• 대한두경부종양학회지
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• 제31권1호
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• pp.5-8
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• 2015

Backgrounds: The purpose of this study was to compare full thickness skin graft with inguinal skin to split thickness skin graft for coverage of the radial forearm free flap donor site. Patients and Methods: 25 patients who was reconstructed with radial forearm free flap for head and neck cancer were reviewed retrospectively. Results: The graft loss rates of full thickness skin graft were less than split thickness skin graft or split thickness skin graft with dermal substitutes. The recovery times of donor site and skin graft donor site of full thickness skin graft were also shorter than split thickness skin graft or split thickness skin graft with dermal substitutes. Skin texture and aesthetic results of donor site were improved and complications as itching and pain sensation were decreased. Conclusion: Full thickness skin grafts with inguinal skin should be considered for patients requiring a radial forearm free flap.

• 대한화장품학회지
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• 제45권4호
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• pp.373-380
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• 2019

얼굴과 하박내측의 피부는 경피수분손실량(TEWL), 피부 수분량, 탄력 등에서 많은 차이를 보이고 있다. 특히, 이전 연구 결과에서 얼굴피부와 하박내측 피부는 수화(hydrating) 과정에 따른 탄력특성의 차이를 보여 주었다. 이에 본 연구에서는 신체부위에 따른 피부특성 차이는 각 신체부위를 구성하고 있는 각질세포 특성과 연관성이 있을 것이라는 가정하에 atomic force microscopy (AFM)을 이용하여 각질세포 표면 특성을 비교 연구하였다. 각질세포 표면의 거칠기(roughness)와 villus-like projections (VPs)을 이용하여 비교 평가 하였다. 더 나아가 얼굴피부, 하박내측, 입술 피부의 각질세포 표면을 정성적으로 비교해 보았다. 각질세포는 8명의 피험자의 얼굴과 하박내측 피부에서 tape-stripping을 이용하여 채취하여, AFM을 이용하여 40 ㎛ × 40 ㎛ 크기로 각질세포의 아랫면 표면 특성(bottom surface of corneocyte)을 측정하였다. 그 결과, 얼굴 각질세포 아랫면 표면 거칠기는 388.34 ± 86.189 nm이었고, 하박내측 각질세포 아랫면 표면 거칠기는 662.27 ± 224.257 nm로 하박내측 각질세포가 얼굴 각질세포보다 더 거친 표면 특성임을 확인하였다(p < 0.001). 관찰된 VPs의 양을 비교해보면, 입술 각질세포가 가장 많았고, 그 다음이 얼굴 각질세포이며, 하박내측 각질세포는 낮은 수준이었다. 이러한 결과를 통해 볼때, 각질세포 표면 특성이 얼굴과 하박내측 피부 사이에 보이는 특성 차이에 어느 정도 관여하고 있음을 확인할 수 있었으며, VPs는 부위별 피부 특성 연구에 유용한 parameter가 될 수 있는 가능성도 확인할 수 있었다. 그리고, AFM은 각질세포 표면의 미세한 구조적 차이를 비교 연구하는데 매우 유용한 기기임을 알 수 있었다. 향후 조금 더 많은 연구가 진행된다면 각질세포에 대한 새로운 화장품 효능 평가법이 개발될 것으로 사료된다.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.122-128
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• 1998

Radial forearm flap is one of the most useful skin flap in hand reconstructuion with distally based reverse pedicled or free vascularized fashion. Athors modified that flap into reverse pedicled and free vascularized flap which has advantages of both methods. The modification composed with harvesting flap on recipient side distal forearm just as free flap, than apply it as reverse distal pedicled flap fashion with microvascular anastomosis with distal vascular stump of donor radial vessels. We underwent this method in 5 cases in finger reconstruction from 1996, all of the cases had sucessful results. The advantages of this method are: 1. Thin flap which is compatible to finger skin can harvest from distal forearm with very long vascular pedicle that can be passed under the subcutaneous tunnel which avoid additional skin incisions on the hand. 2. The vessels of donor site and recipient site are same vessel in effected side of forearm, which can preserve contralateral side forearm and hand keep intact. 3. The flap can cover the defects on distal portion of the fingers which is difficult in conventional reversed radial forearm pedicled flap because of limited mobilization of flap due to limitation of pedicle length reach to tip of the fingers.

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.60-63
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• 2001

The reconstruction of the suborbital area followed by resection of skin cancer has been used many methods including skin graft, local flaps, free flaps, and skin expansion. The radial forearm free flap has become a workhorse flap in this area because of its lack of bulk, ease of dissection, malleability, and hairlessness. When the suborbital defect especially including full-thickness defect of lower lid was reconstructed with many free flaps, the ectropion and the deformity of medial and lateral canthal area were common problems encountered as late complication due to gravitational descent. To improve the final aesthetic result in patients with suborbital defect, the radial forearm free flap was elevated as a composite radial forearm - palmaris longus free flap, in which the vascularized palmaris longus london was included and anchored to the periorbital bone with $mitek^{(R)}$ as sling, to suspend the flap against gravity and inferior descent, and thereby creating a more natural cheek contour. Two clinical cases were presented as an example of this procedure. Postoperative results emphasize the importance of suspension sling with palmaris longus tendon using $mitek^{(R)}$ in reconstruction of the suborbital defect with radial forearm free flap.

• 패션비즈니스
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• 제7권1호
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• pp.27-37
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• 2003

This study is the first part of the research to reveal the effects of somatotype characteristics on body temperature control reaction as well as thermal sensation. Nine healthy female collegians (classified into 3 body types of thin, normal, and obese according to Rohrer index) living in Busan were chosen as the subjects. The following are the results: Significant differences of skin temperature appeared in the parts of epigastrium (thin/normal>obese), anterior forearm (normal>thin/obese), and anterior leg (obese > thin/normal) as well as mean skin temperature. Mean skin temperature temporarily dropped owing to the exercise but tended to recover as time went by. Skin temperature of normal/thin shows higher than obese type. The change of skin temperature was noticed in the order of forehead > epigastrium > anterior forearm > anterior leg > anterior thigh (obese type) ; epigastrium > forehead > anterior forearm > anterior thigh > anterior leg (normal type) ; epigastrium > forehead > anterior forearm > anterior thigh > anterior leg (thin type, before and after exercise); epigastrium > forehead > anterior forearm > anterior leg > anterior thigh (thin type, during exercise). Significant differences were shown in the temperature change inside clothes according to somatotypes. No significant differences were revealed in thermal sensation, moisture sensation, and comfortable sensation according to body types and time.

• 대한임상전기생리학회지
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• 제7권1호
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• pp.7-10
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• 2009

Purpose : The purpose of this study was to investigate the effect of electrical stimulation applied in dominant forearm on autonomic nervous system response of both hands. Methods : Fourteen healthy subjects (women) received low frequency-high intensity electrical stimulation to one forearm. The subjects assigned to two groups; a ipsilateral stimulation group (n=7) and a contralateral stimulation group (n=7). The electrode attachment was arranged on the forearm of the dominant arm and the electricity stimulus time was set as 15 minutes. Measuring items were the skin conduction velocity, the blood flow, and the pulse rate, which were measured total 3 times (pre, post, and post 10 min.). Results : The skin conduction velocity showed a significant difference according to the change of the time in both hands, but there was no significant difference according to time in the blood flow, and the change of the pulse frequency regardless of stimulus side. Conclusion : These results demonstrate that the low frequency-high intensity electrical stimulation applied dominant forearm can increase selectively only with the skin conduction velocity, which may be helpful for the activation of the sudomotor function of both hands by the activation of sympathetic nerve.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.225-228
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• 2009

Purpose: Urethral reconstruction following failed hypospadias repair is difficult because of a severe shortage of the skin on ventral surface of the penis. We experienced a successful reconstruction of a failed hypospadias repair using the radial forearm free flap. So we present our case. Methods: A 16 - year - old boy had a proximal shaft hypospadias and had been taken a transverse preputial island flap but it completely broke down. There was no spare skin on the shaft of the penis. So we reconstructed a neo - urethra and the ventral skin of the penis with the radial forearm free flap. Results: Postoperatively he made relatively good process. The urethral catheter was maintained for 10 days and self - voiding was started. The suprapubic catheter was removed at the postoperative 30th day after control of cystitis. The postoperative appearance of the penis is acceptable and a straight erection is achieved. Conclusion: In the scarred penis with hypospadias, the radial forearm free flap transfer is a reliable reconstructive method for the neo - urethra and the ventral skin of the penis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.227-232
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• 2007

The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.45.1-45.8
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• 2015

Background: Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of double-layered collagen graft to the donor site of the forearm free flap without skin graft. Methods: Twenty-two consecutive patients who underwent oral cancer ablation and forearm reconstruction between April 2010 and November 2013 were included in this study. Male to female ratio was 12:10, and average age was 61.0 years old (27-84). Double-layered collagen was grafted to the donor site of the forearm free flap and healed for secondary intention. Upper silicone had been trimmed at the periphery during secondary intention, and dry dressing was used. Postoperative scar healing and esthetic results and function were evaluated. Results: An average follow-up period was 34.9 months. The scar area was decreased to 63.9 % in average. The complete healing was obtained between 1.5 and 3 months according to the defect size. There was no functional defect or impairment 3 months after operation. All patients were satisfied with the esthetic results. Three patients died of recurred cancer. Conclusions: Double-layered collagen graft was successfully performed in this study. Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.365-371
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• 2009

Purpose: Good color match holds a key position in facial reconstruction for good aesthetic result. To correct the wide facial soft tissue defect were usually used the tissue expanded cheek flap, deltopectoral flap or radial forearm free flap. This study is aimed to analyse the color difference after flap surgery by using chromameter. Method: From August 1995 to December 2006, 30 patients underwent flap operations were chosen randomly and evaluated color differences between flap site and adjacent skin. Reconstructive procedures included tissue expanded cheek flap(n = 10), deltopectoral flap(n = 10), and radial forearm free flap(n = 10). The measured sites were flap center within a radius of 1 ㎝ and four points of adjacent skin along the flap margin. The color was quantified in a three dimensional coordinate system $L^*$ (brightness), $a^*$ (redness), $b^*$ (yellowness). Results: There was no significant color difference between the pedicled flaps(tissue expanded cheek flap and deltopectoral flap) and adjacent skin area. On the other hand, color values of the radial forearm free flap were statistically different from those of adjacent skin area. Total color difference(${\Delta}E$) of tissue expanded cheek flap and deltopectoral flap were $7.45{\pm}5.78$ versus $9.41{\pm}7.09$, and that of radial forearm free flap was $11.74{\pm}3.85$. They suggest that pedicled flaps have a potential of better color match than radial forearm free flap. Conclusion: Thus, better esthetic result and satisfaction is more likely to be expected in pedicled flaps as long as it could be applied comparing radial forearm free flap.