The periareolar excision technique for improved scars in breast burns

주홍실,Seung Je Lee,성건용 대한미용성형외과학회 2019 Archives of Aesthetic Plastic Surgery Vol.25 No.2

Regardless of size or severity, post-burn breast scars can be traumatic for patients. There are various approaches to post-burn scar management, but herein we present the results of a novel approach in which we tried to remove the scars in an early stage of treatment. Breast burn patients, whose wound area included the nipple-areolar complex, were treated using a periareolar incision design similar to that of periareolar reduction mammoplasty. The remnant scar was located only along the periareolar complex. As a result, more cosmetically satisfactory results were achieved compared to skin grafting or local flap procedures.

두피에 발생한 암육종의 치험례

주홍실,전영준,김영진 대한성형외과학회 2003 Archives of Plastic Surgery Vol.30 No.6

Carcinosarcoma is a biphasic tumor composed of an intimate admixture of epithelial and mesenchymal element, both of which are malignant.Primary cutaneous cases are extremely rare. There have been reported only 18 cases of cutaneous carcinosarcoma in the world and only one case can be found in the korean pathology literature. Therefore it has been difficult to characterize the clinical course of carcinosarcoma of the skin.We present a further case of primary cutaneous carcinosarcoma in a 86-years-old woman with exophytic and hemorrhagic mass on scalp. Histologic and immunohistochemical studies revealed both squamous cell carcinoma and spindle cell sarcomatoid change intermingled in the same tumor.The clinical and histologic findings of cutanous carcinosarcoma were described.

외상 후 발생한 무지의 Boutonniere 변형

주홍실,권호,정성노 大韓成形外科學會 2004 Archives of Plastic Surgery Vol.31 No.3

Early Debridement and Cultured Allogenic Keratinocyte Dressing Prevent Hypertrophic Scarring in Infants with Deep Dermal Burns

주홍실,Seung Je Lee,성건용 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.3

Background Deep dermal burns are frequently treated with excision and skin grafting. Otherwise, wound healing may take up to 4 to 6 weeks, with serious scarring. Especially in pediatric patients, post-burn scarring could result in psychologic trauma and functional disability. We aimed to investigate the efficacy of early debridement and dressing using cultured allogenic keratinocytes in infants with deep dermal burns to prevent hypertrophic scarring. Methods From April 2016 to April 2018, 18 infants were treated for deep dermal burns. Except for 5 infants who underwent skin grafting or excision, 13 infants were included in this study. We performed early debridement in these patients using Versajet™ and serial dressings using Kaloderm®. Results The average operative date was 8.3 days after the accident. The mean healing time was 18.3 days after the accident. The patients did not experience any contraction, but 3 patients had hyperpigmentation, 2 patients had mild hypertrophic scarring, and 1 patient had mixed pigmentation (hyperpigmentation and hypopigmentation). Conclusions Our prophylactic scar therapy, using early debridement with VersajetTM and dressings with Kaloderm®, may be beneficial for infants with dermal burns. This method was able to shorten the healing time, resulting in better scar outcomes. Our follow-up findings revealed that the scars had an aesthetically pleasing appearance and patients were able to perform normal activities without restrictions.

지연성 요추 부위 Morel-Lavalee Lesion에 대한 경피적 배농술 및 경화술을 이용한 치료 - 2명의 사례 보고 -

주홍실 ( Hongsil Joo ),서상교 ( Sang Gyo Seo ),이상열 ( Sang Yeul Lee ),성건용 ( Kun Yong Sung ) 대한골절학회 2016 대한골절학회지 Vol.29 No.4

비개방적인 박탈성 손상은 근막과 피하조직 사이의 분리와 연관되는 중요한 연부조직 손상이다. 이러한 Morel-Lavallee lesion 의 진단은 임상적 영상학적으로 이루어지지만, 약 1/3에서 적절한 진단을 내리지 못하는 경우도 많고, 치료에의 어려움도 있다. 본 연구에서는 골절이 동반되지 않은 지연성 Morel-Lavallee lesion에 대해 경피적 배농술 및 경화술을 통한 치료 증례를 보고하고자 한다. 본 증례에서는 최소 침습 경피적 접근을 통하여 성공적인 병변의 치료를 얻었다. 이러한 치료는 피하의 혈류를 보존할 수 있어 절개 수술에 비해 피부의 손상을 최소화할 수 있을 것으로 판단된다. Closed internal degloving is a significant soft-tissue injury associated with a trauma that results in a tear of the subcutaneous tissue away from the underlying fascia. Although the diagnosis of Morel-Lavallee lesion (MLL) is routinely based on clinical and radiological examinations, in one-third of the cases, there is a possibility that clinicians may fail to diagnose MLL due to its inconsistent clinical manifestations. Additionally, it often involves initial skin bruising due to underlying soft-tissue injury. We present two cases of delayed MLL without a fracture treated using percutaneous drainage and sclerotherapy. Our cases demonstrated successful treatment with a minimally invasive percutaneous approach. The potential advantage of using a percutaneous technique is to preserve the subdermal arterial plexus, which is the only remaining blood supply to the skin in the area of the lesion. Maintaining this blood supply may result in healthier skin at the time of any open procedure.

Periumbilical Dermal Graft as a Good Option for Volume Enhancement in Secondary Cleft Lip Deformity: A Case Report

표승범,주홍실,임수아,송진경,임성윤 대한미용성형외과학회 2017 Archives of Aesthetic Plastic Surgery Vol.23 No.1

Volume deficiency and poorly defined cupid’s bow of the upper lip are frequently encountered problems in secondary cleft lip deformities. In this report, we present the method of a periumbilical dermal graft for correcting secondary cleft lip deformity. A 17-year-old male patient presented with a poorly defined notching cupid’s bow and volume deficiency of the upper lip. He had undergone cleft lip surgery when he was 2 years old. We planned to perform a periumbilical dermal graft. There were sufficient amount of periumbilical subdermis and fat tissue thickness to obtain abundant volume. The periumbilical contour was similar to the natural contour of the lip. Less scarring was expected. There was no need to change the posture during operation, making it easy to harvest. Postoperative evaluations showed vermilion symmetry. Ideal cupid’s bow shape and position were achieved without color mismatch. As a result, we obtained an ideal volume of the upper lip. Therefore a periumbilical dermal graft is a good option for correcting volume deficiency of the lip with good aesthetic outcomes.

Reconstruction of Large Orbital Floor Defect Caused by Maxillary Sinus Mucocele

표승범,송진경,주홍실,임성윤 대한두개안면성형외과학회 2017 Archives of Craniofacial Surgery Vol.18 No.3

Maxillary sinus mucocele can occur due to many medical factors such as chronic infection, allergic sinonasal disease, trauma, and previous surgery. However, it occurs mainly after Caldwell-Luc operation, usually more than 10 years after surgery. There are a few cases of maxillary sinus mucocele with ocular symptoms. Also, a case causing ocular symptoms because of invasion to the orbital floor is rare. Therefore, we report a case of a 55-year-old male patient who underwent Caldwell-Luc operation about 30 years ago. Then, symptoms such as exophthalmos, diplopia, and visual disturbance developed suddenly 3 months prior to admission. Computed tomography showed a cyst invading the orbital floor which resulted in eyeball deviation. The orbital floor defect measured approximately 2.5×3.3 cm. Maxillary sinus mucocele was removed through an endoscopic approach. After this, we reconstructed the orbital floor through a subciliary incision. Observation was carried out after three years, and ocular symptoms such as diplopia and exophthalmos did not recur.

Nasal Tip Plasty Using a Batten Graft with Ear Cartilage in East Asians

태상필,송진경,주홍실,임성윤 대한미용성형외과학회 2016 Archives of Aesthetic Plastic Surgery Vol.22 No.2

Background Plastic surgeons have constantly investigated methods of nasal tip plasty and nasal lengthening in rhinoplasty. The septal extension graft has been widely applied as a very useful method for East Asians who have different internal nasal structures and nasal skin from those of Caucasians. In this study, we performed nasal tip plasty with a batten-type septal extension graft using ear cartilage. Methods Nasal tip plasty was performed for 48 patients by batten graft with ear cartilages at the Cocoa Plastic Surgery Clinic and in the plastic surgery unit of Hanil General Hospital from January 2009 to January 2015. A batten-type septal extension graft was constructed with cymba of the concha cartilage. An average area of 2.0 cm x 1.4 cm of the cymba and 1.0 cm x 1.0 cm of the cavum from the concha cartilage was harvested. Results Of the 48 patients who underwent batten-type septal extension graft using ear cartilages, nasal tip plasty and columellar lengthening were successfully achieved in almost all of the patients. The nasal tip’s height was well-maintained for the follow-up period ranging from 6 months to 5 years after surgery. Conclusions Nasal tip plasty using a septal extension graft is a very useful method for East Asians with a low nasal tip. The septal extension graft with ear cartilage enables the creation of a desirable nasal shape because there is a sufficient amount of ear cartilage to stably support the nasal tip, thus creating a natural and smooth nose shape.

전신성 혈관염 환자의 족부 만성 창상의 치험례

임진수,김형준,주홍실,최윤석 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.1

Management of chronic wound has been a great problem to many surgeons because the wound is usually associated with an underlying disease of the patient. Without accurate diagnosis and treatment of the disease, the wound can not be healed. Systemic vasculitis is a rare systemic disease which causes inflammation and obstruction of the vessels. This autoimmune disease involves multiple organs and may inflict skin wound spontaneously without traumas. It would improve or aggravate the wound in proportion to the activities of the disease. Our experience is a case of 28-year-old female who has had chronic ulcers on her right foot, especially on the great toe for 1 year. Although she had several operations of sympathectomy, debridement and artificial dermal graft, her wound was not improved. She has been diagnosed as systemic vasculitis during the evaluation for histopathology and cause of fever and pancytopenia. After medical treatments, she had the operation of adipofascial turnover flap coverage and skin graft, and the wound was improved without any complication or relapse. The diagnosis and treatment of the underlying disease should be ahead of the management of chronic wound.

폐와 입술의 이중 원발암을 가진 환자에서 손가락 끝으로의 전이 1례

안건형(Gun Hyung Ahn),송진경(Jin Kyung Song),주홍실(Hong Sil Ju),임성윤(Seong Yoon Lim) 대한두경부종양학회 2016 대한두경부 종양학회지 Vol.32 No.2

Lung cancer is one of high mortality malignancy. It is known that skin metastasis from lung cancer is uncommon. We report a very rare case of finger tip metastasis from double primary cancer of the lung and lower lip. A 79 year-old man diagnosed with non small cell lung cancer presented with protruding solid mass in his lower lip. It showed central necrosis with purulent discharge. It had appeared rapidly growing features. Simultaneously, another solid mass accompanying painful swelling without skin lesion was found in his left middle finger tip. Both two solid masses were moderately differentiated squamous cell carcinomas. Lower lip mass was a primary cancer, while middle finger tip mass was diagnosed with clinically metastatic cancer from lung or lower lip, which means that it had double primary cancer origin.