Serhat Özbek

Comparison of the biological activities of high-density porous polyethylene implants and oxidized regenerated cellulose-wrapped diced cartilage grafts.

The use of alloplastic materials in plastic surgery has become more extensive with advancement of autogenous-tissue reconstruction techniques for the repair of defects, tissue augmentation, and the stabilization of bones. An ideal alloplastic material should be nonallergenic, noncarcinogenic, sterilizable, and easy to shape and should not cause rejection. Alloplastic material used for tissue augmentation should have a low rate of resorption and distortion. High-density porous polyethylene implants (Medpor) have been used widely and successfully for tissue augmentation. The Turkish Delight is a material composed of diced cartilage grafts wrapped in oxidized regenerated cellulose (Surgicel). Its indications are similar to those of the Medpor implant, and an additional donor site is usually not needed. Both materials are used in the same anatomical locations, especially for augmentation. Therefore, the authors evaluated the long-term stability of and suitable anatomical sites for these materials. Medpor implants or Turkish Delights were placed subperiosteally or subfascially in 10 young rabbits, and the resultant changes were evaluated 16 weeks after the operation by macroscopy and histopathology. Changes in projections were measured with an ocular micrometer. Medpor implants were neither resorbed nor distorted when placed subperiosteally or subfascially, and were highly stabilized by the surrounding tissues. Turkish Delight also enabled tissue augmentation, but had a significantly higher rate of resorption compared with the Medpor implant and was loosely bound to the surrounding tissue. The Turkish Delight was less resorbed and better fixed to adjacent tissues when placed subperiosteally than when placed subfascially.

Temporomandibular joint reconstruction with free microvascular transfer of the metatarsophalangeal joint: A case report

Free microvascular transfer of the second metatarsophalangeal joint was performed for the treatment of temporomandibular joint ankylosis in a 15‐year‐old male patient. The result is excellent in one‐year follow‐up. The technique seems to be a good alternative to the problem in selected patients.

Histological evaluation of wound healing performance of electrospun poly(vinyl alcohol)/sodium alginate as wound dressing in vivo.

Poly(vinyl alcohol)/sodium alginate nanofibrous mats were produced by electrospinning method at optimum process parameters. Evaluation of alginate-based electrospun nanofibrous mats as a wound dressing material and their comparison to commercially available wound dressings produced with conventional methods were carried out in vivo. Tissue specimens were examined histopathologically on 4th, 6th, 15th, 21st postoperative days. In contrast to other dressings it was observed that nanofibrous mat could survive on the wound crust in early stages of healing. In terms of epithelization, epidermis characteristics, vascularization and formation of hair follicles, nanofibrous mat showed the best healing performance. This could be explained with presence of nanofibrous mat acting as an artificial skin on the wound region until new tissue regenerated.

Free rectus abdominis muscle flap with plantar skingraft--a combined method of aesthetic and functional reconstruction of the heel.

A 16‐year‐old girl presented with a contusion of the left calcaneus that was treated by combined free rectus abdominis muscle flap and plantar skin graft. The main advantages of this procedure are that it replaces weight‐bearing skin of the heel with histologically similar skin from the instep, and the fibrofatty pad of the heel with muscle; it provides a good cosmetic result in the heel, and the scars of the donor site are well‐hidden.

An unusual cause of burn injury: fig leaf decoction used as a remedy for a dermatitis of unknown etiology.

Medicinal plant extracts are commonly used worldwide. Their use relies mostly on historical and anecdotal evidence and might be so hazardous. Phytophotodermatitis is a well-known entity that is caused by the sequential exposure to certain species of plants containing furocoumarins and then to sunlight. In this article, superficial burn lesions caused by fig leaf decoction that was applied to a patients both upper extremity as a remedy for a dermatitis of unknown etiology is reported. Direct sun exposure is an essential component of phytophotodermatitis. All reported cases to date have in common that patients are exposed to direct sunlight or to artificial UVA lights (like solarium) of varying durations. In our case neither direct sun exposure, other than inevitable indoor UVA influence, nor blister formation was present. The etiologic factors, symptoms, signs, course, and treatment alternatives for phytophotodermatitis are also reviewed briefly.

End-to-side nerve coaptation: is an additional proximal coaptation useful when available?

The aim of this experimental study was to evaluate the effects of end-to-side coaptation of the proximal end of a severed nerve to the same intact nerve, in addition to traditional end-to-side coaptation of the distal end, with an aim to use the intact nerve as a nerve conduit in a rat model and to compare the functional and histologic results of this modality to those obtained after nerve grafting and traditional end-to-side nerve coaptation. In group A, a peroneal nerve defect measuring 1 cm was created in the left hind limb, and a nerve graft 1 cm long was used to bridge the defect. In group B, only the distal stump of the peroneal nerve was coapted to the intact tibial nerve. In group C, both ends of the peroneal nerve defect were coapted to the intact tibial nerve in an end-to-side fashion 1.5 cm apart from each other, and in group D, the peroneal nerve defect was left unrepaired. Group E was consisted of nonoperated peroneal nerves that were used to obtain normative data. Although significantly higher myelinated axon densities were observed in groups B and C compared with group A and group E, total number of the myelinated axons was significantly higher only in group C. Peroneal functional index assessments demonstrated that nerve recovery in the peroneal nerve was similar in groups A and C, and both were better than those observed in groups B and D. Collectively, these results suggest that end-to-side coaptation of both ends of a severed nerve to an intact nerve, in case of a nerve defect in this length, may serve as an alternative for nerve grafting.

Custom subatmospheric dressing for fingertip injuries.

Fingertip injuries are difficult to treat. Although the best way is to cover the wound with flap or graft without finger shortening, coverage of the wound with flap or graft cannot be suitable in each case. For some cases, secondary wound healing can be an alternative treatment. In the secondary healing process, to promote the granulation tissue and to reduce wound-healing time, subatmospheric dressing (vacuum dressing) can be a useful method. In this study, a new custom-made subatmospheric dressing method designed for fingertip injuries has been described.

Effect of lyophilized heterologous collagen on new cartilage formation from perichondrial flaps in rabbits: an experimental study.

New cartilage formation originated from perichondrium has previously been researched in many clinical and experimental studies. 1–6 After these studies, the use of perichondrium for the repair of cartilage defects has been used clinically when enhancing neochondrogenesis has been found to be of great value in decreasing the recovery period. Collagen is the major protein of whole connective tissue, and in vitro positive effects of collagen matrices on neochondrogenesis have also been studied before. 7–9 In this experimental study, in vivo effects of heterologous collagen sponge in perichondrial neochondrogenesis were examined in an animal model, and acceleration and enhancement effects were observed.

Delayed removal of a primary incisor embedded in the upper lip after dental trauma: a case report about the importance of soft tissue examination

This article describes a child patient who initially had inadequate treatment and suffered concomitant soft tissue trauma involving complete displacement of a primary central incisor into the lip tissue. The primary tooth was subsequently removed by surgery under general anesthesia. Despite the delay in diagnosis, there was an excellent outcome following removal of the embedded tooth. This paper again emphasizes the importance of an accurate history, physical, and radiographic evaluation of these patients in the acute phase. The importance of soft tissue inspection even in cases that are presented late for dental trauma management is also highlighted. This case shows that educated emergency room staff preferably including an oral and maxillofacial surgeon is required for a proper emergency management in orofacial traumas.

Outcomes of elderly burn patients requiring hospitalization

Abstract Background: The elderly population is more likely to be affected by accidents, such as burns, compared to younger populations because of their diminished host defense. There is limited data about the outcomes of elderly burn patients requiring hospitalization. Methods: In this retrospective study, we assessed the epidemiology and outcomes of burn injuries in elderly patients (>60 years old) admitted to a burn unit of a tertiary medical center based on patient characteristics, type and extent of burns, treatment, hospital stay and mortality rates. Results: Forty-eight elderly burn patients among 870 burn patients during the study period were evaluated. Fire was the most common cause of burns (77.1%). Most of the burns involved more than 20% of total body surface area. Twenty-six (54.2%) patients died during hospitalization. Although burn surface area slightly and non-significantly increased in patients over 75 years, there was a significantly increased mortality rate in these patients. Multivariate linear regression analysis revealed burn area and age as independent associates of mortality. Conclusion: Our data show a high mortality rate in elderly burn patients. Extensive burns and increased age seem to increase the mortality risk.