• Archives of Reconstructive Microsurgery
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• 제25권2호
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• pp.25-28
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• 2016

Purpose: Reconstruction of small defects of the dorsal fingers and toes is a challenging task. Although adipofascial flap is widely used for these areas, additional refinements are warranted. In this paper, we define the appropriate defect size in the finger and toes that can be treated with the adipofascial flap, refine its surgical indications and present a few surgical tips. Materials and Methods: Twelve patients with dorsal defects of the fingers and toes were treated with a random-type adipofascial turn-over flap and skin graft. If the defect area exceeded the size that could be covered by a conventional design, the flap base was designed in oblique or curvilinear fashion to lengthen the flap. For accurate defect coverage, the width of the flap base was designed in an asymmetrical shape depending on the defect configuration, varying the width from 0.3 to 1.0 cm, as opposed to the standard 0.5 to 1.0 cm width. Moreover, the lateral limit of the flap was defined as the lateral axial line. The size of the defect ranged from $3.0{\times}1.7cm$ to $1.5{\times}1.3cm$. Results: All flaps survived completely. Gliding function of the hand was well preserved and there was no evidence of tendon adhesion. Conclusion: The small defect in the dorsal finger and toe can be defined as less than one phalanx-length, measuring about $3.0{\times}2.0cm$ in size. If the defect exceeds this dimension, it is recommended that a different option be considered. We believe the adipofascial flap is an excellent option for treating small defects.

• 한국레이저가공학회지
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• 제15권1호
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• pp.6-9
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• 2012

In TFT-LCD manufacturing process, various defects are generated by manufacturing machine trouble or particle. These defects can be repaired through the TFT-Laser repair process that only can't be automated in TFT-LCD manufacturing Process. In this Paper, we propose auto defect algorithm for TFT-LCD laser repair machine using image processing algorithm in order to automate process. Proposed algorithm can detect very small defects (< 2um) in 98% success ratio, and generated laser repair path guarantee highly precise position accuracy. Through proposed system, much of the work still done the old-fashioned way, by hand, can be automated and manufacturing company can be strengthed the competitiveness of cost.

• 대한전기학회:학술대회논문집
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• 대한전기학회 1998년도 추계학술대회 논문집 학회본부 C
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• pp.723-725
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• 1998

STI CMP process are substituting gradually for LOCOS(Local Oxidation of Silicon) process to be available below sub-0.5um technology and to get planarized. The other hand, STI CMP process(especially STI CMP with RIE etch back process) has some kinds of defect like Nitride residue, Torn Oxide defect, etc. In this paper, we studied how to reduce Torn Oxide defects after STI CMP with RIE etch back process. Although Torn Oxide defects which occur on Oxide on Trench area is not deep and not sever, Torn oxide defects on Moat area is sometimes very deep and makes the yield loss. We did test on pattern wafers witch go through Trench process, APCVD process, and RIE etch back process by using an REC 472 polisher, IC1000/SUV A4 PAD and KOH base slurry to reduce the number of torn defects and to study what is the root causes of torn oxide defects.

• Archives of Reconstructive Microsurgery
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• 제1권1호
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• pp.9-16
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• 1992

Volkmann's ischemic contracture is the end result of an untreated, delayed or Inadequately decompressed compartment syndrome in which muscle ischemia and necrosis have occurred. Once the muscle necrosis have happened, the involved muscle undergo permanent change into fibrous tissue. So secondary shortening and distal joint contracture will be a final outcome, which results in marked functional impairment of hand and forearm. Even though several procedures, such as muscle sliding operation has been attempted, overall results were far from satisfaction, compare to healthy opposite hand. The management of these unfavorable condition of the forearm and hand was regarded as one of challenging area in orthopedics. Recently new approach, using microsurgical technique which transfers functioning muscle unit, has been developed and its result was much better than any other methods in the aspect of an active motion. Among these musculocutaneous free flaps, gracilis has obtained special reputation due to its easiness to handle such as elevation of flap and reliable neurovascular pedicle. Other advantages are flexibility of flap size to adjust variable size of the defect in the forearm and minor morbidity of the donor site. Authors have performed 7 cases of functioning gracilis musulocutaneous free flap transplantation for the functional loss of forearm and hand due to Volkmann's ischemic contracture or muscle and skin defect due to severe trauma since November, 1981 till May, 1991. The results in most cases were satisfactory and acceptable.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.43-50
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• 2004

One of the major advantages of microsurgical reconstruction for defects of the hand is that these techniques allow for selection of the most ideal tissue to reconstruct a particular defect, thus optimizing the functional and aesthetic outcome. The dorsalis pedis free flap is an excellent reconstructive tool for various hand reconstructions. It has a reliable vasculature with vessels that are relative large on a long pedicle. It provides thin pliable tissue and be innervated by deep peroneal nerve. Coupled with its thinness and pliability, it is ideal for innervated cover of critically sensitive area, especially such as the hand. Thus it can be used as a cutaneotendinous flap, or an osteocutaneous flap. Otherwise, the major criticism with this flap is related to its uncertain vascularity and the donor defect. It is the purpose of this paper to outline our technique of flap elevation and donor site closure and to indicate our current use of this flap in hand reconstruction. We have treated 10 cases (6 burn scar contracture cases, 4 acute hand trauma cases) of hand reconstruction from Dec. 3, 1997 to Mar. 4, 2004 using dorsalis pedis free flap. The key points for sucess in terms of a viable flap and acceptable donor site are the preservation of the critical dorsalis pedis-first dorsal metatarsal vascular axis and the creation of a viable bed for grafting. In addition, we substituted preserved superficial fat skin graft for split thickness skin graft and wet environment was offered for good graft take. Preserved superficial fat skin is defined as composite graft containing epidermis, dermis and superficial fat layer. With sufficient care in flap elevation and donor site closure, a good graft take of preserved superficial fat skin under wet environment can be achieved with no functional disability and minimal cosmetic deformity in donor site. This flap has proved itself to be a best choice for hand reconstruction.

• Archives of Reconstructive Microsurgery
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• 제20권2호
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• pp.89-95
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• 2011

Purpose: The purpose of this study was to evaluate the clinical results of anterolateral thigh free flap on soft tissue defect following wide excision in malignant soft tissue tumor of lower extremities. Methods: Between February 2005 to April 2010, we followed up 19 cases who were undergoing anterolateral thigh free flap because of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity, including 9 cases were heel, 5 cases in foot, 3 cases in ankle, 2 cases in knee and leg. We observed that of implanted area's color, peripheral circulation at 3, 5, 7 days after operation and evaluated operating time, amount of hemorrhage, implanted skin necrosis, additional operations, complications. And we also evaluated the oncologic results, including local recurrence, metastasis, and morbidity. Results: Average operation time of wide excision and anterolateral thigh free flap was 7 hour 28 minutes. 18(94.7%) of total 19 cases showed successful engraftment, on the other hand, failure of engraftment due to complete necrosis of flap in 1 case. In 18 cases with successful engraftment, reoperation was performed in 4 cases. Among them, removal of hematoma and engraftment of flap after bleeding control was performed in 3 cases, because of insufficient circulation due to the hematoma. In the remaining 1 case, graft necrosis due to flap infection was checked, and grafted after combination of wound debridement and conservative treatment such as antibiotics therapy, also skin graft was performed at debrided skin defect area. Skin color change was mainly due to congestion with hematoma, flap was not observed global congestion or necrosis except 4 cases which shows partial necrosis on margin that treated with conservative therapy. Conclusions: Anterolateral thigh free flap could be recommended for reconstruction of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity.

• Journal of Korean Dental Science
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• 제5권1호
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• pp.21-28
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• 2012

Purpose: In this study the bone healing ability of autogenous tooth bone graft material as a substitute material was evaluated in a mini-pig cranial defect model through histologic examinations and osteonectin reverse transcription polymerase chain reaction (RT-PCR) quantitative analysis. Materials and Methods: A defect was generated in the cranium of mini-pigs and those without a defect were used as controls. In the experimental group, teeth extracted from the mini-pig were manufactured into autogenous tooth bone graft material and grafted to the defect. The mini-pigs were sacrificed at 4, 8, and 12 weeks to histologically evaluate bone healing ability and observe the osteonectin gene expression pattern with RT-PCR. Result: At 4 weeks, the inside of the bur hole showed fibrosis and there was no sign of bone formation in the control group. On the other hand, bone formation surrounding the tooth powder granule was observed at 4 weeks in the experimental group where the bur hole was filled with tooth powder. Osteonectin gene expression; there was nearly no osteonectin expression in the control group while active osteonectin expression was observed from 4 to 12 weeks in the experimental group. Conclusion: We believe this material will show better results when applied in a clinical setting.

• Archives of Reconstructive Microsurgery
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• 제22권2호
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• pp.82-85
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• 2013

If the replantation on the original position is not possible, the amputated tissue of a hand may be used as a donor for recovering hand functions at other positions. This procedure is termed 'heterodigital replantation'. An 63-year-old male patient who was in press machine accident came to Our Hospital. He had large dorsal soft-tissue defects ($5{\times}3cm$) on his left long finger and complete amputation on his left index finger through the proximal interpharyngeal joint. Replantation was not indicated because crushing injury of index finger was severe. So we decided to use index finger soft tissue as heterodigital free flap for the coverage of the long finger defect. The ulnar digital artery and dorsal subcutaneous vein of the free flap were anastomosed with the radial digital artery and dorsal subcutaneous vein of the long finger. The heterodigital free flap provided satisfactory apperance and functional capability of the long finger. The best way to treat amputation is replantation. But sometimes surgeon confront severely crushed or multi-segmental injured amputee which is not possible to replant. In this situation, reconstructive surgeons should consider heterodigital free flap from amputee as an option.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.227-232
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• 2007

The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.55-59
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• 2001

The hand is a frequently affected area in high voltage electrical burn injury as an input or output sites. Therefore, early debridement and synchronous flap coverage are generally accepted as a primary treatment of several electrical burns complicated by exposure of tendons, neurovascular structures, and bones. So, in order to establish convenient, promising methods for the reconstruction of hand defects in electrical burn patients, we performed various reverse forearm flaps. From March 1997 to February 2000, we reconstructed 12 cases of hand defects in high voltage electrical burn wounds with reverse forearm flaps. Reverse radial fasciocutaneous flap were 3 cases, reverse ulnar fasciocutaneous flap were 3 cases, reverse ulnar fasciocutaneous flap and STSG were 4 cases, reverse ulnar fascial flap and STSG were 2 cases. We successfully reconstructed hand defects in all 12 cases, and obtained following conclusions. 1 Various reverse forearm flaps provide well vascularized, profitable tissues and they require short operative time with relatively easy procedures. 2. Reverse fascial flap and STSG, reverse fasciocutaneous flap and STSG provide thin flaps with good aesthetics and minor donor site morbidity.