Browsing by Author "Uysal, Cagri A."

Now showing 1 - 20 of 24

Adipose-Derived Stem Cells Enhance Axonal Regeneration through Cross-Facial Nerve Grafting in a Rat Model of Facial Paralysis
(2016) Abbas, Ozan L.; Borman, Huseyin; Uysal, Cagri A.; Gonen, Zeynep B.; Aydin, Leyla; Helvacioglu, Fatma; Ilhan, Sebnem; Yazici, Ayse C.; https://orcid.org/0000-0001-6236-0050; https://orcid.org/0000-0002-6026-0045; https://orcid.org/0000-0002-3132-242X; 27465163; AAJ-2949-2021; AAH-8887-2021; AAS-6810-2021
Background: Cross-face nerve grafting combined with functional muscle transplantation has become the standard in reconstructing an emotionally controlled smile in complete irreversible facial palsy. However, the efficacy of this procedure depends on the ability of regenerating axons to breach two nerve coaptations and reinnervate endplates in denervated muscle. The current study tested the hypothesis that adipose-derived stem cells would enhance axonal regeneration through a cross-facial nerve graft and thereby enhance recovery of the facial nerve function. Methods: Twelve rats underwent transection of the right facial nerve, and cross-facial nerve grafting using the sciatic nerve as an interpositional graft, with coaptations to the ipsilateral and contralateral buccal branches, was carried out. Rats were divided equally into two groups: a grafted but nontreated control group and a grafted and adipose-derived stem cell-treated group. Three months after surgery, biometric and electrophysiologic assessments of vibrissae movements were performed. Histologically, the spectra of fiber density, myelin sheath thickness, fiber diameter, and g ratio of the nerve were analyzed. Immunohistochemical staining was performed for the evaluation of acetylcholine in the neuromuscular junctions. Results: The data from the biometric and electrophysiologic analysis of vibrissae movements, immunohistochemical analysis, and histologic assessment of the nerve showed that adipose-derived stem cells significantly enhanced axonal regeneration through the graft. Conclusion: These observations suggest that adipose-derived stem cells could be a clinically translatable route toward new methods to enhance recovery after cross-facial nerve grafting.
Asymmetric Z-plasty for Telephone Deformity in Prominent Ear Correction
(2014) Uysal, Afsin; Uysal, Cagri A.; Cologlu, Harun; Borman, Huseyin; https://orcid.org/0000-0001-6236-0050; https://orcid.org/0000-0002-8605-9032; 25098579; AAJ-2949-2021
There have been plenty of surgical techniques for the correction of prominent ears. "Telephone deformity" or "reverse telephone ear" has been described as the undesired result of the inappropriate correction of the prominent ear, mainly the deficient correction of the lobule. We have performed an asymmetric Z-plasty to the lobule to overcome this deformity not only by excision of the excess skin but also by transposition of the soft tissue. Between 2005 and 2011, the technique currently described was performed in 19 patients. Preoperative, intraoperative, and postoperative standardized photographs were taken, and measurements were done on postoperative first week, first month, and first year. The measurements include ear height at 3 different horizontal planes as follows: (1) the most cranial point of the ear, (2) the middle point of the ear, and (3) the most caudal point of the ear. The angle between the vertical plane of the head and the ear was measured at these previously defined 3 points. These measurements were used for indication and preoperative planning. There were statistically significant differences between preoperative and postoperative values (P < 0.05). The postoperative first year results indicated the effectiveness of this alternative technique for the long-term maintenance of the position of the lobule.
Clinical Experiences with Closed Incisional Negative Pressure Wound Treatment on Various Anatomic Locations
(2020) Ozkan, Burak; Ertas, Nilgun Markal; Bali, Ulas; Uysal, Cagri A.; 0000-0003-3093-8369; 0000-0001-6236-0050; AAI-5063-2020; AAJ-2949-2021
Background Closed incisional negative pressure wound treatment (ciNPWT) is one of the promising methods for the prevention of complications in surgical incisions. The mechanisms of ciNPWT have previously been elucidated and in this series, we demonstrate various, as of yet, underreported uses for the technology. Our aim is to share our experience with ciNPWT on various anatomic sites with novel indications. Materials and methods ciNPWT was used in 24 patients. The mean age was 49.6. All the incisions were sutured, clean, and non-infected. Patients' sex, age, comorbidities, anatomic location of the wound, and the indications for ciNPWT were recorded. Results The mean number of applications was three per patient. One suture dehiscence after one session of ciNPWT was encountered in a flap donor site of an infant operated for meningomyelocele. Late-term seroma and hematoma formation were encountered in two patients. No surgical site infection, wound dehiscence, and ciNPWT related complications were seen in other patients. The majority of the applications were on the trunk, lower extremity, pelvis, upper extremity, and scalp respectively. Indications for ciNPWT utilization were preventing dehiscence, seroma, and hematoma formation in the majority of the patients. Conclusion ciNPWT is reliable and effective in the prevention of post-operative wound dehiscence and surgical site infections. It can be used safely in various locations and different indications for preventing complications such as preventing dehiscence in revision surgeries, cerebrospinal fluid (CSF) fistula formation in the scalp, and wound breakdown in chronic corticosteroid use,
A Custom-Made Nostril Retainer for Adult Population
(2020) Ozkan, Burak; Albayati, Abbas; Akinci, Kadri; Uysal, Cagri A.; Ertas, Nilgun M.; 0000-0001-6236-0050; 32371700
Elongation of the stylohyoid process or calcification of the stylohyoid ligament is known as the Eagle syndrome. Mostly, it is seen incidentally on imaging or with extreme suspicion and usually patients are asymptomatic. Surgery is the preferred method in symptomatic patients. Transcervical or transoral methods may be preferred as surgical route. A 28-year-old female patient who had formerly underwent tonsillectomy presented with throat and ear pain. A neck computed tomography was performed, and the patient was diagnosed as Eagle Syndrome. Surgery was recommended. Patient developed transient velopharyngeal insufficiency on postoperative day 4. Ventilation exercise and follow-up was recommended. Complaints of the patient decreased on the 15th day. It should be kept in mind that stylohyoid ligament may be calcified in young age group and middle age group patients with dysphagia or odynophagia, and differential diagnosis should be performed. Another issue is the condition of velofaringeal insufficiency which may occur due to the damage of the pharynx muscles by deep dissection during surgery.
A descriptive study of facial lacerations presenting to pediatric emergency in Turkey
(2021) Albayati, Abbas; Ozkan, Burak; Eyuboglu, Atilla; Uysal, Cagri A.; Ertas, Nilgun M.; https://orcid.org/0000-0003-2806-3006; https://orcid.org/0000-0001-6236-0050; 33394475; AAC-3344-2021; AAJ-2949-2021
BACKGROUND: Soft tissue trauma of the face is considered a leading cause of presentation and referral to the pediatric emergency department. The present study aims to evaluate the demographics properties of facial injuries presenting to the pediatric emergency. METHODS: In this study, 1160 patients presented with a simple facial laceration to the pediatric emergency department of Baskent University were reviewed from 2011 to 2017. Patients up to 18 years of age were included. We evaluated demographics about patients' age, sex, the cause of injury, the location of laceration and timing of the injury. Age was categorized according to the National Institute of Child Health and Human Development (NICHD) pediatric terminology into five groups as follows: 0-12 months, 12 months-2 years, 2-5 year, 6-11 year, and 12-18 years. The following analyses were performed to each age group: a number of cases, male to female predominance, timing of injury (e.g., early morning, afternoon, evening, late evening and at night), the place that the injury has occurred (e.g., at home, at school, in sport hall), the cause of injury (fall, hitting a hard subject, sports-related), the location of laceration (forehead, periorbital area, cheek, perioral area, nose, submental area) and the incidence according to the season. RESULTS: Number and relative percentages of cases were as follows: 0-12 months (n=127, 10.9%), 12-24 months (n=113, 9.7%), 3-5 years (n=385, 33.1%), 6-11 years (n=403, 34.7%) and 12-17 years (n=132, 11.3%). The average age of children was 6.5 year (range, 5 month - 17.9 year). The age group 6-11 showed a higher incidence compared to other age groups (n=403, 34.7%). Fifty-three percent of the population was younger than six years and there was a male predominance in all age groups. CONCLUSION: The demographic data provided in this study can be useful in trauma prevention programs which are effective in reducing the incidence, nature and severity of facial lacerations. Parents should be reminded of age-specific preventive measures in injury avoidance.
Does methylene blue increases capsular contracture in immediate breast reconstruction with silicone implant? An experimental study
(2020) Albayati, Abbas; Ozkan, Burak; Atilgan, Alev O.; Sencelikel, Tugce; Uysal, Cagri A.; Ertas, Nilgun M.; 0000-0003-2806-3006; 0000-0001-8595-8880; 0000-0001-6236-0050; 0000-0003-3093-8369; 33030384; AAC-3344-2021; AAK-3333-2021; AAJ-2949-2021
Recently, most of the immediate breast reconstructions following mastectomy are being carried out with the use of silicone implants. In these patients, methylene blue is being used for the detection of sentinel lymph nodes. This experimental study was performed to determine the effect of methylene blue on capsular contracture around breast implants. Thirty-two Sprague Dawley rats were divided into 4 groups. Custom made silicone blocks were placed on the back of animals. In group 1, the incision was closed without performing any additional procedure. In group 2 (control), 0.1 mL of 0.9% normal saline was instilled into the pocket. Group 3 and 4 (study groups) received 0.1 and 0.2 mL of 1% methylene blue, respectively. On postoperative day 60, implants and capsular tissue were extracted. Capsule formation was evaluated both macroscopically and microscopically. The histological evaluation included capsule thickness, inflammation, neovascularization, and fibrosis gradients. Regarding capsule thickness, there were statistically significant differences between groups 1-3, 1-4, 2-3, and 2-4. Although there were more moderate and severe inflammation gradients in groups III and IV, there was no significant difference regarding inflammation severity between control and study groups. In respect of vascular proliferation, there was a statistically significant difference between control and study groups. Similarly, fibrosis gradients were higher in both groups 3 and 4. The study showed that the injection of methylene blue around silicone implants enhanced the formation of capsular contracture. In this case, the degree of contracture was independent of the dose given.
Double Layer Reconstruction of Exposed Cardiac Implantable Electronic Devices in Elderly Patients
(2021) Ozkan, Burak; Albayati, Abbas; Yilmaz, Kerem C.; Ciftci, Orcun; Ozin, Bulent; Uysal, Cagri A.; Ertas, Nilgun Markal; 0000-0001-8926-9142; 33542888; AAJ-1331-2021; W-5233-2018
Background Elderly patients with multiple comorbidities may not be candidates for cardiac implanted electronic device (CIED) explantation in cases of exposition. Excision of all unhealthy and inflamed scar tissue results in a skin defect that must be covered. Small- to moderate-sized local skin flaps and subpectoral placement of CIEDs have been described in the literature. However, these techniques still could not eliminate the risk of recurrence. In terms of minimizing the recurrence risk, we aim to increase the flap dimensions for getting better circulation and tension-free closure after subpectoral placement. Material and methods Six patients who were operated for a dual-layer reconstruction of exposed cardiac implants between 2017 and 2020 were included in the study. All patients were referred to plastic surgery as soon as the wound biopsy culture results were negative after systemic and topical antibiotic treatment by cardiology department. Results No flap loss or wound dehiscence was seen with a mean duration of 11 months follow-up. Early hematoma was encountered in a patient who was managed with irrigation and drain renewal. One patient developed suture abscess in the second month postoperatively. Knots were removed and wound healed without further intervention. Conclusion Double layer closure of exposed cardiac implants with large breast fasciocutaneous flap after subpectoral placement of pulse generator and leads suggest durable and reliable coverage in elderly patients with multiple comorbidities.
The Effect of Adipose Derived Stromal Vascular Fraction on Flap Viability in Experimental Diabetes Mellitus and Chronic Renal Disease
(2022) Ozkan, Burak; Eyuboglu, Atilla Adnan; Terzi, Aysen; Ozturan Ozer, Eda; Tatar, Burak Ergun; Uysal, Cagri A.; 0000-0003-3093-8369; 35450516
Background The presence of chronic renal disease(CRD) concurrently with diabetes mellitus(DM) increases the flap failure. Adipose derived stromal vascular fraction (SVF) is known to enhance skin flap viability in both healthy and diabetic individuals. The aim of this experimental study was to investigate the effect of SVF on skin flap viability in rats with DM and CRD. Methods 48 Sprague-Dawley rats were separated into four groups as follows: group I (control), group II (diabetes mellitus), group III (chronic renal disease), and group IV (diabetes with chronic renal disease).Two dorsal flaps were elevated. Flaps on left side of all groups received 0.5 cc of SVF, while same amount of plasma-buffered saline (PBS) was injected into right side. On postoperative day 7, flaps were harvested for macroscopic, histopathologic and biochemical assessments. Areas of flap survival were measured macroscopically. Blood level of vascular endothelial growth factor (VEGF) was measured after injection of SVF. Results Macroscopically, SVF has significantly improved flap viability (p < 0.05). Flap viability percentage was lower in DM and CRD groups when compared with healthy control group. In respect of new capillary formation, there was a statistically significant difference between SVF injected flaps and PBS injected sides (p < 0.05). Similarly, VEGF levels were higher in all study groups and there was a significant difference in comparison to control group (p < 0.05). Conclusions The study showed that injection of SVF increased flap viability via endothelial differentiation and neovascularization. In vivo function of stem cells might be impaired due to uremia and diabetes-related microenviromental changes.
The Effect of Adipose Derived Stromal Vascular Fraction on Stasis Zone in An Experimental Burn Model
(2018) Eyuboglu, Atilla Adnan; Uysal, Cagri A.; Ozgun, Gonca; Coskun, Erhan; Ertas, Nilgun Markal; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-6236-0050; 0000-0002-9805-9830; 29032969; AAJ-8097-2021; AAJ-2949-2021; IQW-7940-2023
Background: Stasis zone is the surrounding area of the coagulation zone which is an important part determining the extent of the necrosis in burn patients. In our study we aim to salvage the stasis zone by injecting adipose derived stromal vascular fraction (ADSVF). Methods: Thermal injury was applied on dorsum of Sprague-Dawley rats (n=20) by the "comb burn" model as described previously. When the burn injury was established on Sprague-Dawley rats (30min); rat dorsum was separated into 2 equal parts consisting of 4 burn zones (3 stasis zone) on each pair. ADSVF cells harvested from inguinal fat pads of Sprague-Dawley rats (n=5) were injected on the right side while same amount of phosphate buffered saline (PBS) injected on the left side of the same animal. One week later, average vital tissue on the statis zone was determined by macroscopy, angiography and microscopy. Vascular density, inflammatory cell density, gradient of fibrosis and epithelial thickness were determined via immunohistochemical assay. Results: Macroscopic stasis zone tissue viability (32 + 3.28%, 57 + 4.28%) (p<0.01), average number of vessels (10.28 +/- 1.28, 19.43 +/- 1.72) (p<0.01), capillary count (15.67 +/- 1.97, 25.35 +/- 2.15) (p<0.01) vascular density (1.55 +/- 0.38, 2.14 +/- 0.45) (p<0.01) epithelial thickness (0.014 +/- 0.009mm, 0.024 +/- 0.0011mm) were higher on ADSVF side. Fibrosis gradient (1.87 +/- 0.51, 1.50 +/- 0.43) (p<0.01) and inflammatory cell density (1.33 +/- 0.40, 1.20 +/- 0.32) (p<0.01) were higher on the PBS side. Conclusion: Macroscopic and microscopic findings determined that ADSVF has a statistically significant benefit for salvaging stasis zone on acute burn injuries. (c) 2017 Elsevier Ltd and ISBI. All rights reserved.
The effect of adipose stromal vascular fraction on transverse rectus abdominis musculocutaneous flap: an experimental study
(2016) Ataman, Murat Gorkem; Uysal, Cagri A.; Ertas, Nilgun Markal; Bayraktar, Nilufer; Terzi, Aysen; Borman, Huseyin; 0000-0002-7886-3688; 0000-0001-6236-0050; 0000-0002-1225-1320; 27010192; Y-8758-2018; AAJ-2949-2021; F-7546-2013
Effect of Mesenchymal Stem Cells on Skin Graft to Flap Prefabrication: Reply
(2015) Uysal, Cagri A.; 0000-0001-6236-0050; 25668502
Effect of Mural or Intra-Arterial Injection Adipose Derived Stromal Fraction on TNBS-Induced Colitis: An Experimental Study
(2019) Tugan, Tezcaner; Aydin, Huseyin Onur; Uysal, Cagri A.; Ozgun, Gonca; Ozer, Huriye Eda Ozturan; Ekici, Yahya; Haberal, Mehmet A.
Effectiveness of Bone Marrow Stromal Cell Sheets in Maintaining Random-Pattern Skin Flaps in an Experimental Animal Model
(2016) Uysal, Cagri A.; 0000-0001-6236-0050; 27070212; AAJ-2949-2021
Elimination of Reperfusion-Induced Microcirculatory Alterations In Vivo by Adipose-Derived Stem Cell Supernatant without Adipose-Derived Stem Cells
(2015) Uysal, Cagri A.; 26284793
Escharotomy for the Face: Facial Aesthetic Subunit Principle-Based Approach
(2021) Ozkan, Burak; Ertas, Nilgun M; Uysal, Cagri A.; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0003-3093-8369; 32845003; AAJ-8097-2021
Escharotomy is the relaxation of an eschar through longitudinal or horizontal incisions in order to protect regional perfusion. In peripheral areas, such as limbs, trunk, and neck, eschar pressure poses significant issues; it causes circulatory disorder in limbs and potential limb loss, inadequate thoracic expansion in the thorax, and perfusion and oxygenation problems in the neck. To prevent complications, a basic rule of burn surgery is to perform escharotomy incisions quickly and without hesitation. However, the face is not an area in which eschar formation is commonly seen due to its robust vascular supply and patients' protection reflex. Although descriptive drawings and guides for facial escharotomy have yet to be published, relaxation of axial arteries in terms of compression from eschar formation may be needed. Here, we present a case of escharotomy based on facial subunit principles.
Giant Basal Cell Carcinoma Causing Axillary Contracture: A Case Report of an Unusual Localization of an Advanced Case
(2023) Albayati, Abbas; Ozkan, Burak; Tepeoglu, Merih; Uysal, Cagri A.; 0000-0003-2806-3006; 0000-0003-3093-8369; 0000-0001-6236-0050; 38061706; AAC-3344-2021
Basal cell carcinoma (BCC) is the most common type of non-melanoma skin cancer. Although BCC arises most commonly in sun-exposed areas of the body, such as the head and neck, it infrequently can be seen in sun-protected parts as well. Axilla is one of the least encountered areas of BCC. Delay in the diagnosis or management alongside negligence of the patient can lead to a tumor reaching a giant size. We report a case of giant axillary BCC in a 59-years old female patient with no known risk factors for skin cancers. The tumor was excised with wide margins, and the tissue defect was reconstructed with latissimus dorsi musculocutaneous flap. A 3-year follow-up did not show any sign of recurrence or metastasis.
Novel Scalp Flap Elevation With Balloon Trocar Dissection Device
(2023) Ozkan, Burak; Savran, Suleyman; Uysal, Cagri A.; 37470710
Background:Balloon trocar devices have been utilized in several surgical cases to reach a difficult-to-access location, achieve hemostasis, and obtain safe, efficient surgery.Objective:Highlight the balloon trocar dissection device in a novel technique of scalp flap elevation for tissue expander placement.Methods:The pocket for the tissue expander was determined at the scalp. A 2 cm vertical incision was made. A 12 mm balloon trocar is then introduced and insufflated. Through the trocar, endoscopic light is then inserted. Scalp flap elevation was performed with the device. The exact location of the pocket was seen with the lumination of endoscopic light.Results:The balloon trocar dissection device provides easy scalp flap elevation and bleeding control. With the help of endoscopic light, the pocket for the expander was created precisely.Conclusion:The balloon trocar device is simple, effective, low-cost equipment for tissue expander placement in the scalp.
Platelet-Rich Plasma Increases Pigmentation
(2017) Uysal, Cagri A.; Ertas, Nilgun Markal; 0000-0001-6236-0050; 27438442; AAJ-2949-2021
Platelet-rich plasma (PRP) is an autologous solution of plasma containing 4 to 7 times the baseline concentration of human platelets. Platelet-rich plasma has been widely popular in facial rejuvenation to attenuate wrinkles and has been practically used. The authors have been encountering various patients of increased hiperpigmentation following PRP applications that were performed to attenuate the postinflammatory hiperpigmentation especially after laser treatment. The authors have been using PRP for facial rejuvenation in selected patients and in 1 patient the authors have encountered increased pigmentation over the pigmented skin lesions that were present before the application. The authors recommend that the PRP might increase pigmentation especially in the face region and precautions might be taken before and after the application. Platelet-rich plasma should not be used for the treatment of post inflammatory hiperpigmentation.
A Practical Cleft Palate Training Model
(2020) Ozkan, Burak; Cologlu, Harun; Uysal, Cagri A.; Ertas, Nilgun M.; 0000-0003-3093-8369; 0000-0001-6236-0050; 32309100; AAI-5063-2020; AAJ-2949-2021
Educational models are essential for training surgeons and making them familiar with experience- and skill-dependent operations such as cleft palate closure. The development of computer and 3D printer technology has allowed cleft lip and palate models to be produced and used for surgical training. However, these technology-dependent models are not affordable and reproducible for surgeons in developing countries where cleft cases are more commonly seen. Thus, we aimed to create a cleft palate educational model prepared with play-dough and latex. The play-dough is shaped in the form of a palate and the cleft is created by scissors. Then, a latex glove is cut and applied to the dough to mimic the mucosal layer. The combination of the latex glove and play-dough lets the trainee perform surgical markings, incisions, elevation of the flaps, and layer closure. We think this easily producible model might be beneficial for demonstrating cleft types, surgical techniques, and improving surgical skills, especially in developing countries.
Practical Things You Should Know about Wound Healing and Vacuum-Assisted Closure Management
(2021) Ozkan, Burak; Uysal, Cagri A.; Ertas, Nilgun M.; 0000-0001-6236-0050; 33177445