Purpose: The aim of the study was to describe the average values of the nasal anthropometric meas... more Purpose: The aim of the study was to describe the average values of the nasal anthropometric measurements by using the landmark-based geometric morphometric technique in young male patients who applied for rhinoplasty in the Black Sea Region in Turkey. Materials and methods: The study group consisted of 110 healthy male patients all were born in the Black Sea Region, Turkey. The landmark-based geometric morphometric technique was used to analyze the nasal shapes as described in the literature. The mean age was 29 years (ranging from 23 to 35). All patients underwent primary rhinoplasty in our clinic between 2006 and 2011 years. All data were obtained from standardized digital photographic images. Anterior and worm's eye view photos of the patients were analyzed by using standard anthropometric measurement methods. Results: The mean total length and nasal bridge length of the noses were 58.90 and 57.35 mm, respectively. The mean nasal bridge width and the morphologic nose width were 32.65 and 35.50 mm, respectively. The average width of the anatomic nose was 26.25 mm. The mean length and width of the ala were 22.72 and 4.73 mm, respectively. The mean length and width of the columella were 11.35 and 5.20 mm, respectively. The mean frontonasal angle was 137.88 and the mean nasolabial angle was 87.34. Conclusion: Black Sea nose was characterized by being considerably longer than average in nasal length and columellar height. Also nasolabial angle was found to be more acute than average when compared to other noses.
Background: Angular artery, lateral nasal artery, and infraorbital artery pedicled nasolabial fla... more Background: Angular artery, lateral nasal artery, and infraorbital artery pedicled nasolabial flaps have been used for reconstruction of lower nose and medial cheek defects. An alternative pedicle to raise a f lap in the nasolabial area is the superior labial artery. Superior labial artery is a constant branch of the facial artery, arising above or at the angle of mouth and anastomoses with its counterpart in the middle of the upper lip. This makes a reverse superior la-bial artery pedicle possible for elevation of a nasolabial f lap. Patients and Methods: Reverse superior labial artery island f laps were used for reconstruction of lower nose and medial cheek defects in 12 patients. Eleven patients presented with malignant skin lesions and 1 with a traumatic defect of the lower nose. Auricular cartilage graft to support the alar rim and nasal tip was combined to the f lap in 3 patients. Results: All f laps survived completely. Temporary venous congestion was observed in 3 f laps in the early postoperative period but this resolved in 3 to 5 days. All patients healed without any postoperative complications and the final results were considered satisfactory. Conclusions: Reverse superior labial artery pedicled nasolabial island f lap proved to be a good choice for reconstruction of the lower nose and moderate sized medial cheek defects. This pedicle should be considered where the defect is located on the course of lateral nasal artery or angular artery. Arc of rotation and reliability of this new f lap is considered superior to angular artery and infraorbital arteryYbased nasolabial f laps where these arteries could also be used as pedicle.
The aim of this study was to evaluate the efficacy of autologous fat graft with different surgica... more The aim of this study was to evaluate the efficacy of autologous fat graft with different surgical repair methods on reconstruction of a 10-mm long rat sciatic nerve defect model. 144 sciatic nerves were operated on in 72 Wistar rats. The right limbs were assigned as Group A (n=72) and the left limbs as Group B (n=72). In Group B, autologous fat graft was added to the surgical area so as to stay in contact with the coaptation site. Nerve regeneration was evaluated by walking track analysis, sciatic functional index (SFI), pin-prick, electrophysiologic and histologic tests at commencement, 4 and 12 weeks after the operation. The rats receiving fat graft showed better regeneration, but the difference was only significant according to SFI and pin-prick test (p<0.05). Primary repair, autogenous nerve graft, acellularized nerve graft, vein fresh and denaturated muscle graft subgroups in Group B showed significantly better regeneration than those of Group A according to SFI (p<0.05)...
The management of postburn lower eyelid ectropion is difficult, since the contraction of the skin... more The management of postburn lower eyelid ectropion is difficult, since the contraction of the skin graft may give rise to secondary deformities especially around the lateral 1/3 of the lower eyelid. In this paper, the results of reconstruction in lower eyelid ectropion with a laterally based orbicularis oculi myocutaneous flap from the upper eyelid in 7 young patients are presented. Satisfactory function and cosmesis were obtained in the evaluation of the patients up to 40 months follow-up. The method proved versatile as the donor scar was well-hidden in the supratarsal fold and the temporally based myocutaneous flap provided additional support to the lower eyelid by exerting an upward pull against the gravity. It is concluded that usage of this flap in postburn ectropion cases is worthwhile to avoid any recurrences. reserved.
The aim of this retrospective study was to evaluate the efficacy of vacuum-assisted closure (VAC)... more The aim of this retrospective study was to evaluate the efficacy of vacuum-assisted closure (VAC) and GranuFoam Silver(®) dressing (KCI, San Antonio, TX) compared with conventional GranuFoam(®) dressing in the management of diabetic foot ulcers. Twenty-one consecutive patients treated with conventional or silver-coated foam dressing were reviewed retrospectively. The wound duration was 6 mo. Group 1 (n=10) received conventional foam dressing (GranuFoam) and group 2 (n=11) received silver-coated foam dressing (GranuFoam Silver). The wound surface area, duration of treatment, bacteriology, and recurrence were compared between the groups. The mean age of the patients was 61.70±10.52 y in group 1 and 67.27±11.28 y in group 2. In group 1, the average surface area of the wounds was 45.30±46.96 cm(2) and 18.40±23.48 cm(2) in the pre-treatment and post-treatment periods, respectively. There was a statistically significant difference between two measurements (p=0.005). Average duration of the treatment was 25.50±27.13 d in this group. In group 2, average surface area of the wounds in the pre-treatment and post-treatment periods were 41.55±36.03 cm(2) and 7.64±3.91 cm(2), respectively. There was a statistically significant difference between two measurements (p=0.003). Average duration of the treatment was 10.09±3.51 d in this group. The patients treated with silver-impregnated polyurethane foam dressing had reduced recurrence (2 vs. 7 wounds, p=0.030) and increased number of the culture-negative cases at the end of the treatment. With the results of the study, it was concluded that VAC GranuFoam silver dressing can be superior to conventional GranuFoam dressing in reducing the recurrence rate of infected diabetic foot ulcers.
Since the introduction of negative pressure wound therapy (NPWT), the physiological effects of va... more Since the introduction of negative pressure wound therapy (NPWT), the physiological effects of various interface dressing materials have been studied. The purpose of this experimental study was to compare the use of loofah sponge to standard polyurethane foam or a cotton gauze sponge. Three wounds, each measuring 3 cm x 3 cm, were created by full-thickness skin excision on the dorsal sides of 24 New Zealand adult white rabbits. The rabbits were randomly divided into four groups of six rabbits each. In group 1 (control), conventional saline-moistened gauze dressing was provided and changed at daily intervals. The remaining groups were provided NPWT dressings at -125 mm Hg continuous pressure. This dressing was changed every 3 days for 9 days; group 2 was provided polyurethane foam, group 3 had conventional saline-soaked antimicrobial gauze, and group 4 had loofah sponge. Wound area measurements and histological findings (inflammation, granulation tissue, neovascularization, and reepi...
Macrodactyly or megalodactyly is a rare anomaly of the extremities. Neural factors are involved i... more Macrodactyly or megalodactyly is a rare anomaly of the extremities. Neural factors are involved in the etiology. Presented here are eight cases which comprise five macrodactylous toes and three fingers. The mean age at first referral was 6.8 years. Six patients underwent resection of the proximal phalanges together with bulk reduction of the soft tissue mass. Only soft tissue reduction was performed in the remaining two patients. Skin necrosis was observed in two cases, one of which necessitated amputation at the proximal interphalangeal joint level. The functional outcome was evaluated as poor with limited range of motion and stiffness in the joints. As far as functional results are concerned, macrodactylous toes had a better prognosis than that of fingers. It was concluded that none of the available methods as yet gives ideal functional and cosmetic results in macrodactyly.
ABSTRACT Dermatofibrosarcoma protuberans (DFSP) is a rare tumor of the skin, which has a propensi... more ABSTRACT Dermatofibrosarcoma protuberans (DFSP) is a rare tumor of the skin, which has a propensity for local recurrence. Surgery is the only option of treatment and resection with wide surgical margins including the underlying fascia has become the standard treatment. Two cases of DFSP located on the trunk and forearm are presented who were managed with 3 cm tumor free lateral margins and in depth resection including underlying muscles. The patients were found to have no tumors after 3 and 4 years follow-up. This aggressive approach including excision of underlying muscles is advocated for DFSP located on the trunk or extremities to prevent local recurrence.
The primary aim in the treatment of inverted nipple is to achieve a satisfactory and permanent pr... more The primary aim in the treatment of inverted nipple is to achieve a satisfactory and permanent projection of the nipple. The drawbacks of reported techniques include sensory disturbance of the nipple, marked scarring of the nipple and areola, destruction of breast function and incomplete correction. In the present study, the authors introduced a new modification of using two opposite nipple-based areolar dermal flap in the treatment of grades 2 and 3 inverted nipple cases. Nipple-based areolar flaps designed at 3 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock and 9 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock were raised by two linear incisions and the tip of each flap was sutured on the base of the nipple close to the base itself in a reverse S shape at 6 and 12 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock. Successful outcome was obtained due to a strongly suspending effect of the design of the flaps. The mean follow-up period was 6 months. The patients were satisfied with the result and the scars were minimal. The authors recommend the use of the technique that is a simple, reliable and with minimal scars for correcting grades 2 and 3 inverted nipples.
... 1 Aside from the aim to regain function, Feller et al. 1 emphasized the importance of aesthet... more ... 1 Aside from the aim to regain function, Feller et al. 1 emphasized the importance of aesthetic and psychological aspects, which must always be considered. Moreover ... Mustafa Akyürek, MD. Naci Kostakoğlu, MD. Abdullah Keçik, MD. Department ...
Purpose: The aim of the study was to describe the average values of the nasal anthropometric meas... more Purpose: The aim of the study was to describe the average values of the nasal anthropometric measurements by using the landmark-based geometric morphometric technique in young male patients who applied for rhinoplasty in the Black Sea Region in Turkey. Materials and methods: The study group consisted of 110 healthy male patients all were born in the Black Sea Region, Turkey. The landmark-based geometric morphometric technique was used to analyze the nasal shapes as described in the literature. The mean age was 29 years (ranging from 23 to 35). All patients underwent primary rhinoplasty in our clinic between 2006 and 2011 years. All data were obtained from standardized digital photographic images. Anterior and worm's eye view photos of the patients were analyzed by using standard anthropometric measurement methods. Results: The mean total length and nasal bridge length of the noses were 58.90 and 57.35 mm, respectively. The mean nasal bridge width and the morphologic nose width were 32.65 and 35.50 mm, respectively. The average width of the anatomic nose was 26.25 mm. The mean length and width of the ala were 22.72 and 4.73 mm, respectively. The mean length and width of the columella were 11.35 and 5.20 mm, respectively. The mean frontonasal angle was 137.88 and the mean nasolabial angle was 87.34. Conclusion: Black Sea nose was characterized by being considerably longer than average in nasal length and columellar height. Also nasolabial angle was found to be more acute than average when compared to other noses.
Background: Angular artery, lateral nasal artery, and infraorbital artery pedicled nasolabial fla... more Background: Angular artery, lateral nasal artery, and infraorbital artery pedicled nasolabial flaps have been used for reconstruction of lower nose and medial cheek defects. An alternative pedicle to raise a f lap in the nasolabial area is the superior labial artery. Superior labial artery is a constant branch of the facial artery, arising above or at the angle of mouth and anastomoses with its counterpart in the middle of the upper lip. This makes a reverse superior la-bial artery pedicle possible for elevation of a nasolabial f lap. Patients and Methods: Reverse superior labial artery island f laps were used for reconstruction of lower nose and medial cheek defects in 12 patients. Eleven patients presented with malignant skin lesions and 1 with a traumatic defect of the lower nose. Auricular cartilage graft to support the alar rim and nasal tip was combined to the f lap in 3 patients. Results: All f laps survived completely. Temporary venous congestion was observed in 3 f laps in the early postoperative period but this resolved in 3 to 5 days. All patients healed without any postoperative complications and the final results were considered satisfactory. Conclusions: Reverse superior labial artery pedicled nasolabial island f lap proved to be a good choice for reconstruction of the lower nose and moderate sized medial cheek defects. This pedicle should be considered where the defect is located on the course of lateral nasal artery or angular artery. Arc of rotation and reliability of this new f lap is considered superior to angular artery and infraorbital arteryYbased nasolabial f laps where these arteries could also be used as pedicle.
The aim of this study was to evaluate the efficacy of autologous fat graft with different surgica... more The aim of this study was to evaluate the efficacy of autologous fat graft with different surgical repair methods on reconstruction of a 10-mm long rat sciatic nerve defect model. 144 sciatic nerves were operated on in 72 Wistar rats. The right limbs were assigned as Group A (n=72) and the left limbs as Group B (n=72). In Group B, autologous fat graft was added to the surgical area so as to stay in contact with the coaptation site. Nerve regeneration was evaluated by walking track analysis, sciatic functional index (SFI), pin-prick, electrophysiologic and histologic tests at commencement, 4 and 12 weeks after the operation. The rats receiving fat graft showed better regeneration, but the difference was only significant according to SFI and pin-prick test (p<0.05). Primary repair, autogenous nerve graft, acellularized nerve graft, vein fresh and denaturated muscle graft subgroups in Group B showed significantly better regeneration than those of Group A according to SFI (p<0.05)...
The management of postburn lower eyelid ectropion is difficult, since the contraction of the skin... more The management of postburn lower eyelid ectropion is difficult, since the contraction of the skin graft may give rise to secondary deformities especially around the lateral 1/3 of the lower eyelid. In this paper, the results of reconstruction in lower eyelid ectropion with a laterally based orbicularis oculi myocutaneous flap from the upper eyelid in 7 young patients are presented. Satisfactory function and cosmesis were obtained in the evaluation of the patients up to 40 months follow-up. The method proved versatile as the donor scar was well-hidden in the supratarsal fold and the temporally based myocutaneous flap provided additional support to the lower eyelid by exerting an upward pull against the gravity. It is concluded that usage of this flap in postburn ectropion cases is worthwhile to avoid any recurrences. reserved.
The aim of this retrospective study was to evaluate the efficacy of vacuum-assisted closure (VAC)... more The aim of this retrospective study was to evaluate the efficacy of vacuum-assisted closure (VAC) and GranuFoam Silver(®) dressing (KCI, San Antonio, TX) compared with conventional GranuFoam(®) dressing in the management of diabetic foot ulcers. Twenty-one consecutive patients treated with conventional or silver-coated foam dressing were reviewed retrospectively. The wound duration was 6 mo. Group 1 (n=10) received conventional foam dressing (GranuFoam) and group 2 (n=11) received silver-coated foam dressing (GranuFoam Silver). The wound surface area, duration of treatment, bacteriology, and recurrence were compared between the groups. The mean age of the patients was 61.70±10.52 y in group 1 and 67.27±11.28 y in group 2. In group 1, the average surface area of the wounds was 45.30±46.96 cm(2) and 18.40±23.48 cm(2) in the pre-treatment and post-treatment periods, respectively. There was a statistically significant difference between two measurements (p=0.005). Average duration of the treatment was 25.50±27.13 d in this group. In group 2, average surface area of the wounds in the pre-treatment and post-treatment periods were 41.55±36.03 cm(2) and 7.64±3.91 cm(2), respectively. There was a statistically significant difference between two measurements (p=0.003). Average duration of the treatment was 10.09±3.51 d in this group. The patients treated with silver-impregnated polyurethane foam dressing had reduced recurrence (2 vs. 7 wounds, p=0.030) and increased number of the culture-negative cases at the end of the treatment. With the results of the study, it was concluded that VAC GranuFoam silver dressing can be superior to conventional GranuFoam dressing in reducing the recurrence rate of infected diabetic foot ulcers.
Since the introduction of negative pressure wound therapy (NPWT), the physiological effects of va... more Since the introduction of negative pressure wound therapy (NPWT), the physiological effects of various interface dressing materials have been studied. The purpose of this experimental study was to compare the use of loofah sponge to standard polyurethane foam or a cotton gauze sponge. Three wounds, each measuring 3 cm x 3 cm, were created by full-thickness skin excision on the dorsal sides of 24 New Zealand adult white rabbits. The rabbits were randomly divided into four groups of six rabbits each. In group 1 (control), conventional saline-moistened gauze dressing was provided and changed at daily intervals. The remaining groups were provided NPWT dressings at -125 mm Hg continuous pressure. This dressing was changed every 3 days for 9 days; group 2 was provided polyurethane foam, group 3 had conventional saline-soaked antimicrobial gauze, and group 4 had loofah sponge. Wound area measurements and histological findings (inflammation, granulation tissue, neovascularization, and reepi...
Macrodactyly or megalodactyly is a rare anomaly of the extremities. Neural factors are involved i... more Macrodactyly or megalodactyly is a rare anomaly of the extremities. Neural factors are involved in the etiology. Presented here are eight cases which comprise five macrodactylous toes and three fingers. The mean age at first referral was 6.8 years. Six patients underwent resection of the proximal phalanges together with bulk reduction of the soft tissue mass. Only soft tissue reduction was performed in the remaining two patients. Skin necrosis was observed in two cases, one of which necessitated amputation at the proximal interphalangeal joint level. The functional outcome was evaluated as poor with limited range of motion and stiffness in the joints. As far as functional results are concerned, macrodactylous toes had a better prognosis than that of fingers. It was concluded that none of the available methods as yet gives ideal functional and cosmetic results in macrodactyly.
ABSTRACT Dermatofibrosarcoma protuberans (DFSP) is a rare tumor of the skin, which has a propensi... more ABSTRACT Dermatofibrosarcoma protuberans (DFSP) is a rare tumor of the skin, which has a propensity for local recurrence. Surgery is the only option of treatment and resection with wide surgical margins including the underlying fascia has become the standard treatment. Two cases of DFSP located on the trunk and forearm are presented who were managed with 3 cm tumor free lateral margins and in depth resection including underlying muscles. The patients were found to have no tumors after 3 and 4 years follow-up. This aggressive approach including excision of underlying muscles is advocated for DFSP located on the trunk or extremities to prevent local recurrence.
The primary aim in the treatment of inverted nipple is to achieve a satisfactory and permanent pr... more The primary aim in the treatment of inverted nipple is to achieve a satisfactory and permanent projection of the nipple. The drawbacks of reported techniques include sensory disturbance of the nipple, marked scarring of the nipple and areola, destruction of breast function and incomplete correction. In the present study, the authors introduced a new modification of using two opposite nipple-based areolar dermal flap in the treatment of grades 2 and 3 inverted nipple cases. Nipple-based areolar flaps designed at 3 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock and 9 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock were raised by two linear incisions and the tip of each flap was sutured on the base of the nipple close to the base itself in a reverse S shape at 6 and 12 o&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;clock. Successful outcome was obtained due to a strongly suspending effect of the design of the flaps. The mean follow-up period was 6 months. The patients were satisfied with the result and the scars were minimal. The authors recommend the use of the technique that is a simple, reliable and with minimal scars for correcting grades 2 and 3 inverted nipples.
... 1 Aside from the aim to regain function, Feller et al. 1 emphasized the importance of aesthet... more ... 1 Aside from the aim to regain function, Feller et al. 1 emphasized the importance of aesthetic and psychological aspects, which must always be considered. Moreover ... Mustafa Akyürek, MD. Naci Kostakoğlu, MD. Abdullah Keçik, MD. Department ...
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