Biomedical subjects

Tayfun Akoz

Publications and source records attributed to Tayfun Akoz.

9 recordsLinked to original sources

PubMed2006

Reliable option for reconstruction of amputation stumps: the free anterolateral thigh flap.

The increased use of microsurgery has enabled reconstructive surgeons to deal with tissue defects of various sizes and compositions. The limited amount of qualified tissue for covering is the primary problem in stump reconstruction. Free flaps offer the ideal solution by providing the optimal cover, and by preserving the length of the amputation site. Anterolateral thigh flaps were preferred for reconstruction of lower extremity amputation sites of nine patients admitted both in the subacute and chronic periods. All underwent previous stump reconstruction with local flaps in other clinics. Anterolateral thigh flaps avoided further shortening of the extremities, and provided stable tissue for prosthesis use. The flap offers reliable soft-tissue reconstruction of amputation stumps.

Adolescent↗

PubMed2006

Alar transposition flap for stenosis of the nostril.

We present a technique that has successfully corrected severe bilateral nasal stenosis. It comprised an alar transposition flap. After a year's follow up the patient was satisfied with the results. We recommend this technique for selective stenosis of the nostril.

Constriction, Pathologic↗

PubMed2005

Sensorial donor site morbidity after saphenous neurocutaneous flap.

Neurocutaneous flaps based on the arterial network around the superficial sensory nerves are popular in soft tissue coverage of the lower extremities, and are usually preferred in reconstruction of the lower leg and foot. Although sacrifice of sensory cutaneous nerves is mentioned as one of their major disadvantages to our knowledge the morbidity in the foot and at the donor site has not been properly investigated. We investigated sensorial morbidity in the foot and at the donor site caused by raising a saphenous neurocutaneous flap in 14 patients by using static two-point discrimination test, Semmes-Weinstein monofilament test, vibration test, and by measuring somatosensory evoked potentials in the twelfth postoperative month. Our results suggest that sensory recovery is good and protective sensation is gained in most patients.

Adult↗

PubMed2004

Can indications for lower limb replantation and revascularization be expanded with simultaneous free-flap transfer for limb salvage?

High-energy trauma from road accidents and work-related injuries is the most common cause of lower-limb traumatic amputations. Many of these cases require extensive debridement and substantial bone shortening for primary closure because of crushing and/or avulsion of the involved parts. Since 1998, the authors have replanted or revascularized five lower limbs in five patients. Free tissue transfers have been used to cover soft-tissue defects during replantation and revascularization in all patients. The numbers and kinds of free flaps include one latissimus dorsi muscle, two transverse rectus abdominis musculocutaneous (TRAM), and two anterolateral thigh fasciocutaneous flaps. Survival of the replanted and revascularized limbs and transferred flaps was obtained in four patients. Below-knee amputation was performed because of flap necrosis and extensive infection in one patient. Simultaneous free-tissue transfers may be used simultaneously with lower limb replantation or revascularization to obtain functional extremities in appropriately selected patients. The indications for lower limb salvage may be enhanced and successful results may be obtained in one stage, with low complication rates and shorter hospital stays. The authors report their experience with simultaneous free tissue transfers and lower limb replantation or revascularization.

Adolescent↗

PubMed2004

Increasing vessel diameter with the open Y technique for diameter discrepancy.

Free tissue transfers have increasingly become the mainstay of plastic surgery for the last two decades. Size discrepancy between the vessels in microsurgery is frequently encountered in clinical practice and may potentially be an important factor in the patency of the anastomosis. A rat model has been devised to improve the diameter discrepancy in microvascular anastomosis. Twenty Wistar rats have been used for this purpose. The external jugular vein was cut 1 mm distally from the bifurcation of the anterior and posterior facial veins. Both legs of the resultant Y-shaped vessel were united after inserting microscissors from one leg and exiting from the other. Performing an end-to-end anastomosis between the vein, which acquired an increased diameter as a result of this procedure, and the carotid artery prepared in the neck, helped to create an arteriovenous shunt. Patency was assessed in the operated rats 2 weeks later. In order to achieve a better understanding of the advantages of this technique, another study was carried out. In this subsequent study, specimens were collected from fresh sheep cadavers, including the brachiocephalic trunk, right common carotid, and right subclavian arteries. Different specimens were compared from each of the vessels and also from each of the subclavian and carotid arteries after they were joined together with the open Y technique and increased diameters of the vessels are obtained. As a result, the authors demonstrated that size discrepancy between the vessels was decreased, patency with a percentage of 94.1 was obtained, and when specimens from the fresh cadavers were evaluated, a reasonable gain was achieved. (p < 0.0001).

Anastomosis, Surgical↗

PubMed2004

Using silicone gel sheet for the treatment of facial telangiectasias with sclerotherapy.

BACKGROUND: Telangiectasias are superficial cutaneous vessels that are visible to human eye and are present as a dilated venule, capillary, or arteriole. They are a common cause of concern, especially when located in face. Sclerotherapy is among the treatment alternatives, but facial telangiectasias are less responsive than those located on the leg. OBJECTIVE: To show the effectiveness of silicone gel sheet in improving the results obtained by sclerotherapy in facial telangiectasias. METHODS: Between 1998 and 2003, 32 patients were treated with sclerotherapy and silicone gel sheet (group 1). Twenty-six patients were treated with sclerotherapy and cotton ball (group 2), and 30 patients were treated only sclerotherapy (group 3). Patients were evaluated for 12 weeks for the degree of improvement and side effects. All complications, side effects, and number of sessions were also recorded at each follow-up visit. The number of sessions is limited to six. After the final follow-up visit, the photographs taken of each treatment site at baseline and at final visit were reviewed in a double-blinded manner based on a 0 to 4 scale by two physicians. RESULTS: Fifty one of the 88 patients showed improvement totally. In the silicone sheet-sclerotherapy group, 22 of the 36 patients showed improvement. In the sclerotherapy-cotton ball group, 14 of the 26 patients showed improvement, and in the sclerotherapy-only group, 15 of the 30 patients showed improvement completely within the 12 weeks. The patients treated with sclerotherapy-silicone gel sheet (group 1) had more improvement than the other groups. CONCLUSION: Combining silicone gel sheeting to sclerotherapy increases the success rate in treating facial telangiectasias, especially facial subunits, which have bone support.

Adolescent↗

PubMed2003

Use of honey as an adjunct in the healing of split-thickness skin graft donor site.

BACKGROUND: Different techniques are being used in treatment of split-thickness skin graft donor sites; however, there is not a widely accepted method established for these partial-thickness wounds. It is well known that honey has been very effective in the treatment of various types of wounds, but there is not any information about the usage of honey as split-thickness skin graft donor site dressing in the literature. OBJECTIVE: To evaluate and compare the effectiveness of honey-impregnated gauzes, hydrocolloid dressings, and as a conventional dressing, saline-soaked gauzes for skin graft donor sites. METHODS: This is a nonrandomized, prospective, open-label (noncontrolled), side-by-side comparison trial of various options that are available for second-intention healing of donor site for split-thickness skin grafts. Eighty-eight patients who underwent skin grafting were observed using two different groups. In the first group, the donor site was divided into two equal halves, with each half being treated with honey-soaked gauzes and the other half with paraffin gauzes (group 1A), hydrocolloid dressings (group 1B), and saline-soaked gauzes (group 1C) alternatively. In the second group, two separate donor sites were formed, with one of them being treated with honey-impregnated gauzes (groups 2A-C) and the other one treated with either paraffin gauzes (group 2A), hydrocolloid dressings (group 2B), or saline-soaked gauzes (group 2C). The healing time, rate of infection, and sense of pain were evaluated. RESULTS. : In the treatment of split-thickness skin graft donor sites, honey-impregnated gauzes showed faster epithelization time and a low sense of pain than paraffin gauzes and saline-soaked gauzes. There was no significant difference between honey-impregnated gauzes and hydrocolloid dressings with regard to epithelization time and sense of pain. CONCLUSION: The use of honey-impregnated gauzes is effective, safe, and practical. Honey can be an alternative material for the split-thickness skin graft donor site treatment.

Adolescent↗

PubMed2003

Immediate use of medicinal leeches to salvage venous congested reverse pedicled neurocutaneous flaps.

Reverse pedicled neurocutaneous flaps have recently become popular for reconstructing soft tissue defects of the lower extremity. Venous congestion is a relatively common problem in these flaps in diabetic patients and those with electric burns, and this may cause partial or complete loss if capillary perfusion is not re-established urgently. We describe our experience of 13 neurocutaneous flaps, of which five developed venous congestion and were treated successfully with leeches placed immediately.

Adult↗

PubMedDate not supplied

Familial severe gigantomastia and reduction with the free nipple graft vertical mammoplasty technique: report of two cases.

BACKGROUND: : Gigantomastia, characterized by massive breast enlargement during adolescence or pregnancy, is thought to be caused by an abnormal and excessive end organ response to a normal hormonal milieu. The amputation technique with the free nipple-areola graft is the mainstay for severe macromastia, but it has been criticized because it results in a flattened, nonaesthetic breast with poor projection. This report presents two sisters with unusual, excessive breast enlargement. METHODS: : The measured distance from the sternal notch to the nipple was 50 cm for the first case and 55 cm for the second case. The free nipple graft transplantation based on the vertical mammoplasty technique was used, and an average of 4,200 g of breast tissue per breast was removed. To increase breast projection, superior dermoglandular flaps were used RESULTS: : The follow-up period was 24 months. The patients had long-lasting, pronounced breast mound projection, and the level of satisfaction for both cases was very high. CONCLUSION: The ideal geometric structure of the breast is rather conical, and the authors believe that reshaping the breast tissue in a vertical plane using the vertical mammoplasty technique may be more effective in the long term and may provide better projection.

Female↗