• Archives of Plastic Surgery
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• v.36 no.6
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• pp.685-690
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• 2009

Purpose: Autologous fat graft is a widely accepted technique used for soft tissue augmentation. Nonetheless, the use of fat graft is limited by unpredictable survival rates and repeated grafting. To avoid repeated grafting, cryopreserved fat graft technique has recently been widely used. On the other hand, the number of patients with chronic infection(who received cryopreserved fat injection) has currently been increasing. Therefore, this study was focused on the safety of cryopreserved fat injection from the infection. Methods: We collected 150 samples from local aesthetic clinics to examine the safety of cryopreserved autologous fat. To test for microbacterial contaminations of the cryopreserved fat specimens, microbacterial cultures & antibiotics sensitivity tests were performed. Then, we examined possible correlation between the preservation period and donor sites, focused on the results of microbacterial culture. Results: Cultures were positive for Staphylococcus epidermidis in 5 samples(methicillin - resistant Staphylococcus epidermidis in 4 samples), Micrococcus species in 3 samples. An average duration of preservation was 191 days and there was no significant correlation between the duration of preservation and microbacterial growth. Conclusion: Staphylococcus epidermidis was the leading cause of cryopreserved fat contamination, and the resistance to methicillin is common. Based on the above results, aseptic handling of fat during harvesting and preservation appeared to be most important.

• Restorative Dentistry and Endodontics
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• v.41 no.4
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• pp.310-315
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• 2016

Two case reports describing a new technique of creating a repositionable piezoelectric bony window osteotomy during apicoectomy in order to preserve bone and act as an autologous graft for the surgical site are described. Endodontic microsurgery of anterior teeth with an intact cortical plate and large periapical lesion generally involves removal of a significant amount of healthy bone in order to enucleate the diseased tissue and manage root ends. In the reported cases, apicoectomy was performed on the lateral incisors of two patients. A piezoelectric device was used to create and elevate a bony window at the surgical site, instead of drilling and destroying bone while making an osteotomy with conventional burs. Routine microsurgical procedures - lesion enucleation, root-end resection, and filling - were carried out through this window preparation. The bony window was repositioned to the original site and the soft tissue sutured. The cases were re-evaluated clinically and radiographically after a period of 12 - 24 months. At follow-up, radiographic healing was observed. No additional grafting material was needed despite the extent of the lesions. The indication for this procedure is when teeth present with an intact or near-intact buccal cortical plate and a large apical lesion to preserve the bone and use it as an autologous graft.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.277-287
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• 2000

For the regeneration of osseous defect on the furcation area, autogeneous bone graft has been primarily used. But it has the limitation of donor site, additive surgical operation etc. Recently anorganic xenogenic bone graft materials of removing all organic components are commonly used for the regeneration of periodontal defects. This study was the comparison of the effect on the regeneration with two types xenografts($Bio-oss^{(R)}$ and Ca-P thin coated Bovine bone powder) on the furcation involvement in Beagle dogs. After surgically induced chronic periodontitis in bifurcation area of premolar, $Bio-oss^{(R)}$ and Ca-P BBP were grafted on the osseous defects. Tissue blocks including defects with soft tissues were harvested following a four-& eight-week healing interval and prepared for histologic analysis. The results of this study were as follows: 1. $Bio-oss^{(R)}$ group: there were significant differences among the $Bio-oss^{?}$ group at 4weeks and 8weeks, but the control group had various appearances : new bone formation, resorption of graft materials by multinuclear giant cells, connective tissue cells intervention in the bone graft sites etc. 2. Ca-P BBP group: lots of new bone formation were observed but the arrangement of periodontal ligament was not completed at 4weeks. New bone were replaced mature bone and the periodontal ligaments showed the functional arrangement at 8weeks. 3. By reason of undergrowing the epithelium within the osseous defects, new bone formation was not happened in the upper area of bifurcation in $Bio-oss^{(R)}$ group. 4. In Ca-P BBP group, epithelial undergrowth was not seen and generally showed much more new bone formation. 5. Ca-P BBP group showed the osteocyte-like cells at the inner portion of the graft materials 6. Both groups were similar to resorptive appearances of graft materials, but Ca-P BBP group had the better effects of osteoconduction.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.4
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• pp.353-360
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• 2007

In a one-stage approach, where the implant installation is performed simultaneously with the iliac bone graft, various complications are observed. The observed complications are as follows; severe bone resorption at the maxillary anterior region and the area adjacent to the nasal cavity, shortage of soft tissue to cover the augmented alveolar bone, difficulties with oral hygiene care caused by the diminished vestibular space and non-esthetic prosthesis. These are good reasons for choosing the two-stage approach over the one-stage approach in spite of all the advantages it has, and should be taken into careful consideration when diagnosing and planning treatment using the one-stage approach.

• The Journal of the Korean dental association
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• v.44 no.1 s.440
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• pp.45-54
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• 2006

Piezosurgery uses modulated ultrasonic vibration to allow controlled cuting of bony structures. delicate bony structures can be cut easily and with great precision without destruction of soft tissue. Piezosurgery can be used to harvest the chin bone for intra-oral augmentation. Maxillary sinus membrane perforation is the most common complication that occurs with the sinus elevation augmentation procedure. This complication can occur during the osteotomy, which is performed with burs, or during the elevation of the membrane using manual elevators. The purpose of this study is to introduce new surgical technique that simplifies chin bone graft and maxillary sinus surgery, thus avoiding perforating the membrane.

• Archives of Reconstructive Microsurgery
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• v.22 no.1
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• pp.24-28
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• 2013

Purpose: Soft tissue defect of the hand, which cannot be covered with skin graft or local flap, is usually reconstructed using a free flap. Temporoparietal fascial free flap is one of the best alternatives for functional reconstruction of the hand with exposed tendons, bones, and joints. Materials and Methods: We have experienced four cases of reconstruction using a temporoparietal fascial flap with a skin graft and followed up for 20 years. We conducted a retrospective review of the patients' clinical charts and photos. Results: At the time of initial injury, the average age of patients was 50.3 (39~62) years. The radial artery was used for reconstruction of the dorsal side of the hand, whereas the ulnar artery was used for that of the volar side of the wrist. Short term complication such as skin graft loss and donor site alopecia occurred. However, during the long term follow-up period, no change of flap volume was noted, and full range of motion in the adjacent joint was maintained. In addition, hyperpigmentation of the grafted skin on the flap disappeared gradually. Conclusion: Selection of the optimal flap is important for reconstruction of the hand without functional limitation. We obtained satisfactory soft tissue coverage and functional outcomes using a temporoparietal fascial free flap and followed up for 20 years.

• Archives of Craniofacial Surgery
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• v.22 no.6
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• pp.337-340
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• 2021

Full-thickness nasal tip reconstruction is a challenging process that requires provision of ample skin and soft tissue, and intricate cartilage structure that maintains its architecture in the long term. In this report, we describe reconstruction of a full-thickness nasal tip and ala defect using a posterior auricular artery perforator based chondrocutaneous free flap. The flap consisted of two lay ers of skin covering conchal cartilage, and was based on a perforating branch of the posterior auricular artery. A superficial vein was secured at the posterior margin. The donor perforator was anastomosed to a perforating branch of the lateral nasal artery. The superficial vein was connected to a superficial vein of the surrounding soft tissue. The donor healed well after primary closure. The flap survived without complications, and the contour of the nasal rim was sustained at follow-up 6 months later. As opposed to combined composite reconstructions using a free cartilage graft together with a small free flap or pedicled nasolabial flap, the posterior auricular artery perforator free flap encompasses all required tissue types, and is similar in contour to the alar area. This flap is a useful option in single-stage reconstruction of nasal composite defects.

• Journal of Periodontal and Implant Science
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• v.51 no.5
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• pp.364-372
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• 2021

Purpose: This study aimed to clinically evaluate the efficacy of vestibuloplasty around lower molar implants using 3 different modalities: apically positioned flap alone (APF), APF with a free gingival graft (FGG), and APF with modified periosteal fenestration (mPF). Methods: Three different vestibuloplasty procedures during second-stage implant surgery were performed at the mandibular molar area in 61 patients with a shallow vestibule and insufficient keratinized tissue (KT). The clinical measurements of KT width were recorded at baseline, immediately after surgery (T0), 6 months after surgery (T6), and 12 months after surgery (T12). Soft tissue esthetic scores were measured. Results: An additional KT width gain from baseline to T12 of approximately 2 mm was obtained with FGG and mPF compared to that with APF. Shrinkage of the re-established tissue was lower with mPF and FGG than with APF, whereas the esthetic profile was better with APF and mPF than with FGG. Conclusions: Within the limitations of this study, mPF showed potential as a promising approach for vestibuloplasty around the lower molar implants compared to the traditional APF and FGG.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.1-10
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• 2002

Purpose : To analyze the clinical results of free vascularized osteocutaneous fibula graft to tibial defect combined with soft tissue defect and infection. Materials and Methods : In the retrospective study of 51 consecutive cases of vascularized osteocutaneous fibular graft, the length of the grafted fibula, size of the skin flap, anastomosed vessels, ischemic time of the flap, time for union, hypertrophy of fibula and the complications were evaluated. Results : Initial bony union of the grafted fibula was obtained at 3.74 months after operation, except 4 cases of nonunion and delayed union. The weight bearing without external supports was possible at 18 months after operation in average. The fracture of grafted fibula was most common complication(16 cases). Conclusion : The vascularized osteocutaneous fibula graft provided satisfactory bony union and functional results in the cases not responsible for conventional treatment methods.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.610-614
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• 2023

Necrotizing fasciitis is an uncommon yet fatal soft tissue infection. Current recommended treatment includes antibiotics with repeat surgical exploration and wound debridement followed by reconstruction. In burn patients, the Meek micrograft has demonstrated a higher true expansion ratio, faster reepithelialization rate, more resilient toward infection, and reduced risk of graft failure as compared with meshed graft. To our best knowledge, the use of Meek micrografting technique in reconstruction of postdebridement wounds of necrotizing fasciitis has not been reported. Hereby, we present a case of a 57-year-old gentleman who was referred to us for wound reconstruction after surgical debridement of Fournier's gangrene and extensive necrotizing fasciitis involving the anterior abdomen and bilateral femoral region. Meek micrografting technique was used to reconstruct the anterior abdomen as the wound bed was large. Although the graft was complicated with a small area of localized infection, it did not spread across the entire graft and was successfully treated with topical antibiotics and regular wound dressing. In our case, wound reconstruction using Meek micrografting technique in a patient with extensive necrotizing fasciitis was successful and showed positive outcome. Therefore, we suggest further studies to be conducted to investigate the applications and outcomes of the Meek micrografting technique, especially in patients with extensive wound bed and limited donor site availability.