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- 저자 : 공병선(Byeong Seon Kong) (검색결과 6 건)
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하지의 연부조직 결손 재건을 위한 대퇴부 천공지 유리 피판술
공병선,서무삼,하정민,Kong, Byeong-Seon,Seo, Moo-Sam,Ha, Jung-Min 대한족부족관절학회 2007 대한족부족관절학회지 Vol.11 No.2
Introduction: To report the result of the thigh perforator free flap for the reconstruction of the soft tissue defect of the lower extremities and usefulness of this flap. Materials and Methods: We have performed 23 cases of thigh perforator free flap to reconstruct the soft tissue defect of the lower extremities between February 2004 and July 2005. The anterior aspect of the legs were 9 cases, the ankle joints were 4 cases, the dorsal aspect of the feet were 6 cases, the sole of the feet were 4 cases as recipient sites. The anterolateral thighs were 13 cases, the anteromedial thighs were 10 cases as donor sites. The size of the flap ranged from $4{\times}5\;cm$ to $12{\times}18\;cm$. The mean flap area was $73.2\;cm^2$. The length of the pedicle ranged from 5 cm to 15 cm. Every patient except children was operated under the spinal anesthesia. Results: 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. In the 21 flaps that had survived, there were partial necrosis in 4 cases, which healed without any additional operation. In the 13 anterolateral thigh perforator flaps, 9 cases survived totally, 3 cases had the partial necrosis, 1 case failed. In the 10 anteromedial thigh perforator flaps, 8 cases survived totally, 1 case had the partial necrosis, 1 case failed. Conclusion: The authors had a good result with the thigh perforator free flap and believe that this flap is a good option for the reconstruction of the soft tissue defect of the lower extremities, because this flap has a thin thickness and it is easy to dissect the vessels. Moreover the patients can be operated with supine position.
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수지 수질부 재건을 위한 족부의 제 1물갈퀴부 유리 피판술
공병선,김윤석,이형석,정대원,곽재용,이현석,Kong, Byeong Seon,Kim, Yun Seok,Lee, Hyeong Seok,Jung, Dae Won,Kwak, Jae Yong,Lee, Hyun Suk 대한미세수술학회 2012 Archives of reconstructive microsurgery Vol.21 No.2
Purpose: The first web space of the foot has a similar thickness and skin texture of the pulp of the fingers. Moreover, it has a reliable blood vessel and sensory nerve. The purpose of this study was to evaluate the clinical results of the first web space free flap to reconstruct the pulp of fingers. Materials and Methods: Authors have performed 23 cases of first web space free flap to reconstruct the pulp defect of the fingers between June 2004 and May 2009. The age of the patients ranged from 20 years old to 55 years old. The size of the flap ranged from $1{\times}1.5cm$ to $8.5{\times}2.5cm$. The mean flap area was 5.4 cm2. In 4 cases, we elevated the flap including lateral aspect of the big toe and medial aspect of the second toe. And then we made an artificial syndactyly to reconstruct the pulps on two fingers at the same time. In all cases, we performed 1 digital artery and 1 dorsal vein anastomosis. Every donor site that had a small defect healed spontaneously without any additional operations to cover it. Results: Of this type of surgery 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. There was no severe complication in the donor sites. There was no walking disturbance due to the skin defect of the donor site. The static 2 point discrimination in 11 cases that we could check ranged from 3 mm to 15 mm. Conclusion: The authors believe that the first web space free flap of the foot is a good option for the reconstruction of the pulp of the fingers and it has a minimal donor site morbidity.
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전 내측 대퇴부 천공지 유리 피판술을 이용한 사지의 연부조직 재건
공병선,이상현,김용진,Kong, Byeong-Seon,Lee, Sang-Hyun,Kim, Yong-Jin 대한미세수술학회 2005 Archives of reconstructive microsurgery Vol.14 No.1
Thigh perforator flaps are used popularly, because they have a small thickness, a long vascular pedicle and a low rate of donor site morbidity. Among thigh perforator flaps, anterolateral thigh perforator flaps are generally used, but it is not easy to dissect the vastus lateralis muscle to find the vasuclar pedicle. The authors have planed 11 anteromedial thigh perforator flaps that have septocutaneous perforators. We were able to find anteromedial thigh perforators in 8 cases(72.7%). The perforators originated from the medial descending branch of the lateral circumflex femoral artery in 2 cases and a branch to the rectus femoris muscle in 6 cases. Of this type of surgery, 7 flaps survived. However, 1 flap failed because of arterial insufficiency. We believe the anteromedial thigh perforator flap is a good option when the thigh region is decided as a donor site, but surgeons should keep in mind that the perforator of anteromedial thigh flap may be absent.
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공병선,김용진,Kong, Byeong-Seon,Kim, Yong-Jin 대한미세수술학회 2003 Archives of reconstructive microsurgery Vol.12 No.2
It has been known that the vessels of the finger tip are very small and have many branches, so the anastomosis of this vessel is very difficult. But when this operation achieves success, the replanted finger tip provides adequate soft tissue, restoration of the length, sensory and nail. The authors describe the result of finger tip replantation in 94 patients, 103 finger tips, from October 1999 to June 2002. We performed the salvage procedure in all cases. The success rate of finger tip replantation was 74.8%. We achieved higher success rate, when we succeeded anastomosis of the central artery. The function of the replanted fingers was good. The average TAM was 80% and patient satisfaction was high. We be live that we can achieve higher success rate by anastomosing central artery and performing delicate salvage procedure.
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동맥화 정맥 유리 피판술을 이용한 수부와 수지 연부조직 결손의 재건
공병선,김용진,조광우,Kong, Byeong-Seon,Kim, Yong-Jin,Cho, Kwang-Woo 대한미세수술학회 2004 Archives of reconstructive microsurgery Vol.13 No.2
Flaps are necessary, when important structures such as bone, tendon, nerve and vessel are exposed. Arterialized venous free flap is suited to the coverage of finger and hand because the thickness of venous flap is thin. Authors performed 65 cases arterialized venous free flap for the soft tissue reconstruction of the hand and finger. The size of donor defect were from $1{\times}1cm\;to\;7{\times}12cm$. The mean flap area was $9.1cm^2$. The recipient sites were finger tip in 34 cases, finger shaft in 29 cases and hand in 2 cases. The donor sites were volar aspect of distal forearm in 40 cases, thenar area in 17 cases and foot dorsum in 6 cases. The types of arterialized venous free flap were A-A type in 4 cases and A-V type in 61 cases. The length of afferent vein was from 0.5 cm to 3 cm (mean 1.7 cm) and efferent vein was from 1 cm to 10 cm (mean 2.2 cm). 58 flaps(89.2%) survived eventually. 42 flaps(64.6%) survived totally without any complication. 8 flaps(12.3%) showed the partial necrosis but they were healed without any additional operations. 8 flaps (12.3%) showed the partial necrosis requiring the additional skin graft. We had a satisfactory result by using arterialized venous free flap for the soft tissue reconstruction of finger and hand. We believe that volar aspect of distal forearm, thenar area, foot dorsum are suited as a donor site and the short length of the flap pedicle, the strong arterail inflow affect the survival rate of arterialized venous free flaps.
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