• Title/Summary/Keyword: primary closure

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Soft-tissue management for primary closure in immediate implant placement (즉시 식립 임플란트의 일차폐쇄를 위한 연조직 처치)

  • Kim, Kang-Woo;Lee, Jae-Kwan;Um, Heung-Sik;Chang, Beom-Seok
    • Journal of Periodontal and Implant Science
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    • v.38 no.2
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    • pp.253-262
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    • 2008
  • Background: Incomplete flap coverage or early exposure over implants and/or barrier membranes have a negative effect on bone regeneration. In cases of using regenerative techniques, complete soft tissue coverage of the implant area is necessary to promote adequate conditions for guided bone regeneration. Primary socket closure may be difficult, when periosteal releasing incision is only used, due to the opening left by extracted tooth. Therefore, Soft tissue grafting techniques are used to achieve primary soft tissue closure. Materials and Methods: Soft tissue grafting techniques, with or without barrier membranes, were performed for primary closure in four cases of immediate placements. Three different methods were used (CTG, VIP-CT, Palatal advanced flap). Clinical results of the grafting were evaluated. Result: One case showed early exposure of cover-screw and, no other complications were noted. In the others, Primary closure was achieved by soft tissue grafting techniques. One of the cases, Graft showed partial necrosis, but there were no exposure over implants and/or barrier membranes. Conclusion: The use of grafting techniques, in immediate implant placement, can predictably obtain primary closure of extraction sockets, thereby providing predictable bone formation and improved implant results.

Delayed Sternal Closure After Heart Surgery in Neonate (신생아 개심술후 지연 흉골봉합)

  • 성시찬
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.977-982
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    • 1995
  • Early repair of complex congenital heart malformation may lead to life-threatening respiratory and hemodynamic embarrassment on sternal closure. We performed delayed sternal closure in nine neonates to avoid a fatal outcome in these situations. Primary elective open sternum was used in 8 [66.7% and primary sternal closure in 4 [33.3% of the 12 patients studied. one patient with primary sternal closure underwent delayed sternal reopening in the intensive care unit. Of the 9 patients with open sternum, 2 patients died of low cardiac output and acute renal failure respectively before delayed sternal closure. 7 patients could undergo delayed sternal closures 3 days after initial operation. The mean age at open cardiac procedure was 14.3 days [range 3 to 30 and mean preoperative weight was 3.4kg [range 2.8 to 4.1 . The aortic cross-clamping time was longer in the group with open sternum than the group with closed sternum [p=0.042 . There was no morbidity and mortality related to delayed sternal closure. Given the low morbidity and potential benifits, this technique should be used in neonates after open heart procedures when postoperative mediastinal compression produces frank low cardiac output or respiratoy compromise during a trial of sternal closure.

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Squamous cell carcinoma of lower lip: the results of wide V-shaped resection

  • Sung Bin Youn;Hoon Myoung;Ik-Jae Kwon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.5
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    • pp.292-296
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    • 2023
  • Generally, if the size of a lip cancer defect exceeds 30% of the lower lip, a local flap or free flap is recommended. However, defects up to 50% of the lower lip in size have been reconstructed successfully by primary closure without a local flap or free flap. In one case, an 80-year-old male farmer who had smoked for more than 50 years presented with squamous cell carcinoma of the lower lip and underwent mass resection and supraomohyoid neck dissection. The defect accounted for almost 2/3 of the lower lip and was repaired by primary closure with V-shaped resection. Biopsy results confirmed pT2N0cM0 stage II disease with clear margins. In another case, a 68-year-old male also presented with squamous cell carcinoma of the lower lip and underwent mass resection. The defect accounted for about half the size of the lower lip but was repaired by primary closure with V-shaped resection. Both patients experienced no discomfort while eating or speaking and were satisfied with the cosmetic and functional outcomes with no evidence of recurrence. Thus, direct closure can be considered even in large lower lip cancers.

The use of granulation tissue for the esthetic implant restoration for missing tooth due to alveolar bone loss (치조골 소실로 발치하게 된 치아의 심미적인 임플란트 수복을 위한 granulation tissue의 활용)

  • Lee, Chang Kyun
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.1
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    • pp.33-39
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    • 2021
  • When maxillary anterior tooth is extracted due to alveolar bone loss, the augmentation of alveolar ridge is very important for esthetic implant restoration. Because alveolar bone loss increases after extraction, the ridge preservation performed right after tooth extraction is meaningful for esthetic implant restoration. However, no achievement of primary closure during ridge preservation can negatively affect bone regeneration. To overcome this problem, we can use granulation tissue in the extraction socket for primary closure. This case report confirmed that primary closure using granulation tissue resulted in not only ridge preservation but also ridge augmentation by providing an environment more advantageous of bone regeneration than the open wound.

Myringoplasty Outcomes From a 5-Year Single Surgeon's Experience and Important Surgical Technical Aspects

  • Karunaratne, Dilhara;Violaris, Nick
    • Journal of Audiology & Otology
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    • v.25 no.4
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    • pp.224-229
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    • 2021
  • Background and Objectives: The United Kingdom (UK) national standard for the closure rate for myringoplasty is 89.5% (90.6% and 84.2% for primary and revision surgeries, respectively). The average hearing gains for primary and revision myringoplasty are 9.14 dB and 7.86 dB, respectively. This study compared the myringoplasty outcomes for a single surgeon over 5 years. Subjects and Methods: Data for 68 cases were analyzed retrospectively. The outcome measures were achievement of the tympanic membrane closure and the average hearing gain or loss. Results: The overall and primary closure rates were 97% and 98%, respectively and significantly higher than the UK national standard (p=0.0210 and p=0.0287, respectively). The revision closure rate was 93%; however, it was not significantly higher than the national standard (p=0.1872). The average hearing gain was 5.18 dB. The gains for primary and revision surgeries were 5.15 dB and 5.25 dB, respectively. Conclusions: We propose that these outcomes are a result of our surgical technique, including the simultaneous use of cortical mastoidectomy in ears with discharge.

Myringoplasty Outcomes From a 5-Year Single Surgeon's Experience and Important Surgical Technical Aspects

  • Karunaratne, Dilhara;Violaris, Nick
    • Korean Journal of Audiology
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    • v.25 no.4
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    • pp.224-229
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    • 2021
  • Background and Objectives: The United Kingdom (UK) national standard for the closure rate for myringoplasty is 89.5% (90.6% and 84.2% for primary and revision surgeries, respectively). The average hearing gains for primary and revision myringoplasty are 9.14 dB and 7.86 dB, respectively. This study compared the myringoplasty outcomes for a single surgeon over 5 years. Subjects and Methods: Data for 68 cases were analyzed retrospectively. The outcome measures were achievement of the tympanic membrane closure and the average hearing gain or loss. Results: The overall and primary closure rates were 97% and 98%, respectively and significantly higher than the UK national standard (p=0.0210 and p=0.0287, respectively). The revision closure rate was 93%; however, it was not significantly higher than the national standard (p=0.1872). The average hearing gain was 5.18 dB. The gains for primary and revision surgeries were 5.15 dB and 5.25 dB, respectively. Conclusions: We propose that these outcomes are a result of our surgical technique, including the simultaneous use of cortical mastoidectomy in ears with discharge.

Reconstruction Techniques for Tissue Defects Formed after Preauricular Sinus Excision

  • Lee, Myung Joon;Yang, Ho Jik;Kim, Jong Hwan
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.45-49
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    • 2014
  • Background Preauricular sinuses are congenital abnormalities caused by a failure of fusion of the primitive tubercles from which the pinna is formed. When persistent or recurring inflammation occurs, surgical excision of the infected tissue should be considered. Preauricular defects inevitably occur as a result of excisions and are often difficult to resolve with a simple suture; a more effective reconstruction technique is required for treating these defects. Methods After total excision of a preauricular sinus, the defect was closed by a plastic surgeon. Based on the depth of the defect and the degree of tension when apposing the wound margins, the surgeon determined whether to use primary closure or a posterior auricular flap. Results A total of 28 cases were examined. In 5 cases, including 2 reoperations for dehiscence after primary repair, reconstruction was performed using posterior auricular transposition flaps. In 16 cases of primary closure, the defects were closed using simple sutures, and in 7 cases, closure was performed after wide undermining. Conclusions If a preauricular defect is limited to the subcutaneous layer and the margins can be easily approximated, primary closure by only simple suturing may be used to perform the repair. If the defect is deep enough to expose the perichondrium or if there is tension when apposing the wound margins, wide undermining should be performed before primary closure. If the extent of the excision exposes cartilage, the procedure follows dehiscence of the primary repair, or the tissue is not sufficiently healthy, the surgeon should use a posterior auricular flap.

Comparison of alveolar ridge preservation methods using three-dimensional micro-computed tomographic analysis and two-dimensional histometric evaluation

  • Park, Young-Seok;Kim, Sungtae;Oh, Seung-Hee;Park, Hee-Jung;Lee, Sophia;Kim, Tae-Il;Lee, Young-Kyu;Heo, Min-Suk
    • Imaging Science in Dentistry
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    • v.44 no.2
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    • pp.143-148
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    • 2014
  • Purpose: This study evaluated the efficacy of alveolar ridge preservation methods with and without primary wound closure and the relationship between histometric and micro-computed tomographic (CT) data. Materials and Methods: Porcine hydroxyapatite with polytetrafluoroethylene membrane was implanted into a canine extraction socket. The density of the total mineralized tissue, remaining hydroxyapatite, and new bone was analyzed by histometry and micro-CT. The statistical association between these methods was evaluated. Results: Histometry and micro-CT showed that the group which underwent alveolar preservation without primary wound closure had significantly higher new bone density than the group with primary wound closure (P<0.05). However, there was no significant association between the data from histometry and micro-CT analysis. Conclusion: These results suggest that alveolar ridge preservation without primary wound closure enhanced new bone formation more effectively than that with primary wound closure. Further investigation is needed with respect to the comparison of histometry and micro-CT analysis.

Primary Angle-Closure Glaucoma in a Maltipoo Dog

  • Jiwoo Park;Manbok Jeong
    • Journal of Veterinary Clinics
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    • v.40 no.3
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    • pp.221-224
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    • 2023
  • A two-year-old spayed female Maltipoo dog was presented with a two-month duration of glaucoma in the right eye. On the first presentation, menace response and dazzle reflex were absent in the right eye, but it was present in the left eye. Slit-lamp biomicroscopy showed buphthalmia, mild corneal edema, and conjunctival and episcleral hyperemia in the right eye. The intraocular pressures were 70 mmHg and 30 mmHg in the right and left eyes, respectively. On the gonioscopic and high-resolution ultrasound examinations, both the iridocorneal angle and ciliary cleft were completely closed in the right eye. However, gonioscopy revealed an opened iridocorneal angle even with some broader base of pectinate ligament fiber, but high-resolution ultrasound showed a narrowed ciliary cleft and increased contact of the iris base with the limbal cornea in the left eye. Based on these results, a diagnosis of primary angle-closure glaucoma was made in both eyes. This case report highlighted the importance of evaluating the ciliary cleft with high-resolution ultrasound as a critical diagnostic and prognostic role in canine glaucoma.