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- 저자 : 임홍철(Hong Cheol Lim) (검색결과 5 건)
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Microvascular Anastomotic Coupler System을 이용한 쉽고, 빠른 혈관문합
정남연(Nam Yun Chung),임홍철(Hong Cheol Lim),이순혁(Soon Hyuck Lee),박종훈(Jong Hoon Park),박종웅(Jong Woong Park) 대한정형외과학회 2008 대한정형외과학회지 Vol.43 No.1
목적: 골, 연부조직 결손의 재건을 위한 유리조직 이식 시 microvascular anastomotic coupler (MAC)를 이용한 미세혈관 문합의 결과를 보고하고자 한다. 대상 및 방법: 유리 조직 이식술 시 MAC coupler 시스템을 이용하여 정맥 문합을 시행한 12명의 환자 20예의 정맥문합을 대상으로 하였다. 환자의 연령, 성별, 수술 당시 진단명, 공여부 조직, 공여부 및 수여부 혈관의 직경, coupler의 크기, 문합 소요시간, 문합 직후 문합 부위의 혈관 개존 및 누혈 여부, 유리 조직 이식술의 성공 여부 등을 조사하였다. 결과: MAC coupler를 이용한 정맥 문합에 소요된 시간은 평균 3분 15초였다. 전 예에서 문합 직후 문합부의 누혈이나 혈전 형성이 관찰되지 않아 100%의 직후 개존율을 보였으며 이식 조직은 장기 추시 시 전 예에서 혈관의 개존이 유지되어 생존하였다. 결론: 정형외과 영역의 미세 재건술 시 coupler 시스템을 사용함으로써 미세 혈관 문합시간을 단축할 수 있어 수술 시간과 유리 조직의 허혈시간을 획기적으로 단축할 수 있었다. 이 시스템은 사용방법의 습득이 용이하고, 혈관 내막의 손상이 적으며, 초기 문합 강도가 우수할 뿐 아니라 문합 혈관의 직경차도 쉽게 극복할 수 있어 미세 봉합사를 이용한 고식적 혈관 문합을 대치할 수 있는 좋은 수술방법으로 사료된다. Purpose: We report the results of microvascular anastomosis using a microvascular anastomotic coupler (MAC) system. Materials and Methods: Twenty cases (12 patients) of venous anastomoses performed using a coupler system were examined. The patients' age, gender, preoperative diagnosis, donor tissue, vessel diameters, size of coupler, time for anastomosis, patency rate immediately after surgery and the final survival rate of the transferred tissue were evaluated. Results: The mean time for anastomosis using the coupler system was 3 min and 15 sec. The immediate patency rate after anastomosis was 100% without any leakage of blood or thrombus formation. At the final follow up, the transferred tissue survived in all cases. Conclusion: Microvascular anastomosis using a coupler system in orthopaedic reconstructive surgery can shorten the vascular anastomosis time and significantly reduce the total ischemic time of the transferred tissue. This system can be easily used after a short training period. This system minimizes the intimal damage of the vessel, easily overcomes the diameter discrepancy and provides secure fixation at the anastomosis site. This system can be a good strategy for substituting the conventional suture anastomosis.
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임홍철,양정열,나한조,강양수,이명주,정우철 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.6
As the use computed tomographic(CT) scanning spread, the diagnosis of blowout fractures of the medial orbital wall increased. Now, the diagnosis of blowout fracture in the medial wall are not uncommon. Conventionally, the surgery of blowout fractures in medial orbital wall was performed by the various approach with external incision. The conventional method had seveal possible disadvantages, including an external scar, incomplete reduction, increased mobidity rate and general anesthesia. Recently, endoscopic reconstruction of the medial orbital wall has provided good functional and cosmetic results. We performed endoscopic transnasal reduction surgery without external incision in 12 cases of medial blowout fracture under local anesthesia. The fractured bony fragments were removed after the intranasal ethmoidectomy and the entrapped medial rectus was released. And then a sheet of silicone late or uncinate process were placed on the fracture site. For the maintain of the position of fractured wall, Merocel packing or urinary ballon catheter were used in orbital fracture site for 1-3 weeks. There were no specific complications related to this procedure. Result of the surgery in all cases were satisfactory. In this article, we discussed the surgical procedure, the benifit of the transnasal endoscopic approach, the indications for surgery, and possible comlications.
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양정열,오형근,임홍철,류봉수,이명주 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.5
The lower extremity often has so insufficient soft tissue, poor vascularity, that a conventional local flap may have limitation for the reconstruction of the foot and ankle. when soft tissue defects occur in the foot and ankle, the island flap renders a feasible one stage reconstructive operation, and has a remarkable vascularization and high quality result. We reconstructed 25 cases of soft tissue defects of the foot and ankle by using various island flaps at the Department of Plastic and Reconstructive Surgery in Chosun University Hospital from March, 1991 to May, 1994. Lateral calcaneal arterial island flaps were used to 9 cases, lateral supramalleolar island flaps to 12 cases, a dorslis pedis artery island flap to 1 case, medial plantar arterial island flaps to 2 cases, and a digital plantar island flap to 1 case. Minute areas of distal necrosis developed in 3 out of 12 lateral supramalleolar island flaps. There was hematoma formation in 2 out of 12 lateral supramalleolar flaps. But all the these is land flaps recovered completely. There was partial loss of skln graft on the donor sites. We have found that island flaps are very useful for reconstruction of soft-tissue defects of the foot and ankle, because island reaps have good vascularity, and less risk of infection. generous flap size, comfort to the patients, early ambulation, easy operative technique of flap transfer, lower cost, shorter operative time, and minimum morbidity at the donor site, are other advantages. We attained satisfactory results, Thus we presented our experience of the cases with review of the literatures.
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강양수,류봉수,이명주,양정열,임홍철 조선대학교 부설 의학연구소 1999 The Medical Journal of Chosun University Vol.24 No.2
Background and Objective: The facial region is defined for our purposes as the whole face, together with the underlying viscera and skeletal structure. The epidemiology of facial injuries is of practical importance for several view points, not least in planning trauma services. Materials and Method: This retrospective study include 815 patients of facial bone fractures who were treated at the Department of Plastic and Reconstructive Surgery at the Chosun University Hospital between January 1994 and December 1998. These patient's medical records were then retrospectively analysed in order to gain insight into a clinical pattern. Results and Conclusion: An analysis datas were as follow: An increase of fractures of 10.2% per year was noted. The injuries were most frequently occured in July(10.4%), Saturday(23.9%) and between 18:00 and midnight. Most injuries occured in young male with the highest incidence in the third decade of life and males were predominated more than female, 3.4 to 1. The most common cause of fractures were traffic accident(42.3%) followed by assault, fall(or slip) down and others. Among the number of fractures, the most common fractures were found in the nasal bone(25.2%) followed by zygoma, maxilla, orbit, mandible and frontal bone. Associated soft tissue injuries were combined in 58%, and the other site of fractures associated with facial bone were developed in 22.2%. The average interval between onset to arrival and onset to surgical intervention was 2.48 hours, 6.2 days, and average hospital day was 12.7 days. Treatment for fractures were consist of open reduction(52.8%), closed reduction(19.5%) and conservative treatment(15.6%). The complication rate was 15.2% and most common complication was the eye problem, followed by post-traumatic psychosis and facial asymmetry.
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