• Archives of Plastic Surgery
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• v.51 no.1
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• pp.126-129
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• 2024

The square flap method has been successful in releasing contracture bands at various body regions. However, the original square flap method alone may not be efficient in releasing long contracture bands. We, therefore, proposed an extended design to the traditional design, which is called the "square-plus flap." A 4-year-old girl presented with a postburn web-like contracture band over the right axilla. We marked a square flap technique at the center of the contracture band and then two additional Z-plasties were placed on both edges of the flap. After the release and securing of the square flap, the adjacent distal Z-plasty was then transposed and sutured in their new locations. We do not need to incise the proximal Z-plasty as we could achieve complete relaxation of the contracture band. This novel modification can be added to the plastic surgeon's armamentarium for releasing long postburn contracture bands involving distinct body regions.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.655-658
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• 2006

Purpose: The main goals of correcting syndactyly of the hand are to form normal web appearance and to prevent motor dysfunction. We modified the original three-square-flap to improve interdigital web space and to reduce the wound healing problem due to tension. Methods: From July 2005 to February 2006, three cases of moderate to minor syndactyly were treated using modified three-square-flap. These flaps were made in such as way that the A flap from dorsal side, the B flap from the interdigital surface, and the C flap from the volar side. We modified the design of dorsal A flap as a hourglass shape instead of square shape to make normal hourglass shaped interdigital web and to reduce the tension of closure with other two flaps(B and C flap). The B and C flap were made as square shape. Results: During 4 to 10 months follow-up period, acceptable esthetic results were obtained without any specific complication, using our modification of the three-square-flap. Conclusion: Our method showed more satisfactory web appearance and was safe to use even in the cases of syndactyly secondary to burns and post-traumatic scars because of excellent blood circulation.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.333-339
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• 2018

Background Flap volume is an important factor for obtaining satisfactory symmetry in breast reconstruction with a transverse rectus abdominis myocutaneous (TRAM) free flap. We aimed to develop an easy and simple method to estimate flap volume. Methods We performed a preoperative estimation of the TRAM flap volume in five patients with breast cancer who underwent 2-stage breast reconstruction following an immediate tissue expander operation after a simple mastectomy. We measured the height and width of each flap zone using a ruler and measured the tissue thickness by ultrasound. The volume of each zone, approximated as a triangular or square prism, was then calculated. The zone volumes were summed to obtain the total calculated volume of the TRAM flap. We then determined the width of zone II, so that the calculated flap volume was equal to the required flap volume ($1.2{\times}1.05{\times}$the weight of the resected mastectomy tissue). The TRAM flap was transferred vertically so that zone III was located on the upper side, and zone II was trimmed in the sitting position after vascular anastomosis. We compared the estimated flap width of zone II (=X) with the actual flap width of zone II. Results X was similar to the actual measured width. Accurate volume replacement with the TRAM flap resulted in good symmetry in all cases. Conclusions The volume of a free TRAM flap can be straightforwardly estimated preoperatively using the method presented here, with ultrasound, ruler, and simple calculations, and this technique may help reduced the time required for precise flap tailoring.

• Journal of the Korean Home Economics Association
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• v.44 no.1 s.215
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• pp.151-157
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• 2006

Ten types of male headgear-Kwonwoonkwan, crown-like headgear, hats with a square flap, hats with feathers, crowns with plumes, Ballip, hats with flat crowns, Somo, turban, and fur hats-were described in Jip-Sah, which was published in the 14th century. Mongolian people used summer headgear, winter hats, and crown ornaments, which had been used until the Ch'ing dynasty of China. From the late 12th century to 1304, the headgear styles remained the same, suggesting that the Mongolian people kept their tradition. Kwonwoonkwan, crown-like headgear, and Somo, presented in Jip-Sah, were also described in U. Yadamsuren's album, a pictorial depiction of the 20th century Mongolian headgear.

• Archives of Reconstructive Microsurgery
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• v.16 no.2
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• pp.57-62
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• 2007

Non-vascularized free composite graft is one of the simple and effective reconstructive options, but its clinical use has been limited due to questionable survival rate. Early vascularization is essential for graft survival and is mainly carried out via recipient bed or repaired sites. This study was designed to investigate the effect of the lateral marginal approximations on the survival of the free composite flap using a model of skin-subcutaneous composite graft in rats. Thirty 1.5 ${\times}$ 1.5 $cm^2$ sized square shape composite flaps were elevated freely and reposed in place immediately on the dorsum of five Sprague-Dawley rats, and divided into five groups of six flaps. In all groups, graft bed was isolated with silastic sheet. In the group I, all sides of flap were repaired with blockage of silastic sheet insertion. Three, two, and one sides of flap were treated with same method in the group II, III, and IV respectively. Other sides of flaps were repaired without blockage, so all sides of flap were repaired in the group V. At 14 days later, the survived rate of each flap was evaluated according to the numbers of the repair sites. Histological examination was done for the evaluation of new vessel development quantitatively. Overall survived rates were increased with the number of repaired sites, but the group V only showed increased survival rate up to more than fifty percentile of the flap size with a significant difference statistically. New vessels were also increased in proportion with the number of repaired sites, and the repair site more than two had significant effect on the increased number of new vessels. In conclusion, at least more than three-fourth of flap circumference should be repaired in order to increase flap survival effectively under the condition of bed isolation.

• The Transactions of the Korean Institute of Electrical Engineers C
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• v.49 no.6
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• pp.360-366
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• 2000

This paper presents the fabrication and test of a micropump consisting of a pair of Al flap valves and a phase-change type actuator. The actuator is composed of a heater, a silicone rubber diaphragm and a working fluid chamber. The diaphragm is actuated by the vaporization and the condensation of the working fluid. The micropump is fabricated by the anisotropic etching, the boron diffusion and the metal evaporation. The forward and the backward flow characteristics of the flap valves illustrate the appropriateness as a check valve. Also, the flow rate of the micropump is measured. When the square wave input voltage of 8 V, 70% duty ratio and 2 Hz is applied to the heater, the maximum flow rate of the micropump is $97\muell/min$ for zero pressure difference.

• Phonetics and Speech Sciences
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• v.1 no.3
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• pp.133-144
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• 2009

Pharyngeal flap surgery changes the space and shape of the oral cavity and vocal tract, and these changing conditions bring resonance change. The purpose of this study was to determine the most reliable and valuable parameters for evaluating hypernasality to distinguish two patients before and after pharyngeal flap surgery. Each patient was asked to clearly speak the vowels /a/, /i/, /u/, /e/, /o/ for voice recording. There were nine parameters: Formant (F1, F2, F3), Bandwidth (BW1, BW2, BW3), LPC energy slope ($\Delta$ |A2-A1/F2-F1|), and Band Energy (0-500 Hz, 500-1000 Hz) by each vowel. From the results of discrimination analyses on acoustic parameters, the vowels /a/, /e/ appeared to be insignificant but vowels /i/, /u/, /o/ appeared to be efficient in the separation. A 95%, 100%, and 100% recognition score could be reached when vowels /i/, /u/, and /o/ were analyzed. The results showed that F2, BW3, and LPC slope are more important parameters than the others. Finally, there is a relation between perceptual evaluation score and LPC energy slope of acoustic parameters by least square slope.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.418-424
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• 2018

Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005-2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day follow-up. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.

• The Transactions of the Korean Institute of Electrical Engineers C
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• v.49 no.5
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• pp.315-320
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• 2000

This paper presents the fabrication and test of a micropump with an electromagnetic actuator and a pair of aluminum flap valves. The actuator consists of a solenoid coil, a permanent magnet and an actuator diaphragm. The actuator diaphragm is fabricated by the spin coating of silicone rubber. The valve are passive ones and are fabricated by micromachining. The deflection of the fabricated actuator diaphragm is measured with a laser vibrometer. The deflection of the actuator diaphragm is proportional to the input current. The measured deflection of the fabricated diaphragm is $400 \mum$,/TEX> when the input is 118 mApp, and the cut-off frequency is 50 Hz. The maximum flow rate of the fabricated micropump with the electromagnetic actuator is about 5$0 \muell/min$ at 5 Hz when the input current and the duty ratio of the square was are 118 mApp and 50%, respectively.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.51-54
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• 2001

Objective : Authors analyzed clinical outcomes of cranioplasty according to the materials used for covering defects of the skulls. Methods : From January 1997 to February 2000, there were forty one patients undergone cranioplasty at our institution. We used refrigerated autogenous bone flaps in 19 cases(group A) and methyl methacrylate(MMA) in 22 cases(group B). The medical records and plain skull radiographs of the patient were reviewed. Results : There were thirty men and eleven women. Mean follow up period was 12 months(From operation to last Outpatient department follow up). The mean operative time of the group A($136.8{\pm}3$ minutes) was shorter than the group B($172.7{\pm}2$ minutes, Mann-Whitney test, p=0.001). In group A, the degree of satisfaction was good in 8 cases, fair in 10, and poor in 1. In the group B, there were fair in 13 and poor in 9. So the cosmetic result was superior in the group A(Chi-square test, p=0.00). The complications were occured in one case of flap infection in the group A and 6 in the group B(one stitch abscess, 4 infected flaps, one subgaleal hematoma). Conclusion : Cranioplasty using refrigerated autogenous bone flap showed shorter operative time, better cosmetic results, and less complication rate than those using MMA.