An improvement in dorsal reverse adipofascial flap for fingertip reconstruction: Nail matrix preservation

Dorsal reverse adipofascial flap (DRAF) is one of the most reliable choices for reconstruction of fingertip amputations. A drawback of this method is matrixectomy, which is routinely performed in distal phalangeal amputations, even when the germinal matrix and some nail bed is intact. However, the nail is important for both functional and esthetic reasons and should not be killed. We described a new approach to DRAF, in selected cases, for preserving the nail. As a result, we obtained useful and esthetic fingertip with a nail unit. Copyright © 2005 by Lippincott Williams & Wilkins

An unusual association of cleft lip/palate and upper extremity anomalies [20]

[No abstract available

A case of lipoma of the deep lobe of the parotid gland.

Lipoma of the deep lobe of the parotid gland is extremely rare. A forty-two-year-old man presented with a painless, soft, and slow-growing mass in the left preauricular area. Ultrasonography and computed tomography findings were consistent with lipoma. The patient was treated with superficial parotidectomy and total excision of the mass with preservation of the facial nerve. Histologic findings confirmed the diagnosis. No recurrences were detected during 1.5 years in the postoperative period

Atypical presentation of Kaposi's sarcoma in the external ear.

We presented a case of Kaposi's sarcoma that occurred in the external ear of a 36-year-old Caucasian man. He was otherwise healthy without a history of any predisposing factors. He had a nodular lesion in the left ear, of three-month duration. The lesion was excised completely. Histologic and immunohistologic findings were consistent with a diagnosis of Kaposi's sarcoma. Serologic analyses were negative for anti-HIV antibody and anti-cytomegalovirus IgM and IgG and blood count was normal. Differential count of leucocytes and immunoglobulin electrophoresis were normal. During a two-year follow-up, no recurrences, development of new lesions, or HIV seroconversion were detected. To our knowledge, this case is the first to report a solitary lesion of Kaposi's sarcoma occurring in the helix of the ear in a healthy young patient

Experience with vaginoplasty

We did 27 vaginoplasties (7 gracilis musculocutaneous flaps, 8 pudendal thigh flaps, 12 full-thickness skin grafts) during the period 1994-2000. The preoperative assessment and postoperative follow up were done in collaboration with the gynaecologists. All patients had vaginal agenesis. With the gracilis flaps we found it difficult to achieve an adequate blood supply. With pudendal thigh flaps we achieved perfect innervation and a good contour, but they did tend to be hairy. With full-thickness skin grafts the innervation was not perfect, but the contour was good. Having compared the three operations during a follow up period ranging from 1-5 years we think that the full-thickness skin graft gives the best results

Best aesthetic results of postoperative scars after gynecologic and obstetric operations [Jinekolojik ve obstetrik operasyonlar sonrasi postoperatif skarda i·yi estetik sonuç]

Although incisions which are used for gynecologic and obstetric operations could be disguised, scar develops as a natural result of wound healing. Patients can be troubled related to these scars. For this reason, medical professionals must be aware of some methods which are useful for minimal scar development after operations. Incision scar is a result of normal wound healing and can be classified as physiological scars, hypertrophic scars and keloids. Physiological scar features are plain shape, clear colour, not itchy and similar to contour tissue. Hypertrophic scars features are redness, swelling, sometimes itchy and limited to incision edge. Keloids are commonly thick, untidy, not limited to incision edge and itchy. Surgical exicision, silicone gel sheeting, pressure therapy, corticosteroid injections, onion extract gel, radiotherapy, laser therapy, cryothreapy, adhesive microporous hypoallergenic paper tape and some others are treatment methods of scars. There are many different practices with which we are obtaining successful results: first of all favourable surgical closure (subcuticular and intradermal continuous suture placement reduces tension), which is followed by one or a combination of the following: silicone gel sheeting, silicone gel, pressure therapy, corticosteroid injections, onion extract gel. In this review, we aimed to discuss the succesful approaches to avoid hypertrophic scars or keloids in the light of our clinical experience. We believe that best aesthetic results and patient satisfaction at the postoperative period is directly related with these practices

Hemangioma of the nasal bone: a case report.

Hemangiomas of the bone account for 0.7% of all bone tumors. The craniofacial region is a rare site of involvement, with the mandible, zygoma, and maxilla being the most frequently affected areas. Hemangioma of the nasal bone is very rare. A 60-year-old male patient presented with complaints of difficult breathing through the nasal airway and a slowly growing hard mass at the nasion with a history of 10 years. Computed tomography demonstrated a round mass involving the left nasal bone with submucosal extension. An en bloc excision of the mass and its extension was performed. Histopathological examination showed two neighboring tumors, cavernous hemangioma of the bone and arteriovenous malformation of the nasal mucosa. During a-year follow-up, the patient had no complaints and the functional and cosmetic results were excellent

The effect of combined use of vitamin C, vitamin E, and ibuprofen on flap viability: an experimental study [C vitamini, E vitamini ve ibuprofenin birlikte kullanilmasinin flep yaşamina etkisi: Deneysel çalişma.]

OBJECTIVES: Many studies have been carried out to investigate the individual effects of vitamin C, vitamin E, and ibuprofen on flap viability, with favorable results. This study aimed to determine the effect of combined use of these agents on flap viability. DESIGN AND METHODS: Sixty Wistar rats weighing 250-300 grams were divided into six groups, equal in number, to receive saline solution (group 1, control), vitamin C (group 2), vitamin E (group 3), vitamin C and E (group 4), ibuprofen (group 5), and vitamin C, vitamin E, and ibuprofen (group 6). Following ketamine anesthesia, a caudally based reverse McFarlane flap on the back of the rats, 3x10 cm in size, was elevated and sutured back. The agents were administered intraperitoneally once daily for seven days, after which viable flap areas were estimated. RESULTS: The percentages of the viable area of the flaps in groups 1, 2, 3, 4, 5, and 6 were 58.0%, 68.1%, 61.4%, 73.4%, 69.1%, and 80.5%, respectively. The use of vitamin C, vitamin E, and ibuprofen in combination resulted in a significantly greater flap viability compared to individual uses. CONCLUSION: Administering vitamin E and vitamin C together has a greater effect on flap viability than used alone; however, the benefit is the greatest with the addition of ibuprofen

Effect of Steroids on Edema, Ecchymosis, and Intraoperative Bleeding in Rhinoplasty

A double-blind, randomized study was designed to determine the efficacy of dexamethasone in decreasing periorbital edema and ecchymosis after rhinoplasty. Sixty rhinoplasty patients undergoing hump resection and lateral osteotomy were included in the study and were divided into 6 groups: group 1 (n = 10), single dose of 8 mg intravenous (IV) dexamethasone 1 hour before the operation; group 2 (n = 10), single dose of 8 mg IV dexamethasone at the beginning of the operation; group 3 (n = 10), 3 doses of 8 mg IV dexamethasone 1 hour before the operation, and 24 and 48 hours after the operation; group 4 (n = 10), 3 doses of 8 mg IV dexamethasone at the beginning of the operation, and 24 and 48 hour after the operation; group 5 (n = 10), 3 doses of 8 mg IV dexamethasone immediately after the operation, and 24 and 48 hours after the operation; group 6 (n = 10), control, no dexamethasone administration before or after the operation. Intraoperative blood loss was recorded for each patient. Patients were evaluated at 24 hours and days 2, 5, 7, and 10. For the postoperative evaluation of periorbital ecchymosis and edema, a scale of 0 to 4 points was used. There was no significant difference between groups in terms of bleeding (P > 0.05). In the groups using steroid before osteotomy, edema and ecchymosis were significantly lower during the first 2 days compared with the control group (P 0.05). There was no significant difference between groups on day 10. In conclusion, if the first dose is given before osteotomy, triple-dose steroid application is the best bet for decreasing postoperative edema and ecchymosis. None of the patients had any complications related to the use of dexamethasone