PubMed Health⌕ Search

Biomedical subjects

A Numanoğlu

Publications and source records attributed to A Numanoğlu.

At least 19 recordsLinked to original sources
PubMed2000

Fat prefabrication using a fascial flap in the rat model.

Prefabrication of fat tissue using a fascial flap based on the superficial inferior epigastric artery was studied in rats. First, the superficial inferior epigastric fascia was transposed over the inguinal fat pad. Two weeks later fascia and fat were elevated together as a prefabricated composite flap. At this stage, a pilot study was done in ten rats and perfusion of the flaps was tested with fluorescein. After confirming fluorescein staining of the prefabricated flaps, the study continued with experimental and control groups of rats. In the experimental group, prefabricated flaps were transposed to the subcostal area. In the control group, the pedicles of the flaps were severed, creating composite grafts. These grafts were transferred to the subcostal area in the same manner as in the experimental group. One week later the flaps were re-elevated and grafts were exposed. Fluorescein tests and Indian ink microangiography were carried out. In the experimental group, the flaps were stained, while grafts in the control group were not stained. Fat and fascia were found to be viable in the experimental group, while they were necrotic in the control group on histopathological examination. Based on these findings, we can conclude that the prefabrication of fat by vascular fascia is successful and may have application in plastic surgery.

Adipose Tissue↗
PubMed2000

A neurocutaneous island flap model: an experimental study in rats.

Neurocutaneous flaps have been popularized recently in clinical reconstructive surgery. However, controversies exist concerning their anatomy and physiology. The particular role of neural vasculature in the survival of these skin flaps is also quite undefined in the experimental setting, and additional studies on this subject are necessary. The goal of this study was to describe a neurocutaneous flap in a rat model and to investigate its blood supply. Thirty male Sprague-Dawley rats weighing 300 to 350 g were used in this study, which was conducted in two stages. During the first stage, the lower extremities of 10 rats were dissected for the anatomic study of the neurocutaneous flap. A constant cutaneous nerve innervating the anterolateral thigh skin was exposed. It arose either from the saphenous nerve or the superficial epigastric nerve and was accompanied by a constant longitudinal arterial plexus. The tiny neural vessels were conveyed by the superficial fascia along their course. A 30 x 30-mm cutaneous island flap, which was based only on the cutaneous nerve with its accompanying vessels and a strip of superficial fascia, was raised on the anterolateral thigh skin using an operating microscope. The well-perfused skin territory was marked after sodium fluorescein injection. The stained skin territory was located centrally and medially on the whole island flap, and it was approximately 10 x 20 mm. This finding was confirmed by the qualitative assessment of the vascularity for this skin territory in microangiography. After studying the pedicle anatomy and determining the optimal viable skin island, the second stage of the study was performed. The remaining 20 rats were divided into two groups. In the experimental group (N = 10), a neurocutaneous island flap (10 x 20 mm) was outlined on the anterolateral aspect of the thigh at its middle third. It was designed in such a way that its short and long axes lay in the center of the distance between the anterior superior iliac spine and the anterior aspect of the knee joint. After identification and dissection of the neurovascular pedicle, the flap was raised in a lateral-to-medial direction without including the deep fascia. At this point the flap remained connected only by the pedicle and a strip of superficial fascia surrounding it. It was sutured in the same place. In the control group (N = 10), the pedicle of the flap was severed and the skin island was sutured back as a composite graft. All the experimental flaps survived well. In the control group, none of the flaps survived except one that was partially viable. The flaps in the experimental group were reelevated as neurocutaneous island flaps on day 7 for microangiographic study, and specimens were processed for histologic staining. Microangiography revealed the extent of neural vasculature and vascularization of the skin through cutaneous perforators. Histologic investigation demonstrated the neural vessels that were related closely to the superficial fascia. The authors propose a neurocutaneous island flap model in the lower extremity of the rat in which the survival of the flap depended mainly on the neural arterial supply. It was also demonstrated that the superficial fascia played a role as a connective tissue framework for conveying tiny neural blood vessels to reach the skin. This model may serve as a reproducible and reliable neurocutaneous island flap model for additional studies in this field.

Animals↗
PubMed2000

A new test for superficialis flexor tendon function.

Diagnosis of flexor digitorum superficialis tendon injury is difficult if the profundus tendon functions properly. A new test, called the DIP extension test, to diagnose isolated flexor digitorum superficialis tendon injuries is described. The test is particularly useful for the index finger. During the test the patient is asked to flex the proximal interphalangeal joint of the injured finger while this finger is in a precision pinch position with the thumb. The distal interphalangeal (DIP) joint normally has to go in hyperextension after this action. Inability to hyperextend the DIP joint confirms a superficialis tendon injury. Fifteen isolated superficialis tendon injuries in 10 patients were evaluated with the DIP extension test. Nine of these patients were later explored and the diagnosis was confirmed in all patients.

Adolescent↗
PubMed2000

Practical do-it-yourself device for accurate volume measurement of breast.

A simple and accurate method of measuring differences in breast volume based on Archimedes' principle is described. In this method, a plastic container is placed on the breast of the patient who is lying in supine position. While the breast occupies part of the container, the remaining part is filled with water and the volume is measured. This method allows the measurement of the volume differences of asymmetric breasts and also helps the surgeon to estimate the size of the prosthesis to be used in augmentation mammaplasty.

Anthropometry↗
PubMed1999

Use of fascial grafts as an interface in flap prefabrication: an experimental study.

An experimental study was conducted to investigate whether a fascial graft can be used as an interface between a vascular pedicle and target tissue to augment tissue survival in a prefabricated flap. Thirty-six male Sprague-Dawley rats were divided into three experimental groups according to the type of the recipient bed prepared for the vascular implantation. The left saphenous vascular pedicle was used as the vascular source. A 9 x 9-cm inferiorly based peninsular abdominal flap was elevated in each animal. In group I, the pedicle was tacked beneath the abdominal flap, in which the epigastric fascial layer was untouched. In group II, a 3 x 5-cm graft of epigastric fascia was harvested from the abdominal flaps under loupe magnification. The graft was sutured back into its original position after a 180-deg rotation. The vascular pedicle was then implanted just beneath the center of the fascial graft. In group III, the same size of epigastric fascia was removed in the same manner as group II, exposing the subcutaneous layer for pedicle implantation. Four weeks later, abdominal flaps were raised as island flaps connected only to the saphenous pedicle and were sutured in place. Flap viability was assessed visually on day 7. Overall, the ultimate flap survival in group I was the largest, with some necrotic areas at the periphery of the flaps. In group II, flap survival was typically centralized over the fascial graft, and crescent-shaped necrosis was noted superiorly. In group III, an almost linear pattern of survival overlying the vascular pedicle was observed. The mean surviving flap area of group I (12.13 +/- 1.615 cm2) was statistically greater than that of group II (8.83 +/- 0.663 cm2, p < 0.001) and group III (6.3 +/- 0.815 cm2; p < 0.001). There was a statistically significant difference between the mean flap survival in groups II and III (p < 0.001). Vascular arborization was examined by microangiography, and specimens were processed for histological staining. In group II, vascularization was distributed in a larger area along the fascial graft in comparison with limited vascularization around the pedicle in group III. In this study it was revealed that the interposition of a fascial graft as an interface between the vascular source and the target tissue seems to increase the size of the prefabricated flap.

Angiography↗
PubMed1998

Contraction of experimental skin flaps.

Contraction of experimental skin flaps in loose-skinned animals is a well-known but underestimated phenomenon that in fact may vary in different circumstances and complicate the calculations of survived and necrosed areas. A standard abdominal island skin flap design in the rat was used in this study to investigate the difference between the contraction rates of necrotic and survived tissues, and to determine its significance in the experimental models. The abdominal island skin flap was based on the inferior epigastric neurovascular bundles, and it extended from the pubis to the xiphoid and between the both midaxillary lines. The study was conducted in two steps. In the first step, contraction rates of completely necrosed (both pedicles severed) and completely survived (vascular pedicles were intact on both sides either with or without a nerve supply) flaps were assessed in 45 animals. After 1 week, area loss was highly significant in both necrosed and survived flaps (p < 0.001). The rate of contraction was significantly higher in necrosed tissues than in survived tissues (p < 0.001), and it was also significantly higher in the neurovascular flaps than in the denervated flaps (p < 0.05). The contraction of all flaps occurred in the vertical dimension, whereas the horizontal dimension stayed almost the same. In the second step of the study, a unilateral, pedicled abdominal flap was used, which had a constant necrotic zone on the nonpedicled half, either with or without a nerve supply in 30 animals. After 1 week the pedicled halves of all flaps were significantly larger than the nonpedicled halves (p < 0.001). Although the total area loss was higher in the neurovascular flaps than the denervated flaps, the difference was not significant statistically (p > 0.05). There was no statistically significant difference between the areas of necrosis seen in both groups when it was expressed as a proportion of the total flap area (p > 0.05). However, this insignificant difference became significant when the amount of necrosis was expressed as a proportion of only the nonpedicled flap half, favoring the denervated flaps (p < 0.005). It appears in this study that ultimate proportions of surviving and necrosed tissues may be inconsistent owing to the variable contraction rates of these tissues, and misleading conclusions may appear during the assessment of given treatment modalities.

Abdomen↗