Fakülteler / Faculties
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Item Novel Scalp Flap Elevation With Balloon Trocar Dissection Device(2023) Ozkan, Burak; Savran, Suleyman; Uysal, Cagri A.; 37470710Background: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.Item 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-3344-2021Basal 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.Item Temporal Muscle Capillary Hemangioma: Case Report(2014) Cologlu, Harun; Ozkan, Burak; Uysal, Ahmet Cagri; Kocer, Nazim Emrah; Borman, Huseyin; https://orcid.org/0000-0003-3093-8369; https://orcid.org/0000-0001-6236-0050; https://orcid.org/0000-0002-5943-9283; AAO-4286-2020; AAI-5063-2020; AAJ-2949-2021; AAM-5436-2021Item Bilateral Propeller Flap Closure of Large Meningomyelocele Defects(2014) Cologlu, Harun; Ozkan, Burak; Uysal, Ahmet Cagri; Cologlu, Ozlem; Borman, Huseyin; https://orcid.org/0000-0002-8605-9032; https://orcid.org/0000-0003-3093-8369; https://orcid.org/0000-0001-6236-0050; 24918736; AAO-4286-2020; AAI-5063-2020; AAJ-2949-2021Background: Meningomyelocele is a defect of the spinal cord, vertebral spine, and overlying skin and is the most common form of spinal dysraphism. Multiple methods of soft tissue closure for larger myelomeningocele defects have been described, including skin grafting, random fasciocutaneous flaps, skin undermining with relaxing incisions, and musculocutaneous flaps. Most current methods for closure of defects of 8 cm and greater and kyphotic spines usually remains inadequate. In this study, we present our clinical experience with a new surgical procedure, bilateral propeller (BP) flaps based on dorsal intercostal and lumbar artery perforator, for the closure of large thoracolumbar meningomyelocele defects. Patients and Method: Between January 2011 and April 2012, 7 newborns (5 males and 2 females) with thoracolumbar large meningomyelocele were included in the study. Six patients had lumbar kyphosis. Myelomeningocele defects with a mean size of 89.3 cm(2) (range, 58.9-136.8) were closed with BP flaps. Results: All flaps survived; hematoma, seroma, wound dehiscence, flap necrosis, or infection was not observed. No patients required any surgical revisions. The patients had a follow-up of 4 to 16 months with a mean of 10 months, and no long-term complications, including necrosis of flap edges, wound breakdown, or instability, have been apparent in our series. Conclusions: We believe that the BP flaps represent a useful tool in the management of soft tissue defects associated with especially kyphotic large thoracolumbar and lumbosacral myelomeningoceles.Item Inhibition of the Notch Pathway Promotes Flap Survival by Inducing Functional Neoangiogenesis(2015) Abbas, Ozan Luay; Borman, Huseyin; Terzi, Yunus K.; Terzi, Aysen; Bayraktar, Nilufer; Ozkan, Burak; Yazici, Ayse C.; 0000-0002-7886-3688; 0000-0003-3093-8369; 0000-0002-1225-1320; 0000-0002-3132-242X; 0000-0001-5612-9696; 25180956; Y-8758-2018; AAI-5063-2020; F-7546-2013; AAS-6810-2021; B-4372-2018Objective The Notch pathway seems to function as an antiangiogenic factor, negatively regulating the sprouting effect of vascular endothelial growth factor (VEGF). This function is well defined in embryonic and tumor vasculature. However, little is known about its function in ischemia-induced angiogenesis. In the first part of this study, we investigated the role of Notch in reparative angiogenesis after ischemia. In the second part, we hypothesized that anti-Notch therapy will result in increased angiogenic sprouting. We analyzed the effect of Notch inhibition in the induction of angiogenic sprouting. Methods In the first part, we investigated the effect of ischemia on the Notch ligand delta-like ligand 4 (DLL4). Twenty rats were divided equally into 2 groups. In the surgery group, dorsal skin flap was used as model of ischemia. In the control group, no surgical procedure was performed. DLL4 and VEGF gene expressions were assessed. Immunohistochemical staining was used for detection of DLL4 in tissue materials. Plasma levels of VEGF and DLL4 were measured. In the second part, we investigated the effect of Notch inhibition using a gamma-secretase inhibitor (GSI) on inducing neoangiogenesis. Twenty rats were assigned to 2 equal groups. In all animals, dorsal skin flap was raised and sutured back into its bed. Animals in the GSI-treated group received GSI intravenously after surgery for 3 days. Saline was administered in the control group. Necrotic area measurements, microangiography, and histologic evaluations were performed to compare groups. Results In the first part, VEGF and DLL expressions increased in ischemic tissues (P < 0.01). Immunohistochemical analysis revealed that DLL4 expression was upregulated in capillary endothelial cells after ischemia. Plasma levels for VEGF and DLL4 were higher in the animals that underwent surgery (P < 0.01). In the second part, GSI treatment resulted in higher flap survival rates (P < 0.05). Microscopic analysis exhibited increase in the number of microvascular structures after GSI treatment (P < 0.05). Microangiographic evaluation showed that neovascularization increased in the GSI-applied flaps. Conclusions We present an evidence for the importance of the Notch pathway in the regulation of ischemia-induced angiogenesis. Notch inhibition promotes flap survival by creating a neovasculature that has an increase in vascular density.Item 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-3344-2021