• Archives of Plastic Surgery
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• v.32 no.4
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• pp.428-434
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• 2005

Extensive and complicated defects on the body call for an omnipotent tool for a perfect reconstruction. Flaps derived from the omentum has many advantages over the conventional flaps. From 1999 to 2004, Omental flaps were applied for various soft tissue reconstructions. Among total 20 total 7 cases were for immediate reconstruction, 2 cases for chronic infection, 3 cases for simultaneous reconstruction of two defects, 4 cases for functional joint reconstruction and 4 cases were for flow- through revascularization. Among these cases, 3 cases were operated with minimal incision harvest technique. There were no complete flap failures, partial necrosis of the distal parts were noted on three cases. The omental flap is indicated on a large contaminated defect reconstruction due to its large size, well-vascularized, and malleable properties. The omental flap provides several additional advantages over other flaps, which are; the availability of the one staged simultaneous reconstruction of two defects with one flap, providing gliding function for the joint motion, and a flow-through characteristics with long vascular pedicle. But there are some serious shortcomings, including a long abdominal scar and intraabdominal problems. However, these are rare and can be minimized with our minimal incision technique. Due to its unique characteristics. the omentum is one of the ideal tissues for the reconstruction of the complicated soft tissue defects due to its unique characteristics.

• Advances in pediatric surgery
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• v.6 no.1
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• pp.64-67
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• 2000

Although intraperitoneal teratomas are rare, teratomas of the greater omentuma are seldom reported. A single case of omental teratoma with torsion in a 26-month-old girl is reported. The patient presented with abdominal pain and a palpable mass. Ultrasonography and CT of the abdomen showed a large cystic mass with a non homgenious solid component composed of fat and calcification. The lesion was surgically excised. Pathology revealed a mature omental teratoma. The hospital course was uneventful.

• Asian-Australasian Journal of Animal Sciences
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• v.13 no.2
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• pp.155-160
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• 2000

In order to understand the effects of sex or age on cellular characteristics of adipocytes from Hanwoo and sheep, samples were obtained from omental, subcutaneous, intermuscular and intramuscular adipose tissue depots of bulls, steers, heifers and cows in Hanwoo, and perirenal, omental and subcutaneous adipose tissues of fetal lambs, suckling lambs and wethers in sheep. In case of Hanwoo, mean diameter, surface area and volume of adipocytes from each depot were obtained by multisizer II (Coulter Co., UK). Osmium-fixed adipocytes were sized and counted using $560{\mu}m$ aperture. For samples obtained from sheep, cellularity was measured by using microscope and MCV program of Texas Instrument. Bulls had less subcutaneous and kidney fat than steers even though their slaughter and carcass weight were heavier. The amounts of fat from cows were greater in subcutaneous, kidney and internal organs than heifers. Steers had larger adipocytes in subcutaneous, intermuscular and intramuscular adipose tissues than bulls, although the differences were significant only for the subcutaneous adipose tissue depots. Adipocytes appeared to be largest in omental and smallest in intramuscular adipose tissue, although there were no significant differences among tissues. In a comparison of heifers and cows, significant site effects (p<0.05) were shown in adipocyte diameter, surface area and volume, and adipocyte appeared to be largest in omental tissue. Statistical difference (p<0.05) was only shown in cell volume of intramuscular tissue which was higher in cow than heifer. Intramuscular adipose tissue tended to have relatively greater numbers of cells per gram tissue and reflect lesser maturity of intramuscular adipose tissue relative to other adipose tissues. In sheep, regardless of adipose tissue depots, wethers had the greater adipocyte diameters than those at any other growth stage of sheep. Within adipose depots, the ranking of cell size was the greatest in the omental tissue of wether and the lowest in the renal and subcutaneous adipose tissue depots of fetal lamb. The cell size of adipocyte became larger with age, especially from fetal to suckling lamb due to a rapid hypertrophy of both perirenal and subcutaneous adipocytes during the suckling period.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.623-631
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• 2004

Background: Using the neovascularizing properties of the omentum, we studied the viability and vascularity of the cryopreserved rat tracheal allografts with omental implantation. Material and Method: The cryopreserved tracheal allografts of eight-week old male Sprague Dawley rats were implanted into the omentum. The rats were divided into the four groups according to the duration of cryopreservation and of omental implantation. We examined the tracheal allografts histologically for viability of cartilages, inflammation and fibrosis of smooth muscle and connective tissue, and degree of vascularity. Result: The degree of inflammation in the smooth muscle and the connective tissue of the tracheal allografts was not statistically related to neither the duration of cryopreservation or of omental implantation. The tracheal cartilages of the tracheal allografts were found to be severely calcified in all cases. Significant difference in vascularity was found between the groups I and II (p < 0.05). And a sufficient vascularity in the intercartilaginous space was observed in the mid portion of the tracheal allografts as well as both ends. Conclusion: In conclusion, the omental implantation for 2 weeks could establish a sufficient vascularity in the intercartilaginous spaces for maintaining the viability of the tracheal allografts. This study might provide a possibility of the sequential tracheal allotransplantation after omental implantation.

• Asian-Australasian Journal of Animal Sciences
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• v.13 no.4
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• pp.446-450
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• 2000

The experiment was conducted to study the effects of water soluble vitamins and retinoic acid on the differentiation of preadipocyte from omental, subcutaneous, intermuscular and intramuscular adipose tissue of Hanwoo. Differentiation was assessed by the change in enzyme activity, glycerol-3 phosphate dehydrogenase in serum free cell culture system. Preadipocytes treated with biotin ($10{\mu}M$) and pantothenic acid ($100{\mu}M$) were significantly (p<0.05) less differentiated than those from the control in all adipose tissue depots except intramuscular tissue. Although there was no significance, vitamin C was shown to stimulate the adipocyte conversion in omental and subcutaneous, but not in intermuscular and intramuscular adipose tissues. Lower values of GPDH activity in intermuscular preadipocyte were interpreted to be caused by relatively higher amounts of protein. In this experiment vitamin C did not stimulate fat deposition in intramuscular adipose tissue but further experiments are needed on the role of vitamin C in preadipocyte differentiation. When treated with different levels of retinoic acids, differentiation of preadipocytes was significantly (p<0.05) reduced from the level of $0.5{\mu}g/ml$ in omental and intermuscular, from $50{\mu}g/ml$ in subcutaneous, and in intramuscular at $500{\mu}g/ml$, thus showing that intramuscular preadipocytes were least responsive to retinoic acid in differentiation. All-trans retinoic acid appeared to inhibit the differentiation in a dose dependent manner, regardless of adipose tissues type.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.16-23
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• 1996

The omental pedicle based on right gastroepiploic vessels is designed new experimental model for prefabrication(revasculirization) of skin flaps in rats. A $2.5{\times}4cm$ pack of omentum with right gastroepiploic vessels was transferred under a bipediceld panniculocutaneous flap which is $2.5{\times}8cm$ size. At day 7, all four margin was divided and the flap was rasied as an secondary island flap connected only by its vascular pedicle, then the composite flap sutured back in place. The flap perfusion was examined by dermofluorometry and flap survival area was measured at day 12. The Secondary island flap demonstrated a dye fluorescence index(DFI%) of $31.38{\pm}12.33$ and survival rate $80.47{\pm}9.61$ The survival rate was increased when DFI% and contact surface between vascular carrier and skin flap was increased. An india ink injection and histologic examination provided visual evidence of revasculization. The omental pedicle is a promising and safe model for revasculirization of other tissues.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.819-825
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• 1992

The omental pedicle flap[OFF] has been used for management of complicated problems in various fields of cardiovascular surgery. Its unique properties of enhancing neovascularity, relieving lymphedema, providing fibroblasts to promote healing, providing soft tissue coverage, & functioning in the face of existing infection make it ideal in managing many of the more complicated problems facing the thoracic surgeon. We have used omental pedicle for colosing of the bronchial fistula R esophageal fistula with filling the adjoining cavity after pneumonectomy. The successful closure of the bronchial stump with OFF were obtained in 2 cases, but one case was failed who was suffered from the esophageal fistula. The primary operation in each cases were right pleuropneumonctomy for tuberculous empyema in 2 cases & left pneumonectomy for chronic empyema in 1 case, We believe that the OFF is effective for closing fistula due to postoperative empyema k plombage procedures for dead space of infected thoracic cavity.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.670-673
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• 2009

Purpose: Epidural abscesses and subdural empyemas after craniotomy are uncommon, potentially lethal, complications of neurosurgery. Patients with these complications may be difficult to manage and dural reconstruction in these patients are challenging. Methods: A 28 - year - old female patient showed recurrent intracranial infection after craniotomy for evacuation of a arachnoid cyst and subdural hematoma. Despite prolonged systemic antibiotic administration and a debridement of the subdural space, infection persisted, as evidenced by persistent fever, an elevated WBC count, CSF leakage, low CSF glucose level, and purulent wound discharge. The authors removed the previously applied lyophilized dura and transferred free omental flap to reconstruct the dura, obliterate the cyst and cover the cerebral hemisphere in the craniotomy defect. Microvascular anastomosis was between gastroepiploic and superficial temporal vessels. Results: The postoperative course was uneventful and flap survival was excellent. The infection - resistant omental tissue allowed sufficient blood circulation and dead space control. The patient was discharged 1 month after surgery and wound discharge or recurrence was absent during 13 months of follow up periods. Conclusion: The use of vascularized free omentum proved useful in cases of intractable cranial wound infection and cerebrospinal fluid leakages.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.968-971
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• 2001

Pedicled omentoplasty is effective in thoracic surgery, but it is associated with several postoperative complications. A case of diaphragmatic hernia as a complication of pedicled omentoplasty in a 65-year-old male is reported. Because aortoesophageal fistula occurred three months after the patch aortoplasty for mycotic aneurysm of descending thoracic aorta, he underwent ascending thoracic aorta to abdominal aorta bypass surgery with resection of thoracic aortic aneurysm and esophagorrhaphy with wrapping of the esophageal suture line and the stumps of aorta with pedicled omental flap. Three years after the operation, herniation of the stomach developed. The pedicled omental flap was ligated and divided, and the diaphragm defect was repaired.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.101-104
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• 1998

Partial splitting of the upper sternum provides an excellent surgical view in reconstruction of the intrathoracic trachea. However, when deep-seated mediastinitis develops postoperatively, it is difficult to manage especially when combined with sternal osteomyelitis. It also needs an additional consideration compared to the usual treatment modality applied to mediastinitis following a standard median stemotomy because the lower part of the stemum remains intact. We treated a 50 year old female patient with deep-seated mediastinitis and sternal osteomyelitis following resection and end-to-end anastomosis of the trachea through an upper midline sternotomy. The patient underwent extensive stemectomy, omental free grafting, and pectoral myocutaneous flap. Postoperative viability of the free-grafted omentum was evaluated by angiography and CT scan.