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Biomedical subjects

Tayfun Aköz

Publications and source records attributed to Tayfun Aköz.

At least 19 recordsLinked to original sources
PubMed2006

One-stage reconstruction of large scalp defects: anterolateral thigh flap.

Seven patients with large scalp and calvarial defects underwent reconstruction with free tissue transfer. Patients fell into two groups according to etiology: tumoral (five) or traumatic (two). A single type of free flap was used in each patient, i.e., the anterolateral thigh flap. Duraplasties with the flaps' vascularized fasciae were performed in two patients with minor calvarial defects, and nonvascularized fasciae were used in another two, with a cranioplasty using methylmethacrylate. One postoperative death and one venous congestion necessitating exploration were observed. The explored anastomosis revealed occlusion of the venous anastomosis; drainage with a venous graft into the neck veins was performed. Minor tissue loss with secondary healing was observed in the flap. Extensive scalp defects often necessitate challenging reconstructive procedures. Single-stage reconstruction with good qualified tissue is possible with a free tissue transfer. The anterolateral thigh flap provides a large amount of tissue with decreased donor-site morbidity and good cosmetic results.

Adult↗
PubMed2006

"Open y" technique in vessel diameter discrepancy.

For the last 20 years, free tissue transfers have increasingly become the mainstay of plastic surgery. Size discrepancy between the vessels during tissue transfers are frequently encountered in clinical practice, and this may potentially be an important factor in the patency of anastomosis. In our clinic, we first studied a rat model and a fresh sheep cadaver to improve the diameter discrepancy in microvascular anastomosis with "open y" technique. At the end of our research, we progressed to success, and the open y technique was applied to nine patients in our clinic with a diameter discrepancy in microvascular anastomosis. After finding the bifurcation of vessels (artery, vein, or a vein graft) that are prepared for anastomosis, a distal cut of 2-3 mm was made for the anastomosis, which is considered to increase the diameter. Both legs of the resultant "y"-shaped vessel were united after inserting the microscissors from one leg and exiting from the other. Performing an end-to-end anastomosis between the vessels, we obtain an increase in the diameter. By using this method, we eliminated the diameter discrepancy in microvascular anastomosis in nine patients in our clinic. There was not any flap loss. To increase the usage of this technique, when we come across a problem of size discrepancy, it is important to use the open y technique, both to the recipient vessels, donor vessels, and to the vein grafts. Owing to its high prevalence and the ease of application, we are convinced that this is a suitable technique in appropriate cases.

Anastomosis, Surgical↗
PubMed2006

Reconstruction of crush injuries of the foot dorsum: is the latissimus dorsi muscle flap a reliable choice?

Thirteen patients who underwent 13 latissimus dorsi free flaps for subacute foot dorsum defects were identified over a 4-year period. The average age of the patients was 30.5 years (range: 8 to 52 years). There were eight male, five female patients. The average follow-up was 23 months (range: 2 to 47 months). The soft-tissue defect resulted from motor vehicle accident in all cases. All of the patients presented with soft-tissue loss combined with extensor tendon and/or bone injury. The wounds were treated with serial debridement and free latissimus dorsi or latissimus dorsi-serratus anterior muscle and split-thickness skin graft coverage in all cases. The mean size of the flaps was 19 x 11 cm (range: 15 to 24 cm x 9 to 16 cm). Twelve of 13 flaps survived. Complications included infection (1 case), seroma in the donor region (2 cases), total flap failure (1 case), partial flap necrosis (2 cases), and wound dehiscence (2 cases).

Adolescent↗
PubMed2006

Reconstruction of large orbital exenteration defects after resection of periorbital tumors of advanced stage.

Orbital exenteration is a devastating procedure because of the social impact and psychological stress put upon the patient. Besides cancer ablative surgery, reconstruction after removal of the tumor constitutes a major problem and the final aesthetic result is quite important. Both obliteration of the orbital cavity and continuation of the epithelial lining are required. Free rectus abdominis muscle and musculocutaneous flaps are versatile flaps which both enable filling the cavity and reconstituting the skin defect with a cutaneous portion or with a skin graft. Both free rectus abdominis muscle and musculocutaneous flaps were used for reconstruction of orbital exenteration defects in 19 patients. All suffered partial maxillectomy as well. The flaps provided satisfactory aesthetic results in all patients.

Adult↗
PubMed2006

Free flap choice for soft tissue reconstruction of the severely damaged upper extremity.

Reconstruction of complex wounds of the hand associated with severe bone, tendon, nerve and soft-tissue injuries has been a major problem in hand surgery. Early definitive soft-tissue coverage of this kind of extensive wound with well-vascularized tissue is one of the most important stages of reconstruction for salvage of the extremity and restoration of function. Although multiple free flap donor sites have been described for complex upper extremity wounds, the authors think that anterolateral thigh (ALT) and lateral arm (LA) flaps are good choices for soft-tissue reconstruction in the upper extremity because of their reconstructive characteristics. These flaps can be used as flow-through and also sensate flaps. There is no need for position change intraoperatively and two teams may work simultaneously. Donor sites can be hidden and there is no required sacrifice of major artery or muscle.

Adolescent↗
PubMed2006

Combined reconstruction of complex defects of the chest wall.

Defects of the chest wall are often encountered, and good results can be obtained both cosmetically and functionally from their treatment. We treated 13 patients with full thickness chest wall defects. Follow up ranged from 12 days to 19 months. Three had had recurrent breast carcinoma, seven relapse after excision of a sarcoma, two had had lesions of the chest wall after irradiation, and one had a sternal fistula. Local skin, musculocutaneous and free latissimus dorsi and anterolateral thigh flaps were done to cover soft tissue. Fascia lata, polypropylene (Marlex) mesh, and Marlex mesh-methylmethacrylate sandwich prosthesis, were used to stabilise the skeleton in nine patients. Two of the patients died postoperatively, one early. The use of Marlex mesh-methylmethacrylate sandwich prostheses for the stabilisation of the skeleton and local musculocutaneous flaps for covering soft tissues after resection of three or more ribs is effective.

Adolescent↗
PubMed2006

Composite anterolateral thigh-fascia lata flap: a good alternative to radial forearm-palmaris longus flap for total lower lip reconstruction.

BACKGROUND: Major defects of the lower lip are challenging to the reconstructive surgeon. The major goals in treating total lower lip defects are reconstruction of the external skin and mucosal lining and maintenance of oral competence and sphincter function. The authors describe reconstruction of total lower lip and larger full-thickness defects including the cheek and commissure by means of a composite anterolateral thigh-fascia lata free flap. METHODS: The flap was harvested with 5-cm fascial extensions at the superior and inferior margins. The flap was folded over the fascia lata to restore the intraoral lining and cover the external skin defect. Fascia lata extensions were divided longitudinally into two fascial strips at both margins of the flap. Two strips were tunneled through the orbicularis muscle in the upper lip and sutured to each other and to the orbicularis muscle. The remaining two strips were anchored to the zygomatic bone periosteum by permanent sutures. This procedure was used in 11 patients. RESULTS: In all cases, disease was advanced squamosus cell carcinoma. The patients' ages ranged from 37 to 72 years. Nine patients had cancer of the lower lip and two patients had a buccal cancer involving the lip. The entire lower lip, bilateral modiolus, and part of the cheek were resected in all patients, and mandibulectomy was performed in three patients. Flap survival was 100 percent. One patient died 10 days after the operation because of cardiopulmonary arrest. At the end of the 1-year follow-up period, all patients had good oral continence at rest and had achieved sufficient oral competence when eating. Eight patients were able to resume a regular diet and two patients could eat a soft diet. CONCLUSIONS: This flap is a good choice for reconstruction of the extensive head and neck defects. We think that anterolateral thigh-fascia lata composite flap has maximum reconstructive capacity and minimal donor-site morbidity. This flap has many advantages over the radial forearm flap and should replace to the composite radial forearm palmaris longus tendon flap when total lower lip reconstruction is concerned.

Adult↗
PubMed2005

Postoperative camouflage therapy in facial aesthetic surgery.

BACKGROUND: This study investigated the effectiveness of makeup camouflage procedures for patients who have experienced social problems because undesirable ecchymoses and edemas after aesthetic surgery, The impacts of camouflage procedures for such patients also were studied. METHODS: For this study, 46 rhinoplasty patients were divided into two groups: postoperative camouflage makeup was used for 23 patients, whereas the other 23 patients were assessed as the control group, Additionally, 18 blepharoplasty patients also were divided into two similar camouflage and control groups. RESULTS: The State-Trait Anxiety Inventory test given to the patients postoperatively indicated that postoperative makeup provided positive effects for patients. CONCLUSION: The current clinical study investigated the effects of cosmetics on the psychological state of patients during the postoperative period and included the application of camouflage makeup for postrhinoplasty and postblepharoplasty patients with edemas and ecchymoses. Psychologically, the patients felt better.

Adolescent↗
PubMed2005

Is surgery an effective and adequate treatment in advanced Marjolin's ulcer?

Malignancies in scars are generally known as Marjolin's ulcers. Between 1999 and 2004, 15 patients with Marjolin's ulcer were treated in our clinic. All lesions were secondary to burns of various causes. We perform a combined approach and aggressive surgery for treatment of Marjolin's ulcer; excision with safe margin, lymphatic dissection, postoperative radiotherapy, chemotherapy and amputation if needed. We think that the scar tissue acts as a barrier for the tumors, which will enlarge. We believe that, if we release this barrier like scar tissue, the virulent the spread of the tumor will be permitted. In this article, we consider whether or not surgical excision alone as recommended in the treatment of Marjolin's ulcers is adequate and effective. An aggressive combined approach is essential for treatment in early stages with high success rate. But there is no consensus for the treatment of advanced disease and results are generally unsuccessful.

Adult↗
PubMed2005

Toe-to-hand transfer from a cross-foot replantation in a traumatic four-extremity amputation.

Treatment of mutilating hand injuries often requires multiple innovative procedures. This report describes a case of multi-limbed amputations from a train injury and the extraordinary microsurgical approaches for a two-hand reconstruction. The first stage of the procedure was a cross replantation of the left foot to the right leg. The second stage was a combined second and third toe transfer from the cross replantation of the left foot to the right hand, and a sensate fibular osteocutaneous flap transfer for left hand reconstruction. Satisfactory function was restored, including good protective sensation. These kinds of extraordinary microsurgical approaches are useful salvage procedures for hand reconstruction, when presented with a case of multi-limb amputation.

Adolescent↗
PubMed2005

Effects of clopidogrel and high dose aspirin on survival of skin flaps in rats.

Clopidogrel is a new antiplatelet agent with a different mechanism of action from aspirin. It is thienopyridine derivative that is chemically related to ticlopidine, which irreversibly inhibits platelet aggregation by selectively binding to adenylate-cyclase-coupled adenosine diphosphate receptors on the platelet's surface. Aspirin is an antiplatelet agent that acetylates cyclo-oxygenase and decreases the products of arachidonic acid metabolism, including thromboxane and prostacyclin. Necrosis of a flap is still an important complication in reconstructive surgery. To investigate the effects of clopidogrel or high dose aspirin on the survival of skin flaps, 30 rats were divided into three groups of 10 animals each: a control group, a clopidogrel group, and a high-dose aspirin group. No pharmacological agents were used in the control group. Of the two treated groups, the first was given clopidogrel 50 mg/kg/day and the second aspirin 200 mg/kg/day for three days before the operation. After seven days the viable areas of each flap were evaluated and the mean (SD) percentage in the control group was 47 (6), in the clopidogrel group 63 (4), and in the aspirin group 65 (5). Although the mean area of flaps that survived in the aspirin group was slightly higher than in the clopidogrel group, the difference was not significant (p = 0.54).

Animals↗
PubMed2005

The true triplication of the thumb: a case of unclassified thumb polydactyly.

A child with true triplication of the thumb is reported. Each thumb has a well-developed metacarpal, and one of them is biphalangeal; the remaining 2 are triphalangeal. Satisfactory result was obtained from a functional and esthetic point of view. Our surgical approach to this interesting anomaly and the necessity of a new group under the Wassel classification for the categorization of different forms of thumb triplications is discussed.

Child↗
PubMed2005

Use of fascia component of the anterolateral thigh flap for different reconstructive purposes.

The anterolateral thigh flap is commonly used for reconstruction of soft-tissue defects located at various sites of the body. This versatile flap offers many advantages to the reconstructive microsurgeons for the treatment of difficult defects. From 2000 to 2005, 70 anterolateral thigh flaps were transferred to reconstruct soft-tissue defects. We retrospectively reviewed these patients and found that the fascia lata component of the flap was used for different purposes in 19 patients. The fascia lata component of the flap was used for suspension of the flap in lip reconstruction in 12 patients, for reconstruction of dural defect in the scalp in 2 patients, for reconstruction of tendon defects in the forearm in 3 patients, and for reconstruction of fascia defect in the abdominal wall in the remaining 2. Complete loss of the flap was seen in an anterolateral thigh flap (5.2%) that was used for lower lip reconstruction. One flap necrosed partially (5.2%), and it was treated with surgical debridement and transposition of latissimus dorsi musculocutaneous flap. The objective of this study is to focus on the reliability of the fascial component of the anterolateral thigh flap. Although many authors have described other advantages of the anterolateral thigh flap extensively, this peculiarity has not been stressed adequately. Anterolateral thigh flap offers a thick and vascular fascial component with large amounts that can be used for different reconstructive purposes, and it should be taken into consideration as an important advantage of the flap, together with other well-known advantages.

Adolescent↗
PubMed2005

[Screw-wire combination technique in the reconstruction of anterior mandible fractures].

BACKGROUND: Fractures of the mandible are among frequently seen facial injuries and their reconstruction requires unique procedures. The purpose of this study is to demonstrate the efficacy of screw-wire combination osteosynthesis technique in the treatment of simple and displaced, symphisis and parasymphisis mandible fractures. METHODS: In our clinic 9 simple and displaced, symphysis and parasymphysis fractures of mandible were treated with screw-wire combination osteosynthesis technique. By intraoral approach 4 screws were applied to both sides of the fracture site 5 mm away from either side placed at superior (n = 2) and inferior (n = 2) localizations. Lower and upper wires were placed bicortically, and unicortically respectively . In order to surround them with wire, the screws were not fully tightened. After surrounding the screws, the wires were tightened in a manner that would properly face the fracture sites mutually. Intermaxillary fixation was applied for 7 to 10 days in all patients. RESULTS: During follow up period we did not encounter infection, malunion, nonunion, delayed union and patient discomfort necessitating extirpation of the materials fixed. CONCLUSION: We think that screw-wire combination technique is an easy and effective method with low cost and fast healing especially in reconstruction of anterior mandible fractures.

Bone Screws↗
PubMed2004

Use of Kirschner wire in mandible reconstruction: a case report and review of the literature.

Reconstruction of massive defects in head the and neck usually requires different tissues such as skin, bone, and muscle in three-dimensional organization. Therefore, reconstruction of mandibular defects in particular include many difficulties for the head and neck, and for reconstructive surgeons. Various techniques and materials are available, and each has some advantages and disadvantages. But no materials or methods have all the reconstructive requirements. The surgeon's choice of techniques should be safe, simple, economic, and effective. We present a patient with a massive facial defect that was reconstructed successfully by using a 2-mm K wire with a free transverse rectus abdominis myocutaneous flap, and we also review the literature about the use of K wires in mandible fixation and reconstruction. We think that K wires should be kept in mind as a readily available, easily applicable, safe, inexpensive, and stable prosthetic material for mandible reconstruction, especially in cases with advanced disease.

Bone Wires↗
PubMed2004

Big-toe replantation in a three-month-old child: case report.

A 3-month-old child underwent successful replantation of her big toe at the level of the metatarsophalangeal joint after traumatic amputation caused by a falling heavy object. The length of the big toe from the metatarsophalangeal joint to the tip was equal to that of the contralateral big toe at a 6-month follow-up. Within 4 months, pain sensation returned to the toe. Traumatic amputation of the big toe is uncommon and only a few articles have been published on its replantation. The case presented here is the youngest patient for big toe replantation in the literature. The big toe plays an important role functionally in walking and standing. In addition, the appearance of the foot without the big toe may be unacceptable from an aesthetic point of view for many people. Reconstructive microsurgeons should not hesitate to replant the big toe in suitable cases, even if patients are only a few months old.

Amputation, Traumatic↗