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Biomedical subjects

Mustafa Sengezer

Publications and source records attributed to Mustafa Sengezer.

At least 19 recordsLinked to original sources
PubMed2006

Correction of thumb deformities after burn: versatility of first dorsal metacarpal artery flap.

In the management of a debilitated burned hand due to contractures, thumb reconstruction constitutes the most crucial part for a beneficial functional outcome. Among the limited local flap alternatives for the thumb, the first dorsal metacarpal artery flap, harvested from the dorsal aspect of the index finger can provide elastic, durable and sensate coverage for soft tissue defects after contracture release. In a 3-year period, neurovascular island first dorsal metacarpal artery flap was used in 14 patients suffering thumb deformities. The time elapsed after the underlying injury until reconstruction ranged from 5 months to 17 years. Follow-up revealed that all deformities were successfully treated with satisfactory functional recovery and cosmetic results. Donor site morbidity was minimal with an acceptable scar on the dorsum of the index finger and adequate tendon gliding without producing extension deficit. Our experience with management of deformities involving the thumb and/or adjacent thenar area revealed that the first dorsal metacarpal artery flap is a reliable local neurovascular island flap option, offering acceptable functional and cosmetic outcomes in respect to sensation, elasticity, durability and skin-match.

Adult↗
PubMed2006

Treatment of 'en coup de sabre' deformity with porous polyethylene implant.

Linear scleroderma "en coup de saber" (LSCS) deformity is a subgroup of scleroderma characterized by unilateral atrophy and depression above the level of the eyebrow. In rare cases where it involves the whole unilateral face it can be mistaken with Parry-Romberg syndrome. Involvement of the trunk and extremities together with facial lesions has been extremely rare in the literature. We report an unusual case of linear scleroderma "en coup de sabre" where there is concomitant involvement of the ipsilateral side of the trunk and lower extremity. The patient's facial deformity is reconstructed with a polyethylene implant.

Adipose Tissue↗
PubMed2006

Reconstruction of acquired partial auricular defects by porous polyethylene implant and superficial temporoparietal fascia flap in adult patients.

BACKGROUND: Six patients with acquired partial auricular defects with various causes were treated with porous polyethylene implants and superficial temporoparietal fascia flaps. METHODS: The mean of the auricular defects was 39 percent (range, 27 to 61 percent). The defects were situated in different parts of the auricles. Helical rim implants and/or ultrathin sheet implants were used as frameworks and covered with superficial temporoparietal fascia flaps. RESULTS: The symmetry of the reconstructed ears was satisfactory, and the cosmetic appearance was acceptable for all patients. Neither skeletal collapse nor flattening of the lateral helical rim was seen in any of the patients. Minor revision was required for debulking of the pedicle in one early patient. No additional complications were encountered. CONCLUSION: The authors recommend using this single-stage combined technique for reconstruction of various types of partial auricular defects in adult patients.

Adult↗
PubMed2006

Vertical distraction osteogenesis of fibular bone flap in reconstructed mandible.

Excellent functional and aesthetic results can be achieved in mandibular reconstructions with using free fibular bone flap. However, the vertical deficiency between the reconstructed segment and the occlusal plane made dental rehabilitation impossible in some cases. We encountered this problem in our 3 patients who had mandibular reconstruction with fibular flap due to extensive bone defect result from gunshot injury. To overcome this segmental vertical distraction of the reconstructed mandible was performed. Fibular bone segments (40-70 mm) were distracted with using extraoral distraction device after a latency period of 5-7 days. The rate of distraction was 1 mm/day, and the rhythm was 4 times (4 x 0.25 mm). Distraction was continued until the desired height was achieved, and the distractor left in place for 12 weeks for bony consolidation. No minor or major complications were encountered. The increase of vertical height was between 9 and 13 mm, and it was stable during the follow-up period (7-22 months). Following the vertical distraction and vestibuloplasty operations, the dental restoration of the patients was performed with mandibular removable partial dentures.

Adult↗
PubMed2006

A retrospective analysis of 101 zygomatico-orbital fractures.

A 5-year review of 101 cases of zygomatico-orbital fractures is presented. The epidemiology, fracture patterns, treatment modalities, and complications were evaluated in this retrospective study. A majority of fractures were sustained by males and resulted from trauma inflicted during altercations and traffic accidents. The most common fracture pattern was tripod fracture and the most common associated facial fractures were mandibular fractures. Open reduction and rigid fixation was the most frequently employed treatment modality. Depending on the stability of reduced zygoma, one, two and three-point fixations were applied. Orbital floor exploration was performed in 41 cases. Ten out of 16 orbital floor bone defects required reconstruction. In these cases orbital floor was reconstructed with 1.5-mm porous polyethylene implant. Although we encountered a few complications related to the incisions for open reduction, the rate of complication in which correction was difficult (e.g. facial asymmetry) was lower with this approach when compared with the literature.

Accidental Falls↗
PubMed2006

Psychiatric analysis of suicide attempt subjects due to maxillofacial gunshot.

The studies of maxillofacial gunshot injuries mainly focused on evaluating the surgical interventions and physical outcomes of the procedures. In this study we aimed to analyze the pre- and post-injury psychiatric status of the patients with self-inflicted gunshot wounds to the face. This study is based on 12 subjects who attempted suicide resulting in extensive maxillofacial injuries using guns placed beneath their chins. The psychiatric evaluation was conducted by interview and using SCID-I, SCID-II, MMPI, Rosenberg Self-Esteem Scale and Suicide Probability Scale. Two subjects were healthy, 1 had bereavement, 6 had current and 5 had previous MDD (major depressive disorder), 2 had dysthymic disorder, 3 had alcohol abuse, 2 had drug abuse and 4 had antisocial personality disorder. The suicidal group was more socially introverted according to MMPI. According to Rosenberg self-esteem subscale, self esteem, the constancy of self respect and depressive mood subtests were statistically significant in the suicide group compared to the healthy controls (P < 0.01). Depressive spectrum disorders are the most common causes. It is obvious that untreated or undiagnosed depression may increase risk of committing suicide. The changes in the physical facial appearance after the suicide attempt caused impairment of self-esteem and the constancy of self-respect. Similar to other studies, none of our patients reattempted suicide and all tried to return to their pre-injury lifestyle and appeared to accommodate to the stigma of their physical deformities. Early diagnosis and treatment should be considered as a factor to reduce the risk for suicide attempt.

Case-Control Studies↗
PubMed2005

Saving the zone of stasis: is glutathione effective?

One of the main subjects that burn researches are focused on is saving the zone of stasis. There are many molecules that are used for this purpose, but all have their drawbacks. Glutathione is one of the major buffer molecules of the cells and is known to increase the thermo-resistance of the cells. In this study, the effect of the systemic glutathione on the zone of stasis was evaluated. The results showed that glutathione is an effective molecule for saving the zone of stasis. It is well-known cheap, and easy to use.

Animals↗
PubMed2005

Congenital double lip: review of 5 cases.

Congenital double lip is rare and usually involves the upper lip. Apart from a deformity that interferes with speech and mastication, operation may be indicated for cosmetic reasons. We have operated on five patients with double lip deformities for cosmetic reasons. Although a midline constriction band between two mucosal bulges is thought to be a constant feature, four of our five cases did not have a midline constriction. We used an elliptical excision of the mucosal excess in the four patients. The one with central constriction had an elliptical excision on each side, combined with a vertical midline Z-plasty to release the central constriction. Satisfactory aesthetic results were achieved in all patients.

Adult↗
PubMed2005

Subacute reconstruction of lower leg and foot defects due to high velocity-high energy injuries caused by gunshots, missiles, and land mines.

The present study reviews 215 male patients suffering high velocity-high energy injuries of the lower leg or foot caused by war weapons such as missiles, gunshots, and land mines. They were treated in the Department of Plastic and Reconstructive Surgery at Gulhane Military Medical Academy (Ankara, Turkey) between November 1993-January 2001. Severe soft-tissue defects requiring flap coverage and associated open bone fractures that were treated 7-21 days (mean, 9.6 days) after the injury were included in the study. Twenty-three of 226 extremities (10.2%) underwent primary below-knee amputation. The number of debridements prior to definitive treatment was between 1-3 (mean, 1.9). Gustilo type III open tibia fractures accompanied 104 of 126 soft-tissue defects of the lower leg. Sixty-four bone defects accompanied 83 soft-tissue defects of the feet. Eighteen local pedicled muscle flaps and 208 free muscle flaps (latissimus dorsi, rectus abdominis, and gracilis) were used in soft-tissue coverage of 209 defects. Overall, the free muscle flap success rate was 91.3%. Bone defects were restored with 106 bone grafts, 25 free fibula flaps, and 14 distraction osteogenesis procedures. Osseous and soft-tissue defects were reconstructed simultaneously at the first definitive treatment in 94% of cases. The mean follow-up after definitive treatment was 25 (range, 9-47) months. The average full weight-bearing times for lower leg and feet injuries were 8.4 months and 4 months, respectively. Early, aggressive, and serial debridement of osseous and soft tissue, early restoration of bone and soft-tissue defects at the same stage, intensive rehabilitation, and patient education were the key points in the management of high velocity-high energy injuries of the lower leg and foot.

Adult↗
PubMed2005

Correction of bilateral congenital swan-neck deformity by use of Mitek mini anchor: a new technique.

Congenital swan neck deformity is a rare condition, secondary to congenital laxity of the palmar plate of the proximal interphalangeal joint. Here, we describe a new surgical method which is based on the palmar plate reinforcement using the Mitek mini anchor system (Mitek Surgical Products Inc., Norwood, MA, USA). Four fingers of a patient with congenital swan neck deformities were corrected with this technique at two stages. First, the anchor was inserted into the volar surface of the proximal phalanx. The two sutures of the anchor system were then crossed the PIP joint in a V fashion. Two holes, 5mm apart from each other, were created through the middle phalanx distal to both insertion points of superficial flexor tendon. The suture ends of the anchor were passed through these holes from the volar to the dorsal side of the middle phalanx and then turned around the edges of the bone to the volar surface. They were tied to each other as the PIP joint was stabilised at 20 degrees flexion by use of a K-wire. The K-wire was removed 21 days later and a rehabilitation program was then initiated. A second operation for the two fingers of the opposite hand was performed 2 months after the first operation. No postoperative complications were encountered. At 2 years follow-up, the active range of motion was within normal limits at PIP and DIP joints of all four fingers without any recurrence of hyperextension or hyperflexion. The final result was satisfactory regarding both the functional and cosmetic aspects. The Mitek mini anchor offers a practical, reliable and functional reconstruction of the volar plate in the management of congenital swan neck deformities. We believe that it may also be used for the acquired deformities.

Adult↗
PubMed2005

The cell based dressing with living allogenic keratinocytes in the treatment of foot ulcers: a case study.

In this study, we aimed to investigate the efficacy of cell based dressing with living allogenic keratinocytes in diabetic foot patients. To address this issue, the cultured keratinocytes were attached to the microcarriers produced from polyethylene and silica. The microcarriers were then applied to the wounds at 3-day intervals. Forty patients with grade II and III diabetic foot ulcers were included into the study. The patients were randomised into two groups (n=20). The treatment and control groups received cell based dressing and microcarriers kept in culture medium overnight, respectively. The wound size was recorded at 3 days intervals. The wounds were also categorised by a specific scoring system considering the wound contraction, granulation tissue formation, epithelisation and discharge from the wounds. The high score indicates better condition. The mean reduction of the wound area was 92% in the treatment group and 32% in the control group at the end of the 30 days treatment (p<0.001). When considered the complete healing, the mean number of dressings was 9.2+/-3.2 in the treatment group whereas it was 16.5+/-2.3 in the control group (p<0.001). The initial mean score of the treatment and control groups were 2.5 and 2.35, respectively. At the end of the 30th day, the mean score of the treatment group was 17.15+/-2.7 and of control group was 9.05+/-3. Allogenic keratinocyte treatment delivered with microcarriers can make significant contributions to wound healing in diabetic foot patients.

Biological Dressings↗
PubMed2005

Versatility of the reverse lateral arm flap in the treatment of post-burn antecubital contractures.

If they are not managed with proper treatment and rehabilitation, full thickness burns involving the cubital fossa may result in severe contractures that may impair upper extremity functions. Later release of these contractures discloses a large soft tissue defect that should be replaced. We used reverse lateral arm flaps for coverage of the cubital fossa in 11 selected cases of antecubital contracture. Ten flaps survived totally while we experienced one distal partial necrosis, which was later treated by skin grafting. We achieved considerable functional improvements in all cases. Although fasciocutaneous flaps offer the advantage of using regional tissue in a single stage, few versatile local flaps relying on the vascular anatomy around the elbow joint are available for cubital fossa coverage. Being a rapid, easy and one-staged procedure with no necessities for sacrifice of a major artery or muscle and for a long-term immobilization of the involved joints, reverse lateral arm flaps appears to be advantageous in comparison to other options for coverage of the cubital fossa defects after the release of antecubital contractures.

Adult↗
PubMed2005

Psychological evaluation of self-inflicted burn patients: suicide or parasuicide?

Self-inflicted burns have an increasing incidence all around the world. There is a high mortality and morbidity rate among these patients. We retrospectively analysed the psychiatric characteristics of self-inflicted burn patients. The results showed that these attempts are somewhat different from suicidal acts and may be defined as parasuicides. The treatment and rehabilitation strategies of so called parasuicidal burns are discussed.

Adult↗
PubMed2005

Evaluation of late functional results of patients treated with free muscle flaps for heel defects caused by land-mine explosions.

BACKGROUND: High-energy land-mine explosions cause extensive soft-tissue and bone defects in the heel area, which mostly require free flap coverage. In this article, the authors present the long-term functional outcomes of 72 patients who had free muscle flap reconstructions for composite heel defects caused by land-mine explosions. METHODS: The composite heel defects of 72 male patients caused by land-mine explosions were reconstructed by means of free muscle flaps. The mean follow-up was 6.5 years (range, 1 to 12 years). Each patient completed a questionnaire rating his level of satisfaction. Dynamic foot pressure distribution testing, three-dimensional motion analysis, and dynamic electromyography were performed for all patients. The data were compared with the control group of 20 volunteers. Statistical analysis was performed by Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests. RESULTS: Dynamic pressure distribution tests revealed significantly higher pressure and load in the injured feet of the patients (p < 0.05). Three-dimensional motion analysis showed restricted range of motion at the ankle joints of the injured extremity (p < 0.05). Seventeen patients were able to stand as long as the control group; the mean standing time for the others was 2.85 hours per day (range, 36 minutes to 5.32 hours). Many of the patients (71 percent) declared their satisfaction of having their own feet instead of prostheses. CONCLUSIONS: This is the longest series documenting the long-term functional results of patients injured by land mines who were treated with free muscle flaps. Reconstructive options should be preferred to amputation procedures in extensive tissue loss caused by land-mine explosion where possible.

Adult↗