Search

Introduction: Percutaneous revascularization is one of the interventions through which results are obtained quite quickly among the current treatment of blockage artery diseases. In fact, the success achieved is lower than expected due to stenosis formation and spontaneous thrombosis. Vascular endothelial damage after endovascular interventions causes it to become a sticky surface for leukocytes and platelets, the distortion of the normally smooth surface through which the blood moves nonstop causes an increase in adhesion and procoagulant activities and permeability. While many cytokines, vasoactive molecules, and growth factors are released intermittently, if the inflammatory response is not suppressed in some way, the accumulation of extracellular matrix occurs with smooth muscle cell migration and proliferation in the vascular wall. This process, known as neointimal hyperplasia, has become a nightmare for many surgeons. As the known physiopathological mechanism of restenosis began to be understood, many pharmacological agents, mechanical agents were developed to prevent this process and tested with animal and human clinical trials. In our study, we aimed to show the inhibitive effect of cilostazol on neointimal hyperplasia by giving the experimental animal model an oral way. Methods: Intimal damage was created in the control and experiment group using the rat carotid artery balloon damage model. A group of animals was reserved as a Sham group. Preparations obtained from rat common carotid after oral cilostazol treatment for 2 weeks were evaluated histopathologically. Their statistical significance was observed. Results: In within-group analyses, while no difference was observed among themselves, in cross-group analyses, in terms of intimal thickening, a significant difference was found between Group 1 (Sham) and Group 2 (Control), Group 2 and Group 3 (Experiment), however, between Group 1 and Group 3, no statistically significant difference was detected. In light of these results, we reached the conclusion that cilostazol has an inhibitive effect on intimal hyperplasia when taken through the oral path. On the other hand, when comparing intimal and medial thickness rates, that the low artery intima/media ratio was found only in the experimental group, shows that the endothelial damage created in the intima was limited by cilostazol and decreased neointimal hyperplasia unrelated to the media layer. Discussion and Conclusion: This drug whose systemic and topical effectiveness has been detected previously, would yield positive results not only in patients with peripheral artery disease, but also in peripheral artery patients with symptoms of claudicatio intermittence because of the fact that it shows the most effective and direct impact when administered orally, it is easy to use and its absorption is quite high. [ABSTRACT FROM AUTHOR]

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bagcilar Medical Bulletin / Bağcılar Tıp Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bagcilar Medical Bulletin / Bağcılar Tıp Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Fournier's gangrene, traumatic lesions and excision of scrotal skin lesions can all lead to significant scrotal defects. The perineum's diverse bacterial flora, difficulties in providing immobilization, and achieving a natural surface of the testes make testicular cover challenging. Several methods have been described to reconstruct the penoscrotal area. This report aims to present the medial circumflex femoral artery perforator (MCFAP) flap technique in this difficult area. Method: From January 2019 to September 2022, 12 male patients underwent scrotal reconstruction in our clinic using the MCFAP flap due to Fournier's gangrene. These patients were retrospectively evaluated according to age, gender, comorbidities, defect size, donor area, perforators, length of hospital stay, follow-ups and complications. Results / Discussion: In all cases complete scrotal coverage was accomplished with the MCFAP flap. The resulting scrotal shape was satisfactory (Fig. 1). Contamination was controlled by colostomy. In two patients venous insufficiency, and in three patients wound dehiscence was seen. Venous insufficiency improved with leech therapy. Detachments were healed by secondary suturing. Conclusion: For perineoscrotal defects, the MCFAP flap offers a minimal donor site deformity, a one-stage procedure, and an acceptable scrotum-like shape. Additionally, it can be used as a chimeric flap, that includes the gracilis muscle. According to our findings, MCFAP is a superior local flap amongst the limited reconstructive options in this challenging area. Because this flap protects the testicle without raising its temperature, it also gives the testes a pliable local flap without being bulky. Figure 2. The MCFAP flap can reach an axial rotation of 180°. [ABSTRACT FROM AUTHOR]

Aim: Debridement is crucial for facilitating healing in a problematic wound. There are various debridement methods available. The most common way is surgical debridement; however, it cannot be applied to patients with comorbidities or poor general condition. Maggot therapy (MT) is one of the non-surgical treatments that have been applied to a variety of wounds. This study aims to assess the efficacy of maggot therapy. Method: Ten chronic wound patients who applied to our outpatient clinic between 2019 and 2022 received MT. These patients were retrospectively evaluated according to wound type, age, gender, comorbidities, second procedures, recovery, pain level and complications. Results / Discussion: There were three female and seven male cases. The average age was 61. Six patients were diagnosed with diabetic foot and four with sacral decubitus. Seven patients were found to be at risk for an operation due to additional comorbidities. MT provided appropriate area debridement and infection control in this high-risk group. Clean wound tissues were left for secondary healing. In the remaining three cases, MT was used to prepare for an operation. A clean wound bed and optimal granulation tissue were observed (Fig. 1. B,D). Patients with osteomyelitis did not have any negative effects. In 60% of cases, complaints such as disgust and irritation called 'Yuk' factor from the applied larvae were observed. Conclusion: MT decreases time to healing as well as in surgical contraindications. Moreover, this therapy may decrease the risk of major amputations and reduces the need for systemic antibiotics. In spite of lacking clinical evidence, it may be a valuable alternative to surgical debridement according to our clinical experiences. [ABSTRACT FROM AUTHOR]

Objective: Starting in December 2019 in Wuhan, China, COVID-19 which was defined as a severe acute respiratory syndrome has become a global epidemic in a short period of time. Burn is a type of trauma during which the immune system is weakened due to changes in the leukocytelymphocyte distribution in the clinical presentation of blood, decreased chemotaxis and phagocytosis activity of granulocytes, decreased T cell activity and changes in their distribution, changes in humoral immune elements, and being susceptible to bacterial wound infections and is very common in all countries of the world. We aimed to evaluate the effects of COVID 19 pandemic on burn patients demographically and to share our experiences on preventing COVID 19 infection which may be superposed to burn patients, and on preventing health workers and public health, and our new treatment algorithm with our colleagues from different nations. Method: We statistically interpreted the effects of the new life process that entered our lives with applications such as curfew, closure of workplaces or slowing down work during the pandemic process aiming at controlling the infection on the differences in the demographic distribution of burn demography and its sociology by comparing the data of 3 consecutive years. Results: While the data of the years did not show significance according to the months, a significant difference was found between the data of the previous 2 years and the data of 2020 between the gender, the types of burn and the time of first admission to the hospital. Conclusions: We believe that the fact that all burn physicians are experiencing similar things on the international platform is going to enable us to create our algorithms in a short time for a common treatment and follow-up approach to burn patients during the pandemic. [ABSTRACT FROM AUTHOR]

Generally dorsal hand defects are often closed with a flap. Dorsoradial forearm artery flap has generally been used in thumb defects; however, it can also be used in the reconstruction of dorsal hand defects thanks to its wide rotation arc and appropriate pedicle length. In this case report, we presented the outcome of a case where the dorsoradial forearm flap was applied to treat the dorsal hand defect. A 27-year-old patient was admitted to emergency room with trauma on hand. Fixation of metacarpal bone fractures was performed. The dorsoradial forearm flap was elevated and inserted in order to close an opening exposing bones and tendons in the dorsum of hand. There was no complication with flap viability in the postoperative period. Patient's joint range of motion and vital functions were acceptable. Dorsoradial forearm flap, which is generally used in thumb reconstruction, can also be used in dorsal hand defects. [ABSTRACT FROM AUTHOR]

Congenital isolated anomalies of nasal cartilages are very rare and the etiology is still not fully understood. Although congenital defects of the lower lateral cartilage are usually associated with functional or major cosmetic problems, they may also occasionally be presented as asymptomatic and incidental. Although their superiority to each other is not well known, several methods have previously been described for reconstruction of the defect with autologous cartilage grafts or allogenic grafts. With proper intraoperative planning, satisfactory results can be achieved in rhinoplasty operation in such cases. In this article we aimed to present a case of congenital unilateral isolated total lower lateral cartilage absence in a patient without any functional complaints and the reconstruction of it with autogenous cartilage graft. [ABSTRACT FROM AUTHOR]

Aim: There are several methods for covering post-traumatic soft tissue defects, such as skin grafts or flaps. However, these options have some limitations, including a paucity of suitable adjacent tissue, and exposure of neurovascular, bony, or cartilage structures. Therefore, alternative dermal substitutes have been developed for soft-tissue defects. Matriderm® (Dr. Suwelack Skin and Health Care AG, Billerbeck, Germany), a single-layer dermal matrix, has been used often in burn treatment. This study aims to present the use of a dermal matrix in reconstructive surgery. Method: A 39-year-old male presented to the emergency department with a complaint of total amputation of the right ear due to a dog bite. Surgical debridement and proper antibiotic therapy were administered. A two-stage ear reconstruction was then planned using a costal cartilage graft. After the first stage of ear reconstruction surgery, it was noticed that the skin flap on the cartilage prefabrication was thinner, there were detachments in the infected suture lines (Fig. 1). The infected wound was debrided. Afterwards, the exposed cartilage prefabrication, which excludes the perichondrium, was covered with a one-mm Matriderm® and a split-thickness skin graft in a single-step procedure. In addition, a vacuum device was applied. Results / Discussion: The presented case had cartilage exposition, in which Matriderm® allowed the host cell to produce a fuller subdermal bed, over which the skin can epithelize. Complete healing of the skin graft was confirmed through outpatient follow-up at 4 weeks postoperatively. Conclusion: The use of Matriderm® in combination with a skin graft in exposed structures is a simple, feasible method. Therefore, Matriderm® can be indicated in reconstructive surgery, where flap options are limited. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Surgery & Medicine (JOSAM) is the property of Journal of Surgery & Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background In our study, we investigated graft viability, Growth Hormone (GH), Insulin-like growth factor (IGF)-1, and IGF-binding protein (IGFBP)-3 in autograft-transplanted pediatric major burn cases. Methods This descriptive study was conducted with the participation of pediatric patients with major burn wounds. The laboratory data and characteristics of the patients were accessed retrospectively, and the obtained data were recorded in the data form developed by the researchers. In the analysis of the data, descriptive statistical methods, chi-squared test, Wilcoxon signed-rank test, one-way ANOVA, and post hoc analyses were used. Results The sample of our study consisted of 93 pediatric major burn patients with a total burnt body surface area of more than 20%. It was found that 65.59% of the patients were between the ages of 1 and 5, 63.43% of them were in the 41–55 percentile range, 58.06% had a hot liquid burn, 74.2% had a second-degree burn, 60.21% had a burn percentage in the range of 21–40 of their total body surface area. It was determined that the GH and IGF-1 levels of the patients who experienced loss after graft transplantation remained below the normal value in the first 14 days, and the differences in the GH and IGF-1 values between the patients with good functioning grafts and those with graft loss were statistically significant (p < 0.01). It was found that the IGFBP-3 value remained low on the 14th day in the patients with good functioning grafts, and the difference in the IGFBP-3 values between the patients with good functioning grafts and those with graft loss was statistically significant (p < 0.05). Conclusion Today, it is known that the parameters of GH, IGF-1, and IGFBP-3 are related to many problems. However, no study examining their relationships with graft viability in autograft-transplanted pediatric patients with major burns was encountered. Our study may be the first to determine that changes in these three laboratory parameters negatively affect the healing of burn wounds. [ABSTRACT FROM AUTHOR]