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골괴사를 동반한 만성 방사선 궤양의 치료를 위한 피판술

Other Titles
 Various Flap for Treatment of Radiation Ulcer and Osteoradionecrosis 
Authors
 윤인식  ;  이원재  ;  정희선  ;  유대현  ;  탁관철 
Citation
 Journal of the Korean Society of Plastic and Reconstructive Surgery (대한성형외과학회지), Vol.35(2) : 174-180, 2008 
Journal Title
 Journal of the Korean Society of Plastic and Reconstructive Surgery  (대한성형외과학회지) 
ISSN
 1015-6402 
Issue Date
2008
Abstract
PURPOSE: While radiotherapy remains an essential part of the multidisciplinary treatment of cancers, it may cause unwanted consequences such as tissue break down and chronic non-healing wounds as a result of hypoxia, hypovascularity, and hypocellularity. The conservative treatment of osteoradionecrosis was effective only in the early stages or has a limited result. The surgical treatment of osteoradionecrosis includes various local fasciocutaneous flaps, local myocutaneous flaps and different kinds of free flaps with cancellous bone graft or alloplastic material after removal of all devitalized tissue. This study reviews recent cases of osteoradionecrosis in Severance hospital and investigates the use of various flaps for reconstruction of osteoradionecrosis. METHODS: From 2000 to 2006, a total of 29 patients, nine men and twenty women with a mean age of 60.4 years were identified and included in the study. Fasciocutaneous flaps were used on 7 patients and myocutaneous flaps were used on the remaining patients. Mean follow-up period was 10.4 months. RESULTS: In the fasciocutaneous flap group, we noted two complications including total flap failure and a partial flap necrosis. In the myocutaneous flap group, four complications were noted including a partial flap necrosis and 3 cases of wound dehiscence. Considering the complications noted in this study, the natural history of progression to flap necrosis appeared to follow the following sequence of events: marginal flap necrosis, infection, wound dehiscence, flap floating and partial flap necrosis, serially. CONCLUSION: Successful surgical treatment of osteoradionecrosis includes wide radical debridement and reconstruction with a well vascularized flap like myocutaneous flap or fasciocutaneous flap.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Lew, Dae Hyun(유대현)
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
Tark, Kwan Chul(탁관철)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107242
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