구순열 환자의 비 성형술

민승기,이의석,이동근 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

솔레노이드 인젝터와 피에조 인젝터의 파형과 분사량 분석을 위한 실험적 연구

강성구,김철수 한국기계기술학회 2020 한국기계기술학회지 Vol.22 No.1

In this paper, we investigate the relationship between control system of Bosch system and that of Delphi system by measuring the high and low voltage waveform, current waveform and fuel injection quantity of D-2 and R- engines. Waveform measurements are used the PICO scope and the CDS tester. The injectors of D-2 and R-engines were tested under no load condition using injector with normal fuel injection quantity, injector with small fuel injection quantity and injector with many fuel injection quantity. The relation between current energy and fuel injection quantity shows that the injector variation rate of D2-engine is much larger than that of R-engine. The injector current energy of the D2-engine was more linear than that of the R-engine, therefore making the system more stable. Although the control system of the D2-engine is a more stable system only in terms of the durability of the internal parts of the injector, the injector of the R-engine has a good response because the current value is large.

Patterns in the amount of discharge at split-thickness skin graft donor sites

이준호,Chan-Su Kang,김태곤,정규진 대한미용성형외과학회 2019 Archives of Aesthetic Plastic Surgery Vol.25 No.1

Background Split-thickness skin grafts (STSGs) are commonly used in the reconstruction of skin defects induced by trauma or burns. Although STSGs are used to successfully treat various wound types, donor site wounds can be challenging, and complications often develop. Therefore, optimal donor site dressings are required. In this study, we introduce an evidence base for patterns in how the discharge amount decreases over time, with the goal of providing insights into the selection of dressing materials. Methods Twenty patients with burns who received STSGs harvested from the thigh between January 2016 to April 2017 were prospectively reviewed. A donor site dressing with foam was changed daily. The weight of the foam dressing was measured before and after placement on the donor site. The wound area was calculated using Visi-Trak. The mean weight of the discharge amount per unit area (g/10 cm2) was calculated. Results The mean weight of the discharge amount per unit area (g/10 cm2) decreased from 3.84 to 2.02 (P<0.05) and 1.09 (P<0.05) on postoperative days 5 and 10, respectively. It further decreased to 0.61 by postoperative day 14. Conclusions To prevent infections induced by donor site leakage, the use of highly-absorptive foam materials until 5 days after the operation is beneficial. Moreover, hydrocolloid or highly-absorptive foam materials can be used to promote re-epithelialization of the donor site after 5 days postoperatively. For re-epithelialization and wound protection, it is effective to use hydrocolloid materials starting on postoperative day 10.

안와 격막내 자가지방이식술과 절개식 중검술을 이용한 함몰된 상안검의 교정

윤동주,강철욱,배용찬 대한미용성형외과학회 2008 Archives of Aesthetic Plastic Surgery Vol.14 No.2

Sunken upper eyelids are one of the common and complicated problems that occur with an aging process or after double eyelidplasty. Autologous microfat grafting is a technique that has frequently been used for sunken eyelids. The traditional blind method of microfat grafting has a some complications. Therefore, we performed the open method with incisional double eyelidplasty. Between June, 2005 and February, 2008, we performed incisional double eyelidplasty and autologous microfat grafting into orbital septum in 63 patients(124 cases) with sunken upper eyelids. The fat was harvested from periumbilical regionand centrifuged at 3000rpm for 3 minutes. After the middle fat layer was obtained by 1cc syringe, we made skin incision and separated orbital septum(inner layer) and levator aponeurosis. And then, we injected the microfat into orbital septum with 0.9mm blunt cannula. At this time, one of the important things was to make the patient gaze upward during the fat injection. All the patients were satisfied, except 5 cases which were 3 cases of undercorrection and 2 cases of asymmetry. Surgical revision was required for only the above 5 cases(4%). Patients with some transient complications of ptosis (13 cases), overcorrection(4 cases) and nodular appearance(2 cases) were self-improved. We found that the method using incisional double eyelidplasty and autologous microfat grafting into orbital septum has many advantages which include less traumatic, less complication rate, less absorption rate of fat. and less burden of patients.

Quantitative assessment of nipple perfusion with laser-assisted indocyanine green imaging in nipple-sparing mastectomy with breast reconstruction

김재우,김일국,Ung Sik Jin,Hak Chang 대한미용성형외과학회 2019 Archives of Aesthetic Plastic Surgery Vol.25 No.1

Background It remains unknown whether perfusion mapping using the SPY system can predict mastectomy skin flap necrosis in each type of breast surgery. We analyzed intraoperative indocyanine green (ICG) angiography images of breast cancer patients who underwent nipple-sparing mastectomy (NSM) with implant-based breast reconstruction, and evaluated the perfusion of the nipple-areolar complex (NAC) with the SPY Elite system to predict NAC necrosis with a single quantitative value. Methods We analyzed nipple perfusion in 30 patients from October 2016 to November 2018. After NSM, ICG injection and SPY angiography were performed to characterize NAC perfusion before immediate reconstruction. The nipple perfusion rate was measured by analyzing fluorescence at the central point of the nipple, and the presence of NAC necrosis was evaluated at 5 days and 1 month postoperatively. Results Three of the 30 patients developed NAC necrosis that secondarily healed within 1 month, and five developed NAC necrosis and underwent surgical debridement within 1 month. Seven of eight patients with a perfusion rate <13% developed NAC necrosis, and all four patients with a perfusion rate <10% needed partial surgical debridement or total NAC excision. Conclusions The nipple perfusion rate could be useful for predicting NAC necrosis before immediate reconstruction. For patients at a high risk for NAC necrosis, tissue expander insertion rather than a direct-to-implant procedure may be considered, and close follow-up with thorough wound management should be done to reduce complications.

Analysis of long-term outcomes after surgery in patients with severe blepharoptosis

가순일,김성은,박대환 대한미용성형외과학회 2019 Archives of Aesthetic Plastic Surgery Vol.25 No.1

Background Blepharoptosis is the drooping of the margin of the upper eyelid, which narrows the palpebral fissure and makes it difficult to open the eye. Various surgical methods are used to correct blepharoptosis and have been investigated in different studies. After surgery, blepharoptosis can relapse over time, which affects a patient’s satisfaction with the operation. However, few studies have investigated the long-term outcomes of patients after blepharoptosis surgery. Methods From 1991 to 2013, 325 patients (480 eyelids) underwent frontalis muscle transfer or Müller- aponeurosis composite flap advancement in our clinic. We analyzed 12 patients (13 eyelids) with severe ptosis who had been followed-up for more than 5 years. Six patients underwent frontalis muscle transfer for the correction of seven eyelids, while Müller-aponeurosis composite flap advancement was performed on six patients (six eyelids). The marginal reflex distance (MRD1), area of corneal exposure (ACE), and height of the eyebrow were used to analyze the objective outcomes, and the Glasgow Benefit Inventory questionnaire was used for the analysis of subjective patient satisfaction. Results There were no significant differences in the MRD1, ACE, and eyebrow height between the two methods used to correct ptosis. However, over the long-term (>5 years), the MRD1, ACE, and eyebrow height were better maintained in patients who underwent Müller-aponeurosis composite flap advancement than in patients who received frontalis muscle transfer. Conclusions Both surgeries were effective for blepharoptosis correction. However, Müller-aponeurosis composite flap advancement was better for long-term maintenance after surgery than frontalis muscle transfer.

Unilateral pedicled transverse rectus abdominis musculocutaneous flap and unilateral free deep inferior epigastric artery perforator flap as a surgical alternative in bilateral autologous breast reconstruction

조정목,Hyung Chul Lee,이택종,김은기 대한미용성형외과학회 2019 Archives of Aesthetic Plastic Surgery Vol.25 No.1

Background Bilateral microsurgical autologous reconstruction is known to increase operating time, costs, and complications compared to unilateral procedures. This study aimed to determine whether a unilateral pedicled transverse rectus abdominis myocutaneous (TRAM) flap and a unilateral deep inferior epigastric artery perforator (DIEP) free flap could be a feasible option for bilateral reconstruction in selected circumstances. Methods A retrospective chart review identified patients who underwent unilateral pedicled TRAM and unilateral DIEP reconstruction for bilateral breast reconstruction between 2011 and 2014. Surgical outcomes, complications, and aesthetic scale questionnaire responses were evaluated. Results Fourteen patients were included in this study. Ten patients received bilateral immediate reconstruction, while four patients with a previous history of mastectomy underwent unilateral immediate reconstruction and contralateral delayed reconstruction. All flaps survived without any major complications. A case of nipple-areolar skin necrosis on the pedicled TRAM side and a case of mild abdominal bulging at the free DIEP donor site were reported. There was no partial flap necrosis or palpable fat necrosis. On the aesthetic outcome scale, the free DIEP flaps scored significantly higher than did the pedicled TRAM flaps for overall shape, the upper medial and lower lateral quadrant, and the lateral chest wall. Conclusions Our findings suggest that a unilateral pedicled TRAM flap together with a unilateral free DIEP flap could be performed as a bridging surgical option as institutions move toward bilateral free-flap reconstructions, as a way to reduce operating time and the risk of microsurgery-related complications with acceptable donor site morbidity and aesthetic outcomes.

The periareolar excision technique for improved scars in breast burns

주홍실,Seung Je Lee,성건용 대한미용성형외과학회 2019 Archives of Aesthetic Plastic Surgery Vol.25 No.2

Regardless of size or severity, post-burn breast scars can be traumatic for patients. There are various approaches to post-burn scar management, but herein we present the results of a novel approach in which we tried to remove the scars in an early stage of treatment. Breast burn patients, whose wound area included the nipple-areolar complex, were treated using a periareolar incision design similar to that of periareolar reduction mammoplasty. The remnant scar was located only along the periareolar complex. As a result, more cosmetically satisfactory results were achieved compared to skin grafting or local flap procedures.

A Quick and Easy Technique for Lateral Canthoplasty Using Reverse V-Y Advancement: A Case Report

Jae Yeon Park,Hyo Joong Kim,Seil Lee,Sung Gyun Jung 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.1

Cosmetic lateral canthoplasty has become popular among Asians in the last few decades, but few techniques have withstood the test of time to be accepted as both effective and noninvasive, with minimal complications. Novel techniques have been developed, but are not free from complications. Moreover, these methods often have limited indications and may require a rather long learning curve to master. Herein, the authors present their experiences performing a simple lateral canthoplasty procedure in 61 patients using a slightly modified V-Y advancement flap, previously known as the Uchida method.

Bilateral Autologous Breast Reconstruction in a Patient with Unilateral Breast Cancer: A Case Report

Young Chul Kim,Byungho Son,Eun Key Kim 대한미용성형외과학회 2018 Archives of Aesthetic Plastic Surgery Vol.24 No.1

Various reconstructive and/or oncoplastic options are available for breast cancer patients. In properly selected patients, autologous tissue-based reconstruction usually results in aesthetic, natural breasts. The choice of a reconstructive option for a breast cancer patient is a multifactorial decision that should consider the patient’s values and preferences, as well as oncologic variables. A case of a 47-year-old woman who underwent bilateral skin-sparing mastectomy (SSM) and bilateral abdominally-based reconstruction despite having unilateral breast cancer. Right SSM and left lumpectomy were indicated for ductal carcinoma in situ in the right breast and benign tumors with microcalcifications in the left breast. The patient had very small breasts and wished for larger breasts, using her own tissue, to be created in a single-stage operation. Right SSM and left subcutaneous mastectomy were followed by bilateral free transverse rectus abdominis flap reconstruction and nipple sharing.