Hüray Karaca

A Clinical Comparison of EMLA Cream and Ethyl Chloride Spray Application for Pain Relief of Forehead Botulinum Toxin Injection.

ObjectivesThis study aims to analyze the efficiency of EMLA cream and ethyl chloride spray application for pain alleviation before botulinum toxin injection. MethodsForty-five patients were divided into 3 treatment groups. Skin cooling with ethyl chloride spray (in group 1), topical anesthetic cream (EMLA) (in group 2), was used on the forehead area on one side previous to injection; the opposite side served as the control. In the third group (n = 15), cold was applied using ethyl chloride spray to one side, and to the other side topical anesthetic cream (EMLA) was applied. A visual analog scale was used for pain intensity. ResultsIn the first group, the average pain score was 3.20 ± 1.20 on the side where ethyl chloride spray was applied and 7.26 ± 1.94 on the control side (P < 0.05). It was 4.20 ± 1.37 on the side receiving EMLA and 7.66 ± 1.54 (P < 0.05) on the control side in the second group. In the third group, the average score was 6.80 ± 1.37 for the EMLA side and 2.93 ± 1.03 for the ethyl chloride sprayed side (P < 0.05). ConclusionsSkin cooling with ethyl chloride spray significantly decreases the pain associated during forehead botulinum toxin injections.

Rare complication after VAC therapy in the treatment of tissue defect due to surgical excision of pilonidal sinus.

BACKGROUND: Pilonidal sinus is frequently managed with surgical incision. If the wound is left open to heal by secondary intention, negative pressure wound therapy (NPWT) is often used to promote healing. CASE: We describe the case of a 60-year-old patient referred after excision of a pilonidal sinus, which was managed postoperatively with NPWT. Unfortunately, the patient developed squamous cell carcinoma, which was undetected postoperatively, as the dressing was left in place for 5 days. CONCLUSION: Guidelines for the use of NPWT should be followed, with dressing intervals at 2 to 3 days. Wounds managed by NPWT should be monitored carefully for malignancy at the time of dressing changes.

Effects of Intraarticular Prp Administration in Temporomandibular Joint Arthritis: An Experimental Study

Meandros Med Dent J Ad dress for Cor res pon den ce/Ya zış ma Ad re si: Heval Selman Özkan MD, Department of Plastic and Reconstructive Surgery, Adnan Menderes University Faculty of Medicine, Aydin, Turkey Phone: 0256 244 12 56 E-mail: selman_ozk@yahoo.com Received/Geliş Ta rihi : 20.03.2017 Accepted/Ka bul Ta ri hi : 20.11.2017 Anah tar Ke li me ler Temporomanbibuler eklem, trombositten zengin plazma, osteoartrit

Medial sural artery perforator flap in head and neck reconstruction.

Medial sural artery perforator (MSAP) flap is a relatively new flap which is a modification of medial gastrocnemius myocutaneous flap. Both radial forearm flap and MSAP has common benefits, such as thinness, long pedicle and pliability; however, MSAP has lower donor site morbidity when compared with radial forearm flap. Because of this reason, the MSAP flap has gained popularity during the last decade. The objective of this study was to determine clinical application results of this flap in reconstruction of post-oncologic defects in the head and neck region. 11 patients operated for head and neck post oncologic defects and reconstructed with MSAP between June 2014 and Dec 2015 were included in the study. Age, gender, histopathology, area of reconstruction, flap size, number of perforators were reviewed. Postoperatively recipient and donor site complications, hospital stay and additional surgical procedures were also analyzed. We had seven uncomplicated cases; one total flap failure due to arterial problem, in three cases due fistula formation and local wound healing problems additional surgeries were performed. All venous anastomosis were performed with 9/0 sutures, nine arterial anastomosis were performed with 9/0 and two arterial anastomosis were performed with 10/0 nylon sutures. Medial sural artery perforator flap is a good alternative in head and neck reconstruction, with the advantages of thin and pliable skin, a reliable vascular pedicle, straightforward intramuscular dissection. But there are certain drawbacks like tedious pedicle and perforator dissection, small arterial pedicle size which complicates anastomosis and obscurities of anatomy. Surgical team must always be ready for a difficult micro anastomosis and an alternative flap choice must be prepared and counseled with the patient in case of inadequate perforators.

Iliac Lymph Node Resection with Modified J Shaped Incision for Improved Exposure in Iliac Metastases: Case Report

Fatty abdomen or inguinal hernia is typical situations where every effort for perfect exposure of iliac lymph nodes may be difficult. We present a modification that improves the exposure of the iliac nodes whilst reducing nerve, artery and peritoneal damaging. The longitudinal portion of the incision runs from the umbilical line downward, and curves gently at anteripr superior iliac spine. The transverse component extends medially, approximately 1 cm above the inguinal ligament and ends at the junction of the lateral two-third and medial one-thirds of the inguinal ligament. When required, the incision combined with the femoral incision and a cephalic cut is made for additional exposure. We present our experience in two patients who had iliac lymph node metastasis. We find the incision useful and versatile that provides excellent exposure of the iliac region with protection of the iliac vessels.

Nasal Dermoid Cyst and Surgical Approach

Dermoid kistler, gelişimsel patolojiler olup, ekdoderm kaynaklı skuamozepitelle döşelidirler. İçlerinde farklı deri ekleri (sebasebezler, kilfolikülleri ve ter bezleri bazen yağ, kemik, tırnak, diş, göz, kıkırdak ve tiroid dokusu içerir) barındırırlar. Buna bağlı olarak kist lumeni keratin, sebasemateryal ve bazen de kılla doludur. Matür doku içermesi nedeniyle dermoid kistler çoğu zaman selimdir.Dermoid kistin nadiren görülen malign formu erişkinlerde sıklıkla skuam özhücrelikarsinom, bebek ve çocuklarda da endodermal sinus tümörü olarak gelişir. Dermoid kistler gerçek hamartomlardır ve malignite ihtimali nedeniyle dermoid kistlerin bütünüyle cerrahi olarak eksizyonu önerilir. Biz bu çalışmada, nazal bölgede dermoid kisti (NDSK) mevcut olan hastayı ve hastaya uygulanan cerrahi yöntemi sunmaktayız.