Reconstruction of Regions Below the Knee Using Island Flaps

PURPOSE: The lower leg often has poor vascularity, proximity to bone, and insufficient soft tissue. The island flaps offer a feasible one stage reconstruction and has a remarkable vascularization and high quality results for soft tissue defect with or without bony problems to occur on regions below the knee. So we reported our experience of island flaps with review of the literatures. METHODS: We reconstructed 29 cases of soft tissue and 2 cases of bony defect on regions below the knee by using various island flaps at our hospital from December, 1991 to January, 2006. We used 2 fibular osteocutaneous island flaps, 15 reverse sural island flaps, 6 extensor digitorum brevis muscular island flaps, 2 medial plantar island flaps, 5 saphenous island flaps, and a dorsalis pedis island flap. RESULTS: Partial necrosis was developed in 4 out of 15 reverse sural island flaps and 1 out of 5 saphenous island flaps, but they were healed with secondary skin graft. There was partial loss of skin graft on the donor sites in 2 cases. CONCLUSION: Island flaps are very useful for reconstruction of regions below the knee because island flaps have good vascularity and less risk of infection. Generous flap size, easy operative technique, lower cost, shorter operative time, and minimal morbidity at the donor site are other advantages. We attained satisfactory results.

A Case of Elastofibroma

PURPOSE: Elastofibroma is a rare benign tumor that is characterized histologically by the presence of abnormal elastic fibers within a stroma of fibroadipose tissue. Usually it is slow-growing, solid, ill-defined mass occurring chiefly in elderly woman and arising from the soft tissue around the inferior angle of the scapula. METHODS: We experienced a representative case of elastofibroma. A 73-year-old women complained of a soft-tissue mass, which measured 6x6cm, at the inferior angle of the left scapula, which had been found incidentally 4 months before. When the arm was elevated, the mass projected out beneath the scapula. The entire mass was resected with a tumor-free margin. RESULTS: The resected tumor appeared to be nonencapsulated, fibrous and white mass, and it contained yellow fatty streaks. We confirmed that the histopathologic diagnosis of this tumor was elastofibroma. Follow- up examination revealed no evidence of local recurrence for 10 months. CONCLUSION: This entity is rarely reported in Korea. However, more patients could be diagnosed if physicians pay more careful attention to clinical and radiological features of elastofibroma. Moreover, recognizing the benign nature of this lesion is important to avoid an unnecessary operation.

The Effect of Low-power Laser on the Murine Hair Growth

Low-power laser(LPL) delivers a small amount of energy without elevation of tissue temperature. LPL has been reported to have biostimulation effects including anti-inflammatory, analgesic, regenerative, immunocorrective, and vasodilative effects. However, the effect of LPL on hair growth has rarely been studied. We investigated the effect of LPL on hair growth in the mouse. After depilation of back skin of mice, we classified the mice into 4 groups: control, laser irradiated group, MoandMore(R) applied group, and Spella 707(R) applied group. Laser irradiation or application of these drugs were performed on the back skin of the mice for 30 days. The results are summarized as follows. Hair growth of control was first observed at 13 days after depilation, and complete hair regrowth was observed at 25 days. Hair growth of both laser irradiation group and MoandMore(R) applied group was first observed at 9 days after depilation, and complete hair regrowth was observed at 20 days. Hair growth of Spella 707(R) applied group was firstly observed at the 9 days after depilation, and complete hair regrowth was observed at the 15 days. Hair growth started at the irradiation site in the laser irradiation group, but it started at the random sites in other groups. In conclusion LPL irradiation have a stimulating effect on the hair growth in the mouse.