• Archives of Plastic Surgery
• /
• v.49 no.1
• /
• pp.61-69
• /
• 2022

Background Single free flaps are a commonly used reconstructive method for multiple soft tissue defects in digits. We analyzed the flap size, division timing, and degree of necrosis in cases with various types of flap division. Methods We conducted a retrospective review of the medical charts of patients who had undergone single free flap reconstruction for multiple soft tissue defects across their digits from 2011 to 2020. The flap types included were the lateral arm free flap, venous forearm free flap, thenar free flap, hypothenar free flap, anterolateral thigh free flap, medial plantar free flap, and second toe pulp free flap. Flap size, anastomosed vessels, division timing, and occurrence of flap necrosis were retrospectively investigated and then analyzed using the t-test. Results In total, 75 patients were included in the analysis. The success rate of the free flaps was 97.3%. All flaps were successfully divided after at least 17 days, with a mean of 47.17 days (range, 17-243 days) for large flaps and 42.81 days (range, 20-130 days) for the medium and small flaps (P=0.596). The mean area of flap necrosis was 2.38% in the large flaps and 2.58% in the medium and small flaps (P=0.935). Severe necrosis of the divided flap developed in two patients who had undergone flap division at week 6 and week 34. Conclusions In cases where blood flow to the flap has been stable for more than 3 weeks, flap division can be safely attempted regardless of the flap size.

• Journal of Korean Clinical Nursing Research
• /
• v.28 no.1
• /
• pp.13-22
• /
• 2022

Purpose: Extravasation of diagnostic and therapeutic materials might occur when the intravascular solution leaks into the surrounding tissues. Injury associated with extravasation depends on various factors. It may range from mild skin reaction to severe necrosis. However, the incidence rate for extravasation is largely unknown because of the limited reporting in Korea. Therefore, this study was conducted to identify the incidence of extravasation and nurses' attitude and knowledge of extravasation for providing high-quality nursing care. Methods: Three acute care hospitals were surveyed to estimate the occurrence of extravasation. Knowledge and attitude toward extravasation were investigated from 793 nurses working in six hospitals. Results: The incidence rate of extravasation was 0.5%. Extravasation commonly occurred in elderly patients aged 66 or older (59.9%) and internal medicine (48.2%), and it happened 13.73±20.68 days after hospitalization on average. It mostly occurred in the forearm site (52.9%) and was mainly caused by parenteral nutrition (33.6%). The mean scores of nurses' knowledge and attitude were 14.63±2.86 and 28.91±36.00, respectively. There was a significant negative correlation between the subjects' knowledge and attitude (r=-.11, p=.002). Conclusion: It is necessary to have a reporting system that can accurately monitor the occurrence of extravasation for patient safety management. In addition, it is necessary to develop a protocol that can be applied to clinical practice and a nurse education program.

• Archives of Plastic Surgery
• /
• v.49 no.2
• /
• pp.184-194
• /
• 2022

The face and the external nose define an individual's physical appearance. Nasal deformities can cause facial disfigurement along with unwanted psychological repercussions. Nasal deformities range in severity, with the most severe cases being indications for a rhinectomy, due to the complexity of the nasal defect. According to published literature, there is no consensus among otolaryngologists and plastic surgeons on which technique or flap use is preferred in terms of complications, aesthetic outcome, or patient satisfaction. The goal of this study is to provide a comprehensive analysis of published studies on nasal reconstruction following rhinectomy. Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines for writing systematic reviews, a systematic review was conducted. Four databases were searched using a search strategy. These articles were then imported into the COVIDENCE software and went screening and thorough article review. After screening 2,237 articles, 23 studies were then extracted for data collection analysis. We collected data from 12 case series, 4 case studies, 1 prospective case series, and 4 retrospective chart review studies. The most commonly reported flaps were forehead flaps, superior extended nasal myocutaneous island, forearm free flaps, anterolateral thigh (ALT) free flap, medial femoral condyle free flap (n = 8), and zygomaticus implants (n = 6), and retained nasal prosthesis. Although not specifically indicated by a certain number, the most common indication for the rhinectomy was malignancy, followed by traumas, postsurgical complications, radionecrosis, and congenital nasal malformations.

• Archives of Plastic Surgery
• /
• v.50 no.3
• /
• pp.264-273
• /
• 2023

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.

• Archives of Plastic Surgery
• /
• v.50 no.4
• /
• pp.415-421
• /
• 2023

The revision of the Korea Organ Transplantation Act (KOTA) in 2018 included hand/arm among the organs that can be transplanted. The first hand transplantation since the revision of KOTA took place in January 2021. A 62-year-old male patient experienced hand amputation on July 13, 2018, by a catapult injury. The patient first visited our institute 3 months after the injury. After serial interviews and an overall evaluation, the patient was registered on the hand transplantation waiting list in January 2020. On January 9, 2021, the patient underwent hand transplantation at the right distal forearm level. The total operation time was 17 hours 15 minutes, and the cold ischemic time was 4 hours 9 minutes. Postoperative immunosuppression was administered based on the protocol used for kidney transplantation. Two acute rejection episodes occurred, on postoperative days 33 and 41. Both rejection episodes were reversible with rescue therapy of a higher tacrolimus trough level, steroid pulse therapy, and topical immunosuppressants. Controlled passive range of motion exercise was started on postoperative day 10. Dynamic splint was applied on postoperative day 18. At 1 year, graft maintenance and functional improvement were satisfactory, and the patient showed a Disabilities of Arm, Shoulder and Hand score of 25.8. We successfully performed the first hand transplantation surgery under the KOTA amendment. It came from the organic and effective cooperation of plastic, orthopaedic, and transplantation departments and we believe it will guarantee the future ongoing success.

• The Korea Journal of Herbology
• /
• v.24 no.1
• /
• pp.133-139
• /
• 2009

Objectives : This study was designed to investigate the effects of alcoholic fermentation extract from ovary and rind of pear on human skin. Methods : We investigated the effects of samples on human skin in terms of clinical trial. 32 of healthy volunteers, who lived in mokpo participated in clinical trial. Effects of sample on hygroscopicity and water-holding capacity were investigated. Sebum, moisture, scabrousness and desquamation were also investigated. Facial massages were conducted 8 times in each volunteers. Results : Single treatment group showed elevated levels of hygroscopicity (Normal : 106.4$\pm$2.1%, vs Pear : 114.1$\pm$6.2) and water-holding capacity (Normal : 87.1$\pm$4.4%, vs Pear : 96.2$\pm$1.3) on forearm of 16 volunteers respectively. In addition, massage group using sample showed elevated moisture (Control : 3.8$\pm$5.8%, vs Sample : 15.2$\pm$4.7%) and lowered scabrousness levels (Control : -12.3$\pm$4.4%, vs Sample : -22.0$\pm$5.2%) significantly. However, the levels of sebum did not affected by sample. Conclusions : These result suggest that alcoholic fermentation extract from ovary and rind of pear has moisturizing effect on human skin.

• Physical Therapy Korea
• /
• v.30 no.1
• /
• pp.41-49
• /
• 2023

Background: Scapular dyskinesis may cause not only rotator cuff (RC) tear but also weakness of the upper extremity, studies on scapular dyskinesis that may occur after RC repair is still lacking. Objects: To determine whether scapular dsykinesis was present in patients after arthroscopic RC repair and to investigate the influence of passive scapular stabilization on upper extremity strength. Methods: A total of 30 patients after RC repair participated in this study. To compare the scapula of the arthroscopic RC repair shoulder and the contralateral shoulder, the winged scapula (WS) was measured using a scapulometer and scapular dyskinesis was also classified by type. Fixed instruments for muscle strength measurements were used to measure upper extremity muscle strength differences depending on passive scapular stabilization position or natural scapular position. A chi-square test, an independent t-test and a 2-way mixed measures analysis of variance (ANOVA) was used as statistical analysis. In analyses, p < 0.05 was deemed to be statistically significant. Results: Postoperative shoulder had a significant association with scapular dyskinesis and the WS compared to the contralateral shoulder (F = 0.052, p < 0.01). Postoperative shoulder, muscle strength in the shoulder abduction (p < 0.01), elbow flexion (p < 0.01) and forearm supination (p < 0.05) were significantly greater in the scapular stabilization position than in the scapular natural position. Conclusion: Patients underwent arthroscopic RC repair had a significant association with scapular dyskinesis and muscle strength was improved by a passive scapular stabilization position, therefore scapular stabilization is important in rehabilitation program.

• PNF and Movement
• /
• v.21 no.1
• /
• pp.47-52
• /
• 2023

Purpose: This study aims to examine the functional difference in the long and short heads of the biceps brachii by investigating the onset time of muscle contractions in the biceps brachii in the supination motion according to whether the flexor of the elbow joint is excluded. Methods: This study was conducted with 21 healthy men aged in their 20s. While performing forearm pronation at an elbow flexion angle of 90 degrees, the onset time of muscle contractions in the long and short heads of the biceps brachii was measured and compared in a posture where the humerus is placed on a table and the posture is lifted against gravity. Using an independent samples t-test, the difference in the onset time of muscle contractions in the long and short heads of the biceps brachii was analyzed. Results: The onset time of the long head was shorter if the flexor activity of the elbow joint was excluded, while that of the short head of the biceps brachii was shorter if it was not excluded. Conclusion: It is noted that the long head of the biceps brachii mainly functions as a supinator muscle, while the short head of the biceps brachii plays a role in stabilizing and maintaining flexion of the elbow joint.

• Physical Therapy Rehabilitation Science
• /
• v.11 no.4
• /
• pp.400-408
• /
• 2022

Objective: The purpose of this study is to compare EMG activity during horticulture motion and upper limb rehabilitation motion, to confirm whether horticulture motion is suitable for upper extremity rehabilitation of hemiparesis. Design: Three-group cross-sectional design. Methods: The 45 subjects were divided into three groups: hemiparesis (n=15), elderly (n=15) and healthy (n=15). We have recorded EMG signals of six upper limb muscles Upper trapezius (UT), Middle deltoid (MD), Anterior deltoid (AD), Biceps brachii (BB), Triceps brachii (TB), Brachioradialis (BR) during horticultural motions and three upper limb rehabilitative motions. The dependent variables were peak EMG, integral EMG, co-contraction ratio. A two-way repeated measures ANOVA was used to compare the horticultural motion and rehabilitation motion of the three groups. Results: The peak EMG was significantly different in MD, AD, BB, TB according to the motion(p<0.05), and the UT, BB were significant differences according to the group(p<0.05). The integral EMG was significantly different in MD, AD, BB, TB, BR according to the motion(p<0.05), and the BB were significant differences according to the group(p<0.05). The co-contraction ratio was significantly different in TB/BB according of the motion, and there was no difference between the groups. Conclusions: As a result of this study, horticultural motion alone was insufficient for upper arm rehabilitation, and horticultural motion alone was insufficient to induce continuous activity of the forearm.

• The Journal of the Convergence on Culture Technology
• /
• v.8 no.3
• /
• pp.507-514
• /
• 2022

This study is to compare and analyze the evaluation of cleaning cleanliness and usability according to the muscle activity and cleaning method in the wrist rotation motion when using a bottle washer for women with childbirth experience. To this end, when using an automatic bottle washer and a manual bottle washer, the muscle activity and cleaning cleanliness of the forearm muscles were quantitatively evaluated using equipment, and the effects of variables were analyzed and the following conclusions were obtained. First, it was found that the muscle activity was lower than that of the automatic baby bottle cleaner when using a manual bottle cleaner. Second, the cleanliness was judged to be the best in automatic washing (forward + reverse direction), followed by automatic washing (forward direction) and manual washing. Third, the usability evaluation of the use of the baby bottle washing machine showed higher satisfaction than that of the automatic baby bottle washing machine. Through these conclusions, this study can be used as basic data for product advancement in the future by proving the effectiveness of using an automatic bottle washer.