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1.
Ulus Travma Acil Cerrahi Derg ; 20(1): 51-5, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24639316

RESUMEN

BACKGROUND: We aimed to describe herein the clinical features, diagnosis and treatment of intraorbital wooden foreign body injuries. METHODS: A case series review of orbital injuries managed at Trakya University Faculty of Medicine between 2002 and 2012 was performed retrospectively. The clinical analysis of 32 intraorbital wooden foreign body injuries was reviewed. RESULTS: Among the 32 cases, injuries in 16 were caused by a tree branch, in 10 by a pencil, in 5 by a stick, and in 1 by a bush. With respect to preoperative vision, postoperative vision was improved in 69% of patients. Time lapse from injury to presentation was correlated with the size of the foreign body. The subjects were comparable in etiological factor, and distribution of injury according to orbit was as follows: superior 28%, medial 25%, lateral 22%, inferior 16%, and posterior 9%. Computerized tomography (CT) for foreign body was definitive in 72% (n=23) and suggestive in 28% (n=9). CONCLUSION: The diagnosis of orbital wooden foreign body is difficult because it may be missed clinically and from the imaging perspective. If a foreign body is suspected, optimal patient management should be done. Prior to the surgery, imaging modalities should be maximally utilized. A careful preoperative evaluation, imaging studies, which are event-specific, a high index of suspicion, and rigorous surgery and postoperative care are the keys in the management of orbital wooden foreign body injuries.


Asunto(s)
Cuerpos Extraños en el Ojo/diagnóstico , Cuerpos Extraños en el Ojo/terapia , Lesiones Oculares Penetrantes/diagnóstico , Lesiones Oculares Penetrantes/terapia , Madera , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
2.
Rev Int Androl ; 22(2): 1-9, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39135368

RESUMEN

The aim of this study is to share our preliminary outcomes of the pedicled Antero Lateral Thigh flap (ALTf) phalloplasty technique, which we presume to be the first reported case series of a single center from Turkey. A cross-sectional study, comprising all cases who underwent pedicled ALTf phalloplasty in our clinic, between January 2015 and December 2019, was designed. Demographic data, case characteristics and surgical details including complications were recorded. The mean age of our 26 cases was 30 (28-34) years. The mean penile length and diameter were 15.07 ± 0.98 cm and 3.9 ± 0.34 cm, respectively. Tactile sensation was evaluated by touching the radix, corpus and tip of the neo-phallus showing response in 17 (65.4%), 7 (26.9%) and 2 (7.7%) of the cases, respectively. In 14 (53.8%) of all our cases no complication was reported at all. However, in 12 (46.1%) cases, although no intraoperative complication occurred; postoperative complications were observed as Clavien-2 (3.8%), Clavien-3a (3.8%) and Clavien-3b (71%). Postoperative satisfaction rates were found 77.14% (38-94). Although relevant studies are limited, in addition to low complication rates and high satisfactory outcomes, by leading to a concealable donor site, the pedicled ALTf can be used as a preferred phalloplasty technique, especially in transmen with religious or cultural sensibility.


Asunto(s)
Pene , Complicaciones Posoperatorias , Cirugía de Reasignación de Sexo , Colgajos Quirúrgicos , Muslo , Humanos , Masculino , Adulto , Turquía , Cirugía de Reasignación de Sexo/métodos , Estudios Transversales , Pene/cirugía , Muslo/cirugía , Complicaciones Posoperatorias/epidemiología , Femenino , Resultado del Tratamiento
3.
Transgend Health ; 8(6): 558-565, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38130982

RESUMEN

Purpose: The aim of this study was to share our outcomes, including complications and their management, of a "modified" penile inversion vaginoplasty (PIV) technique applied to transgender individuals, which we presume to be the first reported case series of a single center from Turkey. Methods: A cross-sectional study, including adult transgender cases who underwent male to female gender-affirming surgery in our institution, between January 2015 and December 2019, was planned. The same "modified" PIV technique, in which the spatulated urethra was incorporated to the penile skin flap, was applied to all cases. Demographic data including case characteristics, medical history with prior operative details, and complications detected during follow-up examination were collected prospectively. Results: The mean age of 30 cases included in the study was 31.03±7.05 years. The mean length of hospitalization after the surgical procedures was 10.13±2.24 days. The mean vaginal depth measured at postoperative 1st year follow-up examination was 14.2±2.95 cm. Satisfactory neovaginal moistening was reported by 24 (80%) cases. In 8 (26.6%) of 30 cases, no complication was reported at all. Intraoperative (rectal injury) and postoperative (meatal stenosis, vaginal narrowing, scars, infections, etc.) complications occurred in 22 (63.4%) cases. Postoperative satisfaction rates including mental, physical, and social health in general were found to be 81.84% (66-98%). Conclusion: The "modified" PIV can be used as a preferred technique showing high satisfactory outcomes, especially in cases with short penile skin or circumcision, due to the achievable lubricity and vaginal width/depth.

4.
Ann Plast Surg ; 69(2): 152-6, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22772068

RESUMEN

Electrical injuries induce progressive tissue loss. We evaluated the effect of lidocaine on tissue necrosis after electrical burn injuries. Forty-two male Wistar albino rats (250-300 g) were divided into 3 groups [Group A (n=6), control group without an electrical burn injury; and Groups B (n=18) and C (n=18), electrical burn injury groups without and with lidocaine therapy, respectively]. Three separate analyses were performed at different time points on 6 of 18 rats from Groups B and C at each time point. Electrical burns were induced by applying 220 V AC between the left upper and right lower extremities for 10 seconds. Myeloperoxidase and malondialdehyde levels were measured in skin and muscle biopsy specimens after the first hour, fresh and dry weight differences in the amputated extremities were calculated after 24 hours, and live and necrotic tissue areas were measured at 7 days after burn injury. We found that lidocaine reduced edema, the number of neutrophils, and neutrophil damage in tissues. We conclude that lidocaine decreased the amount of necrotic tissue caused by electric injury.


Asunto(s)
Anestésicos Locales/uso terapéutico , Quemaduras por Electricidad/tratamiento farmacológico , Lidocaína/uso terapéutico , Anestésicos Locales/farmacología , Animales , Quemaduras por Electricidad/patología , Esquema de Medicación , Edema/etiología , Edema/prevención & control , Infusiones Intravenosas , Inyecciones Intravenosas , Lidocaína/farmacología , Masculino , Modelos Animales , Músculo Esquelético/efectos de los fármacos , Músculo Esquelético/lesiones , Músculo Esquelético/patología , Necrosis/etiología , Necrosis/prevención & control , Ratas , Ratas Wistar , Piel/efectos de los fármacos , Piel/lesiones , Piel/patología , Resultado del Tratamiento
5.
Aesthetic Plast Surg ; 34(3): 394-6, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19768491

RESUMEN

BACKGROUND: Anaphylaxis after the administration of tissue expanders has been reported. Late onset hypotension, thrombocytopenia, disseminated intravascular coagulation (DIC) and pulmonary edema due to the tissue expanders have not been reported. METHODS: In this case report, late onset hypotension, thrombocytopenia, disseminated intravascular coagulation and pulmonary edema due to the administration of tissue expanders were described. RESULTS: The authors report a 16-year-old girl with burn scar deformities scheduled for reconstruction of the scar contractures with insertion of tissue expanders in which the administration of latex tissue expanders was associated with late onset hypotension, thrombocytopenia, disseminated intravascular coagulation and pulmonary edema. Skin tests performed for latex demonstrated strong positive weal and flare reactions. CONCLUSION: Late onset anaphylactic reactions due to latex tissue expanders, an unusual unpredictable adverse reaction, must be kept in mind. Early recognition and proper emergent treatment are essential to reversing this complication.


Asunto(s)
Anafilaxia/inducido químicamente , Coagulación Intravascular Diseminada/etiología , Hipersensibilidad al Látex/complicaciones , Hipersensibilidad al Látex/inmunología , Complicaciones Posoperatorias , Edema Pulmonar/etiología , Adolescente , Femenino , Humanos , Factores de Tiempo , Dispositivos de Expansión Tisular
6.
Aesthet Surg J ; 30(1): 44-50, 2010 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-20442074

RESUMEN

BACKGROUND: Anthropometric measurements and proportions of the human body have made a significant contribution to the science of aesthetic and reconstructive plastic surgery. OBJECTIVE: The present study was performed to measure anthropometric breast values in Turkish female students and compare them with those of women in other nations. METHODS: The study included 385 female undergraduate student volunteers between the ages of 18 and 26 years with no physical or developmental deformity and with a body mass index between 20 and 26. A total of 19 parameters were measured in a standing position. The parameters measured were body weight, height, shoulder width, upper chest width, middle chest width, lower chest width, waist width, hip width, clavicle-nipple length, sternal notch-nipple length, nipple-nipple length, upper arm length, medial mammary radius, lateral mammary radius, nipple-inframammary fold length, nipple diameter, areola diameter, nipple projection, and mammary projection. Breast volume, breast ptosis, and retracted nipple rates were also assessed. RESULTS: The mean breast volume was determined to be 407.2 +/- 263.6 cc. The mean values of the right and left breast volumes were calculated as 415.2 +/- 264.5 cc and 399.1 +/- 265.5 cc, respectively; the right breast volume was significantly greater than the left breast volume (P < .001). The ideal external view of the breasts with equal volume for both sides and no ptosis was observed in 35.1% of the volunteers. The percentage of women with unilateral or bilateral retracted nipple was 2.6%. CONCLUSIONS: The results of the present study will help in comparing the anthropometric breast values of young Turkish women with those of women in other countries. They may also be useful either in planning aesthetic and reconstructive breast surgery or in designing breast augmentation accessories and clothing.


Asunto(s)
Antropometría/métodos , Mama/anatomía & histología , Adolescente , Adulto , Pesos y Medidas Corporales/métodos , Femenino , Humanos , Masculino , Tamaño de los Órganos , Valores de Referencia , Estudiantes , Turquía , Adulto Joven
7.
Aesthetic Plast Surg ; 33(4): 570-5, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19101759

RESUMEN

Silicone is a material commonly used in reconstructive and aesthetic surgery, but capsular formation is a very frequent complication of silicone implants. This study aimed to investigate whether verapamil, a calcium-channel blocker, can reduce the thickness of the peri-implant capsule in rats when it is instilled into the subcutaneous pockets. For this study, 60 female Wistar albino rats were used, and cubes of silicone blocks (10 x 10 x 5 mm) were crafted. The rats were divided into five groups of 12 each, and the groups were distinguished according to the use of silicone and artificially created hematoma relevant to administration of a single dose of 5 mg verapamil (Isoptin). The control group was left without silicone. In two of the four silicone groups, hematoma was artificially created around the silicone by a 1-ml injection of blood. The implants were removed 6 months later, and capsulectomy was performed. Under light microscopic examination, no severe inflammation was observed in any of the capsule tissues. Additionally, the thickness of the capsule was measured and found to be significantly reduced statistically in all the verapamil-treated groups, including the groups with the artificially created hematoma. In conclusion, based on the statistically significant data obtained in this study, subcutaneous verapamil administration may be a useful adjunct for preventing formation of capsular contracture after silicone implantations. This preliminary work in rats should be confirmed with larger mammals before carefully controlled clinical trials are considered.


Asunto(s)
Bloqueadores de los Canales de Calcio/uso terapéutico , Complicaciones Posoperatorias/prevención & control , Prótesis e Implantes/efectos adversos , Siliconas , Verapamilo/uso terapéutico , Animales , Femenino , Complicaciones Posoperatorias/etiología , Ratas , Ratas Wistar
8.
Ulus Travma Acil Cerrahi Derg ; 25(2): 93-98, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30892673

RESUMEN

BACKGROUND: In the present study, the aim was to evaluate the effects of Hyalobarrier gel (Anika Therapeutics S.r.l., Abano Terme, Italy) and Seprafilm adhesion barrier (Genzyme Corporation, Cambridge, MA, USA) in the prevention of peritendinous adhesions following a crush-type injury. METHODS: Twenty five female Wistar Albino rats, weighing 230 to 270 g and 7 to 9 months of age were randomized into 5 groups. Group 1 was the control group, Group 2 comprised the Hyalobarrier gel group, Group 3 was made up of the Seprafilm-treated subjects, Group 4 was the tendon repair and Hyalobarrier gel group, and Group 5 was the tendon repair and Seprafilm group. Two gastrocnemius muscle tendons of each animal, a total of 50 tendons, were used. The animals were sacrificed with the administration of a high dose of anesthetic on postoperative day 40. Macroscopic evaluation of adhesions was classified by 2 blinded researchers according to Tang's adhesion grading system. The number of fibroblasts and the density and formation of collagen fibers were noted for histopathological examination. RESULTS: None of the subjects in Group 2 was determined to have a severe adhesion, and moderate or severe adhesions were detected in Groups 3, 4, and 5. There was no statistically significant difference between Group 2 and the control group (p=0.737). Groups 3, 4, and 5 demonstrated fewer adhesions than Groups 1 and 2 (p<0.05). Groups 4 and 5 had fewer adhesions than Groups 2 and 3 (p<0.05). There was no statistically significant difference between Groups 4 and 3 (p=0.342). The histopathological findings were consistent with the macroscopic findings. CONCLUSION: Seprafilm was found to be effective in the prevention of peritendinous adhesions following a crush-type injury with or without repair of the tendon fibers. In contrast, Hyalobarrier gel was found to be effective only following repair of the tendon fibers.


Asunto(s)
Geles , Ácido Hialurónico , Adherencias Tisulares , Animales , Femenino , Ratas , Lesiones por Aplastamiento/cirugía , Geles/uso terapéutico , Ácido Hialurónico/uso terapéutico , Distribución Aleatoria , Ratas Wistar , Adherencias Tisulares/tratamiento farmacológico , Adherencias Tisulares/prevención & control
9.
Turk J Phys Med Rehabil ; 65(4): 352-360, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31893272

RESUMEN

OBJECTIVES: : In this study, we aimed to compare morphological and histological differences between magnetic field and electric stimulation therapies in an experimental burn injury model in rats. MATERIALS AND METHODS: Between February 2011 and July 2011, a total of 21 Sprague-Dawley female rats were used in this study. Second-degree burns were induced on the back areas of the rats. All rats were equally divided into three groups including seven in each: the first burn group was treated with antibacterial pomade (Group 1, control group); the second group was treated with both antibacterial pomade and pulsed electromagnetic field therapy (Group 2); and the third group was treated with antibacterial pomade and electric stimulation for 14 days (Group 3). RESULTS: Earlier re-epithelialization, wound area contraction, reduction of edema, and hyperaemia were observed on gross examination in the pulsed electromagnetic fields and electric stimulation therapy groups compared to the control group. Neovascularization, collagen density, granulation tissue formation, cell proliferation, and inflammatory cell response of the pulsed electromagnetic fields and electric stimulation group increased, compared to the control group, in the histopathological evaluation (p<0.05). CONCLUSION: Our study results showed the positive healing effects of electric stimulation and pulsed electromagnetic fields on burn injury. Pulsed electromagnetic fields therapy produced more positive signs of healing than the electric stimulation group.

10.
Dermatol Surg ; 33(12): 1442-50; discussion 1450-1, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18076609

RESUMEN

BACKGROUND: Reconstruction of facial skin defects requires good-quality skin cover to satisfy aesthetic expectations of patient, especially when the skin defect is on the uncovered area of the face. Limitations in the available local tissue and donor-site morbidity restrict the options. OBJECTIVE: In an effort to solve these problems, we have begun to use a subcutaneous pedicled retroauricular reverse-flow flap. METHODS: Between January 1997 and December 2005, reverse-flow subcutaneous pedicled retroauricular island flap was used to cover facial defects in 12 patients who underwent surgical excision of skin tumor. The patients ranged in age from 44 to 81 years with a mean age of 58 years. RESULTS: Only one case experienced a superficial necrosis in the distal one-quarter part of the flap. The functional and aesthetic results were satisfactory for both patients and surgeons, and no tumor recurrence was observed during the 12 to 28 months (mean, 18.8 months) follow-up period. CONCLUSIONS: This flap can be used reliably for the reconstruction of facial skin defects of small and medium size. The preference of frontal branch pedicled flap enables more distal facial area defects to be covered, such as dorsal nasal, nasolabial, and upper lip, than flaps based on parietal branch.


Asunto(s)
Cara/cirugía , Procedimientos de Cirugía Plástica , Neoplasias Cutáneas/cirugía , Colgajos Quirúrgicos/irrigación sanguínea , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Heridas y Lesiones/etiología , Heridas y Lesiones/cirugía
11.
Balkan Med J ; 34(2): 147-155, 2017 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-28418342

RESUMEN

BACKGROUND: Subcutaneous mastectomy for female- to-male transsexuals is usually the first surgical pro- cedure in sexual reassignment. The main objective of subcutaneous mastectomy is to create an aesthetically pleasing male chest contour by removing all glandular tissue while minimizing chest wall scars. AIMS: In this paper, we present our experience with subcutaneous mastectomy performed in female-to- male transsexual patients. The authors recommend their point of view to aid in selecting the most suitable subcutaneous mastectomy technique depending on breast characteristics. STUDY DESIGN: Retrospective cross-sectional study. METHODS: Between March 2011 and December 2014, 52 patients underwent bilateral subcutaneous mastec- tomies (total of 104 mastectomies), performed using the following four techniques: Webster semicircular, concentric circular, vertical, and apron flap. The tech- nique decision depended on the breast size, degree of skin excess, skin elasticity, chest width, nipple areolar complex size and position. RESULTS: Seventeen patients (32.7%) were operated with Webster semicircular, 7 patients (13.5%) with con- centric periareolar, 12 patients with vertical (23%); and 16 patients (30.8%) with the apron flap technique. The overall postoperative complication rate was 13.4%. All patients were satisfied with the aesthetic results of their subcutaneous mastectomies within the follow-up period. CONCLUSION: To obtain higher patient satisfaction with aesthetic results and lower postoperative complication rates, breast characteristics are evaluated in a detailed fashion, while choosing the ideal technique of Female-to-Male (FtM) subcutaneous mastectomy. The presented surgical new algorithm facilitates the selection of the most reliable surgical technique.


Asunto(s)
Mastectomía Subcutánea/métodos , Mastectomía Subcutánea/normas , Transexualidad/cirugía , Adolescente , Adulto , Índice de Masa Corporal , Estudios Transversales , Estética/psicología , Femenino , Humanos , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Retrospectivos , Cirugía de Reasignación de Sexo/métodos , Personas Transgénero/psicología , Transexualidad/patología
12.
Eur J Nucl Med Mol Imaging ; 33(12): 1500-7, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16896671

RESUMEN

PURPOSE: Although various non-invasive procedures have been proposed to determine the optimal level of amputation of limbs in patients who have vascular disease, currently there are no consistent criteria that can be applied before surgery. The purpose of this study was to determine whether (99m)Tc-sestamibi imaging can accurately predict the healing of amputation sites. METHODS: In a prospective study in 26 patients (21 men, 5 women; age range 23-94 years) presenting with ulcers or gangrene of the foot and hand, (99m)Tc-sestamibi imaging was performed preoperatively. The indications for amputation included gangrene (23 patients), electrical injury (2 patients) and trauma (1 patient) of extremities. Although the amputation levels were chosen according to clinical criteria and scintigraphic results, the final amputation level was defined by scintigraphic results. Two below-knee, one above-knee, 12 toe, 11 transmetatarsal, two phalanx, one finger and one thumb amputations and one shoulder disarticulation were performed. In four cases, the amputation defect was not suitable for coverage using a local dermal flap; rather, it was covered with free tissue transfer. Patients had clinical follow-up for 6-36 months (mean 11.69 months) to assess healing of the stump. Scan results were compared with clinical outcome to assess prediction of healing. RESULTS: There was healing in all amputations at the end of the follow-up period. When evaluated regarding preoperative (99m)Tc-sestamibi uptake pattern, there was no perfusion to the lesion site in 21 patients and perfusion to an area smaller than the extent of skin necrosis in four patients; thus, in these 25 patients, (99m)Tc-sestamibi scintigraphy suggested non-viable tissue in the extremities with clear-cut edges of perfused muscle tissue. Diffusely decreased uptake was seen below the left knee in one case. How scintigraphy changed management was analysed. The amputation levels proposed before scintigraphy were divided into two groups, "definite" (n=14) and "indefinite" (n=12), based on visual examination and Doppler findings. In nine patients in the definite group, the proposed amputation level before scintigraphy was not altered by the scintigraphic data. However, (99m)Tc-sestamibi scan enabled unnecessarily high amputation levels to be avoided in 12 patients in the indefinite group and in five patients in the definite group. Therefore, there was change in management of 65% of cases based on scintigraphic findings. CONCLUSION: Since healing of the stump was seen in all cases, outcome was correctly predicted by scintigraphy. This preliminary study supports the use of (99m)Tc-sestamibi scan in selecting the optimal amputation level consistent with subsequent stump healing.


Asunto(s)
Amputación Quirúrgica , Pie/diagnóstico por imagen , Pie/cirugía , Mano/diagnóstico por imagen , Mano/cirugía , Tecnecio Tc 99m Sestamibi , Cicatrización de Heridas , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Cintigrafía , Sensibilidad y Especificidad
13.
Eur J Dermatol ; 16(3): 276-80, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16709493

RESUMEN

Spitzoid melanoma is a rare variant of melanoma. It has morphological features similar to those of Spitz's nevus. In this study, the histologic and immunohistochemical features of both Spitzoid melanoma and Spitz's nevus are emphasized. We report two cases of melanoma with spitzoid features occurring in the extremities of 9 and 8-year-old girls. Histologically both lesions had typical features of Spitzoid melanoma. We conclude that the differential diagnosis of Spitzoid melanoma and Spitz's nevus is at times problematic in childhood, in that distant metastasis may be the only diagnostic criteria for some cases to be distinguished from Spitz's nevus if strict criteria are followed. Spitzoid melanoma must be treated as other types of melanoma.


Asunto(s)
Melanoma/diagnóstico , Niño , Diagnóstico Diferencial , Humanos , Melanoma/patología , Melanoma/cirugía
14.
Nucl Med Commun ; 27(1): 91-8, 2006 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-16340728

RESUMEN

BACKGROUND: Free tissue transfer is a method of moving any tissue from a donor area of the body to a recipient site and re-attaching the arteries and veins to the blood vessels at the recipient site by microvascular surgery. Improved microsurgical techniques have resulted in a high percentage of successful free tissue transfers. Post-operative monitoring of tissue viability can detect early problems in free tissue transfer which may allow early intervention and salvage. Although many flap monitoring methods have been described, there is still no consensus on which of these techniques will become the standard accepted method for monitoring free muscle flaps. OBJECTIVE: In present study, we investigated the use of 99mTc sestamibi scintigraphy in determining free muscle flap viability and complications, and also in directing treatment. METHODS: Thirteen patients were examined prospectively during the post-operative period after free tissue transfer for foot defects. The cause of the defect was diabetic foot ulcer in 10 patients, dermatofibrosarcoma in one patient, squamous cell carcinoma in one patient and gunshot wound in one patient. Foot defect covering was carried out with a free latissimus dorsi muscle flap and skin graft (n=12) and a free gracilis muscle flap (n=1). All patients were examined with a monitoring system that consisted of visual inspection, hand-held Doppler ultrasonography and scintigraphic examinations. Scintigraphic imaging of all cases was performed routinely within the first 48 h post-operatively, and also on days 10 and 91 in two patients. RESULTS: There were four flap failures during the study. One of these patients had viable findings upon visual inspection and no evidence of vascular compromise on Doppler at the first examination. In the other patient, visual inspection of the flap showed that it was ischaemic in one region, but there was no vascular compromise on Doppler examination. Scintigraphic images of each of these patients showed a partial hypoperfused area in the flap region. Later, these two flaps showed positive clinical indications of hypoperfusion (colour of muscle and appearance of skin graft) and Doppler abnormalities. The remaining two patients had non-viable scintigraphic images as well as positive clinical indicators of hypoperfusion and evidence of vascular compromise on Doppler. Nine patients each had a viable flap. In these patients, all three examination tools demonstrated that the flaps were totally viable and there were no vascular complications. CONCLUSION: According to the results of this study, 99mTc sestamibi scintigraphy appears to be a feasible and promising method in the evaluation of free muscle flap viability and complications. On the other hand, to demonstrate any impact on management or patient outcome, further evaluation of 99mTc sestamibi imaging, including comparative studies with different established methods in a larger patient population, is highly recommended.


Asunto(s)
Enfermedades del Pie/diagnóstico por imagen , Enfermedades del Pie/cirugía , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/trasplante , Procedimientos de Cirugía Plástica/métodos , Colgajos Quirúrgicos , Tecnecio Tc 99m Sestamibi , Adulto , Anciano , Estudios de Factibilidad , Femenino , Pie/diagnóstico por imagen , Pie/cirugía , Humanos , Masculino , Persona de Mediana Edad , Cuidados Posoperatorios/métodos , Cintigrafía , Radiofármacos , Supervivencia Tisular , Resultado del Tratamiento
15.
Hand (N Y) ; 10(1): 143-6, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25762889

RESUMEN

BACKGROUND: Thumb hypoplasia and thenar muscle anomalies are complex congenital conditions that are associated with other congenital anomalies or syndromes. Congenital absence of the opponens pollicis muscle is very rare and is associated with the absence of other muscles. METHODS: A 6-year-old male was referred to our clinic with a provisional diagnosis of carpal tunnel syndrome because electromyography findings at the referring hospital were consistent with this diagnosis. He was unable to oppose his thumbs to his other fingers or grasp objects. All physical examination, electromyography, and magnetic resonance imaging findings were consistent with bilateral absence of the opponens pollicis muscle. RESULTS: The patient underwent bilateral transfer of the extensor indicis proprius tendon. At 1 year after surgery, he had satisfactory thumb opposition on both sides. CONCLUSIONS: Differentiation between congenital muscle anomalies and carpal tunnel syndrome is very important in order to avoid performing unnecessary surgical procedures. We present a case of bilateral congenital absence of the opponens pollicis muscle, which has not previously been reported, and review the literature regarding congenital muscle anomalies of the hand.

16.
Plast Reconstr Surg ; 113(2): 574-84, 2004 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-14758220

RESUMEN

Composite tissue defects may involve skin, mucosa, muscle, and bone together or in combinations of two or three of these tissues. Defects involving bone and skin are frequently encountered. Osteocutaneous flaps may be used to reconstruct these composite tissue defects. Sometimes, it is not possible to obtain a vascular osteocutaneous flap. Another way of producing an osteocutaneous flap that has the desired feature is prefabrication. Prefabrication of osteocutaneous flaps can be performed in two ways: (1) a vascularized osseous flap may be grafted with skin and (2) an osteocutaneous flap can be prefabricated by implanting an osseous graft into an axial island flap. There are many articles describing osteocutaneous flap prefabrication, but there is no comparison of both methods in the literature. As an experimental model for osteocutaneous flap prefabrication, rat tail bone was chosen. For the experiments, five groups were formed. Each group contained 10 rats. In the first experimental group, a vascularized osseous segment was skin grafted and an osteocutaneous flap was prefabricated. In the second experimental group, an osseous graft was implanted into an axial skin flap. To compare viability of skin and bone components of the two prefabrication groups, vascularized tail bone was elevated with overlying skin in the third group, a bone flap was elevated in the fourth group, and a skin flap that had been prefabricated by using vascular implantation was elevated in the fifth group. The authors examined five rats in each group by microangiography at the end of 4 weeks. On microangiographic analysis, all groups showed patency of vascular pedicles. There was no difference among the groups from the point of view of vascular patency and bone appearance. Bone scintigraphy was performed on the five rats in each group. On bone scintigraphic scans, the bone component of flaps was visualized in all groups except for group 5. The mean radioactivity value on the flap side was 10,362 +/- 541.1 in group 1, 10,241 +/- 1173 in group 2, 10,696 +/- 647.1 in group 3, and 10,696 +/- 647.1 in group 4. When the radioactivity values on the flap side were compared, no statistically significant difference among groups was seen, except for group 5 (p < 0.05). To evaluate bone metabolic activity, the bone component of flap and remaining last tail bone was harvested and the radioactivity of each specimen was measured with a well-type gamma counter. The parameter of percentage radioactivity in counts per minute per unit per gram of tissue was calculated. The value of the bone component of the flap side and the value of normal bone were estimated and results were compared. The mean result was 0.86 +/- 0.08 in group 1, 0.88 +/- 0.07 in group 2, 0.87 +/- 0.07 in group 3, and 0.81 +/- 0.04 in group 4. The difference among all groups was not statistically significant. Histologic examination was performed on all rats in each group and demonstrated that the bony component was viable, showing a cellular bone marrow, osteoblasts along bony trabeculae, and vascular channels in bone-containing groups. There were no significant microangiographic, histologic, or scintigraphic differences between the two experimental methods.


Asunto(s)
Colgajos Quirúrgicos , Angiografía , Animales , Trasplante Óseo , Huesos/irrigación sanguínea , Huesos/citología , Huesos/diagnóstico por imagen , Huesos/metabolismo , Neovascularización Fisiológica , Cintigrafía , Ratas , Ratas Wistar , Procedimientos de Cirugía Plástica/métodos , Piel/irrigación sanguínea , Piel/citología , Trasplante de Piel , Colgajos Quirúrgicos/irrigación sanguínea
17.
J Plast Reconstr Aesthet Surg ; 67(12): 1744-6, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25163851

RESUMEN

Circumcision is a common minor surgical procedure. However, if it is performed by untrained individuals, it may cause serious complications. In this case report, we describe an unusual circumcision complication with subglanular stricture and hypoplastic glans, which we named "exclamation mark deformity," its treatment that involved glans augmentation by fat injection, and results together with further treatment options.


Asunto(s)
Grasa Abdominal/trasplante , Circuncisión Masculina/efectos adversos , Pene/patología , Pene/cirugía , Procedimientos de Cirugía Plástica/métodos , Constricción Patológica/etiología , Constricción Patológica/cirugía , Humanos , Masculino , Adulto Joven
18.
Burns ; 37(7): 1216-21, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21641115

RESUMEN

BACKGROUND: Electrical injuries induce progressive tissue loss caused by free oxygen radicals released from neutrophil aggregates. Fucoidin, a potent inhibitor of L-selectin function, reduces the aggregation of neutrophils. The aim of this study was to evaluate the effect of fucoidin on tissue damage in rat electrical burn injury model. METHODS: Forty-two male Wistar albino rats (250-300 g) were divided into 3 groups (Group A (n=6), control group without electrical burn injury; Groups B (n=18) and C (n=18), electrical burn injury groups without and with fucoidin therapy, respectively). Three separate analyses were performed at different time points on 6 out of 18 mice from Group B and C at each time point. Biochemistry (myeloperoxidase and malondialdehyde levels) and histopathology (number of neutrophils) of the skin and muscle biopsies at 1st hour; tissue edema (ratio of wet weight/dry weight of extremities) at 24th hour; and necrotic areas at 7th day after electrical injury were evaluated. The electrical burn was induced by exposing rats to 220 V AC between their left upper extremity and right lower extremity for 10 s. Fucoidin was administered as 25 mg/kg intravenous bolus injection at 15 min after electrical burn injury. RESULTS: Myeloperoxidase and malondialdehyde levels, number of neutrophils, tissue edema, and necrotic area were significantly less in fucoidin-applied rats than the group without fucoidin therapy. CONCLUSIONS: Fucoidin inhibits tissue damage induced by electrical burn injury in rats by reducing necrotic area, edema and number of neutrophils.


Asunto(s)
Anticoagulantes/uso terapéutico , Quemaduras por Electricidad/tratamiento farmacológico , Polisacáridos/uso terapéutico , Animales , Anticoagulantes/administración & dosificación , Quemaduras por Electricidad/metabolismo , Quemaduras por Electricidad/patología , Edema/patología , Inyecciones Intravenosas , Masculino , Malondialdehído/metabolismo , Modelos Animales , Músculo Esquelético/metabolismo , Músculo Esquelético/patología , Necrosis/patología , Neutrófilos/citología , Peroxidasa/metabolismo , Polisacáridos/administración & dosificación , Ratas , Ratas Wistar , Piel/metabolismo , Piel/patología
19.
J Burn Care Res ; 31(5): 803-8, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20848718

RESUMEN

The purpose of this study was to research regeneration and growing properties of an immature rat ear cartilage and its adjacent tissue after a thermal injury. Fifteen 30-day-old male Sprague-Dawley rats were used. Burn wounds were created by applying a heated plaque. All the rats, based on their tissue sampling day, were placed in two groups for histopathologic evaluation. In group I (n = 5), the burned right auricles were amputated on the first day,and the left auricles were amputated as a control at the same time. In group II (n = 10), the burned right auricles were amputated on the 30th day, and the left auricles were amputated as a control at the same time. Epithelization of skin was completed in period ranging between 12 and 15 days in all burned ears. The skin appendages were few throughout the affected area.Chondroid tissue regenerated from perichondrium and increased capillary vessels were observed.On the first day of the burn injury, electron microscopic findings were karyopyknosis, karyorrhexis, and karyolysis of the nucleus, and there were also signs of necrosis. New chondroblasts were formed around the collagen fibrils in the scar tissue on the 30th day. CD-31 immunohistochemical staining showed increased capillary vessels in the burned ear. The peripheral nerve fibers decreased and regenerative signs of nerves were shown with the use of S-100 immunohistochemical staining. Differentiation of chondroblasts to chondrocytes occurs in the burned immature ear, and new cartilage tissue regenerates from perichondrium. In addition, regenerative signs of nerves appear.


Asunto(s)
Quemaduras/patología , Cartílago Auricular/lesiones , Amputación Quirúrgica , Animales , Modelos Animales de Enfermedad , Cartílago Auricular/cirugía , Inmunohistoquímica , Masculino , Necrosis , Ratas , Ratas Sprague-Dawley , Regeneración , Cicatrización de Heridas/fisiología
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