ABSTRACT
Diabetic patients have an increased risk of burn injuries on foot. Because of their diabetic neuropathy, they could contact with hot water or warming device without being aware of it. Split-thickness skin graft (STSG) is successful in treatment of various wound types; however, donor site wounds are sometimes problematic, and complications such as pain and impaired healing often occur. Although, donor site wounds in healthy young individuals can rapidly heal without complications, the wound-healing capacity of elderly patients or those with a comorbidity has been reported to be low. The dermatome is the most commonly used tool because it can harvest a large skin graft in one attempt. However, it is difficult to harvest tissues if the area is not flat. Furthermore, because the harvested skin is usually rectangular, additional skin usually remains after skin grafting. Therefore, use of razor blade and fragmented STSG on a large defect area is advantageous for harvesting a graft with a desired size, shape, and thickness. From January 2018 to July 2018, fragmented STSG was used in 9 patients who suffered from burn induced open wound on foot with diabetic neuropathy. With this approach, healing process was relatively rapid. The mean age of patients was 70 (57∼86 years) and all of 9 patients had diabetes mellitus type 2. In all patients, the skin graft on the defect site healed well and did not result in complications such as hematoma or seroma.
ABSTRACT
Background@#Subdermal shaving is a surgical procedure for the treatment of axillary osmidrosis. In this procedure, a direct axillary incision is made, and the apocrine glands are removed. Insufficient subcutaneous tissue removal during subdermal shaving can lead to recurrence due to the presence of remaining apocrine glands, while excessive removal can injure the subdermal plexus and cause skin necrosis. We measured the depth of the apocrine glands from the basement membrane of the epidermis to develop a quantitative method of determining the thickness of the skin flap to be removed. @*Methods@#A chart review of patients who underwent subcutaneous shaving to treat osmidrosis between 2012 and 2019 was performed. Axillary subcutaneous tissues were harvested from five randomly chosen patients with osmidrosis before and after surgery. The apocrine gland depth was then measured via immunofluorescence (IF) staining of the collected tissues. A questionnaire was administered to 10 of the patients to investigate postoperative outcomes. @*Results@#Of the 47 total patients, six (12.8%) experienced recurrence, seven (14.9%) had complications, four (8.5%) had skin necrosis, two (4.3%) had hematomas, and one (2.1%) had an infection. One patient underwent reoperation due to hematoma. IF staining revealed the mean distance from the basal layer of the epidermis to the apocrine glands to be 1.4312±0.8064 mm. On the questionnaire, the mean patient rating of axillary odor was 8.6 pre-surgery and 4.4 post-surgery. @*Conclusions@#During subdermal shaving, the subcutaneous tissue must be preserved up to 14.312±8.064 mm from the epidermal basement membrane to remove the apocrine glands while preserving the subdermal plexus.
ABSTRACT
BACKGROUND: Since the initial Research and Reconstruction Forum (R&R Forum) in 2011, the R&R Forum, Korean Society for Aesthetic Plastic Surgery (KSAPS), and Korean Society of Plastic and Reconstructive Surgeons (KSPRS) have held annual meetings. This study was conducted to provide updated information on the publication rate of presentations at those meetings. METHODS: Plastic surgery–related abstracts presented at the R&R Forum, KSAPS, and KSPRS between 2011 and 2015 were collected. The sessions were divided into free papers, posters, and e-presentations (or e-posters) for each annual meeting. Abstract publication status was confirmed through PubMed, Google Scholar, the KCI-Korean Journal Database, and the KMbase database. RESULTS: In total, 2,335 abstracts were presented in the free paper, poster, and e-presentation sessions. Of these, 622 (26.6%) were published. The overall publication rates were 240 of 684 abstracts (35.1%) presented at the R&R Forum, 56 of 216 abstracts (25.9%) presented at the KSAPS meetings, and 326 of 1,435 abstracts (22.7%) presented at the KSPRS meetings. In terms of specific annual meetings, the 2014 R&R Forum had the highest publication rate (39.9%), followed by the 2015 KSAPS (31.0%) and the 2015 KSPRS (28.8%). CONCLUSIONS: Scientific researchers present diverse results at these professional meetings, with a focus on innovative surgical techniques and improved surgical outcomes. This is our second study on this topic. Despite its limitations, this study indirectly shows that the recognition of Korean plastic surgeons and the quality of the annual meetings of Korean societies of plastic surgery have risen to the global level.
Subject(s)
Plastics , Publications , Surgeons , Surgery, PlasticABSTRACT
BACKGROUND: Lidocaine spray is a local anesthetic that improves random-pattern skin flap survival. The fractional ablative carbon dioxide laser (FxCL) produces vertical microchannels that delivers topically applied drugs to the skin. In this study, we hypothesized that FxCL therapy would enhance the lidocaine effect to improve random-pattern skin flap survival in rats. METHODS: McFarlane random-pattern skin flaps were elevated in 48 rats, which were divided into four groups according to treatment: FxCL+lidocaine, FxCL, lidocaine, and nontreatment (control). On postoperative day 7, necrotic flap areas, the number of capillary vessels, and neutrophil count were evaluated. Anti-rat vascular endothelial growth factor (VEGF) and CD31 antibody activity were also evaluated by immunohistochemical staining. RESULTS: Flap survival rate was 53.41%±5.43%, 58.16%±4.80%, 57.08%±5.91%, and 69.08%±3.20% in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Mean neutrophil count in the intermediate zone excluding the necrotic tissue was 41.70±8.40, 35.43±6.41, 37.23±7.15, and 27.20±4.24 cells/field in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Anti-rat VEGF and CD31 antibody activity were the highest in the FxCL+lidocaine group. CONCLUSION: FxCL with lidocaine had a positive effect on random-pattern skin flap survival in rats. Thus, FxCL with lidocaine spray should be considered as a new treatment option to improve flap viability.