Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item 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-5233-2018Background 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.Item 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; 33177445Item Reconstruction of Burn Contractures with Free Anterolateral Thigh Flap in Various Anatomic Sites(2021) Bali, Zulfukar Ulas; Ozkan, Burak; Kececi, Yavuz; Ertas, Nilgun; Yoleri, Levent; 33884605BACKGROUND: Burn contractures that cause a restriction in extremity movements have to be reconstructed. Free microvascular flaps are generally needed in cases of severe contractures. The ideal free flap for severe contracture defects has to have a large skin island without bulk and a long pedicle for preventing recurrence and tension-free adaptation. Anterolateral thigh flap (ALT flap) that meets these features has widely been used for several indications in reconstructive surgery. Usage of ALT flap in burn contracture was described for burn and axillary contractures in literature. In this study, the usage of free ALT flaps in various anatomic contracture sites was reported. METHODS: Fifteen free ALT flaps were performed in 14 (12 male, two female) patients with a mean age of 36.6. Burn contracture defects in neck, axilla, popliteal, cubital region, plantar foot and hand were reconstructed with ALT flap. RESULTS: No total flap loss was encountered. Distal flap necrosis was seen in one case. All patients had significant improvement in a range of motions. Recurrence in contracture was seen in one patient with hand flexor contracture due to lack of physical treatment. CONCLUSION: ALT flap can safely be used in various anatomic contracture sites. Suprafascial elevation of the flap can be preferred for better adaptation in the neck, hand and foot and prevention of bulky appearance.Item 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-2949-2021Educational 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.Item Securing Posterior Auricular Incision with Button Headbands in Prominent Ear Patients Wearing Surgical Masks for Self-protection in the Pandemic(2020) Ozkan, Burak; Uysal, Cagri A.; Ertas, Nilgun M.; 0000-0003-3093-8369; 0000-0001-6236-0050; 32500322; AAI-5063-2020; AAJ-2949-2021In this letter, we describe an attachment on conventional headbands recommended for the postoperative period in prominent ear patients to confidently wear surgical masks without disturbing the posterior auricular incision.Item 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-2949-2021Background 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,Item Effect of long-term intermittent hypothermia on random skin flap viability and new vessel formation(2020) Caglar, Ibrahim Baris; Ozkan, Burak; Albayati, Abbas; Uysal, Ahmet Cagri; Ertas, Nilgun Markal; 0000-0001-6236-0050; 0000-0003-2806-3006; AAJ-2949-2021; AAC-3344-2021Background: Preconditioning is the improving the overall viability of the flaps before surgery. Hypothermia is one of preconditioning methods. In literature, the effect of short time hypothermia in skin flap viability has been studied. However, there is no information about the effects of long-term application of hypothermia on skin flap viability. In this study, we investigated the effect of long-term local hypothermia on flap viability and new vessel formation on random pattern skin flaps. Materials and Methods: Thirty-six adult male Sprague-Dawley rats were used. The flap model was, 3 cm x 9 cm sized random pattern skin flap. Three groups were composed as control group, continuous hypothermia induction group with ice bags, and intermittent hypothermia induction with chloroethyl spray. Flaps were raised on the 15th day of hypothermia sessions. Flap viability was measured in the software program. Microangiography and blood vascular endothelial growth factor (VEGF) levels were assessed for the detection of new vessel formation. Results: Average flap viabilities were found to be 64.87% in Group I, 57.69% in Group II, and 62.22% in Group III. The difference between Group II and other groups were statistically significant. When microangiographies were examined macroscopically, diameters, and amount of vascular branches of vessels in Group II were found to be higher than other groups. The difference between blood VEGF levels day 1 values among groups was not statistically significant. When day 4 values were compared to baseline values difference in Group III was statistically significant. At days 7 and 15, differences between groups and corresponding baseline values were not statistically significant. Conclusion: Continuous long-term application of hypothermia with ice-water bags causes a significant increase in neovascularization in random pattern skin flaps without an increase in skin flap viability. Hence, we can say that 2 weeks of hypothermia on random pattern skin flaps is not an efficient preconditioning method in clinical use.Item Inferior Gluteal Artery Perforator Flap for Closure of Sacral Defects after Pilonidal Sinus Surgery(2019) Bali, Zulfikar Ulas; Ahmedov, Anvar; Ozkan, Burak; Mazican, Mustafa; Kececi, Yavuz; 0000-0003-3093-8369; AAI-5063-2020Introduction: The aim of the current study was to introduce the use of the inferior gluteal artery perforator flap (IGAPF) as a new alternative surgical technique for closure of sacral defects after pilonidal sinus surgery. Patients and Methods: Inferior gluteal artery perforators were used on 15 male patients operated in the plastic and reconstructive surgery deportment of our tertiary care centers between March 2014 and May 2017. Age, size of the defect, duration of follow-up, complications, and recurrence rate were assessed. Results: The average age was 30.2 (range: 17-54) years, and the mean duration of follow-up was 8.2 (range: 7-16) months. No recurrence was detected within the follow-up period, and the only remarkable complication reported was total flap necrosis attributed to venous congestion in one patient. The mean size of the defects after excision was 21.6 cm(2). Conclusion: Our preliminary results imply that IGAPF can be a safe and effective alternative for closure of large defects after pilonidal sinus surgery. Further controlled trials on larger series are warranted to establish the advantages and disadvantages of this alternative technique.Item 35-year Onset of a Squamous Cell Carcinoma Originating from Sacral Pilonidal Sinus(2019) Ozkan, Burak; Cologlu, Harun; Uysal, Cagrı A.; Ertas, Nilgun M.; 32537300Item The Role of Choice-Lock Catheter and Trocar Technique in Percutaneous Ablation of Symptomatic Renal Cysts(2014) Ozkan, Burak; Harman, Ali; Emiroglu, Baris; Arer, Ilker; Aytekin, Cuneyt; 25035702Background: The most common benign lesions of the kidney are simple cysts. They are acquired lesions and mostly affect the elderly population. Objectives: To describe the usage of choice-lock catheter and trocar technique in percutaneous renal cyst treatment and determining long-term outcomes. Patients and Methods: This retrospective study was carried out between February 2000 and July 2011 Eighty-eight cysts all of which were Bosniak type-1 cysts were selected in 75 patients. The treatment indications were flank pain, hydronephros is and hypertension. The choice-lock catheter was used for 84 cysts with the trocar technique. Ninety-five percent ethanol was used as the sclerosing agent. Maximum volume of the injected ethanol was 175 ml. The mean follow-up time after the treatment procedure was 23 months. Sixty-four cysts were located in the cortical and 24 cysts were located at the parapelvic region. Results: Fifty-seven cysts had complete regression, while 31 cysts regressed partially After the procedure, pain was relieved in 44 (82%) patients and the pain alleviated in four (8%). Normotension was obtained in five (62.5%) of the eight hypertensive patients and no hydronephrosis was detected in nine patients. There were no relationship between the localization and the regression rate. No major complications occurred. Conclusions: Percutaneous ethanol sclerotheraphy in simple cysts is a safe, cost-effective and minimally invasive method. We consider that this technique may be an alternative solution in the percutaneous cyst treatment.