다양한 부위의 재건에 있어 유리복직근 피판술의 이용

안기영,이재욱,한동길,Ahn, Ki-Young,Lee, Jae-Wook,Han, Dong-Gil 대한미세수술학회 1996 Archives of reconstructive microsurgery Vol.5 No.1

A free rectus abdominis flap can include a variable amount of muscle length depending on recipient site requirements. There is also great flexibility in flap design in terms of size, orientation of its axis, and the level of its location over the muscle. It is safe to design the skin island across the midline. Though skin islands designed over the most inferior portion of the abdomen have not always proved reliable when based on the superior epigastric artery, free flaps based on the inferior pedicle can be successfully designed in this area. As free flap based on the inferior epigastric vessels, this flap has been useful for large head and neck defects following ablative procedures, for facial contour restoration as a buried flap, for upper extremity defects, for lower extremity defects such as coverage of grade III tibial fractures and for breast reconstruction. A free rectus abdominis muscle or myocutaneus flap was used in 8 patients. The operations were performed between Sep. of 1994 and April of 1996. The patients were tongue cancer 1 case, chronic facial palsy 1 case, unilateral breast reconstruction 1 case, upper and lower extremity injury 5 cases. The free rectus abdominis muscle flaps were 4 cases and the free myocutaneous flaps were 4 cases. There was no failure of the flap, except one partial necrosis. One case of the skin grafts on the muscle flap was regrafted. One case of reoperation due to venous thrombosis was performed. In tongue cancer patient, a orocutaneous fistula was occurred, but conservative treatment and secondandry skin graft were done. In conclusion, a free rectus abdominis flap has many advantages such as a long and constant pedicle, easy dissection, enough soft tissue available, scar on the donor site to be hiddened, no need for changing position. So we think that this flap is the most useful one for small or moderate sized defects on the various sites.

유리 복직근 및 복직근피판술을 이용한 사지의 재건술

안기영,장경수,한동길,Ahn, Ki-Young,Jang, Kyoung-Soo,Han, Dong-Gil 대한미세수술학회 1995 Archives of reconstructive microsurgery Vol.4 No.1

Severe upper and lower extremity trauma may result in soft tissue loss with exposed bone and the subsequence of risk of chronic osteomyelitis or malunion of fracture fragments. Such injuries present a major reconstructive problem. But Since the introduction of microsugical technique, free muscle and myocutaneous flaps were employed to provide coverage of severely injured defects. Since Tai and Hasegawa(1974) first reported a breast reconstruction using by rectus abdominis myocuraneous flap, the free rectus myocutaneous flap has been widely employed for breast reconstuction, head and neck reconstruction, and extremity reconstruction in these days. The authors present their successful experience with free rectus abdominis muscle and rectus abdominis myocutaneous flaps for upper and low extremity reconstruction. From Nov. 94, to May 95, Five cases of severely injured extremites due to trauma or contact burn were treated with free rectus abdominis muscle flap or free rectus abdominis myocutaneous flap. All flaps except 1 case were survived without severe complications. As free muscle or myocutaneous flap, the free rectus abdominis flap has the advantages of a reliable pedicle, easy dissection, and an acceptable donor site, so it seems logical to apply the free rectus abdominis flap to apply in upper and lower extremity reconstruction.

이온교환수지를 이용한 새로운 암로디핀 복합체 개발

정상영 ( Sang Young Jeong ),안기영 ( Ki Young Ahn ),안건석 ( Geon Seok Ahn ),길영식 ( Young Sig Gil ),황성주 ( Sung Joo Hwang ) 한국약제학회 2008 Journal of Pharmaceutical Investigation Vol.38 No.1

수지첨부 손상재건을 위한 수지부 역혈행성 도서형 피판술

한동길,안기영,박대환,Han, Dong-Gil,Ahn, Ki-Young,Park, Dae-Hwan 대한미세수술학회 1998 Archives of reconstructive microsurgery Vol.7 No.2

Reverse digital artery flaps were performed successfully to resurface the fingertip defect in 13 patients as noninnervated pattern and in 12 patients as innervated pattern from March 1993 to February 1996. No loss of flap in this series was noted. Refinements in flap design and surgical technique resulted in favourable functional and ethetic results. The average two-point discrimination of the reconstructed fingertip was 7.2mm and 4.5mm in the noninnervated and innervated flaps, respectively. This flap is an one of the ideal and reliable option for reconstruction of fingertip defects.

안와부위에 발생한 신경섬유종증의 임상적 치험례

박대환(Dae Hwan Park),김태모(Tae Mo Kim),한동길(Dong Gil Han),안기영(Ki Young Ahn) 대한두경부종양학회 1997 대한두경부 종양학회지 Vol.13 No.1

Neurofibromatosis, now termed neurofibromatosis type I, is known as a congenital and familial disease presenting abnormalities of the skin, nervous system, bones, and soft tissue. We experienced a case of extremely large neurofibromatosis which developed on the orbital and temporal region of a 24-year-old man. The tumor was widely excised including normal skin margin, outer table of cranium, a part of zygoma and maxilla. Bony defect was reconstructed by rib bone graft and secondary cosmetic correction of blepharoptosis was performed using supratarsal fixation in postoperative 6 months.

Malleable Retractor 및 조직 확장기를 이용한 두피 재건

장경수,한동길,박대환,안기영 대구효성가톨릭대학교 1997 연구논문집 Vol.55 No.2

The application of tissue expansion to the scalp has a valuable technologic adjunct in coverage of large cutaneous defects as well as in the reduction of alopecia. Control of expander's position on the curved contour of the calvarium is determined by the extent of elevation at the subgaleal level. This dissection may be performed with an array of instruments throuth limited incisions. Because of the working length and contour of these instruments, however, additional incisions or increased incision may be necessary when large multiple expanders are needed. This result in additional scarring and increase the risk of devascularized segments depending on their location in the area of expansion. To overcome these shortcomings we use long malleable retractor to dissect the pocket of expander according to curved contour of the calvarium. We had experiences of tissue expansions with malleable retractor to a series of 9 patients. We present that the alternative use of a malleable retractor for more controlled and rapid dissection in the scalp for tissue expander placement.

욕창 재건법에 대한 임상적 고찰

안기영 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.3

Recently the incidence of pressure sores has been increased, due to the increased number of patients with injuries after traffic and industrial accidents or with long term loss of consciousness after various diseases. The patients have frequently required long term hospitalization and time-consuimg operation. According to these, the interest of plastic surgeon in pressure sore has increased and the techniques in the surgical management of pressure sores were also much improved. After World War Ⅱ, various methods for treatment of the pressure sore have been developed such as excision and direct closure, local rotational and transpotional flap, fasciocutaneous flap, myocuatenous flap, neurovascular island flap, microvascular surgery, or method by using tissue expanders, etc.. Author reviewed 16 patients who had received surgical treatment for pressure sore in the department of plastic surgery in Taegu Catholic Hospital from June 1990 to September 1991, and the following results were obtained; 1. On etiologic distribution, the spinal cord injuries due to traffic accidents was most common. 2. Locations of pressure sore were ordered in frequency as follows; Sacral area, 8 cases. Ischial area, 7 cases. Trochonteric are, 2 cases. Buttock, 1 case. 3. 16 patients were treated as follows; Exicison and direct closure, 2 cases. Local rotational and transpositional flap, 7 cases. Fasciocuataneous flap, 4 cases. Myocuatenous flap, 5 cases. The performed myocutaneous flaps were as follows: Bilateral gluteus maximus V-Y advancement(2 cases), Tensor fasuia lata myocutaneous flap(2 cases), Biceps and semitendinous V-Y advancement (1 case). 4. Post-op complications were found as follows; wound disruption, 4 cases, wound infection 3 cases, flap tip necrosis 1 case, secondary operation due to wound infection 1 case.

안검하수의 치료

안기영,백봉수,박효천 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.1

The aim of this thesis is to study 20 cases of blepharoptosis who were followed-up among many patients who received ptosis surgery at Kyungpook National University Hospital from Jan. 1980 to April 1984. To obtain the best surgical results in blepharoptosis, it was necessary to select the appropriate operation form each case according to levator function, the amount of ptosis, its etiology, as well as other factors. In cases of 4.1mm or more levator function, the author attempted to resect the levator muscle, but in cases of between 3mm and 4mm, the combination of levator muscle resection and frontalis sling was selected. On the other hand, in cases of 3mm or less levator function the fontalis sling was selected combined with fascia lata. The results were as follows; 1. The ratio of congenital versus acquired ptosis was 17 : 3. 2. Among 17 cases of congenital ptosis, male versus female was 11 : 6, and monocular versus bi-ocular was 9 : 8. Among 9 cases of congenital monocular ptosis, Lt. versus Rt. eye incidence was 5 : 4. 3. Among 3 cases of acquired ptosis, the causes were traumatic, neurofibromatosis, and birth injury respectively in each separate case. 4. In 5 of the congenital cases, blepharophimosis was combined, and in 4 strabismus was observed. 5. In the amount of ptosis, 7 cased were belew 2mm, 3 cases between 2.1∼4,9mm, and 10 cases above 5mm. In the measurement of the lavator muscle function, 7 cases were belew 3.0mm, 2 cases between 3.1∼4mm, and 11 cases above 4.1mm. 6. The best results were obtained by the levator muscle resection: Which was done for the patients with more than 4.1mm of levator muscle function. Good to excellent results were obtained in 8 cases among 10 cases. 7. The combination of levator muscle resection and frontalis sling was done for the patients with levator muscle function of 3.1mm∼4mm, and gave poor results. 8. Undercorrection and lid fold deformity were the most common types, except for lid lag and lagophthalmos in sleeping.

내시경을 이용한 관골궁골절 정복술

박대환,이재욱,장경수,송철홍,한동길,안기영 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.1

Although the zygomatic arch can be employed as a key landmark to the accurate alignment of a displaced zygoma fracture, it has been traditionally avoided because of the need for a bicoronal incision. Exposure of the zygomatic arch by means of the conventional bicoronal incision has several possible disadvantages, including an increased risk of blood loss, alopecia, loss of sensation posterior to the incision, and traction palsy of the facial nerve. Endoscopic-assisted exposure of a zygomatic arch can largely obviate the disadvantages of a bicoronal incision and yield this site accessible to reduction and internal fixation in the routine treatment of displaced zygoma fractures. 9 cases of endoscope-assisted open reduction of zygomatic arch fracture and 3 cases of internal fixation of a moderately displaced zygoma fracture are presented. To accomplish this technique, a rigid 4 mm, 30 degree down-angled endoscope, trocar and cannula, endoscopic forehead lift instrument were used. The postoperative courses were satisfactory with few complications. The use of endoscope in the treatment of zygoma reduction provided an expanded field of vision, direct manipulation of lesions, minimal postoperative scar. In particular, exposure and fixation of the zygomatic arch were performed without the need for a bicoronal incision.

안검성형수술 전 주의해야 할 안검경련환자에 대한 증례보고

안기영,이재욱,박미영 대한미용성형외과학회 1997 Archives of Aesthetic Plastic Surgery Vol.3 No.1

With the aging process, the senile lids are manifested by the excessive skin, decreased height of palpebral fissures with interference of the vision. Sometimes these patients often complained the blepharitis on the lateral canthal area and phtophobia. But there are many diseases to differentiate from senile lids such as dermatochalasia, blepharochalasia, hypertrophy of orbicularis oculi, herniation of orbital fat, myasthenia gravis, and blepharoptosis. Blepharospasm must also be differentiated because of sysmptoms similar to the above described senile lids. Essential blepharospam is an idiopathic progressively debilitating desease which involve bilateral spasm of the orbicularis oculi. So just only an conventional blepharoplasty could not get an improvement of symptoms and some times it makes the symptoms worsen. This case report is about blepharospasm patients visiting for blepharoplasty. And the patients got relatively the satisfied results with the injection of botulinum A toxin, aided by neurologist, instead of blepharoplasty. In conslutions, The blepharospasm in required to detect in preoperative evaluation for blepharoplasty. Once the blepharospasm is diagnosed, it is better to cooperate with neurologist and to do the blepharoplasty.