Mehmet İhsan Okur

Phytocontact dermatitis mimicking a burn injury due to Ranunculus constantinopolitanus

R. Kose, M. _ I. Okur, _ I. Bingol and H. Cxetin Department of Plastic and Reconstructive Surgery, Kahramanmaras x State Hospital, 46100 Kahramanmaras x, Department of Plastic and Reconstructive Surgery, Firat Medical Center, Firat University, 23119 Elazig, and Department of Plastic and Reconstructive Surgery, Elazig State Hospital, 23119 Elazig, and Department of Dermatology, Kahramanmaras x State Hospital, 46100 Kahramanmarasx, Turkey

Effects of Rosmarinus officinalis on the survivability of random-patterned skin flaps: An experimental study

Abstract Improving survival of skin flaps used in soft-tissue reconstruction is clinically an important goal, and several systemic and local agents have been used for this purpose. However, a substance that prevents the flap necrosis has not yet been defined. This study aimed to investigate whether a Rosmarinus officinalis extract could improve the skin flap survival. In this study, 21 Wistar albino rats were divided into three groups. Rectangular 8 × 2 cm random-pattern flaps were elevated from the back of the rats. Group I was considered the control group. In Group II, a 0.5-cc of Rosmarinus officinalis oil was applied with an ear bud to the flap area 30 minutes before the flap elevation. After suturing the flaps to their location, the oil was administered twice a day for a week. In Group III, 0.5 cc of the oil was applied twice a day to the area that was elevated for a week until surgery. At the end of the week, the flaps were sutured to their location, and wiped postoperatively twice a day for a week with the oil. Mean percentage of these areas was found to be 29.81%, 58.99%, and 67.68% in Group I, Group II, and Group III, respectively. The mean percentage of the flap survival areas and vessel diameters were significantly greater in the Groups II and III than in the control group (p < 0.05). The results revealed that the topical use of the Rosmarinus officinalis extract can increase the flap survivability.

Development of Hyperalgesia in Patients Treated with Autologous Platelet Rich Plasma Due to Androgenetic Alopecia

Amac: Platelet zengin plazmanin (PZP) etkisini trombositlerin alfa granullerinde bulunan buyume faktorleri ile yuksek trombosit konsantrasyonuna bagli olarak gosterdigi dusunulmektedir. Tekrarlayan girisimlerde artan agri hissi, PZP’nin hipersensitizasyonla iliskili hiperaljeziye neden olabilecegi sorusunu gundeme getirmektedir. Literaturde tekrarlayan PZP enjeksiyonunun neden oldugu periferik duyarliligi bildiren yayin yoktur. Bu calismada, androjenik sac kaybi olan PZP hastalarinda hipersensitizasyona bagli hiperaljezinin olup olmadigini arastirmayi amacladik. Hastalar ve Yontem: Calismaya 2016-2017 yillari arasinda androgenetik alopesisi olan 25-35 yaslari arasinda 10 erkek hasta dahil edildi. Otolog PZP, frontal ve parietal bolge derisine cm2 basina 1 mL enjekte edildi ve enjeksiyon birinci, ikinci ve altinci ayda tekrarlandi. Hastalarin agrili uyaranlara verdigi cevaplar, tum enjeksiyonlardan hemen once ve ilk yilda, degisken olarak Von Frey filamentleri kullanilarak arastirildi. Her bir olcumun hiperaljezi skorlari, iki cerrahin ortalama sonuclari ile belirlendi. Sac kaybi olan hastalar dermoskopi ile degerlendirildi. Birim alandaki sac folikulu sayisi tespit edildi ve hastalarin her bir kontrolunde fotograf cekildi. Bulgular: Hastalarin yas ortalamasi 29,4 idi. Hastalar hiperaljezi acisindan degerlendirildiginde, her PZP uygulamasindan sonra, PZP enjeksiyonu oncesi ile karsilastirildiginda agrinin daha az g stimulasyonu ile hissedildigi gozlendi (P < 0.05). Hiperaljezinin en yuksek periyodu PZP’den sonraki ilk yildaydi (P < 0.05). Sac yogunlugundaki artis, ilk tedaviden sonra 1., 2., 6. ve 12. aylarda % 6,4 , 9,4 , 21 ve 27,6 olarak hesaplandi. Sonuc: Hastalarda tekrarlayan PZP enjeksiyonlari nedeniyle hiperaljezi ortaya cikabilir. Bu hastalarda hiperaljezinin gelisimi PZP icerigindeki buyume faktorlerine bagli olabilir. Tekrarlanan PZP enjeksiyonlarindan sonra ortaya cikan hiperaljezinin nedenini belirlemek icin ileri deneysel ve klinik calismalara ihtiyac vardir.

Do rhomboid flaps provide more elongation than Z-plasty flaps? An experimental study

Abstract Background and aim: A Z-plasty flap is one of the most widely used geometric relaxation methods to release contracture bands. A rhomboid flap is a lesser used geometric relaxation method than a Z-plasty flap. This study aimed to determine the length and rate of elongation provided by rhomboid and Z-plasty flaps. Methods: Bilateral contracture bands were created in the inguinal skins of rats. A rhomboid flap was planned for the right side of the inguinal region, and a single Z-plasty flap was planned for the left side. The length and rate of elongation provided by the two flaps were calculated after completing the procedures and were compared using Student’s t-test. Results: Experimental contracture bands disappeared in both the inguinal regions after creating rhomboid and Z-plasty flaps. The mean postoperative elongation of the contracture band was 1.4 ± 0.119 and 2.47 ± 0.281 cm using the rhomboid and Z-plasty flaps, respectively. The difference was statistically significant (p < .001). Conclusion: Z-plasty flaps provide more elongation than rhomboid flaps and also appear to be better options for releasing linear contracture bands. However, rhomboid flaps may be used as alternatives when Z-plasty flaps cannot be used and in regions such as the axilla, genital region, nipple-areola, where their distortion effects should be avoided.

A comparison of rat degloving injury models

Objective Two different rat models for degloving injury were described in the literature. Our aim in this study is to compare these rat models to determine which one is more reliable and reproducible. Methods We surgically induced degloving injury on tails and left hindlimbs of Wistar albino rats (n = 8), and sutured the avulsed tissues back in their original positions after a waiting period. We observed the changes in the avulsed flaps every other day for 10 days. At the end of follow-up period we evaluated the lesions in avulsed flaps by macroscopic measurement of necrosis and histological ulcer scoring using the National Pressure Ulcer Advisory Panel (NPUAP) Scale. Results The average length of necrosis in avulsed tail flaps was 28.42 ± 3.04 mm, whereas there was no necrosis in avulsed hindlimb flaps (p < 0.05). The average ulcer score of the lesions in tail and left hindlimb were 3.42 ± 0.78, and 1.28 ± 0.48, respectively (p < 0.05). Despite the lack of visible necrosis TUNEL staining revealed an increased amount of apoptotic cells in avulsed hindlimb flaps. Literature review revealed a significant variability in previous studies in terms of the amount of necrosis observed in tail degloving injury model. Conclusion Tail degloving injury model proved to be a more reliable animal model for degloving injuries. However, standardization of the magnitude of degloving force is required to decrease the variability of necrosis observed in the literature.

Comparison of nasal senses following open and closed rhinoplasty

BACKGROUND/AIM The objective of this study was to compare the postoperative changes taking place in the nasal senses of patients who underwent a rhinoplasty through the open or closed incision method. MATERIALS AND METHODS In a prospective study, 15 patients had a closed rhinoplasty surgery and 15 others had an open one. By pinpointing 9 spots in the nose, a sensory assessment was made by means of Semmes-Weinstein monofilaments prior to the surgery and 1 week and 1, 3, and 6 months after the surgery. RESULTS In the open and closed groups, there was hypoesthesia 1 week after the surgery compared with the preoperative period (P = 0.01 and P = 0.016). In the first week a sense reduction in the upper columella was observed in the open group when compared with the closed one (P = 0.035). There were no other significant differences between the groups in the nasal regions at other times. CONCLUSION It was ascertained that there was reduced sensation in the upper columella in the open incision group in the first postoperative week. The sensation was reduced in both groups in the first postoperative week. The nasal sensation recovered after the first month.