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조직확장법,술중 조직확장법 및 술전 봉합법의 임상적 응용에 관한 비교 연구
오석준,하지운,김응춘,서인석,조세흠 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.3
The purpose of soft tissue defect reconstruction is minimal scar with aesthetic and functional good results. Reconstruction of head and neck, upper extremity, chest, and lower extremity defects has been reported with standard available tissue expansions. Various surgical methods have been used in an attempt to achieve a normallooking skin color, texture, sensation, thickness and same skin adenexa. Therefore, in accordance with defect size and location, the operative method was considered so we select adequate method. Authors achieved good results from 48 cases of tissue expansion, 18 cases of ISLE (intraoperative sustained limited expansion), and 35 cases of presuturing technique. 1)The most common cause of reconstruction for soft tissue defect was post grafted scar 51cases(51%), next was tattoo 20 cases(19.6%), traumatic soft tissue defect 16cases(15.7% ) and nevus 8 cases(7.8%)in order. 2)Males(55.9%)were affected more often than females(44.1%)in the ratio 1, 3 : 1 and the most frequently affected group was the age of 20 to 30 years as 36% . 3)The distribution of incidence and location were as follow : face(39.2%), upper extremity(25.5%), scalp(17.6%), lower extremity(9.8%) and trunk(7.8%). 4)The cause and distribution were scalp in 20 cases(39.2%), face in 40 cases(29.4%) in the post grafted scar, upper extremity 18 cases(90.0%) in the tattoo, upper extremity 4 cases(50.0%), face 2 cases(25.0%) in the nevus and even distribution in the traumatic soft tissue defects. 5)The presuturing technique was best recommended method for soft tissue defect in 4cm diameter lesion on extremity, but ISLE method was used in the open traumatic soft tissue defect. Over 9cm wide scar was resurfaced by expanded skin using tissue expander.
오석준,서인석 韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.4
Surgical resection of the head and neck often leaves large defects that demand reconstruction. Traditional methods of reconstruction of large defects are skin graft, local or distant flap and myocutaneous flaps. All these mdthods often resulted undeirable features. They often do not provide sufficient to be less pliable than adjacent facial skin. Recently, the free flap circumvents the disadvantages. This method is particularly suited for reconstruction of large orbitomaxillary defect where obliteration of the orbital cavity and restoration of deficient facial skin are needed. Four patients with extensive orbitomaxillary defect after extirpative surgery of tumor have been reconstructed by closing the facial defect using the microvascular composite tissue transfer with good result.
Preauturing Technique을 이용한 피부결손의 직접 재건술
공봉택,김응춘,서인석,하지운 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.2
According to the increase of skin defects by accident and operation for malignant skin disease, congenital giant nevus, and acquired skin lesions, reconstruction methods take a growing interest in plastic and reconstructive surgeon or others. Especially new techniques such as tissue expander by Neumann, Radovan and Austad, ISLE by Sasakin and presuturing by Liang et al., have developed through the animal experiments, cadaveric studies and clinical experiences, because various biomechnical properties of skin have studied extensively since 1960. We ve obtained good results in 13 patients who had a large skin defect with aiding of presuturing technique which may have otherwise required a skin graft or flap. This technique is based on biomechnical properties of skin which allow skin to stretch beond its inherent extensibility and practiced by Marc D. Liang, et.al.So, we are willing to report the practical results with review of the literatures for presuturing technique and its mechanism.
서인석,정철훈,양현진,오석준,신용호 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.2
Advances in the field of microsurgery over the past decade have made it possible to provide continuous circulation to the bone grafts used in the reconstruction of large bone defects following trauma, chronic osteomyelitis or tumor resection. The vascularized fibular graft has been used to treat twelve patients with large bone effect(mean length 13.5cm) resulting from severe trauma or infection (6 cases), tumor resection for regional tumor (5 cases), and vascular necrosis of femur head(1 case). The vascularized fibular graft had been performed in all cases during last nine years from 1987 to 1995. The versatility of the vascularized fibula graft is presented as a one-stage reconstruction for large bony and soft tissue defects without the usual replacement of the graft bone by creeping substitution. Postoperative results were good in all cases with satisfactory cosmetic and functional reconstruction except partial loss of skin flap in one case.