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Surgical Outcomes of Cooling Composite Graft for Fingertip Amputation
임효섭,탁승완,정찬민,조상헌,이종욱,고성훈 대한수부외과학회 2019 대한수부외과학회지 Vol.24 No.4
Purpose: This study aimed to report the surgical outcomes of postoperative management of ice-cooling combined with moist-open dressing and intravenous prostaglandin E1 (PGE1) injection. Ice cooling as postoperative management was also discussed.Methods: Forty-one fingertip amputation of 38 patients between January 2007 and December 2017 were investigated ret-rospectively. Fingertip amputations were managed with postoperative ice bag application for 72 hours followed by moist open dressing and PGE1 injection.Results: Twenty-five composite grafts (61.0%) survived with complete healing at 8 weeks after surgery, with favorable outcomes in cases with low injury level (type I, 82.3%) and guillotine injury (77.8%). A higher survival rate was signifi-cantly correlated with female sex, guillotine injury, injury without osseous tissue (type I), and cold outdoor temperature (p<0.05). Multivariate analysis revealed that differences between types I and III injuries, injury mode, and outdoor tem-perature were independent clinical parameters associated with composite graft survival.Conclusion: The present study reported comparable results with postoperative ice cooling in cases with low injury level, guillotine injury, and low outdoor temperature. Prospective studies on the specific parameters of ice cooling and standards of manageable postoperative care should be conducted to enhance survival.
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Chan Min Chung,탁승완,임효섭,조상헌 대한미용성형외과학회 2019 Archives of Aesthetic Plastic Surgery Vol.25 No.4
Congenital cystic lymphatic malformations on the extremities are very rare. The patient described in this case study presented with a cutaneous and pedicled macrocystic lymphatic malformation that was eliminated by electrocauterization. A 4-day-old female infant with a congenital cutaneous mass on the dorsal area of her left first metacarpophalangeal joint presented to an outpatient clinic. An electrocautery device was used to cut the pedicle gently with minimal bleeding to avoid mass rupture and to minimize morbidity. A simple wet dressing was applied for 1 week, and the wound subsequently healed completely. Cutaneous macrocystic lymphatic malformations are very rare, especially on the extremities, and no consensus exists on their treatment, which has not been previously described. This report presents this rare case, along with a review of the literature.
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