마세수술로 복합조직 이식술을 이용한 두경부 종양의 재건

오석준(Suck Joon Oh) 대한두경부종양학회 1985 대한두경부 종양학회지 Vol.1 No.1

Although regional and myocutaneous flaps are still the standard in head and neck reconstruction. The capacity to transfer distant tissues by microsurgical technique expands the reconstructive surgeon's ability to restore severe deformities of the head and neck. From 1981 to 1985, thirteen patients with extensive defects of the head and neck after extirpative surgery of tumor have been reconstructed utilizing the technique of microsurgical composite tissue transplantation. In this series of patients, six presented with reconstructions in the different region of the head and neck with review of literatures. The results of case analysis are summarized as follows: 1) Transplantation was successful in twelve among thirteen patients (92%). 2) Seven patients presented witn malignancy and six with benign tumor. 3) Frequent sites of reconstruction were face and mandible. 4) Fourteen free composite tissue transplantations for reconstruction of thirteen patients were obtained six different tissue compositions from eight different donor sites. 5) The recipient artery and vein was most often superficial temporal or facial vessels. 6) The average time of operation was ten hours.

한국인의 심장골회선동맥에 관한 해부학적 연구

이세일,탁관철,정철훈,오석준 大韓成形外科學會 1984 Archives of Plastic Surgery Vol.11 No.1

The blood supply of the iliac bone is derived from the deep branch of the superior gluteal artery, the deep circumflex iliac artery, the ascending branch of the lateral circumflex femoral artery, and the superficial circumflex iliac artery. However, Taylor(1977) noted that the deep circumflex iliac artery has a major role in the supply of the ilium. Taylor(1979) had made clear also anatomical system of the deep circumflex iliac vessels. The anatomical study of these vessels was not reported in Korea until now, so we observed and analysed in details by the dissection of 30 adult cadavers (23: bilateral, 7: unilateral). The results were summarized as follows. 1. The external diameter of the deep circumflex iliac artery and the deep circumflex iliac vein at their origin are 2.0mm and 3.1mm on an average. 2. The length of the pedicle is about 5.7cm by use of these vessels. 3. The most common types of the ascending branch of these arteries are type A and type C. 4. The nutrient branches of the deep circumflex iliac artery for the ilium were noted along the iliac crest and between 2cm proximal and distal to the anterior superior iliac spine.

유리공장 전이술을 이용한 경부식도의 재건

오석준 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.2

Reconstruction of the cervical esophagus has been attempted with wide varieties of techniques by the lead and neck surgeon. Recent advances in microvascular surgery have been resulte to be accomplished safe free jejunal transfer as a method of primary reconstruction of the cervical esophagus. Author present a 47 year old male patient suffering from recurrent laryngeal epidermoid carcinoma which is reconstructed with a free jejunal transfer for the cervical esophagus and a pectoralis major myocutaneous flap for the coverage of skin defect after radical excision including skin and cervical esophagus. The postoperative course of patient is uneventful except the wound infection and tolerable early oral diet.

수부 및 수지의 재접합 수술 220예의 임상적 고찰

김지희,이세일,김용성,오석준 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.2

A clinical case review of 220 patients of replantation which performed at the Department of Plastic and Reconstructive Surgery, National Medical Center from April 1981 to October 1984 is presented. The total replants were 377 with overall success rate of 85 percent. This result is comparable to Tamai , Kleinert, O'Brien, and Urbaniak. Particularly it deserves attention that the success rate of salvage procedure which performed at zone Ⅱ and Ⅲ was relatively high with 62% success rate. The clinical results are as follows: 1. The average age is 24 years and male to female ratio is 6:1 2. The causes of injury are detailed as follows: presser,cutter,electric saw. 3. The average ischemic time is 13 hours. 4. The survival rate is 85 percent. 5. The survival rate is more related to type of injury than ischemic time.

Forehead flad을 利用한 鼻再建

金勇成,朴曉天,李世一,吳錫俊 대한성형외과학회 1981 Archives of Plastic Surgery Vol.8 No.1

The nose occupies the most prominent position of the face, a position that makes it vulnerable to distortion by trauma and the most frequent feature involved with skin cancer. It may be ravaged by an infectious process or deformed by congenital abnormality. Any deviation from the normal is quick to incite ridicule. In ancient times amputation of the nose was considered a justifiable punishment for a variety of crimes ranging from robbery to adultery. The art of nose making was born in the back streets of ancient India in the hands of potters. Reconstruction of the nose requires an accurate assessment of the extent of loss and need for the nasal lining, skin covering, and skeletal support for the best results. In addition, careful evaluation of the methods and materials available for repair to ensure the best possible match in terms of color, texture, and contour is obligatory. At the present time the most popular cover is still the forehead, because of color, texture and vascularity. It is fashioned and transported by various popular methods, among which are Gillies "up and down flap", New's "sickle flap", Converse's "scalping flap" and Kazanjian's revivl of the Indian vertical midline flap. It is not necessary to adhere strictly to stereotyped forehead patterns. The angle at which the flap is cut must vary with the case. Authors reconstructed two cases of subtotal nasal defects by forehead flap with good result.

Flexor digitorum brevis island myocutaneous flap를 이용한 발꿈치 결손의 치험례

이도현,이세일,오석준 大韓成形外科學會 1982 Archives of Plastic Surgery Vol.9 No.2

The weight bearing and friction bearing skin of the foot differs significantly from the skin in other parts and best developed over the metatarsal heads and the lateral aspect of the sole and the heel . skin losses in the heel continue to present a problem in coverage. Most of the literatue on the subject of resurfacing the weight bearing part of the foot consists of papars describing new techniques such as local flap, cross foot flap, reverse derma - fat flap, innervated full thickness skin graft, free groin flap, free groin flap, free dorsalis flap, and muscle transposition flap with skin graft Recently, for the eight bearing area coverage, the unit may be elevated as an island neurosensory musculocutaneous unit from the nonweight bearing to the weight bearing surface of the heel. The flexor digitorum brevis island myocutaneous flap is a safe and reliable unit. Authors report a case of large heel defect reconstruction by flexor digitorum brevis island myocutaneous flap with a good result.

경직수지관절의 인공관절 대치

김용성,한현언,이세일,오석준 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.3

Replacement of man's diseased or degenerated part has been a dream. The purpose of this paper is to describe an flexible hinge silicone arthroplasty for the small joint of hand which has been helpful in certain selected cases. The basic principle of this operation is to correct the deformity and subluxation by bone resection, implantation, and encapsultion thereby preserving range of motion which often is compromised. Since Aug. 1983, we have been using a high performance silicone elastomer double stemmed flexible hinge as an adjunct to resection arthroplasty of the metacarpal joint and proximal interphalangeal joint in thumb, index and middle finger. No. 4 Swanson flexible hinge implant was used in metacarpophalangeal joint of thumb and proximal interphalangeal joint of middle finger, and No. 3 in proximal interphalangeal joint of index finger and metacarpophalangeal joint of index and middle fingers. Active exercise was gradually started at 3∼6 days postoperatively in majority of the cases. Although the follow up(range 4 months-9 months) in the majority is too short to permit a complete assessment of the results. The postoperation range of motion was gained up 30 degree.

上願骨에 發生한 Fibrous Dysplasia의 治驗例

李道鉉,李世一,吳錫俊 대한성형외과학회 1981 Archives of Plastic Surgery Vol.8 No.1

Fibrous dysplasia was first described as a disease entity by Leichtenstein in 1938. Fibrous dysplasia is characterized by proliferation of connective tissue within a bone, which may produce cortical expansion. When facial bones are involved, considerable esthetic deformity may result. Monostotic fibrous dysplasia affects the maxilla more frequently than the mandible. Someone reported an equal predilection for male and female, but others a greater incidence in female. Monostotic fibrous dysplasia is more common in children and young adults. The lesion grown very slowly, causing expansion of the involved bone which may produce a nontender facial asymmetry. As a role, the lesion stops growing when skeletal growth ceases. Historical clinical radiographic and histological data are all essential to confirm the diagnosis of fibrous dysplasia. The treatment of choice is surgical, depending upon the size and consistency of the lesion as ascertained by the radiographic picture and by biopsy. In the osteolytic type, radical curretage is indicated, whereas in the more mature, solid type, surgical shaving or recontouring is indicated. Authors report a case of monostotic fibrous dysplasia on the left maxilla. Surgical shaving of the involved left midfacial area through intraoral approch was done in good result.

軟部組織 缺損을 同伴한 上下顎 固定 變形의 治療

李道鉉,李世一,吳錫俊 大韓成形外科學會 1980 Archives of Plastic Surgery Vol.7 No.2

Ankylosis of temporomandibular joint is classified as intra-articular,or true and extra-articular,or false ankylosis The extra-articular type is caused by pathologic conditions outside the joint,which usually result in the formation of strong fibrous adhesions that limit the mandibular movements. In the repair of the maxillomandibular fusion with soft tissue defects,providing satisfactory lining,as well as exess tissue,for the adequate reconstruction of buccal sulci highly important. Lager areas may be closed with skin graft or pedicle flap the lining defect.Postexcisional full thickness cheek defects are amendable to repair by temporal flaps,simultaneous temporal and deltopectoral flaps. Authors report two cases of maxillomandibular fusion with soft tissue defect.The maxillomandibular fusion was corrected by excision of scar tissue and skin graft.Soft tissue defects of the cheek was reconstructed as followings;One case was repaired by the adjecent tissue of defect turned down to form lining and bilobed flap as skin cover,and the other,cevical flap for lining and deltopectoral flap for skin cover.

Silastic Beads를 利用한 外傷性 眼球陷沒의 治驗例

沈榮基,李世一,吳錫俊 대한성형외과학회 1981 Archives of Plastic Surgery Vol.8 No.1

As the increase of the incidence of blow out fracture, plastic surgeons encounter the case of the traumatic enophtahlmos more frequently than before. Enophtalmos is the second major complication of blow out fracture and the deformity becomes the more complex in orbital fracture associated with fractures of adjacent bones. Surgical of enophthalmos is more difficult in late correction due to malunion of the fracture and fibrosis of the injured orbital structure. We experienced the case of the traumatic enophthalmos. By traffic accident, frontal bone fracture and blow out fracture was developed and at first, he received the reconstruction of the superior orbital rim by using the cartilage autograft and repair of the blow out fracture by implantation of silastic sheet. However enophthalmos was under corrected. Secondarily, he received the correction of the enophthalmos by subperiosteal implantation of silastic beads.