• Archives of Plastic Surgery
• /
• v.36 no.4
• /
• pp.497-499
• /
• 2009

Purpose: Leiomyoma is a rare benign tumor of nonstriated muscles. Leiomyoma is most commonly found in the uterus and rarely occur in the hand. 150 cases of leiomyoma of the hand have been reported in the English literature; however, to the best of our knowledge only four of these have been in children and none were reported in Korean literature. We present a case of leiomyoma in the hand of a 8 - year - old boy, which is a rare site for localization and unusual for age. Methods: A 8 - year - old boy presented with a painless mass on the ulnar side of his thumb. Physical examination revealed a $1.2{\times}1.2cm$ round, rubbery mass that was nontender to palpation. The vascular, sensory, and motor exams were otherwise unremarkable. Further evaluation with CT demonstrated an enhancing mass at dorsoulnar aspect of 1st proximal phalangeal region suggestive of a hemangioma versus other enhancing solid mass. The diagnosis of a leiomyoma was confirmed following surgical excision with histologic evaluation. Results: At 3 months follow - up, the incision was healed, motor and sensory function were intact, and there were full range of motion. Neither recurrence nor postoperative complication were observed. Conclusion: Leiomyoma is a rare tumor of the hand, especially in children. Diagnosing hand tumors in children is more difficult than in adults, hand surgeons should be aware of the diagnostic possibilities based on examination and imaging of a hand tumor ; however, surgical excision with histologic examination is required for definitive diagnosis.

• Archives of Plastic Surgery
• /
• v.43 no.1
• /
• pp.71-76
• /
• 2016

Background The purpose of this study was to identify comprehensive hand injury patterns in different pediatric age groups and to assess their risk factors. Methods This retrospective study was conducted among patients younger than 16-year-old who presented to the emergency room of a general hospital located in Gyeonggi-do, Republic of Korea, and were treated for an injury of the finger or hand from January 2010 to December 2014. The authors analyzed the medical records of 344 patients. Age was categorized according to five groups. Results A total of 391 injury sites of 344 patients were evaluated for this study. Overall and in each group, male patients were in the majority. With regard to dominant or non-dominant hand involvement, there were no significant differences. Door-related injuries were the most common cause in the age groups of 0 to 3, 4 to 6, and 7 to 9 years. Sport/recreational activities or physical conflict injuries were the most common cause in those aged 10 to 12 and 13 to 15. Amputation and crushing injury was the most common type in those aged 0 to 3 and 4 to 6 years. However, in those aged 10 to 12 and 13 to 15, deep laceration and closed fracture was the most common type. With increasing age, closed injuries tended to increase more sharply than open injuries, extensor tendon rupture more than flexor injuries, and the level of injury moved proximally. Conclusions This study provides a comprehensive overview of the epidemiology of hand injuries in the pediatric population.

• Archives of Plastic Surgery
• /
• v.42 no.2
• /
• pp.164-172
• /
• 2015

Background The use of a tourniquet in hand surgery is generally accepted as necessary to create a clear visualization of the operative field. This study aims to determine the effectiveness of one-per-million tumescent solution (1:1,000,000 epinephrine concentration) in creating a bloodless operative field in post-burn hand deformity surgeries performed without a tourniquet. Methods This retrospective observational study was conducted on a series of 12 patients with post-burn hand deformities who underwent surgery between February 2013 and January 2014. A total of 29 operative fields were recorded. The one-per-million tumescent solution was used for hemostatis instead of a tourniquet. The clarity of the operative field, volume of solution injected, duration of surgery, scar thickness and density, and functional outcomes at least three months after the surgery were observed. The relationship of scar thickness and density with the clarity of the operative field was analyzed with the chi-square test. Results Of the 29 operative fields in which the one-per-million tumescent technique was used, 48.2% were totally bloodless, 44.8% had minimal bleeding, and 6.9% had an acceptable level of bleeding. Both scar thickness and density were shown to have a significant relationship with operative field clarity (P<0.05). Conclusions The one-per-million tumescent technique is effective in facilitating post-burn hand deformity surgeries involving meticulous, multiple, and lengthy procedures by creating a relatively clear operative field without the use of a tourniquet. Although scar thickness and density are associated with the clarity of the operative field, this technique can be considered safe and effective in creating a clear operative field.

• Archives of Plastic Surgery
• /
• v.35 no.6
• /
• pp.716-722
• /
• 2008

Purpose: Split or full thickness skin graft is generally used to reconstruct the palmar skin and soft tissue defect after release of burn scar flexion contracture of hand. As a way to overcome and improve aesthetic and functional problems, the authors used the preserved superficial fat skin(PSFS) composite graft for correction of burn scar contracture of hand. Methods: From December of 2001 to July of 2007, thirty patients with burn scar contracture of hand were corrected. The palmar skin and soft tissue defect after release of burn scar contracture was reconstructed with the PSFS composite graft harvested from medial foot or below lateral and medial malleolus, with a preserved superficial fat layer. To promote take of the PSFS composite graft, a foam and polyurethane film dressing was used to maintain the moisture environment and Kirschner wire was inserted for immobilization. Before and after the surgery, a range of motion was measured by graduator. Using a chromameter, skin color difference between the PSFS composite graft and surrounding normal skin was measured and compared with full thickness skin graft from groin. Results: In all cases, the PSFS composite graft was well taken without necrosis, although the graft was as big as $330mm^2$(mean $150mm^2$). Contracture of hand was completely corrected without recurrence. The PSFS composite graft showed more correlations and harmonies with surrounding normal skin and less pigmentation than full thickness skin graft. Donor site scar was also obscure. Conclusion: The PSFS composite graft should be considered as a useful option for correction of burn scar flexion contracture of hand.

• Archives of Plastic Surgery
• /
• v.43 no.5
• /
• pp.466-469
• /
• 2016

External volume expansion of the recipient site by suction has been proposed as a way of improving fat graft survival. The objective of this study was to present an innovative and simple intraoperative external expansion system to enhance small-volume autologous fat grafting (40-80 mL) and to discuss its background and its mechanism of action. In this system, expansion is performed using a complete vacuum delivery system known as the Kiwi VAC-6000M with a PalmPump (Clinical Innovations). The recipient site is rapidly expanded intraoperatively 10 times for 30 seconds each with a negative pressure of up to 550 mm Hg before autologous fat injection. During this repetitive stimulation, the tissues become grossly expanded, developing macroscopic swelling that regresses slowly over the course of hours following the cessation of the stimulus. The system sets various mechanisms in motion, including scar release, mechanical stimulation, edema, ischemia, and inflammation, which provide an environment conducive for cell proliferation and angiogenesis. In order to maintain the graft construct in its expansive state, all patients are encouraged postoperatively to use the Kiwi three times daily for one minute per session over the course of three days. The handling of this system is simple for both the patients and the surgeon. Satisfactory clinical outcomes have been achieved without significant complications.

• Journal of Korean Academy of Nursing
• /
• v.30 no.2
• /
• pp.476-487
• /
• 2000

The purpose of this study was to examine the effects of hand massage as a nursing intervention on the anxiety of the hysterectomy patients in immediately prior to surgery. The method of this study was Nonequivalent Control Group Non-Synchronized Design. The data were selected from at K university hospital in Pusan, and they consisted of Experimental group-25 patients, Control group -24 patients. The data were collected from Jan. 4 to Jan. 30 in 1999. The subjects′ self-reports of anxiety (measured by the Spielberger Trait-State anxiety Inventory and Visual Analogue Scale developed by Cline et al.) were recorded before and immediately after the intervention. The objective physiologic measures of blood pressure and pulse rate. The collected data were analysed by means of frequency, percentage, standard deviation, chi- square test, t-test, ANCOVA with SPSS program. The results of this study were as following; 1. Hypothesis 1: The 1st hypothesis that "There will be significant difference of the state anxiety level just before surgery in the experimental group and control group" was supported(P= .000). 2. Hypothesis 2: The 2nd hypothesis that "There will be significant difference of the visual analogue scale score just before surgery in the experimental group and control group"was supported(P= .000). 3. Hypothesis 3: The 3rd hypothesis that "There will be significant difference of the systolic and diastolic blood pressure level just before surgery in the experimental group and control group"was supported (P= .003, P= .041). 4. Hypothesis 4: The 4th hypothesis that "There will be significant difference of the pulse rate just before surgery in the experimental group and control group"was supported(P= .004). In conclusion, hand massage is a benefical nursing intervention that alleviates the psychological, physiological anxiety of the hysterectomy patients in immediately prior to surgery. therefore it is recomended to use the hand massage as a nursing intervention for patients undergoing anxiety. The results of this study appear promising, additional research is recomended to further the appropriate uses of hand massage in nursing practice for this and other patient population.

• Women's Health Nursing
• /
• v.20 no.2
• /
• pp.126-136
• /
• 2014

Purpose: The purpose of this study was to examine the effects of aroma hand massage on anxiety and immune function in patients who had gynecology surgery under local anesthesia. Methods: The research design was a nonequivalent control group with pre-and posttest design. Data were collected from June 5 to October 6, 2010. Participants included 20 patients in the aroma hand massage group, 20 patients in a hand massage group, and 20 in a control group. As an experimental treatment, hand massage was carried out following the hand massage protocol. Measures consisted of the State Trait Anxiety, Numeric Rating Scale (NRS) for anxiety, vital signs (systolic and diastolic blood pressure, pulse rate), and salivary cortisol for anxiety, and immunoglobulin A for immune function. Results: Aroma hand massage and hand massage group showed lower levels in NRS for anxiety, systolic and diastolic blood pressure, and pulse rate (p<.001) compared to controls. No group differences were found for state anxiety, salivary cortisol and immunoglobulin A. Conclusion: The results indicate that aroma hand massage and hand massage are effective in reducing anxiety and can be complementary alternative interventions for women having gynecology surgery under local anesthesia.

• Archives of Plastic Surgery
• /
• v.33 no.5
• /
• pp.652-654
• /
• 2006

Beau first described transverse depressions of the fingernails after an acute febrile illness in 1846. It was the result of the temporary arrest of nail matrix formation. The transient interference of nail growth rate is usually induced by disability caused by severe systemic disease. Such as Raynaud disease, myocardial infarction, pulmonary embolism, acute renal failure, psoriasis and dysmenorrhea were reported to be the cause of Beau's line. The trauma caused either in a hand or in a forearm was also reported to be the cause of Beau's line. We experienced patients with Beau's line, two cases secondary to fingertip injury and one case due to fracture in radius. They had Beau's lines in all fingers of traumatized hand and nails of opposite hand were normal. During the follow-up, the growth rate of traumatized fingernails were normal and there was no complication.

• Journal of Gastric Cancer
• /
• v.12 no.2
• /
• pp.120-125
• /
• 2012

Purpose: Mechanical stapler is regarded as a good alternative to the hand sewing technique, when used in gastric reconstruction. The circular stapling method has been widely applied to gastrectomy (open orlaparoscopic), for gastric cancer. We illustrated and compared the hand-sutured method to the circular stapling method, for Billroth-II, in patients who underwent laparoscopy assisted distal gastrectomy for gastric cancer. Materials and Methods: Between April 2009 and May 2011, 60 patients who underwent laparoscopy assisted distal gastrectomy, with Billroth-II, were enrolled. Hand-sutured Billroth-II was performed in 40 patients (manual group) and circular stapler Billroth-II was performed in 20 patients (stapler group). Clinicopathological features and post-operative outcomes were evaluated and compared between the two groups. Results: Nosignificant differences were observed in clinicopathologic parameters and post-operative outcomes, except in the operation times. Operation times and anastomosis times were significantly shorter in the stapler group (P=0.004 and P<0.001). Conclusions: Compared to the hand-sutured method, the circular stapling method can be applied safely and more efficiently, when performing Billroth-II anastomosis, after laparoscopy assisted distal gastrectomy in patients with gastric cancer.

• Archives of Plastic Surgery
• /
• v.46 no.2
• /
• pp.176-180
• /
• 2019

Post-traumatic soft tissue defects sometimes require sequential flap coverage to achieve complete healing. In the era of propeller flaps, which were developed to reduce donor site morbidity, Feng et al. introduced the concept of the free-style puzzle flap, in which a previously harvested flap becomes its own donor site by recycling the perforator. However, when a perforator cannot be found with a Doppler device, we suggest performing a new type of flap, the flip-flap puzzle flap, which combines two concepts: the free-style puzzle flap and the flip-flap flap described by Voche et al. in the 1990s. We present the cases of three patients who achieved complete healing through this procedure.