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Lim, Hyoseob,Han, Dae Hee,Lee, Il Jae,Park, Myong Chul Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.2
Background Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.
김효섭(Hyoseob Kim),이정익(Jungik Lee),임학수(Hak-Soo Lim) 한국연안방재학회 2018 한국연안방재학회지 Vol.5 No.1
Available measured time-series of simultaneous waves and alongshore data sets at Anmok Beach, east coast of Korea, for two periods were chosen to construct artificial neural network. Network inputs are the wave height and the wave direction, and the output is the alongshore current speed. The first period data sets were used for training, and the second period data sets were used for testing. Three neural networks were constructed, i.e. a two-layered one (input and output layers), and two, three-layered ones (one input, one hidden, and output layer). Test results of the two networks show high correlation between predicted and measured data: the three-layered networks show lower correlation coefficient than the two-layered network. The two layers network supplies valuable coefficients which may be used for other empirical formula for the alongshore current speed. The three-layered network also shows reasonable prediction capability of the alongshore current speed when two nodes were used in the hidden layer. The three networks show superior performance on prediction of the alongshore current speeds for measured input variables.
Kim, Jungmin,Lim, Hyoseob,Lee, Se Il,Kim, Yu Jin Korean Society of Plastic and Reconstructive Surge 2012 Archives of Plastic Surgery Vol.39 No.5
Background Rectus abdominis muscle and abdominal subcutaneous fat tissue are useful for reconstruction of the chest wall, and abdominal, vaginal, and perianal defects. Thus, preoperative evaluation of rectus abdominis muscle and abdominal subcutaneous fat tissue is important. This is a retrospective study that measured the thickness of rectus abdominis muscle and abdominal subcutaneous fat tissue using computed tomography (CT) and analyzed the correlation with the patients' age, gestational history, history of laparotomy, and body mass index (BMI). Methods A total of 545 adult women were studied. Rectus abdominis muscle and abdominal subcutaneous fat thicknesses were measured with abdominopelvic CT. The results were analyzed to determine if the thickness of the rectus abdominis muscle or subcutaneous fat tissue was significantly correlated with age, number of pregnancies, history of laparotomy, and BMI. Results Rectus abdominis muscle thicknesses were 9.58 mm (right) and 9.73 mm (left) at the xiphoid level and 10.26 mm (right) and 10.26 mm (left) at the umbilicus level. Subcutaneous fat thicknesses were 24.31 mm (right) and 23.39 mm (left). Rectus abdominismuscle thickness decreased with age and pregnancy. History of laparotomy had a significant negative correlation with rectus abdominis muscle thickness at the xiphoid level. Abdominal subcutaneous fat thickness had no correlation with age, number of pregnancies, or history of laparotomy. Conclusions Age, gestational history, and history of laparotomy influenced rectus abdominis muscle thickness but did not influence abdominal subcutaneous fat thickness. These results are clinically valuable for planning a rectus abdominis muscle flap and safe elevation of muscle flap.
Current strategies for aesthetic soft tissue refinement in nasal reconstruction
Kim, Min Ji,Lim, Hyoseob,Park, Dong Ha Korean Cleft Palate-Craniofacial Association 2022 Archives of Craniofacial Surgery Vol.23 No.3
The challenges of successful nasal reconstruction, which are related to the anatomical complexity of the region, have been extensively studied. Revisional operations are often required to achieve proper nasal reconstruction, with results resembling the premorbid nasal status. This is necessary to ensure the quality of life of skin cancer patients. Fundamental nasal reconstruction requires both proper soft tissue coverage and proper function. However, earlier studies in the field primarily focused on the functional aspect of nose reconstruction, although the cosmetic aspect is also an important factor to consider. In response to this need, many recent studies on nose reconstruction have proposed various refinement strategies to improve aesthetic satisfaction. Most plastic surgeons accept the nasal aesthetic subunit principle as a standard for nasal reconstruction. This review outlines the commonly used surgical refinement options and management strategies for postoperative complications based on the subunit principle. In patients with nasal defects, a proper technical strategy might help minimize revision operations and optimize the long-term results.