• Title/Summary/Keyword: total reconstruction

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An Analysis on the Actual Condition and the Influential Factors in Reconstruction Projects for Deteriorated Apartment Housing (노후아파트의 재건축 추진 영향요인 분석 -대구광역시 사례를 중심으로-)

  • 장석하;현택수;최무현
    • Journal of the Korean housing association
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    • v.10 no.1
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    • pp.145-154
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    • 1999
  • In this study, various factors affect on the reconstruction of the deteriorated apartment housing complex in the Taegu-City were analyzed. The conclusions obtained in this research were summarized as follows; 1) In case of 4 to 5 storied apartment buildings, those were main objects for reconstruction. The number of the buildings and households consisting apartment complex and the total building area and the ground area were appeared as major factors. Those factors were highly correlated with the consensus of reconstruction. 2) As a maximun area of reconstruction was limited, higher existing consensus capacity and its ratio affect negatively on reconstruction of deteriorated apartments. 3) The main motivation for reconstruction is disadvantages among the members of reconstruction association were main obstacles to reconstruct the deteriorated apartment buildings. Therefore, a resoanble alternatives for reconstruction plans and administrative managements were needed.

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Mandibular Reconstruction using Simulation Surgery after Segmental Mandibulectomy

  • Hwang, Jong-Hyun;Kim, Ji-Wan;Ahn, Kang-Min
    • Journal of International Society for Simulation Surgery
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    • v.3 no.1
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    • pp.12-15
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    • 2016
  • Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.

Total Tongue Reconstruction with Reinnervated Rectus Abdominis Musculocutaneous Flap (재신경화된 복직근 근피판을 이용한 혀 전체 재건술)

  • Kim, Cheol Hann;Tark, Min Sung
    • Archives of Plastic Surgery
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    • v.33 no.2
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    • pp.161-167
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    • 2006
  • After total glossectomy, recovery of swallowing and speech function can greatly improve quality of life. The reconstructed tongue must be thick enough to contact with the hard palate for articulation. If the free flap is denervation, it may procede to have atrophy postoperatively. Therefor it is difficult to maintain the tongue volume for a long period of time. To resolve this problem, we have used a innervated rectus abdominis musculocutaneous flap and maintaining the volume through a neurorrhaphy. 7 patients underwent immediate reconstruction using a reinnervated rectus abdominis musculocutaneous free flap in which included intercostal nerve was anastomosed to the remaining hypoglossal nerve. The reinnervated rectus abdominis musculocutaneous free flap has provided good tongue contour with sufficient bulk and shown no obvious atrophy in all patients even though postoperative 9 months later. Considering swallowing and articulation, we concluded that reinnervated rectus abdominis musculocutaneous flap is a viable method after total glossectomy

A Case of Primary Reconstruction using Fibular Osteocutaneous Free Flap after Total Maxillectomy Due to Rhabdomyosarcoma (횡문근육종으로 인한 상악골 전절제술 후 유리비골골피판을 이용한 치험례)

  • Kim, Tae Hyung;Oh, Deuk Young;Lee, Paik Kwon;Kim, Min Sik;Rhie, Jong Won;Ahn, Sang Tae
    • Archives of Plastic Surgery
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    • v.32 no.3
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    • pp.381-384
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    • 2005
  • Rhabdomyosarcoma is a rare malignancy of head and neck region. When rhabdomyosarcoma occurs in maxillary area, total maxillectomy is necessary. Total maxillectomy causes defects of orbital floor, palate, gingiva, and alveolar bone, causing severe facial deformity and functional impairment. Immediate maxillary reconstruction has to cover both bone and soft tissue to minimize cosmetic and functional problems. The fibular osteocutaneous free flap can provide paranasal, gingiva, oral mucosal lining and foundation for dental prosthesis, thus ensuring good cosmetic results and mastication, phonation function. We have experienced a reconstruction case of a 19-year-old man with rhabdomyosarcoma of the left maxillary sinus. The patient underwent total maxillectomy and neck dissection. We designed a fibular free flap that had a vascularized bone segment and a double skin paddle. Surgical outcomes were excellent in cosmetic and functional aspects.

Secondary Breast Reconstruction (이차 유방 재건술)

  • Ahn, Hee Chang;Ahn, Yong Su;Kim, Youn Hwan;Choi, Seung Suk
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.761-766
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    • 2009
  • Purpose: Secondary breast reconstruction is defined as a whole reconstructive procedure to correct complications and to improve the aesthetics when a patient is dissatisfied with her initial reconstruction. We would like to present these particular procedures on previously failed breast reconstruction with analysis of unsatisfactory results. Methods: From June 2002 to August 2008, we performed secondary breast reconstructions for 10 patients with failed breasts. Six patients with implant failure underwent secondary breast reconstructions using free TRAM flaps after the removal of implants. Two patients with partial loss of pedicled TRAM flaps underwent secondary breast reconstruction using Latissimus Dorsi flaps. Two patients with 1 total loss of free TRAM flap and 1 extensive fat necrosis underwent secondary breast reconstruction using implants. Results: The average age of the patients were 36.4 years (26 ~ 47 years). All flaps survived completely and had relatively good aesthetic results in free TRAM cases. There was breast asymmetry in one patient using cohesive gell implants in total loss of previously free TRAM patient, which was corrected by exchanging the implants and placing dermofat grafts. Conclusion: Secondary breast reconstruction differs from primary procedures in several aspects; there are changes in the anatomy and tissue environment of the breasts, and various limitations in choosing reconstruction methods. In addition, the patients may be uncomfortable with previous complication. It is important to consider various factors before deciding to undergo a secondary breast reconstruction carefully with informed consent.

End Stage Ankle Arthritis with Ankle Instability Patients Treatment Results Using Autograft Ligament Reconstruction with Total Ankle Arthroplasty (인대 불안정성이 동반된 말기 족근 관절염 환자의 자가 인대 재건술과 인공관절 치환술의 치료 결과)

  • Choi, Jae-Hyuck;Kim, Jeong-Ryoul;Kim, Dong-Hyun;Chung, Woo-Chull;Yoon, Jung-Ro;Yeo, Eui-Dong;Lee, Kyung-Tai
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.47-52
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    • 2010
  • Purpose: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. Materials and Methods: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. Results: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average $8.2{\pm}0.9$ (range, 7~10) to $2.7{\pm}1.7$ (range, 0~6) and the AOFAS score improved from $46.4{\pm}14.6$ points (range, 23~69) to $80.1{\pm}9.3$ points (range, 65~95) at final follow-up. Anterior draw test improved $15.2{\pm}3.4$ mm (range, 12~23 mm) to $8.8{\pm}2.6$ mm (range, 6~13mm), varus stress test improved from $13.9{\pm}4.6^{\circ}$ (range, $10-18^{\circ}$) to $6.2{\pm}4.7^{\circ}$ (range, $2-18^{\circ}$) at final follow up. Conclusion: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.

Usefulness of Omental Flap for Various Soft Tissue Reconstruction (다양한 연부조직 재건에서의 대망피판의 유용성)

  • Lee, Hwa Seob;Park, Sae Jung;Ryu, Hyung Ho;Suh, Man Soo;Lee, Dong Gul;Chung, Ho Yun;Park, Jae Woo;Cho, Byung Chae
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.428-434
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    • 2005
  • Extensive and complicated defects on the body call for an omnipotent tool for a perfect reconstruction. Flaps derived from the omentum has many advantages over the conventional flaps. From 1999 to 2004, Omental flaps were applied for various soft tissue reconstructions. Among total 20 total 7 cases were for immediate reconstruction, 2 cases for chronic infection, 3 cases for simultaneous reconstruction of two defects, 4 cases for functional joint reconstruction and 4 cases were for flow- through revascularization. Among these cases, 3 cases were operated with minimal incision harvest technique. There were no complete flap failures, partial necrosis of the distal parts were noted on three cases. The omental flap is indicated on a large contaminated defect reconstruction due to its large size, well-vascularized, and malleable properties. The omental flap provides several additional advantages over other flaps, which are; the availability of the one staged simultaneous reconstruction of two defects with one flap, providing gliding function for the joint motion, and a flow-through characteristics with long vascular pedicle. But there are some serious shortcomings, including a long abdominal scar and intraabdominal problems. However, these are rare and can be minimized with our minimal incision technique. Due to its unique characteristics. the omentum is one of the ideal tissues for the reconstruction of the complicated soft tissue defects due to its unique characteristics.

Dynamic Upper Eyelid Reconstruction for Total Periorbital Soft Tissue Loss

  • Vathulya, Madhubari;Manohar, Nishank;Jagtap, Manish Pradip;Mago, Vishal;Jayaprakash, Praveen A.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.319-323
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    • 2022
  • Total eyelid defect comprises full-thickness loss of both upper and lower eyelids in a patient. It is a rare and devastating condition with serious implications related to vision, which mandates early and functional reconstruction when associated with intact globe. The primary goal is to give a stable coverage for orbital protection but at the same time provide a functional reconstruction of the defect, to allow for adequate mobility of the eyelids so that the patient's vision is restored to normal with minimal disability. When the defect is massive, and in the absence of loco-regional flaps, microvascular tissue transfer is needed. In this report we describe a radial-artery-based microvascular tissue transfer with a unique innovation utilizing the contralateral frontalis muscle to reconstruct a case of unilateral total upper and lower eyelid loss.

THE USE OF A VARIETY OF INTRAORAL FLAPS IN RECONSTRUCTION OF INTRAORAL SOFT TISSUE DEFECTS (구강내 연조직 결손 재건을 위한 다양한 구내피판의 이용)

  • Kim, Young-Kyun;Yeo, Hwan-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.3
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    • pp.243-249
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    • 1997
  • The purpose of this study is to describe the clinical availability of a variety of intraoral local flaps in reconstruction of oral soft tissue defects, Forty patients with oral soft tissue defects were treated by tongue, buccinator, palatal, labial, facial artery musculomucosal, buccal fat pad, and masseter muscle crossover flap. Total 43 intraoral flaps were used to reconstruct a variety of intraoral soft tissue defects, such as oronasal fistula, oroantral fistula, traumatic deformities and other. The age of patients ranged from 7 to 72 years, with mean age of 39.6 years. Follow up period ranged from 2 to 66 months, mean follow up period of 21.6 months. There were 9 complications, of which four were partial necrosis, three infections, one total necrosis, and 1 speech problem. Except for total necrosis, most of the recipient sited healed uneventually without severe morbidity. We consider that a variety of intraoral local flaps can be available for reconstruction of small of moderate large intraoral soft tissue defects.

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Nipple reconstruction using the C-V flap technique after breast reconstruction with the only breast expander (유방확장기만을 사용한 유방재건술 후 C-V 피판을 이용한 유두재건술)

  • Song, Jea Yong;Han, Byung Kee;Kim, Chung Hun
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.422-427
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    • 2009
  • Purpose: Breast cancer is second most common cancer in women. Almost of patients with breast cancer treated with mastectomy undergoes breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. Methods: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C - V flap technique, who were received breast reconstruction with the only breast expander. We have predicted decrease of the size of reconstructed nipple and designed flap a little larger than wanted nipple size. Nipple splint was applied for 4 - 6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. Results: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There was no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. Conclusion: The authors experienced 17 patients of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction with the only breast expander is safe and reliable. It is considered that a long - term study is necessary.