Browsing by Author "Arpaci, Enver"

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A comparison of rat degloving injury models
(2017) Arpaci, Enver; Altun, Serdar; Orbay, Hakan; Ekinci, Mehmet; Cetinbas, Ahmet; Bal, Ali; Okur, Mehmet Ihsan; 28454780
Objective: Two different rat models for degloving injury were described in the literature. Our aim in this study is to compare these rat models to determine which one is more reliable and reproducible. Methods: We surgically induced degloving injury on tails and left hindlimbs of Wistar albino rats (n = 8), and sutured the avulsed tissues back in their original positions after a waiting period. We observed the changes in the avulsed flaps every other day for 10 days. At the end of follow-up period we evaluated the lesions in avulsed flaps by macroscopic measurement of necrosis and histological ulcer scoring using the National Pressure Ulcer Advisory Panel (NPUAP) Scale. Results: The average length of necrosis in avulsed tail flaps was 28.42 +/- 3.04 mm, whereas there was no necrosis in avulsed hindlimb flaps (p < 0.05). The average ulcer score of the lesions in tail and left hindlimb were 3.42 +/- 0.78, and 1.28 +/- 0.48, respectively (p < 0.05). Despite the lack of visible necrosis TUNEL staining revealed an increased amount of apoptotic cells in avulsed hindlimb flaps. Literature review revealed a significant variability in previous studies in terms of the amount of necrosis observed in tail degloving injury model. Conclusion: Tail degloving injury model proved to be a more reliable animal model for degloving injuries. However, standardization of the magnitude of degloving force is required to decrease the variability of necrosis observed in the literature. (C) 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.
Double-Layered Circular Advancement Flap for Reconstruction of Inguinal Defects
(2017) Arpaci, Enver; Altun, Serdar
Objective: Vascular graft infections are rare complications but can lead to life-threatening outcomes for the patient. Conventional treatment methods are the removal of the vascular graft and an extra-anatomic by-pass procedure. Unfortunately, this treatment presents high morbidity and mortality rates. Treatment of the deep-level perivascular synthetic graft infection and closure of exposed vascular graft reduce graft infection, thereby help to reduce mortality and morbidity rates. Material and Methods: Between 2009-2013 seven cases of complicated defect that involved perivascular graft infection in the inguinal region were performed using omega advancement flaps. In this technique, a circular-shaped flap with a diameter corresponding to the defect was planned adjacent to the defect after debridement of the infected perivascular and the necrotic skin areas. To facilitate the advancement of the flap and to support the subcutaneous region, deepithelialized equilateral triangular flaps were designed on both sides of the main circular flap. Results: Wound dehiscence and infection recurrence did not occur in the follow-up period. No secondary surgeries were required to change the segment of the vascular graft. All flaps survived without any complications such as hematoma, flap necrosis or infection. The results were satisfactory both aesthetically and functionally. Conclusion: Omega fasciocutaneous advancement flap is a reliable, suitable and easy method for the reconstruction of complex inguinal vascular infections.
The Effects of Adipose Derived Stromal Vascular Fraction and Platelet-Rich Plasma on Bone Healing of a Rat Model With Chronic Kidney Disease
(2020) Eyuboglu, Atilla Adnan; Arpaci, Enver; Albayati, Abbas; Uysal, Ahmet Cagri; Terzi, Aysen; Bozalioglu, Sema; Turnaoglu, Hale; Balcik, Cenk; Ozkan, Burak; Ertas, Nilgun Markal; 0000-0002-0781-0036; 0000-0003-2806-3006; 0000-0001-6236-0050; 32784349; AAK-8242-2021; AAC-3344-2021; AAJ-2949-2021
Background Chronic kidney disease (CKD) impairs osteoblast/osteoclast balance and damages bone structure with diminished mineralization and results in bone restoration disorders. In this study, we investigate the effects of adipose-derived stromal vascular fraction and platelet-rich plasma (PRP) on bone healing model in rats with CKD. Methods Sprague-Dawley rats were separated into 4 groups. All groups except group I (healthy control) had CKD surgery using 5/6 nephrectomy model. All groups had intramedullary pin fixation after receiving bone fracture using drilling tools. Group II rats were used as control group for CKD. Group III rats received PRP treatment on fracture site. Group IV rats received PRP and stromal vascular fraction treatment on fracture site. Weight loss and blood samples were followed at the time of kidney surgery, third, sixth, and 12th weeks. Bone healing and callus formations were compared, biomechanically, radiologically, histopathologically, and immunohistochemically. Osteoblastic transformation of stem cells was assessed with DiI staining. Results Negative effects of CKD on bone healing were reduced by increasing mechanical, histological, radiological, and biochemical properties of the bone with stromal vascular fraction and PRP treatments. Although thickness of callus tissue delayed bone healing process, it also enhanced biomechanical features and bone tissue organization. Conclusions Platelet-rich plasma and adipose-derived stromal vascular fraction treatments were effective for bone healing in animal model, which can be promising for clinical trials.
Efficacy of positron emission tomography and computed tomography in clinical staging of cutaneous malignant melanoma
(2020) Yilmaz, Harun; Orhan, Erkan; Sahin, Ertan; Olguner, Anil A.; Arpaci, Enver; 32160381
Accurate staging is very important for determining the prognosis and appropriate treatment for malignant melanoma (MM). The aim of this study is to determine the effectiveness of positron emission tomography and computed tomography (PET/CT) imaging in staging MM. Patients diagnosed with MM who then underwent PET/CT metastasis before treatment were assessed retrospectively. For each patient, the following variables were recorded: Breslow thickness, Clark's level, number of mitoses, the presence of ulceration detected in the pathology report, and the presence of lymph nodes and/or distant metastases detected by PET/CT. The pathology and PET/CT reports of 139 patients (79 female and 60 male) were retrospectively evaluated for staging after MM diagnosis. Patients with a Breslow thickness greater than 3.4 mm and Clark's level of 4 to 5 were found to be statistically significantly higher with regional lymph node metastasis after PET/CT scans. Patients with Breslow thickness greater than 2.85 mm and Clark's level of 4 to 5 were found to be statistically significantly higher with distant metastasis after PET/CT scan. The results of our study suggest that PET/CT imaging for metastasis scanning, starting with T2 patients, may be used in MM staging to reduce the need for sentinel lymph node (SLN) biopsy and lymph node dissection.
The efficacy of ultrasound-guided type-I and type-II pectoral nerve blocks for postoperative analgesia after breast augmentation: A prospective, randomised study
(2019) Karaca, Omer; Pinar, Huseyin U.; Arpaci, Enver; Dogan, Rafi; Cok, Oya Y.; Ahiskalioglu, Ali; 0000-0002-8467-8171; 0000-0003-0473-6763; 0000-0003-1933-2075; 29627431; B-7473-2016; Q-2420-2015; AAU-6923-2020
Purpose: The present study was planned to evaluate the efficacy and safety of ultrasound-guided Pecs I and II blocks for postoperative analgesia after sub-pectoral breast augmentation. Methods: Fifty-four adult female patients undergoing breast augmentation were randomly divided into two groups: the control group (Group C, n = 27) who were not subjected to block treatment and Pecs group (Group P, n = 27) who received Pecs I (bupivacain 0.25%, 10 mL) and Pecs II (bupivacain 0.25%, 20 mL) block. Patient-controlled fentanyl analgesia was used for postoperative pain relief in both groups, and the patients were observed for the presence of any block-related complications. Results: The 24-h fentanyl consumption was smaller in Group P [mean +/- SD, 378.7 +/- 54.0 mu g and 115.7 +/- 98.1 mu g, respectively; P < 0.001]. VAS scores in Group P were significantly lower at the time of admission to the post-anaesthetic care unit and at 1, 2, 4, 8, 12, and 24 h (P < 0.001). The rates of nausea and vomiting were higher in Group C than in Group P (9 vs 2, P = 0.018). Hospital stay duration was shorter in Group P than in Group C (24.4 +/- 1.2 h vs 27.0 +/- 3.1 h, P < 0.001). No block-related complications were recorded. Conclusions: Combine used of Pecs I and II blocks provide superior postoperative analgesia in patients undergoing breast augmentation and shortens hospital stay. (C) 2018 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.
A New Oval Advancement Flap Design for Reconstruction of Pilonidal Sinus Defect
(2018) Arpaci, Enver; Altun, Serdar; Orhan, Erkan; Eyuboglu, Atilla; Ertas, Nilgun Markal; 0000-0002-9805-9830; 29713735; AIC-3493-2022
Backgrounds Pilonidal sinus is a common chronic disease of the sacrococcygeal region. Although many surgical methods have been described for treating pilonidal sinus disease, controversy still exists as to the best surgical technique. The aim of this study is to present a new modified advancement flap technique named omega flap for the treatment of pilonidal sinus disease. Materials and methods This study included 18 patients with pilonidal sinus who were treated between March 2012 and August 2014. All cases underwent oval excision and omega advancement flap reconstruction. Defect size, postoperative complications, postoperative pain, painless sitting time, patient satisfaction and recurrence were evaluated retrospectively. Results All patients were discharged on the first postoperative day. There was no flap necrosis. No recurrence and no major complication were observed during follow-up period. The outcomes were also satisfactory regarding functionally and aesthetically, and the patients were satisfied with the results. Conclusions Presented method has a different geometry than classical advancement flap methods. Our technique provides two-layered repair with minimal tension and off-midline closure for the reconstruction of pilonidal sinus defect. It is easily performed, reliable, associated with no recurrens and good aesthetic results.
Omega (Omega) Advancement Flap: A Circular Flap Design for the Aesthetic Closure of Circular Skin Defect
(2017) Arpaci, Enver; Altun, Serdar; Ertas, Nilgun Markal; Uysal, Ahmet Cagri; Inozu, Emre; 28039499
Background Most skin defects that require reconstruction with a local skin flap have a circular-or oval-shaped pattern. The majority of the skin flaps are planned in an angled shape. Therefore, it may be necessary to modify the shape of the defect or the distal flap border to minimize tissue distortion. We have designed a circular-shaped advancement flap to be compatible with the circular defect. Methods Eighteen cases of reconstruction of skin defects in the face, chest wall, hand and buttock area were performed using the omega advancement flap between 2010 and 2014. In this technique, a circular-shaped flap that has an equal diameter with the defect is planned adjacent to the defect. To facilitate the advancement of the flap and to avoid standing cones, deepithelialized equilateral triangular flaps are designed on both sides of the main circular flap. The circular flap is easily moved to the defect by pulling of the triangular flaps with minimal tension. Results All flaps survived without complication such as infection, hematoma or flap necrosis. No secondary surgery was required to correct contour deformities such as standing cones and trap-door deformities. The results were satisfactory aesthetically and functionally. Conclusions The omega advancement flap is an easy and reliable procedure for reconstruction of circular skin defects located on various anatomical regions.
Reconstruction of Small and Medium-Sized Nasal Defects Using an Omega Advancement Fla
(2020) Altun, Serdar; Bal, Ali; Arpaci, Enver; 31895844
Introduction: The nose is the most common area where malignant skin tumors occur. Repair with a flap after tumor excision provides esthetically and functionally acceptable results. In this study, we aimed to present the use of an omega (omega) advancement flap, which can be applied in all anatomic regions of the nose, in 2 cm or smaller defects. Methods: Between 2015 and 2017, 18 patients underwent repair with omega (omega) advancement flap in the nose after tumor removal. The pathology of 17 patients was basal cell carcinoma, and keratoacanthoma in 1 patient. The average defect diameter was 1.6 x 1.56 cm. The defects were in the nasal tip, nasal wing, lateral nasal wall, and supratip region. After tumors were excised from the safe margin, and were repaired using an omega advancement flap in the same session. Results: No flap necrosis, dehiscence, or infection was observed in the early postoperative period. Three patients developed hematoma under the flap, which was drained. No tumor recurrence was observed during the postoperative follow-up period. The results were satisfactory in all patients. Conclusion: The omega advancement flap is a safe procedure that can be easily applied in the same session for the repair of small-to-medium-sized nasal defects.
Vertical Scar Reduction Mammaplasty
(2016) Altun, Serdar; Unlu, Ramazan Erkin; Ozturk, Mehmet Onur; Arpaci, Enver; 26910708