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Öğe Comparison of Bone Dust With Other Types of Bone Grafts for Cranioplasty(Lippincott Williams & Wilkins, 2014) Karamese, Mehtap; Toksoz, Mustafa Rasid; Selimoglu, Muhammed Nebil; Akdag, Osman; Toy, Hatice; Tosun, ZekeriyaPurpose: Split calvarial bone graft is preferred in the reconstruction of calvarial defects. However, it is not feasible for use in some challenging cases and in children. Particulate bone graft containing viable osteoblasts could be an attractive alternative. Materials and Methods: A total of 32 female rats were randomly separated into 4 groups. Full-thickness bone graft from rat calvaria was harvested in diameters of 8 x 8 mm. In group 1, the periosteum and skin were closed without any bone graft; bone dust particles were placed in group 2; bone fragments were placed in group 3; and full-thickness cranial bone graft was placed in group 4. After 12 weeks, all rats were killed. Degrees of resorption, foreign body reaction, and bone spicule length were assessed histologically, and an immunohistochemical study was used to show bone graft viability. Results: In graft viability, osteogenesis, and osteoblastic differentiation, groups 3 and 4 were similar and superior to groups 1 and 2. No osteoblastic activity and no viable bone dust were detected in groups 1 and 2. Resorption was observed in every preparate that contains bone tissue, and foreign body reaction was prominent in small bone groups, such as in group 2. Conclusions: In the full-thickness cranial bone graft group and the bone fragment group, the preservation of bone viability was obviously superior to the bone dust group and the periosteum-only group. In conclusion, bone dust behaved like the periosteum and could not create new bone, whereas bone particles behaved like the full-thickness cranial bone graft and were capable of preserving viability.Öğe Is It Necrotizing Fasciitis or Necrotizing Cellulitis After Varicella Zoster Infection? Two Case Reports(Lippincott Williams & Wilkins, 2014) Gundeslioglu, Ayse Ozlem; Selimoglu, Muhammed Nebil; Toy, HaticeNecrotizing fasciitis and necrotizing cellulitis are serious cutaneous complications in varicella patients. Differentiation of necrotizing cellulitis from necrotizing fasciitis can initially be challenging because of indistinct clinical course at the onset of infection and the lack of definitive diagnostic criteria. This paper reports 2 children with necrotizing cellulitis that developed after varicella infection to draw the attention of health care providers to necrotizing cellulitis that showed slower clinical course than necrotizing fasciitis and recovered with conservative treatment approaches without aggressive surgical intervention.Öğe TISSUE EXPANDER APPLICATIONS FOR EXTREMITIES(Medknow Publications & Media Pvt Ltd, 2013) Gundeslioglu, Ayse Ozlem; Ince, Bilsev; Dadaci, Mehmet; Inan, Irfan; Selimoglu, Muhammed Nebil; Toksoz, Mustafa Rasid; Ozen, Emine CigdemIntroduction: Tissue expanders have been frequently used in reconstructive surgery in order to obtain the necessary skin for the reconstruction of local or distant tissue defects because of their ability to form skin tissues of the same color, same sense and tissue quality with the defective field. Despite this fact, tissue expander applications for extremities have been shunned because of the high risk of complications. This study presents our approach to patients who had tissue expander applications for upper or lower extremities for various reasons, the technical details of the applications, and the results achieved from these patients alongside with literature. Material and Method: The data of a total of 15 patients who presented to our clinic between September 2010 and January 2013 and who had tissue expander applications for their extremities were retrospectively evaluated. The patients' data were evaluated regarding age, sex, etiological factor, the localization and size of the possible defect, the number, type, sizes, and volume of tissue expander applications, the size of the defect following excision, and complications. Results: 6 out of 15 patients covered by the study were male, while 9 were female. The mean age of the patients was 20.4 years (9-36). The tissue expander was applied to 11 fields for the upper extremities in 9 patients while it was applied to 8 fields for the lower extremities in 6 patients. 4 of the tissue expander applications for the upper extremities were applied for tattoo removal. The etiological reason for the lower extremities was traumatic scar or burn scar in all patients. The volumes of the used tissue expanders varied between 50 and 750 cc. The average expander volume was 168.3 cc (50-340 cc) for the upper extremities while it was 457.8 cc (60-750 cc) for the lower extremities. In 13 of 15 patients (86%) the expansion process was completed without any major complication. Conclusion: Although there is a widespread prejudice against tissue expander applications for extremities, it is possible to achieve successful results in cases where the appropriate implant was placed through the right technique and in cases where the expansion process was spread in time in mini volumes.Öğe VACUUM THERAPY AND PECTORALIS MAJOR MUSCLE FLAP COMBINATION IN TREATMENT OF STERNAL INFECTIONS: A CASE REPORT(Medknow Publications & Media Pvt Ltd, 2014) Karamese, Mehtap; Akdag, Osman; Yildiran, Gokce Unal; Selimoglu, Muhammed Nebil; Gormus, Niyazi; Tosun, ZekeriyaWound infections subsequent to cardiac surgery are challenging surgeons because of being life-threatening situations and these infections are among conditions that require multidisciplinary approach. Antibiotherapy, surgical debride-ments, regional or free flap surgeries are used by multidisciplinary approach in the treatment of sternal wound infections. Beside these known alternatives, some other methods are advanced for wound care. However; sternal instability, ventricular rupture and pneumonia may be mortal in many patient as the course of the disease. In this article, a negative pressure wound therapy and reconstruction with pectoralis major muscle flap was introduced for postoperative mediastinitis occurred in a diabetic, coronary bypass patient. A wound therapy, that controls infection and supplies wound care as an effective treatment alternative for highly mortal mediastinis cases.
