수지첨부 접합수술

한현언,Hahn, Hyun Oun 대한미세수술학회 2011 Archives of reconstructive microsurgery Vol.20 No.2

Although finger tip replantation is popularized nowadays, it is not easy operations even for experienced surgeons. The indication for replantation to treat fingetip amputation is still controversial, but I think replantation for function and cosmetic absolute indication. This paper will discuss about methods of fingertip replantation and unexpected complications on soft tissue after operation.

대한미세수술학회 설문조사 결과 보고

한현언,정덕환,김우경,Hahn, Hyun-Oun,Chung, Duke-Whan,Kim, Woo-Kyung 대한미세수술학회 2007 Archives of reconstructive microsurgery Vol.16 No.2

For the better success in the society, it is important to collect opinions from members. The progress was slow before because it was hard to collect the opinions from each member. But since we have opened the web site it gets easier to evolve with the society for microsurgery, and expect to have active participations from the members. We make 20 questions in three different groups. The researches are made on participation, development in science council that starting from 2005 October to 2007 June, education on training with member's preference to thesis and individuality and suggestion. Thus we have results following to that research. 1.75% of the members vote for the lecture has to be substantial, and also want the atmosphere of the council to be more sincere. 46.2% of members want the council to be not only exchange information but also the place to experience the social intercourse. 2. When the thesis is present and submitted that will also connect to main society. It will be counted as equal as board thesis, only if the thesis can count in both plastic & reconstructive surgery and orthopedic surgery. Then it will be scored as same as examination of board, and will be a receipt of paper by home page 3. The information-oriented project on our council is slower than what members expected. 100% of members voted yes to online thesis examination, and 66.7% of members voted for preference of web site. We need to make improvements on our web pages as soon as possible such as online payment with credit card. 4. According to the result of questionnaire, our web site helps member's participation in council and eventually become a bridge between members. We hope the questionnaires would help us to develop the council and eventually would help us to society with each other in the council. We also hope this council would be the one that connect all of us in society.

300명 환자 수지 재접합수술의 임상적고찰

한현언 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3

On May 23, 1962, Malt and McKahnn of Boston replantated the amputated right arm of a 12-year-old boy. Postoperatively the boy survived with his arm restored. Following this replantationin Boston, surgery in Korea has developed much since the first replantation of a severed left finger was successfully tried at the Kyung Hee University Medical Center in 1975. The replantation operation should not only succeed but also ensure a proper function of the replantated hand and digits. Between January 1989 and July 1991, the author has operated on 300 patients. The author's modified method of replantation procedures is as follows : The flexor tendon is repaired first and bone fixation work is done next; then the nerves were repaired before vessels were repaired. The result was that the digit was neurorraphically complete with its sensations and functions restored to it. The following results were obtained from the clinical analyses and follow-up of the patients : 1. The highest percentage of the patients belongs to the third decade with 133 cases(44.3%) and the male to female ration is 9 to 1. 2. Patients transferred from other hospitals amount to 129 cases (43%) 3. As for territorial distribution, Kyunggi Province topped with 192 cases (64%) 4. The most common level of amputation is in proximal phalanageal bone and proximal phalangeal joint with 242 digits (39.9%) 5. The success rate in all the operations is 97 percent.

절상 치유과정에서의 비반세포에 관한 실험적 연구

한현언,이세일,이대일 大韓成形外科學會 1986 Archives of Plastic Surgery Vol.13 No.4

The mast cells plays a central role in pathophysiology of immunologic or nonimmunologic inflammatory reaction by release of the chemical mediators in their granules. In addition, the mast cells are also probably involved in the healing process of the wound by stimulating proliferation of the fibroblast. To clarify the role of mast cell in the process of the organization of granulation tissue, experimental incised wound of the skin measuring 1.5cm was given to 15 mice and variation of the number and shape of tissue mast cell in and around the granulation tissue were conuted weekly, 3 mice per week. The results are followings: 1. The size of granulation tissue after incision of the skin was the largest in wounds at 1st week and subsided at 5th week. 2. There was no mast cell in the granulation tissue at 1st week. They started to appear from 2nd week granulation tissue after incision of the skin and returned to normal level at 5 week. 3. Dermis surrounding the granulation tissue revealed the greatest number of the mast cells at 1st and 2nd weeks after incision of the skin and declined to normal level at 5th week. Above results showing parallel variation between the size of the granulation tissue and the number of the mast cells around the tissue suggest that the mast cells are involved in the organization of the granulation tissue.

수지재접합수술 후 조기합병증

한현언,오석준,김용성,이세일 大韓成形外科學會誌 1985 Archives of Plastic Surgery Vol.12 No.2

Replantation surgery is long time operative prdcedure in emergency condition. Also anticoagulant therapy after replantation is always necessary to prevent thrombosis of the vascular anastomec sites. This report revieved the complications following microreplantation of 220 patients which have been performed from Apr. 1981 to Oct, 1984. The complication was 88 patients of systemic complication, 111 patients of local complication and 104 patients of abnormal bleeding by anticoagulant therapy. The results were as following: 1. Systemic complications were anemia, decubitus ulcer and psychiatric depression. 2. Local complications were wound infection, skin loss and vascular insufficiency. 3. Abnormal bleeing after anticoagulant therapy showed epitaxis, wound bleeing, hematuria and abnormal menstration in female patient.

경직수지관절의 인공관절 대치

김용성,한현언,이세일,오석준 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.3

Replacement of man's diseased or degenerated part has been a dream. The purpose of this paper is to describe an flexible hinge silicone arthroplasty for the small joint of hand which has been helpful in certain selected cases. The basic principle of this operation is to correct the deformity and subluxation by bone resection, implantation, and encapsultion thereby preserving range of motion which often is compromised. Since Aug. 1983, we have been using a high performance silicone elastomer double stemmed flexible hinge as an adjunct to resection arthroplasty of the metacarpal joint and proximal interphalangeal joint in thumb, index and middle finger. No. 4 Swanson flexible hinge implant was used in metacarpophalangeal joint of thumb and proximal interphalangeal joint of middle finger, and No. 3 in proximal interphalangeal joint of index finger and metacarpophalangeal joint of index and middle fingers. Active exercise was gradually started at 3∼6 days postoperatively in majority of the cases. Although the follow up(range 4 months-9 months) in the majority is too short to permit a complete assessment of the results. The postoperation range of motion was gained up 30 degree.

서혜부 피판을 이용한 음경 파라핀종의 치료

최민혁,서상원,황귀환,차동섭,한현언 대한성형외과학회 2002 Archives of Plastic Surgery Vol.29 No.2

Paraffinoma induces many unexpected complications such as tissue necrosis, granuloma formation, hypersensitivity, embolism and even carcinoma. The treatment modality is known to be primary repair, flap surgery, skin graft, radiotherapy and high frequency current treatment after the excision of the lesion. Although these methods can remove the paraffinoma and resurface penile shaft, various complications such as skin tension after surgery, hypertrophic scars, difficulty of erection, and deficiency of bulkiness are frequently occurred. Groin flap is the proper method for the patients who want simultaneously soft tissue reconstruction and augmentation of penis. A 32 year-old male patient who visited our clinic had firm mass, abscess, skin necrosis, and dyspareunia after the injection of paraffin into penis 3 months ago. Reconstruction was executed using right side of the groin flap after the radical resection of the whole tissues ruined by infections and infiltration of paraffin. The penile bulkiness, erectile function and duration of erection was all satisfactory. The follow-up period was 7 months after the surgery and no specific complication was developed. Groin flap is the satisfactory method to enhance penile bulkiness as well as resurface the lesion.