Muhammet Uraloğlu

Effects of lidocaine plus epinephrine and prilocaine on autologous fat graft survival.

Abstract Although fat grafting is frequently used in plastic surgery practice, debate about the viability of the graft still persists owing to its questionable long-term success. The ultimate aim is to obtain long-term graft viability. Vascularization of the graft is essential for this purpose. The effects of 2 different local anesthetic preparations frequently used during harvesting of fat grafts on long-term graft survival were compared with angiogenesis and volumetric measurements. Twenty-four male Wistar rats were divided into 3 groups. The inguinal region was selected as the fat graft donor site. The first group was injected with isotonic saline, the second was injected with lidocaine plus epinephrine, and the third was injected with prilocaine. Fat grafts were implanted into the dorsal regions of rats, and volumetric measurements were performed initially and on days 30 and 180 at which microvascular angiogenesis were also analyzed. Microvascular angiogenesis was assessed both with the reverse transcription–polymerase chain reaction and immunohistochemistry through determination of vessels stained with factor VIII. No significant difference was obtained between the 3 groups in graft volume or microvascular angiogenesis at any stage of the study. Results from this experimental study indicate that there is no negative effect of lidocaine plus epinephrine or prilocaine on microangiogenesis and the survival of fat grafts.

Necrosis of the donor site after hair restoration with follicular unit extraction (FUE): A case report

Follicular unit extraction (FUE) has been developed as one type of follicular unit transplantation surgery, a widely accepted hair-restoration technique. FUE has many advantages, including a small donor area scar, less pain and a slender graft without extra surrounding tissue. Complications are uncommon in the literature. We describe a case of donor-site necrosis after hair restoration with FUE, leading to cicatricial alopecia in the left half of the occipital region. The surgical management of this complication is also discussed. Cicatricial alopecia was treated by two-stage surgery with tissue expanders. There were no complications in the postoperative period and healing was uneventful. We conclude that although FUE has many advantages, necrosis of the donor site may be a serious problem.

An objective evaluation of an injured vessel wall using fluorescein sodium before microvascular anastomosis in an experimental rat model.

The aim of this study was to establish an objective evaluation method for intraoperative detection of damaged vascular endothelium in avulsion injuries. Twenty male Fischer rats were randomly assigned to control or experimental groups ( N = 10, each). Crush-avulsion injury was performed on right femoral arteries. Resection of damaged segments was performed according to operative microscopic findings in the control group; fluorescein sodium was applied to the artery lumen before resection in the experimental group to help visualize the damaged endothelium. Microvascular repair was performed in five rats in each group. In the other animals, the whole length of the femoral arteries was resected to assess the actual extent of injury histologically. At the end of the follow-up period, patency of microvascular anastomoses was examined and the lengths of the resected segments were compared with the actual length of the injured segment measured histologically. The difference between these two measurements was statistically significant in the control group ( P < 0.05) but not in the experimental group ( P > 0.05). Anastomosis patency was significantly higher in the experimental group ( P < 0.0001). In conclusion, fluorescein sodium may help to accurately determine the length of the injured vascular segment in avulsion injuries.

Giant cementoblastoma of the impacted mandibular incisor.

The cementoblastoma is a relatively rare type of all odontogenic tumors. The incisor and impacted or unerupted tooth involvement by a cementoblastoma is extremely rare. We present a case report of a giant cementoblastoma that involved an impacted mandibular incisor.

The Effect of Platelet-Rich Plasma on the Zone of Stasis and Apoptosis in an Experimental Burn Model

Background: The zone of stasis that forms in acute burn is initially viable, but coagulation progresses to necrosis in the process that follows. Objective: This study investigates the effects of platelet-rich plasma (PRP) on apoptosis in the burn zone of stasis and on the viability of living tissue. Methods: Burns were established in the right ears of 20 female New Zealand rabbits using the “comb burn” model. Platelet-rich plasma was obtained from blood collected from rabbits’ ears (n = 10) and was injected subcutaneously into the zone of stasis (n = 10). The same amount of saline solution was injected into the zone of stasis of the control group rabbits (n = 10). Histological and immunohistochemical apoptosis analysis was performed to evaluate viable areas. Results: Apoptosis levels were higher in the control group than in the experimental group. The area of viable tissue in the zone of stasis was greater than in the control group. Infection-induced neutrophil infiltration was statistically significantly lower in the experimental group. Conclusion: In this animal model, apoptosis count and viable tissue area measurement and the anti-inflammatory results in the burn area confirm that PRP therapy has a statistically significant positive impact on the survival of the zone of stasis and in acute burn injury.

Evaluation of the Extent of Vessel Avulsion Injury: An Experimental Study Using a Rabbit Model

Background Determining the extent of damage in vascular avulsion type injuries still represents a challenge for the microsurgeon. Excision of the damaged section is critical for the success of anastomosis. The purpose of this study was to determine which among vascular endothelial and adventitia damage findings is most effective in determining the extent of avulsion injury. Methods Varying degrees of avulsion were applied to the aorta of 12 (n = 12) adult female New Zealand rabbits. Avulsion was first determined using adventitial findings and then with endothelial findings. The definitive extent of damage was determined histopathologically. Results The mean area of the histopathological sections was 16.7 ± 6.9 mm. The extent of damage measured from the adventitia was 15.8 ± 7.9 mm (the difference in histopathological examinations was not significant, p = 0.590, paired t ‐test), while the extent of damage from the lumen was 13.3 ± 8.2 mm (the difference in histopathological examinations was significant p = 0.004, paired t ‐test). Conclusion Excision based on adventitia findings is more effective in case of avulsion injury.

Microsurgical Replantation of Two Consecutive Traumatic Total Scalp Avulsions

Total scalp avulsion is a rare but severe injury frequently ending in hair loss, and one that can even be life-threatening. It frequently occurs in women and in men with long hair and as a result of injuries by industrial or agricultural equipment or of animal attacks. The first option in treatment is replantation of hairy skin with microsurgery.The authors report 2 consecutive patients with total scalp avulsion presenting to our clinic. Similar injury mechanisms and total scalp avulsions were present in both patients. However, the noteworthy aspect of this report is the different outcomes in terms of scalp viability, which the authors think depends on the number of vessels repaired.

Congenital nail abnormalities: a review of the literature.

AbstractCongenital nail abnormalities (CNAs) are rare conditions in which the nail tissue appears abnormal compared with the fingers and the toes. They usually present accompanying deformities and disorders. Our purpose was to review the current literature on the clinical aspects of CNA. We reviewed the literature to evaluate peer-reviewed articles on the topic. Detailed reports have characterized many types of CNA. In this article, we provide a review of the literature based on the current understanding of CNAs and the clinical varieties thereof.

Giant schwannoma of the little finger.

A 23-year-old man presented at our hospital with a 3-year history of a subcutaneous mass on his right little finger. The tumor had gradually increased in size and caused slight pain. He denied any injury or trauma. Physical examination revealed a solitary tumor with a smooth surface on the radial side of the distal interphalangeal joint of his right little finger (Figure 1A). The tumor was elastic hard when palpated. A radiograph of the right hand was normal. Ultrasound confirmed that the lesion was solid and separate from the adjacent gliding flexor tendons. Tinel’s sign was negative.