PURPOSE: The digital artery perforator flap was recently introduced and has been proven to be useful for reconstruction of various finger defects. Short operative time, less invasive surgery, and reliable flap circulation are the major advantages of this flap. The authors presented the clinical cases of the digital artery perforator flap and compared them with the distant flaps within a hand (thenar and hypothenar flaps) to reveal their differences. METHODS: From May of 2006 to February of 2009, the authors performed reconstructions of finger defects with the digital artery perforator flaps in 10 patients as with the distant flaps within hand in 9 patients (7 thenar and 2 hypothenar flaps). In these two groups of the patients, flap size, use of skin graft, length of stay in hospital, healing time, complications were reviewed retrospectively and compared with statistical analysis (Student's t-test). RESULTS: All flaps survived completely. The mean size of the perforator flap was 0.9 x 1.9 cm and the mean distant flap within a hand was 1.9 x 2.0 cm. The use of skin graft was reduced in the perforator group because the donor site of the flap was closed primarily. The hospitalization period and healing time also reduced significantly in the perforator group. Minor complications (partial flap loss) were noted in small percentages in both groups but resolved with conservative management. Mean follow-up period was about 6 weeks. CONCLUSION: The digital artery perforator flap was smaller than the distant flap but its reconstruction of finger defects was reliable and comparable to the conventional distant flaps within a hand. This flap would be not only an alternative method but very useful in the management of various finger defects, because of ease of operative technique, less invasive surgery, decreased need of skin graft, and shorter period of hospitalization and healing time.
Arteries ; Fingers ; Follow-Up Studies ; Hand ; Hospitalization ; Humans ; Length of Stay ; Operative Time ; Perforator Flap ; Retrospective Studies ; Skin ; Tissue Donors ; Transplants

PURPOSE: Numerous experimental studies have shown the benefits of treating thermal burns by cooling. Nevertheless, few studies have shown the clinical effect of cooling therapy on thermal burns. This study aimed to identify the clinical effect of immediate cooling therapy. METHODS: The research was conducted as a retrospective, case-control study. All patients had thermal injuries characterized as a superficial second-degree burn. In the cooling group, 14 patients had first-aid cooling therapy delivered by either parents, caregivers, general practitioners, local hospitals, and/or Myongji hospital. Included in the study were 22 control patients who were not treated with any cooling therapies. Other clinical factors, such as age, sex, cause of burn injury, and burn area (Total Body Surface Area %), were taken into consideration. The duration of treatment was defined as the time from the occurrence of the injury to the presence of complete re-epithelialization, as confirmed by two surgeons. RESULTS: The duration of treatment in the cooling group was significantly less than that the control group (p < 0.05). CONCLUSION: Cooling therapy as an initial emergent treatment is clinically effective for superficial seconddegree burn injuries.
Body Surface Area ; Burns ; Caregivers ; Case-Control Studies ; General Practitioners ; Humans ; Parents ; Re-Epithelialization ; Retrospective Studies

PURPOSE: The lateral orbital wall fractures have been previously classified by some authors. As there are some limitations in applying in their own classifications, we hope to present a refined classification system of the lateral orbital wall fracture and to identify the correlation between the specific type of the fracture and clinical diagnosis. METHODS: The facial bone CT scans and medical records of 78 patients with the lateral orbital wall fractures were reviewed in a retrospective manner. The classification is based on the CT scan. In type I, the fracture and its segments are away from the lateral rectus muscle and in type II, they are next to or slightly pushing the muscle in axial CT scan. In type III, the fracture segments compress and displace the longitudinal axis of the muscle or the optic nerve in axial view of CT scan. Type IV fracture includes multiple fractures found around the orbital apex or optic canal in coronal view of CT scans of the type I and type II fractures. RESULTS: The most common fracture pattern was type I(43.6%), followed by type IV(29.5%), type II(20.5%), and type III(6.4%). As diplopia and restriction of extraocular muscles were found in type I and II fractures, severe ophthalmic complications such as superior orbital fissure syndrome, orbital apex syndrome, and traumatic optic neuropathy were found in type III and IV fractures almost exclusively. CONCLUSION: We propose an easy classification system of the lateral orbital wall fracture which correlates closely with ophthalmic complications and may help to make further treatment plan. In Type III and IV fractures, severe ophthalmic complications may ensue in higher rates, so early diagnosis and treatment should be performed.
Axis, Cervical Vertebra ; Diplopia ; Early Diagnosis ; Facial Bones ; Humans ; Medical Records ; Muscles ; Optic Nerve ; Optic Nerve Injuries ; Orbit ; Retrospective Studies

PURPOSE: Tuberous sclerosis is an autosomal dominant multisystemic neurocutaneous syndrome characterized by the development of multiple hamartoma distributed through the body, skin, brain, heart, kidney, and lung. The classic triad is seizure, mental retardation, and facial angiofibroma. We experienced a case of a tuberous sclerosis associated with the facial lesion and multiple masses on scalp, forehead, and right lower extremity. METHODS: This a 34-year-old male patient had subependymal giant cell astrocytoma in brain and multiple angiomyolipoma in both kidneys. Tangential excision with razor blade and dermabrasion were done on the centrofacial area. We excised other lesions and the mass on scalp was excised and covered with split thickness skin graft. RESULTS: The histopathological finding revealed that the facial lesion was angiofibroma and the others were multiple fibroma. CONCLUSION: In our case of tuberous sclerosis, we chose the tangential excision to remove the large nodules of angiofibroma, and then dermabrasion was used to smooth the final contour. The patient appeared to have a good results from this treatment modality. But, tuberous sclerosis is an disease that needs long term follow-up to check up the recurrence of skin problem.
Adult ; Angiofibroma ; Angiomyolipoma ; Astrocytoma ; Brain ; Dermabrasion ; Extremities ; Fibroma ; Forehead ; Hamartoma ; Heart ; Humans ; Intellectual Disability ; Kidney ; Lung ; Male ; Neurocutaneous Syndromes ; Recurrence ; Scalp ; Seizures ; Skin ; Tuberous Sclerosis

Correction of bulbous nasal tip in rhinoplasty is a difficult subject, particularly in Asian. Since first published an article on the correction of bulbous nasal tip in 1999, we have accumulated more experiences and improved our result in refining nasal tip. We had 17 patients for the correction of bulbous nasal tip. Age ranged from 20 to 39 years old (Mean age, 26.7 years old) and 6 males and 11 females. We were able to follow up from 1 month to 6 years. We classified our patients into three groups according to the shapes of nasal tip and surgical procedures implicated. Group 1: Simple bulbous nasal tip requiring excision of subdermal soft tissue and rearrangement. Group 2: Bulbous nasal tip with flat dorsum of nose, requiring augmentation of dorsum of nose with silicone implant and augmentation of nasal tip with onlay graft with conchal cartilage. Group 3: Bulbous nasal tip with short columella, requiring nasal tip plasty and lengthening of columella with composite graft using helix of ear. Open rhinoplasty technique was applied in all patients with excising subdermal fibrous tissue from nasal tip, and realignment and fixation of alar cartilage with interdomal sutures. Pressure splint was applied on 7th postoperative days and maintained for a couple of months. Proper preoperative diagnosis, subdermal soft tissue excision, realignment and fixation of alar cartilage, cartilage graft, augmentation of dorsum of nose, columella lengthening, postoperative splint and combinations of these are the key of successful results.
Asian Continental Ancestry Group ; Cartilage ; Ear ; Female ; Follow-Up Studies ; Humans ; Inlays ; Male ; Nose ; Rhinoplasty ; Silicones ; Splints ; Succinates ; Sutures ; Transplants

PURPOSE: The epidermal cyst is a very common skin lesion which usually occurs in the hairy regions. They are generally small but rarely reach more than 5 cm in diameter. We present a patient with a giant epidermal cyst on buttock area. METHODS: A 50-year-old man with a slowly enlarging, huge mass in his left buttock was examined. There was no history of trauma in this area. Physical examination revealed a soft, nontender, 15x15cm-sized mass in his left buttock. T1-weighted magnetic resonance images demonstrated a well-circumscribed, multilocular cystic lesion with homogeneous, slightly high signal intensity. On T2-weighted images the lesion had wide areas of high signal intensity. The mass was totally excised. RESULTS: A histopathological finding revealed that the cystic wall was lined with whole layers of stratified squamous epithelium. Keratin layers from the surface of the epithelium were seen to be sloughing into the cystic lumen. Multinucleted giant cells were found outside the cystic wall. CONCLUSION: Herein we report a rare case of giant epidermal cyst occurring on the buttock.
Buttocks ; Epidermal Cyst ; Epithelium ; Giant Cells ; Humans ; Middle Aged ; Physical Examination ; Skin

PURPOSE: Breast volume is one of the crucial measurements in preoperative planning and postoperative evaluation of the results in mammoplasty. There are several methods suggested by different authors, but there is still no commonly accepted standard methods for measuring breast volume. To help the surgeons to base their estimation on an objective evaluation, we developed a simple method using Polyethylene bag and plaster molding. METHODS: After Polyethylene bags were put in suitable size on both breasts of the patient in upright position, silk plaster was molded on the surface evenly. Then molds can be obtained after marking boundaries of breasts with a pen. Breast volume measurement can be done by filling water in the molds and measuring it. Moreover, postoperative design for natural skin brassier was possible using the molds. RESULTS: This method was applied to 2 patients for reduction mammoplasty and the breast volume measurement was simple, hygienic and accurate, done within 10 minutes. CONCLUSION: This method using Polyethylene bag and plaster molding has several advantages. 1.It is comparatively accurate regardless of the size and shape of patient's breasts in upright position. 2.Measurement time is short and inconvenience and shame of patients can be reduced by making molds after putting on Polyethylene bags. 3.It is relatively economical and uses easily available hygienic materials . 4.The postoperative shape and volume of breasts can be predicted by using molds preoperatively.
Breast* ; Female ; Fungi* ; Humans ; Mammaplasty ; Polyethylene* ; Shame ; Silk ; Skin ; Water

Plastic surgery of the breast includes; augmentation, reduction, reconstruction of the breast and correction of inverted nipples. For breast augmentation I herein introduce a technique of augmentation while preventing the occurrence of capsular contracture. For reduction surgery, I emphasize a short scar, preservation of nipple sensation and lactation. For reconstruction I suggest that a general surgeon should have a keen interest in reconstruction after mastectomy for better outcomes and improvement in quality of life of the patient. Finally I discuss correction surgery for inverted nipples, which is a challenging field in breast surgery because of its high recurrence rate and possibility of compromised breast-feeding after surgery.
Breast* ; Cicatrix ; Contracture ; Female ; Humans ; Lactation ; Mastectomy ; Nipples ; Quality of Life ; Recurrence ; Sensation ; Surgery, Plastic*

Hypertrophic scars and keloids are difficult to treat. Currently numerous treatment modalities are available, but results are often hard to predict. We used the 585 nm flashlamp-pumped dye laser based on the principle that selective thermolysis of the increased vasculature in a scar may prevent scar hypertrophy through decrease in cellular function/nutrition within the scar. We treated 41 patients with hypertrophic or keloidal scars of more than 6 months duration. The number of treatments per person ranged from 1 to 8 (mean 3.7) and patients were treated every four weeks. Duration of follow-up ranged from 6 to 24 months. There was a significant improvement in appearance, texture and symptoms such as pain and pruritis. No recurrence or worsening of the scar was reported.
Cicatrix ; Cicatrix, Hypertrophic* ; Follow-Up Studies ; Humans ; Hypertrophy ; Keloid* ; Lasers, Dye* ; Pruritus ; Recurrence

No abstract available.
Female ; Mammaplasty*