Yavuz Başterzi - Academia.edu (original) (raw)
Papers by Yavuz Başterzi
PubMed, Jul 1, 2010
Many new antimicrobial dressings have been used for the treatment of or protection against woun... more Many new antimicrobial dressings have been used for the treatment of or protection against wound infection since the early 1980s. There are many different wound dressings such as silver, povidone iodine, and chlorhexidine impregnated materials on the market today. Various manufacturers assert that their dressings are the most effective and therefore should be preferentially employed. However, it is difficult to find a study that clearly identifies the most effective antimicrobial wound dressing. Methods: Eight different commercially available wound dressing materials were compared in terms of their antimicrobial effectiveness on 18 different microorganisms via disk diffusion test (Kirby-Bauer Method) on Mueller-Hinton (MH) agar. Among the 16 bacterial and 2 yeast species grown on MH agar plates, Contreet was the most effective antimicrobial dressing tested (P <0.001). Results: A statistical difference was not found concerning efficacy against gram-positive and -negative bacteria among any of the materials except for Aquacel Ag and Inadine, the activity of which were found to be higher on gram-positive bacteria compared to gram-negative bacteria (P = 0.029, P = 0.030). In-vitro data suggest that Contreet is the most effective for topical treatment of contaminated wounds. Conclusion: Further methods of assessment, including the use of infected animal models and clinical studies, will be necessary to better understand the antimicrobial efficacy of these dressings .
Journal of Craniofacial Surgery, Mar 1, 2007
Aplasia cutis congenita is a rare congenital disorder of skin and most commonly involves the scal... more Aplasia cutis congenita is a rare congenital disorder of skin and most commonly involves the scalp. The skull and dura underlying the defective skin may also be affected, relative to severity of the disease. The typical lesion is present at birth and ranges in size from 0.5-3 cm. The main complications of larger defects include infection, bleeding and trombosis that may be deadly. Therefore, prompt diagnosis and appropriate treatment are critical for avoiding the adverse outcomes. Controversy exists in the literature regarding the treatment of aplasia cutis congenita; both surgical and conservative treatment modalities have their proponents and opponents. We present a case of full thickness aplasia cutis congenital lesion bigger than 3 cm in diameter that healed with the application of novel wound dressing materials without any complications. The physiopathology, classification and treatment options of the disease are discussed.
Plastic and Reconstructive Surgery, 2004
Plastic and Reconstructive Surgery, Apr 1, 2002
Turkish Neurosurgery, 2018
AIM: Bilateral rotation flaps are considered the workhorse flaps in reconstruction of myelomening... more AIM: Bilateral rotation flaps are considered the workhorse flaps in reconstruction of myelomeningocele defects. Since the introduction of perforator flaps in the field of reconstructive surgery, perforator flaps have been used increasingly in the reconstruction of various soft tissue defects all over the body because of their appreciated advantages. The aim of this study was to compare the complications and surgical outcomes between bilateral rotation flaps and dorsal intercostal artery perforator (DICAP) flaps in the soft tissue reconstruction of myelomeningocele defects. MATERIAL and METHODS: Between January 2005 and February 2017, we studied 47 patients who underwent reconstruction of myelomeningocele defects. Patient demographics, operative data, and postoperative data were reviewed retrospectively and are included in the study. RESULTS: We found no statistically significant differences in patient demographics and surgical complications between these two groups; this may be due to small sample size. With regard to complications-partial flap necrosis, cerebrospinal fluid (CSF) leakage, necessity for reoperation, and wound infection-DICAP propeller flaps were clinically superior to rotation flaps. Partial flap necrosis was associated with CSF leakage and wound infection, and CSF leakage was associated with wound dehiscence. CONCLUSION: Although surgical outcomes obtained with DICAP propeller flaps were clinically superior to those obtained with rotation flaps, there was no statistically significant difference between the two patient groups. A well-designed comparative study with adequate sample size is needed. Nonetheless, we suggest using DICAP propeller flaps for reconstruction of large myelomeningocele defects.
Journal of Craniofacial Surgery, Sep 1, 2007
Journal of Plastic Reconstructive and Aesthetic Surgery, Aug 1, 2009
In this study the effects of granulocyte-colony stimulating factor (G-CSF) on angiogenesis and th... more In this study the effects of granulocyte-colony stimulating factor (G-CSF) on angiogenesis and the survival of ischaemic skin flaps are evaluated. Thirty adult Wistar rats were equally randomised into three groups. Caudal-based, ischaemic skin flaps of 10 x 3 cm were designed on the back and injected with saline in group 1 and with 100 microg/kg G-CSF in groups 2 and 3. The injections were performed just prior to flap elevation in groups 1 and 2 and 2 days earlier in group 3. Peripheral leukocyte counts, tissue myeloperoxidase enzyme assays, necrotic to total flap area ratio (NA/TA) calculations, flap tissue inflammation gradings, immunohistochemical vessel counts, and electron microscopic evaluation of endothelial cells were performed on the 8th day. No significant difference was encountered between the groups in terms of the leukocyte counts, myeloperoxidase enzyme assays and inflammation gradings (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05), demonstrating the absence of an increased inflammatory response within the flap tissue. The surviving flap portions were observed to be increased with the application of G-CSF. The mean NA/TA results (when measured in situ) were 0.44+/-0.13 for group 1, 0.30+/-0.17 for group 2, and 0.22+/-0.16 for group 3. The difference between groups 1 and 3 was statistically significant (P = 0.009). The mean vessel count was 3.53+/-1.20 in group 1, 7.36+/-1.41 in group 2 and 7.43+/-0.92 in group 3. The differences between groups 1 and 2 and groups 1 and 3 were statistically significant (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 0.001). Early apoptotic changes were encountered in the endothelial cells of group 1, while activated and proliferating endothelial cells were seen in groups 2 and 3 with electron microscopy. G-CSF promotes angiogenesis by increasing the number of activated and proliferating endothelial cells within the ischaemic flaps by the resettlement of G-CSF-stimulated endothelial progenitor cells into the ischaemic tissue. The overall result is an improved survival of ischaemic skin flaps. These effects are more pronounced when G-CSF is introduced 2 days prior to flap elevation.
Dermatologic Surgery, Oct 1, 2003
ABSTRACT
Aesthetic Plastic Surgery, Jul 10, 2006
Journal of Craniofacial Surgery, Mar 1, 2009
Orbital implants are often used for the correction of volume deficit after enucleation or eviscer... more Orbital implants are often used for the correction of volume deficit after enucleation or evisceration. An orbital implant enhances aesthetics and improves mobility of the subsequent prosthetic eye. With advancements in technology and techniques, implant-related complication rates have been decreased. However, implant exposition as one of the most common complications of socket surgery is still a problem for the oculoplastic surgeon. Many factors are thought to cause orbital implant exposure: Large implants, tension on the wound, and textured surface of the implant may cause a breakdown of the covering layers over the implant. Inadequate fibrovascular ingrowth into the porous implant is the most important factor. Various surgical methods have been described to cover the defect, most offering the use of various tissues as a graft, which are not always satisfactory. We describe a case with silicone implant exposition that was managed with a vascularized superficial temporal fascia flap. According to our knowledge, this is the first article reporting the usage of a vascular tissue in the management of an orbital implant exposure.
Türk Plastik, Rekonstrüktif ve Estetik Cerrahi Dergisi (Turk J Plast Surg), 2006
... Yavuz Başterzi, Alper Sarı, Atilla Fesli, Şakir Ünal, Emrah Arslan, Ferit Demirkan Mersin Üni... more ... Yavuz Başterzi, Alper Sarı, Atilla Fesli, Şakir Ünal, Emrah Arslan, Ferit Demirkan Mersin Üniversitesi Tıp Fakültesi Plastik ve Rekonstrüktif Cerrahi AD ... Plast Reconstr Surg 2000; 106(2): 507 6. Sarıfakıoğlu N, Görkem S, Yüksel A, Aslan G. Staged Tie-Over Dressing Technique. ...
Turkish journal of trauma & emergency surgery, 2005
BACKGROUND OBJECTIVE To evaluate the results we obtained from 37 patients referred to our clinics... more BACKGROUND OBJECTIVE To evaluate the results we obtained from 37 patients referred to our clinics with resorbable plate-screw systems which have been claimed as biodegradable fixation materials and used in craniofacial, maxillofacial and orthopedic reconstructive procedures owing to their advantages such as biocompatibility, adequate biomechanical resistance, longer dwelling time, elimination through physiological routes without causing any foreign body reaction and/or significant sequaleae. METHODS Resorbable plate-screw systems used in 37 patients between 2000-2003 for various craniofacial reconstructive procedures were evaluated as for their efficacy, and biocompatibility. RESULTS Adequate fixation was obtained in all patients, excluding one case operated for mandibula fracture whose reconstruction was completed with titanium plate-screw system. No serious complication was seen except a granuloma and sinus formation on subciliary incision in one patient. CONCLUSION Owing to their improved polylactic acid/polyglycolic acid ratio resorbable plate-screw systems which contain varying compositions of polylactic acid and polyglycolic acid copolymers are ideal fixation materials used favourably in maxillofacial, craniofacial and orthopedic reconstructive surgery in that they make effective fixation and have further advantages such as biocompatibility, adequate biomechanical resistance against distraction and compression forces in the early postoperative period, longer dwelling time and elimination from the body through physiological routes without causing any foreign body reaction or significant sequaleae.
Annals of Plastic Surgery, Apr 1, 2016
Several options have been reported for the reconstruction of myelomeningocele defects. In this ar... more Several options have been reported for the reconstruction of myelomeningocele defects. In this article, we present our experience on soft tissue reconstruction of myelomeningocele defects by using island propeller dorsal intercostal artery perforator (DIAP) flaps. Between January 2008 and February 2014, all newborns with large myelomeningocele defects (13 newborns) were reconstructed with island propeller DIAP flaps. All flaps survived completely. In 8 patients out of 13, venous insufficiency was observed which then resolved spontaneously. Flap donor sites were closed primarily. Myelomeningocele defects with a diameter larger than 5 cm require reconstruction with flaps. To mobilize a well-vascularized tissue over the defect without tension in which the suture lines will not overlap over the midline where the dura is repaired and over the meninges is one of the goals of reconstruction for such defects. Perforator propeller flaps enable us to reach those goals. Use of perforator flaps provides 2 important advantages, namely, more predictability and also more freedom in mobilizing flaps toward the defect. This study proves the reliability of DIAP propeller flaps in the reconstruction of myelomeningocele defects.
SUMMARY Fatal Necrotizing Soft Tissue Infections: A Review and Report of Two Cases Necrotizing so... more SUMMARY Fatal Necrotizing Soft Tissue Infections: A Review and Report of Two Cases Necrotizing soft tissue infections have high mortality, especially for some high risk patients. Rare occurence of these infections make diagnosis difficult and delay the necessary urgent debridement ...
Plastic and Reconstructive Surgery, Jul 1, 2005
Letters to the Editor and Viewpoints are welcome. Letters to the Editor discuss material recently... more Letters to the Editor and Viewpoints are welcome. Letters to the Editor discuss material recently published in the Journal. Letters will have the best chance of acceptance if they are received within 8 weeks of an article's publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. Viewpoints pertain to issues of general interest, even if they are not related to items previously published (such as unique techniques, brief technology updates, technical notes, and so on). Please note the following criteria for Letters and Viewpoints: • Text-maximum of 500 words (not including references) • References-maximum of five • Authors-no more than five • Figures/Tables-no more than two figures and/or one table Authors will be listed in the order in which they appear in the submission. Letters and Viewpoints should be submitted electronically via PRS' enkwell, at www.editorialmanager.com/ prs/. We strongly encourage authors to submit figures in color. We reserve the right to edit letters and viewpoints to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a letter and/or viewpoint constitutes permission for the American Society of Plastic Surgeons and its licensees and assignees to publish it in the Journal and in any other form or medium. The views, opinions, and conclusions expressed in the letters to the Editor and viewpoints represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.tk;2 LETTERS MANAGEMENT OF ACUTE MIGRAINE HEADACHE WITH LIDOCAINE Sir: The incidental discovery that injection of botulinum toxin is beneficial for treating headaches in some individuals 1,2 stimulated Bahman Guyuron and his colleagues to consider the possibility that resection of the corrugator supercilii muscle is beneficial in the treatment of migraine headache. 3 In Guyuron et al.'s report, 4 migraine headaches improved almost 80 percent. Is it possible that nerve stimulation plays a role in this pathology? With this in mind, I think that if I anesthetize this "trigger point" I may improve the migraine headache. In my hospital where I receive patients with acute migraine headache, I ask patients to rate the intensity of their pain on a scale from 1 to 10 (1, without pain; 10, maximum pain). I then infiltrate 3 cc of lidocaine 2% with epinephrine in the supraciliary zone (trigger zone) in the subcutaneous plane. This improves the pain in minutes. I then ask patients to rate their pain again on a scale of 1 to 10 in 5-minute intervals. When the improvement is palpable, I send the patient home. I invite the medical community to probe this "serendipity" and to conduct new studies with more scientific facts.
Damarsal anomalilerin sınıflandırılmalarında süregelen karışıklık, 1982 yılında yapılan yeni sını... more Damarsal anomalilerin sınıflandırılmalarında süregelen karışıklık, 1982 yılında yapılan yeni sınıflandırma ile, plastik ve rekonstrüktif cerrahi literatüründe büyük ölçüde giderilmiş olsa da, lenfatik m alforasyonlar halen p ek çok değişik h isto p a to lo jik tanılar ile klinisyenlerin karşısına çıkabilmededirler. Bu çalışmada, son yedi yıl içerisinde kliniğimize başvuran lenf daman anomalileri retrospektif olarak incelenerek, almış oldukları histopatolojik tanılar, lezyonlann klinik ve morfolojik özellikleri ile birlikte değerlendirilmiştir. Ayrıca değişik klinik özellikler ile karşımıza çıkan bu malformasyonlartn uygun takip ve tedavi şekilleri de avantaj ve dezavantajları ile birlikte tartışılmıştır. Lenfatik malformasyonlartn tedavisinde öncelikli yöntem olarak kabul gören cerrahi eksizyonun hangi genişlikte yapılacağı da tartışmalıdır. Kliniğimizde, limitli ve yüzeyel eksizyonlar yerine, bu lezyonlann çevre anatomik yapıları da dikkate alarak mümkün olduğunca geniş ve derin fasya seviyesinden eksize edilmeleri tercih edilmektedir. Oluşacak fonksiyonel ve estetik kayıplar nedeniyle kısmi eksizyonların yapılabildiği durumlarda ise hastalar olası tekrarlar açısından uyarılarak yakın takip altında tutulmaktadırlar. A n ahtar K elim eler: D a m a rsa l anom ali, le n fa tik malformasyon, geniş eksizyon, kısmi eksizyon.
Journal of Plastic Reconstructive and Aesthetic Surgery, 2017
Dermatologic Surgery, Oct 1, 2003
BACKGROUND. Pseudocyst of the auricle is a rarely seen fluctuant swelling of the ear. Although va... more BACKGROUND. Pseudocyst of the auricle is a rarely seen fluctuant swelling of the ear. Although various hypotheses on the etiology have been suggested, the exact cause still remains unclear. Chronic minor trauma, which is believed to create intracartilaginous cavity, is accepted to be the most probable cause. Several treatment methods have been used for this benign lesion, but higher recurrence rates can be seen if not properly treated. OBJECTIVE. To discuss a new treatment modality for this rare disorder. METHOD. A 44-year-old man presented with a large pseudocyst of the auricle that had been treated several times previously with unsuccessful outcomes. For its treatment, we performed curettage and then used fibrin glue as a sealer between the two leaves of the cartilage. RESULTS. At postoperative 6-months follow-up, there was no evidence of recurrence. The cosmetic outcome was excellent. CONCLUSION. The use of fibrin glue both to obliterate the pseudocyst space and to make the two leaves of the cartilage adhere to each other should be kept in mind in this rare disorder in order to avoid recurrences.
Journal of Craniofacial Surgery, Mar 1, 2004
Craniofacial contouring is a commonly performed procedure applied for traumatic and postsurgical ... more Craniofacial contouring is a commonly performed procedure applied for traumatic and postsurgical cranial vault or facial skeleton irregularities. Hydroxyapatite cement is an alloplastic material composed of tetracalcium phospate and dicalcium phospate anhydrous that transforms into a pastelike substance when these two compounds placed in an aqueous environment. This mixture, which is a nonceramic microporous calcium phosphate combination, is another alternative for refining the craniofacial contour. There are not enough data regarding bone formation within this material after its use in human beings, however. A case requiring secondary craniofacial contouring after a motor vehicle accident is presented. Hydroxyapatite cement was used for reconstruction, and a second look was carried out for further correction during which secondary contouring of the cement was made and a sample of the previously implanted material was histologically evaluated. It was observed in this case that hydroxyapatite cement is incorporated within the surrounding bony structures and permits secondary contouring procedures. New bone and vessel formation was also detected within the implanted material, but this was limited and thus was not convincing for significant osteoconversion as seen in animal studies.
International Wound Journal, Dec 1, 2006
Traitement des plaies par pression né gative: un faisceau de preuves Le traitement par pression n... more Traitement des plaies par pression né gative: un faisceau de preuves Le traitement par pression négative est un mode thérapeutique utilisé pour accélérer la cicatrisation. Il peut être utilisé en traitement initial pour les plaies chroniques/complexes ou comme traitement adjuvant. Si l'on se base sur les preuves accumulées à ce jour, l'efficacité du traitement par la pression negative reste peu clair. Bien que des cas cliniques aient été rapportés et que des études rétrospectives aient démontré une accélération de la cicatrisation dans les plaies aigü es /traumatiques, les plaies chroniques, les plaies infectées, les plaies secondaires au diabète, les plaies sternales, les plaies des membres inférieurs, il n'existe que très peu d'études randomisées et leurs resultants sont peu clairs. Il n'y a pas de preuves pour utiliser le traitement par la Pression negative(TPN) pour d'autres indications dans lesquelles la cicatrisation serait accélérée, comme chez les patients présentant des escarres, ou diabétiques et porteurs de pathologies vasculaires périphériques ou pour améliorer la prise des greffes cutanées Il n'y a pas non plus, détudes de qualité de la vie de partients traités par TPN. Malgré cela, l'utilisation de la TPN a augmenté.. Cette revue de la literature apporte un panorama des études cliniques utilisant la TPN et propose de nouvelles voies de recherches futures pour élucider le mécanisme exact de la TPN, et également de large études randomisées contrôlées de patients soumis à ce traitement. Tratamiento de infecciones de heridas esternales profundas mediante el dispositivo de Cierre Asistido al Vacío TM (V.A.C. Ò) Un grupo de expertos internacionales se reunió en mayo de 2006 para elaborar normas clínicas sobre la aplicació n prá ctica del tratamiento con Cierre Asistido al Vacío TM (V.A.C. Ò) * en infecciones de heridas esternales profundas. Se utilizaron la discusió n del grupo y un sistema de votació n interactiva anó nima para desarrollar el contenido. Las recomendaciones se basaron en pruebas actuales o, en caso de no disponer de ellas, en la opinió n mayoritaria del grupo internacional. Los principios terapéuticos de las infecciones de heridas esternales profundas incluyen la identificació n precoz y el tratamiento de la infecció n. El tratamiento con V.A.C. debe instaurarse precozmente tras la irrigació n minuciosa de la herida y el desbridamiento quirú rgico. El tratamiento con V.A.C. en infecciones de heridas esternales profundas requiere supervisió n
PubMed, Jul 1, 2010
Many new antimicrobial dressings have been used for the treatment of or protection against woun... more Many new antimicrobial dressings have been used for the treatment of or protection against wound infection since the early 1980s. There are many different wound dressings such as silver, povidone iodine, and chlorhexidine impregnated materials on the market today. Various manufacturers assert that their dressings are the most effective and therefore should be preferentially employed. However, it is difficult to find a study that clearly identifies the most effective antimicrobial wound dressing. Methods: Eight different commercially available wound dressing materials were compared in terms of their antimicrobial effectiveness on 18 different microorganisms via disk diffusion test (Kirby-Bauer Method) on Mueller-Hinton (MH) agar. Among the 16 bacterial and 2 yeast species grown on MH agar plates, Contreet was the most effective antimicrobial dressing tested (P <0.001). Results: A statistical difference was not found concerning efficacy against gram-positive and -negative bacteria among any of the materials except for Aquacel Ag and Inadine, the activity of which were found to be higher on gram-positive bacteria compared to gram-negative bacteria (P = 0.029, P = 0.030). In-vitro data suggest that Contreet is the most effective for topical treatment of contaminated wounds. Conclusion: Further methods of assessment, including the use of infected animal models and clinical studies, will be necessary to better understand the antimicrobial efficacy of these dressings .
Journal of Craniofacial Surgery, Mar 1, 2007
Aplasia cutis congenita is a rare congenital disorder of skin and most commonly involves the scal... more Aplasia cutis congenita is a rare congenital disorder of skin and most commonly involves the scalp. The skull and dura underlying the defective skin may also be affected, relative to severity of the disease. The typical lesion is present at birth and ranges in size from 0.5-3 cm. The main complications of larger defects include infection, bleeding and trombosis that may be deadly. Therefore, prompt diagnosis and appropriate treatment are critical for avoiding the adverse outcomes. Controversy exists in the literature regarding the treatment of aplasia cutis congenita; both surgical and conservative treatment modalities have their proponents and opponents. We present a case of full thickness aplasia cutis congenital lesion bigger than 3 cm in diameter that healed with the application of novel wound dressing materials without any complications. The physiopathology, classification and treatment options of the disease are discussed.
Plastic and Reconstructive Surgery, 2004
Plastic and Reconstructive Surgery, Apr 1, 2002
Turkish Neurosurgery, 2018
AIM: Bilateral rotation flaps are considered the workhorse flaps in reconstruction of myelomening... more AIM: Bilateral rotation flaps are considered the workhorse flaps in reconstruction of myelomeningocele defects. Since the introduction of perforator flaps in the field of reconstructive surgery, perforator flaps have been used increasingly in the reconstruction of various soft tissue defects all over the body because of their appreciated advantages. The aim of this study was to compare the complications and surgical outcomes between bilateral rotation flaps and dorsal intercostal artery perforator (DICAP) flaps in the soft tissue reconstruction of myelomeningocele defects. MATERIAL and METHODS: Between January 2005 and February 2017, we studied 47 patients who underwent reconstruction of myelomeningocele defects. Patient demographics, operative data, and postoperative data were reviewed retrospectively and are included in the study. RESULTS: We found no statistically significant differences in patient demographics and surgical complications between these two groups; this may be due to small sample size. With regard to complications-partial flap necrosis, cerebrospinal fluid (CSF) leakage, necessity for reoperation, and wound infection-DICAP propeller flaps were clinically superior to rotation flaps. Partial flap necrosis was associated with CSF leakage and wound infection, and CSF leakage was associated with wound dehiscence. CONCLUSION: Although surgical outcomes obtained with DICAP propeller flaps were clinically superior to those obtained with rotation flaps, there was no statistically significant difference between the two patient groups. A well-designed comparative study with adequate sample size is needed. Nonetheless, we suggest using DICAP propeller flaps for reconstruction of large myelomeningocele defects.
Journal of Craniofacial Surgery, Sep 1, 2007
Journal of Plastic Reconstructive and Aesthetic Surgery, Aug 1, 2009
In this study the effects of granulocyte-colony stimulating factor (G-CSF) on angiogenesis and th... more In this study the effects of granulocyte-colony stimulating factor (G-CSF) on angiogenesis and the survival of ischaemic skin flaps are evaluated. Thirty adult Wistar rats were equally randomised into three groups. Caudal-based, ischaemic skin flaps of 10 x 3 cm were designed on the back and injected with saline in group 1 and with 100 microg/kg G-CSF in groups 2 and 3. The injections were performed just prior to flap elevation in groups 1 and 2 and 2 days earlier in group 3. Peripheral leukocyte counts, tissue myeloperoxidase enzyme assays, necrotic to total flap area ratio (NA/TA) calculations, flap tissue inflammation gradings, immunohistochemical vessel counts, and electron microscopic evaluation of endothelial cells were performed on the 8th day. No significant difference was encountered between the groups in terms of the leukocyte counts, myeloperoxidase enzyme assays and inflammation gradings (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05), demonstrating the absence of an increased inflammatory response within the flap tissue. The surviving flap portions were observed to be increased with the application of G-CSF. The mean NA/TA results (when measured in situ) were 0.44+/-0.13 for group 1, 0.30+/-0.17 for group 2, and 0.22+/-0.16 for group 3. The difference between groups 1 and 3 was statistically significant (P = 0.009). The mean vessel count was 3.53+/-1.20 in group 1, 7.36+/-1.41 in group 2 and 7.43+/-0.92 in group 3. The differences between groups 1 and 2 and groups 1 and 3 were statistically significant (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or = 0.001). Early apoptotic changes were encountered in the endothelial cells of group 1, while activated and proliferating endothelial cells were seen in groups 2 and 3 with electron microscopy. G-CSF promotes angiogenesis by increasing the number of activated and proliferating endothelial cells within the ischaemic flaps by the resettlement of G-CSF-stimulated endothelial progenitor cells into the ischaemic tissue. The overall result is an improved survival of ischaemic skin flaps. These effects are more pronounced when G-CSF is introduced 2 days prior to flap elevation.
Dermatologic Surgery, Oct 1, 2003
ABSTRACT
Aesthetic Plastic Surgery, Jul 10, 2006
Journal of Craniofacial Surgery, Mar 1, 2009
Orbital implants are often used for the correction of volume deficit after enucleation or eviscer... more Orbital implants are often used for the correction of volume deficit after enucleation or evisceration. An orbital implant enhances aesthetics and improves mobility of the subsequent prosthetic eye. With advancements in technology and techniques, implant-related complication rates have been decreased. However, implant exposition as one of the most common complications of socket surgery is still a problem for the oculoplastic surgeon. Many factors are thought to cause orbital implant exposure: Large implants, tension on the wound, and textured surface of the implant may cause a breakdown of the covering layers over the implant. Inadequate fibrovascular ingrowth into the porous implant is the most important factor. Various surgical methods have been described to cover the defect, most offering the use of various tissues as a graft, which are not always satisfactory. We describe a case with silicone implant exposition that was managed with a vascularized superficial temporal fascia flap. According to our knowledge, this is the first article reporting the usage of a vascular tissue in the management of an orbital implant exposure.
Türk Plastik, Rekonstrüktif ve Estetik Cerrahi Dergisi (Turk J Plast Surg), 2006
... Yavuz Başterzi, Alper Sarı, Atilla Fesli, Şakir Ünal, Emrah Arslan, Ferit Demirkan Mersin Üni... more ... Yavuz Başterzi, Alper Sarı, Atilla Fesli, Şakir Ünal, Emrah Arslan, Ferit Demirkan Mersin Üniversitesi Tıp Fakültesi Plastik ve Rekonstrüktif Cerrahi AD ... Plast Reconstr Surg 2000; 106(2): 507 6. Sarıfakıoğlu N, Görkem S, Yüksel A, Aslan G. Staged Tie-Over Dressing Technique. ...
Turkish journal of trauma & emergency surgery, 2005
BACKGROUND OBJECTIVE To evaluate the results we obtained from 37 patients referred to our clinics... more BACKGROUND OBJECTIVE To evaluate the results we obtained from 37 patients referred to our clinics with resorbable plate-screw systems which have been claimed as biodegradable fixation materials and used in craniofacial, maxillofacial and orthopedic reconstructive procedures owing to their advantages such as biocompatibility, adequate biomechanical resistance, longer dwelling time, elimination through physiological routes without causing any foreign body reaction and/or significant sequaleae. METHODS Resorbable plate-screw systems used in 37 patients between 2000-2003 for various craniofacial reconstructive procedures were evaluated as for their efficacy, and biocompatibility. RESULTS Adequate fixation was obtained in all patients, excluding one case operated for mandibula fracture whose reconstruction was completed with titanium plate-screw system. No serious complication was seen except a granuloma and sinus formation on subciliary incision in one patient. CONCLUSION Owing to their improved polylactic acid/polyglycolic acid ratio resorbable plate-screw systems which contain varying compositions of polylactic acid and polyglycolic acid copolymers are ideal fixation materials used favourably in maxillofacial, craniofacial and orthopedic reconstructive surgery in that they make effective fixation and have further advantages such as biocompatibility, adequate biomechanical resistance against distraction and compression forces in the early postoperative period, longer dwelling time and elimination from the body through physiological routes without causing any foreign body reaction or significant sequaleae.
Annals of Plastic Surgery, Apr 1, 2016
Several options have been reported for the reconstruction of myelomeningocele defects. In this ar... more Several options have been reported for the reconstruction of myelomeningocele defects. In this article, we present our experience on soft tissue reconstruction of myelomeningocele defects by using island propeller dorsal intercostal artery perforator (DIAP) flaps. Between January 2008 and February 2014, all newborns with large myelomeningocele defects (13 newborns) were reconstructed with island propeller DIAP flaps. All flaps survived completely. In 8 patients out of 13, venous insufficiency was observed which then resolved spontaneously. Flap donor sites were closed primarily. Myelomeningocele defects with a diameter larger than 5 cm require reconstruction with flaps. To mobilize a well-vascularized tissue over the defect without tension in which the suture lines will not overlap over the midline where the dura is repaired and over the meninges is one of the goals of reconstruction for such defects. Perforator propeller flaps enable us to reach those goals. Use of perforator flaps provides 2 important advantages, namely, more predictability and also more freedom in mobilizing flaps toward the defect. This study proves the reliability of DIAP propeller flaps in the reconstruction of myelomeningocele defects.
SUMMARY Fatal Necrotizing Soft Tissue Infections: A Review and Report of Two Cases Necrotizing so... more SUMMARY Fatal Necrotizing Soft Tissue Infections: A Review and Report of Two Cases Necrotizing soft tissue infections have high mortality, especially for some high risk patients. Rare occurence of these infections make diagnosis difficult and delay the necessary urgent debridement ...
Plastic and Reconstructive Surgery, Jul 1, 2005
Letters to the Editor and Viewpoints are welcome. Letters to the Editor discuss material recently... more Letters to the Editor and Viewpoints are welcome. Letters to the Editor discuss material recently published in the Journal. Letters will have the best chance of acceptance if they are received within 8 weeks of an article's publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. Viewpoints pertain to issues of general interest, even if they are not related to items previously published (such as unique techniques, brief technology updates, technical notes, and so on). Please note the following criteria for Letters and Viewpoints: • Text-maximum of 500 words (not including references) • References-maximum of five • Authors-no more than five • Figures/Tables-no more than two figures and/or one table Authors will be listed in the order in which they appear in the submission. Letters and Viewpoints should be submitted electronically via PRS' enkwell, at www.editorialmanager.com/ prs/. We strongly encourage authors to submit figures in color. We reserve the right to edit letters and viewpoints to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a letter and/or viewpoint constitutes permission for the American Society of Plastic Surgeons and its licensees and assignees to publish it in the Journal and in any other form or medium. The views, opinions, and conclusions expressed in the letters to the Editor and viewpoints represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.tk;2 LETTERS MANAGEMENT OF ACUTE MIGRAINE HEADACHE WITH LIDOCAINE Sir: The incidental discovery that injection of botulinum toxin is beneficial for treating headaches in some individuals 1,2 stimulated Bahman Guyuron and his colleagues to consider the possibility that resection of the corrugator supercilii muscle is beneficial in the treatment of migraine headache. 3 In Guyuron et al.'s report, 4 migraine headaches improved almost 80 percent. Is it possible that nerve stimulation plays a role in this pathology? With this in mind, I think that if I anesthetize this "trigger point" I may improve the migraine headache. In my hospital where I receive patients with acute migraine headache, I ask patients to rate the intensity of their pain on a scale from 1 to 10 (1, without pain; 10, maximum pain). I then infiltrate 3 cc of lidocaine 2% with epinephrine in the supraciliary zone (trigger zone) in the subcutaneous plane. This improves the pain in minutes. I then ask patients to rate their pain again on a scale of 1 to 10 in 5-minute intervals. When the improvement is palpable, I send the patient home. I invite the medical community to probe this "serendipity" and to conduct new studies with more scientific facts.
Damarsal anomalilerin sınıflandırılmalarında süregelen karışıklık, 1982 yılında yapılan yeni sını... more Damarsal anomalilerin sınıflandırılmalarında süregelen karışıklık, 1982 yılında yapılan yeni sınıflandırma ile, plastik ve rekonstrüktif cerrahi literatüründe büyük ölçüde giderilmiş olsa da, lenfatik m alforasyonlar halen p ek çok değişik h isto p a to lo jik tanılar ile klinisyenlerin karşısına çıkabilmededirler. Bu çalışmada, son yedi yıl içerisinde kliniğimize başvuran lenf daman anomalileri retrospektif olarak incelenerek, almış oldukları histopatolojik tanılar, lezyonlann klinik ve morfolojik özellikleri ile birlikte değerlendirilmiştir. Ayrıca değişik klinik özellikler ile karşımıza çıkan bu malformasyonlartn uygun takip ve tedavi şekilleri de avantaj ve dezavantajları ile birlikte tartışılmıştır. Lenfatik malformasyonlartn tedavisinde öncelikli yöntem olarak kabul gören cerrahi eksizyonun hangi genişlikte yapılacağı da tartışmalıdır. Kliniğimizde, limitli ve yüzeyel eksizyonlar yerine, bu lezyonlann çevre anatomik yapıları da dikkate alarak mümkün olduğunca geniş ve derin fasya seviyesinden eksize edilmeleri tercih edilmektedir. Oluşacak fonksiyonel ve estetik kayıplar nedeniyle kısmi eksizyonların yapılabildiği durumlarda ise hastalar olası tekrarlar açısından uyarılarak yakın takip altında tutulmaktadırlar. A n ahtar K elim eler: D a m a rsa l anom ali, le n fa tik malformasyon, geniş eksizyon, kısmi eksizyon.
Journal of Plastic Reconstructive and Aesthetic Surgery, 2017
Dermatologic Surgery, Oct 1, 2003
BACKGROUND. Pseudocyst of the auricle is a rarely seen fluctuant swelling of the ear. Although va... more BACKGROUND. Pseudocyst of the auricle is a rarely seen fluctuant swelling of the ear. Although various hypotheses on the etiology have been suggested, the exact cause still remains unclear. Chronic minor trauma, which is believed to create intracartilaginous cavity, is accepted to be the most probable cause. Several treatment methods have been used for this benign lesion, but higher recurrence rates can be seen if not properly treated. OBJECTIVE. To discuss a new treatment modality for this rare disorder. METHOD. A 44-year-old man presented with a large pseudocyst of the auricle that had been treated several times previously with unsuccessful outcomes. For its treatment, we performed curettage and then used fibrin glue as a sealer between the two leaves of the cartilage. RESULTS. At postoperative 6-months follow-up, there was no evidence of recurrence. The cosmetic outcome was excellent. CONCLUSION. The use of fibrin glue both to obliterate the pseudocyst space and to make the two leaves of the cartilage adhere to each other should be kept in mind in this rare disorder in order to avoid recurrences.
Journal of Craniofacial Surgery, Mar 1, 2004
Craniofacial contouring is a commonly performed procedure applied for traumatic and postsurgical ... more Craniofacial contouring is a commonly performed procedure applied for traumatic and postsurgical cranial vault or facial skeleton irregularities. Hydroxyapatite cement is an alloplastic material composed of tetracalcium phospate and dicalcium phospate anhydrous that transforms into a pastelike substance when these two compounds placed in an aqueous environment. This mixture, which is a nonceramic microporous calcium phosphate combination, is another alternative for refining the craniofacial contour. There are not enough data regarding bone formation within this material after its use in human beings, however. A case requiring secondary craniofacial contouring after a motor vehicle accident is presented. Hydroxyapatite cement was used for reconstruction, and a second look was carried out for further correction during which secondary contouring of the cement was made and a sample of the previously implanted material was histologically evaluated. It was observed in this case that hydroxyapatite cement is incorporated within the surrounding bony structures and permits secondary contouring procedures. New bone and vessel formation was also detected within the implanted material, but this was limited and thus was not convincing for significant osteoconversion as seen in animal studies.
International Wound Journal, Dec 1, 2006
Traitement des plaies par pression né gative: un faisceau de preuves Le traitement par pression n... more Traitement des plaies par pression né gative: un faisceau de preuves Le traitement par pression négative est un mode thérapeutique utilisé pour accélérer la cicatrisation. Il peut être utilisé en traitement initial pour les plaies chroniques/complexes ou comme traitement adjuvant. Si l'on se base sur les preuves accumulées à ce jour, l'efficacité du traitement par la pression negative reste peu clair. Bien que des cas cliniques aient été rapportés et que des études rétrospectives aient démontré une accélération de la cicatrisation dans les plaies aigü es /traumatiques, les plaies chroniques, les plaies infectées, les plaies secondaires au diabète, les plaies sternales, les plaies des membres inférieurs, il n'existe que très peu d'études randomisées et leurs resultants sont peu clairs. Il n'y a pas de preuves pour utiliser le traitement par la Pression negative(TPN) pour d'autres indications dans lesquelles la cicatrisation serait accélérée, comme chez les patients présentant des escarres, ou diabétiques et porteurs de pathologies vasculaires périphériques ou pour améliorer la prise des greffes cutanées Il n'y a pas non plus, détudes de qualité de la vie de partients traités par TPN. Malgré cela, l'utilisation de la TPN a augmenté.. Cette revue de la literature apporte un panorama des études cliniques utilisant la TPN et propose de nouvelles voies de recherches futures pour élucider le mécanisme exact de la TPN, et également de large études randomisées contrôlées de patients soumis à ce traitement. Tratamiento de infecciones de heridas esternales profundas mediante el dispositivo de Cierre Asistido al Vacío TM (V.A.C. Ò) Un grupo de expertos internacionales se reunió en mayo de 2006 para elaborar normas clínicas sobre la aplicació n prá ctica del tratamiento con Cierre Asistido al Vacío TM (V.A.C. Ò) * en infecciones de heridas esternales profundas. Se utilizaron la discusió n del grupo y un sistema de votació n interactiva anó nima para desarrollar el contenido. Las recomendaciones se basaron en pruebas actuales o, en caso de no disponer de ellas, en la opinió n mayoritaria del grupo internacional. Los principios terapéuticos de las infecciones de heridas esternales profundas incluyen la identificació n precoz y el tratamiento de la infecció n. El tratamiento con V.A.C. debe instaurarse precozmente tras la irrigació n minuciosa de la herida y el desbridamiento quirú rgico. El tratamiento con V.A.C. en infecciones de heridas esternales profundas requiere supervisió n