İmperfore himen operasyonu sonrasında gelişen stenoz ve Z-plasti yöntemi ile düzeltilmesi

İmperfore himen IH , dişi genital sistem anomalilerinden en sık karşılaşılanıdır. Vaka sunumumuzda IH nedeniyle opere edilen ve sonrasında himenal stenoz gelişen bu nedenle Z–plasti yöntemi ile himenoplasti yapılan olgu sunulmuştu

Lichen Simplex Chronicus That Accompanies Anogenital Warts during the Childhood

Anogenital warts and lichen simplex chronicus (LSC) are rarely seen during the childhood. A 9-year-old girl has been presented to hospital by her parents with itching in the anogenital area. There were anogenital warts and a different erythematous lesion in the perianal region. On the pulpa of the right thumb, there was a wart extending under the nail. The lesions are surgically removed. The results of the histopathological examination were reported as condyloma acuminata and LSC. Children with anogenital warts should be examined carefully to discover the transmission route and other possible concomitant cutaneous diseases

The effect of nebivolol on rat transverse rectus abdominis flap perfussion

Meme kanseri cerrahisi sonrası kullanılan meme rekonstrüksiyonu yöntemlerinden birisi transvers rektus abdominis kas deri flebidir. Bu flebin zon 3 ve 4 perfüzyon kısımlarında doku nekrozu sıklıkla meydana gelmektedir. Çalışmamızda nitrik oksit aracılı vazodilatasyon ve selektif beta-blokasyon etkisi ile kan basıncı kontrolü sağlayan Nebivolol'ün transvers rektus abdominis flebinin perfüzyonuna etkisini araştırmayı amaçladık. Nebivolol üçüncü jenerasyon beta reseptör antagonistidir ve NO salınımını artırarak periferik vazodilatasyon yapmaktadır.Çalışmada otuz adet Spraque- Dowley ratı beş deney grubuna ayrıldı. Tüm ratlarda, inferior pediküllü TRAM flep kaldırıldı. Birinci gruptaki altı adet rata hiçbir ilaç uygulanmadı. İkinci gruptaki ratlara cerrahi işlemden 24 saat önce 100 mg/kg nebivolol oral gavaj yöntemi ile başlandı ve postoperatif 7 gün uygulamaya devam edildi. Üçüncü gruptaki ratlara cerrahi işlemden 24 saat önce 100 mg/kg nebivolol oral gavaj yöntemi ile başlandı peroperatif ve postoperatif 7 gün uygulamaya devam edildi. Dördüncü gruptaki ratlara cerrahi işlemden 7 gün önce 100 mg/kg nebivolol başlandı ve postoperatif dönemde 7 gün devam edildi. Beşinci gruptaki altı adet rata cerrahi işlemden 7 gün önce 100 mg/kg nebivolol kullanıldı. Peroperatif ve postoperatif dönemde ilaç kullanılmadı. Yedinci gün tüm ratlardaki fleplerin fotoğrafı çekildi ve kan laktat düzeyi belirlendi.Kan laktat değerleri açısından istatistiksel olarak tüm gruplar, kontrol grubuna (grup I) göre belirgin farklıdır. En anlamlı fark kontrol grubu ile nebivololün preoperatif ve postoperatif dönemde kullanıldığı grup (grup 4) arasında tespit edildi. Fotoğraf değerlendirmelerinde nekroz alanının flep alanına oranı hesaplandığında; tüm gruplar, kontrol grubuna göre istatistiksel olarak farklı bulundu (P0,005).Bu çalışma nebivololün TRAM fleplerinde meydana gelebilecek iskemiye bağlı nekrozları azaltmada etkili bir farmakolojik ajan olabileceğini göstermektedir.TRAM flap is one of reconstruction option for breast reconstruction after the breast cancer surgery. Necrosis usually occurrs on zone 3 and 4 of this flap. The aim of this study is to evaluate the effect of nebivolol (which affects on blood pressure regulation with selective ß-1 blocker and nitric oxide associated vasodilation) on rat TRAM flap.In our study, we used 30 Spraque?Dawley rats. Animals were randomly assigned to 5 treatment groups (n=6). A pedicled TRAM flap based upon the right inferior epigastric artery was elevated on all rats. Control group was the first group and no medication was given. In the second group, 100 mg/kg nebivolol was given orally 24 hours before the surgery and continued for 7 postoperatively days. In the third group the same treatment management was used and plus 100 mg/kg nebivolol was given intraoperatively period. In the fourth group nebivolol was given at same dosage orally 7 days before and after surgery for 7 days. In the fifth group the rats received 100 mg/kg orally nebivolol 7 days before surgery and no medication was given after the surgery. Seven days after surgery flaps were photographed and assessed for viability. In seventh day, blood lactate levels were also measured.All groups had low blood lactate levels than the control group. Statically the most significant difference was found between group 4 and group 1 (p<0,005). For necrotic area/ flap area ratio, we found statically difference between control group and other treatment groups (p<0,005). Group 4 showed the greatest improvement in flap viability, than other treatment groups. Group 4 was statically different from the other groups. But there weren?t any differences among groups 2,3 and 5.This study indicates that nebivolol may provide a useful pharmacologic tool for reducing iscemia-reletad necrosis in TRAM flaps

Dorsal el defektlerinin yumuşak doku onarımı için posterior interosseöz arter flebi ile ters akımlı adipofasyal radyal ön kol flebinin kıyaslanması

WOS: 000428237600009PubMed ID: 29350367BACKGROUND: Our objective was to compare the outcomes of dorsal hand defect reconstruction using a posterior interosseous artery flap (PIAF) and a reverse adipofascial radial forearm flap (RARFF). METHODS: From 2008 to 2013, 23 patients who underwent hand soft tissue defect reconstruction with PIAF (11 patients) and RARFF (12 patients) were included in this retrospective study. Reconstruction methods were compared in terms of functionality with disability of the arm, shoulder, and hand (DASH) score and range of motion (ROM) and aesthetically with scar assessment. Operation times, length of hospital stay, and donor site problems were compared. RESULTS: We found no statistically significant differences between PIAF and RARFF in terms of ROM, DASH score, and length of hospital stay. Statistically significant differences were found in operation time, scar assessment, and donor site problems between PIAF and RARFF patients. CONCLUSION: RARFF showed better results than PIAF in dorsal hand defects, but in RARFF, the major arteries of the hand are sacrificed.AMAÇ: Bu çalışmadaki amacımız el dorsumundaki defektlerin posteriyor interosseöz arter flebi (PİA) ve ters akımlı adipofasyal radial önkol (RRÖF)ile onarım sonuçlarını kıyaslamaktır.GEREÇ VE YÖNTEM: Geriye dönük olarak dizayn edilen bu çalışmaya 2008–2013 yılları arasında, PİA ile (11 hasta) ve RRÖF ile (12 hasta) el dorsumundaki yumuşak doku defektleri onarılan 23 hasta dahil edildi. Onarım yöntemleri fonksiyonel olarak kol, omuz ve el sorunları anketi (DASH)skoru, eklem hareket açıklığı (ROM) ile; estetik olarak skarın görünümü ile değerlendirildi. Ameliyat süreleri, hastanede kalış süreleri ve donör alanproblemleri kıyaslandı.BULGULAR: Posteriyor interosseöz arter flebi ve RRÖF arasında ROM ve DASH skorları ve hastanede kalış süresi açısından istatistiksel açıdan farksaptanmadı. Ameliyat süreleri, skar değerlendirmesi ve donör alan problemleri açısından ise istatistiksel açıdan fark saptandı.TARTIŞMA: Dorsal el defektlerinde RRÖF sonuçları PİA’dan daha iyidir, ne varki RRÖF elin ana bir arterini sakrifiye etmektedir

Reverse adipofascial radial forearm flap surgery for soft-tissue reconstruction of hand defects

Objective: The reverse radial forearm flap has been used for soft-tissue hand defect surgical procedures worldwide. One of the major drawbacks of this flap, however, is donor site morbidity, as the donor site is closed with a skin graft. Problems with skin graft donor areas include adhesion, contracture, and wound-healing complications. In this study, only the adipofascial component of a reverse radial forearm flap was used to prevent these problems; in addition, a skin graft was applied over the flap instead of over the donor site. Methods: Between January 2011 and December 2013, a total of 13 hand defects were reconstructed with a reverse adipofascial radial forearm flap. Patients were evaluated for functional results using total active motion criteria and disability of the arm, shoulder, and hand scores, operation time, hospitalization time, and patient satisfaction. Results: All flaps and grafts placed on flaps survived completely and donor sites healed without complications. The total active motion criteria and the disability of the arm, shoulder, and hand score demonstrated that the functional outcomes were successful. Patient satisfaction scores using the visual analog scale had a mean of 88.3 (SD = 2.95) mm. Operation time for the flap surgery was 126.1 (SD = 21.80) minutes, and patients were discharged at an average of 6.3 (SD = 1.44) days. Conclusion: Use of an adipofascial component in reverse radial forearm flap surgery is appropriate for reducing problems with donor site skin grafts. Patients’ functional outcomes denoted that the reverse adipofascial radial forearm flap is a reliable and effective method to cover soft-tissue defects of the hand

An Overview of the Technical Details and Seven Cases of Lagophthalmos Treatment with Gold Implant

Objective: Placing gold implants in the upper eyelids is a widely accepted method in lagophthalmos treatment. Gold can be obtained as custom-made or from medical firms, as well as from jewelers. This review intends to share the algorithm applied in our clinic, to help avoid undesirable postoperative results. Material and Methods: Between 2012 and 2014, seven patients were planned to undergo gold implant surgery for lagophthalmos. In each of the seven cases preoperative weight tests were performed in upright-seated position, incision site and implant weights were measured, and the determined weights were tested twice, sterilization was applied. Results: None of the patients showed any early or late complications. Complete closure of the eyelids was achieved. Aesthetic evaluations of the patients were found to be better than the physician’s evaluations. Conclusion: The weight of the gold is the most important factor that determines the success of the implant treatment. It is possible to reduce postoperative morbidity and increase success by adhering to simple preoperative criteria when gold is obtained from jewelers, a cost-effective method that yields high patient satisfaction

Management of temporomandibular joint ankylosis with temporalis fascia flap and fat graft

WOS: 000328309800015PubMed ID: 23465639Aim: Temporomandibular joint (TMJ) ankylosis is a serious problem that restricts jaw mobility and causes disturbances in facial and mandibular growth. The purpose of this paper is to present an easy and versatile method for the treatment of TMJ ankylosis to decrease postoperative complications such as re-ankylosis. Material and method: Eleven patients who presented with ankylosis of the TMJ underwent surgical release. After performing gap arthroplasty through a preauricular approach, the temporalis fascia flap was transposed to the gap. An autogenous fat graft was then obtained from the abdomen and used as interpositional material. The follow-up time was 3-5 years. Results: Re-ankylosis did not occur in any of the patients, and all had satisfactory mouth opening. Conclusion: Surgical treatment of TMJ ankylosis with gap arthroplasty, interposition of the temporalis fascia flap and fat grafting is an effective and easily procedure for preventing of re-ankylosis. The autogenous nature and close proximity to the joint are the main advantages of the temporalis fascia flap when compared with other interpositional materials, and the fat graft provides additional support by reducing pressure

РАЗВИТИЕ СПОРТИВНОГО ТУРИЗМА В КРАСНОЯРСКОМ КРАЕ

WOS: 000434152500003PubMed ID: 28972286IntroductionThe deep inferior epigastric perforator (DIEP) flap is one of the most commonly utilized flaps of reconstructive surgery. Although the horizontal flap design is the most commonly used, this flap can be vertically designed to avoid drawbacks such as excessive tissue dissection, relatively reduced flap perfusion, and scarification of the contralateral flap opportunity. The aim of this report is to present our case series for foot and ankle reconstruction with vertical designed DIEP flap. Patients and methodsThe free vertically designed DIEP flaps (VDIEP) were used in eight patients (7 male, 1 female) whose age is in a range of 20-66 years for soft tissue reconstructions in the ankle and foot region over a five-year period. The range of defects' size was from 8 x 5 cm to 15 x 7 cm and the causes were electrical burn, trauma and diabetic foot infections. ResultsFlap dimensions varied from 10 x 6 cm to 17 x 9 cm. All the flaps had two or more perforators, and all flaps survived completely. There were no early or late complications. We followed up the patients for 10 months in average. We observed no functional problems, especially in main motions of foot and ankle like eversion, inversion, flexion or extension except one patient. Donor site scars were acceptable in all patients. ConclusionsThe VDIEP flap may be an option for selected lower extremity soft tissue reconstructions, and it may be an alternative to classically designed abdominal flaps