesting technique.

• 한국추진공학회:학술대회논문집
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• 한국추진공학회 2011년도 제37회 추계학술대회논문집
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• pp.919-921
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• 2011

가변노즐은 다양한 고도에서 비행체의 효율을 향상시키기 위하여 사용된다. 가변노즐이 다수의 플랩으로 구성된 경우에, 플랩의 비동기화된 운동은 추력 방향에 영향을 미친다. 동기화 시험장치는 플랩을 포함하는 가변노즐 메커니즘의 동기화 특성를 검증하기 위하여 개발되었다. 본 시험장치는 노즐 공간 내부의 연소압을 모사할 수 있는 기능을 가지고 있으며, 연소압의 크기 및 분포, 각 노즐구동기의 시간 지연 등이 가변노즐 플랩의 동기화 특성에 미치는 영향을 정량화하기 위하여 사용되었다.

• 대한두경부종양학회지
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• 제7권2호
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• pp.92-98
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• 1991

Numerous mycoutaneous island flaps or free flaps have been used to reconstruct a defect which resulted from the wide resection of tumor mass in head and neck region. Since the curative resection of tumor usually include muscles and bones as well as skin and mucosa, the anatomical and functional restoration of the defect depend on which and what amount of tissues were provided to cover the defect; good aesthetic appearance subsequently follows the result. Furthermore, a simultaneous neck nodes dissection usually results in exposure of major neck vessels., which should be protected with sufficient padding. The ideal method to reconstruct a defect in the head and neck region requires a sufficient coverage by muscle layer with good vascularity, a wide arc of rotation, and minimization of donor site defect. The pectoralis major myocutaneous flap which was first decribed by Ariyan and lateral trapezius myocutaneous flap by Demergasso meet these criteria. We describe the use of these myocutaneous flaps in reconstruction of mandible and oral cavity.

• Archives of Reconstructive Microsurgery
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• 제12권2호
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• pp.112-118
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• 2003

Purpose : Soft tissue defect and exposed tendons and bones with concomitant infection in the foot and lower leg have to be covered with vascularized flap as the one stage treatment. Authors have performed 6 cases of pedicled dorsalis pedis island flaps under the loupes magnification and evaluated the benefits. Materials and methods : From 1994 through 2003, we have performed 6 pedicled dorsalis pedis island flaps for reconstruction of soft tissue defects in the foot and lower leg. The causes were trauma in 3 cases, skin necrosis and secondary infection after Achilles tendon repair in 2 cases and acute osteomyelitis in 1 case. Average age was 38 years and 5 cases were male and 1 female. The results of the procedure was evaluated by survival of the island flap, comfort in putting on shoes and walking, comfort in the donor site, comfort in the recipient site and range of motion of the ankle joint. Results : All pedicled dorsalis pedis island flaps survived except 1. Three cases felt discomfort in the dorsum of foot as the donor site and 1 case of the Achilles tendon ruptured and repaired showed limited dorsiflexion of ankle joint. Conclusion : Nonmicrosurgical pedicled dorsalis pedis island flaps under the loupes magnification are one of the useful treatment methods because procedure is rapid, survival is confident and overall reconstructive results are good.

• Archives of Plastic Surgery
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• 제33권2호
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• pp.263-267
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• 2006

In both cosmetic and functional aspects, loss of digital pulp is a common problem. Compound or composite defects of the hand and fingers with exposed denuded tendon, bone, joint, or neurovascular structures may require flap coverage. Most often these lesions can be repaired by using simple local flap, neurovascular flap, thenar flap, and cross-finger flap. But microvascular reconstruction is sometimes needed for large defects. But Authors do not recommend these procedures in case of severe crushing injuries involving multiple finger pulp losses because they have possibility of damage of the vascular network and infection. So we applied distant flaps such as chest flaps, groin flaps, abdominal flaps and etc. And then we applied surgical rubber gloves for remodeling the flap after cutaneous healing. We have acquired satisfactory results, after the simple molding method for distant flap finger by using surgical rubber gloves treatment.

• Archives of Plastic Surgery
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• 제43권5호
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• pp.461-465
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• 2016

Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects. We report a case of perivulvar EMPD that was reconstructed with three-directional local flaps after wide excision of the tumor. We covered the defect sequentially using the following 3 flaps: a gracilis myocutaneous flap from the left thigh, a bipedicled V-Y advancement flap from the lower abdomen, and an internal pudendal artery perforator-based island flap from the right buttock. To the best of our knowledge, this report is the first to describe a three-directional approach to extensive perivulvar reconstruction.

• Archives of Plastic Surgery
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• 제45권4호
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• pp.375-378
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• 2018

In this report, we present a case of successful treatment of a bowel fistula in the open abdomen by perforator flaps and an aponeurosis plug. A 70-year-old man underwent total gastrectomy and developed anastomotic leakage and dehiscence of the abdominal wound a week later. He was dependent upon extracorporeal membrane oxygenation, continuous hemodiafiltration, and a respirator. Bowel fluids contaminated the open abdomen. Two months after the gastric operation, a plastic surgery team, in consultation with general surgeons, performed perforator flaps on both sides and constructed, as it were, a bridge of skin sealing the orifice of the fistula. The aponeurosis of the external oblique muscle was elevated with the flap to be used as a plug. The perforators of the flaps were identified on preoperative and intraoperative ultrasonography. This modality allowed us to locate the perforators precisely and to evaluate the perforators by assessing their diameters and performing a waveform analysis. The contamination decreased dramatically afterwards. The bare areas were gradually covered by skin grafts. The fistula was closed completely 18 days after the perforator flap. An ultrasound-guided perforator flap with an aponeurosis plug can be an option for patients suffering from an open abdomen with a bowel fistula.

• Archives of Reconstructive Microsurgery
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• 제17권1호
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• pp.14-18
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• 2008

Purpose: Evaluation of results of free flap as a method of reconstruction in soft tissue defect after wide excision of soft tissue tumor of extremity. Materials and Methods: From 2000 through 2007, 11 patients received free flap surgery for soft tissue defect after wide excision operation for soft tissue tumor of limbs. Four cases were upper extremities and seven were lower extremities. Four subjects were diagnosed as squamous cell carcinoma, three as malignant melanoma, two as synovial sarcoma and one as malignant fibrous histiocytoma and alveolar soft part sarcoma. Donor sites of free flap varied with anterolateral thigh flaps in six cases, latissimus dorsi flaps in four, reverse forearm flap in one. By the method of doppler ultrasound, venous circulation was evaluated for the survival of each flap on the third, fifth and seventh day respectively after the operation. Results: 10 of 11 free flaps were successfully survived. Necrosis of free flaps in 1 cases occurred in case of anterolateral thigh flap. Conclusion: Free flap can be a useful method for reconstruction of soft tissue defect after wide excision of soft tissue sarcoma of extremity.

• Archives of Reconstructive Microsurgery
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• 제8권2호
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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.

• Archives of Reconstructive Microsurgery
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• 제17권2호
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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.