• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.56-61
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• 2015

Purpose: We report on the clinical result after coverage of a soft tissue defect on the medial foot and ankle with an adipofascial flap based on the perforator from the posterior tibia artery. Materials and Methods: Nine patients with soft tissue defects on the medial foot and ankle area from March 2009 to May 2014 underwent the procedure. Average age was 54 years old (range, 8~82 years). There were five male patients and four female patients. The causes of the defect were trauma (4), tumor (3), and infection (2). The pivot point of transposition of this flap is the lower perforator originating from the posterior tibia artery. The fatty tissue side of this flap could be used to resurface the defect. The donor site was closed primarily with the preserved skin, and a small caliber drain tube was used. The split-thickness skin graft was grafted to the flap and the wound. If the wound was still infected, this skin graft could be performed at a later date. Results: All flaps survived and normal soft tissue coverage was obtained for the medial foot and ankle of all patients after the skin graft. Normal footwear was possible for all cases because of thin coverage. There was an extension contracture on the medial ray of the foot, which was resolved by contracture release and skin graft. Conclusion: For the medial foot and ankle soft tissue defect, the medial crural adipofascial flap based on a perforator branch of the posterior tibia artery could be a good option to cover it.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.304-310
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• 1999

This study was designed to find the effect of Minocycline loaded microcapsule applied locally to tissue by measuring drug concentration in tissue and serum by HPLC and to achieve optimal drug delivery system and duration to a specific target site. Control group were administrated minocycline intramuscularly twice a day with $0.2{\mu}g/100g$ for 1 to 10 days. In experimental group, surgical wound was created on Rt. cheek and then minocycline loaded microcapsule was applied into the space between superficial and deep layer of masseter muscle. Animals were sacrificed at 1, 3, 5, 7, 10 days after initial administration, blood was obtained from heart and right masseter muscle was excised. Blood sample was centrifuged at 3000rpm for 15min. Tissue sample was homogenized, left at room temperature for 48hr and centrifuged at 4000g for 5min. Supernatant was completely dried and dissolved in distilled water. Analysis was conducted using a ${\mu}Bondapack$ C18 column. The mobile phase was 0.2M Ammonium Oxalate/0.1M EDTA/DMF=11/4/5 solution, which was injected into the column and detected with photodiode detector at 344nm wavelength. The results were as follows : 1. This method was reliable, could be replicated and suitable for minocycline analysis in tissue as well as serum. 2. In tissue, concentration of minocycline of experimental group was higher than that of control group for 5days. 3. Except 1 day, concentration of minocycline in serum of experimental group was lower than that of control group. 4. Concentration of minocycline in tissue was much higher than that in serum. From these results, minocycline loaded microcapsule might be effective tool for local drug delivery system might be useful for treatment of infections of oral and maxillofacial region and management of infected surgical wound, minimizing systemic effects.

• Archives of Plastic Surgery
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• v.41 no.1
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• pp.45-49
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• 2014

Background Preauricular sinuses are congenital abnormalities caused by a failure of fusion of the primitive tubercles from which the pinna is formed. When persistent or recurring inflammation occurs, surgical excision of the infected tissue should be considered. Preauricular defects inevitably occur as a result of excisions and are often difficult to resolve with a simple suture; a more effective reconstruction technique is required for treating these defects. Methods After total excision of a preauricular sinus, the defect was closed by a plastic surgeon. Based on the depth of the defect and the degree of tension when apposing the wound margins, the surgeon determined whether to use primary closure or a posterior auricular flap. Results A total of 28 cases were examined. In 5 cases, including 2 reoperations for dehiscence after primary repair, reconstruction was performed using posterior auricular transposition flaps. In 16 cases of primary closure, the defects were closed using simple sutures, and in 7 cases, closure was performed after wide undermining. Conclusions If a preauricular defect is limited to the subcutaneous layer and the margins can be easily approximated, primary closure by only simple suturing may be used to perform the repair. If the defect is deep enough to expose the perichondrium or if there is tension when apposing the wound margins, wide undermining should be performed before primary closure. If the extent of the excision exposes cartilage, the procedure follows dehiscence of the primary repair, or the tissue is not sufficiently healthy, the surgeon should use a posterior auricular flap.

• Journal of Korean Society of Forest Science
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• v.40 no.1
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• pp.57-62
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• 1978

This study was carried out to determine the proper transplanting time of Platanus occidentalis L. (plane tree, sycamore) with 5 to 6 cm and 25 to 30 cm in diameter of breast height at the forest nursery of Chonnam National University in 1977. For that purpose, the experiment of the time of transplantation, and the moisture content and soluble sugar were analysed. The results are as follows: 1. Both its rooting and growth were slightly different in the period of January to early April (before bud-break), but remarkably declined after its bud-break (mid-April to May). 2. And also, its moisture content and soluble sugar were slightly different (January to early April), but, on the other hand, considerably increased in the content of moisture and sharply decreased in soluble sugar after bud-break (mid-April to May). 3. In comparision with healthy trees, rooting and growth of trees infected with Cankers were unusually retarded and its moisture content and soluble sugar were much less. 4. The proper time to plant sycamore was recognized to be the period of November to March, since the higher amounts of soluble sugar and the lesser amounts of moisture in that period. 5. The sudden exposure to the sun of the boles of diseased and wounded trees could be in death in case of sun-scald on the side of south-west. 6. Pruning wounds should be treated with an antiseptic, as soon as they are made, to prevent entrance of decay or disease while the wound is healing. 7. The wound and sun-scald can be presented by covering the trunk with straw ropes before transplantations.

• Research in Plant Disease
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• v.8 no.2
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• pp.107-112
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• 2002

This study was carried out to identify the causal pathogens and investigated the characteristics of Penicillium spp. isolated from postharvest decay of pear. One hundred and ninety eight Penicillium spp. were isolated from infected pear fruits. The lesions were formed when the isolated pathogen were inoculated into the wounds and unwounds of pear fruit. Total isolates were classified into 15 groups by the size, color, pigment of colony and shape of conidia. These isolates were identified to be P.expansum, P.solitum, and P.crustosum according to the types of morphological, cultural and physiological characteristics. The pathogenicity was higher in wound inoculation at low temperature than unwound one. This result confirmed that wound promoted the disease appearance. P.expansum was appeared to have the most strong virulence, whereas P.solitum and P.crustosum were classified as weak virulent species by pathogenicity test on pear fruits.

• Journal of Korean Foot and Ankle Society
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• v.24 no.4
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• pp.148-155
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• 2020

Purpose: Minor foot amputations are performed for recurrent or infected ulcers or osteomyelitis of the diabetic feet. Patients may require a large amount of bone resection for wound closure. On the other hand, this results in more foot dysfunction and a longer time to heal. The authors describe fillet flap coverage to avoid more massive resection in selected cases. This study shows the results of fillet flap coverage for the closure of diabetic foot minor amputation. Materials and Methods: This was a retrospective case series of patients who underwent forefoot and midfoot amputation and fillet flap for osteomyelitis or nonhealing ulcers between March 2013 to November 2017. In addition, the patient comorbidities, hospital days, complications, and duration to complete healing were evaluated. Results: Fourteen fillet flap procedures were performed on 12 patients. Of those, two had toe necrosis, nine had forefoot necrosis, and three had midfoot necrosis. Eleven forefoot amputations and three midfoot amputations were performed. Among forefoot necrosis after a fillet flap, three patients had revision surgery for partial necrosis of the flap, and two patients had an additional amputation. Two patients had additional amputations among those with midfoot necrosis. By the fillet flap, the amputation size was reduced as much as possible. The mean initial healing days, complete healing days, and hospital stay was 70.6 days, 129.0 days, and 60.0 days, respectively. Conclusion: The fillet flap facilitates restoration of the normal foot contour and allows salvage of the metatarsal or toe.

• Korean Journal of Microbiology
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• v.4 no.2
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• pp.5-10
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• 1966

The relationships between tumor score and peroxidase activities of tomato stems infected with Agrobacterium tumefaciens strain A6Kl, B6, T372 11BNV6, 11BV7 and wounded stem as a control were examined in relation to crown gall tumor development on purpose to study the lignification of tumor tissue which is affected to the development of crown gall tumor. As the previous paper has been mentioned the fact that the induction of tumor tissues were inhibited or limited in the lignified stem of host plant. It was presumed that the activities of peroxidase related to the development of lignification were decreased during the period of tumor development. But the experimental result in this experiment shows that the peroxidase activities of crown gall tumor-tissues infected with the A. tumefaciens strains which are already known as virulent are increasing during four weeks, however, in the strain 11BNV6 and wound the peroxidase activities are decreasing on the second week after the inoculation of the bacteria strains. These results could be explained on the basis of that possible regulatory agents of lignification which were accumulated in tumor tissues, IAA, ascorbic acid, glutathion(GSH) and caffeic acid esters, were postulated to act as antioxidants which has been suggested by Stafford. Total nitrogen contents in relation to crown gall tumor development were determined for the detection of protein synthesis related to the enzyme activities which are increasing in the time of plant growth. Generally six groups are contained the largest amount of nitrogen on the second week after the inoculation of the bacterium. Comparing to the tumor score, it is presumed that the all of enzyme activities including peroxidase in tumor tissues are increasing from the second week through the third week after the inoculation of bacterium and the protein synthesis is stimulated under the most appropriated temperature during the above periods.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.1-6
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• 2010

Purpose: Diabetic foot infection is one of the most common and severe complications of diabetes mellitus that delays healing of the wound. Deep tissue biopsy is considered to be the gold standard method for antibiotic selection in treating infected chronic diabetic ulcers. However, swab culture or superficial tissue biopsy is often performed for a microbiologic test since deep tissue biopsy has limitations in application. The purpose of this study is to find out whether microbiologic results of swab culture or superficial tissue biopsy could be used for selection of antibiotics in treating diabetic ulcers. Methods: This study involved 42 patients with diabetic foot ulcers with negative results in bone probing test. Tissue samples for microbiologic tests were collected from all the patients by using superficial cotton swab, superficial tissue, and deep tissue. The microbiologic results of deep tissue biopsy were compared with swab culture and superficial tissue biopsy statistically. Results: Microbiology of the deep tissue showed the same results with those of the swab culture and superficial tissue in 67% and 71%, respectively. Statistical analysis demonstrated that the microbiology of the swab culture and superficial tissue does not coincide with that of the deep tissue. Conclusion: These results suggest that the microbiology of the swab culture and superficial tissue is not concordant with that of the deep tissue in infected chronic diabetic ulcers. To select appropriate antibiotic regimen, the speci specimen for the microbiologic test should be obtained from deep tissue.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.590-593
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• 2011

Purpose: Surgical site infections (SSIs) are the third most frequently reported nosocomial infection. Of these SSIs, mostly were confined to the incision associated with underlying disease as diabetes, cigarette smoking, systemic steroid use, obesity, operating room environment, suture and surgical technique. This study has been planned to reduce the SSIs by using Vicryl $plus^{(R)}$ (Ethicon, USA) which contains triclosan, a broad-spectrum antibacterial agent, into the infected wound to evaluate whether or not Vicryl $plus^{(R)}$ (Ethicon, USA) is effective to nosocomial bacteria using a zone of inhibition assay. Methods: We did a comparison of Vicryl $plus^{(R)}$ suture (with triclosan) size 2-0, 5-0 with $Vicryl^{(R)}$ suture (without triclosan) size 4-0 each as treatment and control group, applied in Mueller-Hinton agar infected by following mircroorganisms: Methicillin-sensitive $Staphylococcus$ $aureus$ (MSSA), Methicillin-resistant $Staphylococcus$ $aureus$ (MRSA), Acinetobacter baumanii, $Escherichia$ $coli$, Enterobacter faecalis, Pseudomonas aeruginosa, Candida albicans. Cultures were made of the selected mircroorganisms, seeding the study strain in agar plates for 24 and 48-hour period in an oven at $37^{\circ}C$ followed by zone of inhibition assay. Results: Vicryl $plus^{(R)}$ group has demonstrated to create a zone of inhibition against MRSA, MSSA and $A.$ $baumanii$, but no effect on $E.$ $faecalis$, $P.$ $aeruginosa$, $C.$ $albicans$. Vicryl $plus^{(R)}$ suture size 2-0 also had antibactericidal effect while Vicryl $plus^{(R)}$ suture size 5-0 did not. $Vicryl^{(R)}$ group had no zones of inhibition showing colonization at all mircroorganisms. Conclusion: Our results seem to warrant the use of Vicryl $plus^{(R)}$ as absorbable buried suture when concerning SSIs as a prophylaxis against surgical nosocomial infection.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.593-600
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• 2023

Background Soft tissue reconstruction around the knee area is still an open question, particularly in persistent infections and multiple reoperations scenario. Flap coverage should guarantee jointmobility and protection, even when foreign materials are implanted. The chimeric harvesting of the musculocutaneous gastrocnemius flap, based on the sural artery perforators, can extend its applicability in soft tissue reconstruction of the upper leg, overcoming the drawbacks of the alternative pedicled flaps. Methods A multicenter retrospective study was conducted enrolling patients who underwent to a pedicled, chimeric gastrocnemius musculocutaneous-medial sural artery perforator (GM-MSAP) or lateral sural artery perforator (GM-LSAP) flap for knee coverage in total knee arthroplasty (TKA) recurrent infections and oncological or traumatic defects of the upper leg from 2018 to 2021. Outcomes evaluated were the successful soft tissue reconstruction and flap complications. Surgical timing, reconstruction planning, technique, and rehabilitation protocols were discussed. Results Twenty-one patients were included in the study. Nineteen GM-MSAPs and 2 GM-LSAPs were performed (soft tissue reconstruction in infected TKA [12], in infected hardware [4], and in oncological patients [5]). Donor site was closed primarily in 9 cases, whereas a skin graft was required in 12. Flap wound dehiscence (1), distal flap necrosis (1), distal necrosis of the skin paddle (1), and donor site infection (1) were the encountered complications. Flap reraise associated to implant exchange or extensive debridement was successful without requiring any further flap surgery. Conclusion The propeller-perforator GM-MSAP offers qualitative defect coverage and easiness of multiple flap reraise due to skin availability and its laxity.