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

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

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

Applications of triangular glanular flap in hypospadias repairs for different purposes

WOS: 000329857200008PubMed ID: 23639333Hypospadias is a congenital anomaly of the penis with an ectopic, ventrally-placed meatus due to insufficient development of the anterior urethra. Tubularisation of glanular flaps without plate incision is performed with addition of a triangular flap in order to move the meatus more distally and avoid meatal stenosis. Subcoronally, mid-shaft, and coronally placed 41 hypospadias cases were treated with the tubularisation of the glanular flaps without incision of the urethral plate, a technique similar to TIP technique. Triangular flaps were added at the most distal end of one of the glanular flaps in all cases for different purposes. A medially-based triangular flap was elevated at the distal end of the right-sided longitudinal flap to carry the last suture more distally. The flap increased meatal diameter and carried the last suture more distally. No meatal stenosis was observed for an average of 18.02 (12-30) months. The final localisation of the meatus was satisfactory in all patients. Meatal stenosis, demonstrated after hypospadias repair, is a challenge for both the surgeon and the patient. A distal triangular glanular flap is planned to avoid this challenge. Besides, it helps to carry the meatus more distally. Promising results support the use of the glanular flap while longer follow-up is required for better evaluation

Pediatrik mandibula kırıklarındaki ikilem: Eriyen plaklar mı yoksa metal plaklar mı?

WOS: 000368269100015PubMed ID: 27054644BACKGROUND: The aim of this study was to compare the efficiency of resorbable and metallic plates in open reduction and internal fixation of mandible fractures in children. METHODS: Thirty-one patients (mean age, 8.05 years; range 20 months-14 years) were operated on various fractures of the mandible (26 [60.4%] symphysis-parasymphysis, 12 [27.9%] condylar-subcondylar fractures, 5 [11.6%] angulus and ramus fractures). Twelve patients were treated with resorbable plates and 19 patients with metallic plates. Mean follow-up time was 41 months (11-74 months) in the metallic hardware group and was 22 months (8-35 months) in the resorbable plate group. Both groups were investigated for primary bone healing, complications, number of operations, and mandibular growth. The results were discussed below. RESULTS: Both groups demonstrated primary bone healing. Minor complications were similar in both groups. The metallic group involved secondary operations for plate removal. Mandibular growth was satisfactory in both groups. CONCLUSION: Resorbable plates cost more than the metallic ones; however, when the secondary operations are included in the total cost, resorbable plates were favourable. As mandibular growth and complication parameters are similar in both groups, resorbable plates are favored due to avoidance of potential odontogenic injury, elimination of long-term foreign body retention and provision of adequate stability for rapid bone healing. However, learning curve and concerns for decreased stability against heavy forces of mastication accompanied with the resorbable plates when compared to the metallic ones should be kept in mind.AMAÇ: Bu çalışmanın amacı çocuklardaki açık redüksiyon ve internal fiksasyon ile tedavi edilen mandibula kırıklarında, emilebilen ve metal plakların etkinliğini karşılaştırmaktır. GEREÇ VE YÖNTEM: Yaşları 20 ay-14 yıl (ortalama 8.05 yıl) arasında değişen 31 hasta mandibulanın farklı yerlerindeki kırıklar nedeniyle ameliyat edildi (26 [%60.4] simfisiz-parasimfisiz, 12 [%27.9] kondil-subkondil, 5 [%11.6] angulus ve ramus). On iki hasta eriyen plaklarla, 19 hasta ise metal plaklarla (titanyum) tedavi edildi. Ortalama takip süresi metal donanım kullanılan grupta 41 ay (11–74 ay), eriyen plak kullanılan grupta ise 22 ay’dı (8–35 ay). Her iki grup primer kemik iyileşmesi, komplikasyonlar, ameliyat sayısı ve mandibuladaki büyüme açısından incelendi. Bulgular aşağıda tartışıldı. BULGULAR: Her iki grupta primer kemik iyileşmesi saptandı. Her iki gruptaki minör komplikasyonlar benzerdi. Metal donanım kullanılan grupta pak çıkartılması için ikinci operasyonlar gerçekleştirildi. Her iki gruptaki mandibula gelişimi tatmin ediciydi. TARTIŞMA: Eriyen plaklar metal donanımlı plaklardan daha pahalı oldukları görüldü. İkinci operasyonların maliyeti göz önünde bulundurulduğunda ise eriyen plaklar daha avantajlıydı. Mandibula büyümesi ve komplikasyon parametreleri heriki grupta benzer olduğundan, eriyen plaklar; olası diş hasarının önlenmesi, uzun süreli yabancı cisim varlığının olmaması ve hızlı kemik iyileşmesi için gerekli olan yeterli sabitlik sağlaması gibi hususlara bağlı olarak tercih edilmektedir. Buna rağmen, emilebilir plakların kullanılması hususunda bir öğrenme periyodunun gerekliliği ve metal plaklarla karşılaştırıldığında, çiğneme kaslarının karşıt gücüne karşı düşük sabitlik sağladıkları gibi endişeler akılda tutulmalıdır