Necrotizing Fasciitis of the Cervical Region following Extravasation Injury

Necrotizing fasciitis is a rapidly progressive soft tissue infection that can cause local tissue destruction, necrosis, and life threatening severe sepsis. Necrotizing fasciitis in the head and neck region caused by an extravasation injury is rare. This paper reports a patient with necrotizing fasciitis of the cervical region caused by an extravasation injury which required an early surgical debridement

Doğuştan makrostomi: Olgu sunumu

Makrostomi genellikle birinci ve ikinci brankiyal ark sendromu ile ilişkilidir. Dış görünüş tutulum alanına bağlı olarak değişebilir. İzole makrostomi olgularında, yarık genellikle masseter kası medial sınırında sona erer. Makrostomi rekonstrüksiyonunundaki amaç, fonksiyonel simetrik ve doğru ağız komissürünü en az yara ile elde etmektir. Bu makalede, izole iki taraflı makrostomisi olan ve vermillonu-kare flep yöntemi ile tedavi edilen sekiz yaşında bir kız olgu sunuldu. Biz hafif ve orta derecede makrostomili hastalarda bu yöntemi önermekteyiz.Macrostomia is often associated with the first and second branchial arch syndrome. Depending on the involvement area, appearance may vary. In isolated cases of macrostomia, the cleft usually terminates at the medial border of the masseter muscle. The goal of macrostomia reconstruction is to achieve functional, symmetrical and accurate mouth commissure with minimal scar. In this article, we present an eight-year-old girl case with isolated bilateral macrostomia treated with vermillion-square flap method. We recommend this method for patients with mild to moderate macrostomia

Direct Cutaneous Metastasis of Lung Carcinoma: Case Report

Akciğer kanserinde cilt metastazı oldukça nadir görülen bir durumdur. Akciğer kanserlerinin içinde cilt metastazının yaygın görüldüğü tip büyük hücreli karsinomken, nadir görüldüğü tip skuamöz hücreli karsinomdur. Genellikle cilt metastazı, hematojen yayılım sonucunda oluşmaktadır. Bu yazıda, skuamöz hücreli tip akciğer kanserli hastada lobektomi insizyon hattında oluşan, nadir görülen direkt cilt metastazı olgumuzu sunmaktayız.Cutaneous metastasis from lung carcinoma is a rare condition. While cutaneous metastasis is commonly seen in large cell carcinoma type of lung carcinomas, rarely seen in squamous cell carcinoma type. Usually, cutaneous metastasis occurs as a result of hematogenous spread. In this report, we presented a case of direct cutaneous metastasis in lobectomy incision site, which is rarely seen in squamous cell lung carcinoma

Malign Melanomanın Eş Zamanlı Olarak İnguinal ve Popliteal Lenf Nodu Metastazı: Nadir Görülen Olgu Sunumu

Bacak distalinde ve ayakta görülen metastatik malign melanomlar genellikle inguinal lenf noduna metastaz yaparlar. Popliteal fossa ise nadir görülen ilk nodal metastaz alanıdır. Alt ekstremite melanomlarının popliteal metastaz oranları %3 ila %7 arasındadır. Eş zamanlı olarak inguinal ve popliteal lenf nodu metastazları ise oldukça nadir görülmektedir. Biz bu makalede, palpe edilebilen popliteal lenf nodu metastazı olan fakat hem klinik muayenede hem de pozitron emisyon tomografisi (PET) görüntülemesinde inguinal metastaza dair herhangi bir bulgu olmadığı halde histopatolojik sonuçlara göre inguinal lenf nodlarında metastaz görülen, topukta malign melanom olgusunu sunmaktayız. Bu olgu ile hem klinik muayenede hem de görüntüleme yönteminde inguinal metastaza dair bir bulgu saptanmasa dahi, popliteal ve inguinal bölgelere eş zamanlı olarak lenf metastazı ihtimali olabileceği cerrahların dikkatine sunulmuştur.Metastatic malignant melanomas of the distal leg and foot typically metastasize to the lymph nodes of the groin. In rare cases, the first site of nodal metastasis is the popliteal fossa. The rate of popliteal metastasis in lower extremity melanomas ranges from 0.3% to 7%. Simultaneous popliteal and inguinal lymph node metastases are also quite rare. We present a case of a melanoma located in the heel with palpable popliteal lymph node involvement, which was not evident on clinical examination and positron emission tomography imaging. Despite this lack of evidence, the histopathological results revealed that the inguinal lymph nodes were infiltrated with melanoma. This case report is presented to draw surgeons' attention to the possibility of lymph node metastases in inguinal and popliteal regions even when neither clinical examination nor imaging reveals inguinal metastasis

Use of Systemic Rosmarinus Officinalis to Enhance the Survival of Random-Pattern Skin Flaps

Background: Skin flaps are commonly used in softtissue reconstruction; however, necrosis can be a frequent complication. Several systemic and local agents have been used in attempts to improve skin flap survival, but none that can prevent flap necrosis have been identified. Aims: This study aims to determine whether the use of systemic Rosmarinus officinalis (R. officinalis) extract can prevent flap necrosis and improve skin flap recovery. Study Design: Animal experimentation. Methods: Thirty-five Wistar albino rats were divided in five groups. A rectangular random-pattern flaps measuring 8×2 cm was elevated from the back of each rat. Group I was the control group. In Group II, 0.2 ml of R. officinalis oil was given orally 2h before surgery. R. officinalis oil was then applied orally twice a day for a week. In Group III, R. officinalis oil was given orally twice a day for one week before surgery. At the end of the week, 0.2 mL of R. officinalis oil was given orally 2 h before surgery. In Group IV, 0.2 mL of R. officinalis oil was injected subcutaneously 2 h before surgery. After the surgery, 0.2 mL R. officinalis oil was injected subcutaneously twice a day for one week. In Group V, 0.2 mL R. officinalis oil was injected subcutaneously twice a day for one week prior to surgery. At the end of the week, one last 0.2 mL R. officinalis oil injection was administered subcutaneously 2 h before surgery. After the surgery, 0.2 mL R. officinalis oil was injected subcutaneously twice a day for one week. Results: The mean percentage of viable surface area was significantly greater (p>0.05) in Groups II, III, IV, and V as compared to Group I. Mean vessel diameter was significantly greater (p>0.05) in Groups II, III, IV, and V as compared to Group I. Conclusion: We have determined that, in addition to its anti-inflammatory and anti-oxidant effects, R. officinalis has vasodilatory effects that contribute to increased skin flap survival

Yüksek Voltajlı Elektrik Yanığı Sonrasında Pubik Bölgenin Skrotal Fasyokutanöz Flep İle Rekonstrüksiyonu

WOS:00041389730001

Closed reduction of zygoma tripod and isolated arch fractures with Volkmann bone hook

Amaç: Bu çalışmada zigoma tripod ve ark kırıklarının tedavisinde internal tespit uygulanmaksızın kapalı redüksiyon tekniğinin etkinliği araştırıldı. Hastalar ve Yöntemler: Haziran 2011 - Aralık 2012 tarihleri arasında zigoma tripod kırığı ve izole ark kırığı nedeniyle Volkman kemik kancası kullanılarak kapalı redüksiyon tekniği ile ameliyat edilen yedi hastaya (2 kadın, 5 erkek; ort. yaş 49.1 yıl dağılım 34-76 yıl) ait tıbbi veriler retrospektif olarak değerlendirildi. Hastaların simetri ve fonksiyonel bulguları, ameliyattan sonra üç ve altıncı aylarda değerlendirildi. Bulgular: Kapalı redüksiyon tekniği ile ilişkili herhangi bir komplikasyon gözlenmedi. Geç dönemde başvuran ve izole zigoma ark kırığı olan bir hastada yetersiz redüksiyon oluştu. Sonuç: Kemik kancası kullanılarak yapılan kapalı redüksiyon, izole zigoma ark kırıklarının yanı sıra komplike olmayan zigoma tripod kırıklarının tedavisinde tespit uygulanmaksızın, güvenle kullanılabilir.Objectives: This study aims to investigate the effectiveness of closed reduction technique for the management of zygoma tripod or arch fractures without internal fixation. Patients and Methods: Between June 2011 - December 2013, medical data of seven patients (2 females, 5 males; mean age 49.1 years; range 34 to 76 years) who were treated using closed reduction technique with Volkman bone hook due to zygoma tripod and isolated arch fractures were retrospectively analyzed. Symmetry and functional findings of the patients were assessed at three and six months postoperatively. Results: No complication related to the closed reduction technique was observed. Inadequate reduction was seen in one patient with isolated zygoma arch fracture who was admitted in late-stage. Conclusion: Closed reduction using a bone hook can be safely applied in the management of isolated zygoma arch fractures and non-complicated zygoma tripod fractures without fixation

A serious soft tissue infection : Necrotizing fasciitis

Nekrotizan fasiit, nadir görülen, özellikle fasyaların nekrozu ile karakterize ciddi seyirli bir subkutan yumu ak doku enfeksiyonudur. Yetmi iki ya ında kadın hasta, iki gün önce ba layan sol bacakta a rı ve kızarıklık ikâyeti ile hastanemize ba vurdu. Sol uyluk medialinde perineye yakın mesafeden ba layan ve dize kadar uzanan eritematöz ve sulantılı lezyon tespit edildi. Magnetik rezonans görüntüleme yönteminde pannikülit, ultrasonografi incelemesinde selülit olarak yorumlanmasına ve geni spektrumlu antibiyotik tedavisi ba lanmasına ra men lezyonun hızla ilerlemesi ile do ru tanıya ula ıldı. Cerrahi debridman yapılan hastanın yara kültüründe Streptococcus pyogenes üredi. Doku grefti ile rekonstrüksiyon uygulandı. Bu makalede; ileri ya , steroid ve nonsteroid ilaç kullanımı ile risk grubunda bulunan nekrotizan fasiitli bir olgu sunulmuştur.Necrotizing fasciitis is a rare subcutaneous soft tissue infection as characterized by severe progressive necrosis of subcutaneous tisuues betwen fascias. A seventy-two year old female patient applied to our clinic with pain and erythema in his left thigh commenced two days ago. On her physical examination; erythematous and exudative lesions were detected on her left medial thigh, starting from upper thigh to knee area. Although lesions were interpreted as cellulitis and panniculitis by ultrasound examination and magnetic resonance imaging respectively, definitive diagnosis was achieved with rapid and poor progression of clinical course in spite of broad-spectrum antibiotics. The patient went to necrotic tissue debridman and skin grafting of defective areas. Wound culture result obtaining from surgical debridement material was Streptococcus pyogenes. In this article, we present a case with necrotizing fasciitis with poor risk factors including old age, steroid and nonsteroidal drug usage