One hundred forty nine cases of single digital replantation were performed in the digital amputated patients from March 1988 to December 1933. Prospective study for the postreplanted edema and late functional recovery was carried out in the 149 patients. For exclusion of additional effects on the edema in replanted digits, multiple finger replantations were excluded in this study.
The results of the analysis were as follows:
1) The early postreplanted edemas were decreased on the 28th postoperative day but it significantly persisted until the 28th postreplanted day.
2) The more increased edema was developed, the more decreased functional recovery rate was seen.
3) The early postreplanted edema was an injurious obstacle for late functional recovery. In conclusion, we try to persevere in our effort for revascularization of possible vein for reducing the postreplanted edema and make the patient early exercise.
The cleft lip nose deformity is caused by multiple factors that include displa-cement of the lower laterial cartilage, with flattening and false lengthening on the cleft side with shifts of the columella, septum and underlying skeletal base. Many plastic surgeons have felt that early rhinoplasty in cleft lip interferes with the growth of nose, causes increased deformity. Then this study was performed to find the result of the early surgery in the clefe nasal recon-struton.
The alar cartilage was repositioned by freeing it from the skin and nasal lining without its exposure through the incision of cleft lip repair and shifting it to a new position at the time of pirmay cleft lip repair. The repositioned lower lateral cartilage was stabilized in its new position by using through and througn sutures tied over stents. These stent sutures went through the skin, cartilage and nasal lining. The nasal soft tissues were released from the skele-tal base, reshaped.
Improvement in the cleft nasal deformity is noted in most cases. Especially the colu-mella inclination was completely corrected. The nasal dome on the cleft side shows the good contour and projection of the tip, which projects in an equal fashion to the concleft side. The nasal alar symmetry with equal projection of the lobule was observed on the cleft and noncleft side.
Early surgical correction of cleft lip nose deformity doesn't interferes with the growth of nose and promotes more normal grown by early proper contour and position of the lower lateral cartilage. It is more important to take better psychological development and good self-image before the adverse effedct of deformity cause damage.
, Jin Han Cha For coverage of sacral pressure sore, the gluteus maximus musculocutaneous flap had been used commonly. We covered these sacral defect with the gluteus maximus fasciocutaneous flap. Forty three parients with relatively large(average 8×8cm) sacral grade IVpressure sores underwent bilateral gluteus maximus fasciocutaneous flap and donor site was closed as a V-Y advancement. The mean postoperative follow up was 32 months, with a range of 4 to 53months. Using this technique, we achieved uniformly good results and minimal complication. There is no recurrance in our cases. We believe that the V-Y advancement technique using the fasciocutaneous unit has some major advantages for repair of large sacral defects. It is a safe, simple, and less invasive method. The purpose of this presentation is to demonstrate our encouraging experience with this surgical modality.
, Kin Han Cha, Yang Woo Kim Reports suggesting that the tendon itself could play is a significant part in the repair process without provision of microcirculation. To investigate the importance of nutritive environment in the healing of reconstructed tendons, the morphology of sutured free tendons in the synovial fluid of the knee joint, without resstablishment of micrecirculation,was studied in rabbits.
The strip of flexor tendon was harvested and divided 2 pieces and repaired with interrupted suture. The knee joit then opened medially through a small incision and repaired tendon strip was transplanted into the open knee joint. After 2 weeks(n=10), 4 weeks(n=10), 6 weeks(n=10) and 8 weeks(n=10), the sutured tendon was removed from the joint and examined histology and measured tensile strength.
Mactoscopically the surface of all piece was smooth and glistening. Fibroblasts were appeared in the sutured gap and produced collagen fiber and after 6 weeks many portions of collagen fibers were maturated. The gain of tensile strength was proportional to the time till 8 weeks.
The findings indicate that diffusion of nutrients may be important for the survival and reconstresstablishment of the microcirculation.
, Kin Han Cha, Yang Woo Kim The exact mechanism by which flexor tendons heal after injury is still not completely clear. Understanding the response of tendon to injury and repair is important to the practicing surgeon who seeks better clinical results. This stuty was intended to determine the course of tendon healing and the gain of tensile strength in the circumstance of normal conditions.
Flexor tendons on both lower extermities were divided and repaired with mersilene 4-0 in rabbits and after 2,4,6,8, weeks we obtained the pieces of tendons and have studied the histologic changes and measured tensile strength as time passed.
Histologically fibrobalst-like cells were proliferated on the epitenon and migrated into the suture site and produced collagen fibers in the central area. Tensile strength was proportionately increased until 8 weeks and well correlated with histologic findings.
In conclusion, healing of the repaired tendon was initiated on the surface area and gained tensile strength with time passed.
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