Clinical analysis of factors affecting the failure of free flaps used in head and neck reconstruction.

Background: Free tissue transfer is the preferred method of reconstructing head and neck defects, with a success rate of approximately 95%. Although flap failure is uncommon, it has a major impact on patient morbidity and diminishes quality of life, making it is important to investigate the causes of flap failure.

Methods: This retrospective chart review analyzed patients who underwent free tissue transfer during head and neck reconstruction at a single institution between 2016 and 2021.

Treatment of malignant perivascular epithelioid cell tumor (PEComa) on the knee with an anterolateral thigh free flap: A case report.

Rationale: The World Health Organization defines a perivascular epithelioid cell tumor (PEComa) as a mesenchymal neoplasia composed of perivascular epithelioid cells with characteristic morphological and immunohistochemical features. Although PEComas have the potential to behave in a malignant fashion, malignant PEComas are extremely rare.

Patient Concerns: An 83-year-old man visited our clinic presented with palpable, painless, and movable mass in the right knee area.

Malignant melanoma associated with a plaque-type blue nevus of the cheek: a case report.

Blue nevi, which are characterized by collections of pigment-producing melanocytes in the dermis, have a variety of clinicopathological characteristics. Plaque-type blue nevus (PTBN) is a variant of blue nevi. PTBN presents at birth or arises in early childhood, and it shows a combination of the features found in common blue nevus and cellular blue nevus.

Limited eye movement caused by clumping of fibrin glue used in blowout fracture surgery: a care report.

Fibrin glue is a topical agent widely used for hemostasis, wound healing, and surgical adhesion. Complications of fibrin glue itself are extremely rare because it is absorbed over time, but can occur as a result of inappropriate application. We report a case of a postoperative complication caused by inappropriate application of fibrin glue in blow-out fracture surgery.

Does reduction of the oncologic safety margin for facial basal cell carcinoma result in higher recurrence rates?

Background: Wide surgical excision is the gold standard for basal cell carcinoma (BCC) treatment. Typically, resection requires a safety margin ≥ 4 mm. We aimed to confirm BCC excisions' cancer recurrence rate and safety on the facial region with new safety margins.

Fasciotomy in compartment syndrome from snakebite.

Background: Local symptoms and signs of snake envenomation mimic the clinical features of compartment syndrome. It is important to measure the intracompartmental pressure to diagnose compartment syndrome. In this study, we present our experiences of confirming compartment syndrome and performing fasciotomy in snakebite patients based on high intracompartmental pressure findings.

Epidemiologic study of hand and upper extremity injuries by power tools.

Background: Hand injuries caused by chain saws, electric saws, and hand grinders range from simple lacerations to tendon injuries, fractures, and even amputations. This study aimed to understand the distribution of various types of hand and upper extremity injuries caused by power tools, in order to help prevent them, by investigating the incidence and cause of power tool injuries treated over a 4-year period at a single institution in Korea.

Methods: We reviewed the medical records of patients who visited a single institution for power tool-induced injuries from 2011 to 2014.

Reconstruction of cutaneous defects of the nasal tip and alar by two different methods.

Background: The alar and nasal tip are important subunits of the nose. Determining the optimal procedure for reconstructing a cutaneous defect in a nasal subunit depends on several factors including size, location, and involvement of deep underlying structures. We treated cutaneous defects after tumor ablation in the alar and nasal tip with a local flap, using an S-shaped design and a modified V-Y advancement flap with a croissant shape.

Panfacial Bone Fracture and Medial to Lateral Approach.

Panfacial bone fracture is challenging. Even experienced surgeons find restoration of original facial architecture difficult because of the severe degree of fragmentation and loss of reference segments that could guide the start of facial reconstruction. To restore the facial contour, surgeons usually follow a general sequence for panfacial bone reduction.

Primary Cutaneous Mucinous Carcinoma Treated with Narrow Surgical Margin.

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant tumor of eccrine origin. Clinically, the carcinoma presents as a solitary, slow growing, and painless nodule. For this reason, this tumor is often considered to be a benign mass in the preoperative setting.

Effectiveness of Dual-Maneuver Using K-Wire and Dingman Elevator for the Reduction of Unstable Zygomatic Arch Fracture.

Background: The zygoma is the most prominent portion of the face. Almost all simple zygomatic arch fractures are treated in a closed fashion with a Dingman elevator. However, the open approach should be considered for unstable zygomatic arch fractures.

Effectiveness of Helmet Cranial Remodeling in Older Infants with Positional Plagiocephaly.

Background: Management of positional plagiocephaly by wearing a cranial molding helmet has become a matter of growing medical interest. Some research studies reported that starting helmet therapy early (age 5 to 6 months) is important and leads to a significantly better outcome in a shorter treatment time. The aim of the present study was to evaluate the effectiveness of cranial remodeling treatment with wearing helmet for older infants (≥18 months).

Zygomatic arch fracture: a new classification and treatment algorithm with epidemiologic analysis.

Determining the optimal method for zygoma fracture reduction is a common challenge. Numerous methods for treating zygomatic arch fractures have been suggested. However, a substantial gap exists between suggested treatment strategies and real-world practice.

Acellular Dermal Matrix to Treat Full Thickness Skin Defects: Follow-Up Subjective and Objective Skin Quality Assessments.

Background: There are several options for replacement of the dermal layer in full-thickness skin defects. In this study, we present the surgical outcomes of reconstruction using acellular dermal substitutes by means of objective and subjective scar assessment tools.

Methods: We retrospectively reviewed the medical records of 78 patients who had undergone autologous split-thickness skin graft with or without concomitant acellular dermal matrix (CGDerm or AlloDerm) graft.

A retrospective review of iatrogenic skin and soft tissue injuries.

Background: Even though the quality of medical and surgical care has improved remarkably over time, iatrogenic injuries that require surgical treatment including injuries caused by cast and elastic bandage pressure, extravasation, and dopamine-induced ischemia still frequently occur. The goal of this study was to estimate the incidence and analyze the distribution of iatrogenic injuries referred to our department.

Methods: A retrospective clinical review was performed from April 2006 to November 2010.

Multiple myopericytoma of the face and parotid gland.

Myopericytoma is a benign tumor that is composed of myoid-appearing oval to spindle-shaped cells with a concentric perivascular pattern of growth. The tumor is morphologically heterogeneous and can exhibit a broad histologic spectrum. We describe a case of multiple myopericytoma occurring in the head and neck skin region with involvement of the parotid gland where it is known to occur very rarely.

Croissant-shaped v-y advancement flap with 2 horns for repair of small- and medium-sized facial defects.

Background: The use of a V-Y advancement flap is an effective technique for the reconstruction of small facial defects. However, in some areas, the use of a conventional V-Y advancement flap is not possible because of the tension caused by size variation. In the current study, we modified this method using a croissant-shaped V-Y advancement flap and repaired intermediate-sized defects without difficulty.

Polymorphisms of 5,10-methylenetetrahydrofolate reductase and thymidylate synthase in squamous cell carcinoma and basal cell carcinoma of the skin.

Genetic instability resulting from mutations in repair genes, defects in folic acid metabolism or DNA synthesis has been reported to contribute significantly to the development of skin cancer. The enzymes 5,10-methylenetetrahydrofolate reductase (MTHFR) and thymidylate synthase (TS) are essential participants in folic acid metabolism and DNA synthesis. Thus, the present case-control study was conducted to determine whether an association exists between the MTHFR/TS polymorphisms and squamous cell carcinoma (SCC) and/or basal cell carcinoma (BCC) among Korean individuals.

Symplastic glomus tumor: a case report.

Symplastic glomus tumors are defined as glomus tumors with a high-grade nuclear pleomorphism in the absence of any other malignant features, such as large size, deep location, infiltrative growth, mitotic activity, or necrosis. Only 11 cases have been reported so far in the English literature. It could be a challenge for pathologists who have no experience with it because the tumor can show marked nuclear atypia and pleomorphism.

Polymorphisms in the DNA repair gene XRCC1 associated with basal cell carcinoma and squamous cell carcinoma of the skin in a Korean population.

DNA in most cells is regularly damaged by endogenous and exogenous mutagens. Unrepaired damage can result in apoptosis or may lead to unregulated cell growth and cancer. Inheritance of genetic variants at one or more loci results in reduced DNA repair capacity.

The use of anterolateral thigh perforator flaps in chronic osteomyelitis of the lower extremity.

From April of 2000 to May of 2003, 28 consecutive patients with chronic osteomyelitis of the lower extremity underwent surgical debridement and reconstruction with anterolateral thigh perforator flaps (six cases were combined with vastus lateralis muscle flaps). All wounds were open for a minimum period of 6 weeks (average, 24.7 months; range, 6 weeks to 52 months).

The effect of hyperbaric oxygen on ischemia-reperfusion injury: an experimental study in a rat musculocutaneous flap.

The effect of hyperbaric oxygen is known to increase survival of ischemic tissue but its mechanism is not fully understood. The purpose of this study was to evaluate the effect of hyperbaric oxygen on a rat musculocutaneous flap versus ischemia-reperfusion injury, focusing on the mechanism involving the expression of adhesion molecules such as intercellular adhesion molecule-1 (ICAM-1) of endothelial cells and CD18 of neutrophils. A transverse rectus abdominis musculocutaneous (TRAM) flap (6 x 5 cm) supplied by a single superior epigastric vascular pedicle was elevated in 100 Sprague-Dawley rats.

Reconstruction of fingertip and stump using a composite graft from the hypothenar region.

Finger amputation with bone exposure when replantation is not feasible requires a procedure for closure and padding of the stump. To preserve the length and provide adequate coverage, various flaps are used. A situation may occur in which local flaps are not sufficient and distant flaps are preferred.