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Biomedical subjects

Ragip Ozdemir

Publications and source records attributed to Ragip Ozdemir.

18 recordsLinked to original sources
PubMed2006

Examination of the skin perforators of the posterior tibial artery on the leg and the ankle region and their clinical use.

BACKGROUND: There are many treatment alternatives for reconstruction of leg and foot defects. One of these treatment alternatives includes local flaps. A detailed understanding of the blood flow of the leg region is essential for producing new alternatives for the reconstruction of defects of this region. METHODS: The leg and foot region blood flow was examined on 11 fresh cadavers, and perforators of this region were examined in three zones. Perforator numbers and their diameters were defined at this region. It was determined in cadaver studies that especially zones I and II were more suitable for the planned flaps based on perforators of the posterior tibial artery. In a clinical study that accompanies this anatomical study, eight patients underwent reconstruction by flaps based on the perforators of the posterior tibial artery. RESULTS: Patients were followed for 3 to 14 months. In three patients, venous drainage problems had developed, and in one of them, partial flap loss had developed. This partially necrosed region was left to heal by secondary intention. Venous drainage problems resolved in 5 to 7 days in the two remaining patients. No other complications were seen. CONCLUSION: Regarding the results of the clinical study, the authors observed that this flap can provide the desired soft-tissue support for defects that expose the bones, tendons, and neural and vascular bundles.

Adult↗
PubMed2006

Multi-centric basal and squamous cell skin malignancies of the craniofacial region.

The etiology of skin malignancies is evaluated as multi-factorial. The human phenotype, syndromes, precursor lesions, and immunologic differences play as risk factors as well as environment. Twenty-seven patients with multi-centric skin malignancies investigated as if having predisposing syndromes. The etiological factors and the classification of skin malignancies are assessed. We last discussed about the management options. The mean age was 47 (9-91). Men to women ratio was 16:11. Four out of 27 patients having multi-centric skin malignancies were realized as syndromic. The localization of these tumors was entirely at the head and neck region. Ninety-eight areas were distinguished as having skin malignancies in 27 patients. Sixty-one incisional biopsies for type analysis and 37 excisional biopsies were handled. Of the 98 malignancies, 24 were squamous cell cancer, 67 were basal cell cancer, and seven were basosquamous cell cancer pathologically. Wound closures were carried out as primarily in 39 excisions; using skin grafts in 21 excisions, local flaps in 28 excisions, and distant flap procedures in 10 regions. The follow-up period was between six and 25 months. No complications or recurrences were seen. Eight patients applied with new lesions on new regions, six patients had excision, and two were treated with radiotherapy.

Adolescent↗
PubMed2005

Plasmacytoma of the hard palate.

Multiple myeloma is a systemic malignant disease and is associated with a poor prognosis. It is characterized by neoplastic proliferation of plasma cells involved in the production and secretion of monoclonal immunoglobulins (M proteins). It is generally a disseminated disease involving many bones. Systemic symptoms include bone pain, pathologic fracture, renal failure, hypercalcemia, weight loss, anemia, thrombocytopenia, and neutropenia. This condition may occur as a solitary lesion (solitary plasmacytoma), which in some patients eventually progresses to plasma cell myeloma. Extramedullary plasmacytoma is defined as neoplastic proliferation of plasma cells in the soft tissue. It usually occurs in the upper respiratory tract, such as the nasal cavity or posterior oropharynx. The authors present a rare plasmacytoma case with maxilla involvement.

Diagnosis, Differential↗
PubMed2005

Anatomy of the platysma muscle and the evaluation of it for the reconstruction of facial defects.

Reconstruction of the defects with various flaps is the main issue in plastic and reconstructive surgery. Tissues used for the repair of the defects of the face should be convenient for this most important aesthetic unit. Color, elasticity, and volume of the transferred tissues have the utmost importance for successful results. Platysma muscle flap appears to be a good alternative method for the reconstruction of the facial defects. Anatomic dissections on five fresh cadavers for the evaluation of the vascular structures and 11 clinical cases of reconstruction of the defects of the face and the neck with platysma muscle and musculocutaneous flaps are performed in this study to evaluate the efficacy and reliability of platysma flaps. Cadaveric dissections were performed on the face and the neck regions on both sides. Eleven patients with various defects on the face and the upper neck regions were surgically treated: three transverse cervical artery-based transverse musculocutaneous platysma flaps, seven facial artery-based vertical musculocutaneous platysma flaps, and one superior thyroidal artery-based platysma muscle flap were used for the repairs. The patients ranged in age from 42 to 74 years. The defects measured 2x3 cm to 6x9 cm and the flaps 3x3 cm to 7x10 cm. The follow-up periods were 2 to 21 months. Postoperative venous congestion between the 5th and 9th days was observed in seven patients. One patient had infection of the donor site, and another had infection of the recipient site; both recovered with systemic and topical antibiotherapy. Partial flap loss occurred in one patient. Our study concluded that platysma flaps showed sufficient tissue match with successful results for the reconstructive procedures of facial defects.

Adult↗
PubMed2005

Osteogenic capacities of periost grafts, periost flaps and prefabricated periosteal flaps: experimental study.

Reconstruction of the bone defects due to various causes is still one of the challenging problems in plastic and reconstructive surgery. Periosteum is accepted to be the essential source for the repair of the bone tissue, which constitutes the basis of the support and the mobility functions of the surrounding tissues. Periosteal grafts and flaps have been used for various purposes by numerous techniques. The osteogenic activity of the periosteal tissues has a great importance regarding the purposes of reconstruction. In this experimental study, 20 New Zealand rabbits were used for the evaluation and the comparison of the osteogenic activities of periosteal grafts, periosteal flaps and prefabricated periosteal flaps. Morphological, histopathological and scinthigraphical observations were carried out for the assessment and the comparison of the groups after a follow-up of 12 weeks. Two of the animals were left out as a result of infection. The results showed that periosteal flaps had a much faster and more stable reconstructive capacity of osteogenesis, whereas prefabricated periosteal flaps had an osteogenic capacity of a lower degree and periosteal grafts apparently less than the former groups. We believe that this study confirms the reconstructive capacity of prefabricated periosteal flaps as an alternative to periosteal flaps for the repair of osseous tissues as well as indicating the osteogenic capacity of the periosteal grafts, though in a lesser degree.

Animals↗
PubMed2005

Evaluation of osteogenic and chondrogenic activities of prefabricated periallografts.

Reconstruction of cartilage and bone defects has always been a challenging problem for the surgeon. Basic elements that are responsible for the repair process of these tissues are periost and perichondrium. Although several methods for the use of periost and perichondrium are proposed in the literature, the osteogenic and chondrogenic capacities of these tissues were shown to be the most important factor for a successful outcome. Bone and cartilage formation in acellular dermal matrix (ADM) prefabricated with periost and perichondrium was studied in 20 New Zealand rabbits. Morphologic and histologic evaluation and comparison of the newly formed tissues were evaluated. Four rabbits were excluded from the study because of infection, and specimens were obtained at 4, 6, 8, and 12 weeks after the study began from the remaining 16 rabbits. A gradual increase in bone and cartilage tissue formation through the 4th to 12th weeks was documented by reason of perichondrium and periost activation infiltrating into acellular dermal allografts. In view of the data obtained, it was concluded that periost or perichondrium prefabricated over ADM may be an alternative technique of cartilage and bone formation that may provide adequate tissue with elastic and osteo- and chondroconductive properties for the reconstruction of challenging defects.

Animals↗
PubMed2005

Axial pattern composite prefabrication of high-density porous polyethylene: experimental and clinical research.

Currently, various alloplastic materials are being used for reconstruction of three-dimensional structures, and high-density porous polyethylene is so far the best and the most commonly used material. Various indications for high-density porous polyethylene have been defined for closure of craniofacial defects, correction of congenital anomalies, and aesthetic augmentations. A common property of various studies published so far is that after being fixed to the bone or underlying structures, high-density porous polyethylene has been covered primarily or by skin flaps. For reconstruction of complex three-dimensional structures such as the ear and nose, the success of current methods is limited by the thinness and pliability of the skin flap. In this study, the authors' aim was to investigate the graftability of high-density porous polyethylene after prefabrication with an axial pedicle and to explore possible clinical applications in light of the new data obtained. In the experimental study, three-dimensional implants (rectangular prism) carved from high-density porous polyethylene were prefabricated using bilateral superficial epigastric arteries and veins of 25 New Zealand rabbits. After a waiting period of 2 to 6 weeks in five groups, control samples were obtained and the prefabricated implants that had been left in place were directly grafted. The results showed that high-density porous polyethylene was vascularized 75 percent after 4 weeks and 90 percent after 5 weeks, and 95 percent of the grafts had survived after 8 weeks. In the clinical study, three nose defects, three ear defects, and one hard palate defect in seven patients ranging in age from 21 to 72 years were reconstructed using the same method. High-density porous polyethylene has been prefabricated and directly grafted for the very first time on a clinical basis. No serious complications have been observed, except for minimal graft loss in two patients. It is obvious that full-thickness skin grafts that are thinner than flaps will adapt better to the fine details of high-density porous polyethylene and will highly increase the detail obtained in the reconstruction of three-dimensional defects.

Abdomen↗
PubMed2004

What is new in the treatment of hypospadias?

Hypospadias is a congenital anomaly characterized by a ventrally placed urethral meatus in a more proximal position on the midline than its normal position in the glanular part of the penis. In 1961, C. E. Horton and C. J. Devine, Jr., developed single-stage modern surgical techniques, namely, local skin flaps and free skin grafts, for urethra reconstruction in hypospadias repair, which may be applied to almost any case with different localizations of the meatus. Later, two new methods, advancement of the urethra and preputial island flap techniques, were added to the surgical algorithm. Because acceptable results were observed, the authors have insisted on using these four techniques for all hypospadias cases since 1972. Complication rates (mainly fistula formation) were quite high (50 percent) in their early series of adults as a result of erection and hematoma formation. The complication rate of their patient population, which is now mainly composed of preschool children, has decreased to 7 to 8 percent, primarily as a result of careful selection of appropriate techniques for each individual case, the development of better surgical materials and equipment, and taking necessary precautions for postoperative care. A brief summary of modern hypospadias repair techniques is presented in four major classes. The results of the authors' 30-year experience and the precautions necessary to avoid postoperative complications are evaluated. The authors conclude that the four modern techniques and their modifications should be performed meticulously for successful hypospadias repair.

Adult↗
PubMed2004

Soft tissue hemangioma formation within a previously excised intraosseous hemangioma site.

Intraosseous hemangiomas are rare benign lesions, occurring often in verbrata and skull. These lesions can present in the head and neck region being the next most common site with a predominance of the mandible. Herein we report a patient who experienced a soft tissue hemangioma occurring at the previous surgical site three years after the first operation.

Adipose Tissue↗
PubMed2004

Incidental idiopathic calcinosis cutis in a rhytidectomy patient.

Calcinosis cutis, deposition of insoluble calcium salts in cutaneous tissues, is an uncommon disorder. This condition can be classified as metastatic, dystrophic, idiopathic, and iatrogenic based on the pathogenesis of the deposition. Whereas dystrophic calcinosis cutis is a fairly common condition, idiopathic cases are very rare. Distinct cutaneous anatomic areas, the vulva, scrotum, penis, and breast, have been reported to develop this disorder. Nevertheless, our case who had idiopathic calcinosis cutis in her neck may be a proof that this condition is not confined to genitals or the breasts and can be seen all over the skin.

Calcinosis↗
PubMed2004

Angiokeratoma circumscriptum.

Angiokeratoma circumscriptum is one of five types in the group of the angiokeratomas. These lesions are usually present at birth and are not related with systemic diseases. Angiokeratoma circumscriptums are hyperkeratotic papules or nodules occurring frequently unilaterally on the leg. These lesions are very rare and very few cases have been reported since its first description. It is of particular clinical importance because of its morphologic similarities to malignant skin tumors such as malignant melanoma or pigmented basal cell carcinoma. Therefore, this rare but significant lesion must be recognized by physician and surgeons who manage skin tumors.

Adolescent↗
PubMed2003

Total lower lip reconstruction using sensate composite radial forearm flap.

In modern plastic and reconstructive surgery, shape and function must be considered together. These are the most important goals of any operation. There are a lot of techniques that have been reported for total lower lip reconstruction. It is believed that the radial forearm flap is the most suitable technique for lower lip and chin reconstruction after tumor excision so as to achieve better shape and functional results. The sensate radial forearm-palmaris longus free flap was used for total lower lip reconstruction in 17 patients with lower lip carcinoma with a mean age of 51 years. Two of the patients were female, and 15 were male. All the patients had squamous cell carcinoma. The patients were followed up for 1 to 3 years. Complications of these operations were partial superficial flap loss in 1 patient, partial graft loss in the donor areas of two flaps, and infection in only 1 patient. Wound dehiscence, fistula formation, suture abscesses, or sialocele was not seen in any patient. In this study, the aim was to demonstrate that the sensate radial forearm flap could produce acceptable esthetic results, good sphincteric function, and sensation in the early period after surgery.

Adult↗
PubMed2002

Anatomicohistologic study of the retaining ligaments of the face and use in face lift: retaining ligament correction and SMAS plication.

Plastic surgeons have sought to improve nasolabial folds, jowls, jaw lines, and cervical contour with face-lifting procedures that are abundant in the literature. The retaining ligaments of the face support facial soft tissue in normal anatomic position, resisting gravitational change. As this ligamentous system attenuates, facial fat descends into the plane between the superficial and deep facial fascia, and the stigmata of facial age develop. In this study, surgical correction of the retaining ligaments and plication of the superficial musculoaponeurotic system (SMAS) to reposition the structures that have descended with gravitation are discussed. The anatomy of the facial retaining ligaments was studied in 22 half-faces of 11 fresh cadavers, and the localization, extension, and width of the ligaments were examined macroscopically and histologically. Surgical correction of the retaining ligaments and plication of the SMAS have been accomplished in 27 face-lift patients with this anatomicohistologic study taken into consideration. There was hematoma in one patient at the cheek region and a permanent dimple caused by postoperative edema in two patients, with a localization of one zygomatic and two parotidomasseteric ligaments. In one patient, hypesthesia in the mandibular nerve region was seen, which remitted at 14 weeks. There were no other complications, and with a follow-up of 24 months, excellent aesthetic results and a high level of patient satisfaction were encountered.

Adult↗
PubMed2002

Reconstruction of facial defects with superficial temporal artery island flaps: a donor site with various alternatives.

Color and texture match is crucial in reconstruction of facial tissue defects. Between March of 1997 and July of 2000, island flaps based on the parietal, anterofrontal, centrofrontal, posterofrontal, and superior auricular branches of the superficial temporal artery were used in the reconstruction of tissue defects localized on different regions of the face in 28 patients. According to the size and the location of the defect, the flap was selected. There were 15 male patients and 13 female patients, with ages ranging between 19 and 74 years. In six of the flaps, venous congestion was observed. Because of the elevation of the eyebrow on the flap side, three patients required a sling to the opposite eyebrow. Excellent color and tissue match and transfer of hair-bearing tissue to the eyebrow and beard areas were achieved with no other complications. Satisfactory aesthetic results were gained.

Adult↗
PubMed2002

Clinicopathological evaluation of parotid gland tumors: a retrospective study.

Two hundred and thirty sequential parotid tumors seen from March 1985 to 1995 were reviewed for their clinical presentation, diagnostic evaluation, pathological diagnosis, treatment modalities, and age and sex distribution. An asymptomatic mass was the most common clinical presentation. All of the operations were performed by the same surgical team. Total and superficial parotidectomy was used for the treatment of the lesions and none of the patients underwent limited excision. Retrograde approach in 79 (34.4%) patients and anterograde approach in 151 (65.6%) was used. Eighteen patients with malignant tumors were followed up in cooperation with the radiation oncology clinic. Tumors were classified according to their histopathologic diagnosis. Among 192 (83%) benign and 38 (17%) malignant tumors, the most common benign tumor of parotid gland was pleomorphic adenoma (79.1%) while the most common malignant lesion was adenocystic carcinoma (44.7%). Incidences of pleomorphic adenoma, adenocystic and epidermoid carcinoma were greater in male patients. Complication rates in benign and malignant tumors were presented and statistically significant difference could not be found between anterograde and retrograde approach in terms of facial nerve injury (P > 0.05).

Adenolymphoma↗
PubMed2002

Intraosseous hemangioma of the mandible: a case report and review of the literature.

Intraosseous hemangiomas are benign lesions, occurring often in vertebra and skull. These lesions can present in the head and neck region being the next most common site with a predominance of mandible. There are approximately seventy intraosseous hemangiomas of mandible in literature reported to date. We present an intraosseous hemangioma of the symphysis mandible. We performed a block resection of the mass preserving the mandibular integrity with no complications. There were no recurrences in the follow-up period of 24 months.

Child↗
PubMedDate not supplied

Reconstruction of heel defects with a proximally based abductor hallucis muscle flap.

The main goals of reconstruction of plantar defects include appropriate soft tissue coverage to facilitate weight bearing, and sufficient blood supply to prevent osteomyelitis. This retrospective study presents the clinical results of 11 patients who received a proximally based abductor hallucis muscle flap for coverage of calcaneal defects. The mean patient age was 43 years (range, 23-69 years). Four patients were women and 7 were men. Seven were non-diabetic patients with neurologic deficits of varying etiology or patients who had pressure ulcers after prolonged hospitalization. Four patients had diabetes with or without neurological deficits, and 6 patients had calcaneal osteomyelitis. In 6 patients, the origin of the muscle was dissected and rotated over the defect. The flap was elevated as an island flap in 5 patients. Postoperatively, partial flap loss was observed in 1 patient, who was then treated successfully with a fasciocutaneous flap. Two patients developed seroma and hematoma at the donor site, which resolved uneventfully after surgical drainage. The 6 patients with calcaneal osteomyelitis showed no recurrence after 1 year of follow-up. The abductor hallucis muscle flap provides enough stability and sufficient blood supply for calcaneal defects up to 3 x 6 cm.

Adult↗