羊膜을 利用한 Biolgical Dressing

姜振聲 최신의학사 1979 最新醫學 Vol.22 No.11

대흉근 근피판으로 큰 안면부결손을 치료한 경험

송중원,강진성 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.4

The surgical reconstruction of major defects of the head and neck such as those following accidental injuries or resection of tumors has been facilitated and advanced by the development of myocutaneous flaps which provide both muscle bulk and skin coverage. Of the many available myocutaneous flaps, the pectoralis major myocutaneous flap has many advantages such as abundant tissue with an excellent vascularity, anatomic proximity, long arc of rotation, reliability and versatility, so it is used most frequently in head and neck reconstruction. It is the purpose of this paper to present our experiences with two cases of pectoralis major myocutaneous island flaps used in reconstruction of major defects of face; one is after resection of very large basal cell carcinoma of the left oral commisure and the other is after resection of a huge fibrous mass and destructed facial bones caused by chronic osteomyelitis.

羊膜을 利用한 火傷의 生物學的 處置

李永吉,姜振聲 大韓成形外科學會 1977 Archives of Plastic Surgery Vol.4 No.2

Burns are an unexpected disaster that kill or deform many people every year. The object of burn treatment is to replace the destroyed skin and to restore normal function. There are 3 method of skin replacement; xenograft, allograft sand autograft. We treated 28 burn patients from Feb. 1, 1977 to July 31, 1977 with amniotic membranes applied to the burned area as one method of allograft. Of these 28 patients, 20 were admitted and 8 were treated in the outpatient department. There were 12 males and 16 females, and 17 were under 5-years of age. 24 patients were scalding burns and 4 were flame burns. 25 patients were 2° and 3 were 2° to 3° burns. 20 patients had burns of less than 15%, 7 were 15% to 30% and 1 was 30% to 40%. Using aseptic technique, amniotic membrane was obtained from placenta by easily peeling it from the chorion. The membrane was cleaned with sterile isotonic saline solution and 0.025% sodium hypochlorite solution for sterilization prior to being stored at 4℃. All membranes cultured microbiologically at weekly intervals reveals revealed negative bacterial growth. The membranes studied histologically at weekly intervals revealed no cellular change or necrosis for 10 weeks, but degenerative change appeared after this period. Of these 28 patients, 13 were grafted with amniotic membranes that had been prepared and preserved for 2 weeks, 9 were grafted with membranes preserved 3 to 4 weeks, 5 were grafted with membranes preserved 5 to 7 weeks, and one was grafted with membranes preserved for 10 weeks. A 3 to 6 months follow up after total healing revealed 21 patients were healed without scarring, 2 patients who had 2° to 3° burns had some flat scarring and 1 patient who had an autogenous mesh skin graft for scattered 3° burns had hypertrophic scarring. 4 patients were impossible to follow up.

顔面部 開放性 創傷의 感染에 對한 臨床的 考察

이덕희,하지운,강진성 대한성형외과학회 1978 Archives of Plastic Surgery Vol.5 No.2

Because of increasing speed, number of automobiles and newly developed machines, open facial wounds more freqently occur and are often combined with facial bone fractures that can result in severe deformities. One of the greatest enemies to treat without noticeable cosmetic and functional problems, is infection. 41 cases of open facial wounds were treated at the Taegue Presbyterian Medical Center, from May 1978 to August 1978. Results of smear, culture and sensitivity tests of open facial wounds were as follows; 1) Of 41 cases, 17 were contaminated or 41.5%; and 76.5% of these contaminated cases were caused by Staphylococcus, and in healthy persons, 70% of the normal flora is Staphlyococcus. 2) Even after meticulous wound preparation and use of prophylactic antibiotics with Hostacillin and Amolex, one case in the 41 or 2.4% was infected and the organism identified as Pseudomonas. 3) In the Staphlococcus cases, Gentamycin was the most sensitive, and Amikacin, Lincocin and Kanamycin were relatively sensitive; in the Pseudomonas cases, Gentamycin and Amikacin were moderately sensitive.

眼底骨折의 治療

姜振聲 慶北大學校 醫科大學 1976 慶北醫大誌 Vol.17 No.2

著者는 1975年 9月 18日부터 1976年 8月 26日까지 大邱 東山督病院 成形外科에서 7例의 眼底骨折患者를 治療하였는데 交通事故에 依한 것이 5例로서 가장 많았고 大部分이 20代의 男子였다. pure blowout 骨折은 1例였고 나머지 6例는 impure blowout 骨折이 였으며 同伴된 顔面骨 骨折은 上顎骨 觀骨, 鼻骨의 順이였다. 全例를 X-線 方法으로 確診한 후 手術로서 治療하였으며 治療后 1例에서는 經度의 複視가 있었으나 나머지 例에서는 滿足할만한 좋은 結果를 얻었다. According to the increasing speed, number of automobiles and complicating automation in industry, blowout fractures of the orbit occur more frequently than before. Early diagnosis and early treatment are essential in preventing permanent disability and deformity in order for patient to return to active life as soon as possible. However, the blowout fractures may be overlooked on the first examination. Seven cases of orbital floor fractures were found in an eleven-month period in this department, September 18, 1975 to August 26, 1976. Five cases of orbital blowout fractures were in the second decade of life that seemed to coincide with an active social life. The most frequent cause was car accidents. Of those even cases, impure blowout fractures were much more frequent, 6 times as frequent as the pure type. Stereo Water's views and tomograms of the orbital floor were the most helpful in making a diagnosis of blowout fractures. In some instances, contrast orbitography was desirable to make a more accurate diagnosis. All cases needed open reduction and fixation, and three cases required the use of Silastic sheets to cover the defect in the orbital floor. All cases except one who sustained a slight diplopia were satisfied with the surgical treatment.

미세혈관문합때 염산 ticlopidine의 항혈전 효과

전종완,강진성 啓明大學校 醫科大學 1998 계명의대학술지 Vol.7 No.1

Recent progress in microvascular surgery has opened new clinical possibilities in tissue transplantation and replantation by direct anastomoses of vessels less than one mm in external diameter. However, a large obstacle still remains in microsurgery, that is, occlusion of the anastomosis site by thormbosis which is mainly composed of platelets. Many anticoagulants and topical vasodilatic agents such as heparin, aspirin, persantin, coumarin, magnesium sulfate have been used to solve this problem. Heparin inhibits the conversion of prothrombin to thrombin and Factors V, IX, XI. Aspirin inhibits collagen-induced platelet aggregation wheras the primary action of persantin is to inhibit ADP-induced platelet aggregation and release reaction of platelets, Currently, ticlopidine-HCl which is known to inhibit the platelet aggregation to ADP, collagen and epinephrine, is widely in use as and effective anticoagulant for the patients of atherosclerosis, hemodialysis and subarachnoid hemorrhage. Animal study was carried out for the tichlopidine-HCl to investigate the possibility of this agent to be used as a choice of anticoagulant in microvascular surgery. One hundred and twenty rats were divided into 3 groups Group A was the control groups. Aspirn and persantin were given orally in group B. Ticlopidine-HCl was given orally in group C. A femoral artery in one inguinal region and one femoral vein in the other side were severed and then were anastomosed with 10-0 nylon. The wounds were closed with 4 ㅡ0 black silk. The patency was confirmed grossly and microscopically at 20 minutes, 3 days and 3 weeks after anastomoses. The patency rates were as follows: At 20 minutes after anastomoses, patency rates of arteries and veins were 100% in all groups. At 3 days after anastomoses, in the control group the patency rates of arteries and veins 95% and 85% respectively. Group B (aspirin-prersantin) were 100% and 90% each. Compared with these, the patency rates of group C (ticlopidine) were better, all of the arteries and veins were patent. At 3 weeks after anastomoses, the patency rates of arteries were 90% and veins were 80% in the control group. Arteries were 95% and veins were 90% in group B, whereas arteries were100% and veins were 95% in group C. Therefore, it is concluded that the ticlopidine can be used in microvasular surgery as and anticoagulant of choice.

국내 선박부착생물 수중제거작업 관리방안 연구

강진성,임병만 해양환경안전학회 2023 해양환경안전학회 학술발표대회 논문집 Vol.2023 No.11

가토 태자의 구순열 교정

한기환,김영환,강진성 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.1

Recent data in A/J mouse and rhesus monkey indicate that a cleft lip repaired in utero heals without inflammation and scar formation typical of postnatal cleft lip repair. Authors developed a model for in utero cleft lip repair in rabbits, and examined the cleft lip nose forms and the histologic features of cleft lip healing. A cleft lip was created by a 1 mm paramedian section of the left side of the upper lip and maxillary alveolus under 6× microscopic magnification in the New Zealand albino rabbits on day 24 of gestation. The defect was simultaneously repaired with two 10-0 nylon sutures at the vermilion border and nostril sill. The same defect was created at a second febus, and the febus returned to the uterus without repair. Control fetuses were exposed and returned to the uterus without operation. Forty-five fetuses in 12 pregnant does were operated on. Twenty-eight fetuses survived the procedure and were alive at the time of harvest (1,3, and 7 days after procedure): 9/15 repaired clefts (60.0%), 10/19 unrepaired clefts (52.6% ). and 9/l1 controls (81.8% ). Clinical examination demonstrated that there was little or no evidence of the lip repair in repaired fetus. Both repaired and unrepaired fetuses had asymmetry of the nose with depression on the cleft side. However, the repaired group had a milder deformity and appeared to be improving with growth. Microscopic examination of the hematoxylin-eosin stained sections confirmed that in both repaired and unrepaired wounds, the fetal rabbit clefts heals mostly without inflammatory cell infilteration or scar formation. In the unreparied cleft, epithelization had not occurred by seven days. The results of this study demonstrate that the fetal rabbit model for cleft lip repair is feasible with acceptable survival, and cleft lip repair in the fetal rabbit heals without inflammation and by regeneration of involved tissue rather than by fibrous replacement.

절골술을 이용한 안면교정

오석희,한기환,강진성 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.5

The most important factor in the beauty of the face is the harmony of the facial skeleton and soft tissue. The postoperative result is not always satisfying after only classic soft tissue surgery. The reason for dissatisfaction is disharmony of the facial skeleton. Recently, the development of maxillofacial surgical techniques enable disharmony of the facial skeleton to be successfully corrected. The authors have had experience with 33 cases of congenital and acquired facial deformities, from March of 1986 to February of 1989, and have followed them from 6 months to 2 years. We used an intraoral approach in most cases and got good results. There were four wound disruptions which were treated conservatively and resolved without sequelae.

압좌시킨 이개 연골을 이용한 안저 골결손의 재건

최동원,송중원,한기환,강진성 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.5

A numerous materials have been used for reestablishing continuity of the orbital floor in orbital floor fracture. Traditionally autogeneous bone has been utilized for reconstructing orbital floor defect but autogeneous bone has criticized for unpredictable resorption, donor site morbidity and difficulty in shaping and fixation. Alloplastic materials have gained some popularity because of their availability and ease of use but they disadvantages like infection. extrusion and implant displacement. There is an alternative to bone grafts and inorganic implants fir reconstruction of orbital floor defect; auricular conchal cartilage, however, has convolution so the authors have made the conchal cartilage flat and malleable by crusher. Crushed autogenuous conchal cartilage has proved to be a material that is easy to obtain and shape and can reliably support the orbit without evidence of resorption. Crushed autogeneous conchal cartilage offers an attractive alternative to inorganic implants and bone grafts in properly selected patient for orbital floor reconstruction.