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Compartment syndrome as a donor-site complication of anterolateral thigh free flap: a case report
문보민,배우식 대한수부외과학회 2022 대한수부외과학회지 Vol.27 No.1
Compartment syndrome (CS) occurs infrequently as a complication at the donor site of an anterolateral thigh free flap (ALT-FF). We treated a 26-year-old male patient who was a professional soldier with large thigh muscles. A defect on the right ankle was reconstructed with a 30×10-cm2-sized ALT-FF. By the pinch test, the flap width was designed to be sufficient for primary closure of the donor site. However, on postoperative day 8, severe pain, tension, and purulent discharge were found at the donor site. We diagnosed CS clinically, and immediately performed incision and drainage. Various extrinsic and intrinsic factors can influence the development of CS. Therefore, in patients with these contributing factors, such as young men with high muscle mass, a higher level of suspicion for CS is needed. Moreover, it would be safer to design the flap width to be smaller than the pinch test would indicate or to cover the donor site with a skin graft.
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문보민,김윤상,Sun Eung Kim,Hye Gwang Mun,Pae Woo Sik 대한창상학회 2022 Journal of Wound Management and Research Vol.18 No.2
The fibular free flap (FFF) is an option used for tibial defect reconstruction in post-traumatic chronic osteomyelitis (PCOM). However, as the tibia is a weight-bearing bone, there exists a risk of compression fracture risk after FFF. This complicates reconstructing distal tibial defects adjacent to the articular cartilage. We report a successful case of reconstruction using FFF for a bone defect adjacent to the distal tibial articular surface in refractory PCOM. The patient was a 73-year-old woman with refractory PCOM in the right distal tibia secondary to a tibial fracture from a traffic accident that occurred 28 years ago. After bone debridement, the tibial bone defect was 8 cm in length, and its distal margin was located 0.5 cm above the articular surface of the tibiotalar joint. Tibial bone and soft tissue defects were reconstructed using a contralateral FFF consisting of an 8-cm fibula bone and a 14×5-cm-sized skin paddle. After 2 months, an Ilizarov apparatus was applied and maintained for 3 months. After 6 months, she started weight-bearing. The follow-up period was 15 months. Imaging studies revealed bone block union. The patient displayed no difficulty in ambulation and had no additional infections or flap necrosis.
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문보민,배우식 대한두개안면성형외과학회 2021 Archives of Craniofacial Surgery Vol.22 No.6
Lip defects often occur following wide excision as a surgical treatment for squamous cell carcinoma of the oral cavity. Defects larger than one-half of the lip cannot be closed primarily and require flap surgery. Reconstruction of the oral sphincter function can be achieved by means of a local flap using the like tissue, rather than with a free flap utilizing different tissues. A defect of the lower lip requires reconstruction using different techniques, depending on its size and location. Herein, we present the case of a patient exhibiting a lip defect spanning more than two-thirds of the lower lip, after a wide resection due to squamous cell carcinoma. The defect was reconstructed using an Abbe flap and a staircase flap. Revision was performed after 16 days. The patient’s oral competencies were fully restored 3 months postoperatively, and the esthetic results were ideal. Based on our experience, a combination of the Abbe and staircase flaps can produce excellent functional and esthetic outcomes in the reconstruction of a lower lip with a large defect. It can serve as a reliable reconstruction option for defects spanning more than two-thirds of the lower lip, not including the oral commissures.
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고일규,문보민,김성은,진준장,황락경,지은상,김창주,김태형,최현희,정경진 대한배뇨장애요실금학회 2016 International Neurourology Journal Vol.20 No.S1
Purpose: Overactive bladder (OAB) causes urinary urgency, usually accompanied by frequency and nocturia. Alpha 1-adrenergic receptor (α1-AR) antagonists are known to improve lower urinary tract symptoms associated with OAB. The α1-AR antagonists constitute a variety of drugs according to the receptor subtype affinity. This study investigated the efficacy of tamsulosin, naftopidil, and a combination of the two on OAB rats. Methods: The OAB rat model was induced by an intraperitoneal injection of cyclophosphamide for 14 days. The experimental groups were divided into 5 groups: control group, OAB-induction group, OAB-induction and tamsulosin monotherapy group, OAB-induction and naftopidil monotherapy group, and OAB-induction and tamsulosin-naftopidil combination therapy group. For the drug-treated groups, each drug was administrated for 14 days after the OAB induction. Cystometry for urodynamic evaluation and immunohistochemical stain for c-Fos and nerve growth factor (NGF) expressions in the central micturition centers were performed. Results: Increased contraction pressure and time with enhanced c-Fos and NGF expressions in the central micturition centers were found in the OAB rats. Tamsulosin suppressed contraction pressure and time while inhibiting c-Fos and NGF expressions. Naftopidil showed no significant effect and combination therapy showed less of an effect on contraction pressure and time. Naftopidil and combination therapy exerted no significant effect on the c-Fos and NGF expressions. Conclusions: Tamsulosin showed the most prominent efficacy for the treatment of OAB compared to the naftopidil and combination. The combination of tamsulosin with naftopidil showed no synergistic effects on OAB; however, further studies of addon therapy might provide opportunities to find a new modality.
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Yang Woo Kim,문보민,Sun Eung Kim,Hye Gwang Mun,배우식 대한수부외과학회 2022 대한수부외과학회지 Vol.27 No.4
Although several studies exist on the simple volume filling of soft tissue defects in lower extremity reconstruction, few reports have described functional reconstruction. In this study, a 52-year-old male patient, after a forklift accident, developed soft tissue defects of the all the right dorsiflexors. The patient underwent surgery with a chimeric anterolateral thigh free flap (cALT-FF), in which 18×8 cm2 fasciocutaneous flaps were harvested, including a 6×9 cm2 vastus lateralis muscle flap in a chimeric pattern. The functionality of the lower extremities was evaluated in terms of the active ankle-dorsiflexion range of motion and the Stanmore system after 15 months, and the result was good. In this study, we focused on functional reconstruction following the use of cALT-FF in a patient with defects of all the dorsiflexor muscles, which play an important functional role in gait.
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