The Relationship between Socioeconomical Status and Incidence of Facial Bone Fracture

PURPOSE: The human face is the most exposed part of the body, and in patients with simple or complex trauma from traffic accidents, industrial calamities, sports injuries, human assaults, and daily accidents, facial trauma occupies an important portion. The etiology of facial trauma vary on a society's economic, cultural, and environmental status. METHODS: Regarding patients who were admitted from between the years 2000 to 2009 at the Hanyang University hospital, the authors studied how the changes in the economic status in the past 10 years of our country influences the incidence of facial bone fractures. RESULTS: In this study, 1) The unemployment rate showed a strong negative relationship with the total number of inpatients with facial bone fractures, the number of male patients, the number of female patients, the number of patients with facial bone fractures caused by fall down, the number of patients who were admitted for shorter than 7 days, and the number of the facial bone fracture patients with their age in the twenties. 2) The consumer price index showed a strong positive relationship with the number of female patients, the number of patients who were admitted for shorter than 7 days, and the number of the facial bone fracture patients with their age in the teens and fifties. CONCLUSION: Looking at the results of correlation analysis and multiple regression analysis with economic indicators, the unemployment rate showed negative influence to the total number of inpatients with facial bone fractures, and the number of inpatients with facial bone fractures caused by fall down, with statistical significance.

Secondary Adjuvant Operation after Free Flap for Functional and Aesthetic Purposes

PURPOSE: The free flap has been widely used as one stage reconstructive procedure the skin and soft tissue defect. The secondary adjuvant operations are often needed for better results as functional and aesthetic compartment. Therefore, we focus on the secondary adjuvant surgeries for better outcome after free flaps. METHODS: One hundred ninety six consecutive patients underwent free flaps between January, 2002 and February 2009. The cases constituted ninety two male patients and one hundred four female patients. For the patients who got free flap operation, we investigated secondary adjuvant operations what type of procedures was applied according to the reconstructed sites. All clinical data were based on the patient's medical records. RESULTS: Of one hundred ninety six patients in whom free flap was performed, a total of eighty two patients(41.8%) received the secondary adjuvant operation. Because of many patients got multiple secondary adjuvant operations, the number of the secondary adjuvant operation become one hundred fifty five cases. The most common used procedure is a liposuction, and the second one is a lipoinjection. CONCLUSION: As the secondary adjuvant operation like a liposuction, lipoinjection, etc., satisfaction for operative result was increased in the aspects of function and aesthetics. So the secondary adjuvant operation in free flap surgeries contributed in raising the patient's quality of life.

Various Applications of Deep Inferior Epigastric Artery Perforator Free Flap

PURPOSE: The deep inferior epigastric perforator (DIEP) free flap is well known as an ideal donor site for the breast reconstruction. The flap can provide huge amount of fat tissue for breast and buttock contour, while it is also very useful as a thin skin flap to reconstruct the upper and lower extremities. We used a DIEP free flap in various site reconstructions besides the breast and would like to reinsure the usefulness of this flap. METHODS: Twenty nine consecutive patients who underwent DIEP free flap surgery from 2001 January to 2007 December were reviewed. The case constituted seven male patients and twenty two female patients. There were sixteen breast reconstructions, five face reconstructions, five lower extremity reconstructions, two upper extremity reconstructions, and one buttock contour reconstruction. All clinical data were based on the patient's medical records. RESULTS: All DIEP free flaps survived without major complications. There was no hematoma, seroma, or partial necrosis. The donor sites were closed primarily with linear scar on lower abdomen. The thinnest part of flap was 0.7cm in thickness. The size of the largest flap was 38 x 13 cm. The flaps were used in various types of skin and adipose tissue, adipose tissue only, and skin only according to the requirement of recipient site. CONCLUSION: The DIEP free flap was enough to provide a thin and huge flap for both breast and extremity reconstructions. It was able to provide versatile designs with sufficient adipose tissue. So we use it for 3-dimensional face and buttock contour reconstructions. The DIEP free flap is a valuable reconstructive donor for face, upper and lower extremity in addition to breast without compromising the integrity of abdominal wall.

Case Report of Angiosarcoma on Scalp(2 Cases)

PURPOSE: Angiosarcoma of the scalp is unusual vascular tumor originating from endothelial cell. Angiosarcoma is an aggressive tumor with high propensity for both local recurrence and distant metastasis. We report 2 cases of angiosarcoma having poor prognosis recently. METHODS: Case 1 was a 67-year-old male patient. He visited the hospital with a 3x5cm sized discolored mass in forehead. It began at one month ago from coming to the hospital. Case 2 was a 64-year-old male patient. He visited for our hospital to remove a 4x5cm sized scalp mass. He had a pruritis on scalp from 9 months ago before coming to the hospital. Despite of the conservative treatments, the wound was not healed and advanced necrotic lesion with hemorrhage. RESULTS: Case 1 was diagnosed as an angiosarcoma. He underwent a radical operation 5 times. But the tumor expanded multiple area in dura & frontal area of the brain. The patient rejected the treatment any more. And he died one month later. Case 2 was diagnosed as an angiosarcoma and metastased to skull in MRI. He got a radical resection including cranium. Three months later, it recurred to ipsilateral Sternocleidomastoideus muscle. He got a additional operation & started radiotherapy. And now he is receiving chemotherapy, but the recurred lesion is expanding. CONCLUSION: Angiosarcoma is a highly malignant tumor. Especially it arises in vascularized area, it easily metastases. So it is best to treat angiosarcoma with surgery included wide margins. Despite the small lesion, we remember that angiosarcoma is a tumor that was consider to be metastases.