• Title/Summary/Keyword: composite graft.

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RECONSTRUCTION OF MANDIBULAR DEFECT WITH COMPOSIITE AUTOGENOUS ILIAC BONE AND COSTOCHONDRAL GRAFTS (자가장골 및 늑연골의 복합이식을 통한 하악골 재건술)

  • Chang, Se-Hong;Ann, Jye-Jynn;Soh, Jae-Jung;Park, Chi-Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.104-109
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    • 1991
  • Loss of mandibular continuity due to neoplasm, trauma, or infection results in major esthetic and biologic compromise. The use of costochondral grafts for reconstruction of temporomandibular joint, described first by Gillies in 1920, has been accepted as a suitable method for replacing the mandibular condyle, especially in growing children. Autogenous iliac bone graft has been a satisfactory source of mandibular reconstruction since Sykoffs report in 1900. Autogenous bone grafts from the posterior aspects of the ilium provide large amount of PMCB with acceptable donor site morbidity. In timing of reconstruction, initial disease, age, medical history, growth and development, esthetic and psychologic factors should be considered. We present a case of osteosarcoma in the mandible that was treated by a hemimandibulectomy and the defect was reconstructed 20 months later with composite method of costochondral and posterior iliac bone graft.

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Reconstruction of hand using anterolateral thigh fascial free flap (전외측대퇴근막 유리피판술을 이용한 수부의 재건)

  • Kim, Ki Wan;Kim, Jin Soo;Lee, Dong Chul;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.571-577
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    • 2009
  • Purpose: The Provision of thin and pliable tissue and the adequate coverage of tendon - gliding surface is necessary for a soft tissue defect of the hand with exposure of bone, tendon and muscle. This report will discuss our experience with anterolateral thigh fascial free flap for the reconstruction of the soft tissue defect of the hand. Methods: Between February 2004 and August 2008, seven patients with full - thickness soft tissue defects of the hand were reconstructed by means of a composite anterolateral thigh fascial free flap. There were soft tissue defects associated with trauma (n=5), scar contracture (n=1) and necrosis due to ischemia (n=1). Flaps were harvested from the anterolateral thigh as adipofascial flaps with only a small sheet of fascia and fatty tissue above it. The fascia and the skin of the donor site was closed directly and delayed split - thickness skin graft was performed. Result: All flaps survived completely. The size of the transferred flap ranged from $2{\times}4cm$ to $5{\times}8cm$. Thin flap coverage was possible without secondary debulking operations. It left minimal donor site morbidity with a linear scar. In one case, the thigh muscle herniation in the donor site was developed. Conclusion: The anterolateral thigh fascial free flap provided thin and pliable tissue which can establish a tendon - gliding mechanism, minimal bulk, minimal donor site morbidity. The disadvantages of this technique were the need for a skin graft and the muscle herniation of donor site.

Usefulness of the orbicularis oculi myocutaneous flap in periorbital reconstruction

  • Kim, Geon Woo;Bae, Yong Chan;Kim, Joo Hyoung;Nam, Su Bong;Kim, Hoon Soo
    • Archives of Craniofacial Surgery
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    • v.19 no.4
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    • pp.254-259
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    • 2018
  • Background: The esthetic and functional outcomes of periorbital defect reconstruction are very important because of the complex anatomy and specialized functions of this region. The orbicularis oculi myocutaneous (OOMC) flap is useful for the reconstruction of periorbital defects. But, according to the location and depth of the defects, the reconstruction using OMC flaps with various techniques is rare. The authors have used various kinds of OOMC flaps in various situations and we present an analysis of our experiences. Methods: From November 2001 to July 2017, we used 36 OOMC flaps to reconstruct 30 periorbital defects in 25 patients. We analyzed the cause of the defect, its location, the type of concomitant surgery, the method of flap movement, and complications. Results: Of the 30 defects, basal cell carcinoma was the most common cause, accounting for 20 cases. When the used OOMC flap was classified according to the location of the defects, the switch flap was used in nine cases among 15 defects of lower eyelid, and the V-Y advancement flap was mainly used for other parts. As surgical methods according to the depth of defect were classified, all cases involving the tarsal plate were reconstructed with a composite graft. In case of skin and muscles, they were reconstructed only with OOMC flap or with full-thickness skin graft. Conclusion: The OOMC flap provides good skin quality that is very similar to that of the defect tissue. Depending on the location and depth of the defect, the OOMC flap may be used properly in a variety of ways to achieve good results.

THE EFFECT OF CALCIUM SULFATE WITH CALCIUM CARBONATE GRAFT AND CALCIUM SULFATE BARRIER ON THE HEAUNGOF 3-WALL INTRABONY DEFECTS IN DOGS (성견 3면 골내낭에서 calcium sulfate를 calcium carbonate와 혼합이식 및 차단막으로 사용시 치주조직의 치유효과)

  • Jeong, Yu-Seon;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.26 no.3
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    • pp.605-624
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    • 1996
  • Various bonegraft materials and the technique of guided tissue regeneration have been used to regenerate lost periodontal tissue. Calcium sulfate has been known as a bone graft material because of good biocompatibility, rapid resorption and effective osteoinduction. It has been known that calcium sulfate works as a binder to stabilize the defect when it is used with synthetic graft materials. The effects on the regeneration of pericxiontal tissue were studied in dogs after grafting 3-wall intrabony defects with calcium carbonate and calcium sulfate and covering with calcium sulfate barrier. The 3-wall intrabony defectstdmm width, 4mm depth, 4mm length) were created in anterior area and treated with flap operation alone(contol group), with porous resorbable calcium carbonate graft alonetexperirnental group 1), with calcium sulfate graft alonetexperimental group 2) and with composite graft of 80% calcium carbonate and 20% calcium sulfate with calcium sulfate barriertexperimental group 3). Healing responses were histologically observed after 8 weeks and the results were as follows: 1. The alveolar bone formation was $0.59{\pm}0.19mm$ in the control group, $1.80{\pm}0.25mm$ in experimental group 1, $1.61{\pm}0.21mm$ in experimental group 2 and $1.94{\pm}0.11mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(P<0.05). There were statistically significant differences between experimental group 1 and group 2 (P<0.05). 2. The new cementum formation was $0.48{\pm}0.19mm$ in the control group. $1.72{\pm}0.26mm$ in experimental group 1, $1.43{\pm}0.17mm$ in experimental group 2, $1.89{\pm}0.15mm$ in experimental group 3 with statiscally significant differences between control group and all experimental groups (p<0.05). There were statistically significant differences between experimental group 1 and group 2, and between experimental group 2 and group 3(P<0.05). 3. The length of junctional epithelium was $1.61{\pm}0.20mm$ in the contol group, $0.95{\pm}0.06mm$ in experimental group 1, $1.34{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.11mm$ in experimental group 3 with statiscally significant differences between control group and experimental group 1. and btween control group and experimental group 3(p<0.05). There were statistically significant differences between experimental group 1 ,and group 2, and between experimental group 2 and group 3(P<0.05). 4. The connective tissue adhesion was $1.67{\pm}O.20mm$ in the control group, $1.33{\pm}0.24mm$ in experimental group 1. $1.23{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.14mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(p<0.05). There were nostatistically significant differences between all experimental groups. As a result, epithelial migration was not prevented when calcium sulfate was used alone, but new bone and cementum formation were enhanced. Epithelial migration was prevented and new bone and cementum formation were also enhanced when calcium carbonate was used alone and when both calcium carbonate and calcium sulfate were used.

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Bone Formation Effect of the RGD-bioconjugated Mussel Adhesive Proteins Composite Hydroxypropyl Methylcellulose Hydrogel Based Nano Hydroxyapatite and Collagen Membrane in Rabbits

  • Kim, Dong-Myong;Kim, Hyun-Cho;Yeun, Chang-Ho;Lee, Che-Hyun;Lee, Un-Yun;Lim, Hun-Yu;Chang, Young-An;Kim, Young-Dae;Choi, Sung-Ju;Lee, Chong-Suk;Cha, Hyung Joon
    • Journal of Marine Bioscience and Biotechnology
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    • v.7 no.2
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    • pp.58-70
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    • 2015
  • Injectable RGD-bioconjugated Mussel Adhesive Proteins (RGD-MAPs) composite hydroxypropyl methylcellulose (HPMC) hydrogels provide local periodontal tissue for bone filling in periodontal surgery. Previously we developed a novel type of injectable self-supported hydrogel (2 mg/ml of RGD-MAPs/HPMC) based porcine nano hydroxyapatite (MPH) for dental graft, which could good handling property, biodegradation or biocompatibility with the hydrogel disassembly and provided efficient cell adhesion activity and no inflammatory responses. Herein, the aim of this work was to evaluate bone formation following implantation of MPH and collagen membrane in rabbit calvarial defects. Eight male New Zealand rabbits were used and four circular calvarial defects were created on each animal. Defects were filled with different graft materials: 1) collagen membrane, 2) collagen membrane with MPH, 3) collagen membrane with bovine bone hydroxyapatite (BBH), and 4) control. The animals were sacrificed after 2 and 8 weeks of healing periods for histologic analysis. Both sites receiving MPH and BBH showed statistically increased augmented volume and new bone formation (p < 0.05). However, there was no statistical difference in new bone formation between the MPH, BBH and collagen membrane group at all healing periods. Within the limits of this study, collagen membrane with MPH was an effective material for bone formation and space maintaining in rabbit calvarial defects.

Facilitated Transport Membranes Based on PVA-g-PAA Graft Copolymer (PVA-g-PAA 가지형 공중합체 기반 촉진수송 분리막)

  • Park, Min Su;Kang, Miso;Park, Bo Ryoung;Kim, Jeong-Hoon;Kim, Jong Hak
    • Membrane Journal
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    • v.31 no.3
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    • pp.212-218
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    • 2021
  • It is inevitable to generate incomplete combustion gases when mankind utilizes fossil fuels. From this point of view, gas separation process of combustion gas suggests the possibility of recycling CO gas. In this study, we fabricated a facilitated transport polymeric composite membrane for CO separation using AgBF4 and HBF4. The copolymer was synthesized via free-radical polymerization of poly(vinyl alcohol) (PVA) as a main chain and acrylic acid (AA) monomer as a side chain. The polymer synthesis was confirmed by FT-IR and the interactions of graft copolymer with AgBF4, and HBF4 were characterized by TEM. PVA-g-PAA graft copolymer membranes showed good channels for facilitated CO transport. In this perspective, we suggest the novel approach in CO separation membrane area via combination of grafting and facilitated transport.

A Simulation Study on the Stress Distribution of the Transplanting Part of Artificial Knee Joint due to Elastic Modulus (탄성계수에 따른 무릎 인공관절 이식 부품의 응력분포에 관한 시뮬레이션 연구)

  • Lee, J.H.;Hwang, G.W.;Cho, J.U.;Cheon, Seong S.
    • Composites Research
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    • v.28 no.3
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    • pp.89-93
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    • 2015
  • This study analyzes the transplanting parts used as the graft of artificial knee joint. The low elastic titanium alloy is applied to clear up the stress shield effect. The simulation analysis is carried about the stress distribution of the transplanting parts. The correlation with frame is inferred and investigated through the equivalent stress distribution of titanium alloy due to elastic modulus. The stress of the transplanting parts decreases as the elastic modulus decreases at the first time. It decreases greatly near the stress of 46 GPa and increases again. Because the stress happened at the transplanting parts decreases, more stress is applied on the frame. This phenomenon is the stress shield effect. The result of this study can be thought to be necessary to develop the safe design of composite material.

Local ridge augmentation using a composite of bone substitute and collagen membrane at peri-implant dehiscence defects: a clinical, radiographic and histological analyses. (성견에서 차단막/골이식재 복합체를 이용한 임플란트 주위 골유도재생 효과: 임상적, 방사선학적, 조직학적 평가)

  • Song, Young Woo;Yoon, So-Ra;Cha, Jae-Kook;Lee, Jung-Seok;Choi, Seong-Ho;Jung, Ui-Won
    • The Journal of the Korean dental association
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    • v.55 no.10
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    • pp.676-687
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    • 2017
  • Objectives : The aim of this study was to evaluate the effects of a composite of bone substitute and collagen barrier membrane (bone patch) for local ridge augmentation at peri-implant dehiscence defects on the clinical efficacy and positional stability in dogs. Materials and methods : Implant placement and ridge augmentation procedure were performed at surgically created peri-implant dehiscence defects in canine mandible (n=6). Four treatment modalities were randomly applied: i) bone patch group, ii) Guided bone regeneration (GBR) without pin fixation group (bone graft and collagen membrane), iii) GBR with pin fixation group, and iv) negative control group. After 12 weeks, clinical, micro-CT and histological analyses were performed. Results : Histologic analysis showed that bone patch group had similar results to GBR group and GBR with fixation group in terms of new bone formation. Micro-CT analysis revealed similar results to histologic analysis in terms of total volume maintenance. Operating time was shorter in bone patch group compared to GBR group and GBR with fixation groups. Conclusions : GBR using bone patch could simplify the ridge augmentation procedure with reduced operating time and equivalent biological performance compared to the conventional procedure.

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One Year Experience of the Hand Allotransplantation First Performed after Korea Organ Transplantation Act (KOTA) Amendment

  • Nara Lee;Woo Yeol Baek;Yun Rak Choi;Dong Jin Joo;Won Jai Lee;Jong Won Hong
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.415-421
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    • 2023
  • The revision of the Korea Organ Transplantation Act (KOTA) in 2018 included hand/arm among the organs that can be transplanted. The first hand transplantation since the revision of KOTA took place in January 2021. A 62-year-old male patient experienced hand amputation on July 13, 2018, by a catapult injury. The patient first visited our institute 3 months after the injury. After serial interviews and an overall evaluation, the patient was registered on the hand transplantation waiting list in January 2020. On January 9, 2021, the patient underwent hand transplantation at the right distal forearm level. The total operation time was 17 hours 15 minutes, and the cold ischemic time was 4 hours 9 minutes. Postoperative immunosuppression was administered based on the protocol used for kidney transplantation. Two acute rejection episodes occurred, on postoperative days 33 and 41. Both rejection episodes were reversible with rescue therapy of a higher tacrolimus trough level, steroid pulse therapy, and topical immunosuppressants. Controlled passive range of motion exercise was started on postoperative day 10. Dynamic splint was applied on postoperative day 18. At 1 year, graft maintenance and functional improvement were satisfactory, and the patient showed a Disabilities of Arm, Shoulder and Hand score of 25.8. We successfully performed the first hand transplantation surgery under the KOTA amendment. It came from the organic and effective cooperation of plastic, orthopaedic, and transplantation departments and we believe it will guarantee the future ongoing success.

ANEURYSAMAL BONE CYST : REPORT OF A CASE (동맥류성 골낭종의 증례보고)

  • Lim, Seok-Kyun;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan;Chi, Jae-Hyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.237-240
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    • 1998
  • Aneurysmal bone cyst is a benign lesion of bone consisting of a septated, cystic cavity filled with non-endothelium-lined, blood-filled spaces. As it grows, expanding and destroying the affected part of the bone by direct compression, the lesion characteristically produces a prominent bulging of the affected bone, which eventually erodes the overlying cortex. Patients rarely complain of pain unless the cyst affects adjacent nerves or its expasion is great enough to impinge on the surrounding joints and soft tissue. Teeth adjacent to the cyst may be displaced, but usually remain vital. Development of the lesion in the craniofacial region is rare, and the mandible is more often affected than the maxilla. Complete surgical excision is used to treat aneurysmal bone cyst, with either curettage or composite resection. This is a case report of 49 years old female with aneurysmal bone cyst treated with surgical excision & DFDB graft.

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