• Title, Summary, Keyword: Reconstruction

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Nipple reconstruction using the C-V flap technique after breast reconstruction with the only breast expander (유방확장기만을 사용한 유방재건술 후 C-V 피판을 이용한 유두재건술)

  • Song, Jea Yong;Han, Byung Kee;Kim, Chung Hun
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.422-427
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    • 2009
  • Purpose: Breast cancer is second most common cancer in women. Almost of patients with breast cancer treated with mastectomy undergoes breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. Methods: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C - V flap technique, who were received breast reconstruction with the only breast expander. We have predicted decrease of the size of reconstructed nipple and designed flap a little larger than wanted nipple size. Nipple splint was applied for 4 - 6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. Results: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There was no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. Conclusion: The authors experienced 17 patients of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction with the only breast expander is safe and reliable. It is considered that a long - term study is necessary.

Breast Reconstruction Using Free TRAM Flap in Korean Women (유리 횡복직근 근피판술에 의한 한국여성의 유방재건술)

  • Ahn, Hee-Chang;Kim, Jeong-Cheol
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.84-91
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    • 1999
  • The female breast is a potent symbol of maternity, sexuality, and feminity. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea, so the reconstruction of breast becomes a important surgical procedure. The purpose of this study is to analyze the results of breast reconstruction using free TRAM flap and to suggest the operative techniques for more successful results. This study is based on a series of 39 cases of breast reconstruction using free TRAM flap in mastectomized patients. Among these cases, 21 patients underwent immediate reconstruction and 18 patients underwent delayed reconstruction. 2 patients underwent immediate bilateral reconstruction. The postoperative courses of these cases are uneventful. Breast reconstruction following mastectomy is one of the most challenging problems in plastic surgery. Nowadays the free TRAM flap is accepted as an excellent method of autogenous tissue breast reconstruction. We conclude that this technique has advantages as follows. The free TRAM flap has not associated with the complications of implant-based reconstruction. It provides sufficient volume for ptotic and natural breast, easily concealed donor site, and secondary aesthetic benefit of abdominoplasty. Unlike conventional pedicled TRAM flap, it has superiority in blood supply, and can make liberal setting of flap and sparing of rectus muscle. So it can provide more satisfaction about the final result of breast reconstruction.

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Shape Reconstruction of Solder Joints on PCB using Iterative Reconstruction Technique (반복복원 기법을 이용한 전자회로기판의 납땜부 형상 복원)

  • 조영빈;권대갑
    • Journal of Institute of Control, Robotics and Systems
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    • v.5 no.3
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    • pp.353-362
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    • 1999
  • This paper presents a shape reconstruction method for automatic inspection of the solder joints on PCBs using X-ray. Shape reconstruction from X-ray radiographic image has been very important since X-ray equipment was used for improving the reliability of inspection result. For this purpose there have been lots of previous works using tomography, which reconstructs the correct shape, laminography or tomosynthesis, which are very fast algorithm. Latter two methods show outstanding performance in cross-sectional image reconstruction of lead type component, but they are also known to show some fatal limitations to some kinds of components such as BGA, because of shadow effect. Although conventional tomography does not have any shadow effect, the shape of PCB prohibits it from being applied to shape reconstruction of solder joints on PCB. This paper shows that tomography using Iterative Reconstruction Technique(IRT) can be applied to this difficult problem without any limitations. This makes conventional radiographic instrument used for shape reconstruction without shadow effect. This means that the new method makes cost down and shadow-free shape reconstruction. To verify the effectiveness of IRT, we develop three dimensional model of BGA solder ball, make projection model to obtain X-ray projection data. and perform a simulation study of shape reconstruction. To compare the performance of IRT with that of conventional laminography or tomosynthesis, reconstruction data are reorganized and error analysis between the original model are also performed.

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Long-term Result of Nipple Reconstruction Using Skate Flap after Breast Reconstruction (유방재건 후 Skate 피판을 이용한 유두재건술의 장기추적결과)

  • Kim, Deok-Yeol;Dhong, Eun-Sang;Yoon, Eul-Sik;Son, Gil-Su
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.401-407
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    • 2011
  • Purpose: A number of flap for nipple reconstruction have been well described in the literature. However, most of these techniques do not permit the reconstruction of a projecting nipple and all are hampered to some extent by long-term loss of nipple projection. The objective of this study is to evaluate the long-term result and clinical efficacy of nipple reconstruction using skate flap technique after breast reconstruction. Methods: A retrospective chart review was carried out on 23 patients who underwent 25 nipple reconstructions. In those patients with greater than 10 mm nipple projection, reconstruction with skate flap and full-thickness skin graft and/or tattooing was performed. Maintenance of nipple projection was then carefully assessed over one-year follow-up. The following factors were analyzed: type of breast reconstruction, type of areola reconstruction, followup period, decrease in nipple projection, complication, and whether secondary nipple reconstruction was necessary and/or performed. Results: Breast reconstructions were performed in 17 patients with free transverse rectus abdominis musculocutaneous flap, 3 patients with extended latissimus dorsi musculocutaneous flap, and 3 patients with expander and implant. The mean follow-up after nipple reconstruction was 17 months. Mean loss of projection were $17.0{\pm}13.99%$, $25.0{\pm}12.70%$, $30.0{\pm}12.57%$ and $30.8{\pm}12.49%$ at 3, 6, 9 months and over one year, respectively. The greatest decrease in projection was noted in the first 3 months following surgery. Conclusion: These results indicated that nipple reconstruction with skate flap showed about 70 percent of the projection achieved over one year postoperation. Therefore, the skate flap may be a reliable method of nipple reconstruction in those patients with greater than 10 mm nipple projection.

Immediate Nipple Reconstruction in Breast Reconstruction with TRAM Free Flap (횡복직근 유리피판을 이용한 유방재건술에서의 즉시 유두재건)

  • Kim, Jeong Tae;Kim, Chang Yeon;Cha, Ji Hun;Hwang, Weon Jung
    • Archives of Plastic Surgery
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    • v.32 no.1
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    • pp.76-84
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    • 2005
  • Immediate breast reconstruction in breast cancer patients is universalized and now with a wide variety of methods to choose from, we can select a breast reconstruction method according to the patient's condition. Among these methods, immediate breast reconstruction with TRAM free flap is the most commonly used. Nipple reconstruction is usually performed as a secondary procedure, reconstructed. Nipple is reconstructed with contralateral nipple composite graft or with local flap. Areola is reconstructed with skin graft and tattooing. Therefore, to reconstruct complete breast, two or more staged operations are needed and are troublesome to both the surgeon and the patient. If we could reconstruct breast mound and nipple at same time, we would reduce the operative stages and heighten the patient's satisfaction. The author performed delayed or immediate breast reconstruction with TRAM free flap and nipple reconstruction at the same time. If the TRAM flap was to situate in the whole of the breast or at the center of the breast mound, nipple was reconstructed with a local flap from the TRAM flap. If the TRAM flap was not situated in center of breast mound, nipple was reconstructed with a local flap from remnant breast skin. Immediate nipple reconstructions in breast reconstruction consisted total of 22 cases. Among these, delayed breast reconstruction were 5 cases and immediate breast reconstruction were 17 cases. According to patient's condition and mastectomy method, nipple reconstruction method was selected; nipple reconstruction with contralateral nipple composite graft(3 cases); nipple reconstruction with remnant breast skin(6 cases); nipple reconstruction from flap margin(10 cases); nipple reconstruction with prefabricated nipple on flap(3 cases). Malposition of the reconstructed nipple was the most common and serious complication(6 cases). The other complications were atrophy of the nipple(1 case), and necrosis(1 case). Reconstruction of the breast and nipple at the same time can reduce the need of a secondary operation and use remnant skin or redundant flap tissue maximally. On the other hand, it must be considered that position and shape of nipple could be deformed, because the nipple reconstruction is performed before the shape of reconstructed breast settles completely. Prudent attention is needed, because the danger of complication is higher than delayed nipple reconstruction.

A comparison of delayed versus immediate reconstruction following lower-extremity sarcoma resection

  • Zhou, Sarah;Azzi, Alain J;Safran, Tyler;Zadeh, Teanoosh
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.49-53
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    • 2020
  • Background Identifying patients who may be at high risk for wound complications postsarcoma resection and reconstruction is essential for improving functional outcomes and quality of life. Currently, the effect of timing on sarcoma reconstruction has been poorly investigated. The purpose of this study was to compare outcomes of delayed and immediate reconstruction in the setting of sarcoma resection requiring flap reconstruction in the lower extremity. Methods A retrospective review of the senior author's sarcoma reconstruction patients from January 2005 to July 2017 was completed. All patients undergoing flap reconstruction of the lower extremity were included. Complications in the early postoperative period were compared between delayed and immediate reconstructive procedures. Results A total of 32 patients (7 delayed, 25 immediate) were included in this study. There was a significantly increased rate of overall complications (100% vs. 28.0%, P=0.001) and rate of hematomas (28.6% vs. 0.0%, P=0.042) in the delayed reconstruction group. Other complications including dehiscence, seroma, infection, venous thrombosis, and total/partial flap loss were also increased in the delayed reconstruction group, but this was not considered to be significant. Conclusions This study suggests that delayed reconstruction following sarcoma resection of the lower extremity had a higher incidence of overall complications and hematoma formation. We emphasize the importance of early plastic and reconstructive surgeon referral and the necessity to closely monitor delayed reconstruction patients for complications.

An Analysis on the Actual Condition and the Influential Factors in Reconstruction Projects for Deteriorated Apartment Housing (노후아파트의 재건축 추진 영향요인 분석 -대구광역시 사례를 중심으로-)

  • 장석하;현택수;최무현
    • Journal of the Korean housing association
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    • v.10 no.1
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    • pp.145-154
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    • 1999
  • In this study, various factors affect on the reconstruction of the deteriorated apartment housing complex in the Taegu-City were analyzed. The conclusions obtained in this research were summarized as follows; 1) In case of 4 to 5 storied apartment buildings, those were main objects for reconstruction. The number of the buildings and households consisting apartment complex and the total building area and the ground area were appeared as major factors. Those factors were highly correlated with the consensus of reconstruction. 2) As a maximun area of reconstruction was limited, higher existing consensus capacity and its ratio affect negatively on reconstruction of deteriorated apartments. 3) The main motivation for reconstruction is disadvantages among the members of reconstruction association were main obstacles to reconstruct the deteriorated apartment buildings. Therefore, a resoanble alternatives for reconstruction plans and administrative managements were needed.

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A Study on Safety Diagnosis for Reconstruction of the Non-Association Apartment (비조합 공동주택 재건축안전진단에 관한 연구)

  • Bang, Je Don;Oh, Tae Keun
    • Journal of the Korean Society of Safety
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    • v.29 no.5
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    • pp.82-87
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    • 2014
  • The procedures of safety diagnosis assessment have been applied by synthetical consideration of structural safety, functionality, and economic efficiency in determining reconstruction or remodeling, but they have limitations in some special cases such as the non-association apartment. In this regard, this study was conducted to establish more desirable criteria and procedures in determining reconstruction or new construction and suggests a way to improve policy and laws of reconstruction correctly by reviewing the safety diagnosis in reconstruction process. Besides, the safety diagnosis of reconstruction for non-association apartments in government-owned public district was carried out preemptively to remove reckless procedures. As a result, the reconstruction of non-association apartments should be effectively without interference in the administrative procedures. This requires that the policy and laws of reconstruction safety diagnosis should be revised in priority in order that similar projects in future can be effectively executed.

Mandibular Reconstruction using Simulation Surgery after Segmental Mandibulectomy

  • Hwang, Jong-Hyun;Kim, Ji-Wan;Ahn, Kang-Min
    • Journal of International Society for Simulation Surgery
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    • v.3 no.1
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    • pp.12-15
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    • 2016
  • Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.