- Reconstruct yourselfedit
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Aim: Adding platelet-rich plasm (PRP) or mesenchymal stem cells are the most accepted methods to increase fat graft’s permanence. However, there is no consensus on timing and whether the effect of stem cells or PRP is observed more in the... more
Aim: Adding platelet-rich plasm (PRP) or mesenchymal stem cells are the most accepted methods to increase fat graft’s permanence. However, there is no consensus on timing and whether the effect of stem cells or PRP is observed more in the recipient area or in the donor area. It is aimed to present the application method and localization of PRP to be combined with fat graft to increase the survival. Material and Methods: in vitro part: Fat grafts were kept in a medium containing PRP. Cell output from the fat graft to the Petri dishes was examined every day. The time to recruit the maximum number of stem cells to the medium was determined (day 10). in vivo part: Eight group of rats were received PRP in different concentrations either to recipient or donor areas of fat grafts. After ten days, fat grafts were transferred to the recipient area. Ninety days after the transfer, histopathological examination and immunohistochemical staining were performed. Results: The group which had recei...
Aim Primary cleft lip and palate (CLP) repair is the most critical stage throughout lifetime. CLP surgery involves risks of surgery and anaesthesia related complications. In this study, it was aimed to evaluate complications occurred in... more
Aim Primary cleft lip and palate (CLP) repair is the most critical stage throughout lifetime. CLP surgery involves risks of surgery and anaesthesia related complications. In this study, it was aimed to evaluate complications occurred in early period after primary CLP surgery and to determine early factors that trigger these conditions. Materials and Methods In this study 328 surgeries of 271 CLP patients were included. Complications were classified as minor complications such as fever occurring within first 3 days. Complications that cannot be treated with palliative care or required transfer to intensive care were considered as major complications. Epidemiology and causal link of early complications were statistically evaluated. Results Early complications were seen in 19% (n: 63) of all cases that operated for cleft lip and palate. Among them rate of minor complications were 9% (n: 25). It was determined that prolongation of anaesthesia lead to rising of minor complications such a...
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Giris: Ust goz kapagina altin agirlik yerlestirilmesi, lagoftalmi tedavisinde genel kabul gormus bir yontemdir. Ingilizce literaturde “custom-made” olarak gecen sekilde kisiye ozel yapilabilecegi gibi hazir ticari form olarak veya kuyumcu... more
Giris: Ust goz kapagina altin agirlik yerlestirilmesi, lagoftalmi tedavisinde genel kabul gormus bir yontemdir. Ingilizce literaturde “custom-made” olarak gecen sekilde kisiye ozel yapilabilecegi gibi hazir ticari form olarak veya kuyumcu araciligiyla da temin edilebilir. Istenmeyen postoperatif sonuclari onlemek icin klinigimizde uygulanan algoritmanin paylasilmasi amaclanmistir. Gerec ve yontem: 2012-2014 yillari arasinda lagoftalmi icin altin implantla tedavi planlanan 7 hasta icin preoperatif agirlik testi, oturur pozisyonda bekletme, delikler acildiktan sonraki agirligin saptanmasi, altin agirligin iki kez denenmesi ve sterilizasyon islemleri uygulandi. Erken ve gec komplikasyonlar, altin gramaji ve maliyet degerlendirildi. Bulgular: Hastalarin hicbirinde erken veya gec komplikasyona rastlanmadi. Goz kapaginda tam kapanma elde edildi. Hastalarin estetik degerlendirmeleri, hekim degerlendirmesinden daha iyi olarak saptandi. Sonuclar: Altin implant tedavisinin basarisini belirley...
Research Interests: Medicine and Gynecology
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Endoscopic treatment of maxillofacial fractures is a minimally invasive method and which is the application of a different way of open reduction internal fixation (ORIF) procedure. Between April 2013-December 2013, 13 patients admitted... more
Endoscopic treatment of maxillofacial fractures is a minimally invasive method and which is the application of a different way of open reduction internal fixation (ORIF) procedure. Between April 2013-December 2013, 13 patients admitted with maxillofacial trauma were treated with this method. All patients were evaluated clinically and radiographically. In the course of postoperative evaluation, two minor and one major complications were observed in 3 patients in total. In other patients, satisfactory results were obtained. In our study, in accordance with the data obtained from these patients, operative techniques have been described in detail and the results were compared with literature. We suppose that endoscopic surgery, which we consider as a different and innovative method for maxillofacial trauma surgery, will take part of standard treatment protocols with appropriate patient, equipment and experience. Keywords: endoscopic management, maxillofacial fractures, minimal invasive
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Background Various local techniques have been successfully used for the reconstruction of auricular defects. However, most local techniques are not suitable for extensive auricular defects. The aim of this study is to investigate the... more
Background Various local techniques have been successfully used for the reconstruction of auricular defects. However, most local techniques are not suitable for extensive auricular defects. The aim of this study is to investigate the utility of a retroauricular artery perforator–based propeller flap for the reconstruction of extensive auricular defects by evaluating aesthetic outcomes using objective and quantitative parameters. Methods Twenty-one patients with extensive full-thickness and partial-thickness defects were treated with retroauricular artery perforator–based propeller flaps harvested from the mastoid and neck regions. The surgical procedures were performed using single-stage reconstruction in postauricular partial-thickness defects and 2-stage reconstruction in full-thickness auricular defects. Levels of final satisfaction and tissue matching as well as donor scar perception were evaluated by the patients and objective observers. Results The original sizes and projectio...
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Objectives Better healing results of any tissue or area is closely linked with a well-blood supply in reconstructive surgery. Peripheric nerve healing is closely related to blood supply as well. We aimed to assess whether there was any... more
Objectives Better healing results of any tissue or area is closely linked with a well-blood supply in reconstructive surgery. Peripheric nerve healing is closely related to blood supply as well. We aimed to assess whether there was any difference between digital nerve healing with and without extrinsic blood supply. Methods We assessed 48 patients with unilateral digital nerve injury at zone 2. Twenty-four of them had unrepairable arterial injury and other 24 had no arterial injury. The 24 patients in the “unrepaired artery group” (UA) and 24 patients in the “intact artery group” (IA) were compared. Results Mean follow-up time was 17.7 months. The mean two-point discrimination (2PD) was 5.29 mm in IA group and 5.37 mm in UA group. One neuroma in IA group and two neuromas in UA group were determined. We found no statistically significant difference between these groups in terms of neuroma, 2PD, and cold intolerance. The results of British Medical Research Council sensory recovery cli...
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Foreign bodies are common entities found in hand surgery practice. However, they are a very rare cause of the acute cubital tunnel syndrome. A 48-year-old male patient was consulted for cubital tunnel symptoms after 2-day unconscious... more
Foreign bodies are common entities found in hand surgery practice. However, they are a very rare cause of the acute cubital tunnel syndrome. A 48-year-old male patient was consulted for cubital tunnel symptoms after 2-day unconscious state in the intensive care unit. The ulnar nerve was explored, a piece of glass was removed inside the cubital tunnel, and the nerve was repaired. However, compression neuropathy symptoms due to the acute trauma are interesting. Nerve laceration with a foreign body should be considered in acute-onset cubital tunnel syndrome, in which the foreign body history of a trauma patient cannot be determined explicitly.
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Vascular malformations are developmental anomalies of vessels, and arteriovenous malformations are the vascular malformations with the high-flow pattern. Arteriovenous malformations are most often located in the head and neck region. The... more
Vascular malformations are developmental anomalies of vessels, and arteriovenous malformations are the vascular malformations with the high-flow pattern. Arteriovenous malformations are most often located in the head and neck region. The upper extremity location for arteriovenous malformations is relatively rare. A case of intramuscular, symptomatic, forearm arteriovenous malformation is reported. The 11-year-old female patient was referred with pain, and clinical examination revealed a deep mass on the volar side of the forearm. Ultrasonography revealed a high-vascularized mass which was intraoperatively identified inside the flexor digitorum superficialis muscle fibers and MRI was revealed with no connections with the neurovascular structures. The mass was safely excised inside the muscle fibers. Located both in the forearm and inside the muscle fibers show the infrequency of presented arteriovenous malformation. Surgical excision may be a reliable option for these masses because of being symptomatic and focal.
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Free extensor digitorum brevis muscle flap in facial paralysis, and the second metatarsophalangeal joint flap is used at the temporomandibular joint reconstruction for a long time. Anatomically, these flaps can be harvested through even... more
Free extensor digitorum brevis muscle flap in facial paralysis, and the second metatarsophalangeal joint flap is used at the temporomandibular joint reconstruction for a long time. Anatomically, these flaps can be harvested through even the same pedicle flap even on the same regions. Literature is available of their usage along with the use of hand and upper extremity reconstruction. Unlike this example, the authors have used these flaps in maxillofacial region where facial paralysis and temporomandibular joint reconstruction will be performed together. In this study, clinical report and surgical details of this flap have been shared.
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Objectives: Adhesions around the flexor tendons block tendon gliding. The most common problem in secondary surgery is inadequate and ineffective tenolysis. Local anesthesia facilitates patient comfort and early active mobilization, which... more
Objectives: Adhesions around the flexor tendons block tendon gliding. The most common problem in secondary surgery is inadequate and ineffective tenolysis. Local anesthesia facilitates patient comfort and early active mobilization, which is very important after tenolysis surgery and even surgery without tourniquet. This study presents a tenolysis series managed with local anesthesia. Methods: We performed 22 tenolysis surgeries for zone 1 and zone 2 tendon adhesions under local infiltration anesthesia. If active flexion was achieved due to unblocked motor function, we removed the screen between the surgery area and patient to allow the patient to view their own movement. Results: There was 1 relapse. However, the results of the remaining patients were good or excellent. Discussion: This anesthesia technique enables comfortable surgery without tourniquet, unblocked motor function, and less postoperative pain. Preserving motor function is crucial for evaluating the adequacy of tenolysis intraoperatively. We recommend local infiltration anesthesia for suitable patients undergoing tenolysis.
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Introduction Plantar fibromatosis is a rare hyperproliferative disease of plantar aponeurosis and is also called Ledderhose disease. Case properties and treatment are discussed in this report. Case Report A 30-year-old man presented with... more
Introduction Plantar fibromatosis is a rare hyperproliferative disease of plantar aponeurosis and is also called Ledderhose disease. Case properties and treatment are discussed in this report. Case Report A 30-year-old man presented with painful bilateral plantar nodules. He had multiple and bilateral fixed and solid nodules on the plantar and medial side of his feet measuring 1 cm each. Ultrasound was performed and hypoechoic homogeneous nodules were detected. The patient underwent surgery, and the nodes were removed via a plantar incision with 2-cm safety distance. Discussion Ledderhose disease is a rare, hyperproliferative disorder of the plantar aponeurosis. The nodules are slow growing and found in the medial part of the plantar fascia. The precise etiology remains unknown. The treatment options are conservative management, steroid injections, radiotherapy, and surgery. Conclusion The main cause of this disease remains uncertain. Related conditions should be evaluated, and a pa...
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METHODS: 60 patients who had non-melanocytic skin cancer on the only nasal tip were included in this study. There was no previous history of nasal surgery, allergic rhinitis, concha hypertrophy and other breathing problems in any... more
METHODS: 60 patients who had non-melanocytic skin cancer on the only nasal tip were included in this study. There was no previous history of nasal surgery, allergic rhinitis, concha hypertrophy and other breathing problems in any patients. Six patients were treated with forehead flap, ten patients nasolabial island flap, twenty patients bilobe flap that based on inferior, 24 patients bilobe flap that based on superior. Function of the internal and external nasal valves were evaluated by preoperative and postoperative comparison of Cottles test, nasal endoscopy and digital phography of nares during forced inspiration and expiration and were followed up 1-years.
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In this case report, combined treatment of female patient with skeletal and dental Class III malocclusion with orthodontic-orthognathic surgery, and subcondylar fracture which is a rare complication of surgical treatment are discussed.
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Research Interests: Medicine and Gynecology
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1 Mestak O, Kullac R, Mestak J, Nosek A, Krajcova A, Sukop A. Evaluation of the long-term stability of sheath plication using absorbable sutures in 51 patients with diastasis of the recti muscles: an ultrasonographic study. Plast Reconstr... more
1 Mestak O, Kullac R, Mestak J, Nosek A, Krajcova A, Sukop A. Evaluation of the long-term stability of sheath plication using absorbable sutures in 51 patients with diastasis of the recti muscles: an ultrasonographic study. Plast Reconstr Surg. 2012 Nov;130(5):714e-719e. 2 Tadiparthi S1, Shokrollahi K, Doyle GS, Fahmy FS. Rectus sheath plication in abdominoplasty: assessment of its longevity and a review of the literature. J Plast Reconstr Aesthet Surg. 2012 Mar;65(3):328–32.
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Winer noduler kalsinozis, dogumda ya da erken cocukluk cagi doneminde gorulen asemptomatik, sert, sari ya da beyaz renkte noduler tarzda gorulen, idiopatik kalsinozis kutisin bir alt formudur. Winer noduler kalsinozis uzerinde ulserasyon... more
Winer noduler kalsinozis, dogumda ya da erken cocukluk cagi doneminde gorulen asemptomatik, sert, sari ya da beyaz renkte noduler tarzda gorulen, idiopatik kalsinozis kutisin bir alt formudur. Winer noduler kalsinozis uzerinde ulserasyon gelisimi oldukca nadirdir. Ulasilabilen Turkce ya da Ingilizce literaturde bugune kadar Winer noduler kalsinozis ile karisabilecek malign cilt lezyonundan bahseden benzer yazi ya da vakaya rastlanilmamistir. Bu yazida, sol kulak heliksinde beyaz renkte, uzeri ulsere, 3*2mm boyutlarinda noduler lezyon sikayetiyle ailesi tarafindan klinigimize getirilen 3 yasinda cocuk olgu sunuldu. Lezyonun ulsere olmasi, makroskobik goruntusu ve gunes maruziyetinin en sik oldugu kulak heliksinde yerlesimi nedeniyle on tani olarak skuamoz hucreli karsinom dusunuldu.
Research Interests: Medicine and Gynecology
METHODS: 60 patients who had non-melanocytic skin cancer on the only nasal tip were included in this study. There was no previous history of nasal surgery, allergic rhinitis, concha hypertrophy and other breathing problems in any... more
METHODS: 60 patients who had non-melanocytic skin cancer on the only nasal tip were included in this study. There was no previous history of nasal surgery, allergic rhinitis, concha hypertrophy and other breathing problems in any patients. Six patients were treated with forehead flap, ten patients nasolabial island flap, twenty patients bilobe flap that based on inferior, 24 patients bilobe flap that based on superior. Function of the internal and external nasal valves were evaluated by preoperative and postoperative comparison of Cottles test, nasal endoscopy and digital phography of nares during forced inspiration and expiration and were followed up 1-years.
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Wound infections subsequent to cardiac surgery are challenging surgeons because of being life-threatening situations and these infections are among conditions that require multidisciplinary approach. Antibiotherapy, surgical debridements,... more
Wound infections subsequent to cardiac surgery are challenging surgeons because of being life-threatening situations and these infections are among conditions that require multidisciplinary approach. Antibiotherapy, surgical debridements, regional or free flap surgeries are used by multidis ciplinary approach in the treatment of sternal wound infections. Beside these known alternatives, some other methods are advanced for wound care. However; sternal instability, ventricular rupture and pneumonia may be mortal in many patient as the course of the disease. In this article, a negative pressure wound therapy and reconstruction with pectoralis major muscle flap was intro duced for postoperative mediastinitis occurred in a diabetic, coronary bypass patient. A wound therapy, that controls infection and supplies wound care as an effective treatment alternative for highly mortal mediastinis cases.
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To the Editor: The auricle is an organ including both skin and cartilage tissues. When the auricular anatomy is investigated, peri-chondrium and underlying cartilage are observed under a thin skin layer and a very small amount of... more
To the Editor: The auricle is an organ including both skin and cartilage tissues. When the auricular anatomy is investigated, peri-chondrium and underlying cartilage are observed under a thin skin layer and a very small amount of subcutaneous tis-sue. Cartilage is thickest in the ...
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... Zekeriya TOSUN, Zeynep KARAÇOR, Demet AYDOĞDU KIREŞİ, Mehmet Erkan ÜSTÜN, Mustafa Cihat AVUNDUK, Nedim SAVACI Selçuk Üniversitesi Meram Tıp Fakültesi ... 6. Elmacı İ, Dağçınar A, Özgen S, Ekinci G, Pamir N. Diastematomyelia and spinal... more
... Zekeriya TOSUN, Zeynep KARAÇOR, Demet AYDOĞDU KIREŞİ, Mehmet Erkan ÜSTÜN, Mustafa Cihat AVUNDUK, Nedim SAVACI Selçuk Üniversitesi Meram Tıp Fakültesi ... 6. Elmacı İ, Dağçınar A, Özgen S, Ekinci G, Pamir N. Diastematomyelia and spinal teratoma in an adult. ...
Research Interests: Medicine and Gynecology
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In ankle and heel region, tissue defects can be occurred due to diabetes, osteomyelitis, trauma and tumor excisions and these defects should be repaired with flaps. Reverse-flow sural island flap is a reliable alternative for repairing... more
In ankle and heel region, tissue defects can be occurred due to diabetes, osteomyelitis, trauma and tumor excisions and these defects should be repaired with flaps. Reverse-flow sural island flap is a reliable alternative for repairing these regions’ defects. Delayed reverse-flow sural island flap procedure was applied for 11 smoker or diabetic patients who have tissue defects due to trauma. While we haven’t seen flap failure in any patient, we also didn’t have any difficulty except 2 minor problems. Besides clinical results, patient satisfaction was evaluated with “patient satisfaction rate scale”. In this article, it is reported our ankle and heel reconstruction cases with delayed reverse-flow sural island flap as an alternative of free flap and their satisfaction rate. Keywords: Sural flap, Ankle and heel defects, Delay procedure.
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INTRODUCTION: In reconstruction of upper extremity defects there are many options like local, free, island and perforator flaps. Reconstruction with perforator flaps is new trend in plastic surgery.1 Because of good vascularity, upper... more
INTRODUCTION: In reconstruction of upper extremity defects there are many options like local, free, island and perforator flaps. Reconstruction with perforator flaps is new trend in plastic surgery.1 Because of good vascularity, upper extremity is one of the most suitable part of the body for designing well known and also ad hoc perforator flaps. In this study we aimed to compare of reconstruction of upper extremity deformities with free versus perforator flaps.
Decubitus ulcers can develop in immobilized patient. Patients with spinal cord injury and elderly patients are at high risk. We presented 36 patient with pressure sore that we operated between May 1994 and January 2000 and our... more
Decubitus ulcers can develop in immobilized patient. Patients with spinal cord injury and elderly patients are at high risk. We presented 36 patient with pressure sore that we operated between May 1994 and January 2000 and our reconstructive procedures. Sacral, trochanteric and ischial pressure sores we are included the study, other sites were excepted. As 3 patient with ischial ulcer were accepted because of recurrence, there were no recur- rence for sacral and trochanteric ulcers. This recurrences were not depend on surgical technicues perhaps due to pressure. Selecting the proper surgical technique for decubitus ulcer, is important eitherpreventing recurrence and funtional loss. We revievved our experience with reconstruction of decubit ulcers betvveen 1994 and 2000 years.
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Objective: The reverse radial forearm flap has been used for soft-tissue hand defect surgical procedures worldwide. One of the major drawbacks of this flap, however, is donor site morbidity, as the donor site is closed with a skin graft.... more
Objective: The reverse radial forearm flap has been used for soft-tissue hand defect surgical procedures worldwide. One of the major drawbacks of this flap, however, is donor site morbidity, as the donor site is closed with a skin graft. Problems with skin graft donor areas include adhesion, contracture, and wound-healing complications. In this study, only the adipofascial component of a reverse radial forearm flap was used to prevent these problems; in addition, a skin graft was applied over the flap instead of over the donor site. Methods: Between January 2011 and December 2013, a total of 13 hand defects were reconstructed with a reverse adipofascial radial forearm flap. Patients were evaluated for functional results using total active motion criteria and disability of the arm, shoulder, and hand scores, operation time, hospitalization time, and patient satisfaction. Results: All flaps and grafts placed on flaps survived completely and donor sites healed without complications. Th...
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RESULTS: Mean nerve fiber diameter in the central region of the regenerated nerve was not significantly different between AG and NerbridgeTM rats (5.39 ± 2.42 μm vs. 4.88 ± 1.44 μm). However, myelin width differed significantly between... more
RESULTS: Mean nerve fiber diameter in the central region of the regenerated nerve was not significantly different between AG and NerbridgeTM rats (5.39 ± 2.42 μm vs. 4.88 ± 1.44 μm). However, myelin width differed significantly between both groups (0.82 ± 0.45 μm vs. 0.45 ± 0.12 μm). Also, AG rats showed significantly greater improvement in g-ratio, an index of nerve maturation, (0.70 ± 0.12 mm vs. 0.82 ± 0.04 mm).
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... TEDAVİSİ *Mustafa KESKİN, *Tolga BEYDEŞ, *Zekeriya TOSUN, *Nedim SAVACI *Selçuk Üniversitesi Meram Tıp Fakültesi Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı, Konya ... 2. O Neyzi, H Alp, A Yalcindağ, S Yakacıklı, A Orphon.Sexual... more
... TEDAVİSİ *Mustafa KESKİN, *Tolga BEYDEŞ, *Zekeriya TOSUN, *Nedim SAVACI *Selçuk Üniversitesi Meram Tıp Fakültesi Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı, Konya ... 2. O Neyzi, H Alp, A Yalcindağ, S Yakacıklı, A Orphon.Sexual maturation in Turkish boys. ...