진피(반흔 조직)이식과 C-V피판을 이용한 유두재건술

이백권,임지현,안상태,오득영,이종원,한기택 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.1

Nipple reconstruction is an important step in breast reconstruction after mastectomy. The authors' preferred reconstructive technique is the local C-V flap in case that a small opposite nipple is not adequate for composite graft. This flap produces an excellent reconstruction, but it is not easy to produce an adequate projection and firmness of the nipple. This article describes the technique and experience in nine patients treated over two years with dermis(scar tissue) graft for nipple reconstruction. This is the first report of application of autologous dermis(scar tissue) grafting to reconstruct a nipple primarily after breast mound reconstruction, decreasing the absorption of the reconstructed nipple and increasing the hardness. The dermis(scar tissue) is taken from scar revision and/or dog-ear correction in the second stage operation after free TRAM flap breast reconstruction. And the dermis(scar tissue) graft is inserted vertically between the local flaps and horizontally under the reconstructed nipple base. Between September 2002 and February 2005, nine patients underwent C-V flap with dermis(scar tissue) graft as a part of their nipple reconstruction. The patient's ages ranged from 28 to 55 years old (mean, 41.1 years old). The follow-up period ranged from 5 to 35 months, with an average of 14.5 months. None of the nipples showed skin flap necrosis or local infection, and uneventful wound healing. Our result showed good nipple projection with less absorption and enough firmness. Our experiences shows that dermis(scar tissue) grafts in C-V flap is a very useful method for nipple reconstruction.

아미노필린이 지방세포의 지방분해 및 세포독성에 미치는 영향

이백권,최종필,허진,오득영,조현미,이종원,안상태 대한성형외과학회 2003 Archives of Plastic Surgery Vol.30 No.6

A concern about drug therapy for obesity has been increased with launching of new anti-obesity drug in Korea. Subcutaneous injection of aminophylline was used for regional lipolysis, but its effectiveness and safety are controversial. The purpose of this study is to investigate the effects of aminophylline on lipolytic activity and cytotoxic effect in adipocytes. Preadipocytes obtained from human breast fat tissue were cultured in monolayer culture system. Cells were treated with media added 1, 5, 10, 15, 25 mM aminophylline concentrations, respectively. Cytotoxicity was measured by XTT colorimetric assay and cell count. The lipolytic activity was measured by enzymatic autoanalyzed system. At above 15mM of aminophylline concentration, preadipocyte and adipocyte markedly presented cytotoxic effects. In proportion to concentration, lipolytic activity was increased and maximal lipolytic activity without marked cytotoxicity was measured at 10mM of aminophylline concentration.

요골 전완부 감각신경 유리건피판술 후 생긴 근육탈출증의 증례보고

이백권,김민철,전영준,오득영,이종원,안상태 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.2

Purpose: Although muscle hernia has been well described in the lower-extremity, muscle hernias in the upper extremity are extremely rare. As with lower extremity muscle hernias, the forearm muscle hernia may result from forced exertion of strenuous activity or following blunt trauma. The objective of this paper is to report an extraordinary case of forearm muscle hernia after radial forearm sensory tendocutaneous free flap with references.Methods: A 58-year-old male patient received wide excision and radical neck dissection and lower lip reconstruction with radial forearm sensory tendocutaneous free flap for squamous cell cancer on the lower lip. 16 weeks after the operation, he complained of protruding mass on the forearm and the size was increasing. In postoperative 18 weeks, MRI showed herniation of flexor digitorum superficialis. For unaesthetic cause and preventing progress, the authors performed direct fascial closure and Mesh graft. Results: In 12 months after the surgery there was no recurrence and the patient remained symptom-free. Conclusion: Pain on extremity exertion and unaesthetic buldge of forearm due to forearm muscle hernia were the primary indications for surgery which consist of direct closure, fasciotomy, fascia lata onlay graft, fascia lata inlay graft, etc. The authors experienced uncommon forearm muscle hernia after radial forearm free flap and satisfying result of treatment.

외음부의 재건에 있어서 다양한 근막피부피판의 비교

이백권,최문섭,오득영,이종원,안상태 대한성형외과학회 2004 Archives of Plastic Surgery Vol.31 No.4

The reconstruction after radical vulvectomy presents a difficult challenge. Ideal flap for vulvoperineal reconstruction has thin character, constant vascular supply, and presents concealed scar after reconstruction. Various flaps are used for reconstruction of the vulvar area, have their own advantages and disadvantages. The authors performed 15 vulvoperineal reconstructions using three kinds of different 28 fasciocutaneous flaps. Gluteal fold fasciocutaneous island flap seems like labia major and remains concealed donor scar along the gluteal fold. But secondary debulking procedure is sometimes required. Vulvoperineal V-Y advancement fasciocutaneous flap is thin, reliable, easily elevated, and matches with regional skin quality, but donor site scar is conspicuous on medial thigh. Gluteal fold V-Y advancement fasciocutaneous flap is also reliable, easily elevated, and matches with regional skin quality with thin flap and concealed donor scar on gluteal fold. Also, it can be advanced even a long distance. Through our experiences, these flaps are very useful for vulvar reconstruction, but in the aspect of donor site scar, thickness, and degree of advancement, gluteal fold V-Y advancement fasciocutaneous flap is superior to the other two patterns for the reconstruction of the large sized vulvoperineal defect.

유방에 생긴 융기성 피부섬유육종의 치험례

이백권,김현태,김영진 대한성형외과학회 2002 Archives of Plastic Surgery Vol.29 No.3

Dermatofibrosarcoma protuberans is a moderate degree malignant tumor that has high recurrent rate and low metastatic rate. This occurs most frequently on the trunk, the proximal part of upper limbs and lower limbs. However, the occurrence of this disease in the breast is extremely rare. Our case is a 20-years-old female patient who has a non-elevated nodule in the lower part of right breast. The mass was lobulated and relatively fixed to skin, but movable. The color of the overlying skin was reddish purple. The biopsy showed characteristic storiform pattern of the spindle cells on the H-E stain, and positive and negative stain on the immunohistochemical stain of anti-CD34 antibody and S-100 protein respectively. Based on the above findings we confirmed dermatofibrosarcoma protuberans (DFSP) and did wide excision for preventing recurrence and reconstructed the breast using a pedicled latissimus dorsi musculocutaneous flap. F-U taken 11 months after the operation shows no recurrence and good cosmetic result without deformity of breast or donor site morbidity.

횡복직근 유리피판술로 유방재건 후 발생한 화상의 임상적 특성

이백권,배준성,안상태,오득영,이종원,한기택 대한성형외과학회 2005 Archives of Plastic Surgery Vol.32 No.4

Following a transverse rectus abdominis musculocutaneous(TRAM) flap breast reconstruction, denervated state of the flap causes the flap skin prone to thermal injury, calling for special attention.During the last 5 years, 69 breast reconstruction with 72 free TRAM flaps, were performed. Four out of thesse 69 patients sustained burn injury. Heat sources were a warm bag(n=2), heating pad(n=1) and warming light (n=1). The thermal injuries occured from 2 days to 3 months following the reconstruction. Three patients healed with conservative treatment, but one patient required debridement and skin graft. Initially 3 out of 4 patients with the burn had shown superficial 2nd degree burn with small blebs or bullae. However all 4 patients healed with scars. Mechanism of burn injuries of the denervated flap are known to be resulting from; 1) loss of behavioral protection due to denervation of flap with flap elevation and transfer, 2) loss of autonomic thermoregulatory control with heat dissipation on skin flap vasculature contributing to susceptibility of burn injury. 3) changes of immunologic and normal inflammatory response increasing thromboxane, and a fall in substance P & NGF (nerve growth factor).Including the abdominal flap donor site, sensory recovery of the reconstructed breast varies individually from 6 month even to 5 years postoperatively. During this period, wound healing is delayed, resulting in easier scarring compared to that observed in the sensate skin. Patients should be carefully informed and warned of possible burn injuries and taught to avoid exposure to heat source at least until 3 years postoperatively.

떨어진 코끝의 코성형술 : 분류 및 교정 Classification & Correction

이백권,송진경,이종원,안상태,오영환 大韓成形外科學會 2004 Archives of Plastic Surgery Vol.31 No.2

복부 반흔을 가진 환자에서 유리 횡복직근 피판을 이용한 유방재건술

이백권,강준모,안상태,이종원,오득영 大韓成形外科學會 2004 Archives of Plastic Surgery Vol.31 No.1

좌골신경 결손부의 신경재생시 이식한 병성근의 역할

이백권,임풍 가톨릭대학 (가톨릭신학대학) 대학원 1993 가톨릭大學醫學部 論文集 Vol.45 No.1

횡유륜 유두주위절개를 통한 이중포켓 유방확대술

이백권,김지훈,서병철,오득영,이종원,안상태 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.1