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요추부 천공지 유리피판을 이용한 대전자부 결손의 재건 - 증례보고 -
허찬영,백룡민,민경원,은석찬,Heo, Chan-Yeong,Baek, Rong-Min,Minn, Kyung-Won,Eun, Seok-Chan 대한미세수술학회 2007 Archives of reconstructive microsurgery Vol.16 No.1
There could be several methods for trochanteric reconstruction including local flap, pedicled perforator flaps, free flap, etc. We performed greater trochanteric reconstruction with lumbar artery perforator free flap in some aberrant method. So we report this experience with review of literatures. A 42-year-old man visited our hospital with a large soft tissue defect in his left greater trochanteric area by traffic accident. The patient had wide skin and soft tissue defect combined with open femur fracture. During one month period of admission, he underwent femur open reduction and wound debridement four times. After that we planned thoracodorsal perforator free flap reconstruction. The flap was outlined as large as $20{\times}15\;cm$ and elevated in a suprafascial plane from the lateral border. During intramuscular perforator dissection, we found that two 1.5 mm diametered perforator vessels coursed inferomedially toward second lumbar region. Finally the flap became lumbar artery perforator flap based on second lumbar artery perforator as a main pedicle. After flap transfer, the perforator vessels were connected with inferior gluteal artery and vein microsurgically. The operation was successful without uneventful course. We found no significant postoperative complication and donor site morbidity during six months follow up periods. Lumbar artery perforator flap could be an alternative procedure for thoracodorsal perforator flap in some patients with anatomic variant features.
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하악각축소술시 절제된 골의 간치이식을 이용한 턱끝증대술
이태일,백룡민,오갑성,백세민 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.5
The square face or the box face appearance is quite common in orientals as well as occidentals and consists of flaring at the mandible angle areas with exaggerated posterior inferior projection of the mandibular angle in combination with a small and weak chin, resulting in widened bigonial distance and shortened lower third of face. Such patients complain of unbalanced and masculine appearance and may regard themselves as unaesthetic. To correct these deformities simultaneously, the mandible angles were resected (angled osteotamy) and the bone fragment from these ostectomized mandibular angles were used to augment the chin as an autogenous interpositional bone graft. At the Institute of Plastic and Reconstruction Craniofacial Surgery(IPRCS), Ice University Collage of Medicine, twenty eight cases were successfully operated in this manner during a six-year period from June 1989 to May 1995. Patient's satisfaction was high and improved esthetics were noted in all patients with minimal complications. The advantages are: l. Simultaneous correction of prominent mandible angle and augmentation of the deficient chin area. 2. Provides vertical elongation of the chin and lower face, which gives visual compensation for agittal weakness of the lower face. 3. Improves upper and lower facial balance. 4. Another donor site for bone is not necessary, thus avoiding unnecessary donor site morbidity. 5. Homogenous autologous bone is used thus reducing the chance of resorption. 6. Minimal chance of infection.
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오갑성,백룡민,이태일,임재호,백세민 대한미용성형외과학회 1997 Archives of Aesthetic Plastic Surgery Vol.3 No.1
The chin plays a decisive role in the contour of the lower face. And harmonious jaw will correspond to good facial profile and positive image. Osseous genioplasty is a widely used method to correct the 3-dimensional(sagittal, vertical, transverse) deformity of the chin with minimal complications. During an 8 year period from 1988, the authors at the In-Je University Seoul Paik Hospital experienced 198 patients of osseous genioplasty. Results of clinical analysis are as follows: 1)Mail to female ratio was 1 : 3 with female being predoniment. The average age was 24.9 years. 2) Horizontal advancement genioplasty in 169 cases was the most common precedure with 7.0mm of average advancement. There was 4 cases of horizontal retrusion with average retrusion of 4.3mm. 52 cases had vertical augmentation with average of 7.5mm increase. 9 cases had vertical reduction with average redution of 4.9mm. 3) Although malocclusion is not necessarilly contraindication to genioplasty alone, genioplasty following surgical with or without orthodontical correction of malocclusion is the way to get better result with patient satisfaction. 4) 77% of the patients had adjunctive procedures simultaneously to acheive a better contour and profile 5) Complications such as hematoma, infection, fracture, nerve damage were minimal.
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백승준,임재호,백룡민,오갑성,백세민 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.5
The harvesting of costal cartilage for the total ear reconstruction elicits various functional and aesthetic problems such as pneumothorax, atelectasis, pain, scar and chest contour deformities. Although the costal cartilage has been the most popular autogenous tissue for the total ear reconstruction, the studies about problems of donor site after harvesting the costal cartilage were relatively rare. From March 1989 to October 1996, 153 cases of total ear reconstruction by the costal cartilage framework insertion were done in our hospital and 61 cases whose follow up were done over 6 months were analysed for donor site scar, contour deformity and rate of satisfaction. The optimal age of microtia reconstruction was considered as over the age of 8, because of the growth of the ear and the volume of costal cartilage. Through a small incision, 3 ~ 4 cm, on the contralateral chest, the 6th, 7th and 8th costal cartilage were harvested with the outer layer of perichondrium for survival of the costal cartilage framework, the inner layer of perichondrium was remained for the growth of costal cartilage. There were 4 cases of uneventful pleural perforation, and remained no problems on the patients. The state of chest donor site were analyzed on 61 patients by use of medical records, medical photos and interview with the patients. Mean length and width of chest scar were 5.2 cm and 2.3 mm 79% of patients classified as excellent or acceptable. Chest contour deformity was observed on 39% and 85% of patients were satisfied with the result of donor site.
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