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근육 내 보형물 삽입을 이용한 엉덩이 확대 수술 후 발생한 감염의 치험례
석정훈,박성수 대한미용성형외과학회 2012 Archives of Aesthetic Plastic Surgery Vol.18 No.2
Gluteoplasty is getting more concerns among female population with their rather flat contour of upper hips. We experienced a case of wound infection after intramuscular gluteal augmentation and cured with several steps of treatment protocol. We hereby report the case with treating devices and treatment protocol. A 38-year-old female who underwent gluteal augmentation with silicone implant 9 days ago, presented with prulent discharge at the suture site with general myalgia. Under IV general anesthesia, the wound was explored and more than 50 cc of prulent discharge was evacuated from the right gluteal pocket and subcutaneous tunnel. Massive irrigation and wound debridement was done with the help of Water-jet device and left the wound open for drainage. Several cautious steps are applied for reoperation including isolation of perianal skin, protection from skin maceration and contamination, Water-jet debridement, tight bleeding control with endoscope, progressive tension sutures, negative suction drains, occlusive dressings and stabilizing the buttock with Fixmull cotton tape splints. Wound infection is not a rare complication in gluteal augmentation surgery but if it is not treated properly, that would lead to a disastrous result. Therefore surgeons must be well accustomed to the treatment protocol for treating gluteal infection.
후방까지 연장된 안와하벽골절에서 안구함몰 예방을 위한 Medpor® 내고정술
석정훈,지소영,김태범,양완석 대한두개안면성형외과학회 2008 Archives of Craniofacial Surgery Vol.9 No.2
Purpose: The purpose of this study is to evaluate the effectiveness of internal fixation method of MedporⓇ implant with BioSorbTMFX screw which is used for prevention of enophthalmos in posteriorly extended large orbital floor fracture. Methods: From Jun. 1997 to Dec. 2007, 21 patients who were diagnosed with posteriorly extended large orbital floor fractures were classified into two groups. One group(n=11) had undergone reduction surgery with regular MedporⓇ sheets without any fixation method, while the other group(n=10) had their MedporⓇ sheets fixed with the BioSorbTMFX screws. The two groups were evaluated by comparison of their enophthalmos degree and effectiveness. Results: In the non-fixation group, six patients had enophthalmos preoperatively and three of them showed persistent enophthalmos postoperatively. In postoperative CT examination, displacement of MedporⓇ implant with soft tissue impaction into maxillary sinus was observed in the patients. In the screw fixation group, three patients had enophthalmos preoperatively, but none of them suffer from complication such as residual enophthalmos, soft tissue impaction, muscle entrapment or optic nerve compression postoperatively. Received July 31, 2008 Revised September 11, 2008 Accepted September 19, 2008 Address Correspondence: Wan Suk Yang, M.D., Department of Plastic and Reconstructive Surgery, DongKang General Hospital, 123-3 Taewha-dong, Jung-gu, Ulsan 681-320, Korea. Tel: 052) 241-1326/Fax: 052)241-1324/E-mail: artpsyang@yahoo.co.kr *본 논문은 2007년 11월 대한성형외과학회 제63차 추계학술대회에서 포스터로 발표되었음. Conclusion: Internal fixation method of MedporⓇ implant with BioSorbTMFX screw on the medial surface of orbital floor provides firm stabilization of implants and surrounding soft tissues and can be an effective option especially when postoperative implant displacement or malposition was expected.
뮐러근과 올림근널힘줄로 구성된 복합피판의 전진술에 의한 눈꺼풀처짐의 치료
백봉수,석정훈,최원석,양완석 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.2
Purpose: Even in a small levator resection for blepharoptosis, 10-13mm of Müller's muscle and levator aponeurosis is resected. To solve the problem, Müller's muscle was detached from the superior tarsal border and conjunctiva, and the muscle with overlying levator aponeurosis was advanced on the upper tarsus as a composite flap. The purpose of this study is to evaluate the effectiveness of the Müller's muscle-levator aponeurosis complex advancement technique for the correction of blepharoptosis. Methods: From 2003 to 2008, 107 patients(183 eyes) underwent the advancement procedure of the Müller’s muscle-levator aponeurosis composite flap for blepharoptosis. The advanced composite flap was fixed 3 mm below the superior tarsal border and 2-3mm of distal flap stump was left after trimming up to 5mm. The results of the operations were evaluated. Results: The mean age of the patients was 35.2 years and 83 patients(145 eyes) were followed up for a mean of 16.7 months. 128 eyes(88.3%) showed a normal level of upper eyelid margin(MRD1 4.1-5.0mm) or less than 1mm ptosis(MRD1 3.1-4.0mm). 10 eyes(6.9%) showed 1-2mm ptosis(MRD1 2.1-3.0mm). 7 eyes(4.8%) showed more than 2mm ptosis which required secondary correction. About 80% of the 183 eyes needed no trimming of the flap stump with 5-6mm of composite flap advancement and 20% had about 3mm of the flap stump trimmed with 8-9mm of composite flap advancement (shortening of the levator complex). Conclusion: Müller’s muscle-levator aponeurosis complex advancement technique offers several advantages: There is no, or minimal, sacrifice of the normally functioning Müller’s muscle; it is more physiological; it is reproducible and it is predictable-with gratifying results for blepharoptosis.