Preparation of harvested skin using the Versajet Hydrosurgery System in full-thickness skin grafts

최서길,Hyun Woo Shin,Kun Chul Yoon 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.6

During a full-thickness skin graft procedure, the thickness of the harvested donor skin is adjustedbased on the location of the recipient site and the judgment of the surgeon. Conventionally,the thickness of the harvested skin is roughly adjusted using surgical instrumentssuch as scalpels and scissors. However, this method is not only time-consuming, but also requireseffort to obtain both the desired thickness of the harvested skin and a smooth surfaceof that skin. Moreover, there is a possibility of skin perforation. Hence, the authors devised amethod of adjusting harvested skin thickness using the Versajet Hydrosurgery System. TheVersajet device is a handheld hydrosurgical tool that delivers a high-speed jet stream of salinesolution, which enables the precise debridement of tissue. This method makes it easier andfaster for the surgeon to obtain the desired thickness of harvested skin. In addition, by obtaininga smooth surface and an even thickness of harvested donor skin, this technique maylead to improved graft viability.

Preparation of harvested skin using the Versajet Hydrosurgery System in full-thickness skin grafts

Choi, Seo Gil,Shin, Hyun Woo,Yoon, Kun Chul Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.6

During a full-thickness skin graft procedure, the thickness of the harvested donor skin is adjusted based on the location of the recipient site and the judgment of the surgeon. Conventionally, the thickness of the harvested skin is roughly adjusted using surgical instruments such as scalpels and scissors. However, this method is not only time-consuming, but also requires effort to obtain both the desired thickness of the harvested skin and a smooth surface of that skin. Moreover, there is a possibility of skin perforation. Hence, the authors devised a method of adjusting harvested skin thickness using the Versajet Hydrosurgery System. The Versajet device is a handheld hydrosurgical tool that delivers a high-speed jet stream of saline solution, which enables the precise debridement of tissue. This method makes it easier and faster for the surgeon to obtain the desired thickness of harvested skin. In addition, by obtaining a smooth surface and an even thickness of harvested donor skin, this technique may lead to improved graft viability.

Effect of Toluene Application to Skin on the Liver Injury in Rats

Soon-Nim Chae,Sang-Hee Lee,Chong-Guk Yoon 대한의생명과학회 2001 Biomedical Science Letters Vol.7 No.1

To investigate an effect of the topical toluene application to rat skin on the liver injury, toluene (35 ㎎/㎠) was sequentially applied for 3 or 5 days to rat skin and then the animals were sacrificed. 5 day toluene-treated rats showed the slight increase of liver weight per body weight (%) compared with control. Serum levels of xanthine oxidase and alanine aminotransferase activity were significantly increased both in 3 days and 5 days toluene-treated animals compared with control. In the histopathological findings, cytoplasmic degeneration of hepatocytes around the central vein was noted in the liver of rats applied with toluene to the skin. These results indicate toluene application to rat skin leds to somewhat slight liver injury. On the other hand, the hepatic benzylalcohol or aldehyde dehydrogenase activities were significantly decreased by toluene application to rat skin. In conclusion, the liver injury was induced by toluene application to rat skin, and it can be hypothesized that accumulation of benzaldehyde in liver cell may be responsible for liver injury.

A Simple Strategy in Avulsion Flap Injury: Prediction of Flap Viability Using Wood’s Lamp Illumination and Resurfacing with a Full-thickness Skin Graft

임효섭,한대희,이일재,박명철 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.2

Background: Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood’s lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods: We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood’s lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results: Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions: A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood’s lamp illumination and a full-thickness skin graft.

A Simple Strategy in Avulsion Flap Injury: Prediction of Flap Viability Using Wood's Lamp Illumination and Resurfacing with a Full-thickness Skin Graft

Lim, Hyoseob,Han, Dae Hee,Lee, Il Jae,Park, Myong Chul Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.2

Background Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.

Effect of Toluene Application to Skin on the Liver Injury in Rats

Chae, Soon-Nim,Lee, Sang-Hee,Yoon, Chong-Guk 대한의생명과학회 2001 Journal of biomedical laboratory sciences Vol.7 No.1

To investigate an effect of the topical toluene application to rat skin on the liver injury, toluene (35 mg/cm2) was sequentially applied for 3 or 5 days to rat skin and then the animals were sacrificed. 5 day toluene-treated rats showed the slight increase of liver weight per body weight (%) compared with control. Serum levels of xanthine oxidase and alanine aminotransferase activity were significantly increased both in 3 days and 5 days toluene-treated animals compared with control. In the histopathological findings, cytoplasmic degeneration of hepatocytes around the central vein was noted in the liver of rats applied with toluene to the skin. These results indicate toluene application to rat shin lads to somewhat slight liver injury. On the other hand, the hepatic benzylalcohol or aldehyde dehydrogenase acclivities were significantly decreased by toluene application to rat skin. In conclusion the liver injury was induced by toluene application to rat skin and it can be hypothesized that accumulation of benzaldehyde in liver cell may be responsible for liver injury.

Color Texture Analysis as a Tool for Quantitative Evaluation of Radiation-Induced Skin Injuries

Sung Young Lee,Jin Ho Kim,Ji Hyun Chang,Jong Min Park,Chang Heon Choi,Jung-in Kim,So-Yeon Park 대한방사선방어학회 2023 방사선방어학회지 Vol.48 No.3

Background: Color texture analysis was applied as a tool for quantitative evaluation of radiation- induced skin injuries. Materials and Methods: We prospectively selected 20 breast cancer patients who underwent whole-breast radiotherapy after breast-conserving surgery. Color images of skin surfaces for irradiated breasts were obtained by using a mobile skin analyzer. The first skin measurement was performed before the first fraction of radiotherapy, and the subsequent measurement was conducted approximately 10 days after the completion of the entire series of radiotherapy sessions. For comparison, color images of the skin surface for the unirradiated breasts were measured similarly. For each color image, six co-occurrence matrices (red-green [RG], red-blue [RB], and green-blue [GB] from color channels, red [R], green [G], blue [B] from gray channels) can be generated. Four textural features (contrast, correlation, energy, and homogeneity) were calculated for each co-occurrence matrix. Finally, several statistical analyses were used to investigate the performance of the color textural parameters to objectively evaluate the radiation-induced skin damage. Results and Discussion: For the R channel from the gray channel, the differences in the values between the irradiated and unirradiated skin were larger than those of the G and B channels. In addition, for the RG and RB channels, where R was considered in the color channel, the differences were larger than those in the GB channel. When comparing the relative values between gray and color channels, the ‘contrast’ values for the RG and RB channels were approximately two times greater than those for the R channel for irradiated skin. In contrast, there were no noticeable differences for unirradiated skin. Conclusion: The utilization of color texture analysis has shown promising results in evaluating the severity of skin damage caused by radiation. All textural parameters of the RG and RB cooccurrence matrices could be potential indicators of the extent of skin damage caused by radiation.

간승격(肝勝格) 혈위(穴位)에 시술된 침자(鍼刺)와 침습(侵襲) 및 비침습(非侵襲) 레이저 침요법(鍼療法)이 간손상(肝損傷) 회복에 미치는 영향

신형진 ( Hyung Jin Shin ),김영선 ( Young Sun Kim ),윤대환 ( Dae Hwan Youn ),이석희 ( Suk Hee Lee ),오광환 ( Gwang Hwan Oh ),정성호 ( Sung Ho Jeong ),나창수 ( Chang Su Na ) 대한경락경혈학회 2010 Korean Journal of Acupuncture Vol.27 No.1

Objective: This study was performed to investigate the effect of manual acupuncture, invasive laser acupuncture and laser skin irradiation at LU8, LR4, HT8 and LR2(Liver Seunggyeok) on D-galN-induced liver injury in rats. Method: Liver injury was induced with D-galN. The experimental rats were divided four groups(Control group, EXP-1, EXP-2, EXP-3). In the Control group, liver injury-induced and not treated. EXP-1 group was liver injury-induced and carried out manual acupuncture with Young-Su(against the meridian course and following the course of the meridian) & Won-Bang(by twisting and rotating the needle) acupuncture method at Liver Seunggyeok. EXP-2 group was liver injury-induced and carried out invasive laser acupuncture at Liver Seunggyeok. EXP-3 group was liver injury-induced and carried out laser skin irradiation at Liver Seunggyeok. Result: In the change of body weight(in 1 week), EXP-1, EXP-2 and EXP-3 groups were significantly increased as compared with control group. In the change AST & ALT, EXP-1 and EXP-2 groups were significantly decreased as compared with control group. In the change of SOD, EXP-1, EXP-2 and EXP-3 groups were significantly increased as compared with control group. In the change of WBC, EXP-2 group was significantly increased as compared with control group. Conclusion: Manual acupuncture, invasive laser acupuncture and laser skin irradiation at Liver Seunggyeok had hepatotherapeutic effect on the treatment of hepatocytotoxity. Invasive laser acupuncture was as effective as manual acupuncture on the treatment of hepatocytotocity.

Saving a large volume of soft tissue by using an untailored composite graft after total degloving amputation of the hand: a case report

Kyung Jin Lee,Jae Yong Lee,Sung Hoon Koh,Jin Soo Kim,Si Young Roh,Dong Chul Lee 대한수부외과학회 2022 대한수부외과학회지 Vol.27 No.3

Total degloving amputations present surgeons with unique challenges to preserve function and prevent amputation of the digits. Obviously, the replantation of avulsed skin is the best option; however, there are situations in which vascular networks are severely contused, making it difficult to restore the circulation, due to the crushing mechanism of injury. As an alternative, defatted or meshed skin grafts from the avulsed skin have been proposed. However, those options have not been proven to guarantee viable digits. Moreover, the application of thinned skin grafts usually results in cosmetically and functionally unsatisfactory outcomes due to the lack of sufficient tissue volume. We present a case in which we successfully saved a large volume of the amputated stump with minimal digit amputation by performing a composite graft of the untailored (i.e., without defatting or meshing) avulsed skin on a totally degloved hand.

Skin injury occurrence estimation model for the wearable robot use and its experimental validation

Chang-Hwan Lee,Kwan-Woong Gwak 제어로봇시스템학회 2021 제어로봇시스템학회 국제학술대회 논문집 Vol.2021 No.10

The wearable robot"s support delivered to the human wearer induces various types of force and pressure interactions. Continued and repeated interaction of shear stress and normal pressure with human skin under the cuff eventually leads to pain and skin injury. In fact, redness and abrasions corresponding to pressure ulcers(PU) have been reported in real wearable robot use cases. In addition, the authors confirmed cases of similar outbreak of pressure ulcer through interviews with wearable robot users, physicians, and robot makers. However, studies on PU breakout mechanisms related to the use of wearable robots are very rare. Therefore, we developed the skin injury breakout time estimation model in the wearable robot use environment through the comprehensive analysis of PU breakout mechanism in general biomedical circumstances. Three major causes of PU and their relationship with breakout time were identified, and two unmeasurable causes of PU were converted into the measurable skin normal pressure by applying the friction coefficient and FEM analysis of human muscular skeletal tissue. Through this conversion process, it was possible to establish a pressure ulcer breakout time estimation model based on the measurable skin normal pressure. The proposed PU breakout time estimation model was validated through experiments with human subject.