Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Isolated Upper Eyelid Coloboma(2017) Eyuboglu, Atilla Adnan; Cologlu, Harun; Uysal, Cagri Ahmet; Albayati, Abbas; Ertas, Nilgun Markal; 0000-0002-9805-9830; 0000-0002-8605-9032; 0000-0001-6236-0050; 0000-0003-2806-3006; AIC-3493-2022; AAO-4286-2020; AAJ-2949-2021; AAC-3344-2021Item Non Melanoma Skin Cancers in Solid Organ Transplant Recipients: A Single Center Experience(2018) Ertas, Nilgun Markal; Uysal, A. Cagri; Albayati, Abbas; Ozkan, Burak; Haberal, Mehmet; 0000-0003-2806-3006; 0000-0003-3093-8369; 0000-0002-3462-7632; AAC-3344-2021; AAI-5063-2020; AAJ-8097-2021Item Aesthetic Surgery in Transplant Patients: A Single Center Experience(2018) Ozkan, Burak; Albayati, Abbas; Eyuboglu, Atilla Adnan; Uysal, Ahmet Cagri; Ertas, Nilgun Markal; Haberal, Mehmet; 0000-0003-3093-8369; 0000-0003-2806-3006; 0000-0002-9805-9830; 0000-0001-6236-0050; 0000-0002-3462-7632; 29528026; AAI-5063-2020; AAC-3344-2021; AIC-3493-2022; AAJ-2949-2021; AAJ-8097-2021Objectives: Transplant patients, like the nontransplant population, can have surgical interventions for body shape disorders. Studies on aesthetic surgeries in transplant patients are scarce. Our aim was to share our experiences with various aesthetic procedures in solid-organ transplant recipients. Materials and Methods: Six (5 female, 1 male) transplant patients who received surgical corrections of the aging face, ptosis and lipodystrophy of the breast, and abdomen at the Baskent University Plastic Reconstructive and Aesthetic Surgery Department between 2010 and 2017 were included. Five patients had renal transplants, and 1 patient had liver transplant. Minimal aesthetic procedures, including botulinum toxin, dermal filler injections, and scar revisions, were excluded. All patients were consulted to transplant team preoperatively and hospitalized in the transplant inpatient clinic. Results: Mean age was 46 years. Aesthetic surgeries included breast reduction (2 patients), high suprasuperficial musculoaponeurotic system face lift (1 patient), blepharoplasty (2 patients), and dermofat grafting (1 patient). Mean hospitalization duration was 2.5 days. Four patients had no minor or major complications. One patient had skin flap necrosis, which healed with secondary intention. Another patient had ectropion after lower lid blepharoplasty, which was corrected with another procedure. Conclusions: Transplant patients are a special group of patients who receive long-term immunosuppressive treatment and medications like high-dose steroids. These treatments can lead to dermal atrophy and cause pseudo-skin laxity. Removal of excess skin and fat tissue should be considered. Efforts should be made to avoid complications such as skin necrosis and unpredictable wound healing problems when resetting the excess tissue. Preoperative consultation with transplant surgeons and keeping operative times short are other important factors. Body dysmorphologies that interfere with normal life activities and demand for younger appearance are the main reasons of aesthetic procedures. Transplant patients can be operated safely with preoperative planning, consultation with transplant surgeons, and close follow-up.Item Nonmelanoma Skin Cancers in Solid-Organ Transplant Recipients: A Single Center Experience(2018) Albayati, Abbas; Ozkan, Burak; Eyuboglu, Atilla Adnan; Uysal, Ahmet Cagri; Ertas, Nilgun Markal; Haberal, Mehmet; 0000-0003-2806-3006; 0000-0003-3093-8369; 0000-0002-9805-9830; 0000-0001-6236-0050; 0000-0002-3462-7632; 29528001; AAC-3344-2021; AAI-5063-2020; AIC-3493-2022; AAJ-2949-2021; AAJ-8097-2021Objectives: Skin cancers are one of the most common malignancies in solid-organ transplant recipients. Increased age and immunosuppressive drug use are risk factors for posttransplant skin malignancies. We evaluated nonmelanocytic skin cancer incidence and development time in transplant patients. Materials and Methods: We reviewed 1833 patients who received kidney, liver, and heart grafts between 1996 and 2016 at Baskent University. We excluded melanocytic skin cancers, premalignant lesions, and benign skin tumors. Results: Of 1833 patients, 1253 were male (68.4%) and 580 were female (31.6%), composed of 1133 kidney (61.8%), 512 liver (27.9%), and 120 heart recipients (6.5%). Of these, 22 patients (18 kidney/3 liver/1 heart) developed 23 different types of skin cancer. Prevalence of skin cancer was 1.20%. Mean age at presentation was 55.8 years (range, 37-71 y). Average time from transplant to skin malignancy was 6.1 years (range, 1-13 y), with the most common being basal cell carcinoma (43%, 10 cases), followed by squamous cell carcinoma (39%, 9 cases) and Kaposi sarcoma (13%, 3 cases). Tumor sites included head and neck (15 case), trunk (2 cases), lower extremity (2 cases), and upper extremity (2 cases). Neither local recurrence nor distant metastasis was shown. Conclusions: Skin cancer risk is increased in solid-organ transplant recipients versus the general population. Although squamous cell carcinoma is the most common tumor in this patient population, followed by basal cell carcinoma, we found this reversed in our patients. The low prevalence of skin malignancy (1.20%) may be associated with close clinical follow- up to detect premalignant skin lesions and the low-dose immunosuppressive drug regimen. We believe that local recurrence and distant metastasis were absent because we use a wide surgical margin of excision and provide strict follow-up. Routine dermatologic follow-up visits of transplant recipients are recommended to detect and treat early skin cancer and premalignant lesions and thus lower morbidity and mortality.Item A severe electrothermal ring burn case and a proposed treatment algorithm(2022) Ozkan, Burak; Albayati, Abbas; Savran, Suleyman; Uysal, Cagri Ahmet; 0000-0003-2806-3006; AAC-3344-2021Ring-associated burns are infrequent comprising only a tiny fraction of burn consults. Due to the circular nature of rings, these burns are often circumferential, with an increased risk for compartment syndrome and neurovascular injury. The severity of ring burn is related to the type of material and electrical current. Low-voltage injuries are generally due to contact with batteries and household devices, while high-voltage electric injuries occur with occupation-related accidents or natural disasters. Low-voltage ring burn can be managed conservatively with close follow-up. However, high-voltage ring burn might have dramatic consequences such as finger amputation. To date, there have been few cases reported in the literature of a ring burn. Most cases were superficial burns and managed with secondary healing or skin grafting. However, the literature has not reported the management of a severe ring burn with deteriorated finger circulation. In this case report, we present a circumferential electrothermal ring burn case with resulted in total loss of a finger. Furthermore, we propose an algorithmic approach to ring burn injuries.Item Extraocular Sebaceous Carcinoma in Muir-Torre Syndrome(2022) Albayati, Abbas; Ozkan, Burak; Ayva, Ebru Sebnem; Uysal, Ahmet Cagri; Ertas, Nilgun Markal; 0000-0003-2806-3006; 36092191; AAC-3344-2021Item Quality and Reliability of YouTube Videos for Hand Surgery Training(2023) Savran, Suleyman; Albayati, Abbas; Ozkan, Burak; Uysal, Cagri A.; 0000-0003-2806-3006; 0000-0003-3093-8369; AAC-3344-2021Background Hand injuries might present with exposed tendons, bones, and neurovascular structures, requiring flap reconstruction. Comprehending various flap options for hand injuries requires detailed knowledge, surgical skills, and considerable practice. Surgery residents commonly use web-based learning; one is YouTube for surgical education. We aim to evaluate the reliability and quality of the videos on YouTube for hand surgery training. Methods Video extraction from YouTube were done by keywords on 24 August 2021. JAMA scores and flap reconstruction of the hand-specific scoring system (FH-SS) were used to evaluate the selected videos. Results The mean JAMA score and FH-SS were 1.72 and 8.54, respectively. JAMA scores and FH-SS of the videos from Europe were significantly lower than from America and Asia (p = 0.0001 and p = 0.0063, respectively). The JAMA scores of physicians were significantly higher than that of medical sources (p < 0.0001). Conclusions The low JAMA score and the average FH-SS suggest that YouTube videos are unreliable and poorly qualified for hand surgery residents. The high JAMA score of the physician's videos emphasizes the reliability of YouTube videos depending on the sources. Surgery residents should be skeptical of the information of YouTube videos on surgical education. Level of Evidence: Not ratableItem The use of mathematically standardized bilobed design perforator flaps for coverage of sacral pressure ulcers(2022) Ozkan, Burak; Albayati, Abbas; Tatar, Burak Ergun; Uysal, Cagri Ahmet; https://orcid.org/0000-0003-3093-8369; 36205233Background Sacral pressure ulcer reconstruction is frequently applied in plastic surgery practice. Although perforator flaps are frequently used, recurrence is not uncommon in patients. For this reason, using the as little area as possible during the reconstruction is vital. Therefore, we aimed to describe a mathematically standardized bilobed perforator flap design for sacral pressure ulcer reconstruction with a certain proportion and angle relation between limbs. Methods A total of 17 patients (5 female/12 male)were included in this report. The mean age of the patients was 50.4 years (Ranging from 32 to 79 years). The patients with grade 3-4 sacral pressure ulcers were included in the report. The patients have grade 1-2 sacral ulcers or the other areas of pressure ulcer excluded. The size of the defects ranged from 8 x 14 cm to 5 x 16 cm. For ulcers in the sacral region, we used bilobed flaps that we mathematically standardized. The length of the first limb of the flap was planned 90 degrees vertically oriented according to the distance between the perforator zone to the distal lateral border of the defect. The width of the first limb was kept equal to the length of the defect. The orientation of the second limb of the flap was designed 90 degrees horizontally according to the first limb. Therefore, the lengths of second limbs were calculated as half of the first limb's width, and the widths of second limbs were calculated as 3/4 width of the first limb's width. Results A total of 10 flaps were elevated based on superior gluteal artery perforators, and seven flaps were nourished by inferior gluteal artery perforators. The mean size of the first limb of the flaps was 14.7 x 7.2 cm (Ranging from 8 to 20 x 6 to 13 cm). The mean size of the second limb of the flaps was 6.7 x 5.3 cm (Ranging from 5 to 12 x 4 to 8 cm). The mean size of defects was 10.5 x 7.3 cm (Ranging from 8 to 14 x 5 to 16). The mean rotation angle was 91.7 degrees (ranging from 90 to 100). In the early postoperative period, the hematoma was detected in three patients and evacuated in one patient, resulting in wound separation. Tip necrosis was seen in a patient that was healed by wound care. No total flap loss was encountered. No late-term recurrence was seen during the follow-up. The mean follow-up time was 13.1 months (Ranging from 4 to 24 months). Conclusion Unilateral standardized bilobed perforator can reliably be preferred in medium to large size sacral pressure ulcer defects.Item 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-2949-2021BACKGROUND: 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.Item 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-2949-2021Recently, 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.