Long and Short Term Results of Karydakis Flap Technique for Surgical Treatment of Sacrococcygeal Pilonidal Sinus Disease

Amaç Bu çalışmanın amacı kliniğimizde Karydakis flep ile tedavi edilen sakrokoksigeal pilonidal sinüs hastalığının kısa ve uzun dönem sonuçlarını retrospektif olarak sunmaktır. Gereç ve Yöntem Kasım 2008 ile Aralık 2012 tarihleri arasında sakrokoksigeal pilonidal sinüs tanısıyla ameliyat edilen ve cerrahi yöntem olarak Karydakis flep prosedürü uygulanan 186 hasta incelendi. Hastalar yaş, cinsiyet, ameliyat süresi, postoperatif erken dönem komplikasyon ve nüksler açısından değerlendirildi. Bulgular Olguların 147’si (% 79) erkek, 39’u (% 21) kadındı. Hastaların yaş ortalaması 26±13 yıl idi. Ortalama ameliyat süresi 56 (38-76) dakika olarak bulundu. Hastaların takip süresi ortalama 24 (4-48) ay idi. Bu süre içerisinde 4 hastada (% 2,1) nüks saptandı. Ayrıca 6 hastada (% 3) seroma, 3 hastada (% 1,6) yara yeri enfeksiyonu ve 1 hastada (% 0,53) flep iskemisi gelişti. Sonuç Pilonidal sinüs hastalığı için ideal bir tedavi yöntemi henüz netlik kazanmamıştır. Bu konu güncel cerrahide hâla tartışmaya açıktır. Cerrahi ve cerrahi olmayan yöntemler mevcut olup bu çalışmaya göre Karydakis flep tekniği düşük nüks oranı ile sakrokoksigeal pilonidal sinüsün tedavisinde iyi bir cerrahi yöntemdir.Aim The aim of this study was to determine the long and short term results of Karydakis flap technique retrospectively. Material and Methods A retrospective analysis was done in patients who were treated with Karydakis flap techniques between November 2008 and December 2012. Patients are evaluated in terms of age, sex, time of surgery, postoperative early period complication and recurrences. Results One hundred and forty-seven cases (79%) were male and 39 (21%) were female. The mean age was 26 ± 13 years. Mean operation time was 56 (38-76) minutes. Mean followup time was 24 (4-48) months. Four patients (2.1%) had recurrence in this time. The rates of postoperative complications as seroma, wound infection and flap ischemia are respectively 3 % (n=6), 1.6 % (n=3) and 0.53 % (n=1). Conclusion There isn’t any ideal treatment for pilonidal disease yet. This subject has controversies in actual surgery. There are different procedures, surgical and nonsurgical, for this disease. According to this study Karydakis flap technique, with low recurrence rate, is a good surgical procedure for the treatment of sacrococcygeal pilonidal disease

The efficacy of fibrin glue to control hemorrhage from the gallbladder bed during laparoscopic cholecystectomy

Amaç: Laparoskopik kolesistektomi sırasında safra kesesi yatağından gelişen ve klasik yöntemlerle durdurulamayan kanamalarda fibrin yapıştırıcı uygulama deneyimimizi sunmak.Gereç ve Yöntemler: Laparoskopik kolesistektomi uygulanan 382 hastadan, safra kesesi yatağında kanama meydana gelen ve konservatif yöntemlerle durdurulamayan ve bu nedenle de fibrin glue kullanılan 14 hasta retrospektif olarak incelendi.Bulgular: Fibrin yapıştırıcı kullanılan hastaların 10'u (%71) kadın, 4'ü (%29) erkekti. Hastaların ortalama yaşı 55,7 idi. 14 hasta da semptomatik safra kesesi taşı nedeniyle ameliyat edildi. On üç hastada (%92) yandaş bir hastalık mevcuttu. Kanamanın kontrol altına alınarak hemostazın sağlanması için harcanan zaman ortalama olarak 23,9 dakika olarak saptandı. Hemoglobin değeri 8 mg/dL altına düşen 2 hastaya kan transfüzyonu yapıldı. Bir hastada fibrin yapıştırıcı kullanılmasına rağmen kanama kontrolü sağlanamadı ve açık cerrahiye geçildi.Sonuç: Laparoskopik kolesistektomi yapılan hastalarda, karaciğerde safra kesesi yatağından meydana gelen kanamalarda fibrin yapıştırıcı uygulanmasının açığa geçme oranlarını düşürdüğü saptanmış olup bu konu ile ilgili daha geniş çalışmalara da ihtiyaç duyulmaktadırObjective: The aim of the study is to report our experience with fibrin glue application in the management of bleeding from the gallbladder bed during laparoscopic cholecystectomy, which could not be controlled by conventional methods.Material and Methods: Three hundred eighty-two patients underwent laparoscopic cholecystectomy. Fourteen patients with bleeding from the gallbladder bed, which could not be controlled by conventional methods, were analyzed retrospectively.Results: Fibrin glue was used in 10 patients, 6 (71%) were female and 4 were (29%) male. The mean age was 55.7 years. Fourteen patients were operated for the presence of symptomatic gallstones. Thirteen patients (%92) had a concomitant pathology. The mean time spent to maintain hemostasis was 23.9 minutes . Blood products were used in two patients with hemoglobin under 8 mg/dL. Hemostasis could not be achieved in a patient despite fibrin glue application, and the operation was converted to open surgery. Conclusion: The application of fibrin glue for bleeding from the gallbladder bed during laparoscopic cholecystectomy can reduce conversion rates, further studies including more patients are require

Electrochemical synthesis of tunable polypyrrole-based composites on carbon fabric for wide potential window aqueous supercapacitor

Facile one-step electrochemical synthesis of a novel graphitic oxide/polypyrrole/2-acrylamido-2-methyl-1-propanesulfonic acid composite on carbon fabric were described for development of an efficient positive electrode for supercapacitor applications. The 2-acrylamido-2-methyl-1-propanesulfonate monomers behave as dopant in 3D polypyrrole network formed by synergetic coupling with graphitic oxide. Their free acrylic groups interact with each other to form polymer-hydrogel-layer on the external surface that facilitate transport of aqueous electrolyte ions inside of the electrode. The most efficient electrode material was synthesized by tuning dopant concentration at 0.01 M. The full-cell assembled using the composite electrode and graphite counter electrode works at 2.2 V in 3 M NaCl solution that equals to the highest values achieved yet for aqueous supercapacitors. This cell has a capacitance as high as 698.8 F g(-1) at 5 mV s(-1) and preserves its initial value even after 10 000 continuous CV cycles at 1000 mV s(-1). It also exhibits a high-energy density of 446.1 W h kg(-1) at a power density of 366.7 W kg(-1), and it is still 65.2 W h kg(-1) at 18.3 kW kg(-1). The asymmetric capacitor with 1 x 1 cm(2) area successfully lit a red light-emitting diode

<p>Electrochemical synthesis and characterization of self-doped aniline 2-sulfonic acid-modified flexible electrode with high areal capacitance and rate capability for supercapacitors</p>

Polypyrrole and aniline 2-sulfonic acid (CFt/PPy/ASA(0.03) composite was synthesized on carbon felt (CFt) under acid conditions. Here, we report investigated in concentration of ASA on the electropolymerization of the PPy, to improve performance of supercapacitor by a facile and effective one-step electropolymerization method. To form a 3D carbon felt, homogeneous and large grains are grown on the surface with the addition of ASA, which provides high active mass and potential redox materials of pseudocapacitive supercapacitor. The flexible electrode shows a high specific areal capacitance 4000 mF.cm(-2) at the scan rate of 10 mV.s(-1) and excellent rate capability. A symmetric supercapacitor was also assembled with 1 M H2SO4 electrolyte which delivers a maximum energy density of 18.8 Wh.kg(-1) at a power density of 312.5 kW.kg(-1), and a maximum power density of 1875 kWh.kg(-1) can be reached up while delivering a energy density 2.2 Wh.kg(-1). The device displays retention of capacitance performance 82.7% even after 2500 cycles in aqueous electrolyte on the PPy-based materials. Therefore, (CFt/PPy/ASA(0.03) electrode has an important role in practical applications of flexible, wearable and portable electronics

An ultrahigh-energy density and wide potential window aqueous electrolyte supercapacitor built by polypyrrole/aniline 2-sulfonic acid modified carbon felt electrode

In this study, excellent performance and wide operating voltage are obtained with an aqueous electrolyte. Aqueous electrolytes are attracted more attention than other electrolytes (such as organic solvents, ionic liquids) in supercapacitor applications because of their safety, low cost, nontoxicity. Polypyrrole (PPy), aniline 2-sulfonic acid (ASA) modified electrodes are hydrothermal synthesized on carbon felt (CFt) for supercapacitor applications. We investigate the presence of the concentration of ASA on the polymerization of the PPy. Furthermore, a high operating voltage of 3.0 V asymmetric supercapacitor (ASC) with graphite plate is assembled 3 M KCI. CFt/PPy/ASA(0.02)//GP exhibits a high specific capacitance value of 902.9 F g(-1) at 5 mV s(-1) and after 5000 cycle-life testing 93.6% capacitance retention at a scan rate of 1000 mV s(-1). The assembled ASC has an ultrahigh-energy density of 1005 Wh kg(-1) while delivering a power density of 3000 W kg(-1) at a current density of 2 A g(-1). The effect of ASA concentration on the supercapacitor performance has been observed

Hydrothermal Synthesis of Flexible Fe-Doped Polyaniline/Dye-Functionalized Carbon Felt Electrode for Supercapacitor Applications

In this study, Fe-doped polyaniline/dye-functional composite modified carbon felt electrode was synthesized using hydrothermal method and a supercapacitor exhibiting 1.5 V was obtained with 3.0 M KCl aqueous electrolyte. In order to improve supercapacitor performance easily and effectively, the effect of Lanaset Green B (LGB) acidic dye concentration on supercapacitor performance in polyaniline polymerization was investigated. Electrochemical, morphological and structural characterizations of the synthesized electrodes (CFt/Fe-PANI/LGB) were carried out. The results showed that the capacitance increases due to the strong interaction of functional groups between PANI and dye molecules and improves the properties of pseudocapacitive supercapacitors by providing potential redox materials. The CFt/Fe-PANI/LGB(3 mM) electrode displayed a high specific capacitance of 1543 F g(-1) at a scan rate of 5 mV s(-1) in half-cell electrode system. In full-cell, the assembled symmetric supercapacitor has a maximum energy density of 32.7 Wh kg(-1) and power density of 1250 W kg(-1). The supercapacitor electrode and symmetric supercapacitor display retention of capacitance performances 82.3 % and 78.8 % after 2400 and 5000 cycles in 3.0 KCl electrolyte, respectively. CFt/Fe-PANI/LGB(3 mM), flexible, wearable carbon felt electrode material and improved redox behavior of the polymer material play an important role for textile electronics applications