Microvascular surgery in Korea started in 1970's. Doctor Poong Lim was one of several dedicated surgeons who made great efforts to develop this field in Korea. By performing inguinal free flap in 1978, he became the first man who applied microvascular surgical technique to the clinical field in Korea. In addition, he played an important role in the settlement of microvascular surgery in Korea, performing variety of free flaps such as omental free flap, dorsalis pedis free flap, and deltopectoral free flap in 1979. He also introduced microvascular surgery to the traumatic field by successfully performing multiple finger replantation and forearm replantation in 1979. Both his clinical and experimental works made it possible for microvascular surgery to become an important part of plastic surgery in Korea.
Fingers ; Forearm ; Free Tissue Flaps ; Korea* ; Memory* ; Replantation ; Surgery, Plastic

Free Tissue Flaps ; Head/surgery* ; Head and Neck Neoplasms/surgery* ; Humans ; Neck/surgery* ; Reconstructive Surgical Procedures ; Surgical Flaps ; Technology

OBJECTIVETo observe the clinical effects of free musculo-cutaneous flap bridging with contralateral posterior tibial vessel on repair of lower extremity soft tissue defect.

METHODSFrom February 2006 to June 2013, 10 patients with soft tissue defect on lower shank and foot were included. The posterior tibial vessel on healthy lower extremity was chosen as recipient vessel and anastomosed with free latissimus dorsi musculo-cutaneous flap, or free latissimus dorsi musculo-cutaneous flap combined with thoracic-umbilical skin flap or anterolateral femoral musculo-cutaneous flap. The retrograde bridged flap was transposed to repair defect on contralateral lower shank and foot. The wound area ranged from 40 cm x 21 cm to 22 cm x 15 cm, with flap size from 48 cm x 26 cm to 25 cm x 18 cm. Meanwhile the defects on donor sites were covered with skin graft and both lower extremities were fixed with kirschner wires at middle tibia and calcaneus. The kirschner wires were removed at 4 weeks and pedicles were cut off 5-8 weeks postoperatively. Six patients received posterior tibial vessel reanastomosis at the same time of pedicle cutting.

RESULTSAll the 10 flaps survived and 3 patients received thinning of flaps due to excessive thickness. During the follow-up period of 3 months to 2 years follow up, the ambulatory function of injured legs recovered gradually with satisfactory appearance. The reanastomosed posterior tibial vessel on the healthy side was recovered.

CONCLUSIONSAppropriate bridged musculo-cutaneous flaps is suitable for extensive soft tissue defect of lower shank and foot. It is a safe and effective method for limb salvage.

free flap (RFFF) is a thin, pliable soft tissue flap with large-caliber vessels for microvascular anastomosis. Its additional advantages include consistent flap vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with a tumor resection. For a better understanding of RFFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of RFFF in the Korean language.]]>
Curriculum ; Forearm ; Free Tissue Flaps ; Humans ; Mouth ; Radial Artery ; Surgery, Oral ; Tissue Donors

free flap (LDMFF) was also first described for the coverage of a chronically infected scalp by Maxwell et al. As a pedicled flap, LDMF has been often used for breast reconstruction and for soft tissue replacement near the shoulder and the lower reaches of the head and neck. LDMFF is a flat and broad soft tissue flap with large-caliber thoracodorsal vessels for microvascular anastomosis. A skin paddle of the LDMFF can be more than 20x40 cm, so very large defects in the oral cavity and outer facial region can be covered by this LDMFF. Other advantages include consistent vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with tumor resection. For a better understanding of LDMFF as a routine reconstructive procedure in large defects of the oral cavity and facial legion, anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of LDMFF with Korean language.]]>
Curriculum ; Female ; Free Tissue Flaps ; Head ; Humans ; Mammaplasty ; Mouth ; Neck ; Scalp ; Shoulder ; Skin ; Surgery, Oral ; Surgical Flaps ; Tissue Donors

OBJECTIVE: To investigate the usefulness of anterolateral thigh flap for reconstruction of the defect after maxillectomy. METHOD: Seventy-two cases with defect after maxillectomy were constructed with anterolateral thigh flap in our department during 10 years. All cases were undertaken total maxillectomy. RESULT: All flaps except one were transferred successfully. Patients were satisfied with their appearances. No serious complications had happened. CONCLUSION Anterolateral thigh flap could be an donor flap for the reconstruction of the defect after maxillectomy.
Face ; surgery ; Free Tissue Flaps ; Humans ; Maxilla ; surgery ; Reconstructive Surgical Procedures ; Thigh

To determine appropriate surgical methods and flaps to apply plastic surgery of facial defects. Several plastic methods were introduced progressively to eight cases. From simple to complex, we discussed the direct suture, relaxation suture, Z-flap, flap-footed, combined or multiple flaps, and free flap method to decrease the tension in wounds. The skin and flaps were successful in all eight cases and healed the wounds. It is important to choose appropriate surgical techniques and flaps to repair facial injuries.
Face ; surgery ; Facial Injuries ; surgery ; Free Tissue Flaps ; Humans ; Reconstructive Surgical Procedures ; Skin ; Wound Healing

This paper describes a new technique in the repair of the hand defect with digital extensor tendon injury. The anterolateral thigh flap with the thick femoral fascia has been used in the reconstruction of the composite defect of the dorsal hand, especially the defect of tendon. This technique requires short period of treatment and hence causes less damage to the donor site but shows a better recovery of the hand function. A favorable curative effect has been obtained in this patient.
Adult ; Contusions ; surgery ; Fingers ; surgery ; Free Tissue Flaps ; Hand Injuries ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Tendons ; surgery ; Thigh

Extensive surgical resection of the aerodigestive track can result in a large and complex defect of the oropharynx, which represents a significant reconstructive challenge for the plastic surgery. Development of microsurgical techniques has allowed for free flap reconstruction of oropharyngeal defects, with superior outcomes as well as decreases in postoperative complications. The reconstructive goals for oral and oropharyngeal defects are to restore the anatomy, to maintain continuity of the intraoral surface and oropharynx, to protect vital structures such as carotid arteries, to cover exposed portions of internal organs in preparation for adjuvant radiation, and to preserve complex functions of the oral cavity and oropharynx. Oral and oropharyngeal cancers should be treated with consideration of functional recovery. Multidisciplinary treatment strategies are necessary for maximizing disease control and preserving the natural form and function of the oropharynx.
Carotid Arteries ; Free Tissue Flaps* ; Head and Neck Neoplasms ; Mouth ; Oropharyngeal Neoplasms ; Oropharynx ; Postoperative Complications ; Surgery, Plastic

Computer-aided surgery (CAS) started being used for head and neck reconstruction in the late 2000s. Its use represented a paradigm shift, changing the concept of head and neck reconstruction as well as mandible reconstruction. Reconstruction using CAS proceeds through 4 phases: planning, modeling, surgery, and evaluation. Thus, it can overcome a number of trial-and-error issues which may occur in the operative field and reduce surgical time. However, if it is used for oncologic surgery, it is difficult to evaluate tumor margins during tumor surgery, thereby restricting pre-surgical planning. Therefore, it is dangerous to predetermine the resection margins during the pre-surgical phase and the variability of the resection margins must be taken into consideration. However, it allows for the preparation of a prebending plate and planning of an osteotomy site before an operation, which are of great help. If the current problems are resolved, its applications can be greatly extended.
Free Tissue Flaps ; Head ; Mandible ; Mandibular Reconstruction* ; Neck ; Operative Time ; Osteotomy ; Surgery, Computer-Assisted*