Faculty Profiles - HASHIKAWA Kazunobu

Papers - HASHIKAWA Kazunobu

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野村正, 橋川和信, 寺師浩人

Ｓｋｉｎ　Ｃａｎｃｅｒ Vol. 30 ( 3 ) page： 157 - 162 2015

NOMURA Tadashi, OSAKI Takeo, ISHINAGI Hiroyoshi, MORIWAKI Aya, TAKASU Hiroyuki, EJIRI Hirotaka, SAKAKIBARA Shunsuke, HASHIKAWA Kazunobu, TERASHI Hiroto

Journal of Japanese Society of Reconstructive Microsurgery Vol. 27 ( 3 ) page： 79 - 88 2014

Language：Japanese Publisher：Japanese Society of Reconstructive Microsurgery

The goal for foot reconstruction is to restore the structure and walking function. To achieve this goal, it is important to assess precisely the defects in anatomical structure, residual function, reconstructive procedure, and postoperative therapy, including rehabilitation and fitting of braces or footwear. We experienced twelve free tissue transfers and thirteen pedicle skin flaps for foot reconstruction in our hospital or branch hospitals. In all cases, tailored braces or footwear were used postoperatively under advice from a prosthetist. The free flaps we selected were: one rectus abdominis musculo-cutaneous flap, six latissimus dorsi musculo-cutaneous flaps, three groin flaps, a free scalp flap, and a scapular flap. Two of the patients who underwent free latissimus dorsi musculo-cutaneous transfer had a failed procedure due to vascular thrombus. The pedicled flaps we used were: six distally based sural flaps, five medial plantar flaps, and two lateral calcaneal flaps. Partial flap necrosis was encountered in two of six distally based sural flaps. Ulceration developed in one flap due to bulkiness. As restoring foot contour is ideal for foot reconstruction, we conclude that using thin flaps or thinning of flaps avoids bulkiness. Subsequent footwear fitting is also very important.

DOI： 10.11270/jjsrm.27.79

CiNii Research

The Various Flap Monitoring after Free Flap Transfer

SAKAKIBARA Shunsuke, NOMURA Tadashi, TAKASU Hiroyuki, HASHIKAWA Kazunobu, TERASHI Hiroto

Journal of Japanese Society of Reconstructive Microsurgery Vol. 27 ( 3 ) page： 72 - 78 2014

Language：Japanese Publisher：Japanese Society of Reconstructive Microsurgery

The development of microvascular surgery has been contributed the patients' quality of life after the expanded resection of malignant tumor or large tissue defect caused by trauma. On the other hand, vascular complication, such as thrombosis, relates to the flap necrosis and strict monitoring of flap condition is necessitated. We basically monitor the flap every 4 hours for 5 days by inspection or palpation. In addition, we have been introduced blood glucose measurement, regional oxygen saturation index ( rSO2 ), pulse oximeter ( SpO2 ) and indocyanine green fluorescent ( ICG ) imaging for flap auxiliary monitoring. Because each of those methods has advantage and disadvantage, understanding of characteristics of each methods may helps us the earlier detection of vascular trouble, which directly relate to the flap salvage rate.

DOI： 10.11270/jjsrm.27.72

CiNii Research

Summary of the chairmen

HASEGAWA Kazuki, HASHIKAWA Kazunobu

Journal of Japanese Society of Oral Oncology Vol. 26 ( 3 ) page： 53 - 53 2014

Review of Critical Limb Ischemia Patients Requiring Major Amputations Because of Invasive Infection after Revascularization

Nishio Yumi, Sakakibara Shunsuke, Terashi Hiroto, Hashikawa Kazunobu, Tahara Shinya

Japanese Journal of Surgical Wound Care Vol. 5 ( 4 ) page： 189 - 193 2014

Language：Japanese Publisher：Japan Society for Surgical Wound Care

In patients with critical limb ischemia ( CLI ) who have an intractable ulcer of the lower limbs, there is a higher level of need for an amputation due to severe infection after revascularization. Three out of the thirteen patients with CLI ended up with major amputations in the past five years. A comparative study was performed between these patients and those who were cured by only minor amputations. Patient factors in the comparative study included age, sex, medical history of diabetes and chronic kidney disease, diabetes medication, history of lower limb amputation on the other side, complement-reactive protein ( CRP ) levels before and after revascularization and in the early period after local surgery, and serum albumin ( Alb ) before local surgery. The patient risk factors of major amputation were late diabetic nephropathy, history of lower limb amputation on the other side and under-nutrition. There was a possibility of major amputations if patients had high CRP levels early after they completed local surgeries compared with those after revascularization. Perioperative CRP levels may be one of the indicators to use in order to avoid major amputations.

DOI： 10.11310/jsswc.5.189

CiNii Research

A case of an uncontrollable fistula after incisional drainage of submandibular necrotizing fasciitis treated by Negative Pressure Wound Therapy with a V.A.C.® ATS system

SAKAKIBARA Akiko, SAKAKIBARA Shunsuke, MINAMIKAWA Tsutomu, SHIGETA Takashi, HASHIKAWA Kazunobu, KOMORI Takahide

Japanese Journal of Oral and Maxillofacial Surgery Vol. 60 ( 2 ) page： 71 - 75 2014

Language：Japanese Publisher：Japanese Society of Oral and Maxillofacial Surgeons

Necrotizing fasciitis is treated by incisional drainage or immediate debridement. Generally, an infected wound should not be sutured or closured, but should be allowed to secondarily heal as an open wound. Treatment of necrotizing fasciitis involving the neck or submandibular region requires careful attention to major blood vessels or nerves. We therefore could not perform debridement radically. The wound should be continuously irrigated or applied ointment, but the presence of a fistula sometimes leads to prolonged wound healing. We describe our experience with an uncontrollable fistula attributed to debridement of submandibular necrotizing fasciitis, although irrigation had been continued for 6 weeks. After performing Negative Pressure Wound Therapy, with a V.A.C.® ATS system good granulation tissue proliferated in 3 days, and the fistula disappeared. The wound completely healed in 1 week. Furthermore, the clinical course has been good, with no recurrence of a fistula after 3 months. We report a case of early healing of an uncontrollable fistula treated by a V.A.C.® ATS system.

DOI： 10.5794/jjoms.60.71

CiNii Research

CAT classification system and CAT concept for reconstruction of oncological mandibular defects (Review Article)

Hashikawa Kazunobu

Journal of Japanese Society of Oral Oncology Vol. 26 ( 3 ) page： 57 - 62 2014

Language：Japanese Publisher：Japanese Society of Oral Oncology

This article reports a new classification system and a practical theory in surgical reconstruction for segmental mandibular defects after oncological ablative surgery: the "CAT classification system" and the "CAT concept". The CAT classification system classifies a mandibular defect with three letters indicating reference points: "C" signifies loss of the condylar head of the mandible, "A" the mandibular angle and "T" the mental tubercle. For example, the defect is described as "A" when the mandibular angle is segmentally resected, as "CA" when the condylar head and the mandibular angle are resected, as "CAT" when the entire hemi-mandible is resected, as "ATT" when the angle and the bilateral mental tubercle are resected, as "body" when only the mandibular body is resected and the angle and the mental tubercle are preserved, and as "neck" when only the mandibular ramus is resected and the condylar head and the angle are preserved. The CAT concept is a theory that is necessary and sufficient to reconstruct three reference points of the CAT classification system ("C", "A" and "T") in order to reconstruct oncological segmental mandibular defects. Previous studies showed that the CAT system and CAT concept are highly practical and useful in the standardization of mandibular reconstructive surgery.

DOI： 10.5843/jsot.26.57

CiNii Research

発症後長期経過した顔面神経不全麻痺例に対するクロスリンク型神経移植術 Reviewed

橋川和信

Facial Nerve Research Vol. 34 page： 32 - 34 2014

顔面神経麻痺再建法における定義ならびに呼称～Fukushima提言～ Reviewed

橋川和信

日形会誌. Vol. 34 page： 783 - 796 2014

Clinical Evaluation of Cases with Maxillectomy Reconstructed by Both Free Flap and Dento-maxillary Prosthesis

KOBAYASHI Masaki, SHIBUYA Yasuyuki, ISHIDA Yu, MINAMIKAWA Tsutomu, YOKOO Satoshi, HASHIKAWA Kazunobu, KOMORI Takahide

Vol. 35 ( 2 ) page： 37 - 45 2012.12

Novel theory for surgical reconstruction of segmental mandibular defect : CAT concept

HASHIKAWA Kazunobu, SUGIYAMA Daisuke, YOKOO Satoshi, TAHARA Shinya

Vol. 38 ( 1 ) page： 84 - 89 2012.4

The Fillet Toe Flap in Toe Amputation

Sakakibara Shunsuke, Terashi Hiroto, Sakurai Sayuri, Hashikawa Kazunobu, Tahara Shinya

Japanese Journal of Surgical Wound Care Vol. 3 ( 3 ) page： 123 - 128 2012

Language：Japanese Publisher：Japan Society for Surgical Wound Care

Toe amputation for chronic ulcers associated with osteomyelitis or malignant tumor requires additional metatarsal bone resection for covering the stump ; alternatively, the stump is kept raw and skin is grafted after the formation of granulation. The fillet toe flap is one of the options for primary coverage of the stump when the lesion is restricted to half the side of the toe and the digital artery is preserved after the lesion is resected. Minimization of the level of amputation is related to improvements in ADL after surgery. Moreover, because long rest causes disuse atrophy, early healing is desirable. Although the fillet toe flap is used only in special cases, it could be used as a sensory flap. We believe the use of the fillet toe flap deserves more widespread consideration in toe amputation.

DOI： 10.11310/jsswc.3.123

CiNii Research

Brow Lift via an Infrabrow Approach for Facial Palsy

HASHIKAWA Kazunobu, SAKAKIBARA Shunsuke

Vol. 31 page： 136 - 138 2011.12

True pedicled fibular graft による脛骨遠位骨欠損の再建

高須啓之, 寺師浩人, 橋川和信, 政岡浩輔, 田原真也

日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery Vol. 31 ( 10 ) page： 716 - 720 2011.10

The Elementary Analysis by X-ray Fluorescense : An Examination of Implant on Upper Eyelid

SAKAKIBARA Shunsuke, HASHIKAWA Kazunobu, SUGIMOTO Isao, KAJITA Satoru, TAHARA Shinya

Vol. 27 ( 3 ) page： 292 - 296 2011.9

仙尾骨・皮膚全層欠損に対して両側 hatchet 型大殿筋皮弁による再建を行った1例

田村亮介, 牧口貴哉, 橋川和信, 寺師浩人, 田原真也

日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery Vol. 31 ( 1 ) page： 43 - 46 2011.1

Iliac Cancellous Bone Graft for Orbital Floor Reconstruction

Hashikawa Kazunobu, Sakakibara Shunsuke, Terashi Hiroto, Tahara Shinya

Japanese Journal of Surgical Wound Care Vol. 2 ( 3 ) page： 97 - 103 2011

Language：Japanese Publisher：Japan Society for Surgical Wound Care

Various grafts with autogenous bone, cartilage, and alloplastic substitutes have been used for orbital floor reconstruction in surgery of facial fractures. Nevertheless, none has been the gold standard of graft material. We have demonstrated good clinical results in cases of pure blowout fracture in which the orbital floor was reconstructed with iliac cancellous bone sheets used as graft material. Here, we detail our surgical technique for orbital floor reconstruction with iliac cancellous bone. The outline of our procedure is as follows: 1)to approach the orbital floor, mainly the subciliary incision is used, 2)the orbital content herniating into the maxillary sinus is repositioned, and the fracture and defect site are exposed subperiosteally, 3)a bone block, a few millimeters thick, is harvested from the inner aspect of the ileum, 4)the cortical bone of the harvested block is burred away and thinned to about a 1 mm-thick cancellous bone sheet, 5)the sheet can be adequately trimmed with surgical scissors, 6)the sheet is placed onto the orbital floor to cover the defect, without any fixation. The iliac cancellous bone graft is as pliable and flexible as to fit the delicate curve of the orbital floor, and as soft as to cut easily with surgical scissors. We consider it the most appropriate material for orbital reconstruction.

DOI： 10.11310/jsswc.2.97

CiNii Research

Facial-Hypoglossal Nerve Cross-Link Surgery and Subsequent Facial Neuromuscular Retraining for Sequelae of Facial Palsy Reviewed

HASHIKAWA Kazunobu, SAKAKIBARA Shunsuke, TAHARA Shinya

Journal of Japanese Society of Reconstructive Microsurgery Vol. 24 ( 3 ) page： 267 - 274 2011

Language：English Publisher：Japanese Society of Reconstructive Microsurgery

Weakness, hypertonicity, loss of isolated control and/or synkinetic movement of the facial mimetic muscle are common sequelae after facial palsy, unlike disruption of nerve continuity as in Bell's palsy or Hunt's syndrome. Here we describe a surgical procedure and postsurgical rehabilitation for the treatment of such sequelae. The surgical procedure comprises facial and hypoglossal nerve cross-linking that connects the nerves by an interpositional nerve graft with end-to-side anastomosis. For postsurgical physical rehabilitation, patients are instructed in the following techniques for facial neuromuscular retraining: 1) to practice isolated facial motion in front of a mirror (mirror-biofeedback technique); 2) to avoid gross voluntary movement both during practice and in daily life; and 3) to frequently massage and stretch the affected facial muscle. Between December 2005 and May 2008, twenty patients with sequelae after facial palsy were treated by our rehabilitation technique. Sixteen patients showed improvement in abnormal facial movement, while four did not. None of the patients developed facial synkinesis associated with tongue motion. Our surgical procedure and postsurgical rehabilitation exercises are alternative techniques for the sequelae of facial palsy.

DOI： 10.11270/jjsrm.24.267

CiNii Research

四肢リンパ浮腫に対するリンパ管静脈吻合術 Reviewed

橋川和信

形成外科 Vol. 54 page： 1263 - 1274 2011

顔面神経麻痺後遺症に対する顔面-舌下神経クロスリンク手術と術後リハビリテーション Reviewed

橋川和信

日本マイクロ会誌 Vol. 24 page： 267 - 74 2011

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