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Utku Can Dölen,Nezih Sungur,Gökhan Koca,Onur Ertunç,Ayşe Tülay Bağcı Bosi,Uğur Koçer,Meliha Korkmaz 대한성형외과학회 2015 Archives of Plastic Surgery Vol.42 No.6
Background It is still difficult to prevent partial or full-thickness flap necrosis. In this study, the effects of a cream containing menthol and methyl salicylate on the viability of randompattern skin flaps were studied. Methods Forty female Sprague-Dawley rats were divided into two equal groups. Caudally based dorsal random-pattern skin flaps were elevated, including the panniculus carnosus. In the study group, 1.5 mL of a cream containing menthol and methyl salicylate was applied to the skin of the flap, and saline solution (0.9%) was used in the control group. Upon completion of the experiment, flap necrosis was analyzed with imaging software and radionuclide scintigraphy. Histopathological measurements were made of the percentage of viable flaps, the number of vessels, and the width of the panniculus carnosus muscle. Results According to the photographic analysis, the mean viable flap surface area in the study group was larger than that in the control group (P=0.004). According to the scintigrams, no change in radioactivity uptake was seen in the study group (P>0.05). However, a significant decrease was observed in the control group (P=0.006). No statistically significant differences were observed between the groups in terms of the percentage of viable flaps, the number of vessels, or the width of the panniculus carnosus muscle (P>0.05). Conclusions Based on these results, it is certain that the cream did not reduce the viability of the flaps. Due to its vasodilatory effect, it can be used as a component of the dressing in reconstructive operations where skin perfusion is compromised.
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Innovation in the planning of V-Y rotation advancement flaps: A template for flap design
Utku Can Dölen 대한성형외과학회 2018 Archives of Plastic Surgery Vol.45 No.1
Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. We designed 2 templates to plan a V-Y rotation advancement flap. The template for a unilateral V-Y rotation advancement flap was used on the face (n=5), anterior tibia (n=1), posterior axilla (n=1), ischium (n=1), and trochanter (n=2). The template for a bilateral flap was used on the sacrum (n=8), arm (n=1), and anterior tibia (n=1). The causes of the defects were meningocele (n=3), a decubitus ulcer (n=5), pilonidal sinus (n=3), and skin tumor excision (n=10). The meningocele patients were younger than 8 days. The mean age of the adult patients was 50.4 years (range, 19–80 years). All the donor areas of the flaps were closed primarily. None of the patients experienced wound dehiscence or partial/total flap necrosis. The templates guided surgeons regarding the length and the placement of the incision for a V-Y rotation advancement flap according to the size of the wound. In addition, they could be used for the training of residents.
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선천성 코눈물관막힘을 가진 영아 중에서 마사지만으로 호전된 경우의 특징
김창호,유혜린,윤영수.Chang Ho Kim. M.D.. He-len Lew. M.D.. Young Soo Yun. M.D. 대한안과학회 2008 대한안과학회지 Vol.49 No.10
Purpose: The treatments for congenital nasolacrimal duct obstruction range from minimally invasive to more invasive methods. Initially, clinicians select lacrimal sac massage with topical antibiotics application or early lacrimal sac probing. We studied if the characteristics of infants improved after lacrimal sac massage with topical antibiotic application. Methods: Two hundred thirty-four eyes of 204 patients diagnosed with congenital nasolacrimal duct obstruction from March 2001 to January 2007 were included. Excluded were infants who had obvious epiblepharon or eyelid abnormalities, tumors of the lacrimal system, or a history of trauma. Neonates less than 1 month were also excluded to rule out neonatal conjunctivitis. At the first visit, we recorded birth profile information such as gestational age, birth weight and height, onset time of symptoms, and post-conceptional age. We compared the results between the successful treatment group and failure group after lacrimal sac massage and topical antibiotic application. Results: One hundred twenty-three eyes showed improvement after conservative treatment (52.6%), and the infants included in the success group visited earlier and had lower PCA (P<0.05). No other factors evaluated in this study contributed toward the improvement in symptoms observed. Conclusions: When considering treatment for congenital nasolacrimal duct obstruction, an evaluation of factors related to birth should be performed. According to the results, infants with the characteristics of favorable outcome should be treated conservatively, while those patients who do not have the characteristics for favorable outcome should be treated by early probing to achieve an effective and satisfactory outcome. J Korean Ophthalmol Soc 2008;49(10):1559-1564
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Multicultural Knowledge and Skills of Singaporean Master Therapists
Len Jennings,Ashley Gulden,Michael Oien,Vilma D’Rozario,Michael Goh,Thomas M. Skovholt 한국상담학회 2012 Journal of Asia Pacific counseling Vol.2 No.2
An international team of researchers from Singapore and the United States conducted a qualitative investigation of the multicultural competencies of Singaporean master therapists (i.e., expert therapists). Six Singaporean master therapists, previously studied and identified through an extensive peer nomination sampling procedure (Jennings et al., 2008), were reinterviewed to explore how these master therapists conceptualize and conduct cross-cultural counseling. Utilizing data analytic procedures from consensual qualitative research (CQR) and grounded theory, eight themes within two categories were identified. The Multicultural Knowledge category contained four themes (Self-Knowledge, Cultural Immersion, Cultural Knowledge, and Knowledge of Systemic/Historic Oppression). Another four themes (Respect, Cultural Misunderstandings Lead to Humility and Growth, Ask, Dontained four th Suspend Judgment and Avoid Imposing Values) were organized under the Multicultural Skills category. Recommendations for future research and implications for clinical practice are discussed.
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