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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.)

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]

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: Mortality and morbidity in burn cases can be reduced with early diagnosis. Many markers are used for early diagnosis of burn complications like sepsis. In this current study, the relationship between numerical/morphologic granulocyte abnormalities and complications was investigated in pediatric burns. It was aimed to introduce histopathologic marker(s) for burn-related complications., Methods: Thirty-two pediatric burn cases hospitalized between December 2006 and December 2009 were included in the study. A total of 192 complete blood count and peripheral blood smear results were analyzed comparatively. Findings were used to identify any correlation among white blood cell count and peripheral blood smear changes (the appearance of immature granular cells, toxic granulation, purple granules and Döhle bodies) and complications such as bacteriemia, sepsis, wound infections, severe anemia, and graft failure., Results: White blood cell count changes and the appearance of immature granular cells were not suitable for use as a diagnostic marker for complications. Nevertheless, there was a statistically significant correlation between the appearance of toxic granulation, purple granules and Döhle bodies and subsequent complications (p: <0.0001, 0.041, 0.001, respectively)., Conclusion: Toxic granulation, purple granules and Döhle bodies appear to be helpful in predicting burn-related complications. Therefore, peripheral blood smear is a suitable test for predicting future complications.