Operation Timing of Free Vascular Fibula Flep in Mandibular Reconstructions

Free tissue transfers are commonly used popular approach with respect to the development of microsurgery. In the present study, we aimed to evaluate the relationship between the operation timing and the succes of the free fibula flap operations for 11 cases, which were applied for mandible reconstruction after the high velocity gundshot wound of face in Cukurova university, Department of Plastic, Reconstructive and Aesthetic surgery between 1986-2004. The ages of the patients were between 17-42 (Mean age 25.8). Ten of them were male (%90.9) and one of them female (%9.1). Defect of the mandible bone were measured between 4 to13 cm. Nine of them were also required to the reconstruction of soft tissues. Nine patients were operated for free flap transfer during the first year and 2 of the patients were operated after the 1 year as a late reconstruction. Free flap failures were noted independently defect size and localizations for three patients, which were operated at l.month, 12.month and after 1 year as a late reconstruction. Free flap failure were noted especially at groups of 10-30 ages and 40-50 ages. Two of them were reoperated but the succes of flap was achieved at the group of 20-30 ages. Flap ischemia time was found to be directly proportional to the flap failure rate. Flap success rate (%100) were achieved at the operations betvveen the 2 and 7 months (mean 4.4 months) with less than 1 mm decrease of bicortical cortical thickness of flap. In conclusion, free flap reconstructipn of mandible defect after the high velocity gunshot wound can be achieved with better results at 4.4 months and between the 30-40 years of ages. [Cukurova Med J 2011; 36(1): 41-46

The Comparison of Open Septorhinoplasty Methods with or without Osteotomies Performed in Situations of Traumatic Nasal Deformation

Bu çalışmanın amacı, travmatik nazal deformasyonlu hastalarda, solunum fonksiyonlarını arttırmak ve deformasyonu düzeltmek amaçlı uygulanan osteotomili ve osteotomisiz açık septorinoplasti yöntemlerinin, fonksiyonel sonuçlarının karşılaştırılmasıdır. Materyal ve Metod: Prospektif ve klinik olarak planlanan bu çalışmada, 2007-2009 yılları arasında travmatik nazal deformasyon şikayetiyle başvuran 26 hasta çalışmaya dahil edildi. Hastaların ameliyat öncesi ve sonrası fizik muayeneleri, fotoğraf kayıtları, periorbital ödem ve ekimoz bulguları ve solunum değişimleri kaydedildi. Hastalarda belirgin nazal dorsum düzensizliği, septum deviasyonu ve solunum zorluğu olduğu tespit edildi. 13 hastaya (% 50) osteotomili, 13 hastaya (% 50) osteotomisiz açık septorinoplasti uygulandı. Osteotomi yapma kararı, nazal dorsum genişliğine ve burun uzunluk ölçümlerine göre verildi. Hastalar postoperatif 1, 3, 6 ve 12 aylık dönemlerde sonuçların değerlendirilmesi amacıyla kontrollere alındı. Bulgular: Operasyonlar sonrası tüm hastalarda fonksiyonel olarak iyileşme saptandı.Osteotomisiz grupta osteotomili gruba göre solunum şikayetlerindeki düzelmenin daha fazla olduğu, nazal pasajda daralmanın daha az olduğu, postoperatif dönemde ödem ve ekimozun daha az olduğu görüldü. Sonuç: Açık septorinoplasti operasyonu, klasik olarak osteotomi uygulanarak yapılsa da osteotomi uygulanmadan yapılan operasyonların, nazal pasajda daralmaya neden olmadığı, postoperatif ödem ve ekimozun daha az olduğu görülmüştür. Osteotomisiz rinoplasti, preoperatif dönemde detaylı ön çalışma ile seçilmiş hastalarda yararlı bir prosedür olabilirThe aim in this study is to compare the functional results of open septorhinoplasty with and without osteotomies performed with the aim of increasing respiratory functions and healing the deformations in patients with traumatic nasal deformations. Material and Methods: In this prospective and clinical study, 26 patients with traumatic nasal deformation, who applied between 2007 and 2009 were analyzed. The physical examination, medical photographies, the findings of periorbital edema and ecchymosis and changes in respiratory behaviors before and after the operation were recorded. Evident irregularities of nasal dorsum, septum deviation and respiratory distress were identified in all of the patients. Open septorhinoplasty with osteotomy (13 patients - 50 %) and without osteotomy (13 patients - 50 %) were applied to a total of 26 patients. Osteotomy decision was given according to nasal dorsal width and nasal height. All the patients were controlled in the in the first, third, sixth and twelfth months of the postoperative period to analyze the results. The data gathered through these cases were compared with the literature. Results: Functional improvements were observed after open septorhinoplasty operations in all patients. When the postoperative results of the open septorhinoplasty operations with and without osteotomy are compared, it was observed that among the group of patients on which osteotomies were not practiced respiratory complaints improved better, stricture in the nasal passage was not caused, edema and ecchymosis in the postoperative period was lesser. Conclusion: In this study, the attempt was to prove that although open septorhinoplasty operations are classically performed with osteotomy, the operations without osteotomy has not cause stricture in the nasal passage, it causes less edema and ecchymosis in the postoperative period compared to the group with osteotomy. It is an acceptable procedure for patients chosen in the preoperative period through a detailed preliminary wor

The Comparison of Open Septorhinoplasty Methods with or without Osteotomies Performed in Situations of Traumatic Nasal Deformation

WOS: 000363969000012Purpose: The aim in this study is to compare the functional results of open septorhinoplasty with and without osteotomies performed with the aim of increasing respiratory functions and healing the deformations in patients with traumatic nasal deformations. Material and Methods: In this prospective and clinical study, 26 patients with traumatic nasal deformation, who applied between 2007 and 2009 were analyzed. The physical examination, medical photographies, the findings of periorbital edema and ecchymosis and changes in respiratory behaviors before and after the operation were recorded. Evident irregularities of nasal dorsum, septum deviation and respiratory distress were identified in all of the patients. Open septorhinoplasty with osteotomy (13 patients - 50 %) and without osteotomy (13 patients - 50 %) were applied to a total of 26 patients. Osteotomy decision was given according to nasal dorsal width and nasal height. All the patients were controlled in the in the first, third, sixth and twelfth months of the postoperative period to analyze the results. The data gathered through these cases were compared with the literature. Results: Functional improvements were observed after open septorhinoplasty operations in all patients. When the post-operative results of the open septorhinoplasty operations with and without osteotomy are compared, it was observed that among the group of patients on which osteotomies were not practiced respiratory complaints improved better, stricture in the nasal passage was not caused, edema and ecchymosis in the postoperative period was lesser. Conclusion: In this study, the attempt was to prove that although open septorhinoplasty operations are classically performed with osteotomy, the operations without osteotomy has not cause stricture in the nasal passage, it causes less edema and ecchymosis in the postoperative period compared to the group with osteotomy. It is an acceptable procedure for patients chosen in the preoperative period through a detailed preliminary work

Perforator flap employment for elbow soft tissue reconstruction of radial collateral artery

WOS: 000431893600049

A Reliable and Useful Flap for Repair Defects of the Hand Fingers: Reverse Flow Dorsal Metakarpal Artery Pediculled Flaps

Reverse flow dorsal metacarpal artery pediculled flap is one of the easily apllicable and useful flap alternatives which are used for closing the defects of the hand fingers. The aim of this study is evaluate complications and outcomes of finger defects repairing with reverse flow dorsal metacarpal artery pediculled flap. From 1999 till 2009 we applied this technique for repairing fingers’ defects in totally of 15 patients. 5 of them represent after electric burn injury, 4 after endustrial trauma, 4 after excision of squamous cell carsinoma ( SCC ) and 2 after contracture opening procedure. Nine of them were male and 6 female with mean age of 39. Most of used arteries were 2nd or 3rd dorsal metacarpal. Follow ups for these patients lasted around 30 month (11 - 45 month). In 2 patients flaps were lost due to inappropriate pedicle rotation and after the debridement of the flaps, the defects were repaired with “cross-finger” flaps. Reverse flow dorsal metacarpal flap which does not damage the major arterial system of the hand and is easily applicable and useful technique, has good skin color and tissue compatibility, and can be used for fingers’ defects repairing. [Cukurova Med J 2011; 36(1.000): 1-7

Our Clinical Experience in Lower Eyelid Reconstruction and Comparison of Reconstruction Techniques.

Lower eyelid reconstruction after tumor resection or trauma is extremely important in order to obtain the protection of the globe and it requires extra care. The aim of this study is to evaluate the techniques that we use in lower eyelid reconstruction. Between the years of 1999-2009, a total of 23 patients who had lower eyelid defects due to tumor resection (21 patients) or trauma (2 patients) were reconstructed by the use of various flaps. Eleven of the patients were women and twelve of them were men. Average age was 60.7. For the reconstruction 13 Mustardé flap, 9 bipedicled Tripier flap, 1 Tenzel flap and 1 bipedicled infraorbital flaps were used. Average postoperative follow up interval was 35 months. (18-47 months). Flap necrosis, function loss in the lower lid were not experienced in any of the patients. Cosmetically satisfactory results were obtained. In lower eyelid reconstruction, the size of the defect and the amount of skin around must be carefully evaluated and should be considered while planning the reconstruction. [Cukurova Med J 2011; 36(1.000): 15-23