• Title/Summary/Keyword: surgical exposure

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Full-Thickness Skin Grafting with De-Epithelization of the Wound Margin for Finger Defects with Bone or Tendon Exposure

  • Lee, Jun Hee;Burm, Jin Sik;Kang, Sang Yoon;Yang, Won Yong
    • Archives of Plastic Surgery
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    • v.42 no.3
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    • pp.334-340
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    • 2015
  • Background Full-thickness skin grafts (FTSGs) are generally considered unreliable for coverage of full-thickness finger defects with bone or tendon exposure, and there are few clinical reports of its use in this context. However, animal studies have shown that an FTSG can survive over an avascular area ranging up to 12 mm in diameter. In our experience, the width of the exposed bones or tendons in full-thickness finger defects is <7 mm. Therefore, we covered the bone- or tendon-exposed defects of 16 fingers of 10 patients with FTSGs. Methods The surgical objectives were healthy granulation tissue formation in the wound bed, marginal de-epithelization of the normal skin surrounding the defect, preservation of the subdermal plexus of the central graft, and partial excision of the dermis along the graft margin. The donor site was the mastoid for small defects and the groin for large defects. Results Most of the grafts (15 of 16 fingers) survived without significant surgical complications and achieved satisfactory functional and aesthetic results. Minor complications included partial graft loss in one patient, a minimal extension deformity in two patients, a depression deformity in one patient, and mild hyperpigmentation in four patients. Conclusions We observed excellent graft survival with this method with no additional surgical injury of the normal finger, satisfactory functional and aesthetic outcomes, and no need for secondary debulking procedures. Potential disadvantages include an insufficient volume of soft tissue and graft hyperpigmentation. Therefore, FTSGs may be an option for treatment of full-thickness finger defects with bone or tendon exposure.

ORTHODONTIC TREATMENT OF THE DISPLACED UNERUPTED MAXILLARY CANINE : CASE REPORT (변위된 미맹출 상악 견치의 교정 치험례)

  • Lim, Hye-Jeong;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.543-549
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    • 2005
  • The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and is a key in esthetics due to its position. Maxillary canine has the longest time to develop and a complex route from the place of formation to the site of eruption, and so it is prone to impaction more than other teeth. The clinician should consider the various treatment options : (a) No treatment and observation, (b) surgical exposure and orthodontic traction (c) autotransplantation (d) extraction. Surgical exposure of the canine and orthodontic treatment to bring the tooth into the line of occlusion is considered the most desirable approach. This case presents the results of treatment for impacted maxillary canine by surgical exposure and orthodontic tooth movement.

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Comparison of Ulnar Collateral Ligament Reconstruction Techniques in the Elbow of Sports Players

  • Moon, Jun-Gyu;Lee, Hee-Dong
    • Clinics in Shoulder and Elbow
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    • v.23 no.1
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    • pp.41-47
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    • 2020
  • Ulnar collateral ligament injuries have been increasingly common in overhead throwing athletes. Ulnar collateral ligament reconstruction is the current gold standard for managing ulnar collateral ligament insufficiency, and numerous reconstruction techniques have been described. Although good clinical outcomes have been reported regarding return to sports, there are still several technical issues including exposure, graft selection and fixation, and ulnar nerve management. This review article summarizes a variety of surgical techniques of ulnar collateral ligament reconstructions and compares clinical outcomes and biomechanics.

Aortopulmonary Window -Report of A Case- (폐동맥 대동맥 중격결손증 1례 보고)

  • 박기진
    • Journal of Chest Surgery
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    • v.28 no.7
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    • pp.721-725
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    • 1995
  • One case of surgical correction of a large aortopulmonary window in a 4 months old female is reported in detail. Clinical symptoms consisted of fatigue when feeding and recurrent upper respiratory tract infection. Under cardiopulmonary bypass with moderate hypothermia and cardioplegic arrest of the heart, the aortopulmonary window was approached through a vertical incision at the anterior wall of window itself. The defect was closed with pericardial patch using continuous suture posteriorly and sandwitch technique anteriorly. The patient was weaned from the cardiopulmoanry bypas without hemodynamic problem and postoperative course was uneventful. This surgical technique is recommandable as it provides good exposure of the defect and can be performed easily and safely.

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Treatment of Peri-implantitis: Cases Report (임플란트 주위염의 치료: 증례보고)

  • Sung, Hun-Mo;Kim, Kyoung-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.2
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    • pp.112-123
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    • 2013
  • This study aims to investigate the clinical outcome following treatment of peri-implantitis lesions. Five subjects with 7 implants were treated with surgical approach. Four subjects with 6 implants were initially treated with non-surgical approach or hygiene control. However, inflammation was not resolved and more bone loss was found. Therefore, surgical treatment was performed. After surgical exposure of the defect, granulation tissue was removed and implant surface was treated using tetracycline and chlorhexidine. Then, the flaps were sutured. The wound healing was performed in a non-submerged mode. The present finding demonstrates stable results without progression of bone loss. In one subject, deep V shaped bone defect was filled with bone substitute (ICB, CanCellous Bone, Rockey Mountain Tissue Bank, USA), and resorbable membrane (Lyoplant$^{(R)}$, B.Braun Aesculap AG, Germany) was placed over the grafted defect and healing abutment was connected. However, the inflammation was not resolved and more bone loss was found. At one month after regenerative surgery, the implant was removed.

Left-Side Surgical Approach to Mitral Valve in Dog Cadaver Study

  • Moon, Jeong-hyeon;Hwang, Byungmoon;Kim, Daesik;Jung, Sunjun;Ha, Yongsu;Lee, Kicahng;Kim, Namsoo;KIM, Min-su
    • Journal of Veterinary Clinics
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    • v.35 no.1
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    • pp.10-12
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    • 2018
  • Mitral regurgitation is the most frequent cause of cardiac disability and death in dogs. A wide range of medical and surgical treatments have been used for mitral regurgitation. Surgical treatments for complete correction of mitral regurgitation include valve repair and valve replacement, which have the advantages of eliminating or correcting the primary cause. Surgical treatments approach the mitral valve via right- or left-side thoracotomy. Aortic root exposure is needed for cardiopulmonary bypass. To compare right-side and left-side approaches, 10 dog cadavers were used in this study. Subsequently, the left-side surgical approach was used in vivo and in conjunction with cardiopulmonary bypass and cardioplegic arrest. Based on the results, and considering ease of access to the aortic root, valve incision site, and visualization of the surgical field, a left-side approach is recommended.

DIAGNOSIS AND TREATMENT OF IMPACTED MAXILLARY CANINE (매복 상악 견치의 진단과 치료)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.3
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    • pp.534-547
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    • 2006
  • Ectopic eruption and impaction of canines is a frequently encountered clinical problems. The incidence of impaction ranges between 1-3%. The cause of canine impaction can be the result of localized factors or can be a polygenic multifactorial inheritance and associated with other dental anomalies. The general dentist and pediatric dentist should know how to properly diagnose and manage potential disturbances in the eruption of maxillary canine. Diagnosis of impacted canine at age 8-10 years can significantly reduce serious ramifications, including surgical exposure and orthodontic traction as well as root resorption of the lateral incisors. Extraction of primary canine would be one of the method to prevent the impaction. The surgical procedure should be designed to minimize the destruction of periodontal tissue of impacted canine. Closed eruption technique is thought to be optimal method of surgical exposure compared with other methods. An overview of the incidence, sequela as well as the surgical periodontal, and orthodontic consideration in the management of impacted canine was presented.

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Pre-contoured reconstruction plate fabricated via three-dimensional printed bending support

  • Song, In-Seok;Ryu, Jae-Jun;Choi, Young-Jun;Lee, Ui-Lyong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.3
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    • pp.233-236
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    • 2021
  • A mandibular continuity defect can be repaired using either a prosthetic device or autogenous bone. A titanium reconstruction plate can be used with a localized or vascularized flap over the defect of the mandible. Unfortunately, the plate may fail due to plate exposure, screw loosening, fracture, or infection, and will need to be removed. Plate exposure though the skin or mucosa is one of the main reasons for failure. In the present work, the authors introduced a lingually positioned reconstruction plate fabricated via three-dimensional printed bending support. This custom reconstruction plate can avoid plate re-exposure as well as reduce surgical errors and operation time.

Corrective Osteotomy of Metatarsal Bone for Surgical Treatment of Morton's Neuroma (모턴씨 신경종의 수술적 치료를 위한 중족골 교정 절골술)

  • Chu, Intak;Jang, Hoseong;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.2
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    • pp.58-62
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    • 2015
  • Purpose: The purpose of this report is to investigate the clinical and radiological results of corrective osteotomy of the 3rd metatarsal bone for shortening and dorsal displacement without exposure around neuroma. Materials and Methods: Twelve cases of patients who underwent corrective osteotomy of metatarsal bone for a Morton's neuroma from November 2013 to September 2014 were retrospectively reviewed. Corrective osteotomy was performed through a dorsal approach at the 3rd metatarsal bone base and distal metatarsal bone was displaced dorsally and proximally. Preoperative and postoperative pain assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographs were evaluated. Results: The mean age of patients was 41.4 years, and the mean follow-up period was 10.7 months. AOFAS score improved from 52 preoperatively to 90 postoperatively. The 3rd metatarsal bone was shortened by an average of 3.39 mm and elevated by 2.38 mm. Conclusion: Corrective osteotomy of metatarsal bone can be regarded as a new surgical option for Morton's neuroma without exposure around neuroma.

Left Common Femoral to Right Common Iliac Venous Bypass Through a Retroperitoneal Exposure

  • Cuen-Ojeda, Cesar;Bobadilla-Rosado, Luis O;Garcia-Alva, Ramon;Arzola, Luis H.;Anaya-Ayala, Javier E.;Hinojosa, Carlos A.
    • Vascular Specialist International
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    • v.34 no.4
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    • pp.117-120
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    • 2018
  • The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.