• Archives of Plastic Surgery
• /
• v.37 no.5
• /
• pp.667-670
• /
• 2010

Purpose: The management of urethral defect represents one of the most challenging clinical problems in uroplastic surgery. Especially for defect after Fournier's Gangrene, optimal management is still a hard problem. During extensive urethral reconstruction, to overcome the poor vascularity due to periurethral scarred tissue and limitation of the choice of local flap, we report our experience with one-stage reconstruction of urethral defect using a longitudinal tubed flap of scrotal skin. Methods: A 72-year-old man with several years of diabetes mellitus history visited for swelling and pain of scrotal area. After diagnosis of Fournier's Gangrene, radical debridement was performed and 6 cm of urethral defect on border of penile-scrotal ventral area was made. Rectangular scrotal skin flap ($6{\times}2.5\;cm$) based on external spermatic fascia was elevated and tubed longitudinally. After transfer the flap to the defect area, end-to-end anastomosis was performed bilaterally. Results: 4 weeks after the operation, the patient started voiding him-self and urethrography showed good fluence of contrast agent. Long term evaluation reveals stable performance characteristics without any complications. Conclusion: We suggest a one-stage reconstruction of extensive urethral defect using a longitudinal tubed flap of scrotal skin. Advantages of this procedures are simple, one-stage reconstruction with the reliable scrotal skin flap based on external spermatic fascial vasculature, and no donor morbidity.

• Archives of Plastic Surgery
• /
• v.40 no.6
• /
• pp.773-778
• /
• 2013

Background In the management of mallet deformities, oblique retinacular ligament (ORL) reconstruction provides a mechanism for automatic distal interphalangeal (DIP) joint extension upon active proximal interphalangeal joint extension. The two variants of ORL reconstruction utilize either the lateral band or a free tendon graft. This study aims to compare these two surgical techniques and to assess any differences in functional outcome. As a secondary measure, the Mitek bone anchor and pull-in suture methods are compared. Methods A single-institutional retrospective review of ORL reconstruction was performed. The standard patient demographics, injury mechanism, type of ORL reconstruction, and pre/postoperative degree of extension lag were collected for the 27 cases identified. The cases were divided into lateral band (group A, n=15) and free tendon graft groups (group B, n=12). Group B was subdivided into the pull-in suture technique (B-I) and the Mitek bone anchor method (B-II). Results Overall, ORL reconstructions had improved the mean DIP extension lag by $10^{\circ}$ (P=0.027). Neither the reconstructive technique choice nor bone fixation method identified any statistically meaningful difference in functional outcome (P=0.51 and P=0.83, respectively). Soft-tissue injury was associated with $30.8^{\circ}$ of improvement in the extension lag. The most common complications were tendon adhesion and rupture. Conclusions The choice of the ORL reconstructive technique or the bone anchor method did not influence the primary functional outcome of extension lag in this study. Both lateral band and free tendon graft ORL reconstructions are valid treatment methods in the management of chronic mallet deformity.

• Proceedings of the Korean Institute Of Construction Engineering and Management
• /
• 2006.11a
• /
• pp.233-239
• /
• 2006

As the number of aged-housing has been rapidly increased, many kinds of defects and problems such as degeneration of housing environment, structural performance, and equipment performance have been appeared. The reconstruction as the way to improve the aged-housing has been used mostly because the legal process of the reconstruction is relatively easy. On the other hand, it has caused problems such as the lack of natural aggregate, the environmental damages owing to construction wastes, the loss of national resources, and the lack of the housing for rent nearby the reconstruction area. This problems limit active tying into the reconstruction business at present in the industrial and political perspective. In this context, it is required to revitalize the remodeling rather than the reconstruction. In order to reach this objective, this research aims at identifying the user-oriented performance for the housing industry and developing the new technologies. It is expected that the result of this research can contribute to more revitalize the remodeling as tying researches in terms of design, structure, equipment, and construction.

• Archives of Plastic Surgery
• /
• v.49 no.3
• /
• pp.397-404
• /
• 2022

Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

• Journal of the Korean housing association
• /
• v.21 no.6
• /
• pp.71-80
• /
• 2010

The purpose of this study is to classify defects of the residential building by analyzing the defect specified by prequalification of residential building reconstruction and to suggest the solution of the problem which can be arisen during each stage of plan, construction and maintenance. By sorting the main defects which is specified by pre-qualification of residential building reconstruction for three years from August 2006 to August 2009 into 4 catagories and analyzing the cause of the defects, we draw the way of maintenance to prevent the defects and make pleasant residential environment. The reason for the frequent defects from residential building is mainly deterioration. It occured on the finishing more than on the structure, which means that residents can find defects easier on the finishing than the structure and clear the demand for repair. The result of analyzing of pre-qualification of residential building reconstruction is that the defects mostly caused small, masonry constructed and lower apartment. The apartment which is not into legal right for maintenance naturally have more defects than the others. In conclusion, it is necessary to establish a law of obligation duty of the maintenance of small apartment.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.29 no.4
• /
• pp.361-365
• /
• 2007

The reconstruction of perioral defects following resection of cancer on the perioral region has been a challenge for oral and maxillofacial surgeons. Surgical management of oral squamous cell carcinoma (SCC) typically involves resection of the carcinoma with a 1cm margin of normal appearing tissue. A large surgical defect is often encountered. The goals of perioral reconstruction are esthetics and function, with oral competence and good lip control. Abbe described the operation that bears his name in 1898, when he reported on the repair of a "conspicuous deformity" in a 21-year-old man born with bilateral cleft lip and palate. Since that time, Abbe flap reconstruction has been used more frequently for repair following resection of malignancies. Large defects of the lips have been repaired with recent modifications of the Abbe flap. The technique has been popularized by Estlander for reconstruction of the lower lip. We have treated 70-year-old male patient with SCC on lower lip using Abbe-Estlander flap. Postoperatively the results showed good prognosis. So we report the result of its treatment and case with review of literatures.

• Archives of Craniofacial Surgery
• /
• v.17 no.4
• /
• pp.233-236
• /
• 2016

Scalp defect management is complicated secondary to reduced laxity in the scalp and forehead area. For reconstruction of larger defects with exposed bone and loss of the periosteal layer, free flap reconstruction is one option for single-stage surgery, although the procedure is lengthy and includes the possibility of flap loss. We successfully performed a single-stage reconstruction of a large scalp defect using a combination of artificial dermis, split-thickness skin graft, and full-thickness skin graft following wide excision of a cutaneous angiosarcoma, and present our method as one option for the treatment of large oncologic surgical defects in patients who are poor candidates for free flap surgery.

• Journal of Korean Foot and Ankle Society
• /
• v.26 no.2
• /
• pp.103-106
• /
• 2022

Peroneal tendon disorders are one of many causes of chronic lateral ankle pain. They are related to chronic conditions and anatomical factors and can cause persistent pain and functional impairment if neglected. Peroneal tendon tears are frequently misdiagnosed due to the absence of clear symptoms. For subacute or chronic peroneal tendon ruptures, tendons often became irreparable, and hence various surgical options have been introduced to address this issue. Current surgical treatment options include debridement and tubularization, tenodesis, tendon transfer, and reconstruction with a graft. There have been a few reports on the use of reconstruction techniques with an allograft. In this report, we present a rare case of a peroneal tendon reconstruction technique using an allograft in a young male with simultaneous irreparable peroneus longus and a complete rupture of the brevis tendon. The management plan, prognostic outlook, and a subsequent review of the relevant literature are also presented.

• Korean Journal of Construction Engineering and Management
• /
• v.7 no.2 s.30
• /
• pp.89-97
• /
• 2006

With the increased demand on housing quality and effective urban redevelopment, a new paradigm in reconstruction project is in need. Especially, the Urban and Residential Environment Improvement Law which initiated on July 1, 2003 has become a significant turning point. This code is expected to function as a consistent and systematic measure. This study will examine the code's major concepts and methods to progress reconstruction projects effectively. The application of construction management is examined carefully since the new code requires renewal project consulting firms to function as a professional complement rather than simply perform administration work, as in the past. Also, construction managing methods that can be related to renewal project consulting are examined and speculated. Lastly, methods to improve efficiency in reconstruction projects are introduced through case study and analysis on applicability and expected results.

• Korean Architects
• /
• s.621
• /
• pp.116-125
• /
• 2021