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Biomedical subjects

Bahattin Celikoz

Publications and source records attributed to Bahattin Celikoz.

14 recordsLinked to original sources

Use of rhomboid flap and double Z-plasty technique in the treatment of chronic postburn contractures.

BACKGROUND: Multiple reconstructive methods have been used for the treatment of postburn scar contractures including skin grafting, geometric relaxation techniques, local flaps and free flaps. PURPOSE: In the present study, the authors evaluated efficiency of the use of rhomboid flap and double Z-plasty technique in the treatment of chronic postburn contractures. METHODS: Twelve white male with postburn scar contracture were treated using rhomboid and double Z-plasty technique. The cause of burn, duration of contracture, postoperative follow-up period, preoperative and postoperative motion lag of joints and improvement in motion were recorded. CONCLUSIONS: All operations were successful. Severe contracture lines crossing flexion folds can be released effectively by using rhomboid flap and double Z-plasty technique without distorting the specialized flexion areas and with broken scar lines which is essential to avoid from recurrence.

Adult↗

Camouflage of self-inflicted razor blade incision scars with carbon dioxide laser resurfacing and thin skin grafting.

BACKGROUND: Self-cutting using a razor blade is a type of self-mutilating behavior that leaves permanent and socially unacceptable scars with unique patterns, particularly on the upper extremities and anterior chest wall. These scars are easily recognized in the community and become a source of lifelong guilt, shame, and regret for the self-mutilators. In the presented clinical study, we aimed to investigate the effectiveness of carbon dioxide laser resurfacing and thin skin grafting in camouflaging self-inflicted razor blade incision scars. METHODS: A total of 26 anatomical sites (11 upper arm, 11 forearm, and four anterior chest) of 16 white male patients, whose ages ranged from 20 to 41 years (mean, 23.8 years), were treated between February of 2001 and August of 2003. Detailed psychiatric evaluation preoperatively; informing the patient that the procedure is a "camouflage" operation; trimming hypertrophic scars down to intact skin level; intralesional corticosteroid injection to hypertrophic scars; carbon dioxide laser resurfacing as a single unit; thin (0.2 to 0.3 mm) skin grafting; compressive dressing for 15 days; use of tubular bandage; and protection from sunlight for at least 6 months constituted the key points of the procedure. RESULTS: The scars were successfully camouflaged and converted to a socially acceptable appearance similar to a burn scar. Partial graft loss in one case and hyperpigmentation in another case were the complications. No new hypertrophic scar developed. CONCLUSIONS: The carbon dioxide laser resurfacing and thin skin grafting method is effective in camouflaging self-inflicted razor blade incision scars.

Adult↗

Treatment of severely contracted fingers with combined use of cross-finger and side finger transposition flaps.

BACKGROUND: In the present study, the authors combined use of the cross-finger flap and the side-finger transposition flap to cover the skin and soft-tissue defect created by contracture release of severely contracted fingers. METHODS: Eight patients having Stern type III flexion contractures of the proximal interphalangeal joints were included. The cause of injury was burn in six patients and trauma in two patients. The average follow-up period was 11.6 months. RESULTS: All operations were successful. Lack of extension of the proximal interphalangeal joint was improved by approximately 81.2 degrees for all digits. CONCLUSION: Stern type III contracture of the proximal interphalangeal joint can be released by transverse incision and ample resection of scarred tissue, and the resulting palmar skin defect that cannot be covered by using the finger's own flaps or cross-finger flap can be covered by combined use of cross-finger and side-finger transposition flaps.

Adult↗

Nerve regeneration through a healthy nerve trunk: a new and hopeful conduit for bridging nerve defects.

BACKGROUND: Considering a healthy nerve trunk as the hypothetically ideal conduit, a new experimental model using an intact nerve for bridging a nerve defect was contemplated. METHODS: Thirty rats were used. In group I (double coaptation), a segment was removed from the peroneal nerve. Both the proximal and distal stumps were repaired end-to-side to the tibial nerve. In group II (only distal coaptation), only the distal nerve stump was repaired. In group III (control), the transected segment was immediately repaired primarily in its original orientation as a nerve graft. A walking track analysis was conducted periodically for 28 months. The horseradish peroxidase retrograde labeling technique was used for tracking the origin of the axons presented in the distal stump of the peroneal nerve in group I, and morphologic studies were also carried out for all the groups. RESULTS: Functional assessment revealed that the difference between group I and group II was significant. The horseradish peroxidase labeling test suggested that the nerve fibers in the distal stump of the peroneal nerve were mostly from its original proximal stump passed by the way of the tibial nerve bridge. CONCLUSION: This study suggested that the axons of the proximal stump of a sectioned nerve can sprout into another intact nerve trunk by the way of an end-to-side repair site, regenerate, and advance in its epineurium distally for a distance and pass into its original distal stump if it was repaired end-to-side. It was thought that the technique could be used in clinical cases with short nerve defects as an alternative method to grafts and conduits.

Anastomosis, Surgical↗

Carbon dioxide laser therapy for an inflammatory linear verrucous epidermal nevus: a case report.

The treatment of an inflammatory linear verrucous epidermal nevus (ILVEN), an uncommon type of epidermal nevus, is still controversial. The use of laser therapy is a recently reported method. Although various results have been reported with the use of the laser in the treatment epidermal nevis, the authors have not seen any report on the use of the carbon dioxide laser in ILVEN treatment. They present case of ILVEN treated with the carbon dioxide laser. All symptoms (erythema, excoriation, granulation, and pruritus) disappeared. Instead, a pale pigmentation was seen.

Adult↗

Y-shape hard palate mucoperiosteal graft and V-Y advancement flap in the reconstruction of a combined defect involving lateral canthus and upper and lower eyelids.

Curative ablation of a baso-squamous cell carcinoma of lateral cantus and both eyelids resulted in a complex full-thickness defect of upper and lower eyelids, lateral canthal area, and lateral canthal tendon. The reconstruction of the defect was performed in a single stage using a Y-shape hard palate mucoperiosteal graft and a Y-shape skin flap advanced from the temporal side of the defect on its subcutaneous pedicle. The graft donor site healed spontaneously and the flap donor site was closed primarily. A durable and stable coverage of the defect could be achieved with minimal donor site morbidity.

Aged↗

Management of maxillofacial problems in self-inflicted rifle wounds.

Severe gunshot wounds to the face, produced by high-velocity rifles or shotgun blasts, present a formidable challenge to reconstructive surgeons. In this study, the results of 14 cases with gunshot wounded faces caused by fire from rifles are presented, and the principles of the management of those victims were determined. These patients had attempted to commit suicide and placed the muzzles of the rifles beneath their chins. The ages of the patients ranged from 20 to 24 years, with a mean age of 22 years. These wounds were caused by close-range gunshots (<10 cm), and the missiles had high velocity (more than 800 m/second). All patients had wounds in their submental triangle areas. The exit sites of the missiles differed among patients. All exit wounds were in the angle limited by the deviation from the gun-barrel axis. After clinical and radiologic evaluation and conservative debridement of all devitalized tissues, the fractures were reduced and stabilized appropriately. Large bony defects were treated by bone grafting, and all soft tissue lesions were closed in layers. The entrance and exit sites were covered primarily after thorough debridement except one case whose defect was reconstructed with bilateral sternocleidomastoid (SCM) flaps, one for submental skin and the other for the mouth floor. Intraoral soft tissues were then repaired by primary closure, tongue flaps, or SCM flaps in case they were necessary. Free tissue transfers were not required for treatment of secondary soft-tissue problems. Resolution of tissue edema, softening of scars in time, and insertion of bone graft may improve the deformity significantly. The initial anatomic reconstruction of the existing bone skeleton and the maximal use of regional tissue for cutaneous reconstruction provide an esthetic appearance that can never be duplicated by secondary reconstruction.

Adult↗

Carbon dioxide laser resurfacing and thin skin grafting in the treatment of "stable and recalcitrant" vitiligo.

Various surgical methods have been used in the treatment of small stable vitiliginous areas, but there is no established surgical approach for larger vitiligo areas and therapy-resistant anatomic sites, such as the hands. Two years ago, we successfully treated large burn scar depigmentation areas at different anatomic sites using carbon dioxide laser resurfacing and thin (0.2 to 0.3 mm) skin grafting. The purpose of this study was to investigate the effectiveness of our method in treating large, stable, and recalcitrant vitiligo areas. Thirteen anatomic sites of seven male patients, whose ages ranged from 20 to 22 years, were treated. The locations of the treated areas were as follows: seven areas on the dorsum of the hands, two areas on the forearms, two areas in the pretibial region, one area on the lateral thigh, and one area in the presternal region. The surface area of treated vitiligo sites ranged from 0.5 to 6 percent of total body surface area (mean, 2.5 percent). Skin graft take was excellent in all patients except for one. The follow-up period for these patients ranged from 6 to 18 months, with an average follow-up period of 14 months. Early and complete repigmentation was achieved and the color match was good or excellent in all patients. No depigmentation occurred again in the treated areas or graft donor sites. In conclusion, with careful patient selection and delicate surgical technique, our method was effective in treating large areas of vitiligo over the extremities and dorsum of hands, which were refractory to other therapies and could not be hidden.

Adult↗

Various applications of the medial plantar flap to cover the defects of the plantar foot, posterior heel, and ankle.

The medial plantar fasciocutaneous flap provides structurally similar tissue to plantar foot, posterior heel, and ankle defects with its thick glabrous plantar skin, shock-absorbing fibrofatty subcutaneous tissue, and plantar fascia. During the past 4 years, 24 patients (20 men, 4 women) with skin and soft-tissue defects over the plantar foot, posterior heel, or ankle were treated. They ranged in age from 20 to 42 years (mean, 24 y). The medial plantar flap was transposed to the defects in four different ways: proximally pedicled sensorial island flaps (N = 18), reverse-flow island flaps (N = 2), free flaps (N = 2), and cross-foot flaps (N = 2). Flap size varied from a width of 2 to 5.5 cm and a length of 5 to 7.5 cm. The follow-up period ranged from 2 to 18 months (mean, 9 mo). Partial flap loss was observed in one free flap and one reverse-flow island flap. Partial skin graft lost in the donor site required regrafting in one patient. Durable, sensate coverage of the defects was achieved in all patients.

Adult↗

Free temporoparietal fascial flaps and full-thickness skin grafts in aesthetic restoration of the nose.

Free tissue transfers have been rapidly replacing distant flaps for use in nasal reconstruction. The temporoparietal fascial flap is a thin, broad, pliable, and well-vascularized flap. It can be used to drape over the cartilaginous and bony framework of the nasal skeleton and nourish the underlying primary cartilage grafts as well as the overlying full-thickness skin graft. The thin contour of the flap is aesthetically superior to thicker skin flaps and eliminates the need for secondary defatting or touch-up procedures. A large, single sheet of full-thickness skin graft, harvested from the supraclavicular region, can be applied over the fascial flap in the same session and provide a quite acceptable color match. The authors present a case whose alar margins and atrophic nasal skin were restored in one session by primary conchal cartilage grafts, a free temporoparietal fascial flap, and a full-thickness supraclavicular skin graft.

Adult↗

Comparison of silver sulfadiazine 1%, mupirocin 2%, and fusidic acid 2% for topical antibacterial effect in methicillin-resistant staphylococci-infected, full-skin thickness rat burn wounds.

Silver sulfadiazine 1%, mupirocin 2%, and fusidic acid 2% were compared to assess the antibacterial effect of a once-daily application on experimental rat 15% full-skin thickness burn wounds seeded 24 hours earlier with a 10 standard strain of methicillin-resistant staphylococci. The quantitative counts of seeded organism in burn eschar and subjacent muscle were determined at postburn day 7, beside the cultures of blood and lung biopsies. All tested topical agents were equally effective against methicillin-resistant in reducing local burn wound bacterial count and preventing systemic infection.

Administration, Topical↗