Başkent Üniversitesi Yayınları
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Item Use of Running Tap Water as an Initial Treatment in Patients With Scald Burns(Başkent Üniversitesi, 2024-12) Cem Aydogan; Murathan Erkent; Ebru Abali; Afig Gojayev; Abbas Albayat; Mehmet HaberalOBJECTIVES: First aid methods can be better understood by clinical events than by experimental studies. We retrospectively investigated how clinical outcomes were influenced by type of first aid method. MATERIAL AND METHODS: We reviewed patient medical records from January 2024 through January 2025 in the Baskent University burn center. We included only outpatients with scald burns (N = 340) in our study. All patients were examined and managed by the same 2 staff burn surgeons. We compared data from patients who were admitted on day 1 of injury and later and compared patients treated with and without cold running water. All patients had standard burn wound management. RESULTS: Wound healing time was reduced in patients who received appropriate first aid (cold running water) versus incorrect or no first aid (P < .05), including in all age groups examined (pediatric, adult, and geriatric groups) (P < .05). In patients who received appropriate first aid, numerical pain scores recorded during day 1 follow-up examinations were found to be lower (P < .05). Among patients who presented to the burn center on the first or second day postinjury, healing times were shorter than for those who presented later (P < .05). Patients who received appropriate first aid (vs incorrect or no first aid) had fewer debridement and graft surgery procedures (P < .05). CONCLUSIONS: Despite its retrospective design, our study emphasized that first aid methods affected clinical outcomes and showed that inappropriate burn wound management in the first 24 hours could negatively affect healing time. Education for prevention of burns and first aid for burns are crucial steps in these accidents. Cooling of wounds reduces further damage, morbidity, and mortality. Effective first aid methods in burns must be easy and fast for practicability.Item A Case of Falling Into an Acid Tank From Height After High-Voltage Electrocution(Başkent Üniversitesi, 2024-12) Burak Özkan; Abdullah Kızmaz; Uğur Bak; Khalid Zeynalov; Süleyman Savran; Abbas Albayati; Çağrİ A. Uysal; Mehmet HaberalIn this case report, we present the management of a dramatic and rare combination of injuries: high-voltage electrical injury, chemical burn, and open tibial and calcaneal fractures resulting from a fall from height. The patient underwent early fasciotomies. After treatments administered by a multidisciplinary team consisting of plastic surgeons, general surgeons, orthopedic specialists, anesthesiologists, and physiotherapists, the patient was discharged without extremity loss after a 135-day hospital stay. This case report discusses the importance of early fasciotomy and debridement in management of extensive burns and fall-related injuries, the potential for extended hospitalization for reconstruction, and the necessity of a multidisciplinary approach.Item Simple Limbal Epithelial Transplant in a Patient With Limbal Stem Cell Deficiency Due to Chemical Burn(Başkent Üniversitesi, 2024-09) Leyla Asena; Mehmet Haberal; Sibel Oto; Dilek Dursun AltİnÖrsABSTRACT Limbal stem cell deficiency develops when corneal epithelial stem cells become dysfunctional or deficient. This deficiency leads to neovascularization of the corneal surface, persistent epithelial defects, scarring, and decreased vision. Simple limbal epithelial transplant is a relatively new technique to address limbal stem cell deficiency. Here, we describe a male patient with chemical ocular burn injury in his left eye that resulted in diagnosis of unilateral limbal stem cell deficiency. The patient was successfully treated with simple limbal epithelial transplant.Item Utilization of Novel Keystone Flap Modification on Various Anatomic Sites(Başkent Üniversitesi, 2024-09) Burak İzkan; Mehmet Haberal; Çağrİ A. Uysal; Abbas Albayati; Ömer Uzun; Uğur Bak; Orkhan Shahbazov; Abdullah Kızmaz; Süleyman SavranABSTRACT We describe our proposed modification of the keystone flap, which adds a V-Y advancement in 3 directions, further optimizing the redistribution of tension forces. This new approach not only improves the overall stability of the flap but also reduces the risk of wound dehiscence and enhances the potential for better healing outcomes. We describe its use in 15 patients treated at our center (mean age of 58 years [range, 18-77 y]) with mean follow-up time of 14 months (range, 6-24 mo). All flaps survived, and no early or late complications were encountered. The keystone flap’s flexibility, combined with its multiple modifications, continues to expand its applicability across diverse anatomical locations, making it a vital tool in reconstructive surgery for complex defects.Item Surgical Management of Limbal Stem Cell Deficiency Secondary to Chemical Ocular Burns(Başkent Üniversitesi, 2024-06) Dilek Dursun Altınörs; Mehmet Haberal; Leyla Asena; Sibel OtoABSTRACT OBJECTIVES: We reported results of surgical management of limbal stem cell deficiency secondary to chemical ocular burns. MATERIALS AND METHODS: We retrospectively reviewed medical records of patients who had surgery with the diagnosis of limbal stem cell deficiency from chemical burns between January 2016 and January 2023. Patients with follow-up of more than 6 months were included. We recorded demographic properties, best-corrected visual acuity at preoperative and last visits, medical and surgical treatment modalities, and outcomes. RESULTS: Nineteen eyes of 13 patients (9 males, 4 females) were included; mean age was 35.7±14.2 years. Limbal stem cell deficiency was bilateral in 6 cases. Mean time from injury to medical treatment was 13.3 ± 8.1 months (range, 4-23 mo). Six patients had bilateral involvement: 3 received living-related conjunctival allograft transplant, and 3 received deceased donor keratolimbal allograft transplant. Seven cases had unilateral involvement, 4 of which underwent conjunctival limbal autograft transplant and 3 had simple limbal epithelial transplant. Mean postoperative follow-up was 25.8 ± 16.6 months (range, 5-42 mo). Corneal transplant was performed simultaneously in 4 patients and 1 and 2 years after limbal stem cell transplant in 5 other patients. At the last visit, 13 eyes (68.4%) had intact and stable ocular surfaces with clear central corneas. Mean best-corrected visual acuity increased from 1.65 ± 0.93 to 0.78 ± 0.65 logMAR at last visit (P < .001). CONCLUSIONS: Treatment and restoration of the ocular surface health are challenging in limbal stem cell deficiency due to chemical injury to the ocular surface. Living-related conjunctival allograft transplant and cadaveric keratolimbal allograft transplant are currently available surgical techniques in bilateral cases. Unilateral cases can be managed with newer techniques such as simple limbal epithelial transplant, allowing the in vivo expansion of limbal stem cells on an amniotic membrane transplant.Item Pedicled Anterolateral Thigh Flap Reconstruction for Defects Between Umbilicus and Knee(Başkent Üniversitesi, 2024-06) Burak Özkan; Abdullah Kızmaz; Khalid Zeynalov; Süleyman Savran; Abbas Albayati; Çağrı A. Uysal; Mehmet HaberalABSTRACT OBJECTIVES: This study evaluated the efficacy and outcomes of pedicled anterolateral thigh flap reconstruction in addressing soft tissue defects between the umbilicus and the knee. MATERIALS AND METHODS: We evaluated 12 patients (8 males, 4 females; mean age of 56 years; range, 15-74 years) who underwent pedicled anterolateral thigh flap reconstruction between 2019 and 2022. Defect locations included the inguinal region, trochanteric region, medial thigh, posterior thigh, lateral knee, and umbilical region. RESULTS: The average operative time was 2.7 hours (range, 2-4 hours). All donor sites were closed primarily, with no major complications. Mean hospital stay was 7 days (range, 4-18 days). CONCLUSIONS: The pedicled anterolateral thigh flap is a versatile and reliable solution for defects in the lower abdomen and lower extremities, offering excellent outcomes with minimal donor site morbidity.Item Electrical Burns: A Special Type of Burn Injury(Başkent Üniversitesi, 2024-03) Cem Aydogan; Murathan Erkent; Ebru Abali; Abbas Albayati; Afig Gojayev; Adem Safak; Mehmet HaberalABSTRACT OBJECTIVES: Electric burn injuries are one of the most devastating types of trauma. Compared with other skin burns, electric burn injuries are more complex and associated with higher morbidity and mortality. The trauma resembles an iceberg; the burn is not only related to skin or deep tissues but has serious systemic hazardous effects to the body, which cause other associated complications. MATERIALS AND METHODS: We retrospectively examined medical records to review electric burns treated at Baskent University Hospital burn centers across Türkiye between January 2008 and October 2023. We reviewed 361 electric burn injuries. We analyzed patient demographic characteristics, epidemiology of the injury, mechanism of injury, size and depth of burn, treatment methods associated with electrical burns, and complications. RESULTS: Of 361 patients, 88% were male patients, and most damage was caused by high voltage (76%). Many accidents occurred at work (48%) but 19% occurred at home. Many accidents occurred in summer and spring (60%). Mean age, percent total body surface area, hospitalization time, creatine phosphokinase, and myoglobulin were 28.9 years (range, 2-89 y), 21.1%, 25.5 days, 8722 U/L, and 1924 ng/mL, respectively. Percentages of debridement, grafting, fasciotomy, amputation, and flaps were 62.2%, 54.6%, 33.7%, 15.1%, and 14.2%, respectively. CONCLUSIONS: Public education and governmental legislation are important for preventing work-related accidents. Coexisting traumas have to be considered in this type of injury. Resuscitation is important at the beginning of treatment. Early fasciotomy can prevent limb salvage or can prevent extensive amputations. After resuscitation, early debridement and reconstruction via grafting or flaps are important. Physiotherapy is crucial after reconstruction.Item Infectious Features of Burn Wounds and Their Influence on the Course of Clinical Outcomes in Burn Victims(Başkent Üniversitesi, 2023-06) Ayse Ebru Abali; Cem Aydogan; Burak Ozkan; Elif Unlu; Mehmet HaberalABSTRACT OBJECTIVES: This study sought to determine the interactions between infectious features of burn wounds and in-hospital clinical outcomes among patients treated at our burn center. MATERIALS AND METHODS: Our study group included 192 inpatients seen from 2020 to 2023. We collected data on age, sex, etiology, total body surface area burned, length of hospital stay, documentation of isolated microorganisms at admission and during hospitalization, requirement of antibiotic therapy, and mortality. We evaluated data among 3 subgroups: group 1 (length of hospital stay of 0-10 days), group 2 (length of hospital stay of 11-30 days), and group 3 (length of hospital stay of >30 days). RESULTS: Mean ± SE age was 32.2 ± 1.6 years (range, 0-86 y), and male-to-female patient ratio was 2.1:1. Mean ± SE total body surface area burned was 12.6 ± 1.3% (range, 1%-85%). Scalds were the most common burn cause. Mean ± SE length of hospital stay was 17 ± 2.4 days (range, 1-363 d). Among the 27 positive wound swab cultures at admission, 9 were resistant. Gram-positive bacteria were the most common at admission. During hospitalization, microorganisms were isolated in wound swabs or tissues in 48 cases. Staphylococcus epidermidis and multidrug-resistant Acinetobacter baumannii were the most common bacteria. Therapeutic antibiotherapy was needed for 83.3% of group 3, 53.1% of group 2, and 20.2% of group 1. Mortality rate was 3.6% (n = 7/192 patients), with 3 patients in group1, 2 patients in group 2, and 2 patients in group 3 who had at least 1 microorganism at admission. CONCLUSIONS: Evaluations of microflora in burn centers and precautions against wound contamination during emergency and transport phases can contribute to informed decisions at burn centers.Item A Case of Progressive Mortal Thrombosis: Phlegmasia Cerulea Dolens(Başkent Üniversitesi, 2023-03) Khalid Zeynalov; Burak Ozkan; Tankut Akay; A. Cagri Uysal; Mehmet HaberalABSTRACT Phlegmasia cerulea dolens is a very rare set of conditions associated with acute, massive venous thromboembolism. Medical and surgical options can be combined in treatment. Patients may experience sudden onset and severe leg pain, edema, cyanosis, compartment syndrome, and post-venous gangrene amputation and death. Medical and surgical treatments can be combined in treatment. Anticoagulants, thrombectomy, percutaneous procedures and amputations are among the treatment options. We present a 60-year-old female patient with a diagnosis of diabetes mellitus with swelling, pain, and discoloration in the left lower extremity who died due to progressive venous thrombosis despite various treatment modalities. Wound debridement and thrombectomy were performed. On day 10 of hospitalization, the patient was intubated to treat resistant low saturation. Despite the interventions, the patient died on day 10 of hospitalization due to cardiopulmonary arrest. Early diagnosis and treatment are vitally important. As in the case we presented, sometimes patients die as a result of rapid clinical progression and side effects, despite the use of different medical and surgical treatments.Item Preservation of the Extremity Length With Free Microvascular Tissue Transfers(Başkent Üniversitesi, 2023-03) Burak Özkan; Orkhan Shahbazov; A. Çağrı Uysal; Cem Aydoğan; Mehmet HaberalABSTRACT OBJECTIVES: Patients who had unhealed amputations stumps have generally poor vascular condition due to vasculopathies or crush injuries. Tendons and bones are superficial and covered with a thin skin and amputation stump should be revised of changed to a more proximal level MATERIALS AND METHODS: 10 patients were reviewed retrospectively between 2020-2023. Patients were evaluated according to demographics, etiology of the amputations, location of the defects, flap type, recipient vessels, anastomosis fashion, early and late complication rates and hospitalization length . RESULTS: The mean age of the patients was 58 years. Nine of 10 extremity length were successfully preserved with free flap transfers. One patient was referred to orthopedic department for higher amputation level. CONCLUSIONS: Free microvascular tissue transfers are important reconstructive options for extremity salvage.