각종 골대체물질들의 골형성능에 관한 비교연구

설정현,최원희,김정철,홍정수,서동보 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.4

We studied the bone forming capacity of the various bone substitute materials for the confirmation of bone regeneration with each case i.e Hydroxyapatite(SURGIBON), kiel obne, B.O.P. and bone dust. The bone dust was used for control. In 18 New Zealand white rabbits, four partial thickness bone defects were created on the outer table of parietal bone, which were measured 1.5mm in depth x 8mm in diameter. Bone substitute materials were filled in each bone defect. The animals were sacrified at 2, 4, 6, 8 weeks after taking a plain skull film, and then both macroscopic and microscopic examinations were done. The results were as follows : 1. Hydroxyapatite : good bone regeneration with moderately increased eosinophil. 2. KIEL BONE : no bone regeneration and markedly increased eosinophil. 3. B.O.P. : no evidence of bone growth during postoperative 8 weeks. 4. BONE DUST : persistent osteoblast existed during experimental period, more likely as own bone. We summarized that the hydroxyapatite is a biocompatible matrix implantable as a bone graft substitute and more bone regeneration than other bone substitutes during the experimental period.

복벽성형술

설정현,정재호 영남대학교 의과대학 1993 Yeungnam University Journal of Medicine Vol.10 No.2

생활수준의 향상과 식생활의 개선으로 복부지방의 과다축적은 여성에게 체형의 불균형을 초래하고, 심하면 요척추관절에 퇴행성병변이 유발되어 요통과 운동장애가 올 수 있다. 이러한 복부지방의 과다축적을 성형외과적 복벽성형수술 방법으로는 지방흡인술(liposuction)과 피부지방절제술(dermolipectomy)의 2가지 방법이 있는데 적당한 환자의 선택, 적당한 수술방법의 선택 혹은 두가지 방법을 적당히 병용함으로 복부지방제거와 더불어 체형의 개선에 좋은 효과를 얻을 수 있다.

제한적 접근을 통한 관골 부정유합의 재건

설정현,강무석,김용하 大韓成形外科學會 1988 Archives of Plastic Surgery Vol.25 No.6

This study includes 40 patients of post-traumatic facial bone deformities to whom underwent realignment of zygomatic bone. In 13 cases, we modified the approach technique using limited exposure such as subciliary, intraoral and preauricular incisions instead of conventional wide exposure. Preoperative evaluation of deformity was done by using x-rays, photographs and detail communication with the patients. Through this limited exposure, osteotomy and repositioning of the zygoma were accomplished. There were no postoperative differences between wide and limited exposure, but limited exposure was more advantageous in terms of reduced operative time, transfusion, hospitalization and scaring. This approach was an effective method for the relatively simple tetrapod type-malunited fracture of zygoma without comminution.

Tissue Expansion의 임상적 이용 및 그 조직학적 변화

설정현,이태숙,이대훈,정재호,최시호 大韓成形外科學會 1987 Archives of Plastic Surgery Vol.14 No.3

Soft-tissue expansion is a new clinical technique of providing donor tissue for modern reconstructive surgery. This technique provides a quantity of tissue of similar color, texture, and hair-bearing qualities for reconstruction of adjacent defects and makes secondary reconstruction of donor site unnecessary. Recently, we performed soft-tissue expansion in ten patients with various defects including postburn alopecia, postburn scar, and breast deformity due to paraffinoma removal. Clinical results, histological changes, and complications were evaluated. Excellent or good results were observed in eigth patients out of a total of ten patient. The major complication rate was 30% in our series due to three major complications, such as infection, esposure of expander, and skin necrosis. On histological study, the epidermis was minimally thickened. Dermis and subcutaneous tissue became thinner, and markedly increased vascularity and collagen synthesis in the dermis compared to preoperative normal histologic findings were also observed. Skin appendages showed no structural changes. In our experience, the application of the soft-tissue expansion technique has proven to be successful. We have determined that the method is safe, simple, and provides good aesthetic results.

皮膚移植후 壓迫處置를 위한 Resin Mold의 利用

薛正泫 대한성형외과학회 1981 Archives of Plastic Surgery Vol.8 No.1

The Use of pressure therapy has been sucessfully employed as a prophylactic measure to prevent the development of hypertrophic scar and secon-dary wound contraction. We has been employed the pressure bandage, cast splint, jacket and dynamic splint but on the face surgery such as hemangioma and nevus etc is very difficult in fixation and it's management. Recently, I was used the Resin mold on the face for pressure therapy and got relatively satisfectory result.

미세혈관 수술시 혈관개존율 향상을 위한 연구

설정현,정영식,최시호,정재호 영남대학교 의과대학 1986 Yeungnam University Journal of Medicine Vol.3 No.1

본 교실에서 백서의 대퇴동맥을 이용하여 혈관감자의 회전없이 continuous suture로 미세혈관 문합을 시행해본 결과 다음과 같은 결론을 얻었다. end-to-end anastomosis시 double clapp의 회전이 어려울 정도로 작업공간이 제한된 경우나 end-to-side anastomosis시 secondary Vessel의 길이가 짧아서 후벽을 잘 볼 수 없는 경우에 continuous suture을 이용하면 Back wall을 완전히 노출시킨 상태에서 쉽게 혈관 문합을 시행할 수 있으며 문합시간도 단축시킬 수 있을 것으로 사료된다. In clinical microsurgery, limitation of space often prohibits rotation of a double clamp in an end-to-end anastomosis, or shortage of length of the secondary vessel in an end-to-side anastomosis does not allow visualization of the bakc wall. In these situation, back wall repair is extremely difficult. To overcome this problem, we use continuous suture technique without rotation of double clamp for end-to-end and end-to-side anastomosis of the 40 rat femoral arteries. After continuous sutures for microarterial anastomosis, the following results were obtained :Continuous sutures are useful in anastomosis where there is unavoidable limited access to the posterior wall and for some of the larger vessels now being anastomosed in free flap and other reconstructive surgery.

皮膚移植에서 供與部創傷 治癒過程에 關한 臨床的 考察

薛正泫,田健秀,柳在德 대한성형외과학회 1977 Archives of Plastic Surgery Vol.4 No.1

Many plastic surgeons are called upon from time to time to carry out skin grafting procedures. Often the sebsequent donor site does not receive the attention or expert management it deserve. The result is an inordinately uncomfortable patient or, worse, delayed healing or infection with conversion to full-thickness loss. The most important goal of donor site care is rapid re-epithelization without infection and minimum discomfort to the patient. So, many techniques have been used in managing the split-thickness skin graft donor site. Basically, these can be categolized into the following dressing classification: occlusive, open and semi-open method. During the past 6 months, 48 cases of the donor dressing at plastic surgery department of Severance Hospital. In the author's observation, the semi-open method is rapid re-epithelization with minimum discomfort compare ti open and occlusive method. Which result suspect the early wound open and dry up after bleeding control is the key of donor wound healing.

정맥경수에 따른 정맥피판의 생존비교

설정현,최용준,정재호 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.3

In recent years it has been shown that it is possible to keep a flap viable by retrograde circulation through the draining vein, instead of the feeding artery. The purpose of this study was to investigate the viability of four types of venous flaps : 1) venous flap with single venous inflow and single outflow, 2) venous flap with single venous inflow and double venous outflow, 3) venous flap with double venous inflow and single venous outflow, 4) venous flap with single vein. And the control group was carried out as the composite graft. Twenty-five rabbits undergone venous flap surgery for comparison of flap survival rate were studied. Mean survival of skin flaps were shown : 1) group 1-63.4%, 2) group 2-75.2%, 3) group 3-96.8%, 4) group 4-45.6%, 5) control group-total necrosis. Results of study validated that flap viability was dependent on the number of vascular pedicle in venous flaps, and the more venous inflow than venous outflow, the flap survival was increased.

복부피부지방 절제술

설정현,김정진,김성언,정재호 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.1

As asthetic measures to correct abdominal adiposity, there are abdominal dermolipectomy and liposuction. Abdominal dermolipectomy was introduced by Kelly in 1899. Although there are many variations, transposition of umbilicus and undermining of flaps are being used currently in almost all abdominal dermolipectomies. Recently developed liposuction technique is very helpful in getting good results, if used simutaneously. But the risk of flap necrosis, a serious compication of abdominal dermolipectomy, could be increased by extensive elevation of the flap and by vigorous, liposuction. Through selection of appropriate patients and consideration of anatomical changes of blood vessels of abdominal wall, we can prevent the complications and expect satisfactory result. We have performed 10 cases of abdominal dermolipectomy during the past 5 years and analyzed the results.

안검하수에 관한 임상적 고찰

설정현,최용준,이경호,홍정수 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.1

The blepharoptosis is drooping of the eyelid which is caused by the weakness of the levator palpebral superior or the Muller's muscle. The management of blepharoptiosis mainly depends on the degree of ptosis and the amount of levator function. The result of surgical correction of the blepharoptosis is determined by the nature of ptosis, methods of operation, and surgeon's skill. Authors had experienced 128 patients of blepharoptosis from March, 1984 to April. 1993. The results were as follows ; 1. The ratio of congenital versus acquired blepharoptosis was 125 : 3. Monocular versus biocular was 82 : 46. male versus female was 85 : 43 and left versus right eye incidence was 45 : 37. 2. The postoperative complication were incidental lagophthalmos during sleep and ptotic change at upward gaze were appeared in almost cases at immediate postoperative period, however these symptoms were improved from 2 to 6 months after operation. Overcorrection was found in 16 cases, undercorrection was found in 20 cases, exposure keratitis was found in 2 cases. asymmetrical lid fold deformity was found in 3 cases and sensory disturbance in 11 cases. 3. The cases of severe weakness of levator muscle function, the frontalis muscle transfer technique was more effective and excellent result comparing with the other methods.