One disaster two traumas: Being under rubble and burn injuries in the 2023 Maras, Turkey earthquakes.

INTRODUCTION: On February 6, 2023, two separate destructive earthquakes with magnitudes of 7.7 and 7.5 occurred in Kahramanmaras, Türkiye. More than 50,000 people lost their lives, and over 100,000 were reported injured. In this study, patients referred to hospitals with burn diagnosis and management of burn wounds following the disaster were evaluated. MATERIAL AND METHODS: Information on burn injury admissions related to the earthquake was collected from all burn facilities in the country within 15 days after the earthquake. The patients' demographics, being under rubble, rescue times, burn causes, grafting procedures, and deaths were recorded. RESULTS: Following the earthquake, burn victims were transferred to the 13 Burn Treatment Centers located in 10 provinces. A total of 191 patients were burned. Among the burn patients, 101 (52.9%) were rescued from the rubble 2-60 h after the earthquake. Eight patients who were hospitalized at the burn centers died. Scalding and flame burns were the most common etiologies. Burned total body surface area, concomitant crush injury, hospitalization, and mortality was higher among the patients trapped under rubble (p < 0.001, p < 0.001, p < 0.001, and p < 0.001, respectively). Victims who stayed longer time under the rubble required significantly more grafting procedures (p < 0.001). CONCLUSION: In a literature review, it was observed that there are a limited number of publications reporting earthquake-related burns. In the February, 6 Türkiye earthquake, flame burns were seen due to small fires that occurred in collapsed buildings during the earthquake. And also contact burns and hot liquid burns were seen in earthquake victims trapped under rubble. Bursting hot water pipes, overturned stoves, contact with hot central heating radiators, and heated construction irons caused scalding and contact burns. It is believed that prolonged entrapment may cause delays in burn treatment or lead to deeper burns due to prolonged contact with the burning agent, increasing hospitalization rates. This earthquake once again drew attention to burn injuries that could occur during and after earthquakes, including those that may occur under rubble.

New Treatment modality for Burn Injury Related ARDS : High-Flow Nasal Oxygen Therapy in Major Burns.

Pulmonary insufficiency is the primary cause of death in cases of major burns accompanied by inhalation damage. It is important to consider the impact on the face and neck in flame burns. Early implementation of bronchial hygiene measures and oxygenation treatment in inhalation injury can reduce mortality. This case series presents the effects of high-flow nasal oxygen application on patient outcomes in major burns and inhalation injury. This report discusses three different patients. One patient, a 29-year-old male with 35% TBSA burns, received high-flow nasal oxygen (HFNO) treatment for inhalation injury on the sixth day after the trauma. After 72 hours of HFNO application, the patient's pulmonary symptoms improved. The second patient had 60% TBSA burns and developed respiratory distress symptoms on the fifth day after the trauma. After 7 days of HFNO application, all symptoms and findings of acute respiratory distress syndrome (ARDS) were resolved. HFNO has used for the treatment of ARDS releated to major burn ( 60% of burned TBSA) 28 years-old patient and improvement was achived. The use of HFNO in pulmonary insufficiency among burn patients has not been reported previously. This series of patient cases demonstrates the successful application of HFNO in treating inhalation injury and burn-related ARDS. However, further clinical studies are necessary to increase its clinical utilization.

The Prevalence of Tobacco Product Use Among Students in the Faculty of Medicine at Pamukkale University and Their Views on the Smoke-Free Campus Implementation.

OBJECTIVE: Tobacco use is an important risk factor for more than 20 types of cancer, especially cardiovascular and respiratory diseases, and many other health problems. Cigarettes are one of the most commonly used tobacco products in the world, and they can cause both physical and mental addiction. Adolescence is known to be the highest-risk period in terms of addiction among all age groups. As a result, smoke-free campus practices have become even more important in universities. This study investigates the prevalence of smoking among Pamukkale Medical School students and their views and behaviors regarding smoke-free campus practices. MATERIAL AND METHODS: This cross-sectional study was conducted with 548 medical students at Pamukkale University Faculty of Medicine during the academic year 2021-2022, between April 1-29, 2022. A face-to-face interview was conducted. Students' smoking status and their views about a smoke-free campus were assessed. In the questionnaire, the independent variables were socio-demographic characteristics, duration of staying in a smoke-free environment, smoking status in the place of residence, areas where smoking is most common, Fagerström nicotine dependence level, knowledge about smoke-free campus applications and campuses with the smokefree application. The Statistical Package for the Social Sciences version 21.0 package program was used to analyze the data. Descriptive statistics are presented with numbers and percentages for categorical variables, while the arithmetic mean and standard deviation are used for continuous variables. The chi-square test was used to compare categorical variables,and the Kolmogorov-Smirnov analysis was used to test the compatibility of data to normal distribution. RESULTS: The student smoking rate increased significantly as the number of semesters increased (P = .021). The smoking rate of male students was higher than that of female students (P = .001). The smoking rate of students living with their family or relatives was lower (P = .020). Smokers (14.7%) were more likely to have heard about the introduction of smoke-free zones on campus than nonsmokers (11%) (P = .280). 81.4% of students affirmed the statement, "The number of smoke-free rooms should be increased," and 84.3% responded, "I support the existence of smoke-free spaces." Nonsmoking students (90.8%) are more likely to agree that smoke-free spaces should be increased than those who smoke (57.7%) (P < .001). Among the students, 17.6% of nonsmokers and 37.8% of smokers find the information about smoke-free spaces sufficient (P < .001). The rate of those who consider smoke-free space inspections to be sufficient is lower for nonsmoking students than for nonsmokers (P = .017). Nonsmokers (89.5%) support the existence of smoke-free spaces to a higher degree than smokers (71.2%) (P < .001). CONCLUSION: One-third of Pamukkale University Faculty of Medicine students smoke, and smoking rates are higher among men and those who do not live with family or relatives. All participants strongly support the existence of smoke-free zones (84.3%), while a proportion of tobacco users (31.4%) support the implementation of a smoke-free campus. Student opinions of the smoke-free zones and the smoke-free campus application are more positive among nonsmokers than smokers.

Do pre-burn center management algorithms work? Evaluation of pre-admission diagnosis and treatment adequacy of burn patients referred to a burn center.

Interventions for burn management until the patient is transferred to a burn center affect mortality and morbidity. Therefore, adherence to the developed algorithms is an important issue. This study aimed to determine deficiencies in different aspects of the implementation of these algorithms during the pre-admission diagnosis and treatment processes of patients referred to our burn center. This study involved a 4-year review of patients referred to our burn center. One hundred and seventy burn cases admitted by referral were enrolled in the study. Adequacy of resuscitation within the first 24 hours, adherence to guidelines, and mortality were investigated. Resuscitation performed within the first 24 hours was found to be inadequate in 88 patients (51.8%). When the burned surface area percentages were evaluated all percentages were calculated higher before arrival. There were 78 major burn cases (45.9%), and the frequency of inhalation burns, intubation requirements and renal failure were more common in this group compared to the minor burn group (P < .001). The frequency of intubation without accurate indications was found to be 70.58%. Inadequate escharotomy was detected at a rate of 52.9%, and inadequate fasciotomy at a rate of 66.6%. The mortality rate was 22.4% among all patients. Interventions undertaken during the period until the patients' referral to these centers affect mortality and morbidity. In this study, it was found that the pre-hospital applications generated were insufficient, and it was proposed that burn patient care algorithms be developed with in-service training throughout the country.

Physical Medicine Applications in Hand Burns: Treatment or Rehabilitation.

The aim of this study is to investigate the contribution of concurrent physical therapy to the preservation of hand function in patients with hand burns. This retrospective cohort study included the records of adult patients who presented with hand burns between July 1, 2020, and December 1, 2021. A total of 67 of 1578 burn patients who attended the clinic were included in this study. The patients' age, sex, total BSA with burns, causative agent, depth of burn on the hand, right or left hand, location of the burned area on the hand, treatment applied, healing time of the burn on the hand, limitation of movement, the joint restrictions, contractures, and compliance with physical therapy were assessed and recorded. Among the 67 patients included, 82.1% (n = 55) had no limitation in terms of their joint range of motion, whereas 17.9% (n = 12) had a limitation of movement in their finger joints. When the prevalence of movement limitation was examined by gender, such limitation was found to be more common in females (P = .041). Moreover, contractures were found to occur more frequently in patients with full-thickness burns (P = .032). It was also found that the limitation of movement was more severe in patients with skin grafts (P = .044). In addition, it was observed that the recovery time of the burn area was longer in those patients who had movement limitations (P = .004). In this study, we found that applying early physical therapy to patients after burn injuries facilitated the recovery of hand functions.

Role of serum levels of tumour necrosis factor-like weak inducer of apoptosis (TWEAK) in predicting severity of acute appendicitis.

Objectives: One of the most prevalent abdominal crises is acute appendicitis (AA). Clinical diagnosis, even for skilled surgeons, is frequently challenging, as indicated by the high proportion of negative investigations. The purpose of this study was to see if serum TWEAK levels might be used to diagnose acute appendicitis. Material and Methods: Between June 2017 and May 2019, all patients who had surgery with the original diagnosis of AA were included in the study. TWEAK, WBC, CRP, and bilirubin levels were compared. Results: The levels of WBC, CRP, and bilirubin were compared to pathology. All three blood indicators increased significantly in AA patients. However, no statistically significant difference in the levels of all three blood indicators was seen between individuals with simple AA and those with severe AA. TWEAK plasma concentrations were considerably greater in patients with severe AA than in the healthy control and NAA groups. TWEAK levels were significantly greater in individuals with severe AA compared to patients with simple AA. Conclusion: Serum TWEAK levels that are elevated may be used to diagnose acute appendicitis as well as prognostic indicators for the severity of appendicitis.

A Rare Bacteremia in a Burn Patient: A Case Report of Achromobacter Xylosoxidans and Denitrificans.

Achromobacter is a rare bacteria that causes bacteremia in immune-compromised patients. In this case, a 26-year-old male patient with major burns with a positive blood culture for Achromobacter is presented. A rare bacterium, Achromobacter xylosoxidans, and denitrificans, was detected in the blood culture of a patient who was hospitalized due to major burn trauma and had delayed wound healing and had no graft take. After treatment with culture-specific antibiotics, the patients' acute phase reactants decreased, and he was discharged with 100% graft-take. Sepsis is the most common cause of death in major burns. Endogenous and exogenous bacteria cause sepsis. Bacteremia and sepsis are the most important factors affecting wound healing in burn patients. This case shows that rare opportunistic bacteria such as Achromobacter spp. should be considered in major burn patients with delayed wound healing and recurrent graft lysis.

Nitric Oxide Detection Using a Corona Phase Molecular Recognition Site on Chiral Single-Walled Carbon Nanotubes.

Semiconducting single-walled carbon nanotubes (s-SWCNT) are structures that fluoresce in the near-infrared region. By coating SWCNT surfaces with polymeric materials such as single-chain DNA, changes in fluorescence emission occur in the presence of reagents. In this way, polymer-coated SWCNT structures allow them to be used as optical sensors for single molecule detection. Especially today, the inadequacy of the methods used in the detection of cellular molecules makes the early diagnosis of diseases such as cancer difficult at the single-molecule level. In this study, the detection of nitric oxide (NO) signals, which are a marker of cancer, was carried out at the single-molecule level. In this context, a sensor structure was formed by coating the 7,6-chiral s-SWCNT surface with ssDNA with different oligonucleotide lengths (AT). The sensor structure was characterized by using UV-vis spectroscopy and Raman spectroscopy microscopy. After formation of the sensor structure, a selectivity library was created using various molecules. As a result of the coating of the SWCNT (7,6) surface with DNA corona phase formation, Raman peaks at 195 and 276 cm-1 were observed to shift to the right. Additionally, the selectivity library results showed that the (AT)30 sequence can be used in NO detection. As a result of the studies using SWCNT (7.6)- (AT)30, the limit of detection (LOD) and limit of determination (LOQ) values of the sensor against NO were found to be 1.24 and 4.13 µM, respectively.

Oxygen transmission rates of skin substitutes and graft survival.

AIM: Oxygen is required for cell migration into the scaffold and for the survival of the overlying graft in the use of a single-layer scaffold. In the absence of diffusion from the avascular wound base, such as in areas above the bone/tendon, oxygen delivery from the lateral edges of the scaffold is important. This study compared the oxygen permeability of skin scaffolds, currently commercially available in Turkey (Nevelia®, MatriDerm®, and Pelnac®), in the lateral plane. MATERIALS AND METHODS: To measure oxygen permeability, an interconnected closed system was created. Oxygen permeability was evaluated based on the color change that occurred as a result of the reaction of iron with oxygen. After the dermal matrices placed in the closed system were exposed to oxygen, the color change on the surface of the dermal matrices was measured, and electron microscopic images were recorded to compare deformation before and after the procedure. RESULTS: Two scaffolds did not show deformation after the procedure while Pelnac® had minimal deformation. The oxygen rates on the nitrogen side of the test apparatus were found to be 29%, 34%, and 27% for Nevelia®, MatriDerm®, and Pelnac®, respectively; and the oxygen transmission lengths (length of color change) of these scaffolds in the lateral plane were 1, 2, and 0.5 cm, respectively. CONCLUSION: Although none of the scaffolds showed significant deformation, and all continued to exhibit their scaffold properties after the procedure, MatriDerm® was determined to be the most suitable scaffold for use in avascular areas, with a 2-cm oxygen transmission length in terms of lateral oxygenation.

Bimetallic Biogenic Pt-Ag Nanoparticle and Their Application for Electrochemical Dopamine Sensor.

In this study, Silver-Platinum (Pt-Ag) bimetallic nanoparticles were synthesized by the biogenic reduction method using plant extracts. This reduction method offers a highly innovative model for obtaining nanostructures using fewer chemicals. According to this method, a structure with an ideal size of 2.31 nm was obtained according to the Transmission Electron Microscopy (TEM) result. The Pt-Ag bimetallic nanoparticles were characterized using Fourier Transform Infrared Spectroscopy (FTIR), X-ray Diffractometry (XRD), and Ultraviolet-Visible (UV-VIS) spectroscopy. For the electrochemical activity of the obtained nanoparticles in the dopamine sensor, electrochemical measurements were made with the Cyclic Voltammetry (CV) and Differential Pulse Voltammetry (DPV) methods. According to the results of the CV measurements taken, the limit of detection (LOD) was 0.03 µM and the limit of quantification (LOQ) was 0.11 µM. To investigate the antibacterial properties of the obtained Pt-Ag NPs, their antibacterial effects on Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacteria were investigated. In this study, it was observed that Pt-Ag NPs, which were successfully synthesized by biogenic synthesis using plant extract, exhibited high electrocatalytic performance and good antibacterial properties in the determination of dopamine (DA).

Effects of hyperbaric oxygen therapy on clinical and economic outcomes in patients with deep second-degree burns.

Introduction: Deep second-degree burn injuries are the most challenging situations for the burn surgeon in the treatment of adult cases. While waiting for spontaneous closure increases the risk of hypertrophic scar and keloid, early excision and grafting pose the risk of donor site wound and permanent color differences. Unlike many studies in the literature, the current study was planned in a way to minimize factors other than burn wounds to investigate the effect of adding hyperbaric oxygen (HBO2) therapy to conventional treatment in deep second-degree burn wounds. Material and Methods: This prospective observational study included patients with burn injuries who underwent conventional treatment alone and those who underwent conventional plus HBO2 treatment performed by a single experienced surgeon and who met the study criteria. Results: Thirty-eight patients completed the study. Mean burned total body surface area (TBSA) was. 9.22 ± 3 43% (range 5% to 20%). There was no difference between the two groups in terms of age, burned TBSA, and burn etiology. The need for surgery and grafting was lower in patients who received HBO2 in addition to conventional treatment (p=0.003 and p=0.03, respectively). The patients in the HBO2 group had a shorter hospital stay, and their wounds epithelialized in a shorter time (p=0.169 and p≺0.001, respectively). They also had a higher satisfaction level and lower treatment cost (p=0.03 and p=0.36, respectively). Discussion: The results of this prospective study, in which co-factors were eliminated, showed that adding HBO2 to the conventional treatment of deep second-degree burns had a significant positive effect on patient outcomes, as well as reducing treatment costs.

Graft of 3D bioprinted autologous minimally manipulated homologous adipose tissue for the treatment of diabetic foot ulcer.

INTRODUCTION: Adipose-derived stem cells are multipotent precursor cells with the ability to differentiate into cell lineages associated with the regeneration of tissues. OBJECTIVE: The authors investigated the efficacy of AMHAT with 3D bioprinting technology in DFU. MATERIALS AND METHODS: Twenty patients were enrolled in a clinical prospective interventional pilot study. The primary endpoint was a reduction in the size of DFU, and the secondary endpoints were the epithelialization rate and amount of granulation of wound bed at weekly assessments. A bioprinter was used to produce AMHAT in the customized shape of DFU. The data were obtained using photography and computerized digital surface calculation. RESULTS: The mean wound size at the time of hospitalization was 7.529 cm2. All but one of the wounds were completely epithelialized at the ninth week. The mean wound areas decreased at weekly assessments for the first 7 weeks of treatment compared to the pre-application. When the mean decrease in the wound size was compared between consecutive weeks, there were decreases at each of the first 7 weeks. The mean time to the complete closure was 32.20±23.862 days. CONCLUSION: These data indicate that AMHAT is beneficial in terms of ease of application, significant decrease in the wound surface area, no scarring compared to grafting, and full healing times.

Synthesis and characterization of activated carbon supported bimetallic Pd based nanoparticles and their sensor and antibacterial investigation.

Activated carbon (AC) supported palladium cobalt bimetallic nanoparticles (PdCo@AC NPs) were obtained by green synthesis method using Cinnamomum verum (C. Verum) extract. The obtained NPs were characterized by Fourier Transform Infrared Spectroscopy (FTIR), X-Ray Crystallography (XRD), Transmission Electron Microscope (TEM) and Ultraviolet Visible (UV-VIS) spectroscopy, and the functional groups and morphology of the nanoparticle were elucidated. The resulting particle size was found to be 2.467 nm. NPs were evaluated using Cyclic Voltammetry (CV), Scan Rate (SR), and Differential Pulse Voltammetry (DPV) techniques for potential dopamine sensors application. According to the obtained DPV results, Limit of Detection (LOD) and Limit of Quantitation (LOQ) values are found to be 5.68 pM and 17.21 pM, respectively. It was also observed that AC supported PdCo nanoparticles obtained from C. verum extract sensed dopamine quite well. Besides, to examine the antibacterial properties of NPs, antibacterial analyzes were performed with Escherichia coli (E. Coli) and Staphylococcus aureus (S. Aureus). It was observed that it showed good antibacterial properties against gram positive (S. aureus) and gram negative (E. coli) bacteria. The study gave important results in terms of the synthesis of bimetallic NPs using the green synthesis method and their usability in different areas. With this study, it was observed that a good antibacterial dopamine sensor were obtained with the successful biogenic synthesis of AC supported PdCo bimetallic NPs.

Comparison of the Efficiency of Epidermal Growth Factor and Negative Pressure Wound Therapy in Diabetic Foot Patients.

Advanced modalities are used for wounds where conventional treatment is insufficient in diabetic foot patients. In this study, we investigated the effects of using Epidermal growth factor (EGF) and NPWTmodalities alone or in combination on the frequency and level of amputation. In the retrospective study, which included 286 patients in total, 76 patients were referred with the decision of amputation or amputation was planned during hospitalization. After the treatments, amputation and distalization of amputation were found 73.3% and 33.3% in the conventional treatment patients. While 86.4% amp and 18.2% amp distalization were found in negative pressure wound therapy (NPWT) only patients, this rate was 52.4% and 90.5% in EGF + NPWT patients, 50% and 83.3% in EGF only patients. While amp and distalization rates were found to be significantly better in those receiving only EGF or EGF + NPWT (P = .015, P = .017 respectively for amputation and P = .000 for distalization), no difference was found in those receiving EGF and EGF + NPWT. As a result of our study, although npwt contributed positively to the number and level of amputations compared to conventional treatment, a significant improvement was found in the number and level of amps when EGF was used alone or combined with NPWT. With this result, EGF was thought to be an important treatment modality that should be evaluated in diabetic foot ulcers (DFUs) without amputation decision.

Synthesis and application of AuNi@AC nano adsorbents for the removal of Maxilon Blue 5G azo dye from aquatic mediums.

In this research, gold-nicel supported on activated carbon (AC) nanoadsorbent (AuNi@AC) synthesized by following a series of physicochemical procedures was prepared for the removal of Maxilon Blue 5G (MB) which is a cationic textile dye. Experimental studies based on parameters specifically pH, contact time, nano catalytic adsorbent particle, initial MB dye concentration and temperature effect were conducted in aqueous solutions in a batch system. AuNi@AC nanoadsorbents (NAs) reached the equilibrium in 30 min under optimum conditions in adsorption of the dye. The pseudo-first, second-order, and intra-particle diffusion models were tested to evaluate a the experimental results. Adsorption kinetics were found to be represented by the pseudo-second-order model, and the maximum adsorption capacity (qmax.) was calculated to be 542.90 mg/g (or 2.041 mmol/g). The synthesized magnetic AuNi@AC nanoadsorbent showed a high-efficiency reusability effect of about 64% after five reuse runs. Also, thermodynamic function parameters such as activation energy (Ea), Gibbs free energy (ΔG *), and entropy (ΔS *) were investigated in the sorption study. After all evaluation of data, it was concluded that the novel AuNi@AC nanoadsorbent could be considered as an effective support material for the removal of various organic pollutants in aquation solution especially for the removal of MB.

Effects of the COVID-19 pandemic on the management of diabetic foot ulcers: experiences from a dedicated diabetic foot care center.

INTRODUCTION: As did many other nations, the Turkish government implemented precautions and lockdown measures in response to the rapid spread of the COVID-19 viral infection. The pandemic has caused millions of deaths globally, resulted in the development of comorbidities, and negatively affected national health care systems. The increased workload at hospitals and spread of the virus among health care professionals have resulted in delays in health care services delivery. The fear of COVID-19 transmission has resulted in people mostly staying at home. OBJECTIVE: The aim of this study is to present the effects of the pandemic on the behavior of patients with diabetic foot ulcers (DFUs). MATERIALS AND METHODS: Patients with DFU were categorized into 2 groups: patients hospitalized during the COVID-19 pandemic and patients hospitalized during the same period in 2019 (prepandemic). Demographic data, length of hospital stay, place of residence, Wagner grade of DFU, comorbidities, laboratory parameters, wound duration, duration of diabetes, and treatments applied were recorded. RESULTS: During the pandemic, the length of hospital stay decreased, and patient referrals from other cities significantly decreased (P <.001). Hemoglobin A1c level was higher and Wagner grade was more advanced during the pandemic period (P =.014 and P =.033, respectively). The number of patients undergoing debridement alone decreased during the pandemic period, while those requiring amputation increased (P =.008 and P =.005, respectively). CONCLUSIONS: Patients with DFU delayed seeking timely proper medical advice during the pandemic. This resulted in a significantly higher amputation rate, with physical, psychosocial, and economic consequences. Virtual techniques (eg, video consultation) can be used to identify patients who require hospitalization. Close follow-up can be provided via home nursing care and by supplying advanced wound care products for in-home use. Patients with DFU should be encouraged to seek proper medical advice and take recommended precautions.

Applying a Silver-containing Dressing to the Incision Site and Its Effect on the Development of Surgical Site Infection After Ostomy Closure: A Prospective Randomized Clinical Pilot Study.

BACKGROUND: Surgical site infections (SSIs) can occur after colorectal surgery. Ionic silver has been used to prevent the development of SSIs. New-generation dressings, defined as total occlusive ionic silver-containing dressings, have been shown to reduce bacterial colonization in SSIs. PURPOSE: To evalute the effect of a silver hydrofiber dressing on the development of SSIs at the abdominal incision after ostomy closure. METHODS: There was a total of 37 eligible patients who underwent temporary ostomy closure. Five patients required an associated intervention during ostomy closure and were excluded. One patient was lost to follow-up. Hence, 32 patients were included in the study. Silver-containing occlusive dressings and conventional dressings were used in patients who underwent ostomy closure. In the control group (n = 16), the wound area was covered with a standard sterile gauze dressing for 24 to 48 hours, and then wound cleansing was performed with 10% povidone iodine, followed by daily dressing replacement with sterile gauze for 5 days. The patients in the study group (n = 16) were treated with a silver-containing hydrofiber dressing, which was not changed for 5 days following application in the operating room. RESULTS: At the end of the 30-day follow-up period, no SSIs were observed in the study group. When the dressing methods applied to the patient groups with and without SSIs were compared, SSIs developed at a higher rate in the control group (n = 4; 26.7%) compared with the study group (n = 0); this result was statistically significant (P = .043). CONCLUSIONS: In this study, the use of a wound care product containing ionic silver reduced the rate of SSIs related to ostomy closure. Multicenter, randomized, clinical studies involving a larger number of patients are needed. In addition, occlusive wound dressings with and without silver should be investigated in further studies.

Is It Necessary to Perform a Histopathological Examination of Pilonidal Sinus Excision Material?

BACKGROUND: Although pilonidal sinus disease is common, development of associated malignancy is very rare. After surgical treatment, most surgeons send the excision material for a histopathological examination. The aim of this study was to examine whether it is necessary to routinely send the pilonidal sinus surgical excision material for this examination. METHOD: The data of 3146 patients were retrospectively screened, and 2486 patients with available histopathological reports of the excision material were included in the study. RESULTS: Of the 2486 patients included in the study, 2165 were men and 321 were women, and 94.7% of the patients were under the age of 50 years while 5.3% were 50 years or above. The rate of patients who underwent surgery due to recurrence was 1.2%. No malignancy was detected in any patient after the histopathological examination. DISCUSSION: In this study, none of the pathology results was reported as malignant. This confirms that it is necessary to ask the question whether we should routinely send the surgical excision material for a histopathological examination.