• Journal of Chest Surgery
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• v.34 no.6
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• pp.485-489
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• 2001

Background: The most important factor in preventing sternal complications is stable sternal approximation. We have tried to find the most effective sternal closure method by examining the incidence of sternal dehiscence with or without infection in patients with cardiac surgery through median sternotomy. Material and Method: This study was performed in 489 patients over 45 years of age with median sternotomy for open cardiac surgery. Simple closure with interrupted 6 wires was performed in 159 patients, figure-of-8 closure technique in 119, overlapping interrupted closure using 10 wires in 150, and combined closure technique of interrupted simple closure and figure-of-8 suture closure in 61. Two hundred thirty-four patients underwent valve and aortic operations and 213 patients coronary artery bypass surgery. Result: Sternal dehiscence with or without infection occurred in 12 (2.5 %) patients. The complication developed in 5 of 159 patients (3.1%) with six interrupted simple closure, in 4 of 119 patients (3.4%) with figure-of-8 closure, and in 3 of 150 patients (2.0%) with overlapping interrupted closure using 10 wires, but there was no complication in 61 patients with combined closure technique (relative risk for other closure techniques, p<0.05). There was no significant difference in the incidence of the sternal complication between valve and aortic operation group and coronary artery bypass group (3.0% vs 2.3%, not significant), but diabetes mellitus was a significant independent risk factor (odds ratio and multivariate analysis, p<0.05). Conclusion: The sternal closure technique that combines simple interrupted suture closure and figure-of-8 suture closure may be a more useful technique to enhance sternal stabilization compared to other closure techniques, such as simple interrupted closure, 8-figure closure, and overlapping interrupted closure.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.353-357
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• 1996

One of the most common cosmetic surgery, the blepharoplasty can be divided two method. there were incisional method and sutured method. Authors try to understand the anatomic difference between the oriental upper eyelids and apply the surgical techniques of constructing upper eyelid crease of oriental case effectively. And we discussed the postoperative complications of the blepharoplasty and proposed the solve of these problems. The sutured method of blepharoplasty was more simple technique than conventional incision method and had low occurrence of complications. Even though slight recurrence, suture method was more esthetic due to no scar formation.

• Journal of Periodontal and Implant Science
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• v.40 no.3
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• pp.139-143
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• 2010

Purpose: Pink gingival esthetic especially on the anterior teeth has been an important success criterion in implant-supported restoration. Inter-implant papillae are a critical factor for implant esthetics, and various techniques for inter-implant papilla reconstruction have been introduced. The aim of this study is to suggest and evaluate a surgical technique for reconstructing inter-implant papillae. Methods: A 28-year-old man had an implant placed on the #13 and #14 area. Four months after implant placement, a second stage surgery was planned for inter-implant papilla reconstruction. At the time of the abutment connection, I-type incisions were performed on the #13i & #14i area followed by full-thickness flap elevation and connection of a healing abutment on underlying fixtures without suture. Results: Two weeks after the second stage implant surgery, soft tissue augmentation between the two implants was achieved. Conclusions: I-shaped incisions for papilla reconstruction performed during the second stage implant surgery were useful for inter-implant papilla reconstruction and showed a good esthetic result.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.457-468
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• 2017

Background Abdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them. Methods A systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles. Results According to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death. Conclusions The complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.

• Journal of Korean Neurosurgical Society
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• v.53 no.5
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• pp.300-302
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• 2013

Reports of traumatic leptomeningeal cysts (TLMC) are rare in adults. The standard treatment approach is craniectomy with careful exposure of the intact dural edges, followed by duroplasty. However, occasionally, the location of the TLMC makes achieving watertight duroplasty impossible. Herein, we report the case of a 28-year-old male who presented with a soft growing mass on the vertex of his head 16 months after the head trauma. Upon enhanced CT examination, a bony defect involving both the inner and outer table of the cranium was observed close to the sagittal sinus, and a well-defined cystic mass, 5 cm in diameter, was nested within the defect. The risks associated with extension craniotomy were high because the lesion was located superficial to the sagittal sinus, we opted to use fibrinogen-based collagen fleece (TachoCombR$^{(R)}$) to repair the dural defect. Two months after surgery, the patient remained asymptomatic with a good cosmetic result. In cases like ours, when the defect is near the major sinuses and the risk of rupturing the sinus during watertight dural closure is high, fibrinogen-based collagen fleece (TachoCombR$^{(R)}$) is an effective alternative approach to standard dural suture techniques.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.465-473
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• 1990

Glutaraldehyde have been used as the most effective cross-linking agent for stabilizing collagen fibers and preventing biodegradation. We processed bovine pericardium in a solution containing 0.625% glutaraldehyde,0.05M HEPES buffer and 0.26% magnesium chloride in saline. The glutaraldehyde-preserved bovine pericardium was implanted in 36 patients at Seoul National University Hospital during a 11-month period between May 1989 and March 1990. 24 were males and 12 females, with ages ranging from 6 months to 168 months [mean age of 43 months]. In 12 patients, the glutaraldehyde-preserved bovine pericardium was used for orthotopic reconstruction of the pericardial sac. In 24 patients. the glutaraldehyde-preserved bovine pericardium was heterotopically implanted.; pulmonary monocusp implant and RVQT [right ventricular outflow tract] patch widening were performed in 10 patients, pulmonary monocusp implant in 6, RVOT patch widening in 4, valved conduit in 2, conduit and pulmonary angioplasty in 1, and ventricular septation in l. With vascular suture techniques, the anastomoses were immediately tight. There was no bleeding from the needle holes and no oozing through bovine pericardium itself. During the follow-up period of up to 10 months, no infections of the glutaraldehyde-preserved bovine pericardium occurred and no bovine pericardium-related complications were observed in this series.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.14-19
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• 2010

Purpose: The purpose of this study was to compare clinical outcomes between the new V-shaped repair method and conventional methods for the arthroscopic repair of Type II SLAP lesions. Materials and Methods: Our study population consisted of 23 people treated with the new V-shaped repair method or conventional methods in the arthroscopic repair of Type II SLAP lesions at our institution between May 2006 and October 2008. Eleven shoulders were treated using the new V-shaped repair method. Twelve shoulders were treated using conventional methods. The average follow up period was 15 months. For evaluation of clinical results, we used UCLA and VAS pain scores. Results: Comparing change scores (preoperative vs. postoperative states) there were no significant differences in UCLA score or VAS score between the two groups. Conclusion: The new V-shaped repair technique elicits similar clinical results with conventional arthroscopic repair techniques and thus can be considered a useful alternative when using an absorbable suture that is anchor linked with only one suture.

• Journal of Periodontal and Implant Science
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• v.40 no.4
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• pp.194-200
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• 2010

Purpose: There is no consensus regarding the relationship between the width of keratinized mucosa and the health of periimplant tissues, but clinicians prefer to provide enough keratinized mucosa around dental implants for long-term implant maintenance. An apically positioned flap during second stage implant surgery is the chosen method of widening the keratinized zone in simple procedures. However, the routine suture techniques used with this method tend to apply tension over the provisional abutments and decrease pre-existing keratinized mucosa. To overcome this shortcoming, a pre-fabricated implant-retained stent was designed to apply vertical pressure on the labial flap and stabilize it in a bucco-apical direction to create a wide keratinized mucous zone. Methods: During second stage implant surgery, an apically displaced, partial thickness flap with a lingualized incision was retracted. A pre-fabricated stent was clipped over the abutments after connecting to the provisional abutment. Vertical pressure was applied to displace the labial flap. No suture was required and the stent was removed after 10 days. Results: A clinically relevant amount of keratinized mucosa was achieved around the dental implants. Buccally displaced keratinized mucosa was firmly attached to the underlying periosteum. A slight shrinkage of the keratinized zone was noted after the healing period in one patient, but no discomfort during oral hygiene was reported. Clinically healthy gingiva with enough keratinized mucosa was achieved in both patients. Conclusions: The proposed technique is a simple and time-effective technique for preserving and providing keratinized tissue around dental implants.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.629-636
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• 2009

Purposes: Wide scars occurring on the lower face and neck are a source of both functional and esthetic problems. Consequently, we can use skin grafts, pedicled flaps, free flaps, and tissue expansion for the reconstruction of this area. Compared with other reconstruction techniques, tissue expansion is advantageous in that it enables the maintenance of a color and texture similar to that of the adjacent tissue. However, the conventional method of tissue expansion has been reported to lead to an unnatural cervicomental angle and to the deformity of adjacent structures. We have therefore made efforts to prevent these problems through the use of several operative procedures. Methods: Forty-one patients with lower facial and cervical scars underwent tissue expansion. The tissue expansion was performed using a rectangular-shaped Nagosil$^{(R)}$ tissue expansion device. On insertion of the tissue expander, the intermediate area of superficial fat layer was dissected and then the tissue expander was inserted to make a flap that was as thin as possible. In advancement of the flap, a capsule-formed by the tissue expander-was used for the interrupted fixed suture of the flap to the fascia of the platysma muscle of the neck. This procedure was performed multiple times and also performed between the flap and the periosteum of the mandible, such that the tension was removed during the suture of the flap margin. Finally, the patients were fitted with a Jobst$^{(R)}$ facial garment in order to stabilize the operation site at least twelve months. Results: The most prevalent location of the scar was the cheek (15 cases), followed by the chin in 14 cases and the neck in 12 cases. The mean size of scar was $55.7{\pm}39.4cm^2$. Conclusions: Using our procedures, we have experienced no significant deformities and have also achieved a more natural cervicomental angle in the patients.

• Journal of Gastric Cancer
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• v.12 no.4
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• pp.237-242
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• 2012

Purpose: Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our study was designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer perforation, and provide a step-by-step protocol with tips and recommendations for less experienced surgeons. Materials and Methods: Between March, 2011 and May, 2012, 21 patients presenting with duodenal ulcer perforation underwent laparoscopic primary repair with omentopexy. There were no contraindications to perform laparoscopic surgery, and the choice of primary repair was decided according to the size of the perforation. The procedure for laparoscopic primary repair with omentopexy consisted of peritoneal lavage, primary suture, and omentopexy using a knot pusher. Results: During the operation, no conversion to open surgery or intra-operative events occurred. The median operation time was 45.0 minutes (20~80 minutes). Median day of commencement of a soft diet was day 6 (4~17 days). After surgery, the median hospital stay was 8.0 days (5~27 days). Postoperative complications occurred in one patient, which included a minor leakage. This complication was resolved by conservative management. Conclusions: Although our study was carried out on a small number of patients at a single institution, we conclude that laparoscopic primary repair can be an effective surgical method in the treatment of duodenal ulcer perforation. We believe that the detailed explanation of our procedure will help beginners to perform laparoscopic primary repair more easily.