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RISS 인기검색어
- 검색키워드
- 저자 : Toshihiko Satake (검색결과 4 건)
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Toshihiko Satake,Jun Sugawara,Kazunori Yasumura,Taro Mikami,Shinji Kobayashi,Jiro Maegawa 대한성형외과학회 2015 Archives of Plastic Surgery Vol.42 No.6
This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP) flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipplesparing mastectomies and immediate reconstruction with “mini-flow-through” DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient’s internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels.
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Satake, Toshihiko,Sugawara, Jun,Yasumura, Kazunori,Mikami, Taro,Kobayashi, Shinji,Maegawa, Jiro Korean Society of Plastic and Reconstructive Surge 2015 Archives of Plastic Surgery Vol.42 No.6
This procedure was developed for preservation of the rectus muscle components and deep inferior epigastric vessel after deep inferior epigastric perforator (DIEP) flap harvesting. A 53-year-old woman with granuloma caused by silicone injection underwent bilateral nipple-sparing mastectomies and immediate reconstruction with "mini-flow-through" DIEP flaps. The flaps were dissected based on the single largest perforator with a short segment of the lateral branch of the deep inferior epigastric vessel that was transected as a free flap for breast reconstruction. The short segments of the donor deep inferior epigastric vessel branch are primarily end-to-end anastomosed to each other. A short T-shaped pedicle mini-flow-through DIEP flap is interposed in the incised recipient's internal mammary vessels with two arterial and four concomitant venous anastomoses. Although it requires multiple vascular anastomoses and a short pedicle for the flap setting, the mini-flow-through DIEP flap provides a large pedicle caliber, enabling safer microsurgical anastomosis and well-vascularized tissue for creating a natural breast without consuming time or compromising the rectus muscle components and vascular flow of both the deep inferior epigastric and internal mammary vessels.
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Free Fat Graft for Congenital Hand Differences
Toshihiko Ogino,Daisuke Ishigaki,Hiroshi Satake,Kousuke Iba 대한정형외과학회 2012 Clinics in Orthopedic Surgery Vol.4 No.1
Background: Free fat graft has been used for the treatment of congenital hand differences. However, there have been a fewreports about the outcome of that treatment. In this study, the outcome of free fat grafts for congenital hand and foot differenceswas investigated. Methods: Fourteen bones with longitudinal epiphyseal bracket, 3 wrists with Madelung deformity, and 5 cases of osseous syndactylywere treated with free fat graft with osteotomy, physiolysis, or separation of osseous syndactyly. Of the fourteen boneswith longitudinal epiphyseal bracket, 9 were treated with open wedge osteotomy with free fat graft and 5 with physiolysis andfree fat graft. The Madelung deformity was treated with physiolysis with free fat graft. For osseous syndactyly, syndactyly releasewith free fat graft was performed fi ve times on four hands. Results: In the fourteen cases with longitudinal epiphyseal bracket, lateral deviation improved in all except two cases after surgery. The average lateral deviation angle changed from 32.5 degrees before surgery to 15.2 degrees after surgery. The average improvementof the lateral deviation angle was 12.2 degrees in the osteotomy group and 20.6 degrees in the physiolysis group. Themean ratio of improvement of the lateral deviation angle to the lateral deviation angle before surgery was 39.4% in the osteotomygroup and 51.2% in the physiolysis group. The Madelung deformity improved after surgery in two cases but there was no improvementin one case. For these conditions, the results were not good enough when surgery was done after age 13 or at age four forseverely hypoplastic brachymesophalangy. Of the 5 cases of osseous syndactyly, reunion of the separated bones occurred in onecase. The grafted free fat should be deep enough to cover the osteotomy site of the bones to prevent reunion of the separatedbones. Conclusions: Physiolysis and free fat graft performed during the growth period can correct the deviation due to longitudinalepiphyseal bracket and Madelung deformity. Free fat graft is also useful to prevent reunion of the bones after separation of osseoussyndcatyly, if the grafted fat is securely fi lled into the space between the separated bones.
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