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인공진피(Terudermis)를 사용한 심부피부 및 연부조직결손에 대한 치료
신준호,야나가(다나베) 히로코,다이 요시아키,기요카와 켄스케,이노우에 요지로,이정형,백봉수 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.5
Various reconstructive procedures have been applied for the skin and soft tissue defect. However, the sacrifice of the donor site in flap surgery and skin grafting and involving problems of deformity or adhesion with underlying tissue in skin have facilitated the development of skin substitute. The history of artificial skin starred in 1980's with the invention of the "Stage I" membrane by Yannas, and Burke. Since then, it has been improved and applied to the clinical cases of extensive burn injury and full thickness skin defect the resection of the nevus. Recently, an artificial dermis(Terudermis), which is composed of fibrillar athelocollagens and heat-denaturated athelocollagens was developed by Terumo Co. Terudermis has the advantage of allowing early incorporation of cellular and vascular components into its collagen sponge due to dehydrothermal cross linking which is very weak. It is very suitable biological material especially in the reconstruction of the deep skin defects without dermis. From Jun 1996 to April 1997, we have grafted this artificial dermis on bony exposures after the trauma in 2 cases, and the deep skin and the soft tissue defects after the release of burn scar contracture in 1 case. Patients follow-up period ranged from 6 months to 10 months. A week after Terudermis grafting neovasculization took place and the granulation tissues appeared in 2-3 weeks. Then the split-thickness skin graft was applied secondarily resulting in the reproduction of enough volume of skin. For this matter, Terudermis is very useful for deep skin defects especially where primary local flap or free flap can not be used.
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유방증대술후 실리콘 노출과 감염을 일으킨 재생불량성 빈혈 환자의 치험례:1례 보고
조병채,기요카와 캔스케,백봉수,이노우에 요지로,다이 요시아키,야나가(다나베)히로코,신준호,이정형 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6
This 53 years old female patient ha had a history of aplastic anemia for 20 years. She had augmentation mammaplasty with silicone gel injection 16 years ago but 10 years later the injected material was partly removed due to induration and skin ulceration. Six years after partial removal of the foreign material, she developed infection again in both breasts and skin ulceration in the left breast, and surgery became inevitable. The laboratory data on admission(WBC : 2600/μℓ, Hb : 6.3/μℓ, platelet : 13.00μℓ) showed apparent pancytopenia and bone marrow aspiration revealed celluar hypoplasia(nucleated cell: 7,000/μℓ). Under interdepartment cooperation with the department of Hematology, general transfusion method(including HLA typing platelet transfusion) and cytokine therapy with G-CSF(granulocyte-colony stimulating factor) and erythropoietin were done to confront preoperative peripheral blood pancytopenia. As results of preoperative planned treatment, left simple mastectomy due to over-granulation and hematoma and right subcutaneous mastectomy could be performed without serious bleeding or other complication. Authors report this case to show effects of transfusion and therapy for the surgical treatment of an aplastic anemia patient.
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