İbrahim Tabakan

Total or Near-Total Lower Eyelid Defect Reconstruction Using Malar Myocutaneous Bridge and Nasojugal Flaps and Septal Chondromucosal Graft.

Purpose: The purpose of this study is to repair total or near-total lower eyelid defects by single-staged operative technique. Methods: The procedure was performed on 7 referred patients who had a total or near-total lower eyelid defects after tumor extirpation or trauma. Patients ages were between 13 and 67 years (average, 46.5). Defects were repaired by simultaneous reconstruction of anterior and posterior lamellae using a bipedicled malar myocutaneous bridge flap, a nasojugal transposition flap, and a septal chondromucosal graft in combination. Results: Patients were followed up for 12 to 24 months (average, 18 months). No necrosis, hematoma, or infection was observed in flaps, and no recurrence was observed in any patients. Mild scleral show was observed at postoperative 12 months in 2 cases. Conclusions: As an addition to classical methods, the present novel single-staged surgical procedure with the malar myocutaneous bridge flap, nasojugal transposition flap, and septal chondromucosal graft combination provides anatomical, functional, and stable reconstruction for total or near-total lower eyelid defects.

A cross flow-through pedicle free latissimus dorsi flap for high voltage electrical burns.

BACKGROUND The management of a high voltage electrical injury and lower limb salvage remains a challenging task for plastic surgeons. Reconstruction with flaps is often the only alternative to limb amputation. The purpose of this study was to present a cross flow-through pedicle free latissimus dorsi muscle flap for the salvage of severely traumatized lower limbs perfused by one remaining vessel (a single vessel lower limb) in high voltage electrical injuries. METHODS In this retrospective study, between 2000 and 2014, six men underwent cross-leg free Latissimus dorsi muscle flap operations for limb salvage. They had soft tissue lower leg defects due to high voltage electrical injuries. Their medical records were retrospectively reviewed. All had only one artery that perfused the leg. Free pedicled thoracodorsal artery latissimus dorsi flaps were harvested and connected to the contralateral posterior tibial artery. RESULTS All defects were successfully covered. No flap loss or major amputation occurred during follow-up (mean; 5.9 years). A computerized tomography angiogram showed intact vessel continuity in the recipient vascular system. The patients were able to walk without any apparatus or assistance after long term follow-up. CONCLUSION We recommend that the cross flow-through pedicle free muscle flap should be considered as a salvage procedure for single vessel lower extremities resulting from high voltage electrical burns. Extremity perfusion was not compromised by this procedure.

Radyografik kontrast maddenin damar dışına kaçmasına bağlı üst ekstremitede kompartman sendromu ve el dorsalinde doku defekti

Radyografik kontrast maddenin damar disina kacmasina bagli ust ekstremitede kompartman sendromu ve el dorsalinde doku defekti radyolojik goruntuleme amaciyla periferik damar yolundan verilen kontrast maddenin damar disina kacmasi bilinen bir komplikasyondur. Olgularin buyuk bir kismi kucuk hacimlerde kontrast maddenin kacisina baglidir ve meydana gelen agri, sislik, kizariklik gibi semptomlar hizli bir sekilde, sekel birakmadan duzelir. Fakat buyuk hacimlerde kontrast maddenin damar disina kactigi olgularda cilt nekrozu ve kompartman sendromu gorulebilir. Calismamizda el dorsalinden acilan damar yolundan tomografi cekimi icin verilen kontrast maddenin damar disina kacmasina bagli olarak ust ekstremitede kompartman sendromu ve el dorsalinde cilt nekrozu gelisen bir olgu sunulmaktadir.

Radial kollateral arter perforatör bazlı propellar flep ile dirsek bölgesi rekonstrüksiyonu

Perforatör bazlı propellar flepler (RKAP) 180 dereceye kadar flep rotasyonuna izin vererek defekt onarımlarında kolaylık sağlamaktadır. Bunun yanında diğer fleplere nazaran donör alan morbiditesinin minimal olması özellikle alt ekstremite rekonstrüksiyonda bu fleplerin yaygın olarak kullanılmasını sağlamıştır. Ancak bu fleplerin üst ekstremitelerde kullanımı hala sınırlıdır. Özellikle dirsek bölgesi gibi onarımın zor olduğu bölgelerde bu fleplerin son yıllarda kullanımı gittikçe artmaktadır.Bu çalışmada dirsek bölgesinde kemiği açıkta bırakan defekti olan bir hastaya radial kollateral arter RKAP ile onarım yaptığımız bir olgu sunulmaktadır.

Use of Thompson Procedure in Pubic Massive Lymphedema

Objective: Massive Localized Lymphedema (MLL) is a benign soft tissue mass with unknown etiology and especially occurs in morbid obese patients. MLL generally appears in the medial thigh, but can rarely occur in the suprapubic area and lower abdominal region. MLL can develop into angiosarcoma. Predisposing risk factors should be taken into consideration for operative treatment. Material and Methods: We evaluated a 50-year-old female patient who had a 30-cm MLL area in her suprapubic area. Her Body Mass Index was 51.4. We performed suprapubic mass excision combined with abdominal dermal pedicled Thompson Procedure. Results: There was no suture dehiscence, seroma or infection in the postoperative 6-month period. We did not encounter recurrence during postoperative follow-up. Conclusion: Excisional methods such as the Thompson Procedure may be a convenient choice for suprapubic MLL via decreasing malignant potential by excision and improving lymphatic drainage.