• Archives of Plastic Surgery
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• 제44권5호
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• pp.420-427
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• 2017

Background It can be difficult to select an appropriate flap for various defects on the hand. Although defects of the hand usually must be covered with a skin flap, some defects require a flap with rich blood supply and adequate additive soft tissue volume. The authors present their experience with the anconeus muscle free flap in the reconstruction of various defects and the release of scar contractures of the hand. Methods Ten patients underwent reconstruction of the finger or release of the first web space using the anconeus muscle free flap from May 1998 to October 2013. Adequate bed preparations with thorough debridement or contracture release were performed. The entire anconeus muscle, located at the elbow superficially, was harvested, with the posterior recurrent interosseous artery as a pedicle. The defects were covered with a uniformly trimmed anconeus muscle free flap. Additional debulking of the flap and skin coverage using a split-thickness skin graft were performed 3 weeks after the first operation. Results The average flap size was $18.7cm^2$ (range, $13.5-30cm^2$). All flaps survived without significant complications. Vein grafts for overcoming a short pedicle were necessary in 4 cases. Conclusions The anconeus muscle free flap can be considered a reliable reconstructive option for small defects on the hand or contracture release of the web space, because it has relatively consistent anatomy, provides robust blood supply within the same operative field, and leads to no functional loss at the donor site.

• 한국수자원학회논문집
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• 제56권2호
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• pp.125-137
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• 2023

지속적으로 증가하는 플라스틱의 사용으로 인하여 현재 해안·해양 환경에서 플라스틱을 찾기란 어렵지 않은 일이 되었다. 하천을 통해 해양으로 유출된 플라스틱 폐기물은 해안 지역에서 장기간 머물며, 파랑, 바람, 유사, 인간 활동 등과 같은 다양한 요인들과 상호작용하며 물리적·화학적 변화를 겪게 된다. 이에, 실험적 연구를 통하여 해안 유사에서 수체로의 플라스틱 입자 방출 과정을 고찰하고자 하였다. 본 연구는 고 레이놀즈 수를 가지는 왕복 흐름과 유사 이동을 구현하기 위한 왕복흐름발생장치를 제작하여 진행되었고, 세 가지의 크기를 가지는 매끈한 구형의 플라스틱 입자를 사용하였다. 실험 결과, 유사 내 플라스틱 입자의 방출은 유사 이동에 가장 큰 영향을 받았으며, 이는 흐름의 세기에 비례한다. 더불어, 입자가 작을수록 더 많은 입자가 방출되었다. 결과를 종합하여 입자의 방출을 결정하는 무차원 매개변수들의 임계값을 제시하였다.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.72-79
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• 2024

Background Congenital muscular torticollis (CMT) is a common musculoskeletal disorder in children. Secondary scoliosis can occur in patients with CMT; however, the extent of inclination and improvement of scoliosis after surgical correction of CMT have not been adequately studied. In this study, we aimed to evaluate and measure the improvement in vertebral tilting after surgical correction according to age at the time of surgery. Methods Between June 2007 and January 2020, 831 patients with CMT underwent sternocleidomastoid release. Among them, 426 patients were enrolled, and their medical records were retrospectively reviewed. Ultimately, 210 patients available for radiological evaluation and analysis were enrolled in this study. The patients were divided into four groups according to age at the time of surgery to determine the relationship between age and changes in scoliosis. Results Our findings showed an improvement in scoliosis in all age groups after surgery. The results for follow-up after 1 year confirmed long-term improvement in vertebral tilting. The degree of improvement in scoliosis was significantly higher in the younger age group than in patients aged 18 years or older. Conclusion The effect of surgical release on scoliosis was significant in all age groups. The findings of this study suggest that CMT should be corrected before the age of 3 years to ensure an optimal surgical mitigation of scoliosis. Furthermore, in cases of neglected CMT, surgical release should be actively attempted because there is significant improvement.

• Archives of Plastic Surgery
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• 제44권3호
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• pp.223-227
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• 2017

Background Carpal tunnel release is one of the most common surgical procedures performed by hand surgeons. The authors created a surgical simulation of open carpal tunnel release utilizing a mobile and rehearsal platform app. This study was performed in order to validate the simulator as an effective training platform for carpal tunnel release. Methods The simulator was evaluated using a number of metrics: construct validity (the ability to identify variability in skill levels), face validity (the perceived ability of the simulator to teach the intended material), content validity (that the simulator was an accurate representation of the intended operation), and acceptability validity (willingness of the desired user group to adopt this method of training). Novices and experts were recruited. Each group was tested, and all participants were assigned an objective score, which served as construct validation. A Likert-scale questionnaire was administered to gauge face, content, and acceptability validity. Results Twenty novices and 10 experts were recruited for this study. The objective performance scores from the expert group were significantly higher than those of the novice group, with surgeons scoring a median of 74% and medical students scoring a median of 45%. The questionnaire responses indicated face, content, and acceptability validation. Conclusions This mobile-based surgical simulation platform provides step-by-step instruction for a variety of surgical procedures. The findings of this study help to demonstrate its utility as a learning tool, as we confirmed construct, face, content, and acceptability validity for carpal tunnel release. This easy-to-use educational tool may help bring surgical education to a new- and highly mobile-level.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.207-212
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• 2010

Purpose: The object of this study is to develop a novel BMP-2 delivery system for continuous osteogenic differentiation and to induce osteogenesis of stem cells using a bi-phase alginate carrier in vitro. Methods: Alginate nanoparticle loaded BMP-2 was prepared by the reverse emulsification-diffusion technique. Physical properties and release profiles of alginate carriers were measured by Instron and ELISA kit, respectively. Cell viability and alkaline phosphate activity of hBMSCs differentiation was also evaluated by MTS and Metra BAP assays, respectively. Results: Optimal concentration for bi-phase alginate carrier was determined as 2 wt% by evaluating mechanical and biological properties, and differentiation of BMSCs for bone regeneration. The 2% bi-phase alginate carrier had the lowest initial and final release ratio. In addition, the 2% bi-phase alginate carrier had a little higher ALP activity than the homogeneous carrier. An improved controlled release profile was obtained by combining alginate hydrogel with lyophilized particles. Conclusion: Bi-phase alginate carrier has many advantages such as biocompatibility and controlled release capability. It is expected to be effective as a scaffold and carrier in bone tissue engineering.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.38-45
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• 2009

Purpose: The congenital muscular torticollis is a neck deformity involving shortening of the sternocleidomastoid muscle, which is detected at birth or shortly after birth. This childhood disease is the third most common congenital musculoskeletal anomaly. The indication for surgery is a persistent head tilt with dificit of passive rotation and lateral bending of the neck and a tight band or tumor in the sternocleidomastoid muscle even after physical therapy. The purpose of this article is to report surgical outcomes with patients who had no or little response to physical therapy. Methods: Surgery was performed on 29 patients and their average age was 4.1 years (from 6 months to 20.1 years). The unipolar open release and partial myectomy were done in 28 cases and the muscle lengthening was done in 1 case. Physical therapy was started from postoperative seventh day. Follow - up period was ranged from 2 months to 5.4 years(mean follow - up, 20.4 months). Result: There were neither rotation nor lateral bending deficit after surgical treatment. Mild head tilt was noticed in 3 cases and residual bend was observed in 4 cases. The subjective assessments of surgical results by parents were excellent. Conclusion: Our surgical outcome encourages the surgical treatment of congenital muscular torticollis for patients who failed to respond to physical therapy.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.126-129
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• 2024

The square flap method has been successful in releasing contracture bands at various body regions. However, the original square flap method alone may not be efficient in releasing long contracture bands. We, therefore, proposed an extended design to the traditional design, which is called the "square-plus flap." A 4-year-old girl presented with a postburn web-like contracture band over the right axilla. We marked a square flap technique at the center of the contracture band and then two additional Z-plasties were placed on both edges of the flap. After the release and securing of the square flap, the adjacent distal Z-plasty was then transposed and sutured in their new locations. We do not need to incise the proximal Z-plasty as we could achieve complete relaxation of the contracture band. This novel modification can be added to the plastic surgeon's armamentarium for releasing long postburn contracture bands involving distinct body regions.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.350-358
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• 2019

Background Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with a high morbidity and healthcare-related costs. Currently there is no consensus about the best treatment option. The purpose of this prospective cohort study conducted at a single institution was to evaluate the clinical outcomes and patient satisfaction following a mini-open carpal tunnel release for idiopathic CTS. Methods A total of 72 patients (53 female and 19 male patients; mean age, $57.8{\pm}15.3$ years; range, 24-94 years) had a mini-open carpal tunnel release performed by a single senior surgeon between June 2015 and June 2016. The patients were evaluated preoperatively, and at 3 and 12 months post-intervention. At every follow-up, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and visual analogue scale (VAS) scores for pain and satisfaction were completed. Digital sensibility (using Semmes-Weinstein monofilaments) was assessed and pinch and grip strengths were measured. Results Statistically significant and clinically relevant improvement was found in terms of digital sensibility, grip and pinch strength (except for 2-point pinch), BCTSQ scores and pain scores. The complication rate was minimal, and no major complications occurred. Two patients experienced recurrence. The availability of follow-up records (including patient-reported outcomes, BCTSQ and VAS scores, and the complication rate) at 1-year post-intervention varied between 69% and 74% (50-53 patients) depending on which parameter was assessed. Patient satisfaction was high (mean, $80.9{\pm}26.0$; range, 0-100). Conclusions This study demonstrates that mini-incision carpal tunnel release is clinically effective in the short and long term.

• 한국화재소방학회논문지
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• 제24권6호
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• pp.120-125
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• 2010

주거 건축 및 가구산업의 자재로써 합성목재(Wood-Plastic Composites)는 점차 각광받고 있다. 본 연구에서는 합성목재의 연소특성을 살펴보기 위하여 한계산소지수 측정(ASTM D 2863) 및 콘칼로리미터 시험(ISO 5660-1)을 실시하였으며 또한 일반목재인 적송과 방부 처리를 한 방부목에 대하여도 동일한 시험을 통하여 합성목재와의 연소특성을 비교.검토하였다. 한계산소지수 측정결과 합성목재가 적송 및 방부목에 비해 낮게 측정되었다. 콘칼로리미터 시험결과 합성목재의 열방출률이 가장 높았고 또한, 최대 열방출률 및 평균 열방출률, 총 방출열량도 적송 및 방부목에 비해 높게 나타났다.

• Archives of Plastic Surgery
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• 제45권2호
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• pp.118-127
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• 2018

Background A variety of island flaps can be based on the superficial temporal artery with variable tissue composition. They can be used for defect reconstruction, cavity resurfacing, facial hair restoration, or contracture release. Methods Seventy-two patients underwent facial reconstruction using a superficial temporal artery island flap from October 2010 to October 2014. The defects had various etiologies, including trauma, burns, tumors, exposed hardware, and congenital causes. We classified the patients by indication into 5 groups: cavity resurfacing, contracture release, facial hair restoration, skin coverage, and combined. The demographic data of the patients, defect characteristics, operative procedures, postoperative results, and complications were retrospectively documented. The follow-up period ranged from 24 to 54 months. Results A total of 24 females and 48 males were included in this study. The mean age of the patients was $33.7{\pm}15.6years$. The flaps were used for contracture release in 13 cases, cavity resurfacing in 10 cases, skin coverage in 17 cases, facial hair restoration in 19 cases, and combined defects in 13 cases. No major complications were reported. Conclusions Based on our experiences with the use of superficial temporal artery island flaps, we have developed a detailed approach for the optimal management of patients with composite facial defects. The aim of this article is to provide the reader with a systematic algorithm to use for such patients.