• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권6호
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• pp.427-431
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• 2021

Objectives: The aim of this study was to describe a simple, convenient, and reliable new technique using local full-thickness skin graft (FTSG) for skin coverage of a donor-site defect of the radial forearm free flap (RFFF). Patients and Methods: Between April 2016 and April 2021, five patients with oral squamous cell carcinoma underwent mass resection combined with RFFF reconstruction. After RFFF harvesting, donor-site defects were restored by proportional local FTSG. Results: The donor-site defects ranged in size from 24 to 41.25 cm², with a mean of 33.05 cm². Good or acceptable esthetic outcomes were obtained in all five patients. There was no dehiscence, skin necrosis, wound infection, or severe scarring at the graft site through the end of the postoperative follow-up period, and no patient had any specific functional complaint. Conclusion: The proportional local FTSG showed promising results for skin coverage of the donor-site defect of the RFFF. This technique could decrease the need for skin grafts from other sites.

• 대한화장품학회지
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• 제44권4호
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• pp.455-463
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• 2018

피부의 탄성은 주로 콜라겐, 탄력섬유 등이 풍부한 진피의 영향을 받는다. 하지만, 피부의 가장 바깥층인 각질층의 변화가 피부의 기계적인 특성에 어떠한 영향을 미치는지에 대해선 아직 명확하게 밝혀지지 않고 있다. 이에 본 연구에서는 새롭게 디자인한 시험방법을 통해 피부 깊이별 탄성 특성과 수화과정을 통한 각질층 변화가 피부 탄성 특성에 어떻게 영향을 주는지를 알아보았다. 또한 이 방법을 이용해 얼굴피부와 하박내측 피부의 특성을 비교 평가하였다. 25-40세 연령의 건강한 성인 10명을 대상으로, 피부 깊이별 탄성 특성을 연구하기 위해 $Cutometer^{(R)}$의 음압을 다양하게 설정하여 얼굴피부와 하박내측 피부의 탄성 특성을 측정하여 비교 평가하였다. 음압은 100, 200, 300, 450 mbar로 구분하여 측정하였다. 또한 충분한 수화과정을 통해 각질층의 변화를 유도하고, 다양한 음압 조건에서 피부 탄성 특성을 측정하였다. 그 결과, 음압 조건을 달리함에 따라 피부 깊이에 따른 탄성 특성 측정이 가능함을 확인하였다. 그리고 하박내측 피부의 R7 값은 모든 음압조건에서 얼굴피부보다 통계적으로 유의하게 높았다(p < 0.05). 또한 수화과정에 의한 각질층의 변화는 피부탄성 특성에 영향을 줄 수 있음을 확인하였다. 특히 얼굴피부의 R7 값은 300 mbar 음압조건에서 수화전 상태의 피부에 비해 통계적으로 유의하게 변화하였다(p < 0.05). 그리고 전체적으로 얼굴피부가 하박내측 피부보다 수화과정에 더 크게 영향을 받고 있음을 알 수 있었다. 이러한 결과는 다양한 음압조건과 피부 수화 과정을 활용한다면, 각질층 및 표피층의 변화를 고려한 피부탄력특성을 평가할 수 있는 유용한 시험법이 될 것으로 사료된다.

• Archives of Plastic Surgery
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• 제45권5호
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• pp.479-483
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• 2018

Malignant peripheral nerve sheath tumor (MPNST) is a very rare type of sarcoma, with an incidence of 0.001%. MPNST has a 5-year survival rate near 80%, so successful reconstruction techniques are important to ensure the patient's quality of life. Sarcoma of the forearm is known for its poor prognosis, which leads to wider excision, making reconstruction even more challenging due to the unique anatomical structure and delicate function of the forearm. A 44-year-old male presented with a large mass that had two aspects, measuring $9{\times}6cm$ and $7{\times}5cm$, on the dorsal aspect of the right forearm. The extensor compartment muscles (EDM, EDC, EIP, EPB, EPL, ECRB, ECRL, APL) and invaded radius were resected with the mass. Tendon transfer of the entire extensor compartment with skin defect coverage using a $24{\times}8cm$ anterolateral thigh (ALT) perforator free flap was performed. The patient was discharged after 18 days without wound complications, and has not complained of discomfort during supination, pronation, or wrist extension/flexion through 3 years of follow-up. To our knowledge, this is the first report of successful reconstruction of the entire forearm extensor compartment with ALT free flap coverage after resection of MPNST.

• 대한두경부종양학회지
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• 제11권1호
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• pp.47-55
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• 1995

A large lateral facial defects especially a through and through defect of the cheek remains as challenging field of reconstruction for the head and neck surgeons. Closure of these wounds is technically troublesome due to the magnitude and location of the soft tissue and skin defect, functional and aesthetic consideration. optimal cancer surveillance, and desire for good nourishment. Most traditional methods dealing with these defects, including split-thickness skin graft, local and regional flaps as well as musculocutaneous flaps have their limitations. We applied four different methods for these reconstruction in four cases. We utilized temporal muscle flap, forearm free flap and secondary healing for repair of mucosal defects, and medial base cervicopectoral flap, pectoralis major myocutaneous flap and cervicofacial flap for the reconstruction of external skin defects. In one case, both sides were reconstructed with single forearm free flap. In our experiences, secondary healing could be one of the useful method for mucosal repair in the defect between upper and lower gingivobuccal sulcus. However, forearm free flap was thought to be more ideal for the cases with mandibulectomy. For the external repair, the regional skin flap was considered to be superior to pectoralis major myocutaneous flap or forearm free flap especially on color matching.

• 한국전문물리치료학회지
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• 제3권2호
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• pp.77-83
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• 1996

The purpose of this study was to determine the effect of transcutaneous electrical nerve stimulation(TENS) on sympathetic tone in healthy subjects. Stimulation in the conventional and burst modes was applied to the skin of the forearm overlying the median nerve. TENS was applied for 20 minutes at an intensity sufficient to produce a perceptible though not uncomfortable sensation and no muscle contracion of the forearm musculature. The change in sympathetic tone was measured with skin temperature. Skin temperature was measured at the index finger and on the volar surface of the forearm in the stimulated limb. The conventional and burst modes did not change the skin temperature at any of the two measurement sites. We conclude that TENS, as applied in this study, does not influence sympathetic tone. Further research is needed to assess the sympathetic effects of TENS on patient groups, long term treatment and other modalities.

• Archives of Plastic Surgery
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• 제42권6호
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• pp.769-775
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• 2015

Background The radial forearm flap is a versatile, widely used flap. However, the possibility of donor site complications has led to concern over its use. Some surgeons prefer using other flaps whose donor sites can be closed primarily with less morbidity, including avoiding unpleasant scarring. However, in our experience, donor site stability of the radial forearm flap can be reliably achieved by using well-implemented specific procedures. Here, we present a collection of donor site cases of the radial forearm flap and investigate factors that affect the aesthetic results as the basis for a reference for selecting a radial forearm flap. Methods In this retrospective study, we reviewed 171 cases in which a radial forearm flap was used for free tissue transfer after resecting head and neck cancer. We focused on donor site morbidity rates. Each operation involved a detailed procedure designed to minimize donor site morbidity. Moreover, statistical investigations were conducted for 22 cases to determine factors affecting the scar appearance. Results Only one case developed total skin graft necrosis as a major complication. Scar-related aesthetic results were acceptable, and the body-mass index, body weight, diabetes, and cardiac problems were significant factors related to the appearance of scars. Conclusions Performing the radial forearm flap using a well-implemented detailed technique helps achieve acceptable donor site morbidity results. The aesthetic results were more promising for patients without excess body weight, diabetes, or cardiac problems. Therefore, anxiety about donor site morbidity should not be a reason to avoid selecting the radial forearm flap in suitable patients.

• 대한기관식도과학회지
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• 제3권2호
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• pp.307-312
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• 1997

Reconstruction of the pharyngoesophagus is one of the most difficult challenges in head and neck surgery. The goals of pharyngoesophageal reconstruction include restoration of a person's ability to swallow and to speak with minimal morbidity, but no current reconstruction modality is clearly best. Following its first introduction as fasciocutaneous flap by Yang in 1981, the forearm flap based on radial artery has become recognized as a very reliable and relatively easy one to use. The forearm flap has thin, pliable and predominantly hairless skin and scant subcutaneous layer In addition, its vascular pedicle is long and of large caliber, which greatly increases the chance of successful revascularization. The forearm flap shows the potentiality for better functional rehabilitation in swallowing and speech as well as the possibility of three dimensional reconstruction. We experienced a case of radial forearm free flap for the reconstruction in a patient with the hypopharyngeal stricture. The early return of oral feeding was possible and successfully enough to return to the normal daily activity.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.593-598
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• 2007

Purpose: Talipes equinus deformity is defined as impossibility of heel weight-bearing and lacking of improvement of toe-tip gait despite sufficient duration of conservative treatment. The incidence of equinus deformity induces post-traumatic extensive soft tissue defect and subsequently increases it. Severe equinus deformities of the foot associated with extensive scarring of the leg and ankle were corrected using achilles Z-lengthening and free-tissue transfer. Methods: Free radial forearm flap was done in nine cases of eight patients from January 2000 to November 2006. Causes of deformity were post-traumatic contracture (one patient) and post-burn scar contracture (seven patients). Seven patients were male, one patient was female. Mean age was 32.1 (range, 10-57). Flap donors were covered with artificial dermis ($Terudermis^{(R)}$) and split thickness skin graft (five cases), and medium thickness skin graft only (four cases). Results: The size of flaps varied from $6{\times}12$ to $15{\times}12cm$ (average, $12{\times}7.8cm$). Achilles tendon was lengthened 4.2cm on average. Free radial forearm flap was satisfactory in all cases. All patients could ambulate normally after the surgery. Cases having donor coverage with $Terudermis^{(R)}$ were aesthetically better than those having skin grafts only. Conclusion: This study suggested that severe equinus deformities associated with extensive scarring of the leg and ankle can be corrected effectively free radial forearm flap and Achilles tendon lengthening.

• 대한본초학회지
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• 제22권2호
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• pp.45-50
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• 2007

objectives: We investigated the moisturizing and cooling effects of the cosmetic product with Scrophularia Buergeriana, Poria Cocos, Lonicera Japonica, Portulaca Oleracea and Ginko Biloba extract on human skin by using non-invasive instrument. Methods: We measured physiological effects after volunteers(female, n=5) applied the cosmetic product containing the extract of oriental herbs. The forearm skin moisturization was measured with $Corneometer^{\circledR}$ CM825 after 15min, 3hr, and 6hr. The forearm skin surface roughness was with Scanning electron microscopy after 15min, and 6hr. The face skin temperatures cooling and microcirculation effects were measured with ThermaCAMTM PM525 and LDl-Periscan PlM II after 15min, and 30min. Results: The forearm skin moisturization was imcreased 108% after 15min. The forearm skin surface roughness was decreased significantly after 15min. The face skin temperatures were cooling down to $30.7^{\circ}C$. The face skin microcirculation effect was normalized time-dependently. Conclusions: We concluded that cosmetic product containing the extract of Scrophularia Buergeriana, Poria Cocos, Lonicera Japonica, Portulaca Oleracea and Ginko Biloba had a moisturization effect and improving the surface roughness, temperature and microcirculation on the human skin.

• 대한약침학회지
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• 제16권4호
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• pp.43-48
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• 2013

Objectives: The current study was performed to compare the bee venom pharmacopuncture skin test reactions among groups with different sexes and Sasang constitutions. Methods: Between July 2012 and June 2013, all 76 patients who underwent bee venom pharmacopuncture skin tests and Sasang constitution diagnoses at Oriental Medicine Hospital of Sangji University were included in this study. The skin test was performed on the patient's forearm intracutaneously with 0.05 ml of sweet bee venom (SBV) on their first visit. If the patients showed a positive response, the test was discontinued. On the other hand, if the patient showed a negative response, the test was performed on the opposite forearm intracutaneously with 0.05 ml of bee venom pharmacopuncture 25% on the next day or the next visit. Three groups were made to compare the differences in the bee venom pharmacopuncture skin tests according to sexual difference and Sasang constitution: group A showed a positive response to SBV, group B showed a positive response to bee venom pharmacopuncture 25%, and group C showed a negative response on all bee venom pharmacopuncture skin tests. Fisher's exact test was performed to evaluate the differences statistically. Results: The results of the bee venom pharmacopuncture skin tests showed no significant differences according to Sasang constitution (P = 0.300) or sexual difference (P = 0.163). Conclusion: No significant differences on the results of bee venom pharmacopuncture skin tests were observed according to two factors, Sasang constitution and the sexual difference.