A New Technique for Retracting the Protrusive Premaxilla With Fewer Patient Visits.

Bilateral cleft lip and palate with premaxillary protrusion is a great challenge due to a large defect area. Retraction of the premaxilla before surgery can be done with numerous orthopedic treatment options. In patients who have cleft lip and alveolus, but not cleft palate, it is quite difficult to get to the place where the premaxilla should be. To effectively reach the location where the premaxilla should be, new appliances with expansion and retraction screws were designed. This new design aims to treat the patient with fewer visits. Our study presents the treatment of a case with excessive premaxillary growth and no palatal defect treated with our new design.

Use of infragluteal folds as a full-thickness skin graft donor site for construction of the neovagina in cases of Mullerian agenesis.

AIM: The aims of this study were to present the results of using infragluteal folds as a skin graft donor site in cases of Mullerian agenesis undergoing full-thickness skin graft vaginoplasty and to evaluate the outcomes of the surgical technique. METHODS: Demographics and clinical parameters of 24 consecutive Mullerian agenesis patients refusing any dilatational procedure and undergoing neovaginal construction using infragluteal folds skin grafts from May 2004 to July 2015 were analyzed. RESULTS: The mean age of the patients was 21.5 ± 5.7 years. Five patients had nonfunctional rudimentary uterus, one patient had unilateral ovarian agenesis, one patient had unilateral renal agenesis, and one had undergone a previous vaginoplasty. There were no serious complications needing surgical or medical intervention. The depth of the neovagina in patients with a follow-up period of more than 6 months (n = 17) varied from 7 to 12 cm. Of these patients, the sexually active ones (n = 8) did not complain of dyspareunia or vaginal dryness during sexual intercourse. The resulting scars were satisfactory and acceptable for all patients. CONCLUSION: It has been our practice to use infragluteal folds as a skin graft donor site for full-thickness skin graft vaginoplasty. We believe that the results of this study demonstrate that this area is versatile and an excellent alternative to the groins and lower abdomen. Further clinical and histomorphological investigations are necessary for strong statements and results.

Septal Deviation Treatment Using Bone or Cartilage Grafts Fixed with Cyanoacrylate Tissue Adhesive.

BACKGROUND: This paper presents a method in which bone or cartilage grafts are fixed to the septal cartilage with cyanoacrylate-based tissue adhesive for the treatment of septal deviation. A prospective study was designed to show the effectiveness of the technique. METHODS: Cyanoacrylate-based tissue adhesive was used to fix the cartilage or bone grafts onto the septal cartilage to straighten deviated septal cartilage in 77 patients. Regarding the patients' preoperative and postoperative nasal respiration, the following were assessed: (1) Nasal Obstruction Symptom Evaluation (NOSE) scales, (2) patient satisfaction with postoperative nasal respiration using visual analog scoring, and (3) computerized tomographic images. RESULTS: The patients were followed up for 29 months on average. Patients' respiration-related problems resulting from septal deviation were relieved in all but four patients. Clinically and radiologically, the straightened septums preserved their new forms, and it was detected with computerized tomography that the bone grafts had acquired permanency. In addition, the NOSE scores improved significantly compared to their preoperative levels. CONCLUSIONS: In cases in which the use of bone or cartilage grafts is chosen to straighten the deviated septal cartilage, fixation of grafts with cyanoacrylate (CA) tissue adhesive is a quick, instantly effective, and reliable method. CA, which enables the subsurface of the graft to have complete contact with the septal cartilage, provides extra benefit by transferring all of the reformative forces of the grafts to the septal cartilage. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. 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 TENS on random pattern flap survival in nicotinized rats.

The adverse effects of cigarettes, due to their nicotine content, may cause important ischemic complications in flaps. Electrical stimulation increases blood flow in ischemic tissues, the level of vascular endothelial growth factor, capillary density, and angiogenesis while decreasing oxygen tension in tissues. Electrical stimulation is also known to increase survival rate in flaps. In this study, which tests the hypothesis that TENS (a type of electrical stimulation) contributes to enhancement of flap viability by eliminating the adverse effects of nicotine, 40 rats were divided into 4 groups of 10 rats. Nicotinization was achieved by subcutaneous administration of 2 mg/kg per day to the rats, other than those in the Control group, for 4 weeks. The rats in one of the nicotinized groups received 20 mA, 80 Hz TENS (TENS1 group) for 1 hour daily throughout the last week before McFarlane flaps of random pattern were made in the backs of all the rats. Another nicotinized group was subjected to TENS in a similar dose after flap elevation (TENS2 group). Flap blood flow was measured before and 48 hours after their construction, and their fluorescein perfusion was measured immediately after the flap elevation. The comparison of the survival rates of the flaps revealed that, although the blood flow in the Nicotine group was significantly lower than in the Control group, it was significantly higher in the TENS1 group than in both the Control and Nicotine groups. The proportion of the area stained with fluorescein, immediately after the elevation of flaps, was significantly reduced in the Nicotine group compared to the Control group. In the TENS1 group, however, it was greater than in the nicotine and TENS2 groups. Flap viability rates decreased significantly in the Nicotine group compared with the Control group. In the TENS2 group, however, an increase was observed compared with the Nicotine group.These findings suggest that although TENS performed before flap elevation does not contribute to flap survival, despite causing a rise in blood flow, it enhances flap survival when applied postoperatively. Given the practicality and low cost of TENS, it can be concluded that it may be possible to use it in the management of ischemic complications in flap operations in smokers.

Flap Preconditioning by Electrical Stimulation as an Alternative to Surgical Delay: Experimental Study.

Partial flap failures are unpredictable complications of reconstructive surgery. Electrical stimulation increases blood flow, capillary density, angiogenesis and vascular endothelial growth factor, anti-inflammatory effects while decreasing oxygen tension in tissues. In this study, we investigated these effective properties of electrical stimulation preoperatively on flap surgery instead of the surgical delay procedure.Modified McFarlane flaps were raised on the backs of 50 Sprague-Dawley rats. In the control group, a skin flap was made and flap survival rate was assessed on the seventh day. In the surgical delay group, 14 days after creating the bipedicled flap, the flap was totally elevated and flap survival rate was assessed on the 21st day. In the preconditioning by electrical stimulation group, the flap was created after application of electrical stimulation for 7 days. Flap survival rate was assessed on the 14th day. In the electrically stimulated ischemic flap group, the flap was created and afterward, electrical stimulation was applied for 7 days. After that, flap survival rate was assessed on the seventh day. In the surgical delay plus electrical stimulation group, following the elevation and suturing of the bipedicled flap back into its bed, electrical stimulation was applied in the first 7 days of delay, the flap was created on the 14th day, and then flap survival rate was assessed on the 21st day. In all groups, blood flow was evaluated at particular times. After completing these procedures, the flap vascularities of 5 animals from each group were assessed with microangiography.The flap survival rate of the preconditioning by electrical stimulation group was significantly higher than those of the other groups (P < 0.05). According to the blood flow estimates, except the preconditioning by electrical stimulation group and surgical delay plus electrical stimulation group, blood flow decreased in all the other groups after the postprocedure. In the microangiographic assessment of the preconditioning by electrical stimulation group, there were thin but numerous networks like vascular structures.Electrical stimulation applied to the normal area before flap elevation increased the flap survival. This increase is paramount to surgical delay which is, so far, widely known as the most effective method of improving flap vascularity.

New flap for the reconstruction of the perinasal region.

Various reconstructive methods ranging from secondary healing to free flap applications are used for the reconstruction of perinasal defects caused by trauma or tumor surgery. The method to be used for the reconstruction of this region is chosen considering many factors because of specific determining structures. The number of studies on the subcutaneous tissue and vascular configurations of this region are gradually increasing along with the accumulation of knowledge in this region. Herein, we describe the nasal superficial musculoaponeurotic system-pedicled island skin flap for the reconstruction of the nasal tip, supratip, lateral nasal margin, and infraorbital area. The described skin flap was performed for defects resulting from basal cell carcinoma excision in all the patients. Of the patients, 12 were females and 5 were males. The mean age was 67.8 years (range, 56-82 years). All patients were operated on under general anesthesia. The flap donor areas were closed primarily. None of the patients developed flap necrosis. Although mild edema and venous insufficiency were observed in the flaps in the acute period only in patients who underwent nasal tip reconstruction, these improved during follow-up. In the operated patients, no problem was observed in the donor area and nasal dorsal skin. The nasal superficial musculoaponeurotic system-pedicled island skin flap which we describe for the perinasal area reconstruction is a safe, easily performed and versatile flap. The multidimensional use of this flap together with a relatively easy reconstruction plan and surgical procedure would be effective in flap choice.

Fractures of the mandible: a 20-year retrospective analysis of 753 patients.

BACKGROUND: The craniofacial region is one of the most frequently injured parts of the body, and mandibular fracture is one of the commonest facial skeletal injuries. The most frequent causes of mandibular fractures are the traumas related to traffic accidents, falls, interpersonal violence, and sports activities, etc. METHODS: Seven hundred fifty-three cases (615 male, 138 female; megan age 36.2 years) (age >16) with mandibular fracture were evaluated retrospectively. Patient records were examined in terms of age, sex, etiology, seasonal variation, fracture localization, accompanying traumas, treatment modality, and postoperative complications. RESULTS: Traffic accidents were the most common etiologic cause in all age groups and both sexes. All cases had a total of 1090 fractures, and the most common fracture localization was the parasymphysis (28.6%), followed by the condyle, corpus, angulus, symphysis, dentoalveolar process, ramus, and coronoid process, respectively. In 25 (3.3%) patients with fissure-like, non-displaced fracture, only symptomatic treatment was applied. Closed reduction with elastic bandage, arch bar, quick-fix screws or Ivy Loop was the only method performed in 280 (37.2%) patients. Osteosynthesis by open reduction and internal fixation (miniplates, screws or transosseous wiring) was performed in 403 (53.5%) patients; closed reduction techniques were also performed in 134 of these patients. CONCLUSION: In the recent years, double-road constructions, increased traffic audits and regulation of the traffic rules decreased the incidence of mandibular fractures.

Investigation of the effects of umbilical cord-derived mesenchymal stem cells and curcumin on Achilles tendon healing - can they act synergistically?

BACKGROUND: It is known that curcumin and umbilical cord-derived mesenchymal stem cells (UC-MSCs) positively affect experi-mental tendon injury healing. This study investigated individual effects and potential synergistic effects of using curcumin and UC-MSCs alone and together. METHODS: Eighty female Wistar albino rats were randomly divided into five groups: Control, curcumin, sesame oil, MSCs, and Curcumin+MSCs groups. In all rats, punch tendon defect was created in both right and left Achilles tendons. While no additional treatment was applied to the control group, curcumin, sesame oil used as a solvent for curcumin, MSCs, and MSCs and curcumin com-bination were applied locally to the injury site, respectively, in the other groups. Curcumin was solved in sesame oil before application. In each group, half of the animals were euthanized in the post-operative 2nd week while the other half were euthanized in the post-operative 4th week. The right Achilles was used for biomechanical testing, while the left Achilles was used for histological evaluation and immunohistochemical analysis of type I, Type III collagen, and tenomodulin. RESULTS: Histologically, significant improvement was observed in the curcumin, MSCs, and Curcumin+ MSCs groups compared to the control Group in the 2nd week. In the 2nd and 4th weeks, Type III collagen was significantly increased in the curcumin group com-pared to the control group. In week 4, tenomodulin increased significantly in the curcumin and MSCs groups compared to the control group. Tendon tensile strength increased significantly in MSCs and Curcumin+MSCs groups compared to the control group in the 4th week. No superiority was observed between the treatment groups regarding their positive effects on recovery. CONCLUSION: Locally used curcumin and UC-MSCs showed positive effects that were not superior to each other in the healing of injury caused by a punch in the Achilles tendons of rats. However, synergistic effects on healing were not observed when they were applied together.

The effect of angiotensin (1-7) on survival of random pattern skin flaps with nicotine-induced ischemia in rats.

OBJECTIVE: The purpose of this study was to reveal the effect of angiotensin (1-7) on survival of random pattern, nicotinized, ischemic flap model in rats. MATERIALS AND METHODS: We used female Sprague Dawley rats weighing between 250 and 300 g. The study was performed on 3 groups each of them was consisted of 30 rats (control [C], angiotensin (1-7) [A] and vehicle [V]).While group C was subjected to 1 mL saline subcutaneous injection once daily for 28 days, groups A and V were nicotinized by 2 mg/kg nicotine subcutaneous injection, twice a day. At the end of this period, McFarlane random flap was constructed in all rats. No drug was applied to the flap bed in the group C, whereas for group A angiotensin (1-7) (A [1-7]) was delivered and a vehicle without an active ingredient was applied to the group V.Following surgery, immediately, Na-fluorescein diffusion tests were performed on 10 subjects of every group and necrotic areas were determined by millimetric paper method. After this, for determining angiogenesis, 10 subjects were killed from each group on the second day and fourth day. Finally, on the seventh day, necrotic areas were measured in 10 subjects of each group. They were then killed after photographs were taken. Specimens were collected from distal and critical zones of flaps, in all the groups, for immunohistochemical and histopathologic analyses. RESULTS: Macroscopic measurements revealed equal ischemic areas for groups A and V in 30 minutes which were both larger than those of the group C (P < 0.005). Measurements performed on the seventh day showed a significant decrease of ischemia, which advanced to necrosis in the group A (P < 0.005). Groups V and C showed a direct progress to necrosis without changes in ischemia levels. Microscopic analysis exhibited a statistically significant increase in the number of microvascular structures and diameters of mature vascular structures in the group A compared with those of groups C and V (P < 0.005). CONCLUSION: A (1-7) increased vasodilatation in nicotinized flaps, triggered angiogenesis in the first 2 days, and contributed remarkably to the flap survival.

Immediate fat and nanofat-enriched fat grafting in breast reduction for scar management.

BACKGROUND: Reduction mammoplasty can be successful but surgical scars may continue to be a most undesirable and unavoidable outcome. Various medical and non-invasive methods are available to minimize scar formation but as yet no methods have been discovered to eliminate them. We hypothesize that immediate fat and nanofat-enriched fat graft transfer may improve the scar quality and optimize results. MATERIALS AND METHODS: This prospective study comprised 45 superomedial pedicle wise-pattern breast reduction patients divided into three groups of 15 in a randomized fashion. The control group had no additional injections whereas the other two groups received injections of fat and nanofat-enriched fat grafts immediately under their surgery scars, respectively. Surgical scar formation was evaluated at six months and scars were scored using the Vancouver scar scale and a visual analogue scale. RESULTS: Fat and nanofat-enriched fat graft-injected groups scored significantly better on all items of the Vancouver scar scale, except for scar height, compared to the control group (p < 0.05). Visual analogue scores were significantly lower in the fat and nanofat-enriched fat graft-injected groups compared to the control group (p < 0.05). CONCLUSIONS: In breast reduction patients, simultaneous fat and nanofat-enriched fat grafting appears to be a safe and promising strategy for scar management.

The effect of erythropoietin and umbilical cord-derived mesenchymal stem cells on nerve regeneration in rats with sciatic nerve injury.

OBJECTIVE: We aimed to investigate the effects of umbilical cord-derived mesenchymal stem cells and erythropoietin on nerve regeneration in the sciatic nerve 'crush injury' in a rat model. METHODS: Experimental animals were randomly divided into 5 groups: Crush Injury, Sham, Crush Injury + Erythropoietin, Crush Injury + Mesenchymal Stem Cell, Crush Injury + Erythropoietin + Mesenchymal Stem Cell groups. Crush injury made with bulldog clamp. Mesencyhmal stem cells delivered by enjection locally. Erythropoietin administered by intraperitoneally. On the 0th, 14th and 28th days, all groups underwent a sciatic functional index test. On 28th day, sciatic nerves were harvested and histopathological appearance, axon number and axon diameter of the sciatic nerves were evaluated with Oil Red O staining. Immunoreactivity of nerve growth factor, neurofilament-H and caspase-3 were determined by immunofluorescence staining in nerve tissue. RESULTS: In histopathological examination, axons and nerve bundles exhibiting normal nerve architecture in the Sham group. Crush Injury + Mesenchymal Stem Cell group has similar histological appearance to the Sham group. The number of axons were higher in the Mesenchymal Stem Cell groups compared to the Crush Injury group. Nerve growth factor immunoreactivity intensity was significantly lower in Crush Injury + Mesenchymal Stem Cell group compared to Crush Injury group. Neurofilament-H density was higher in the treatment groups when compared to the Crush Injury group. CONCLUSIONS: In this study, it was found that umbilical cord-derived mesenchymal stem cells and erythropoietin treatments effects positively regeneration of crush injury caused by bulldog clamp in the sciatic nerve of rats.

Stereologic orbital volume measurements in zygomatic fractures.

PURPOSE: To evaluate the efficacy of stereologic methods to measure the orbital volume using computed tomography images of patients with zygomatic fractures. MATERIALS AND METHODS: The present study was retrospectively conducted using hard-copy computed tomography images acquired during the postoperative period of 22 patients with unilateral zygomatic fractures. Orbital volume measurements were performed on the surgically treated and contralateral normal orbits using stereologic methods. The estimates obtained from both sides were compared statistically using the paired samples t test. The measurements were repeated by 2 different observers to estimate the interobserver variability. RESULTS: When both observers were taken into account, the mean volume in the normal and surgically treated orbits was 23.6 +/- 3.2 and 24.4 +/- 3.1 cm(3), respectively. A statistically significant difference was noted between the surgically treated and normal orbits (P < .05). The volumes of 16 treated orbits were enlarged by 5.8% +/- 3.8% and 6 were diminished by 2.7% +/- 1.4%. A very high statistical correlation was noted between the 2 observers (R > .95). The total time consumed for calculation in each patient (2 orbits) was 9 to 12 minutes. CONCLUSIONS: Stereologic estimation of the orbital volume is an easy, practical, and time-saving procedure that can be performed on readily available, hard-copy computed tomography images. The high interobserver agreement observed in our study shows that it can be safely used in the quantitative detection of preoperative and postoperative volume changes.

Retrospective analysis of two hundred thirty-five pediatric mandibular fracture cases.

Maxillofacial fractures are encountered less commonly during childhood period due to anatomic, social, cultural, and environmental factors. Although the incidence of all maxillofacial fractures is 1% to 15% among pediatric and adolescent patients, this rate drops to less than 1% in children below 5 years age. Two hundred thirty-five cases (

Correcting Concavity of Rabbit Auricular Cartilage: Comparison of Single Scoring Incisions with Butyl Cyanoacrylate-Aided Techniques.

BACKGROUND: The authors present the results of an experimental study in which four different techniques were used for the correction of concave rabbit auricular cartilage. METHODS: Sixteen New Zealand adult male rabbits were used in the study. Butyl cyanoacrylate-aided cartilage graft fixation and butyl cyanoacrylate-aided bone graft fixation and scoring technique, alone or combined with butyl cyanoacrylate application, were performed to correct the concavity of rabbit auricular cartilage. RESULTS: Angle measurements showed that all four techniques were efficient for correction of the cartilage concavities. However, the mean postsacrifice angles of the graft fixation groups were significantly higher than those of the other study groups, reflecting the fact that graft fixation with butyl cyanoacrylate application was more efficient for preserving the final cartilage shape. Furthermore, in the ninth month, graft fixation groups had the lowest chondrocyte densities, the highest degree of inflammation, the highest degree of foreign body reaction, and the highest butyl cyanoacrylate density. CONCLUSIONS: Fibrosis or chondrocyte proliferation on scoring incision lines is not an associated feature of this technique. When the incision depths were standardized, the scoring technique provided efficacy similar to that of the scoring incisions combined with butyl cyanoacrylate application for correction of the cartilage concavity. The scoring incision plus butyl cyanoacrylate group showed less toxicity than the graft fixation groups because of rapid removal of toxic breakdown products. Graft fixation techniques were superior to other corrective procedures with regard to preservation of the final cartilage shape. Although they resulted in greater toxicity, the cartilage correction was not affected unfavorably.

A decision-making guide for the closure of myelomeningocele skin defects with or without primary repair.

OBJECTIVE The closure of the skin defect in myelomeningocele (MMC) repair is an essential step that determines the quality of the surgical result. The success of surgical results is related to the decision to use the most suitable techniques, namely flaps or primary closure. The aim of this study was to evaluate the effectiveness of a decision-making guide to determine whether to use primary repair or a flap for the closure of skin defects that occur in MMC. METHODS Fifty patients underwent surgery after neurosurgical repair and closure of the placode. A simple guide was generated according to the defect height/width and posterior axillary lines/defect width ratio. These 2 ratios were considered to determine which closure technique (with or without primary repair) should be used for the MMC defect reconstruction. RESULTS By using this decision-making guide, 20 of the defects were repaired with various flaps, and those of the remaining 30 patients were repaired with primary closure. In all patients, a successful tension-free 1-stage closure was obtained. Except for 4 patients who had flap reconstruction with partial flap necrosis or minimal flap tip necrosis, healing was uneventful without any complications. There were no additional wound complications during the mean follow-up of 6.8 years (range 5 months to 14 years). CONCLUSIONS Because of various defect sizes and patient characteristics, no single protocol exists for the reconstruction of MMC defects. The guide suggested here might be effective in deciding which method is suitable for closure of MMC skin defects.

The effects of ovariectomy on the mechanical properties of skin in rats.

OBJECTIVE: After menopause, observable changes occur in the physical characteristics of the human skin. These changes and their responses to various treatments can be assessed with non-invasive in-vivo mechanical tests. However, tests measuring breaking strength and tensile strengths can only be done ex-vivo, they require relatively higher quantities of skin and thus have generally been performed on animals. Mechanical changes in the skin of ovariectomized rats, an appropriate model for the study of postmenopausal period, have not been dealt with in the literature. In this study mechanical characteristics of the skin, such as breaking strength and tensile strength have been tested and studied histologically in ovariectomized rats. METHODS: Sixteen rats were divided into two groups, one undergoing ovariectomy and one control group undergoing a sham operation. Three months later, the rats were sacrificed and tensile properties of their back skins were tested with a tensometer and evaluated histologically. RESULTS AND CONCLUSION: Breaking strength, tensile strength and the Young's modulus have increased and the thickness of the subcutis has decreased in ovariectomized rats. This study should be tested by others, because of existence of some conflicts between available knowledge and the results, relating to postmenopausal skin changes.

Role of thymus oil in burn wound healing.

Thymus oil and its components are becoming increasingly popular as naturally occurring antimicrobial and antioxidant agents. The real importance of thymus on nitric oxide (NO) is unknown. NO is an important mediator in numerous physiologic and pathophysiologic events. Stasis and thrombosis in burn wound can progress as a result of the release of local mediators. The implication of NO in burn injury is not well studied. In this study, we tried to determine the role of burn-induced NO and whether thymus oil plays a protective role after a thermal injury. Rats were divided into five groups. We topically applied thymus oil, olive oil, and silverdin and sulfadiazine on the rats, respectively, during a period of 21 days after they were burned while under anesthesia. The burned control group and nonburned control group did not receive any treatment. The results of this study show that NO was overproduced by thermal injury and decreased during the days after burn injury. The decrease in rats treated with thymus and sulfadiazine was higher than the others. These data indicate that thymus oil may serve as a protective agent to the damaged tissues by decreasing the NO level. Histologic examination results show that the formation of new tissue in rats receiving thymus oil was more than other burned groups, and this finding supports our hypothesis.

Previous injuries or scars as risk factors for the development of basal cell carcinoma.

Basal cell carcinoma (BCC) is the most common malignant tumour in humans and most occur in elderly people. The pathogenesis of BCC is directly related to exposure to ultraviolet radiation in sunlight, but trauma is also mentioned occasionally. As well as one published series, several single cases have been reported. Our aim in the present study was to assess any possible relation between the development of BCC and trauma in a series of 92 patients, 12 of whom (13%) gave a history of previous injury. These lesions either developed directly after a sharp or blunt injury or in the scar tissue that had resulted from previous surgical incisions, burns, or dog bites. The male:female ratio was higher in the injured group (10:2) than in the uninjured group (44:36), but not significantly so (p = 0.11). Morphoea-like basal cell carcinomas were more common in the injured group (n = 91) (p = 0.06). We conclude that trauma might be considered as another aetiological agent for BCC.

Experience of 80 cases with Fournier's gangrene and "trauma" as a trigger factor in the etiopathogenesis.

BACKGROUND: The purpose of the present study was to retrospectively analyze the patients' data presented with Fournier's gangrene (FG), to compare obtained data with the literature and to investigate the role of "trauma" in the etiopathogenesis. METHODS: A retrospective study was conducted on 126 patients with FG that consulted to our department. RESULTS: There were 76 male and four female patients. The mean age of the patients was 53.5±13.6 years. The most common presentation of patients was swelling (n=74). The scrotum has been shown to be the most commonly affected area in the patients (n=75). Diabetes mellitus was the leading predisposing factor and trauma was the leading responsible cause for FG. Escherichia coli was the most frequently identified microorganism (n=43, 53.75%). Primary closure was the most common technique used for all patients. Three patients exhibited a mortal course due to sepsis and multi-organ failure. CONCLUSION: FG still has a high mortality rate. Rapid and correct diagnosis of the disease can avoid inappropriate or delayed treatment and even death of the patient. The healthcare professionals should be aware that any trauma in the perineal region could lead to FG.