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가금에서 정맥튜브 및 근막을 이용한 굴곡건초 재건에 관한 실험적 연구
김승홍,윤병일,민대홍,백무현,한형일,고용범,이기룡 大韓成形外科學會 1987 Archives of Plastic Surgery Vol.14 No.4
Tendon sheath is an important structure in nutrition, healing and gliding motion of the tendon. To know the effect of tendon sheath restoration with fasica and vein graft after tendon surgery, experimental surgery was done in chickens. Middle toe profundus tendon was severed and repaired. After tendon repair, sheath was treated in three ways. In group A, tendon sheath of 1cm length was simply excised. Then, sheath was excised and restored with femoral rectus muscle fascia in group B and vein conduit graft in group C. After casting in flexion for 14 days, the operated foot and digits were taken through a full passive range of motion every 3 days. At the 30th postoperative day, all immobilization was removed and free active range of motion began. Active flexion was measured after death by continuous traction on the proximal produndus tendon(simulated active flexion). The non-operated contralateral foot served as the control. All operated middle toes achieved significant greater functional return when the sheath was restored either with fascia patch or vein conduit graft in comparison with simple excision of the sheath. The histologic examination showed that area of healing was better organized with less adhesion when the sheath defect was grafted. The results indicated the possibility of utilizing fascia patch or vein conduit during primary tendon repairs as well as the efficacy of sheath closure.
백서에서 임의형 국소 피판 처치 후 실리콘 박판을 이용한 드레싱의 효과에 대한 조직학적 연구
민대홍,김미경,이기룡,조철현,김승홍 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.3
Silicone gel sheet is elastic, controls evaporative water loss, and conforms to wound surface. This property provide proper pressure on the flap, moist wound environment and effective bacterial barrier, therefore it is effective for wound healing process and scar formation on the incised bed. The purpose of our study is to evaluate the effect of silicone gel sheet dressing in the process of wound healing and scar formation on skin flap in rat by comparing with histologic findings and thickness of scar of conventional dry gauze dressing control group. In 36 rats, the skin flaps were elevated on both sides of back and sutured to their original sites. On left side the silicone gel sheet dressing was applied as an experimental group, and on right side, conventional dry gauze dressing was applied as a control group. We compared the histlogic findings between two groups by observing for changes in contact surface of flap with wound bed at 3rd, 7th and 15th postoperative day and measured thickness of scar at 15th postoperative day respectively. The histologic findings include inflammatory cell infiltration, vascular ingrowth, appearance of fibroblast, collagen synthesis. As a result, the experimental group showed that less inflammatory cell infiltration, more abundant capillary ingrowth and the large amount of fibroblast production and collagen synthesis and less scar formation than the control group. With the above results, we concluded that silicone gel sheet dressing can promote wound healing processes and help early safe flap 'take' and it can decrease scar formation in the contact surface of flap on the wound bed.