• Archives of Plastic Surgery
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• v.40 no.3
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• pp.259-262
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• 2013

After skin grafting, to prevent hematoma or seroma collection at the graft site, a tie-over dressing has been commonly used. However, although the conventional tie-over dressing by suture is a useful method for securing a graft site, refixation is difficult when repeated tie-over dressing is needed. Therefore, we recommend a redoable tie-over dressing technique with multiple loops threads and connecting silk threads. After the raw surface of each of our cases was covered with a skin graft, multiple loop silk thread attached with nylon at the skin graft margin. We applied the ointment gauze and wet cotton/fluffy gauze over the skin graft, then fixed the dressing by connecting cross-counter multiple loop thread with connecting silk threads. When we opened the tie-over dressing by cutting the connecting silk threads, we repeated the tie-over dressing with the same method. The skin graft was taken successfully without hematoma or seroma collection or any other complications. In conclusion, we report a novel tie-over dressing enabling simple fixation of the dressing to maintain proper tension for wounds that require repetitive fixation. Further, with this reliable method, the skin grafts were well taken.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2009.10a
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• pp.221-221
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• 2009

• Journal of the Society of Cosmetic Scientists of Korea
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• v.25 no.2
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• pp.35-44
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• 1999

Dendritic cells(DC) are a system of highly efficient antigen-presenting cells that initiate the primary immune response. There are two kinds of dendritic cells in the skin, Langerhans cell in the epidermis and dermal dendritic cell in the dermis. The knowledge of DC, which are very important in the immune reponse of cancer, autoimmune disease, transplantation and infection, has been known through the study about Langerhans cells. In this paper, the role of Langerhans cell in the contact hypersensitivity and atopic dermatitis is discussed and culture methods of mouse Langerhans cells and human U from pheripheral blood monocytes are described.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.403-408
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• 2013

Background For patients with neuropathy, vasculopathy, and impairment of wound healing, treatment of a diabetic foot ulcer poses many challenges. A large number of dermal analogues have been invented in an effort to overcome these challenges. Matriderm, a dermal analogue, is made from bovine collagen and elastin. This study was conducted in order to evaluate the effectiveness of Matriderm for treatment of diabetic foot ulcers, in comparison with skin grafting. Methods Sixty patients with diabetic foot ulcer were included in this prospective study. The average age of the patients, who had type II diabetes mellitus, was 58 years old. The patients were allocated to an experimental or control group with their consents. The patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a Matriderm appliance and a split-thickness skin graft, while those in the control group received only a split-thickness skin graft. Results A shorter hospitalization period (7.52 weeks) was observed in the experimental group than in the control group (9.22 weeks), and a shorter period of time (8.61 weeks) was required for complete healing, compared with the control group (12.94 weeks), with statistical significance (P<0.05). A higher elasticity ratio of the affected side to the non-affected side was observed in the experimental group, compared with the control group (P<0.01). Conclusions Matriderm enables effective healing and improves elasticity in treatment of patients with diabetic foot ulcer.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.607-612
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• 2005

A traditional tie-over dressing may be applied to support the take of a skin graft. Although there are many advantage of this method, it has significant disadvantages, including time-consuming application. Furthermore, when the dressing is changed, the gauze becomes hard and can be stuck to the graft, causing damage and pain upon removal. The purpose of our study is to evaluate the effect of semi-occlusive dressing using polyurethane foam and film dressing($Allevyn^{(R)}$, $Opsite^{(R)}$) after full thickness skin graft. The authors treated 45 cases including burn scar contracture(n=38), syndactyly (n=1), absence of nipple-areolar complex(n=4), traumatic skin defect(n=1) and contact burn(n=1) with authors' method and 39 patients including burn scar contracture (n=39) with the tie-over dressing between 2000 and 2004. The patients in polyurethane foam and film dressing group ranged from 1 to 62 years of age (mean age, 15.1 years) and the patients in tie-over dressing group ranged from 2 to 60 years of age(mean age, 21.3 years). The postoperative results were analyzed according to the following measures: (1) the duration of graft-taking, (2) the admission period, (3) complications. Compared with the traditional tie-over dressing, polyurethane foam and film dressing was shown to be more successful in a reduced duration of graft-taking, in which was similar to the former in the rate of graft-taking, a reduced admission period and patient's discomfort. We concluded that semi-occlusive dressing using $Allevyn^{(R)}$ and $Opsite^{(R)}$ was an effective method after full thickness skin graft, which was easy to shape to difficult body locations, such as web spaces, fingers and maintains a moist environment for wound healing and does not stick to the wound.

• 한국생물공학회:학술대회논문집
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• 2003.10a
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• pp.356-358
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• 2003

The use of cultured epidermal sheet grafts for large full-thickness wound has been tempered by weak points such as long culture periods, difficulty in handling the fragile sheets, high costs and the detachment of the skin cells from the culture dishes by enzymatic digestion. To overcome the drawback of epidermal sheet grafts, we have developed a transplantation method to spray the cultured human keratinocytes with the mixtures of rhEGF and fibrin gel matrix to the full-thickness wounds on the dorsum of the athymic mice to regenerate epithelial layers. Wound biopsies were retrieved at 7, 14 and 21 days after transplantation and retrieved biopsies were analyzed by histology and immunohistochemistry. Transplanted keratinocytes and EGF-fibriin gel accelerated wound regeneration compared with control groups. The technique developed in this study overcomes the drawbacks of the current cultured epidermal sheet grafts and accelerates epidermal wound healing.

• Archives of Craniofacial Surgery
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• v.12 no.2
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• pp.86-92
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• 2011

Purpose: The purpose of this study was to investigate the possibility that a dynamic facial composite flap with sensory and motor nerves could be made available from donor facial composite tissue. Methods: The faces of 3 human cadavers were dissected. The authors studied the donor faces to assess which facial composite model would be most practicable. A "panorama facial flap" was excised from each facial skeleton with circumferential incision of the oral mucosa, lower conjunctiva and endonasal mucosa. In addition, the authors measured the available length of the arterial and venous pedicles, and the sensory nerves. In the recipient, the authors evaluated the time required to anastomose the vessels and nerve coaptations, anchor stitches for donor flaps, and skin stitches for closure. Results: In the panorama facial flap, the available anastomosing vessels were the facial artery and vein. The sensory nerves that required anastomoses were the infraorbital nerve and inferior alveolar nerve. The motor nerve requiring anstomoses was the facial nerve. The vascular pedicle of the panorama facial flap is the facial artery and vein. The longest length was 78 mm and 48 mm respectively. Sensation of the donor facial composite is supplied by the infraorbital nerve and inferior alveolar nerve. Motion of the facial composite is supplied by the facial nerve. Some branches of the facial nerve can be anastomosed, if necessary. Conclusion: The most practical facial composite flap would be a mid and lower face flap, and we proposed a panorama facial flap that is designed to incorporate the mid and lower facial skin with and the unique tissue of the lip. The panorama facial composite flap could be considered as one of the practicable basic models for facial allotransplantation.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.77-83
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• 1999

The skin on the dorsum of the foot is a source of the reliable thin and sensory cutaneous free tissue transplantation with or without tendon, bone and joint. A composite flap with attached vascularized tendon grafts for the combined loss of skin and tendon on the dorsum of the hand and foot offers an immediate one stage solution to this problem. The flap provides a very durable innervated tissue cover for the heel of the foot and the dorsum of the hand and an osteocutaneous transfer combined with the second metatarsal. The major dorsalis pedis artery is constant in size, but the first dorsal metatarsal artery is variable in size and location. The dorsal surface of the foot receives sensory innervation through the superficial peroneal nerve and the first web through the deep peroneal nerve. Authors had performed 5 dorsalis pedis free flap transplantation in the foot and hand at Department of Orthopedic Surgery, Chonbuk National University Hospital from August 1993 through August 1997 and followed up for the period of between 19 and 67 months until March 1999. The results were as follows 1. 5 cases dorsalis pedis free flap transfer to the foot(4 cases) and the hand(1 case) were performed and the recipient was foot dorsum and heel 2 cases each and hand dorsum 1 case. 2 All of 5 cases(100%) were survived from free flap transfer and recipient artery was dorsalis pedis artery(2 cases), anterior tibial artery(1 case), posterior tibial artery(1 case) and ulnar artery(1 case) and recipient veins were 2 in number except in the hand. 3. Long term follow up of the exterior and maceration was good and sensory recovery was poor 4. Donor site was covered with full thickness skin graft obtained from one or both inguinal areas at postoperative 3rd week and skin graft was taken good and no morbidity was showed.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.661-667
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• 2014

Background Tissue expansion is an effective and valuable technique for the reconstruction of large skin lesions and scars. This study aimed to evaluate the applicability and safety of a newly designed skin expanding bioreactor system for maximizing the graft area and minimizing the donor site area. Methods A computer-controlled biaxial skin bioreactor system was used to expand skin in two directions while the culture media was changed daily. The aim was to achieve an expansion speed that enabled the skin to reach twice its original area in two weeks or less. Skin expansion and subsequent grafting were performed for 10 patients, and each patient was followed for 6 months postoperatively for clinical evaluation. Scar evaluation was performed through visual assessment and by using photos. Results The average skin expansion rate was $10.54%{\pm}6.25%$; take rate, $88.89%{\pm}11.39%$; and contraction rate, $4.2%{\pm}2.28%$ after 6 months. Evaluation of the donor and recipient sites by medical specialists resulted in an average score of 3.5 (out of a potential maximum of 5) at 3 months, and 3.9 at 6 months. The average score for patient satisfaction of the donor site was 6.2 (out of a potential maximum of 10), and an average score of 5.2 was noted for the recipient site. Histological examination performed before and after the skin expansion revealed an increase in porosity of the dermal layer. Conclusions This study confirmed the safety and applicability of the in vitro skin bioreactor, and further studies are needed to develop methods for increasing the skin expansion rate.

• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.80-87
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• 2000

Acute high speed accidents that results in full thickness skin defect and exposure of tendon, nerve, vessel and periosteum over denuded bone demands soft tissue coverage. Exposed bone often ensues chronic infection and requires free flap transplantation which surely covers defects in one stage operation and enhances transport of oxygen-rich blood and converts a non-osteogenic or partially osteogenic site into a highly osteogenic site, but exposed bone which had performed free flap transplantation sometimes necroses and needs secondary bone procedure. Scar contracture limits joint motion should be excised and covered with normal soft tissue to restore normal range of motion. Authors have performed the large latissimus dorsi myocutaneous free flap in 8 cases of extensive soft tissue defect and exposed bone lesion in the leg and 1 case of the flap was failed. The secondary ilizarov bone procedure was performed in 3 of 8 cases. 2 cases of large burn scar contracture and 1 case of posttraumatic scar contracture in lower extremity were restored with the large latissimus dorsi myocutaneous free flap. Authors concluded that large latissimus dorsi myocutaneous free flap is the most acceptable microvascular procedure in large soft tissue defect combined with exposed periosteum and bone requiring secondary bone procedure and in large burn scar contracture limiting knee joint motion.