Burak Ersen

A variant of Poland’s syndrome: axillary web containing rudimentary pectoralis major muscle

Sir, Poland’s syndrome is a congenital anomaly characterized by the unilateral absence of the sternocostal head of the pectoralis major muscle with ipsilateral chest wall and limb deformities. The incidence of Poland’s syndrome is about 1:30,000 live births and the syndrome is more common in males than in females. [1] The true cause of Poland’s syndrome is unknown today. Even though in utero vascular anomalies have been proposed, the real mechanism remains unknown. Since the first mention of Poland’s cadaveric study in 1841 and the naming of Poland syndrome in 1962, many variants of this

The Effect of Fat Graft Wrapping on Nerve Regeneration in Early Nerve Regeneration An Experimental Study

ABS TRACT Objective: It is not easy to establish ideal neural regeneration after peripheral nerve repair. Various types of microsurgical techniques, tools, pharmacological and chemical agents were used to increase the quality of the neural regeneration process. However, we are still far from the perfect neural repair. In this study; it was aimed to investigate the effect of fat graft, wrapped around sciatic nerve repair coaptation zone, in neural regeneration. Material and Methods: Twenty four Sprague-Dawley rats were chosen and separated into two groups equally. In the first twelve rats, skin incision was made in the right gluteal area, after blunt muscle dissection sciatic nerve was exposed. Full thickness nerve cut was performed and primary nerve repair was also performed in the same session. The first group was addressed as normal neural regeneration model. In the other twelve rats, same processes were performed in order to expose sciatic nerve. After nerve repair, fat graft harvested from the right posterior popliteal area was wrapped around the nerve coaptation zone. All the rats were sacrificed 3 weeks post-operatively, nerve segments were removed and sent for histopathological evaluation. Results: Our study demonstrated that macrophage migration and lymphocyte infiltration rates were significantly higher in experimental group. Conclusion: It was observed that wrapping fat graft around the nerve coaptation zone had a positive effect on neural regeneration by increasing macrophage and lymphocyte infiltration to the repair zone.

Secondary Extremity Reconstruction for Contour Deformity: Case Report

The reconstruction of the extremities due to contour deformities is a challenging process. Conventional modalities such as skin grafting have obvious drawbacks. A 18-year-old woman presented with an extensive scar on her right lower leg due to a traffic accident took place 10 years previously. In addition to semi circumferential skin scarring due to former skin grafting, soft-tissue loss was evident. Free tissue transfer of an anterolateral thigh flap was planned for reconstruction. To meet the cosmetic concerns of the patient, special consideration is required during the surgery. An cosmetically pleasing result was obtained within the operation. We consider that lower extremity reconstruction for only cosmetic purposes is a rare entity.

A Giant Lipoma of Left Flank: Case Report and Review of the Literature

ABS TRACT Lipomas are benign soft tissue neoplasms comprised of mature adipocytes encapsulated by a layer of connective fibrous tissue. Our case was 56 years old man who has a slow growing mass on his left loin for ten years. Lately, he suffered from this mass because he complained about wearing pants, sitting a chair and failing daily activities. On physical examination, 25x15 cm soft, mobile mass lining through his left loin was seen. An elliptical incision consisting of expanded skin was made. 21x5 cm expanded skin and 25 cm length, 15 cm width and 6cm depth superficial lipoma was removed by the monopolar electrocautery over the fascia. A hemovac suction drain was placed. Dermis and subdermal tissue have sutured by 3-0 absorbable sutures. Skin was closed by stapler. In our study, we represent a case of giant lipoma in left loin which has a 25x15x6 cm dimensions. We suggest that this lipoma is among the biggest ones in the literature which has been reported.