Biomedical subjects

Salim Ersozlu

Publications and source records attributed to Salim Ersozlu.

5 recordsLinked to original sources

PubMed2006

A new material for prevention of epidural fibrosis after laminectomy: oxidized regenerated cellulose (interceed), an absorbable barrier.

Epidural fibrosis, which may cause persistent back and leg pain, may develop after laminectomy. Several materials have been used in attempts to minimize epidural fibrosis, with varying results. We evaluated the efficacy of an absorbable cellulose adhesion barrier in preventing epidural fibrosis. In 25 New Zealand white rabbits, laminectomies were performed at L3 and L5 vertebrae. The dura mater was covered by the adhesion barrier (Interceed, TC7, Johnson & Johnson, USA) at L3 laminectomy site (group 1), with L5 laminectomy site serving as an internal control (group 2) in each animal. There was no neurological deficit in any of the animals during the postoperative period. Animals were sacrificed at postoperative day 28. The lumbar spine was removed en bloc and placed in neutral, buffered formalin for 72 h. The specimens were then decalcified and embedded in paraffin. Permanent sections of 5 to 7 microm were stained with hematoxylin and eosin and Masson trichrome dye. Epidural fibrosis was evaluated in a double-blinded manner. The extent of epidural fibrosis was graded as 0, no reaction seen; 1, mild reaction; 2, moderate reaction; 3, extensive reaction, and 4, severe reaction. The histological findings of each group were compared. For the statistical analysis, Wilcoxon signed rank test was used. In group 1, the fibrotic tissue formation was minimal in 19 and moderate in 6 laminectomy sites. In group 2, the fibrotic tissue formation was determined as being extensive in 17 and moderate in 8 laminectomy sites. Statistical analysis showed significant decrease in epidural fibrosis in group 1 (P<0.05). This study showed that Interceed, which is commercially available in the market, especially for abdominal and gynecological surgeries, could be used to prevent epidural fibrosis.

Absorption↗

PubMed2004

Neglected major vessel injury after anterior spinal surgery: a case report.

STUDY DESIGN: This is a case report. OBJECTIVES: To present a case of neglected major vessel injury after anterior spinal surgery. SUMMARY OF BACKGROUND DATA: Vascular complications during spinal surgery are fortunately few in number. The incidence and management of vascular complications during anterior approaches to the thoracolumbar spine are not well known, and it is likely that most acute or delayed vascular injuries and complications are not reported. METHODS: A case that underwent anterior spinal surgery for T12 burst fracture with an iatrogenic injury to the aorta was presented. RESULTS: Paraparesis (Frankel B) was present before last operation and disappeared completely at 30 months of follow-up. CONCLUSIONS: As with any complication, the best treatment is prevention. Careful and meticulous exposure of the involved anatomic area is very important for prevention. Early recognition with rapid treatment of vascular complications can reduce potential morbidity and mortality.

Adult↗

PubMed2004

Double reverse-flow island flaps for two adjacent finger tissue defect.

INTRODUCTION: Soft-tissue reconstruction of fingertip injuries remains a challenge for hand surgery. Tissue loss of multiple digits is a serious problem for hand surgeons. Surgical possibilities include regional, distant and local flaps. In this study, five patients presented with tissue loss of two adjacent fingers and were treated by double reverse-flow island flaps. MATERIALS AND METHODS: The surgical technique is an application of the reverse-flow homodigital island flap for two adjacent finger tissue defects. Instead of one flap, double island flaps are applied to two adjacent finger tissue defects. The flaps are raised from the lateral or medial palmar surface of the proximal phalanx level. Anastomoses between the radial and ulnar digital arteries at the distal interphalangeal joint level are preserved. RESULTS: Three of the patients had tissue defects at the fingertip. In these cases, digital nerve anastomosis with the counter lateral digital nerve made the flaps sensitive. In two patients, the tissue defect was on the dorsum of the middle phalanx level. In these cases, the flaps were non-sensitive. Neither infection nor flap failure was seen in the patients. Sensitive function was satisfactory in fingertip applications. CONCLUSION: The reverse-flow homodigital island flap is a commonly used surgical technique for tissue defects in the fingers. The double reverse-flow island flaps involve the application of this technique for two adjacent fingers. The important point in the surgical technique is that the vascular supply of the two flaps should originate from the same common palmar digital artery. This technique offers a possibility to repair the defects of two adjacent fingers.

Adolescent↗

PubMed2004

Limb-sparing surgery for primary malignant tumours of the pelvis.

Treatment of malignant tumours of the pelvis represents one of the most difficult problems in musculoskeletal oncology. The aim of this paper is to present our results in 16 cases of primary malignant pelvic tumours following resection only or following reconstruction with autogenous or allogenous bone grafts without using megaprostheses, and to assess the possibility to restore acceptable function with autogenous or allogenous bone grafts while avoiding the high risks of massive endoprostheses. Wound complication was the most common complication in our series, with 10 patients requiring additional treatment in the form of local surgical debridement, appropriate multi-drug antimicrobial therapy and wound care. Secondary pelvic reconstruction was performed in two patients with chondrosarcoma, due to local recurrence. External hemipelvectomy was not required in any patient. Morbidity also included the sacrifice of nerve roots in 4 patients. The mean follow-up was 42.4 months (range, 24 to 60). One patient is alive with disease, five patients have died of metastatic disease (2 of them had evidence of local recurrence), and the remaining ten patients are alive with no evidence of disease. Major blood loss and long operation time, aggressive radical surgery due to the frequent delay in diagnosis, and wound complications after surgery are important points that should be considered in the treatment of primary malignant pelvic tumours. Therefore, the management requires meticulous preoperative investigation, a multidisciplinary approach and experienced surgeons.

Adult↗

PubMed2003

Results of surgical treatment of osteoid osteoma of the spine.

Ten percent of all osteoid osteomas are located in the spine; they represent the most common cause of painful scoliosis in adolescents. The recommended treatment is surgical excision of the nidus. Nine patients with osteoid osteoma of the spine underwent surgical treatment between 1996 and 2002. Complete nidus removal was performed in all patients and the diagnosis was made by frozen sections intraoperatively. The follow-up period was 27 months. Scoliosis was present in five of the cases (55.5%). All deformities improved during the postoperative follow-up period. All nine patients with the diagnosis of osteoid osteoma who had operations had histological confirmation. All patients had immediate and complete relief of pain after surgery. There were no complications and no local recurrences after a follow-up of two years. In the authors' opinion, removal of the nidus by open surgical technique remains a valid method of treatment for osteoid osteoma of the spine.

Adolescent↗