• Archives of Plastic Surgery
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• 제48권1호
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• pp.10-14
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• 2021

Soft tissue filler injections are widely used due to their immediate effects, predictable results, and high stability. However, as the use of soft tissue filler injections has increased, various complications have been reported. We report a life-threatening complication in a patient who developed sepsis and necrotizing fasciitis. A 45-year-old woman presented with right leg pain and discharge from the labia majora. The patient had received a soft tissue filler injection of unknown composition 1 year earlier and had recently undergone incision and drainage for an inflammatory cystic nodule. Antibiotic treatment was administered for cellulitis, but the infection progressed to necrotizing fasciitis and sepsis. Fasciotomy and intensive care unit treatment improved the systemic infection, but the soft tissue filler injection site did not respond to treatment for 1 month. Thus, the injection site was covered with a pedicled vertical rectus abdominis musculocutaneous flap after wide excision. The area of skin necrosis on the leg was covered with split-thickness skin grafts. Infections occurring after soft tissue filler injections are related to biofilms, and treatment is sometimes difficult. Therefore, although soft tissue filler injections have a favorable safety profile, it is important to be aware of the risk of life-threatening complications.

• Clinical and Experimental Reproductive Medicine
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• 제45권3호
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• pp.143-148
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• 2018

Objective: The favored method of preserving fertility in young female cancer survivors is cryopreservation and autotransplantation of ovarian tissue. Reducing hypoxia until angiogenesis takes place is essential for the survival of transplanted ovarian tissue. The aim of this study was to investigate the role of angiopoietin-1 (Angpt-1), angiopoietin-2 (Angpt-2), and vascular endothelial growth factor (VEGF) in ovarian tissue grafts that were cryopreserved using two methods. Methods: Ovarian tissues harvested from ICR mice were divided into three groups: group I (control), no cryopreservation; group II, vitrification in EFS (ethylene-glycol, ficoll, and sucrose solution)-40; and group III, slow freezing in dimethyl sulfoxide. We extracted mRNA for VEGF, Angpt-1, and Angpt-2 from ovarian tissue 1 week following cryopreservation and again 2 weeks after autotransplantation. We used reverse transcriptase-polymerase chain reaction to quantify the levels of VEGF, Angpt-1, and Angpt-2 in the tissue. Results: Angpt-1 and Angpt-2 expression decreased after cryopreservation in groups II and III. After autotransplantation, Angpt-1 and Angpt-2 expression in ovarian tissue showed different trends. Angpt-1 expression in groups II and III was lower than in group I, but Angpt-2 in groups II and III showed no significant difference from group I. The vitrified ovarian tissues had higher expression of VEGF and Angpt-2 than the slow-frozen ovarian tissues, but the difference was not statistically significant. Conclusion: Our results indicate that Angpt-2 may play an important role in ovarian tissue transplantation after cryopreservation although further studies are needed to understand its exact function.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.600-606
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• 2010

Purpose: Although traditional and current treatment strategies may demonstrate success, persistence or recurrence of difficult-to-heal wounds remain significant problems. A novel product, Hyalomatrix$^{(R)}$ (Fidia Advanced Biopolymer, Abano Terme, Italy) is a bilayer of an benzyl esterified hyaluronan scaffold beneath a silicone membrane. The scaffold delivers hyaluronan to the wound, and the silicone membrane acts as a temporary epidermal barrier. We present the results obtained with Hyalomatrix$^{(R)}$ in the treatment of difficult-to-heal wounds. Methods: From November, 2008 to March, 2010, Hyalomatrix$^{(R)}$ has been used on total 10 patients with wounds that were expected difficult to heal with traditional and other current strategies. After average 37.4 days from development of wounds, Hyalomatrix$^{(R)}$ was applied after wound debridement. On the average, Hyalomatrix$^{(R)}$ application period was 17.6 days. After average 16.5 days from removal of Hyalomatrix$^{(R)}$, skin grafts was performed. Results: In all cases, regeneration of fibrous granulation tissues and edge re-epithelization were present after the application of the Hyalomatrix$^{(R)}$. And all of the previous inflammatory signs were reduced. After skin grafts, no adverse reactions were recorded in 9 cases. But in one case, postoperative wound infection occured due to a lack of efficient fibrous tissues. In this model, the Hyalomatrix$^{(R)}$ acts as a hyaluronan delivery system and a barrier from the external environments. In tissue repair processes, the hyaluronan performs to facilitate the entry of a large number of cells into the wounds, to orientate the deposition of extracellular matrix fibrous components and to change the microenvironment of difficult-to-heal wounds. Conclusion: Our study suggests that Hyalomatrix$^{(R)}$ could be a good and feasible approach for difficult-to-heal wounds. The Hyalomatrix$^{(R)}$ improves microenvironments of difficult-to-heal wounds, reduces infection rates and physical stimulus despite of aggravating factors.

• Journal of Periodontal and Implant Science
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• 제37권3호
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• pp.625-636
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• 2007

Marginal tissue recession makes problems like esthetics, root caries, hypersensitivity and plaque accumulation. Request for root coverage is higer than ever, especially esthetic problems involved. So techniques for root coverage hav been developed. There are some kinds of surgical techniques using soft tissue for root coverage. For example, free gingival graft, kinds of pedicle flap, subepithelial connective tissue graft(SCTG), and so on. Subepithelial connective tissue graft has many advantage for root coverage, that is less pain on donor site, good blood supply for graft, and more esthetic result. For this reaseon, this case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft. Three patients has Miller's class I marginal tissue recession and one patients has Miller's class III marginal tissue recession. The following period is 36.5 month on average. The results are as follows: 1. Root coverage of 100% was obtained in 5 of 6 defects, and 80% was obtained in 1 of 6 defects, The mean root coverage was 96,6% in six cases on 4 patients. 2. The mean root coverage was 3.83mm and mean recession depth decreased from 4mm to 0.16mm. 3. The mean width of clinical attached gingiva increased from 1.5mm to 4mm. The mean width of gained attached gingiva after surgery was 2.5mm. 4. The mean follow up period was 36.5 months. The longest follow up period was 50 months and the shortest follow up period was 22 months. 5. The result that obtained by surgery was stable during follow up period. Within the above results, root coverage with SCTG is an effective procedure to cover marginal tissue recession defect with long term stability.

• Journal of Periodontal and Implant Science
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• 제52권2호
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• pp.170-180
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• 2022

Purpose: This study was conducted to assess the effect of hard and/or soft tissue grafting on immediate implants in a preclinical model. Methods: In 5 mongrel dogs, the distal roots of P2 and P3 were extracted from the maxilla (4 sites in each animal), and immediate implant placement was performed. Each site was randomly assigned to 1 of the following 4 groups: i) gap filling with guided bone regeneration (the GBR group), ii) subepithelial connective tissue grafting (the SCTG group), iii) GBR and SCTG (the GBR/SCTG group), and iv) no further treatment (control). Non-submerged healing was provided for 4 months. Histological and histomorphometric analyses were performed. Results: Peri-implant tissue height and thickness favored the SCTG group (height of periimplant mucosa: 1.14 mm; tissue thickness at the implant shoulder and ±1 mm from the shoulder: 1.14 mm, 0.78 mm, and 1.57 mm, respectively; median value) over the other groups. Bone grafting was not effective at the level of the implant shoulder and on the coronal level of the shoulder. In addition, simultaneous soft and hard tissue augmentation (the GBR/SCTG group) led to a less favorable tissue contour compared to GBR or SCTG alone (height of periimplant mucosa: 3.06 mm; thickness of peri-implant mucosa at the implant shoulder and ±1 mm from the shoulder: 0.72 mm, 0.3 mm, and 1.09 mm, respectively). Conclusion: SCTG tended to have positive effects on the thickness and height of the periimplant mucosa in immediate implant placement. However, simultaneous soft and hard tissue augmentation might not allow a satisfactory tissue contour in cases where the relationship between implant position and neighboring bone housing is unfavorable.

• Journal of Periodontal and Implant Science
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• 제24권3호
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• pp.671-689
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• 1994

The purpose of this study was to compare effects of various bone grafts on periodontal regeneration of alveolar bone defects in dogs. Seven adult dogs aged 12 to 18 months were used in this study. Experimental alveolar bone defects were created surgically with a #1/2 round bur at the furcation area of the buccal surface of the mandibular 3rd, 4th premolars and 1st molar. Each experimental alveolar bone defects were grafted with dense hydroxyapatite, natural coral, and decalcified freeze-dried bone, and respectively divided into DHA, NC, DFDB group. An area without bone graft was divided into control group. At 1,2,4,6, and 12 weeks, dogs were serially sacrificed and specimens were prepared with Hematoxylin-Eosin stain and Mallory stain for light microscopic evaluation. The results of this study were as follows : 1. In control group, the matrix change of granulation tissue was observed at 1 week. And in experimental groups, the appearance of connective tissue around graft materials was loosely formed at 1 week, but densely formed at 2 weeks. 2. In every group, the slight formation of new trabecular bone was seen from remaining bone at 1 week. 3. The DHA and NC particles were gradually encapsulated by new trabecular bone from remaining bone, and the osteoid tissue was directly induced from DFDB particles. 4. The presence of osteoblasts was first observed at 1 week in control group and at 2 weeks in NC group, but at 6 weeks in DHA group. 5. In DHA group, the resorption of particles was not observed until 12 weeks. But in NC and DFDB group, the particles were resorbed at 6 weeks and replaced by new bone. And the amount and size of particles were reduced, and their border represented irregular form. In summary, in three experimental groups the inflammatory or foreign body reaction were slight, but the regeneration of new osteoid tissue and the matrix change of dense connective tissue fiber were observed. Especially, NC and DFDB materials were considered as the biocompatible graft materials which were effective in the regenertion of new bone.

• 대한두개안면성형외과학회지
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• 제24권3호
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• pp.129-132
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• 2023

Scalp defects necessitate diverse approaches for successful reconstruction, taking into account factors such as defect size, surrounding tissue, and recipient vessel quality. This case report presents a challenging scenario involving a temporal scalp defect where ipsilateral recipient vessels were unavailable. The defect was effectively reconstructed utilizing a transposition flap and a latissimus dorsi free flap, which was anastomosed to the contralateral recipient vessels. Our report underscores the successful reconstruction of a scalp defect in the absence of ipsilateral recipient vessels, emphasizing the importance of employing appropriate surgical interventions without necessitating vessel grafts.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2003년도 생물공학의 동향(XII)
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• pp.98-100
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• 2003

합성고분자(PET, ePTFE)로 제작된 기존의 혈관 패치는 혈전생성으로 인한 혈관 막힘 현상과 생체 비적합성으로 인한 석회화 현상 때문에 장기간 혈관 기능을 수행할 수 없다. 본 연구에서는 혈관조직을 형성하는 세포들로 분화가 가능한 중간엽줄기세포와 생체적합성 매트릭스를 이용하여 혈관용 패치를 개발하였다. 이식 후 3주에 관찰하였을 때 조직공학적으로 제조된 혈관 패치는 동물 임상시험에서 혈관막힘 현상 없이 혈관기능을 수행하였고 실제 혈관과 유사한 조직으로 재생되었다. 동물모델에서의 장기간 추가 보완 연구를 거친다면 본 연구에서 개발된 혈관 패치는 기존의 재료를 대체하여 많은 혈관질환 치료에 적용이 가능할 것으로 사료된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권1호
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• pp.21-26
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• 2013

Objectives: Full thickness skin grafts (FTSG) offer several advantages; they are esthetically superb, have less postoperative shrinkage, and offer minimal postoperative pain and scar formation at the donor site. As a donor site of FTSG, the groin offers a relatively large area of skin with high elasticity. The aim of this study was to evaluate FTSG from the groin for reconstruction in oral and maxillofacial surgery. Materials and Methods: In a retrospective study, 50 patients (27 males, 23 females) who received FTSG from the groin were evaluated for their operation records, clinical photography, and medical records. Results: The width of skin from the groin was distributed from 2-8 cm (mean: 5.1 cm) at the donor site, while the long axis length was distributed from 3-13 cm (mean: 7.4 cm). A high number of patients, 47 patients (94%) out of 50, showed good healing at the donor site. Wound impairment was seen in 3 patients (6%), minor wound dehiscence in 2 patients, and severe wound dehiscence in 1 patient. In the recipient site, delayed healing was observed in 2 patients (4%). Conclusion: FTSG from the groin to repair soft tissue defects in reconstruction surgery is a good method due to the relatively big size of the graft, decreasing morbidity at the donor site, and higher graft survival rates.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권4호
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• pp.365-378
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• 1995

Allogeneic bone grafting has recently been used in oral and maxillofacial regions to restore the cosmetic and functional problem. There are several types of allogeneic bone grafts ; bone powder, bone chips, bone blocks. Empirically, it is thought to be better to combine the allogeneic bone chips to any type of tissue adhesive not to displace during packing and condensing. But, there are no reports about using tissue adhesive in allogeneic bone grafting. This experimental study is designed to investigate the effect of the fibrin adhesive on bone healing process after demineralized allogeneic bone grafting in 60 rats. In control groups (30 rats), routine demineralized allogeneic bone grafting were done in 7 ${\times}$ 7mm calvarial bone defects which were drilled intentioally. And we used the fibrin adhesive for holding the bone particle in experimental groups (30 rats). Each experimental specimen was sacrified at 1, 2, 4, 6, 8 weeks postoperatively The results were as follows : 1. The degree of inflammatory cell infiltrations were more prominent in experimental than in control groups till 2 weeks. 2. Early fibroblast proliferation and new capillary proliferation were uncorporated around graft sites in the experimental groups later than in control groups at early stages. 3. Osteoblastic activity in control group was more prominent at 2 weeks. 4. Osteoblastic activity in experimental groups was more prominent than in control group till 4 weeks. 5. New bone formation was more in control group than experimental group till 3 weeks, but similar appearance after that time. As above results, initial bone healing within 2 weeks were more processed in without adhesive group than with adhesive group. But above 4 weeks; similar bone healing were observed.