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Öğe Acquired Constriction Band Syndrome Affecting Multiple Digits - A Case Report(World Scientific Publ Co Pte Ltd, 2022) Kendir, Munur Selcuk; Dadaci, Mehmet; Uyar, Ilker; Yildirim, Mehmet Emin CemRubber band syndrome is a condition that usually affects children because of wearing a rubber band on the wrist or the ankle. Depending on the degree of pressure caused by the band, patients may present acutely with ischemia and necrosis of the tissues distal to the bands or chronically with change in shape, oedema, loss of function, sensation and rarely amputation. This condition is very rare in adults and most reports in literature are in patients with cognitive impairment or psychiatric illness. We report 62-year-old lady with a background of a psychiatric illness who presented with an acquired constriction band syndrome affecting multiple digits of both hands.Öğe Assessing the Effect of Vitamin D Replacement on Basal Cell Carcinoma Occurrence and Recurrence Rates in Patients with Vitamin D Deficiency(Springer, 2019) Ince, Bilsev; Yildirim, Mehmet Emin Cem; Dadaci, MehmetThe study aimed to determine whether 25-OH vitamin D-3 deficiency is present in patients with diagnosed BCC, and the effect of vitamin D replacement on the rates of BCC recurrence in patients with 25-OH vitamin D-3 deficiency. In this prospective study, between 2012 and 2017, in the first stage, 25-OH vitamin D-3 levels of all patients diagnosed with BCC between 2012 and 2013 were evaluated. In the second stage between 2014 and 2015, we evaluated the 25-OH vitamin D-3 level of patients who had 25-OH vitamin D-3 level < 25 ng/mL. All the patients included in the second stage had BCC recurrence. In the third stage, the patients who were diagnosed 25-OH vitamin D-3 deficiency with BCC, between 2015 and 2017, were studied. The mean 25-OH vitamin D-3 level of the patients in the second stage was 10.12 ng/mL. Recurrence was observed in 9.64% of the patients in the second stage. The mean level of serum 25-OH vitamin D-3 in the third stage was 40.1 ng/mL, and 3.49% of these patients presented with recurrence. In all the patients as the initial diagnosis and following the 25-OH vitamin D-3 level in all the patients with BCC recurrence, maintaining 25-OH vitamin D-3 levels above 25 ng/mL can significantly reduce the recurrence rate.Öğe Assessment of Outcomes After Limberg Flap Reconstruction for Scrotal Defects in Patients With Fournier's Gangrene(H M P Communications, 2021) Dadaci, Mehmet; Yildirim, Mehmet Emin Cem; Yarar, Serhat; Ince, BilsevBackground. 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 x 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.Öğe Assessment of sensory outcomes after successful fingertip replantation with or without nerve repair according to amputation level(Wiley, 2021) Dadaci, Mehmet; Yildirim, Mehmet Emin Cem; Kendir, Selcuk; Ince, BilsevBackground Good sensory outcome in fingertip replantation is a major part of the success of reconstruction and using the finger. Although some sensorial outcomes have been reported in various series in the literature, there is no controlled study, which demonstrates the anatomical levels where nerve repair should or should not be performed. We aimed to assess sensorial outcomes of fingertip amputations with or without nerve coaptation according to amputation level. Methods Between January 2013 and July 2018, patients with Tamai Zone 1 and Zone 2 amputations underwent replantation. The patients were divided two main groups. Patients underwent nerve coaptation were grouped as Group 1, and those coaptation not performed as Group 2. In addition, subgroups were designed according to level of the amputation. Tamai zone 1 amputations were grouped as groups 1a and 2a. Tamai zone 2 amputations were grouped as groups 1b and 2b. The mean age was 30.8 +/- 30.8 years in Group 1a, 33.2 +/- 12.6 years in Group 1b, 34.1 +/- 13.6 years in Group 2a, 34.3 +/- 11.1 years in Group 2b. Type of injury were evaluated as clean cut (with knife, saw etc.), moderately crushed, and severely crushed and/or avulsion. In Group 1a, one prominent branch of the nerve was repaired, and in Group 1b, the nerve in both side was repaired. The mean duration of replantation in Group 1a was 1 h and 40 min (1 h and 15 min-2 h), whereas this time was 1 h and 15 min (1 h - 1 h and 35 min) in Group 2a. Then, 2 h 15 min (1 h and 55 min-2 h and 50 min) in Group 1b, and 2 h (1 h and 45-2 h 25 min) in Group 2b. Mean age, type of injury and length of follow-up were statistically compared. Sensorial outcome was evaluated by 2-point discrimination test and the Semmes-Weinstein test. Results According to the Semmes-Weinstein test, 33% of the fingers tested were normal, 58% had diminished light touch, 8% had diminished protective sensation, and 0% had loss of protective sensation in Group 1a; In Group 1b, these values were 35% (7/20), 55% (11/20), 10% (2/20), 0%; in Group 2a, 38% (6/16), 56% (9/16), 6% (1/16), 0%; in Group 2b, 25% (4/16), 44% (7/16), %25 (4/16), 6% (1/16), respectively Mean static two-point discriminations in Groups 1a, 1b, 2a, and 2b were 4.17 +/- 0.58, 4.55 +/- 0.69, 4.25 +/- 0.68, and 5.9 +/- 1.26 mm, respectively. The mean follow-up duration was 24 months in Group 1a, 24 months in Group 1b, 26 months in Group 2a, 21 months in Group 2b. Then, 17 (3 in Group 1a, 6 in Group 1b, 4 in Group 2a, 4 in Group 2b) of the 64 fingers were clean cut amputation, 45 (9 in Group 1a, 14 in Group 1b, 11 in Group 2a, 11 in Group 2b) were moderately crushed amputation, and 2 (1 in Group 2a, 1 in Group 2b) were severely crushed and/or avulsion injury. There was no statistically significant difference between groups 1a and 2a (p = .71). On the other hand, there was a statistically significant increase in sensory outcomes of patients in Group 1b compared to Group 2b (p = .009). There was no statistically significant between the groups in terms of mean age, type of injury and length of follow-up. Conclusion We think that nerve repair does not have a positive effect on sensorial recovery in Tamai Zone 1 amputations, but nerve coaptation should be performed in Tamai Zone 2 replantations if possible for better sensorial result.Öğe Comparison of the Efficacy of Homologous and Autologous Platelet-Rich Plasma (PRP) for Treating Androgenic Alopecia(Springer, 2018) Ince, Bilsev; Yildirim, Mehmet Emin Cem; Dadaci, Mehmet; Avunduk, Mustafa Cihat; Savaci, NedimAndrogenetic alopecia (AGA), the most common cause of hair loss in both sexes, accounts for 95% of all cases of hair loss. Although the literature has suggested that both nonactivated (n-PRP) and activated autologous (a-PRP) PRP can be used to treat AGA, we did not find any study investigating the use of homologous PRP (h-PRP) for this purpose. Also, to the best of our knowledge, there are no studies comparing the efficacy of h-PRP, a-PRP, or n-PRP on AGA therapy. The aim of this study was to compare the increase in hair density, average number of platelets, complications, preparation, and duration of application in the treatment of AGA using a-PRP, n-PRP, and h-PRP. Between 2014 and 2015, we studied male patients who had experienced increased hair loss in the last year. Patients were divided into three groups: Group 1 received n-PRP, Group 2 received active PRP, and Group 3 received h-PRP. For Group 1, PRP was prepared by a single centrifugation prepared from the patient's own blood. For Group 2, the PRP was prepared from the patient's own blood, but a second centrifugation was applied for platelet activation with calcium chloride. For Group 3, the PRP was prepared from pooled platelets with the same blood group as the patient from the blood center. PRP was injected at 1, 2, and 6 months. The hair density (n/cm(2)) of each patient before and after injection was calculated. Each patient was assigned a fixed evaluation point at the time of application to calculate hair density. At 2, 6, and 12 months after the first treatment, the increase in hair density was calculated as 11.2, 26.1, and 32.4%, respectively, in Group 1; 8.1, 12.5, and 20.8%, respectively, in Group 2; and 16.09, 36.41, and 41.76%, respectively, in Group 3. The increase in hair density was statistically significantly greater in Group 1 than in Group 2 and more so in Group 3 than in both groups among all controls (p < 0.05). The efficacy of both PRPs was determined in AGA treatment in our study. However, it was determined statistically that the increase in hair density with h-PRP was greater than with autologous PRP groups. We believe that h-PRP therapy can be used in patients with AGA presenting with hair loss.Öğe A Different Stabilization Technique of Autogenous Cartilage Grafts in Saddle Nose Deformity: Prevention Warping and Resorption(Lippincott Williams & Wilkins, 2019) Gundeslioglu, A. Ozlem; Yildirim, Mehmet Emin Cem; Yarar, Serhat; Uyar, Ilker; Ismayilzade, MajidBackground: Saddle nose deformity (SND) is a collapse of the cartilage and bone structures forming the dorsal projection of the nose. After the use of autologous cartilage in the treatment of SND, resorption and warping continue to be a problem. Methods: This study presents results from 11 patients with SND types III and IV from 2005 to 2017 treated with autologous cartilage fixed with microplates and microscrews. The patients were monitored for at least 1 year. Resorption and warping were measured using postoperative photographs of the patients in the 3rd and 12th months after treatment. Results: No signs of resorption or warping were noted in the patients. Conclusions: Our findings indicate autologous cartilage use with microplates and microscrews is a viable, long-term treatment option for patients with SND types III and IV.Öğe The effect of dobutamine treatment on salvage of digital replantation and revascularization(Springer Heidelberg, 2023) Ince, Bilsev; Uyanik, Orkun; Ismayilzade, Majid; Yildirim, Mehmet Emin Cem; Dadaci, MehmetPurposeOne of the most common causes of a failure after replantation and revascularization surgeries is 'no reflow' from proximal artery that occurs, especially following crush and avulsion injuries. In this study, we aimed to evaluate the effect of dobutamine treatment on salvage of replanted and revascularized digits.MethodsThe patients with no reflow phenomenon detected in the salvage operations of replanted/revascularized digits between the years 2017 and 2020 were included in the study. Dobutamine treatment was infused at a rate of 4 & mu;g & BULL;kg(-1)& BULL;min(-1) intraoperatively and of 2 & mu;g & BULL;kg(-1) min(-1) postoperatively. Demographic data (age, sex), digit survival rate, ischemia time, and level of injury were retrospectively analysed. Pre-infusion, intraoperative and postoperative values of cardiac index (CI), mean arterial pressure (MAP), and heart rate (HR) were recorded.ResultsThe phenomenon of 'no reflow' was encountered in 35 digits of 22 patients who underwent salvage surgery due to vascular compromise. The survival rate in the revascularization group was 75%, while it was 42.1% in the replanted digits. Metaphysis level of proximal phalanx was the most common localization for 'no reflow' phenomenon. The least values of CI, MAP and HR to obtain sufficient perfusion in salvaged digits were as follows: 4.2 l.min(-1).m(-2), 76 mm Hg, and 83 beat & BULL;min(-1), respectively.ConclusionsIt was demonstrated that dobutamine infusion at a rate of 4 & mu;g & BULL;kg(-1)& BULL;min(-1) intraoperatively and at 2 & mu;g & BULL;kg(-1)& BULL;min(-1) postoperatively has favorable effects on the vascular compromise derived from no reflow of proximal artery.Öğe The effects of a combination treatment with mesenchymal stem cell and platelet-rich plasma on tendon healing: an experimental study(Tubitak Scientific & Technological Research Council Turkey, 2022) Uyar, Ilker; Altuntas, Zeynep; Findik, Siddika; Yildirim, Mehmet Emin Cem; Yarar, Serhat; Aktan, Murat; Avci, AlunetBackground/Aim: The objective of this study was to investigate the effects that the application of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) following tendon repair have on the strength and healing of the tendon and also to examine the possible mechanisms of action that take place. Materials and methods: The Achilles tendons of 80 rats were repaired and divided into eight groups. Following the repairs, MSCs obtained from humans were injected into the rat tendons in groups 1 and 2, a combination of MSCs from humans and PRP from rats was injected into the tendons in groups 3 and 4, and PRP from rats was injected into the tendons in groups 5 and 6. These procedures all took place simultaneously. Groups 7 and 8 did not receive any injections following the repairs. The rats were sacrificed at the end of the first and second months following the procedures, and biomechanical and histopathological analyses were performed. Results: Inflammatory cell density increased most significantly in the combined group when compared to the first and second months. The fibroblast density on the tendon repair region was significantly lower in the second-months groups of each intervention compared to their first-month groups (p = 0.001). For the analysis of the maximum tensile breaking force, the behaviors of the groups over time were significant when compared to the control groups (p = 0.0015). Also, the mean maximum breaking force in the combined group was statistically significantly higher at the end of the second month than at the end of the first month (p = 0.0008). Conclusion: The combination therapy increased tendon strength force. This combination therapy can make a positive contribution to the healing of tendons after surgery.Öğe Effects of aspiration time on immediate viability of adipocyte cell in ultrasound-assisted liposuction (UAL) and in traditional suction-assisted lipectomy (SAL)(Taylor & Francis Ltd, 2019) Ince, Bilsev; Oltulu, Pembe; Yildirim, Mehmet Emin Cem; Ismayilzade, Majid; Dadaci, MehmetWe aimed to determine the effect of aspiration periods following liposuction procedure on vascular structures, fibrocollagenous tissues and viability of adipose cells at different minutes, respectively in UAL and SAL. Abdominoplasty materials were divided into two equal parts from middle following excusion during the operations. Traditional SAL was performed to the right part of the abdominoplasty materials therewithal. Each side of the material was then divided into five parts enumarated from one to five and aspiration procedure time for each area was defined according to this ranking. The aspiration periods for each area were as follows: the transition intervals of 30 seconds between each zone were calculated as preoperative preparation time for surgical equipment in every area, and for discharging the lipoaspirates from collecting container. Red blood cell amount, a rate of degeneration in vasculary tissues, adipocyte cell amount with nuclear conformation, a rate of septal structure loss in fibroblast cells and septal fibroblast amount were the histopatological parametres of the study which observed and analysed by the pathologists. Based on the results of statistically analysis we proved that obtaining more surviving fat graft is possible by keeping aspiration period less than 2 minute in operation zone. In case of elongation of stated period clinical accomplishment of fat graft application reduces due to the downward of viable adipocyte cell amount and accelerating injury on tissues. Consequently, keeping the aspiration duration less than two minutes in planned liposuction area in both liposuction methods is favourable for providing maximum viable autologous fat graft.Öğe Effects of Botulinum Toxin on Improving Facial Surgical Scars: A Prospective, Split-Scar, Double-Blind, Randomized Controlled Trial(Lippincott Williams & Wilkins, 2019) Dadaci, Mehmet; Yildirim, Mehmet Emin Cem; Ince, Bilsev[Abstract Not Availabe]Öğe Evaluation of the effectiveness of the tuba uterina tubular flap in the peripheral nervous system regeneration in rats(Taylor & Francis Ltd, 2022) Yildirim, Mehmet Emin Cem; Dadaci, Mehmet; Ince, Bilsev; Uyar, Ilker; Yarar, Serhat; Oltulu, Pembe; Aygul, RecepNerve 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.Öğe Experience of Replantation and Reconstruction in Total Scalp, Partial Forehead, and Ear Avulsions(Lippincott Williams & Wilkins, 2019) Dadaci, Mehmet; Yildirim, Mehmet Emin Cem; Ince, BilsevIn this study, the authors present the challenges of replantation and management of 2 patients who have total scalp, partial forehead and ear avulsion. A 39-year-old male farmer was admitted to the emergency room with the total scalp, forehead, partial right eyebrow and upper eyelid amputation after his hair was catched by an agricultural machine. Anastomoses of 2 arteries and 2 veins in the occipital region were done first. Anastomosis of the right and left superficial temporal arteries and veins were performed end to end by turning the operating table without moving the head, followed by 1 vein anastomoses in the frontal region. Although anastomotic blood flow was observed by Doppler ultrasonography, there were changes suggesting necrosis in the frontal and both temporoparietal regions and later in the occipital region. Necrotic tissues began to be debrided tangentially from the 10th day. During serial debridement, it was observed that the necrotic tissue includes skin and connective tissue. At the end of the post-operative second month, surgical treatment was completed and 12 months after the surgery, the patient lives with the wig because of hair loss, but the patient is cosmetically satisfied. An 18-year-old female gatherer was admitted to the emergency room with the total scalp, both eyebrows, right upper eyelid and partial right ear avulsion, after her hair was catched by an agricultural machine. Totally, anastomoses of 4 arteries and 3 veins were performed. On the 10th postoperative day, necrotic skin findings appeared and serial debridement were performed and it was revealed that aponeurosis was fully intact. The defect areas of skin and connective tissue were repaired with STSG. Intact partial temporal scalp tissue was present. Scalp replantation should always be considered as the first choice, according to the similar tissue principle of tissue repair in plastic surgery if there is no contraindication. Additionally, performing multiple arterial and vein anastomoses, evaluating the patient position in the post-operative period for anastomosis and hemodynamic follow-up, avoiding aggressive debridement and early reconstruction may give the patient the chance of skin grafting which is the basis of the reconstructive ladder.Öğe Histopathological evaluation of the effect of hyperbaric oxygen therapy on capsule occurrence around silicone breast prosthesis: an experimental study(Taylor & Francis Ltd, 2021) Yarar, Serhat; Arslan, Abdullah; Ince, Bilsev; Yildirim, Mehmet Emin Cem; Oltulu, Pembe; Uyar, Ilker; Dadaci, MehmetBackground 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 x 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.Öğe Investigation of the Development of Hypersensitivity and Hyperalgesia After Repeated Application of Platelet-Rich Plasma in Rats: An Experimental Study(Oxford Univ Press Inc, 2019) Ince, Bilsev; Yildirim, Mehmet Emin Cem; Kilinc, Ibrahim; Oltulu, Pembe; Dadaci, MehmetBackground: Hyperalgesia, defined as hypersensitivity to pain, refers to sensitization of nociceptors to normal levels of pain. Objectives: We aimed to determine whether hyperalgesia occurs due to the development of sensitization following repeated applications of platelet-rich plasma (PRP), and to ascertain the mechanism responsible for inducing hyperalgesia. Methods: This study, performed between 2016 and 2017, involved 32 rats. A 2 cm x 2 cm area was shaved on the back of 10 experimental and 10 sham control animals. In the experimental animals this area was divided into 4 equal squares of 1 cm x 1 cm, and these squares were numbered 1 (no treatment; only the needle was inserted), 2 (0.2 mL, saline), 3 (0.2 mL, nonactivated PRP), and 4 (0.2 mL, activated PRP). The response of the animals to painful stimuli in these areas was investigated with Von Frey filaments, immediately before application and 4 weeks after the last application. Skin biopsies were taken, and growth factors were evaluated pathologically and biochemically. Results: Hyperalgesia developed in all 4 areas of each experimental rat but not in the sham group. However, areas 3 and 4 had smaller Von Frey g values than areas 1 and 2. When growth hormones were assessed histopathologically and biochemically, nerve growth factor (NGF) levels were found to be higher in areas 3 and 4 than in areas 1 and 2 and the sham group. Conclusions: Both nonactivated and activated PRP resulted in greater hypersensitivity than saline and sham treatment. Development of hyperalgesia may be associated with an increase in NGF as well as increased inflammatory mediators.Öğe Is Reconstruction Preserving the First Ray or First Two Rays Better Than Full Transmetatarsal Amputation in Diabetic Foot?(Lippincott Williams & Wilkins, 2019) Ince, Bilsev; Yildirim, Mehmet Emin Cem; Dadaci, Mehmet[Abstract Not Availabe]Öğe A Low-Cost, Easily Accessible Simulation Model for Microsurgery Training(Iranian Plastic & Reconstructive Surgery Assoc, 2019) Ince, Bilsev; Yildirim, Mehmet Emin Cem; Dadaci, Mehmet[Abstract Not Availabe]Öğe Midline Mandibular Cleft Treatment(Lippincott Williams & Wilkins, 2021) Dadaci, Mehmet; Ismayilzade, Majid; Yildirim, Mehmet Emin Cem; Ince, BilsevTessier 30 cleft is a more rare anomaly comparing the other clefts and has variable clinical presentations. According to the literature, there were only 66 cases with Tessier 30 cleft reported since 2007. Furthermore, because of the rarity and variable clinical presentation of this condition, there is no consensus on the mode of management and timing of surgical procedures. In this case, we demonstrated the earlier treatment method of a newborn case with Tessier 30 cleft.Öğe A New Technique in Tamai Zone 1 Reconstruction: Reverse Dorsal Terminal Vein Flap (Hat Flap)(Georg Thieme Verlag Kg, 2019) Ince, Bilsev; Yildirim, Mehmet Emin Cem; Dadaci, Mehmet; Yarar, SerhatIntroduction 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 x 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.Öğe A Rare Case: Primary Venous Malformation in Parietal Bone(Karger, 2021) Yarar, Serhat; Uyar, Ilker; Yildirim, Mehmet Emin Cem; Dadaci, Mehmet; Ince, BilsevPrimary 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.Öğe A Rare Congenital Facial Abnormality: Complete Arhinia(Thieme Medical Publ Inc, 2021) Altuntas, Zeynep; Uyar, Ilker; Yildirim, Mehmet Emin Cem[Abstract Not Availabe]
