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Yildirim MEC, Dadaci M, Ince B, Uyar İ, Yarar S, Oltulu P, Aygul R. Evaluation of the effectiveness of the tuba uterina tubular flap in the peripheral nervous system regeneration in rats. J Plast Surg Hand Surg 2021; 56:103-110. [PMID: 34151711 DOI: 10.1080/2000656x.2021.1934844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Nerve conduits could be used to provide a bridge between both nerve endings. In this study, the tuba uterina of female rats were prepared in a vascularized pedicled flap model and it used as a nerve conduit. The aim was to investigate the effectiveness of a vascularized pedicle nerve conduit and its ciliated epithelium in a sciatic nerve defect. The study was conducted between May and August 2018, and used a total of 60, 14-16-week-old female Wistar albino rats. Six groups were created; Cut and Unrepaired Group, Nerve Graft Group, Flap-Forward Group (Tuba uterina tubular flap, forward direction), Flap-Reversed Group (Tuba uterina tubular flap, reverse direction), Graft-Forward Group (Tuba uterina tubular graft, forward direction) and Graft-Reverse Group (Tuba uterina tubuler graft, reverse direction). Nerve regeneration was evaluated 3 months (90 days) after the surgery by the following methods: (1) Sciatic Functional Index (SFI) measurement, (2) Electromyographic (EMG) assessment, (3) Microscopic assessment with the light microscope and (4) Microscopic assessment with the electron microscope. According to the SFI, EMG and microscopic assessments with the light and electron microscope, it was observed that the transfer of tuba uterina tubular conduit as a graft was statistically better in its effect on nerve regeneration than flap transfer, but also indicated that the direction of the ciliated structures had no significant effect. We believe that as this model is improved with future studies, it will shed light on new models, ideas and innovations about nerve conduits.
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Affiliation(s)
- Mehmet Emin Cem Yildirim
- School of the Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University, Konya, Turkey.,Plastic Reconstructive and Aesthetic Surgery Department, Bilecik State Hospital, Bilecik, Turkey
| | - Mehmet Dadaci
- School of the Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University, Konya, Turkey
| | - Bilsev Ince
- School of the Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University, Konya, Turkey
| | - İlker Uyar
- School of the Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University, Konya, Turkey.,Plastic Reconstructive and Aesthetic Surgery Department, Tokat State Hospital, Konya, Turkey
| | - Serhat Yarar
- School of the Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University, Konya, Turkey.,Plastic Reconstructive and Aesthetic Surgery Department, Konya Numune Hospital, Konya, Turkey
| | - Pembe Oltulu
- School of the Medicine, Department of Pathology Konya, Necmettin Erbakan University, Konya, Turkey
| | - Recep Aygul
- School of the Medicine, Department of Neurology, Selcuk University, Konya, Turkey
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Yarar S, Arslan A, Ince B, Yildirim MEC, Oltulu P, Uyar I, Dadaci M. Histopathological evaluation of the effect of hyperbaric oxygen therapy on capsule occurrence around silicone breast prosthesis: an experimental study. J Plast Surg Hand Surg 2021; 55:118-122. [PMID: 33176522 DOI: 10.1080/2000656x.2020.1838296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/23/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND In general, capsular contracture is the underlying cause of complications such as pain, stiffening, breast asymmetry, and animation deformity that are seen in the late postoperative period due to the use of silicone breast prostheses. Considering the positive effects of HBO therapy on wound healing, the objective of this study was to investigate the effect of HBO therapy on capsule reaction occurring due to silicone implants. MATERIAL AND METHODS Rats were divided into four groups. 1 cm × 1 cm silicone implants with rough surface were inserted in subcutaneous plane on the m spinotrapezius muscle fascia at just right of the dorsal region midline in rats in Group 1, while implants with same properties were inserted beneath m spinotrapezius muscle in rats in Group 2.Implants with the same properties were inserted in the subcutaneous area on the m spinotrapezius muscle in rats in Group 3 and into the area under the muscle in rats in Group 4. Beginning from the first postoperative day, rats in Groups 3 and 4 received HBO therapy for 90 min under 2.5 ATM pressure as one session a day over 15 days. RESULTS The mean capsule thickness was statistically significantly lower in the groups treated with HBO compared to the control groups. Fibroblast, neutrophil and macrophage counts were statistically significantly lower in the groups treated with HBO compared to the control groups. CONCLUSION We believe that HBO therapy can be used as an adjuvant treatment options to decrease capsule contraction occurring after silicone implant application.
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Affiliation(s)
- Serhat Yarar
- Konya Numune Hospital, Plastic Reconstructive and Aesthetic Surgery Clinic, Konya, Turkey
- Department of Plastic, Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Abdullah Arslan
- Konya Education Research Hospital, Underwater Medicine and Hyperbaric Medicine Clinic, Konya, Turkey
| | - Bilsev Ince
- Department of Plastic, Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Emin Cem Yildirim
- Department of Plastic, Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
- Bilecik State Hospital, Plastic Reconstructive and Aesthetic Surgery Clinic, Bilecik, Turkey
| | - Pembe Oltulu
- Department of Pathology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ilker Uyar
- Department of Plastic, Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
- Tokat State Hospital, Plastic Reconstructive and Aesthetic Surgery Clinic, Tokat, Turkey
| | - Mehmet Dadaci
- Department of Plastic, Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Yarar S, Uyar I, Yildirim MEC, Dadacı M, Ince B. A Rare Case: Primary Venous Malformation in Parietal Bone. Skin Appendage Disord 2021; 7:322-325. [PMID: 34307483 DOI: 10.1159/000514697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/22/2021] [Indexed: 11/19/2022] Open
Abstract
Primary intraosseous vascular malformations (PIVMs) are rare intraosseous lesions, accounting for approximately 0.5-1% of all intraosseous tumours. In this case report, we aimed to present a rare case of intraosseous vascular malformation causing a large lytic area in the parietal bone. A 25-year-old male patient was admitted to the clinic with a mass on the parietal bone. On physical examination, it was observed that the hair density on the mass was decreased, the mass had a soft consistency, and there was no pain on palpation. The patient was operated under local anaesthesia with a provisional diagnosis of a trichilemmal cyst. However, intraoperative diagnosis was a vascular malformation. There was a 3-cm full-thickness defect on the parietal bone caused by the lesion. The mass was excised completely while preserving the integrity of the dura. The resulting defect was reconstructed with bilateral rotation advancement flaps. The calvarial defect was not reconstructed due to equipment inadequacy. No complications were encountered in the postoperative period. Ninety-three PIVM cases have been reported in the skull since 1845. In very few of these cases, the mass is located in the parietal bone. The pathogenesis of PIVMs is not completely understood. The definitive diagnosis is made by histopathological examination. The therapeutic gold standard is surgery. Surgeons should keep in mind that radiological examination before the operation could prevent undesirable complications.
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Affiliation(s)
- Serhat Yarar
- Plastic Reconstructive and Aesthetic Surgery Clinic, Konya Numune Hospital, Konya, Turkey.,Department of Plastic Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ilker Uyar
- Department of Plastic Reconstructive and Aesthetic Surgery, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.,Department of Plastic Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Emin Cem Yildirim
- Department of Plastic Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey.,Plastic Reconstructive and Aesthetic Surgery Clinic, Bilecik State Hospital, Bilecik, Turkey
| | - Mehmet Dadacı
- Department of Plastic Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Bilsev Ince
- Department of Plastic Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey
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Dadaci M, Yildirim MEC, Yarar S, Ince B. Assessment of Outcomes After Limberg Flap Reconstruction for Scrotal Defects in Patients With Fournier's Gangrene. Wounds 2021; 33:65-69. [PMID: 33793411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Fournier's gangrene (FG) is a rarely encountered necrotizing fasciitis principally affecting skin and subcutaneous tissues of the genital region, perineum, and abdominal wall. The overall incidence of FG is 1.6 cases per 100 000 per year; the incidence in males is higher. Management techniques described in the literature have both advantages and disadvantages, and there is no gold standard treatment technique. OBJECTIVE This study evaluated whether the Limberg flap can be used reliably in scrotal defects with fewer complications than are seen with traditional techniques. The results of unilateral or bilateral Limberg flaps for scrotal reconstruction after FG were assessed. MATERIALS AND METHODS This retrospective, single-center study analyzed records from 29 male patients with scrotal defects after multiple debridements who were treated from January 2013 to January 2018. Twenty-one patients (72.4%) with hemiscrotal defects and 8 patients (27.6%) with defects involving greater than 50% of the scrotal surface were included in this study. Demographic data that were analyzed included smoking history, comorbid conditions, time of surgery, and time of follow-up. Flap dimensions were measured. Patients were evaluated in terms of flap viability and postoperative complications. RESULTS Mean age was 64 years (range, 47-80 years). The mean follow-up period was 16 months (range, 12-26 months). Dehiscence with seroma were detected in 4 patients (13.7%) on postoperative days 4 and 5. The average size of the flaps was 11 cm × 15 cm. Seroma and dehiscence were encountered in 4 patients (13.7%) during postoperative follow-ups. No postoperative infection was observed in any patient, and no partial or total flap loss was reported. CONCLUSIONS These results suggest that use of the Limberg flap technique for scrotal reconstruction following FG has the important benefits of being easily harvested while providing tension-free repair and acceptable cosmetic results.
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Uyar I, Sahin Uyar SB, Cem Yildirim ME, Yarar S, Dadaci M. A Rare Congenital Case: Aplasia Cutis Congenita. Facial Plast Surg 2020; 37:132-133. [PMID: 32916734 DOI: 10.1055/s-0040-1715621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Ilker Uyar
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Tokat State Hospital, Tokat, Turkey.,Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University School of the Medicine, Konya, Turkey
| | - Sibel Burcak Sahin Uyar
- Pediatrics Clinic, Tokat State Hospital, Tokat, Turkey.,Department of Pediatrics, Necmettin Erbakan University School of the Medicine, Konya, Turkey
| | - Mehmet Emin Cem Yildirim
- Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University School of the Medicine, Konya, Turkey.,Plastic, Reconstructive and Aesthetic Surgery Clinic, Bilecik State Hospital, Bilecik, Turkey
| | - Serhat Yarar
- Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University School of the Medicine, Konya, Turkey.,Plastic, Reconstructive and Aesthetic Surgery Clinic, Konya Numune Hospital, Konya, Turkey
| | - Mehmet Dadaci
- Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University School of the Medicine, Konya, Turkey
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Ince B, Cem Yildirim ME, Dadaci M, Yarar S. A New Technique in Tamai Zone 1 Reconstruction: Reverse Dorsal Terminal Vein Flap (Hat Flap). J Hand Microsurg 2019; 11:140-145. [PMID: 31814665 DOI: 10.1055/s-0039-1683949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 02/01/2019] [Indexed: 10/27/2022] Open
Abstract
Introduction The aim of this study was to determine usability of the reverse dorsal terminal vein flap (hat flap) in the reconstruction of Tamai zone 1 defects. Materials and Methods A total of 31 patients with fingertip amputation in Tamai zone 1 defect in the finger operated upon between 2014 and 2016 were included in this study. Flaps were designed from the proximal end of the nail bed to the middle phalanx according to the defect size. After passing through the skin, the proximal parts of the dorsal vein and branches were knotted. The flap was harvested by preserving the paratenon and dorsal digital terminal vein. Then, the flap was rotated and the defect was closed. Results A total of 32 patients were included in this study. The average size of the defects was 2 × 2.2 cm. Loss of epidermis in five patients and partial flap loss in two patients were observed (7/32, 21.8%), but total flap loss was not observed in any patient. Conclusion The reverse flow terminal dorsal vein-based pedicle flaps can be used as a viable surgical technique in the reconstruction of Tamai zone 1 amputations. Level of Evidence This is a Level IV study.
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Affiliation(s)
- Bilsev Ince
- Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University, School of the Medicine, Konya, Turkey
| | - Mehmet Emin Cem Yildirim
- Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University, School of the Medicine, Konya, Turkey
| | - Mehmet Dadaci
- Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University, School of the Medicine, Konya, Turkey
| | - Serhat Yarar
- Konya Numuna Hospital, Plastic Reconstructive and Aesthetic Surgery Clinic, Konya, Turkey
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Ozturk I, Yarar S, Gürgan M, Ceyhan D, Banti C, Hadjikakou S, Manoli M, Moushi E, Tasiopoulos A. Synthesis, characterization and biological evaluation of novel antimony(III) iodide complexes with tetramethylthiourea and N-ethylthiourea. Inorganica Chim Acta 2019. [DOI: 10.1016/j.ica.2019.03.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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9
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Ince B, Yarar S, Dadaci M. Simultaneous flap thinning with ultrasound-assisted liposuction during free flap surgery: Preliminary results. Microsurgery 2018; 39:144-149. [PMID: 30496614 DOI: 10.1002/micr.30377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/18/2018] [Accepted: 08/24/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND Ultrasound-assisted liposuction (UAL) has been previously used for postoperative flap thinning. Although it had been reported that UAL causes less damage to the vessels, the simultaneous use of UAL with free flap reconstruction has not been reported. The aim of this report was to determine the results and the complication rates of simultaneous use of UAL with free flap reconstruction. PATIENTS AND METHODS Twelve patients who underwent simultaneous flap thinning with UAL during free anterolateral thigh flap surgery between 2014 and 2016 were included in this prospective study. The mean age of the patients was 46.7 (ranging 10-76) years. The mean body mass index of the patients was 26.81 (ranging 25.2-29.8). Flaps were thinned with UAL before harvesting. The mean flap thicknesses were measured using a metal ruler before and after the UAL procedure. Biopsies were performed lateral to the center of the flaps, after completion of the UAL procedure. Vascular and collagen structures were histopathologically examined. The Likert scale, which evaluates the general appearance, shape, color, and texture, was used to assess the aesthetic results of the UAL procedure. RESULTS The average flap size was 13 × 9 cm. The mean pedicle length was 8.3 (ranging 7-10) cm. The mean flap thickness was 23 (ranging 19-27) mm and decreased to a mean of 8.1 (ranging 5-11) mm. Wound dehiscence and partial skin necrosis was observed in 2 patients (2/12, 16.66%). None of the patients had total flap necrosis. Vascular and collagen structures of the biopsied samples were normal. Patients were followed for an average of 13 months post UAL. The mean Likert score was 17.1 (ranging 15-19). CONCLUSIONS Flap thinning with UAL can be safely performed during the initial free flap reconstruction operation.
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Affiliation(s)
- Bilsev Ince
- Department of Plastic & Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Serhat Yarar
- Department of Plastic & Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Dadaci
- Department of Plastic & Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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İnce B, Dadacı M, Kılınç İ, Oltulu P, Yarar S, Uyar M. Effect of cineole, alpha-pinene, and camphor on survivability of skin flaps. Turk J Med Sci 2018; 48:644-652. [PMID: 29916225 DOI: 10.3906/sag-1704-166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim: The aim of this study was to determine the specific component of Rosmarinus officinalis (RO) responsible for increased flap survival and how RO displays its efficacy. Materials and methods: Rectangular random-pattern flaps were elevated from the back of each rat. Group I was the control group. In group II 0.1 mL of cineole, in group III 0.1 mL of alpha-pinene, in group IV 0.1 mL of camphor, in group V 0.1 mL each of alpha-pinene and cineole, in group VI 0.1 mL each of alpha-pinene and camphor, in group VII 0.1 mL each of cineole and camphor, and in group VIII, 0.1 mL each of alpha-pinene, cineole, and camphor was orally administered once a day before surgery. The luminal area of the largest blood vessel in the proximal flap was measured. Interleukin-1, tumor necrosis factor alpha, thiobarbituric acid reactive substances, and vascular endothelial growth factor values were measured. Results: The mean percentage of the viable surface area was significantly greater in groups VIII, III, and V. The mean percentage of vessel diameter was significantly greater in groups V, VIII, and VII. Conclusion: We suggest that alpha-pinene and cineole were the components of RO that were responsible for increased flap survival. The most effective of feature of RO was the antiinflammatory effects.
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Ozturk I, Yarar S, Banti C, Kourkoumelis N, Chrysouli M, Manoli M, Tasiopoulos A, Hadjikakou S. QSAR studies on antimony(III) halide complexes with N-substituted thiourea derivatives. Polyhedron 2017. [DOI: 10.1016/j.poly.2016.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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İnce B, Dadacı M, Bilgen F, Yarar S. Comparison between knot and Winograd techniques on ingrown nail treatment. Acta Orthop Traumatol Turc 2016; 49:539-43. [PMID: 26422350 DOI: 10.3944/aott.2015.14.0450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to compare the Winograd and knot techniques based on efficiency, complication rate, surgery time, and amount of local anesthetic required. This study also aimed to determine the etiology of ingrown nails, whether due to involvement of the nail or soft tissue. METHODS Seventy-five patients with a total of 90 ingrown nails (stages 2 and 3) who presented at our clinic between 2012-2014 were included in this study. Patients were divided into 2 groups: those treated with the knot technique and those treated with the Winograd technique. Patients in both groups were evaluated for the amount of local anesthetic required, intraoperative pain, effectiveness of preventing/stopping hemorrhage, surgery time, complications, postoperative nail size, recurrence, nail deformities, and secondary surgery rates. RESULTS The mean surgical time, relapse rate, number of additional surgeries required, and amount of local anesthetic were significantly greater in the Winograd group than in the knot group. The mean nail diameter was significantly decreased, with a mean of 3 mm in the Winograd group. No statistically significant differences were found between the groups in the incidence of infection, intraoperative pain, hematoma, or nail deformity. CONCLUSION This study demonstrated that the knot technique, consisting of wedge excision of soft tissue without affecting the nail itself, is a simple technique to treat ingrown nails with a lower complication rate and shorter surgical time. We believe that successful treatment of ingrown nails depends only on excision of soft tissue, with no need to operate on the nail bed.
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Affiliation(s)
- Bilsev İnce
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Konya, Turkey
| | - Mehmet Dadacı
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Konya, Turkey
| | - Fatma Bilgen
- Kahramanmaraş State Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Kahramanmaraş, Turkey
| | - Serhat Yarar
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Konya, Turkey
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Karacor-Altuntas Z, Dadaci M, Erdi F, Ince B, Uyar I, Yarar S. Facilitating triple rhomboid flaps for meningomyelocele defect closure using a honeycomb structure as a template. Childs Nerv Syst 2016; 32:845-8. [PMID: 26875083 DOI: 10.1007/s00381-016-3038-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/08/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE Various reconstruction options are available for the soft-tissue coverage of meningomyelocele defects. For small defects, primary closure or local single flaps may be sufficient, while large defects require more complex reconstructive techniques. This study suggests an easy way for surgeons to close large meningomyelocele defects using triple rhomboid flaps. METHODS The hexagonal structure of a honeycomb was considered when planning for the coverage of large meningomyelocele defects. The intact skin around the defect was imagined as multiple hexagons, which allowed us to plan triple rhomboid flaps correctly and more easily. This technique was used in seven patients with defects ranging from 7 × 5 to 12 × 8 cm in size. RESULTS No major postoperative complications were seen. Minimal dehiscence was observed in two patients and healed secondarily. CONCLUSIONS The honeycomb modification for planning triple rhomboid flaps is an easy, practical, and memorable approach for surgeons reconstructing large meningomyelocele defects.
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Affiliation(s)
- Zeynep Karacor-Altuntas
- Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Dadaci
- Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Fatih Erdi
- Department of Neurosurgery, School of the Medicine, Necmettin Erbakan University, 42080, Meram, Konya, Turkey.
| | - Bilsev Ince
- Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ilker Uyar
- Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Serhat Yarar
- Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey
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Abstract
Ball sports are the most frequent cause of sport injuries and 60% of all hand injuries involve the fingers. The most common injury is closed rupture of the extensor tendon of the distal interphalangeal joint (mallet finger). Rupture of the deep flexor tendon (jersey finger) occurs particularly in contact ball sports, such as rugby. Injuries of the proximal interphalangeal and metacarpophalangeal joints are of high functional relevance. These injuries frequently represent complex lesions which are demanding both in diagnostics and therapy. Errors in diagnosis or insufficient treatment can lead to misalignment and functional impairment of the hand. This article provides an overview of the current treatment strategies and includes recommendations for the treatment of professional athletes.
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Affiliation(s)
- S Yarar
- Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland,
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Hoffmann M, Reinsch OD, Petersen JP, Schröder M, Priemel M, Spiro AS, Rueger JM, Yarar S. Percutaneous antegrade scaphoid screw placement: a feasibility and accuracy analysis of a novel electromagnetic navigation technique versus a standard fluoroscopic method. Int J Med Robot 2014; 11:52-7. [PMID: 24677600 DOI: 10.1002/rcs.1572] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 10/06/2013] [Accepted: 12/20/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND Central screw positioning in the scaphoid provides biomechanical advantages. METHODS A prospective randomized study of six fluoroscopically guided and six electromagnetically navigated screw (ENS) placements was performed on human cadavers. Accuracy of screw position was determined. Intraoperative fluoroscopy exposure times, readjustments of drilling directions, complete restarts and complications were documented. RESULTS The ENS method provided a mean time benefit of 7.34 min compared with the standard method and the mean screw length ratio (SLR coronar: ENS 0.96 ± 0.04 mm, SFF: 0.92 ± 0.04 mm, P = 0.065; SLR sagittal: ENS 0.98 ± 0.02 mm, SFF: 0.91 ± 0.04 mm, P = 0.009) and the screw axis deviation angle (AD coronar: ENS 3.33 ± 2.34°, SFF: 10.33 ± 2.58°, P = 0.002; AD sagittal: ENS 2.83 ± 0.98°, SFF: 11.00 ± 6.16°, P = 0.002) were lower. Using the electromagnetic navigation procedure no drilling readjustments or restarts were required, no cortical breach occurred. CONCLUSIONS Compared with the standard fluoroscopic technique, the ENS method used in this study showed higher accuracy, less complications, required less operation and radiation exposure time.
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Affiliation(s)
- M Hoffmann
- Department of Trauma, Hand and Reconstructive Surgery, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
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Yarar S, Sommerfeldt DW, Gehrmann S, Rueger JM. Stark dislozierte Radiushalsfrakturen nach minimal-invasiver Joystick-Reposition und Prévot-Nagelung. Unfallchirurg 2007; 110:460-6. [PMID: 17051352 DOI: 10.1007/s00113-006-1181-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Significantly displaced radial neck fractures in children are at risk for functional problems due to malaligned healing or growth disturbances at the proximal growth plate. Anatomic reduction is needed, especially in older children (aged 10+ years). Elastic stable intramedullary nailing (ESIN) (1993 Metaizeau) is the preferred method. When closed reduction is not possible, we use a joystick technique to fully reduce the radial head. The aim of this study was to challenge the hypothesis that this manipulation leads to secondary complications by affecting blood flow. Also, we asked the question to which extent an additional injury to the growth plate leads to functional problems concerning range of motion in the elbow joint. We undertook a retrospective analysis of children with severely displaced radial head fractures that occurred as isolated incidents or in combination with complex elbow fractures who had been treated by us with this technique between 1998 and 2004. We collected data on the clinical and radiological healing process.
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Affiliation(s)
- S Yarar
- Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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17
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18
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Yarar S. [Animal health status and the preventive methods applied in Turkey]. Bull Off Int Epizoot 1967; 68:351-63. [PMID: 5629815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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19
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Yarar S. [Regulations concerning exportation and importation of animals and animal products in Turkey]. Bull Off Int Epizoot 1965; 63:1775-9. [PMID: 5894105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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