The Effect of the Active Ingredient Thymoquinone on Flap Viability in Random Pattern Flaps in Rats.

Thymoquinone (TQ) is a plant extract that has been shown to have antioxidant, anti-inflammatory, angiogenic, antimicrobial, and anticarcinogenic effects. The aim of this study is to research how the use of TQ affects flap viability. 42 rats were placed into 6 groups, with 7 rats in each. A 3 × 10 cm McFarlane flap model was used on the test animals. The sham group had used neither surgical nor TQ treatment. The control group had surgery but no treatment afterwards. The preoperative TQ group was given oral doses of 2 mg/kg. TQ for 10 days preoperatively with no treatment after the surgical procedure. The postoperative TQ group received oral doses of 2 mg/kg TQ for 10 days after the surgical process. The preoperative + postoperative (pre + postoperative) TQ group was given oral doses of 2 mg/kg TQ for 10 days both preoperatively and postoperatively. Finally, the dimethylsulfoxide group received 10 mg/kg dimethylsulfoxide (DMSO) for 10 days both preoperatively and postoperatively. Ten days after surgery the findings were evaluated. The average rates of necrosis were found to be 29.7 % in the control group, 19.18 % in the preoperative TQ group, 13.05 % in the postoperative TQ group, 8.42 % in the pre + postoperative TQ group, and 29.03 % in the DMSO group. The experimental groups had better area measurement, histopathological, and electron microscopic results than the control group (All; p < 0.05). We believe that, because of its antioxidant, anti-inflammatory, and angiogenic properties, thymoquinone is an agent that can prevent ischemia-reperfusion damage and, therefore, prevent necrosis.

An experimental comparison of the effects of propolis, curcumin, and methylprednisolone on crush injuries of the sciatic nerve.

BACKGROUND: Propolis and curcumin have antioxidant, anti-inflammatory, immunomodulatory, and neuroprotective features. The goal of this study was to determine the effects of propolis and curcumin on nerve healing in rat sciatic nerve crush injuries and to compare these effects with results obtained using steroid treatment. METHODS: In the sham group, the right sciatic nerves of rats were dissected and exposed, and the skin was closed without any additional manipulation. In the control group (group C), after the right sciatic nerves of rats were exposed, crush damage was inflicted using a surgical clamp. In the control-methylprednisolone group, crush injuries were inflicted on sciatic nerves as in group C. After injury, 1-mg/kg methylprednisolone was administered daily for 6 days and was then tapered for 4 days. In the curcumin group, crush injuries were inflicted on sciatic nerves as in group C. Then, 100-mg/kg curcumin was given every day. In the propolis group, crush injuries were inflicted on sciatic nerves as in group C. Then, 200-mg/kg propolis was given every day. Rats were evaluated after 28 days using functional (walking track analysis and electrophysiological measurements), histomorphometric, electron microscopic, and muscle weight measurements. RESULTS: Compared to the control groups, the curcumin and propolis groups had better functional (walking track analysis and electrophysiological) results after experimental peripheral nerve crush injury. CONCLUSIONS: Curcumin and propolis, 2 traditional drugs, had a positive effect on nerve crush injuries. We are convinced that they can be used to support routine treatment in such nerve injuries.

Congenital Lateral Cleft Palate of Unknown Etiology.

The term cleft palate (CP) refers to midline defects extending from the prealveolar ark to the uvula, and these defects present with varying degrees. CP may be complete, incomplete, unilateral, bilateral, or submucosal. It is often observed with cleft lip (CL). In various studies, the incidence of isolated CP has been reported as 1.3 to 25.3 per 1000 births. As a result of deterioration of the anatomical structure of the palate, illnesses such as regurgitation, respiratory tract infections, otitis, and speech disorders may occur. These defects are often observed in the midline and are rarely laterally localized. Cleft palates with lateral localization are outside the natural midline cleft closure line and cause clinical complaints similar to other types of CP. Two cases of laterally localized CP have previously been published in the literature. The case presented here is the third known case to be reported.

Technical details of rotation palatoplasty in patients with Veau 1 cleft palate.

In cleft palate repair, elongation of the cleft toward the posterior is critically important to prevent velopharyngeal insufficiency. The purpose of many cleft palate repair techniques has been to ensure this elongation. Rotational palatoplasty is a recent cleft palate repair technique. In this technique, the soft palate is transformed into a rotational flap to allow the palate to elongate in patients with a cleft palate. This technique, which is used in all types of cleft palate and velopharyngeal insufficiency, is easy to use, practical, and efficient, especially in patients with a Veau 1 cleft palate. The aim of this study was to explain the technical details of the rotation palatoplasty technique in Veau 1 cleft palate with the aid of figures.

Technical details concerning myomucosal advancement method in the repair of large lower lip defects.

The most important decision that a surgeon has to make in large lower lip defect reconstruction is whether to use a free flap or local flap. Despite efficient transplantation, serious cosmetic problems can occur in total or in near-total lower lip reconstruction with a free flap. On the other hand, better cosmetic results can be brought about in reconstructions with local flaps when a repair is made in tissues with similar properties in terms of color, thickness, or pilosity. However, functional problems such as microstomy can be encountered when inefficient transplantation is carried out during local flap repairs. If a repair technique with local flap that enables efficient transplantation can be applied, satisfactory cosmetic as well as functional results can be provided. In this text, the technical details of the myomucosal advancement flap method, which is a successful functional local flap application with good cosmetic results, were reported and explained with the help of schematic drawings.

Comparison of the fistula risk associated with rotation palatoplasty and conventional palatoplasty for cleft palate repair.

OBJECTIVES: The aims of the cleft palate repair techniques are to reduce the velopharyngeal insufficiency risk and oronasal fistula development to minimal levels without affecting the maxillofacial development. In this article, we present a retrospective study comparing the conventional palatoplasty techniques with the new technique of rotation palatoplasty for the risk of development of oronasal fistula. MATERIALS AND METHODS: Of the 100 patients who were operated on because of cleft palate between the years 2002 and 2008, 12 patients had Furlow palatoplasty, and 88 patients received the Veau-Wardill-Kilner (V-Y pushback) operation (group C). A total of 67 patients who were operated on between 2008 and 2011 had rotation palatoplasty (group R). RESULTS: One hundred patients were men, and 67 were women. Among all the patient groups, 22.8% were classified as Veau 1, 24.6% were classified as Veau 2, 37.1% were classified as Veau 3, and 15.6% were classified as Veau 4. The rate of fistula was found to be 17.7% in all patients. Fistula development was found in 6% of the patients in group R (4/67) and in 18% of the patients in group C (18/100). The difference between group R and group C regarding the number of patients who developed fistula was statistically significant (P = 0.011). CONCLUSIONS: The Veau classification of the cleft palate affects the risk of fistula development, and the risk for fistula after rotation palatoplasty is lower than that associated with the V-Y pushback technique.

Comparison of The Effectiveness of Thymoquinone, St. John Wort Oil and Silver Sulfadiazine in Experimental Burn Wounds.

We aimed to compare the effectiveness of thymoquinone (TQ), most important bioactive component of black cumin, St. John wort (SJW) oil, a traditional medicinal plant used in burns, and silver sulfadiazine (AgSD), well-known anti-inflammatory agent used in modern medicine, in an experimental burn rat-model. 63 Wistar-Albino rats were randomly divided into 9 groups (n=7). TQ, SJW were administered topically and systemically but AgSD was applied topically. Epithelialization, inflammatory cell response, granulation tissue, vascularization, and fibrosis were evaluated. Malondialdehyde (MDA), total antioxidant status (TAS), total oxidant status (TOS), vitamin E, 8-hydroxy-deoxyguanosine (8-OHdG), coenzyme Q10 (CoQ10) were analyzed in serum. Topical TQ accelerated theepithelialization, enabled granulation, vascularization and fibrosis in wounds (P=0.001). Topical and systemic TQ increased Vitamin-E levels (P=0.003) but reduced TOS and 8-OHdG levels (P=0.001). Topical SJW reduced granulation and vascularization. Topical and systemic SJW decreased TOS, MDA and 8-OHdG levels (P=0.001), but increased TAS (P=0.001), and Vitamin-E levels (P=0.003). Topical AgSD reduced TOS, 8-OHdG, MDA levels (P=0.001). Topical and systemic TQ demonstrated significant advantages in accelerating wound healing process, while also enhancing antioxidant defenses and reducing oxidative damage. SJW oil, particularly in topical application, improved epithelialization and antioxidant status but showed less efficacy in systemic use. AgSD, while effective in reducing oxidative stress, was less successful in promoting wound healing and appeared to delay granulation and fibrosis. TQ offers superior protective and healing benefits, SJW is effective locally but less so systemically, and AgSD should be used cautiously, potentially combined with antioxidants to mitigate its negative impact on wound healing.

Histopathologic evaluation of autologous blood injection to the temporomandibular joint.

PURPOSE: Chronic recurrent temporomandibular joint dislocation is treated by surgical and nonsurgical techniques described in the literature. However, these techniques have some complications noted in the literature. Recently, the autologous blood injection in temporomandibular joint technique has been applied to treat chronic temporomandibular joint dislocation. However, to date, there has been no study that describes the histopathologic effects of autologous blood injection within the literature. The aim of this study was to evaluate the histopathologic effects of autologous blood injection in rabbit temporomandibular joints. METHODS: Eight New Zealand white rabbits underwent bilateral autologous blood injection. After the injection, mandibles were fixed by orthodontic brackets and elastics for 24 hours. One rabbit was included in the control group. After 1-month follow-up period, the animals were killed. Temporomandibular joints were dissected and sent to histological examination. RESULTS: Only fibrin accumulations were seen in the tissue samples. There was no evidence of degeneration in the joint cartilage, and a fibrous bed was not formed in the injected regions. CONCLUSIONS: Although the procedure has successful results in the literature, a fibrous bed that is supposed to be the outcome of the treatment was not seen in the tissue samples. According to this study, therefore, the autologous blood injection does not change the structure of temporomandibular joint in rabbits.

Complex craniofacial reconstruction with prostheses as an alternative method to autogenous reconstruction.

Reconstruction of facial organ and tissue losses using autogenous tissue is a permanent and effective method in plastic surgery. However, in cases where the patient's general condition does not allow for surgical reconstruction or where the patient is in need of reconstruction of complex organs such as the eye, nose, or ear, an epithesis can be considered as an alternative to treatment with autogenous tissue. The purpose of this study was to investigate the factors affecting the success rate of facial reconstructions with an externally retained prosthesis in relation to the defect location and radiotherapy treatment. Between September 2004 and October 2008, 11 patients with facial tissue defects who had been treated with an osseointegrated implant system were evaluated. Because 1 patient with a midfacial defect died 3 months after the surgery, this case was excluded, leaving a total of 10 patients for evaluation. Five patients' facial defects were located in the ear, 2 patients had nasal defects, and 3 patients had defects in the midfacial region. The total numbers of implants applied to these regions were 13, 6, and 25, respectively. A total of 44 implants applied were followed for an average period of 52.4 months (between 6 and 77 months). In cases where the reconstruction was considered satisfactory, no infections were observed, and there were no implant losses in the mastoid region. Implant losses were observed in a total of 14 implants (31.8%), 2 of which were in the glabellar region (4.5%), and 12 were in the midfacial region (27.2%). The implant losses were observed between the first and 18th postsurgical months (with an average of 6 months). The remaining implants were sufficient to retain the prostheses. Because of these results, the use of implant-assisted epitheses can be considered a viable alternative in patients whose facial defects cannot be corrected through reconstructive surgery performed with autogenous tissue.

Reconstruction of the columella with bilateral nostril sill flaps.

The treatment of total columellar defects is very difficult, and there is not any first choice in reconstruction of these defects. Various techniques have been reported for this purpose. Each technique has its own drawbacks, and few can be performed in one stage. We report a pediatric patient with a defect involving the entire columella. Reconstruction of the defect was accomplished with laterally based bilateral nostril sill flaps. An acceptable cosmetic result was obtained. This method can be done as a single-stage operation with an excellent color and texture match. We think that this method leads to good aesthetic results, and should be considered for total columellar reconstruction.

Effects of ozone pretreatment on viability of random pattern skin flaps in rats.

BACKGROUND: Medical ozone is a chemical agent that consists of three oxygen atoms and has antioxidant, angiogenic and vasodilator effects. This study evaluated the effects of medical ozone pre-treatment on flap survival. MATERIALS AND METHODS: Rats were divided into four groups of 10 rats each and a 9 × 3 cm McFarlane flap was used. Sham group: Neither surgical nor ozone pretreatment was used. CONTROL GROUP: No pretreatment was used after surgery. Preoperative ozone group: Preoperative 1 mg/kg ozone was given intraperitoneally for 7 days. No pretreatment was used after surgery. Postoperative ozone Group: Postoperative 1 mg/kg ozone was given intraperitoneally for 7 days. After postoperative 1 week, all groups were evaluated by surface area measurement, histopathology and electron microscopy. RESULTS: With the experimental McFarlane flap model, the experimental groups had better surface area measurements, along with histopathological and electron microscopic results when compared with the control group. CONCLUSION: Medical ozone had positive effects on flap survival due to its antioxidant, angiogenic and vasodilator qualities.

New hemostatic agent: the effect of Ankaferd Blood Stopper on healing wounds in experimental skin incision model.

AIM: To conduct a histopathological evaluation of the effects of Ankaferd Blood Stopper (ABS) on healing wounds in a rabbit skin incision model. MATERIALS AND METHODS: Incisions were performed on the backs of rabbits. The first incision was allowed to undergo normal secondary healing. ABS (1 mL) was applied to the second incision, which was subsequently allowed to undergo secondary healing. The third incision was sutured. ABS (1 mL) was applied to the fourth incision, which was subsequently sutured. During the wound healing period, the histopathologic signs of ulceration, inflammation, the proliferative phase, and the extent of early remodeling were comparatively evaluated by performing biopsies on days 5, 10, and 30. RESULTS: For all of the ABS-treated wounds, the appearance of the cavities during the early stage and the disappearance of the cavities during the late stage were observed. In addition, on days 5-10, the inflammatory granulation tissue in the ABS-treated wounds was less than in the normal wounds. By day 30, all of the wounds had achieved the same symptomatic state. CONCLUSION: As ABS does not exert any negative effects on wound healing, this agent is a secure and effective method for achieving hemostasis.

Reconstruction of periorbital region defects: A retrospective study.

BACKGROUND: Although the periorbital region forms less than 1% of the total body surface, it has a very complex anatomy; therefore, it requires a detailed approach. In this work, we aim to present the clinical applications and related literature for the algorithm of the technique which will be applied, according to the location of the defect, in choosing the surgery treatment method. Factors affecting the results and different treatment methods of the anatomical region, including its difficult reconstruction, will also be included. MATERIALS AND METHODS: A review of 177 periorbital region defect reconstructions was performed. RESULTS: As a treatment method, in 76 (43%) patients primary closure was chosen, 39 (22%) patients had grafts and in 62 (35%) patients a flap was chosen as a treatment alternative. With respect to postoperative complications, there were a total of 6 (3.38%) patients observed with venous congestion. In 11 (6.21%) patients ectropion developed, in 1 (0.56%) patient minimal space between the eyelids while monitoring recovery was observed and in 1 (0.56%) patient, flap loss was observed due to a circulatory disorder. CONCLUSIONS: The aim of reconstruction is to repair the defect suitable to normal physiological and anatomical values. As a result, before the surgical treatments in this difficult anatomical region, the defect width and anatomical localization must be evaluated. The most suitable reconstruction method must be identified, using an evaluation of the algorithm and the required functional and esthetical results can be obtained with intraoperative flexible behavior and a change of method, when necessary.

The effect of chronic temporomandibular joint dislocation: frequency on the success of autologous blood injection.

Autologous blood injection (ABI) is a conservative, non-surgical method of treating chronic temporomandibular joint (TMJ) dislocation. Although many clinicians have reported positive results, procedural success has not been evaluated according to dislocation type. This study investigated the success of ABI on chronic TMJ dislocation with respect to dislocation frequency. ABI was used to treat 27 joints in 17 patients. The patients were divided into two groups based on dislocation frequency: (A) at least twice a week on different days and (B) at least twice a day. The procedure was successful in 13 of the 15 injected joints (86.6 %) in group A and six of the 12 injected joints (50 %) in group B. This difference was statistically significant (p = 0.03814). Autologous blood injection had limited success in patients with very frequent dislocation, while it was useful for treating less frequently dislocated TMJs.

Autologous blood injection to the temporomandibular joint: magnetic resonance imaging findings.

PURPOSE: The aim of this study was to investigate the effect of the autologous blood injection (ABI) for chronic recurrent temporomandibular joint (TMJ) dislocation using magnetic resonance imaging (MRI). MATERIALS AND METHODS: ABI was applied to 14 patients who had chronic recurrent TMJ dislocation. MRIs of the patients were taken and compared before and one month after the injection. RESULTS: All of the patients had no dislocations of their TMJs on clinical examination one month after the injection. In the pre-injection, unilateral or bilateral TMJ dislocations were observed on MRIs in all patients. One month after the injection, TMJ dislocations were not observed in MRI evaluation of any patients. A significant structural change that caused by ABI was not observed. CONCLUSION: The procedure was easy to perform and it caused no foreign body reaction. However, it was unclear how the procedure prevented the dislocation.

Orbicularis oculi myocutaneous advancement flap for upper eyelid reconstruction.

BACKGROUND: Reconstruction of large full-thickness defects of the upper eyelids is challenging because of their complex anatomy and specialized functions. The authors present and discuss a new, simple surgical technique for upper eyelid reconstruction. This is a single-stage procedure and has produced satisfactory to excellent results in the authors' patients. It presents the reconstructive surgeon with several advantages over other techniques. METHODS: The eyelid tumor is excised surgically until clear margins are obtained. The V-shaped orbicularis oculi myocutaneous advancement flap is marked on the remaining superior eyelid tissue and mobilized, leaving the base of the pedicle intact with submuscular tissue attachment. Posterior lamella reconstruction is performed with mucoperiosteal graft harvested from the hard palate in patients with full-thickness defects. Then, the flap is advanced to the defect and the donor site is closed primarily. RESULTS: Eight patients, aged 17 to 72 years, have been operated on with this technique for upper eyelid reconstruction. Follow-up included assessment of position, closure, length of palpebral rim, eyelid opening, aesthetic balance, presence of corneal erosion, ulcer or entropion, levator function, and donor-site morbidity. The flap was viable in every patient, without total or partial necrosis. No patient required surgical revision. The oncologic result was good, and no recurrence was noted. CONCLUSIONS: This method is a simpler, single-stage operation; does not damage the lower lid; provides a thin, mobile eyelid; and, above all, is less invasive than other techniques, and at the same time allows a good functional and aesthetic reconstruction.