• Title/Summary/Keyword: Tissue grafts

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EXPERIMENTAL STUDY OF EFFECT ON INDUCED OSTEOGENESIS ACCORDING TO THE SIZE OF DEMINERALIZED ALLOGENEIC BONE (동종 탈회골의 크기가 유도골 형성에 미치는 영향에 관한 실험적 연구)

  • Bang, Man-Hyeok;Um, In-Woong;Lee, Dong-Keun;Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.350-364
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    • 1995
  • As early as 1889, treatment of ostemyelitis was reported using xenogeneic demineralized bone. In 1965, Urist discovered that demineralized long bone fragment, even when implanted in nonskeletal tissue, would stimulate osteogenesis. The clinical use of demineralized bone of Oral and Maxillofacial surgery is not new. The demineralized bone implants were used for 1) interposition within osteotomy gaps, cystic detects, alveolar clefts ; 2) augmentation, over intact bone surfaces ; 3) construction of new bone within soft tissue. Demineralized bone grafts invokes a induced osteogenesis which is the transformation of host cells into osteoblasts. Demineralized bone has identified several factors that modulate the osteogeneic response : sterilization method, recipient age, particle size etc. Especially, pulverization of bone matrix may enhance its osteoinductive properties, to allow rapid, efficient bridging of large defects. the purpose of the present report was to describe the potential efficacy of demineralized allogeneic bone powder of skull of rabbits as a particle size ; 212 ${\mu}m$, 710 ${\mu}m$, 1 mm each other. Microscopic finding in our experimental studies shown that 710 ${\mu}m$ demineralized bone powder is the most potent osteogenic response, and then 212 ${\mu}m$, 1 mm size. Densitometric analysis shown that density of all group was continue to increase until 4 weeks after operation, and then continue to decrease.

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The Effectiveness of Vacuum-Assisted Closure (V.A.C) Dressing combined with Silver Dressing Material in Open Fracture of the Foot and Ankle (족부 및 족관절의 개방성 골절 환자에서 음압 치료와 실버 드레싱 제재 복합 치료의 유용성)

  • Lee, Yu-Sang;Cho, Jae-Ho;Park, Jin;Han, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.156-162
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    • 2008
  • Purpose: Open fractures of the foot and ankle require prompt repair of the wound due to the complexity of anatomy, insufficiency of soft tissues and inadequate blood supply. Early flaps and skin grafts are used for this purpose yet general condition of the patient as well as local wound environment often precludes such treatment options. Vacuum- Assisted Closure (VAC) is recently being used in such cases. This study was done to validate the use of VAC together with silver antimicrobial dressing materials in contaminated open fracture wounds. Materials and Methods: We have selected 10 patients with Gustillo-Anderson type III open fractures of the foot & ankle treated with VAC and silver antimicrobial dressing materials from March 2007 to January 2008. The relationship between duration of treatment with wound size, contamination, and degree of soft tissue damage was analyzed. Results: The average age of patients was 36.6 years. The average amount of VAC application time was 23.4 days. Silver dressing materials were used for 16.8 days. Average wound healing time was 51.9 days. Statistically significant relationship was found between wound size, VAC application time and silver dressing material application time. No complications such as osteomyelitis were found after treatment. Conclusion: VAC technique is recently being used in open fractures with wide skin and soft tissue defects, producing good results. A wide array of dressing materials such as silver dressing is in development. We have incorporated the VAC technique together with silver dressing materials in the treatment of open fractures and achieved complication free results.

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The Anconeus Muscle Free Flap: Clinical Application to Lesions on the Hand

  • Jeon, Byung-Joon;Jwa, Seung Jun;Lee, Dong Chul;Roh, Si Young;Kim, Jin Soo
    • Archives of Plastic Surgery
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    • v.44 no.5
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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.

Outcomes of grafted skin on the dorsum of the foot after car-tire friction injuries

  • Kim, Shin Hyun;Lee, Won Jai
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.678-684
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    • 2021
  • Background A car-tire friction injury on the dorsum of a child's foot often results in hypertrophic scarring of the wound margins. This study describes the clinical appearance of the injured areas and surgical complications that occurred during the follow-up period in a series of children with car-tire friction injuries who were treated with split-thickness skin grafts (STSGs). We describe the clinical features that we believe need to be highlighted when initially treating car-tire injuries in children. Methods From May 2003 to June 2016, our retrospective study included 15 patients with car-tire injuries on the dorsum of the foot who were treated with surgical excision and STSG to cover the wound. Results A total of 15 patients with car-tire injuries were treated. The average age was 6.26 years old. The average injury grade was 3.26. Two patients were treated using delayed repair, and 13 patients received STSG for initial management. Four patients experienced no complications, while 11 patients had hypertrophic scars and/or scar contracture after surgery. Conclusions A car-tire friction injury on the dorsum of a child's foot often results in hypertrophic scar formation or scar contracture even if proper management is undertaken. Since the occurrence of these complications in childhood can lead to a secondary deformity, it is important to properly treat car-tire friction wounds, inform patients and caregivers about potential complications, and ensure regular follow-up evaluations over a 12-month period following the initial surgery.

Reconstruction of Interdental papilla through connective tissue graft with orthodontic treatment: A Clinical Case Report (교정치료를 동반한 CTG를 통한 치간유두 재생)

  • Jung, Sung Koog
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.29 no.2
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    • pp.84-91
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    • 2020
  • Regeneration of interdental papilla damaged by periodontal disease is a very challenging task. So far, many dentists have devised and introduced great surgical methods. Comparing the pros and cons of the methods introduced so far, I came up with the best way to regenerate interdental papilla. Temporarily creating space between narrow interdental papilla, which cannot be solved by periodontal surgery alone, was a great help for connective tissue graft(CTG). The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. Along with the orthodontic treatment, the area between the narrow interdental papilla was widened to make it easier for the CTG was carried out. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this method ELSA (Enlargement of space-Labial graft-Squeezing-for Augmentation of papilla) technique.

Reconstruction of Interdental papilla through ELSA technique : A Clinical Case Report (ELSA테크닉을 이용한 치간유두의 재생)

  • Jung, Sung Koog
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.2
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    • pp.91-101
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    • 2021
  • The interdental papilla area is a difficult area for connective tissue graft (CTG) due to its narrow space. So Regeneration of interdental papilla is very challenging work. It is very difficult when the teeth have contact with adjacent teeth, but if there was only 3mm of space between the teeth, CTG was not very difficult. Therefore, through the orthodontic force, a 3mm space between the teeth was intentionally created. The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this technique ELSA Technique (Enlargement of space - Labial graft - Squeezing - for Augmentation of papilla). If interdental papilla is lost due to periodontal disease, ELSA techniques can regenerate interdental papilla very efficiently.

The effect of hard-type crosslinked hyaluronic acid with particulate bone substitute on bone regeneration: positive or negative?

  • Yun, Junseob;Lee, Jungwon;Kim, Sungtae;Koo, Ki-Tae;Seol, Yang-Jo;Lee, Yong-Moo
    • Journal of Periodontal and Implant Science
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    • v.52 no.4
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    • pp.312-324
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    • 2022
  • Purpose: The role of hard-type crosslinked hyaluronic acid (HA) with particulate bone substitutes in bone regeneration for combined inlay-onlay grafts has not been fully investigated. We aimed to evaluate the effect of hard-type crosslinked HA used with bone substitute in terms of new bone formation and space maintenance. Methods: A 15-mm-diameter round defect was formed in the calvaria of 30 New Zealand White rabbits. All animals were randomly assigned to 1 of 3 groups: the control group (spontaneous healing without material, n=10), the biphasic calcium phosphate (BCP) graft group (BCP, n=10), and the BCP graft with HA group (BCP/HA, n=10). The animals were evaluated 4 and 12 weeks after surgery. Half of the animals from each group were sacrificed at 4 and 12 weeks after surgery. Samples were evaluated using micro-computed tomography, histology, and histomorphometry. Results: The BCP group showed higher bone volume/tissue volume (BV/TV) values than the control and BCP/HA groups at both 4 and 12 weeks. The BCP and BCP/HA groups showed higher bone surface/tissue volume (BS/TV) values than the control group at both 4 and 12 weeks. The BCP group showed higher BS/TV values than the control and BCP/HA groups at both 4 and 12 weeks. No statistically significant difference in newly formed bone was found among the 3 groups at 4 weeks. The BCP group showed significantly higher new bone formation than the BCP/HA group at 12 weeks. Conclusions: Hard-type crosslinked HA did not show a positive effect on new bone formation and space maintenance. The negative effect of hard-type crosslinked HA may be due to the physical properties of HA that impede osteogenic potential.

Preparation of harvested skin using the Versajet Hydrosurgery System in full-thickness skin grafts

  • Choi, Seo Gil;Shin, Hyun Woo;Yoon, Kun Chul
    • Archives of Plastic Surgery
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    • v.46 no.6
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    • pp.603-607
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    • 2019
  • During a full-thickness skin graft procedure, the thickness of the harvested donor skin is adjusted based on the location of the recipient site and the judgment of the surgeon. Conventionally, the thickness of the harvested skin is roughly adjusted using surgical instruments such as scalpels and scissors. However, this method is not only time-consuming, but also requires effort to obtain both the desired thickness of the harvested skin and a smooth surface of that skin. Moreover, there is a possibility of skin perforation. Hence, the authors devised a method of adjusting harvested skin thickness using the Versajet Hydrosurgery System. The Versajet device is a handheld hydrosurgical tool that delivers a high-speed jet stream of saline solution, which enables the precise debridement of tissue. This method makes it easier and faster for the surgeon to obtain the desired thickness of harvested skin. In addition, by obtaining a smooth surface and an even thickness of harvested donor skin, this technique may lead to improved graft viability.

Using the Dorsal Metacarpal Artery Perforator Flap for Reconstruction of Rheumatoid Ulcers

  • Choi, Min;Son, Kyung Min;Choi, Woo Young;Cheon, Ji Seon;Yang, Jeong Yeol
    • Archives of Reconstructive Microsurgery
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    • v.24 no.2
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    • pp.79-81
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    • 2015
  • Rheumatoid arthritis is a long lasting autoimmune disorder that primarily affects joints, and patients with rheumatoid arthritis are predisposed to development of chronic skin ulcers. In addition, skin ulcers with rheumatoid arthritis tend to persist despite treatment because of sustained inflammation and poor healing capacity. Treatment of skin ulcers involves medications, wound coating agents, and surgical procedures including skin grafting, however, wound dressing or skin grafts are generally excluded because of excessive cost and time and poor intake rate. The dorsal metacarpal artery perforator (DMAP) flap, a vascular island flap for coverage of soft tissue defects on the fingers, provides promising results including matched quality and color. We experienced a case of DMAP flap for reconstruction of a rheumatoid ulcer, and a DMAP flap may be considered as a good faithful option for treatment of patients with rheumatoid ulcer.

Mandibular condyle and infratemporal fossa reconstruction using vascularized costochondral and calvarial bone grafts

  • Jang, Hyo Won;Kim, Nam-Kyoo;Lee, Won-Sang;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.83-86
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    • 2014
  • There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.