Evaluation of Nipple-Areola Circulation in Central Pedicle Mastopexy Patients with Subpectoral Implant Placement: A Quasi-Experimental Study.

OBJECTIVE: Mastopexy is a procedure which is used in breast lift and reconstruction surgery and requires a small amount of parenchymal resection. In this procedure, the preservation of nipple-areola circulation is vital. The purpose of this study is to evaluate nipple-areola circulation in patients undergoing central pedicle mastopexy with subpectoral implant placement. MATERIAL AND METHOD: In this observational quasi-experimental study, data were collected retrospectively from electronic medical records. The perioperative nipple-areola circulation of patients undergoing central pedicle mastopexy with subpectoral implant placement was evaluated by integrated laser Doppler flowmetry. Descriptive statistics, one-way analysis of variance, and Tukey's range tests were used to analyze the data. RESULTS: The preoperative, skin dissection, pectoral elevation, implant placement, 24th hour, and 2nd week nipple-areola circulation statuses of each patient who underwent central pedicle mastopexy with subpectoral implant placement were examined using an integrated laser Doppler flowmeter, and the results were compared. At each stage, all measurements were in the range of 1.8-3.6 ml/min/100g. There was no statistically significant difference between the measurement results. CONCLUSION: Central pedicle mastopexy with subpectoral implant placement seems highly advantageous in terms of better functionality and aesthetics in the reconstruction of heavy and sagging breasts. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/0026.

The Effect of Human Umbilical Cord-Derived Lyophilized Stem Cells on Fat Graft Viability: An Experimental Study.

OBJECTIVE: The extended use of autologous adipose tissue has increased the importance of the viability of fat graft cells. This experimental animal study assesses the effects of lyophilized mesenchymal stem cells on the viability and survival of autologous fat grafts. METHODS: For this prospective treatment control study, 27 male Wistar albino rats were divided into three groups, each containing nine animals. In Group 1 (control), an incision was made in the right inguinal region, and the skin was closed with 4/0 prolene sutures. In Groups 2 and 3, fat pads collected from the right groin of the rats were lipoaspirated and placed on the sternum as a subcutaneous fat graft. The skin was then closed with 4/0 prolene sutures. Saline was added to the fat grafts of the Group 2 (sham) rats, and placenta-derived mesenchymal stem cell lyophilizate (MSC-L) was administered to the fat graft in the Group 3 (treatment) rats. After three months of treatment, the adipose tissue harvested from Group 1 and the fat grafts taken from Groups 2 and 3 were assessed histopathologically, stereologically and biochemically. RESULTS: Adipose tissue volume was lower in Group 2 than in Groups 1 and 3, and the adipose tissue treated with MSC-L in Group 3 was better preserved than that in Group 1. Connective tissue and vascular volumes were greater in Group 3 than those in the other groups. The normal structures of adipocytes, fibrous tissues and vessels were better preserved in Group 3 than in Group 2, and a large number of new blood vessels were noted to have formed in Group 3. Damaged cystic cells, areas of calcification and degenerated adipocytes were noted in Group 2, while the G3PDH levels increased significantly more in Group 3 than in Group 2. CONCLUSION: It was shown that MSC-L treatment plays an active role in maintaining the volume and survival of fat grafts by promoting neovascularization in this animal experimental study. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

The effect of mesenchymal stem cell lyophilizate on the recovery of the zone of stasis following thermal burns.

INTRODUCTION AND AIM: Mesenchymal Stem Cells (MSCs) are known to contribute to wound healing by increasing tissue regeneration. This study examined the effect of MSC-Lyophilizate (MSC-L) on the recovery of the zone of stasis in thermal burns. METHODS: A comb was used to induce second-degree thermal burns (1 × 2 cm) on the dorsum of the rats. Within 30 min after the burn, MSC-L derived from the umbilical cord was administered to the experimental group and 1.5 ml of 0.9% isotonic sodium chloride to the sham group. The control group did not receive any intervention. Tissue samples were collected on postoperative day 7. Histopathological assessments were made using a microscope with digital camera attachment. SPSS for IBM 25 was used for data analysis. RESULTS: Epithelial loss and subepidermal bullae were observed in the control and sham groups on day 7. In the experimental group, the MSC-L administration was found to increase epithelial tissue formation and neovascularization in the dermis. We found no significant pathological findings in the epidermis and dermis in the experimental group. CONCLUSION: Administration of umbilical cord-derived MSC-L is of potential importance in wound healing. In our study, we observed that MSC-L that contained 1.5 million cells contributed significantly to the recovery of the stasis zone of burn.

Illustrations of Hernia Surgery in the Early Period of the Ottoman Empire by Serefeddin Sabuncuoglu.

BACKGROUND: Imperial Surgery (Cerrahiyyetü'l- Haniyye), penned by Serefeddin Sabuncuoglu (C.E. 1385-1468), is an impressive medical book that was written in Turkish using the Arabic alphabet, containing color miniature drawings and human figures, depicted in a fantastic style. The purpose of this report is to present this unique contribution to the literature on the known history of hernia surgery. METHODS: Imperial Surgery is divided into three chapters, each of which is divided into sections that, in general, present patients and diseases in the form of case reports. Some sections detail the procedures to be performed on a patient, the surgical instruments used and the positioning of the patient, which are described in detail with color miniature drawings. CONCLUSIONS: Serefeddin Sabuncuoglu was a great surgeon in Turkish medical history. Given all of the hernia-related information in literature, the treatise written by Sabuncuoglu in fifteenth century and its suggested approaches to hernias show clearly the place that he should hold in the history of the art of healing. Hernia surgery is described step-by-step under four headings in two chapters, supported by four miniature drawings, including surgical tools.

Craniomaxillofacial Surgery Techniques of 15th Century Turkish Surgeon Serefeddin Sabuncuoglu.

INTRODUCTION: Serefeddin Sabuncuoglu, in his surgical medicine book entitled "Imperial Surgery" (Cerrâhiyetü'l-Hâniyye) that was published in the 15th century, described many diseases using colored miniatures, and explained the repair of these conditions using surgical methods and the required patient care after surgery. In his handwritten treatise, Sabuncuoglu raised the curtain on his surgical methods with his illustrations. As a first in medical history, Sabuncuoglu's book should be considered one of the most important original works from that era. MATERIALS AND METHOD: The handwritten "Imperial Surgery" is presented in three chapters divided into 194 sections, and describing 147 surgical procedures with miniature drawings, 160 surgical instruments and 10 types of incision. RESULTS: A separate chapter is allocated to craniomaxillofacial surgery in Imperial Surgery, containing 53 of the total 194 sections. The first chapter describes the use of branding (cauterization) for the treatment of headache and facial diseases. The second chapter describes the treatment of hydrocephalus, headache, vascular surgery, and the surgical treatment of tumors in the head and face. The third chapter describes in detail the treatment of cranial fractures, nasal fractures, mandibular fractures and mandibular dislocations. CONCLUSION: The basic craniomaxillofacial surgery concepts, the descriptions of craniomaxillofacial diseases, the scales indicating the general patient conditions, and the surgical therapies, incisions, surgical instruments, postoperative care and complications put forward in the book are discussed in the present study. In the light of this seminal study, the authors of the present study suggest that Sabuncuoglu should be considered and dignified as one of the leading pioneers of craniomaxillofacial surgery.