비순부 도서형피판을 이용한 비익 및 비첨의 재건

이택종 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.2

Loss of nasal tip and ala has a more disastrous effect on the face than the size of the deformity would suggest, thus reconstruction become vital. Various methods have been developed for nasal reconstruction. Among these are skin graft, composite graft and many local and distant skin flaps. We can select suitable methods considering status of the neighbouring tissue, age, and other clinical situations. The nasolabial flap was originally advocated by Dieeffnbach for the partial reconstruction of nasal ala defects. Recently Herbert and others described anatomy of nasolabial vasculature in detail and possibility of the island flap. This island flap has many advantages, in reliability, location, tissue match, minimal donor defect, ease of performancce. We can also make bilateral flaps. We experienced 6 nasolabial island flaps in 5 patient of nasal ala tip defect. The results were satisfactory and the nasolabial island flap seems to be treatment of choice for these cases.

횡복직근 피판술을 이용한 유방 재건에서 구역 2와 구역 3의 지방 괴사의 비교: 전향적 연구

이택종,김은기,윤상엽,장학,손병호,안세현,이무송 대한성형외과학회 2004 Archives of Plastic Surgery Vol.31 No.6

Fat necrosis in transverse rectus abdominis musculocutaneous(TRAM) flaps is considered to be primarily affected by blood supply. Unreliability of blood supply in zone II has been claimed for years but no accurate comparison has been reported between fat necrosis in zone II and III. A prospective study about the incidences and extent of fat necrosis in zone II and III was designed, comparing relative vascularity between zone II and III. Immediate breast reconstructions after modified radical mastectomy or skin sparing mastectomy were performed in 150 consecutive patients with unipedicled TRAM flaps and 138 contralateral and 12 ipsilateral rectus muscles were used as pedicles. Twenty-one patients(14 percent) suffered from fat necrosis and 22 fat necroses were diagnosed in total. 17 fat necroses occurred in zone II, 3 in zone III and 2 in zone I. The incidence of fat necrosis in zone II was significantly higher than zone III, which was consistent with previous studies claiming poor vascularity of zone II. Therefore placing zone I and zone III medially and zone II laterally after discarding part of zone II will cause less deformity of reconstructed breast if resection of necrotized tissue is needed.

지방보존술식을 이용한 하안검 성형술 : 안와 중격을 안하연하부에 당겨서 고정

이택종,윤상엽 大韓成形外科學會 2001 Archives of Plastic Surgery Vol.28 No.2

보형물을 이용한 즉시 유방재건술에서 노출된 보형물의 보존

이택종,오태석,Lee, Taik-Jong,Oh, Tae-Suk 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.1

Purpose: Common complications of immediate breast reconstruction with implant are capsular contracture, malposition of implant, hematoma and seroma. Especially, the most severe complication is implant exposure caused by inflammation or necrosis of skin flap margin of mastectomy site. This article reports the experience of cases of salvage in such an exposure of implant. Methods: From July, 2002 to Feb., 2009, sixty-five patients who underwent immediate breast reconstruction with implant were retrospectively analyzed. Exposure of implant was happened in 5 of 65 patients and they were treated at out patient district. Two of five patients were reconstructed with saline implnt and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$ and Serratus muscle flap. Remaning three patients were reconstructed with silicone implant and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$. Results: In the group of patients who underwent reconstruction with saline implant, implant exposure was found in one patient due to partial necrosis of the margin of skin flap and debridement and primary repair were done. In the other one patient, dressing with antibiotic ointment were done. And debridement and primary repair were proceeded. In the group of patients who underwent reconstruction with silicone implant, implant exposure was found in one patient. After removal of the implant, tissue expansion was done and a new silicone implant was inserted. Implant exposure were found in the other two patients, antibiotics ointment application and primarily repaired. Conclusion: It was the common knowledge that the exposed implant should be removed. But salvage of the exposed implants may be possible with proper treatment. Four of five patients (80%) with exposed breast implant were salvaged with conservative management.

유경 횡복직근피판을 이용한 유방재건술에서 피판장착의 단순화된 전략

이택종,윤상엽 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.3

Various method of insetting the transverse rectus abdominis myocutaneous flap for breast reconstruction has been reported in literature. The Bostwick's principle is commonly applied, which utilizes contralateral pedicle in a vertical or oblique flap inset position and ipsilateral pedicle in the transverse position. But it is relatively a complex and difficult technique, thus requires a more simplified strategy. We have formulated a new insetting method, in which the contralateral pedicled TRAM flap with an oblique(0-90) flap inset was carried out. We used this method in 100 cases from July 2001 to June 2003. This maneuver places Hartrampf's zones I and III with good vascularity in the medial side, and zone II in lateral side of breast. Fat necrosis was observed in 14 patients(14%) and of these, only three cases needed surgical excision. This simplified method is easy to learn. Specifically, fat necrosis removal is easy with more tolerable aesthetic results, especially in Asian patients with smaller breasts.

일측 상활차동맥에 의해 공급받는 정중부 도서형 전두피판을 이용한 비재건

이택종 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

The Koomas of ancient India, members of the caste of potters, had developed the art of reconstructing the destroyed nose by means of a forehead flap, a method often referred to as the Indian method and described in the writings of Sushruta. The skin of the forehead has the same advantages in general as that of the nasolabial fold and cheek in nasal reconstruction as it provides a close color and texture match. A midline forehead flap is a good one for the repair of the nasal defects because it requires few stages, is easy to transfer, is convient for the patient, and produces neither mutilation nor disturbance of the normal wrinkling of the forehead. The flap has a good blood supply from the paired supratrochlear vessels of both sides. The midline island forehead flap with the subcutaneous pedicle differs from the ordinary midline forehead flap by the absence of the usual pedicle of the skin. The island flap provides greater mobility than other type of the forehead flaps because the subcutaneous pedicle is more readily twisted and the skin flap is more easily adjusted into the recipient site. A second appreciable advantage of the island flap is that only one stage is required. Dhawan designed a rather oblique forehead flap situated off the midline, based on a single supratrochlear artery. This departure from the midline flap adds to the length, but it produces on oblique forehead scar which may be more prominent and thus less acceptable. Nevertheless, if the flap is based on one vessel, the protrusion at the root of the nose as a result of the presence of the subcutaneous pedicle will become less prominent than the flap based on bilateral vessels. Moreover the mobility of the flap with one vessel is much greater than the previous island flap. While retaining the advantage of a midline scar, author have used an midline island forehead flap based on a single supratrochlear artery for the reconstruction of various nasal defects. This paper deals with my experience with such a flap in 5 patients.

The Use of Fibrin Sealant for the Reduction of Seroma

이택종 대한성형외과학회 2012 Archives of Plastic Surgery Vol.39 No.5

로보트 매니퓰레이터의 강인한 적응제어

이택종,고명삼,Yi, Taek-Chong,Ko, Myoung-Sam 대한전자공학회 1990 전자공학회논문지 Vol. No.

본 논문에서는 로보트 매니퓰레이터의 기준모델 적응제어계 설계에 있어서 계통의 미지 파라미터에 대해 계통식이 선형화됨에 착안하고 Augmented 오차변수를 도입하여 파라미터 제이칙 및 제어입력을 제안하였고, 계통의 모델링 과정에서 불가피하게 도입되는 모델링 오차 및 미소한 시정수를 가진 기생요소(parasitics)들이 계통의 파라미터 동정 및 추종오차에 미치는 영향을 검토하였으며 개선책으로 저역 필터를 토입한 적응제어기를 구성하여 제안된 제어칙으로 별다른 가정없이 계통이 대국적으로 안정함을 밝혔다. 끝으로 컴퓨터 시뮬레이션을 통하여 제안된 제어기 구성법이 기생요소의 영향감소에 효과적이고 유용함을 밝혔다. An improved parameter adaptation and control law for robot manipulator are proposed based on a linearized parametric system equation and augmented error vectors. In view of the modeling error and parasitics with small time constants which inevitably introduced during modelling process, their effects on the robustness of the system performance are reviewed and as an conutermearsure, adaptation mechanism with low pass filter is proposed. Proposed parameter adaptation and control low assure the stability of the robot manipulator in the large without further assumption. Computer simulation shows its effectiveness of the proposed adaptation mechanism to improve the robustness of the system in presence of the parasitics in the system and superior performance for high speed operations make it an attractive option in application of the adaptive control field for robot manipulator.

외측 승모근 근피판에 관한 연구

이택종 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

Surgical treatment of the defects of the head and neck has improved with advances in the reconstructive techniques especially myocutaneous flaps. Among various myocutaneous flaps, the trapezius myocutaneous flap, which is better known in Argentina by the creator's name i. e. , Demergasso's flap, is formed by the upper and medial portions of the trapezius muscle and an island of the overlying skin of the shoulder. The only significant blood supply for the trapezius musele is provided by the transverse cervical artery most commonly originating from the thyrocervical trunk. It then crosses anterior to the brachial plexus and anterior scalene muscle, crossing above the clavicle, lateral to the border of the levator scapulae muscle, finally dividing into a ascending and a descending branch. Prominent perforating vcssels from the ascending branch extend onto the skin over the acromioclavicular joint. The lateral trapezius myocutaneous flap includes the skin island and the lateral trapezius muscle supplied by the ascending branch of the transverse cervical artery. Defects of the oral cavity, oropharynx, hypopharynx, and skin of the head and neck can be repaired with this versatile flap in a single operative procedure and the flap can be satisfactorily used in patients who have previously received radiation therapy. The trapezius muscle is used to cover and protect the carotid arteries and to add bulk and contour to a dissected neck. We succefully treated the verrucous carcinoma of the tongue and hypopharyngo-cutaneous fistula using lateral trapezius mycoutaneous flap.

유경 횡복직근피판을 이용한 유방재건과 동시에 시행한 반대편 유방 축소술

이택종,곽인수,윤상엽,장학 大韓成形外科學會 2004 Archives of Plastic Surgery Vol.31 No.3