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안희창,Ahn, Hee-Chang 대한미세수술학회 2010 Archives of reconstructive microsurgery Vol.19 No.1
Lower abdominal tissue is regarded as an ideal donor site for the breast reconstruction because it provides large skin territory and huge amount of soft tissues enough to the breast size. However it is not easy for the surgeon to reconstruct the really natural breast, and needs the learning curve with long time experience. Author represent the various reconstruction procedures for the breast using lower abdominal tissue such as muscle sparing free TRAM, DIEP, and SIEA free flaps to reinsure like breast. Indications, and selection of reconstructive methods, surgical timing, selection of donor sites and recipient vessel of these flaps were reviewed. In addition, detailed procedures, surgical tips and secondary adjuvant procedures are described for more symmetry of reconstructed breast. The muscle sparing free TRAM, DIEP, and SIEA free flaps would be enough to provide supple, huge amount of well vascularized tissue for the breast, if these flaps were selected for the appropriate indication according to patient's general condition, obesity, the opposite breast and abdominal tissue condition. Lower abdominal tissue was able to provide versatile designs with sufficient adipose tissue without compromising the integrity of abdominal wall.
황오열,박치영,김용배,안희창 大韓成形外科學會 1987 Archives of Plastic Surgery Vol.14 No.3
Most mandibulr reconstructions are performed primarily or secondarily for bony defects caused by injuries or removal of tumors. An autogenous bone greft is still the method of choice for the restoration of mandibular defec. But a conventional autogenous free bone graft does not possess an intact blood supply and is dependent on local nutrition to survive. Severely scarred or radiated tissue are unfavorable beds for bone graft and even more the risk of resorption and infection is inceased in these kinds of a pooly vascularized bed. To overcome this difficulty, free vascularized bone graft has been tried with microsurgical gical technuque. A free vascularized bone graft has significantly higher rate of survival, with less resorption and higher resistance to infextion than a connentional free bone graft. A free vascularized iliac bone graft pedicled on deep circumflex iliac vessels is used widely, as it have many advantages such as, availability of large bloc of composite tissue, simplicity of donor dissection, large and long vascular pedicle and few donor site morbidity. In this paper, we represent 4 cases of reconstruction of wide mandibular defects using free vascularized iliac bone graft and free dsteocutaneous groin flap, and review the characteristics of gunshot wound. The result is satisfactory.
정영하,김석권,안희창 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.6
We have experienced of treating 34 patients who had developed the complication after receiving injection of foreign bodies such as silicone or paraffin, and had undergone the surgical treatment. The most common symptom and sign of these patients were redness and palpable mass on the injected area. The time interval from the injection of foreign body to development of the complication was varied from 7 months to 30 years, but mostly 5 to 10 years. The most common site of injection was face. The 38-years old female patient who had augmented her breast with paraffin injection 4 years ago suffered from the breast cancer. Regarding treatment of the complication, these patients were classified into 3 categories according to the severity of symptoms and signs. The conservative treatment was performed on those of the first stages, and the surgical treatment was indicated in those of the second and third stages. In the second staged patients, the foreign bodies were surgically removed and comouflage procedures such as face lift, blepharoplasty, rhinoplasty were performed. Wide resection of the lesion and reconstructive procedures were required in the third staged patients. The results of surgical treatments for these patients were satisfactory in the aspects of symptoms and appearance.
횡복직근 유리 피판술로 재건된 가슴에서의 감각 회복에 대한 임상적 고찰
안희창,성건용,최승석,황원중,Ahn, Hee-Chang,Sung, Kun-Yong,Choi, Matthew Seung-Suk,Hwang, Won-Joong 대한미세수술학회 2005 Archives of reconstructive microsurgery Vol.14 No.2
The purpose of this study is to introduce a sensory restoration in reconstructed breast with free TRAM flap to evaluate recovery aspect and recovery quantity. 144 patients underwent breast reconstruction with free TRAM flap by authors and were followed up at the out patient clinique. We discovered that sensory of operated breast was recoverd. We divide the breast into 5 region (upper medial, lower medial, upper lateral, lower lateral, nipple areolar complex) for examining the sensory restoration. Sense of upper medial region & upper lateral region is recovered more quickly than other region. Touch sensation was recovered more quickly than pain sensation, temperature sensation, vibratory sensation. After about 1 year all protective sensation was recovered in all patient. We discovered that severe postop scar and irradiation of breast is related to delayed sensory recovery, age and size of flap is not related to sensory recovery.
안희창,성건용,조동인,최승석,Ahn, Hee Chang,Sung, Kun Yong,Jo, Dong In,Choi, Seung Suk 대한미세수술학회 2004 Archives of reconstructive microsurgery Vol.13 No.1
Transverse rectus abdominis muscle (TRAM) free flap is widely used for breast reconstruction, however donor-site morbidities such as abdominal wall weakness, hernia, bulging are troublesome. For the purpose of minimizing donor-site morbidity, there has been a surge in interests in muscle sparing free TRAM flap preserving the anatomy of rectus abdominis muscle, fascia, and motor nerve. The purpose of this study is to investigate complication and morbidity after muscle sparing free TRAM flap. Between August, 1995 and May, 2003, there were 108 cases of muscle sparing free TRAM flap of breast reconstruction. There was no abdominal hernia. There were 4 cases of dog ear, 3 cases of marginal necrosis of apron flap, 2 cases of asymmetry of umbilicus. At 1 year after operation, most patients feel comfortness in physical exercise. Muscle sparing free TRAM flap provides ample amount of well vascularized soft tissue with small inclusion of rectus abdominis muscle and fascia. Also it minimizes donor-site morbidity with rapid recovery of abdominal strength.