• 제목/요약/키워드: surgical exposure

검색결과 301건 처리시간 0.029초

Full-Thickness Skin Grafting with De-Epithelization of the Wound Margin for Finger Defects with Bone or Tendon Exposure

  • Lee, Jun Hee;Burm, Jin Sik;Kang, Sang Yoon;Yang, Won Yong
    • Archives of Plastic Surgery
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    • 제42권3호
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    • pp.334-340
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    • 2015
  • Background Full-thickness skin grafts (FTSGs) are generally considered unreliable for coverage of full-thickness finger defects with bone or tendon exposure, and there are few clinical reports of its use in this context. However, animal studies have shown that an FTSG can survive over an avascular area ranging up to 12 mm in diameter. In our experience, the width of the exposed bones or tendons in full-thickness finger defects is <7 mm. Therefore, we covered the bone- or tendon-exposed defects of 16 fingers of 10 patients with FTSGs. Methods The surgical objectives were healthy granulation tissue formation in the wound bed, marginal de-epithelization of the normal skin surrounding the defect, preservation of the subdermal plexus of the central graft, and partial excision of the dermis along the graft margin. The donor site was the mastoid for small defects and the groin for large defects. Results Most of the grafts (15 of 16 fingers) survived without significant surgical complications and achieved satisfactory functional and aesthetic results. Minor complications included partial graft loss in one patient, a minimal extension deformity in two patients, a depression deformity in one patient, and mild hyperpigmentation in four patients. Conclusions We observed excellent graft survival with this method with no additional surgical injury of the normal finger, satisfactory functional and aesthetic outcomes, and no need for secondary debulking procedures. Potential disadvantages include an insufficient volume of soft tissue and graft hyperpigmentation. Therefore, FTSGs may be an option for treatment of full-thickness finger defects with bone or tendon exposure.

변위된 미맹출 상악 견치의 교정 치험례 (ORTHODONTIC TREATMENT OF THE DISPLACED UNERUPTED MAXILLARY CANINE : CASE REPORT)

  • 임혜정;최남기;김선미;양규호
    • 대한소아치과학회지
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    • 제32권3호
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    • pp.543-549
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    • 2005
  • 상악 견치는 가장 긴 치근을 가지며 저작기능과 함께 하악의 측방운동을 유도하고 심미적으로도 치열궁의 구각부위에 위치하여 교합관계의 조화와 대칭을 유지하는 등의 중요한 기능을 수행한다. 상악 견치는 발육기간이 가장 길며 형성되어 맹출하기까지 복잡한 경로를 갖기 때문에 다른 치아보다 매복의 빈도가 높다. 이러한 매복치를 치료하기 위해 임상의는 관찰을 하거나 외과적 노출과 교정적 견인, 자가치아이식, 발치 등 다양한 치료방법을 고려할 수 있다. 외과적 노출과 교정치료는 견치를 교합선상에 배치할 수 있기 때문에 가장 이상적인 접근으로 생각할 수 있다. 본 증례 보고는 구개측으로 매복된 상악 견치를 외과적 노출과 교정적 치아이동을 통해 기능적, 심미적으로 양호한 결과를 얻었다.

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Comparison of Ulnar Collateral Ligament Reconstruction Techniques in the Elbow of Sports Players

  • Moon, Jun-Gyu;Lee, Hee-Dong
    • Clinics in Shoulder and Elbow
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    • 제23권1호
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    • pp.41-47
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    • 2020
  • Ulnar collateral ligament injuries have been increasingly common in overhead throwing athletes. Ulnar collateral ligament reconstruction is the current gold standard for managing ulnar collateral ligament insufficiency, and numerous reconstruction techniques have been described. Although good clinical outcomes have been reported regarding return to sports, there are still several technical issues including exposure, graft selection and fixation, and ulnar nerve management. This review article summarizes a variety of surgical techniques of ulnar collateral ligament reconstructions and compares clinical outcomes and biomechanics.

폐동맥 대동맥 중격결손증 1례 보고 (Aortopulmonary Window -Report of A Case-)

  • 박기진
    • Journal of Chest Surgery
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    • 제28권7호
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    • pp.721-725
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    • 1995
  • One case of surgical correction of a large aortopulmonary window in a 4 months old female is reported in detail. Clinical symptoms consisted of fatigue when feeding and recurrent upper respiratory tract infection. Under cardiopulmonary bypass with moderate hypothermia and cardioplegic arrest of the heart, the aortopulmonary window was approached through a vertical incision at the anterior wall of window itself. The defect was closed with pericardial patch using continuous suture posteriorly and sandwitch technique anteriorly. The patient was weaned from the cardiopulmoanry bypas without hemodynamic problem and postoperative course was uneventful. This surgical technique is recommandable as it provides good exposure of the defect and can be performed easily and safely.

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임플란트 주위염의 치료: 증례보고 (Treatment of Peri-implantitis: Cases Report)

  • 성헌모;김경규
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제35권2호
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    • pp.112-123
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    • 2013
  • This study aims to investigate the clinical outcome following treatment of peri-implantitis lesions. Five subjects with 7 implants were treated with surgical approach. Four subjects with 6 implants were initially treated with non-surgical approach or hygiene control. However, inflammation was not resolved and more bone loss was found. Therefore, surgical treatment was performed. After surgical exposure of the defect, granulation tissue was removed and implant surface was treated using tetracycline and chlorhexidine. Then, the flaps were sutured. The wound healing was performed in a non-submerged mode. The present finding demonstrates stable results without progression of bone loss. In one subject, deep V shaped bone defect was filled with bone substitute (ICB, CanCellous Bone, Rockey Mountain Tissue Bank, USA), and resorbable membrane (Lyoplant$^{(R)}$, B.Braun Aesculap AG, Germany) was placed over the grafted defect and healing abutment was connected. However, the inflammation was not resolved and more bone loss was found. At one month after regenerative surgery, the implant was removed.

Left-Side Surgical Approach to Mitral Valve in Dog Cadaver Study

  • Moon, Jeong-hyeon;Hwang, Byungmoon;Kim, Daesik;Jung, Sunjun;Ha, Yongsu;Lee, Kicahng;Kim, Namsoo;KIM, Min-su
    • 한국임상수의학회지
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    • 제35권1호
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    • pp.10-12
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    • 2018
  • Mitral regurgitation is the most frequent cause of cardiac disability and death in dogs. A wide range of medical and surgical treatments have been used for mitral regurgitation. Surgical treatments for complete correction of mitral regurgitation include valve repair and valve replacement, which have the advantages of eliminating or correcting the primary cause. Surgical treatments approach the mitral valve via right- or left-side thoracotomy. Aortic root exposure is needed for cardiopulmonary bypass. To compare right-side and left-side approaches, 10 dog cadavers were used in this study. Subsequently, the left-side surgical approach was used in vivo and in conjunction with cardiopulmonary bypass and cardioplegic arrest. Based on the results, and considering ease of access to the aortic root, valve incision site, and visualization of the surgical field, a left-side approach is recommended.

매복 상악 견치의 진단과 치료 (DIAGNOSIS AND TREATMENT OF IMPACTED MAXILLARY CANINE)

  • 이상호
    • 대한소아치과학회지
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    • 제33권3호
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    • pp.534-547
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    • 2006
  • 상악 견치의 매복은 임상에서 종종 관찰되며 여러 임상적인 문제점을 유발한다. 상악 매복 견치의 유병율은 1-3%로 협측 매복은 주로 국소적인 원인에 의해 그리고 구개측 매복은 국소적인 원인이냐 유전적인 원인이냐에 대한 견해차를 보이고 있다. 견치가 매복된 경우 인접치의 치근을 흡수시키거나 낭종을 형성하는 등 여러 가지 문제점을 유발한다. 따라서 임상의들은 상악 견치의 매복의 가능성을 조기에 진단하고 일련의 맹출 과정을 감시함과 동시에 적절한 시기에 맹출 공간의 확보나 유견치의 발거 등 국소적인 맹출 방해 요인을 제거하여 매복을 예방하거나 차단해 주어야 한다. 혼합치열기 말기나 영구치열기 초에 견치의 매복이 확실해진 경우 외과적 노출과 교정력을 이용해 견인해 주는 후속적인 처치가 필요하다. 외과적 노출 술식은 후에 견치 주위의 치주조직의 건강에 중요한 영향을 미치는 인자이므로 부착치은의 상실을 최소로 하는 외과적 노출방법에 대한 인식이 매우 중요하다. 즉 외과적으로 판막을 형성하여 매복된 치아를 견인하고자 할 경우 견인 후 부착치은을 최대한 확보해 주는 방향으로 해 주어야 한다. 매복 견치가 치조골 중간이나 전정 깊은 곳에 매복되어 있는 경우 폐쇄 맹출법은 다른 방법에 비해 부착치은이나 골 지지도 면에서 더 우수하지만 부착물이 탈락된 경우 2차 수술의 필요하며 부적절한 견인시 치주적인 문제점이 유발될 수 있다.

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Pre-contoured reconstruction plate fabricated via three-dimensional printed bending support

  • Song, In-Seok;Ryu, Jae-Jun;Choi, Young-Jun;Lee, Ui-Lyong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권3호
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    • pp.233-236
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    • 2021
  • A mandibular continuity defect can be repaired using either a prosthetic device or autogenous bone. A titanium reconstruction plate can be used with a localized or vascularized flap over the defect of the mandible. Unfortunately, the plate may fail due to plate exposure, screw loosening, fracture, or infection, and will need to be removed. Plate exposure though the skin or mucosa is one of the main reasons for failure. In the present work, the authors introduced a lingually positioned reconstruction plate fabricated via three-dimensional printed bending support. This custom reconstruction plate can avoid plate re-exposure as well as reduce surgical errors and operation time.

모턴씨 신경종의 수술적 치료를 위한 중족골 교정 절골술 (Corrective Osteotomy of Metatarsal Bone for Surgical Treatment of Morton's Neuroma)

  • 주인탁;장호성;박현우
    • 대한족부족관절학회지
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    • 제19권2호
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    • pp.58-62
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    • 2015
  • Purpose: The purpose of this report is to investigate the clinical and radiological results of corrective osteotomy of the 3rd metatarsal bone for shortening and dorsal displacement without exposure around neuroma. Materials and Methods: Twelve cases of patients who underwent corrective osteotomy of metatarsal bone for a Morton's neuroma from November 2013 to September 2014 were retrospectively reviewed. Corrective osteotomy was performed through a dorsal approach at the 3rd metatarsal bone base and distal metatarsal bone was displaced dorsally and proximally. Preoperative and postoperative pain assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographs were evaluated. Results: The mean age of patients was 41.4 years, and the mean follow-up period was 10.7 months. AOFAS score improved from 52 preoperatively to 90 postoperatively. The 3rd metatarsal bone was shortened by an average of 3.39 mm and elevated by 2.38 mm. Conclusion: Corrective osteotomy of metatarsal bone can be regarded as a new surgical option for Morton's neuroma without exposure around neuroma.

Left Common Femoral to Right Common Iliac Venous Bypass Through a Retroperitoneal Exposure

  • Cuen-Ojeda, Cesar;Bobadilla-Rosado, Luis O;Garcia-Alva, Ramon;Arzola, Luis H.;Anaya-Ayala, Javier E.;Hinojosa, Carlos A.
    • Vascular Specialist International
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    • 제34권4호
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    • pp.117-120
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    • 2018
  • The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.