The effects of different amounts of thrombin application on fat graft viability in rats: An experimental study

Aims: The most important disadvantage of fat graft, which is also a late-term complication, is graft resorption. The aim of this study is to evaluate the effect of thrombin, which is reported to increase the tissue regeneration and angiogenesis in many areas, to viability of fat graft. Settings and Design: Twenty Wistar-Albino type adult male rats were used in the study. They were divided into four groups as one control group and three experimental group. Subjects and Methods: Inguinal fat pads were excised and reduced to 500 mg (±1 mg) in all animals. To obtain thrombin, 3 animals were sacrificed. One percent amount of 0.25 mg lidocaine hydrochloride was injected to the scapular regions of the animals. Afterward, subcutaneous cavities were formed there to place the fat tissue inside. After placing the graft, varying proportions of thrombin were injected to the animals in the experimental groups. No thrombin was not injected to the control group. After 90 days, the experimental animals were sacrificed, and the fat grafts were removed. Statistical Analysis Used: The data obtained from control and experimental groups were analyzed using SPSS software (version 20.0; SPSS Inc., Chicago, IL, USA). Normal fat ratio, cyst or vacuole development, inflammation, fibrosis, microvascular density, apoptosis, and weight score differences between groups were compared using Kruskal–Wallis test. To compare two groups with different scores, Mann–Whitney U test was used. The statistical significance level was accepted as 0.05 (P = 0.05). Results: Macroscopic, histological, and statistical evaluations showed that thrombin has reduced the weight and volume loss on fat graft, increased viable fat cell amount and reduced inflammation on receptive area. Conclusion: The positive effects of thrombin on the viability of fat graft have given us courage to use it in further studies. Longer follow-ups are necessary and more studies are required to use it in clinical practice in combination with fat grafts

Evaluation of Sentinel Lymph Node Biopsy and Predictors of False-negative Sentinel Lymph Node Biopsy in Cutaneous Malignant Melanoma: A Single-center Study

Aim: Our purpose was to determine the constraints of sentinel lymph node biopsy (SLNB) in malignant melanoma (MM) and to optimize the necessity for additional research to enhance its precision. Materials and Methods: This retrospective study investigated the factors that influence the results of SLNB performed on patients with MM. Eighty-five patients with primary cutaneous MM were analyzed by their histopathological data, surgical records, and clinical follow-up information. An evaluation was conducted on variables including Breslow thickness, Clark level, mitotic rate, lymphatic and vascular invasion, negative predictive value (NPV), and SLNB results. Results: The statistical analysis showed that increased Breslow thickness, lymphatic or vascular invasion, and the presence of ulceration were found to have a significant impact on SLNB positivity. However, there was no correlation found between Clark level and SLNB outcomes. For the NPV of the test, it decreases with increasing Clark level and mitotic rate, as well as lymphatic or vascular invasion. In our study, the NPV was calculated as 81%. We also calculated the false-negative rate, which was found to be 19%. Conclusions: Further, investigation is warranted to optimize SLNB methodologies. To achieve this, we recommend additional investigations to refine SLNB techniques, explore unidentified risk factors, and incorporate advanced imaging methods for better detection of hidden lymph node metastases. In summary, understanding the factors influencing SLNB outcomes in MM is crucial for developing effective treatments and follow-up protocols. Key variables to consider in assessing nodal involvement include Breslow thickness and lymphatic or vascular invasion, among others

A new method for obtaining mesenchymal stem cells in children with burn injury: Tibial bone marrow aspiration by using the C-arm guidance scopy

The utilization of stem cell therapies is a trending topic in plastic surgery and fat tissue is the most commonly used stem cell source. Stem cell injection has become popular in the treatment of burn wound, especially in the late term scar modulation. However, insufficient amounts of fat tissue in the pediatric age group is a major limitation. The present study reports the utilization of tibial bone marrow aspiration as a source of mesenchymal stem cells in the pediatric age group with the simultaneous usage of x-ray examination to avoid epiphyseal damage. [Arch Clin Exp Surg 2017; 6(1.000): 56-57

Extradigital glomus tumor revisited: Painful subcutaneous nodules located in various parts of the body

Background: Glomus tumor is a common lesion of the subungual area of the hand fingers. However, glomus tumors located outside the hand region are rare and the diagnosis is often difficult due to their low incidence and lack of distinct clinical features in the physical examination. The presented article contains five cases of extradigital glomus tumors with a short review of the literature. Patients and Methods: Five cases of extradigital glomus tumor were included in the study. All lesions were purple colored subcutaneous nodules with sharp pain by digital palpation. All lesions were examined with ultrasound imaging were operated under local anesthesia using loupe magnification. Results: Among five patients, only one patient was female with a mean age of 35. Two lesions were located at the arm region, two at the crural region and one at the sternal area. The smallest nodule was 0.5 cm and the biggest lesion was 2 cm in diameter. In all the cases, the early postoperative period was uneventful without any surgical complication or acute recurrence. The postoperative 1 st year examination of all patients revealed complete resolution of the pain and no recurrence was encountered. Conclusions: Glomus tumor should be kept in mind in the differential diagnosis of all painful subcutaneous lesions especially for those with purple reflection on the skin surface. In this manner, patients with extradigital glomus tumors may be diagnosed earlier and unnecessary and wrong treatments may be prevented

An unusual etiology in cold injury: Liquefied petroleum gas

Cold injury is a condition that causes reversible and irreversible damage when tissues are exposed to cold. This injury occurs due to various etiologies, and the most commonly observed ones include contact with liquefied petroleum gas (LPG) used in households, vehicles, and industry. LPG is a type of gas stored in liquid state under high pressure within cylinders. LPG contains a mixture of propane and butane gases. Direct contact of these gases with the tissues has the potential to cause metabolic, toxic, and respiratory damage. In this study, we present the cases of four patients with cold injury in the face and upper extremity caused by a pressurized jet stream of liquid gas that escaped out of the valves of the LPG cylinders. The patients had bullous lesions in the upper extremities and the face and second-and third-degree cold injuries with fibrotic and necrotic areas. The superficial defects secondarily healed with minimal scarring, while the necrotic finger had to be amputated. Cold injury on the skin caused by high-pressure jet streams of liquid gas as in our study is a rare occurrence. Our patients are important cases due to the rare etiology of cold injury