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 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-2949-2021There 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.Item 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-7940-2023Background: 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.Item 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-7546-2013Item 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-6810-2021Background: 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.Item Platelet-Rich Plasma Increases Pigmentation(2017) Uysal, Cagri A.; Ertas, Nilgun Markal; 0000-0001-6236-0050; 27438442; AAJ-2949-2021Platelet-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.Item 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 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; 35450516Background 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.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.