Large lower thigh defects are a reconstructive challenge. Keystone design perforator island flap in the lower thigh is not routinely performed as the skin here is less extensible. We present a case of a large anterolateral lower thigh defect wherein we used double keystone flaps from the remaining circumference of the thigh and grafted the donor site in the posterior thigh. Circumferential incision/scarring in the limbs risk damage of superficial lymphatico-venous circulation and distal edema. However, our case demonstrates an uneventful recovery and excellent aesthetic and functional outcome.
{"title":"Double keystone flap for large lower thigh defect","authors":"Amrita More, Dharini Dharini, A. Sivakumar","doi":"10.4103/tjps.tjps_92_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_92_20","url":null,"abstract":"Large lower thigh defects are a reconstructive challenge. Keystone design perforator island flap in the lower thigh is not routinely performed as the skin here is less extensible. We present a case of a large anterolateral lower thigh defect wherein we used double keystone flaps from the remaining circumference of the thigh and grafted the donor site in the posterior thigh. Circumferential incision/scarring in the limbs risk damage of superficial lymphatico-venous circulation and distal edema. However, our case demonstrates an uneventful recovery and excellent aesthetic and functional outcome.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"43 1","pages":"67 - 71"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74968033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Ustun, Ferhat Kargalioglu, M. Çaydere, Uğur Koçer
Parachordoma is one of the rarest tumors identified, with around fifty cases reported to date. It is reported to have a benign behavior, yet metastatic and fatal cases have been reported. A 63-year-old female patient presented with a subcutaneous mass in the right deltoideal region. After two excisional biopsies with tumor-free surgical margins and 33 cycles of radiotherapy, the case presented with a second recurrence. Due to malignant features in the second histopathological examination, she was treated with excision of the deltoid muscle, and the defect was reconstructed with latissimus dorsi myocutaneous flap. There is no standardized treatment protocol for parachordoma. Yet, increased mitotic activity and atypical mitotic figures arise suspicion for recurrent and malignant behavior. In the presence of these features in histopathological examination, tumor should be considered as low-grade sarcoma and be treated accordingly.
{"title":"Managing one of the rarest: Recurrent parachordoma","authors":"G. Ustun, Ferhat Kargalioglu, M. Çaydere, Uğur Koçer","doi":"10.4103/tjps.tjps_40_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_40_20","url":null,"abstract":"Parachordoma is one of the rarest tumors identified, with around fifty cases reported to date. It is reported to have a benign behavior, yet metastatic and fatal cases have been reported. A 63-year-old female patient presented with a subcutaneous mass in the right deltoideal region. After two excisional biopsies with tumor-free surgical margins and 33 cycles of radiotherapy, the case presented with a second recurrence. Due to malignant features in the second histopathological examination, she was treated with excision of the deltoid muscle, and the defect was reconstructed with latissimus dorsi myocutaneous flap. There is no standardized treatment protocol for parachordoma. Yet, increased mitotic activity and atypical mitotic figures arise suspicion for recurrent and malignant behavior. In the presence of these features in histopathological examination, tumor should be considered as low-grade sarcoma and be treated accordingly.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"14 1","pages":"56 - 60"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83719617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Contour and volume deficiencies in the calf region, either unilateral or bilateral, may raise an esthetic concern in affected individuals. There are numerous methods described for volume augmentation or contour reshaping in this region including implant placement, autogenous tissue transfer, liposuction, and/or fat injections. The authors present their series of patients to whom they performed fat injections with or without platelet-rich plasma (PRP) enrichment for addressing this problem. Methods: Fifty-two patients who had undergone calf lipostructuring procedure(s) in our clinic were included in this retrospective study. The procedure was repeated with a fixed value of fat volume per leg until a satisfactory limit for both the patient and the senior author could be achieved. Regarding the analysis of outcome, the number of sessions needed to be repeated was recorded for each patient. Results: 125 cc of fat was injected per session per leg. Ten patients were treated with PRP enriched fat transplants while 42 were treated with fat only. The mean number of sessions was 2.76 (min. 2, max. 6). For the group treated with PRP-enriched fat grafts a mean 2.00 number of sessions had to be carried out while the mean was 2.95 for the patients in the fat-only group. The mean number of sessions to achieve our goal was significantly lower in the PRP-enriched fat injected group (P < 0.001). Conclusion: Addition of PRP significantly reduces the need of repeated operations to achieve the best possible outcome in lipostructuring around the calf region. Level of Evidence: Retrospective comparative study, level III.
{"title":"Augmentation of the calf region with autologous fat and platelet-rich plasma-enhanced fat transplants: A comparative study","authors":"U. Bilkay, A. Biçer, Zeyyat Ozek, T. Gurler","doi":"10.4103/tjps.tjps_67_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_67_20","url":null,"abstract":"Background: Contour and volume deficiencies in the calf region, either unilateral or bilateral, may raise an esthetic concern in affected individuals. There are numerous methods described for volume augmentation or contour reshaping in this region including implant placement, autogenous tissue transfer, liposuction, and/or fat injections. The authors present their series of patients to whom they performed fat injections with or without platelet-rich plasma (PRP) enrichment for addressing this problem. Methods: Fifty-two patients who had undergone calf lipostructuring procedure(s) in our clinic were included in this retrospective study. The procedure was repeated with a fixed value of fat volume per leg until a satisfactory limit for both the patient and the senior author could be achieved. Regarding the analysis of outcome, the number of sessions needed to be repeated was recorded for each patient. Results: 125 cc of fat was injected per session per leg. Ten patients were treated with PRP enriched fat transplants while 42 were treated with fat only. The mean number of sessions was 2.76 (min. 2, max. 6). For the group treated with PRP-enriched fat grafts a mean 2.00 number of sessions had to be carried out while the mean was 2.95 for the patients in the fat-only group. The mean number of sessions to achieve our goal was significantly lower in the PRP-enriched fat injected group (P < 0.001). Conclusion: Addition of PRP significantly reduces the need of repeated operations to achieve the best possible outcome in lipostructuring around the calf region. Level of Evidence: Retrospective comparative study, level III.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"51 1","pages":"21 - 27"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80681414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Synovial chondromatosis or loose body is frequently encountered in the knee, elbow, and shoulder joints. However, hand is a rare localization. It is aimed to present the arthroscopic excision of the loose body inside the first carpometacarpal (CMC) joint. A 47-year-old female patient presented with pain in the left thumb root. The grind test was positive in the patient; however, there were no signs of arthritis in the first CMC joint. Tomography revealed the loose bodies inside the joint. Under traction, CMC joint was palpated, two portals were opened, dry and wet arthroscopy was performed, and loose bodies were extracted. Synovial chondromatosis is a disorder that can be solved arthroscopically and should be kept in mind in hand and wrist pain, which reminds osteoarthritis of the hand and wrist where there are no signs of osteoarthritis in the physical examination and direct radiographs.
{"title":"Arthroscopic removal of synovial chondromatosis of the first carpometacarpal joint","authors":"G. Yildiran, Z. Tosun","doi":"10.4103/tjps.tjps_38_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_38_20","url":null,"abstract":"Synovial chondromatosis or loose body is frequently encountered in the knee, elbow, and shoulder joints. However, hand is a rare localization. It is aimed to present the arthroscopic excision of the loose body inside the first carpometacarpal (CMC) joint. A 47-year-old female patient presented with pain in the left thumb root. The grind test was positive in the patient; however, there were no signs of arthritis in the first CMC joint. Tomography revealed the loose bodies inside the joint. Under traction, CMC joint was palpated, two portals were opened, dry and wet arthroscopy was performed, and loose bodies were extracted. Synovial chondromatosis is a disorder that can be solved arthroscopically and should be kept in mind in hand and wrist pain, which reminds osteoarthritis of the hand and wrist where there are no signs of osteoarthritis in the physical examination and direct radiographs.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"10 1","pages":"53 - 55"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88080426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ufkay Karabay, R. Husemoglu, M. Egrilmez, H. Havitcioglu
Humans require treatment due to the loss of tissues after trauma and diseases. Tissue engineering is a growing field of engineering and medical science to restore, maintain, or improve function of damaged or diseased tissues. The use of three-dimension (3D) scaffolds in particular offers a potential option for patients with tissue deficiency. Polylactic acid (PLA), poly-caprolactone (PCL), polyether-ether-ketone (PEEK), and thermoplastic polyurethane (TPU) are biomaterials that are commonly used in tissue engineering. Their applications of pure material or composite and supportive materials are of great importance for clinical practices. This review provides information on biomaterials and major areas of application and discusses their advantages and disadvantages against each other. The literature search from the database PubMed was done for the key words 3D PLA, PCL, PEEK, and TPU separately and 2029 articles were identified. These articles were limited according to clinical, in vivo and observational studies published in English and 140 articles were evaluated for this review. We selected the main articles according to the current data of 3D scaffolds and identical articles were removed. Fifty articles were included in the review. Many studies have reported the advantages of 3D scaffolds with composite or supplement materials over pure materials in the medical treatment. The advances in the development of new 3D scaffolds hold great promise for the prospective applications in the medical treatment.
{"title":"A review of current developments in three-dimensional scaffolds for medical applications","authors":"Ufkay Karabay, R. Husemoglu, M. Egrilmez, H. Havitcioglu","doi":"10.4103/tjps.tjps_70_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_70_20","url":null,"abstract":"Humans require treatment due to the loss of tissues after trauma and diseases. Tissue engineering is a growing field of engineering and medical science to restore, maintain, or improve function of damaged or diseased tissues. The use of three-dimension (3D) scaffolds in particular offers a potential option for patients with tissue deficiency. Polylactic acid (PLA), poly-caprolactone (PCL), polyether-ether-ketone (PEEK), and thermoplastic polyurethane (TPU) are biomaterials that are commonly used in tissue engineering. Their applications of pure material or composite and supportive materials are of great importance for clinical practices. This review provides information on biomaterials and major areas of application and discusses their advantages and disadvantages against each other. The literature search from the database PubMed was done for the key words 3D PLA, PCL, PEEK, and TPU separately and 2029 articles were identified. These articles were limited according to clinical, in vivo and observational studies published in English and 140 articles were evaluated for this review. We selected the main articles according to the current data of 3D scaffolds and identical articles were removed. Fifty articles were included in the review. Many studies have reported the advantages of 3D scaffolds with composite or supplement materials over pure materials in the medical treatment. The advances in the development of new 3D scaffolds hold great promise for the prospective applications in the medical treatment.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"39 1","pages":"38 - 43"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88436878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.4103/tjps.tjps_117_20
Z. Doğan, M. Onal, M. Ozkan, U. Ugurlu, Bulent Sacak
Background: As evidence emerged supporting the oncological safety of nipple-sparing mastectomy (NSM), immediate reconstruction following these procedures has also gained popularity. The aim of this study was to identify surgical and patient characteristics that may be associated with skin and/or NAC necrosis following NSM and immediate reconstruction. Patients and Methods: Medical records of patients who underwent NSM with immediate breast reconstruction from January 2013 to September 2020 were retrospectively reviewed. Patient and surgical characteristics were collected. The primary outcome measure was mastectomy skin flap necrosis (MSFN). Results: MSFN was observed in 68 out of 243 (28%) breasts. On univariate analysis, reconstruction method and body mass index (BMI) (odds ratio: 1.09, 95% confidence interval: 1.00–1.18, P = 0.04) were found to be significant risk factors. On multivariate analysis, neither BMI (P = 0.30) nor reconstruction methods (implants (P = 0.16) or tissue expander (P = 0.06) showed significant association with skin flap necrosis. However, BMI was found to be significantly higher in the autologous group (P < 0.0001). The best subset selection method also confirmed the reconstruction method as the single variable related to outcome. Conclusion: Even though our results showed autologous reconstruction to have a higher risk for necrotic complications, it should be kept in mind that this group of patients can be managed in the outpatient clinic with debridement, wound care, and – if necessary – skin grafting. However, full-thickness necrosis in an implant patient will require an implant exchange and possibly a local skin/muscle flap for coverage.
{"title":"Predicting mastectomy skin flap necrosis in immediate breast reconstruction","authors":"Z. Doğan, M. Onal, M. Ozkan, U. Ugurlu, Bulent Sacak","doi":"10.4103/tjps.tjps_117_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_117_20","url":null,"abstract":"Background: As evidence emerged supporting the oncological safety of nipple-sparing mastectomy (NSM), immediate reconstruction following these procedures has also gained popularity. The aim of this study was to identify surgical and patient characteristics that may be associated with skin and/or NAC necrosis following NSM and immediate reconstruction. Patients and Methods: Medical records of patients who underwent NSM with immediate breast reconstruction from January 2013 to September 2020 were retrospectively reviewed. Patient and surgical characteristics were collected. The primary outcome measure was mastectomy skin flap necrosis (MSFN). Results: MSFN was observed in 68 out of 243 (28%) breasts. On univariate analysis, reconstruction method and body mass index (BMI) (odds ratio: 1.09, 95% confidence interval: 1.00–1.18, P = 0.04) were found to be significant risk factors. On multivariate analysis, neither BMI (P = 0.30) nor reconstruction methods (implants (P = 0.16) or tissue expander (P = 0.06) showed significant association with skin flap necrosis. However, BMI was found to be significantly higher in the autologous group (P < 0.0001). The best subset selection method also confirmed the reconstruction method as the single variable related to outcome. Conclusion: Even though our results showed autologous reconstruction to have a higher risk for necrotic complications, it should be kept in mind that this group of patients can be managed in the outpatient clinic with debridement, wound care, and – if necessary – skin grafting. However, full-thickness necrosis in an implant patient will require an implant exchange and possibly a local skin/muscle flap for coverage.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"266 1","pages":"9 - 13"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77547606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erhan Coşkun, B. Ozkan, A. Terzi, E. Ozer, C. Uysal, H. Borman, N. Ertas
Introduction: A prior abdominoplasty is considered as an absolute contraindication to transverse rectus abdominis musculocutaneous (TRAM) flap surgery. The aim of this study is to investigate the effect of nonexpanded adipose stromal vascular fraction (ASVF) on the viability of TRAM flap after abdominoplasty. Materials and Methods: Thirty-five male Sprague Dawley rats were divided into five groups. Reverse abdominoplasty model was used in all groups except Group 1. TRAM flap was performed 2 weeks after abdominoplasty in Groups 2 and 4 and 4 weeks after in Groups 3 and 5. ASVF cells were injected during abdominoplasty in Groups 4 and 5. The viable flap area (VFA) percentage and newly formed perforators were assessed. Capillary density and fibrosis gradient and plasma vascular endothelial growth factor (VEGF) levels were measured. Results: The mean VFA to total flap area was measured as 82.90% ± 7.59%, 3.31% ± 3.29%, 9.40% ± 6.18%, 31.92% ± 9.29%, and 64.98% ± 10.95% in Group 1, Group 2, Group 3, Group 4, and Group 5, respectively (P < 0.05). The number of newly formed musculocutaneous perforating arteries was 0.29 ± 0.49, 1.14 ± 0.69, and 2 ± 0.82 for Groups 3, 4, and 5, respectively (P < 0.05). The mean capillary density was 6.86 ± 0.50, 0.67 ± 0.13, 2.79 ± 0.53, 3.71 ± 0.47, and 7.01 ± 0.70 in Groups 1, 2, 3, 4, and 5, respectively (P < 0.05). There was a statistically significant increase between the baseline VEGF values and the second VEGF values in Groups 4 and 5. Conclusions: The study showed that local injection of ASVF increases the viability of TRAM flap after abdominoplasty.
{"title":"The effect of adipose stromal vascular fraction on the viability of transverse rectus abdominis myocutaneous flap after abdominoplasty: An experimental study","authors":"Erhan Coşkun, B. Ozkan, A. Terzi, E. Ozer, C. Uysal, H. Borman, N. Ertas","doi":"10.4103/tjps.tjps_24_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_24_20","url":null,"abstract":"Introduction: A prior abdominoplasty is considered as an absolute contraindication to transverse rectus abdominis musculocutaneous (TRAM) flap surgery. The aim of this study is to investigate the effect of nonexpanded adipose stromal vascular fraction (ASVF) on the viability of TRAM flap after abdominoplasty. Materials and Methods: Thirty-five male Sprague Dawley rats were divided into five groups. Reverse abdominoplasty model was used in all groups except Group 1. TRAM flap was performed 2 weeks after abdominoplasty in Groups 2 and 4 and 4 weeks after in Groups 3 and 5. ASVF cells were injected during abdominoplasty in Groups 4 and 5. The viable flap area (VFA) percentage and newly formed perforators were assessed. Capillary density and fibrosis gradient and plasma vascular endothelial growth factor (VEGF) levels were measured. Results: The mean VFA to total flap area was measured as 82.90% ± 7.59%, 3.31% ± 3.29%, 9.40% ± 6.18%, 31.92% ± 9.29%, and 64.98% ± 10.95% in Group 1, Group 2, Group 3, Group 4, and Group 5, respectively (P < 0.05). The number of newly formed musculocutaneous perforating arteries was 0.29 ± 0.49, 1.14 ± 0.69, and 2 ± 0.82 for Groups 3, 4, and 5, respectively (P < 0.05). The mean capillary density was 6.86 ± 0.50, 0.67 ± 0.13, 2.79 ± 0.53, 3.71 ± 0.47, and 7.01 ± 0.70 in Groups 1, 2, 3, 4, and 5, respectively (P < 0.05). There was a statistically significant increase between the baseline VEGF values and the second VEGF values in Groups 4 and 5. Conclusions: The study showed that local injection of ASVF increases the viability of TRAM flap after abdominoplasty.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"18 1","pages":"1 - 8"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84588337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vijay Kumar, Navneet Sharma, B. Mishra, D. Upadhyaya, A. Singh
Context: Growth factors released from platelets act on stem cells in the bulge region of follicles and thus stimulate the development of new hair follicles. Aims: Primary aim of the study was to assess the efficacy and safety of activated platelet rich plasma in AGA. Settings and Design: Prospective double arm non-randomized pre-post study. Material and Methods: Activated Platelet-rich plasma was injected in either anterior half of alopecia scalp in first 20 patients and posterior half in next 20 patients (Group I) and the other half was injected with placebo (Group II). Each patient received a total of 5 session of aPRP, 15 days apart. Statistical analysis used: Quantitative variables were compared using student T test and Mann-Whitney Test between two groups. A p value of < 0.05 was considered statistically significant. Results: 40 male patients with a clinical diagnosis of AGA (stage II to VI) were recruited but only 35 patients completed the whole study. At 1 month and 3 months follow-up, Group I showed statistically significant increase in hair count, hair density and anagen/telogen ratio as compared to Group II. Conclusion: aPRP is a safe and good alternative to medical treatment. It seems to have a stabilizing effect on hair fall and may be considered as a measure to prevent progression of alopecia in early stages.
{"title":"To study the effect of activated platelet-rich plasma in cases of androgenetic alopecia","authors":"Vijay Kumar, Navneet Sharma, B. Mishra, D. Upadhyaya, A. Singh","doi":"10.4103/tjps.tjps_86_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_86_20","url":null,"abstract":"Context: Growth factors released from platelets act on stem cells in the bulge region of follicles and thus stimulate the development of new hair follicles. Aims: Primary aim of the study was to assess the efficacy and safety of activated platelet rich plasma in AGA. Settings and Design: Prospective double arm non-randomized pre-post study. Material and Methods: Activated Platelet-rich plasma was injected in either anterior half of alopecia scalp in first 20 patients and posterior half in next 20 patients (Group I) and the other half was injected with placebo (Group II). Each patient received a total of 5 session of aPRP, 15 days apart. Statistical analysis used: Quantitative variables were compared using student T test and Mann-Whitney Test between two groups. A p value of < 0.05 was considered statistically significant. Results: 40 male patients with a clinical diagnosis of AGA (stage II to VI) were recruited but only 35 patients completed the whole study. At 1 month and 3 months follow-up, Group I showed statistically significant increase in hair count, hair density and anagen/telogen ratio as compared to Group II. Conclusion: aPRP is a safe and good alternative to medical treatment. It seems to have a stabilizing effect on hair fall and may be considered as a measure to prevent progression of alopecia in early stages.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"53 1","pages":"28 - 32"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85717048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: One of the main difficulties of revision rhinoplasty is the lack of sufficient septal cartilage. To overcome this problem, additional cartilage sources such as costal or conchal cartilages are widely used among surgeons. However, these methods can cause some complications. The sphenoidal process of septal cartilage (SPSC) is a unique part of septal cartilage located between the vomer bone and the perpendicular plate of the ethmoid bone and generally untouched during the surgery. As an autologous graft option, the SPSC may be an important cartilage source for revision rhinoplasty cases, especially in patients requiring minor surgical intervention. Methods: Between February 2019 and February 2020, a total of 50 patients who underwent paranasal computed tomography were enrolled in this retrospective study. The length, height, and surface area of the SPSC and surface area of total septal cartilage were calculated. Results: The mean total septal area was 886.2 mm2, ranging from 554.7 mm2 to 1277.5 mm2. The mean total SPSC area was 67.39 mm2. The mean length of SPSC was 12.8 mm in all populations. The highest sphenoidal process length measurement was 27.32 mm, and the lowest was 4.82. Mean sphenoidal process height values were similar in female and male groups (4.99 mm and 5.2 mm, respectively). Conclusion: The sphenoid process of septal cartilage may be an important autologous cartilage option for revision surgeries in terms of sufficient length and height dimensions.
{"title":"Sphenoidal process of septal cartilage: Useful autologous graft option in revision rhinoplasty","authors":"Oğuzhan Demirel, M. Ateşçi","doi":"10.4103/tjps.tjps_83_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_83_20","url":null,"abstract":"Background: One of the main difficulties of revision rhinoplasty is the lack of sufficient septal cartilage. To overcome this problem, additional cartilage sources such as costal or conchal cartilages are widely used among surgeons. However, these methods can cause some complications. The sphenoidal process of septal cartilage (SPSC) is a unique part of septal cartilage located between the vomer bone and the perpendicular plate of the ethmoid bone and generally untouched during the surgery. As an autologous graft option, the SPSC may be an important cartilage source for revision rhinoplasty cases, especially in patients requiring minor surgical intervention. Methods: Between February 2019 and February 2020, a total of 50 patients who underwent paranasal computed tomography were enrolled in this retrospective study. The length, height, and surface area of the SPSC and surface area of total septal cartilage were calculated. Results: The mean total septal area was 886.2 mm2, ranging from 554.7 mm2 to 1277.5 mm2. The mean total SPSC area was 67.39 mm2. The mean length of SPSC was 12.8 mm in all populations. The highest sphenoidal process length measurement was 27.32 mm, and the lowest was 4.82. Mean sphenoidal process height values were similar in female and male groups (4.99 mm and 5.2 mm, respectively). Conclusion: The sphenoid process of septal cartilage may be an important autologous cartilage option for revision surgeries in terms of sufficient length and height dimensions.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"75 1","pages":"17 - 20"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84012976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: Due to the complex anatomical structure of the trochanteric region, the options for reconstruction are relatively limited. This study aims to present a unique reconstruction of trochanter defects using a coxal region perforator flap and geometric planning to standardize the flaps. Subjects and Methods: Twelve patients with trochanteric defects that had been repaired with coxal region perforator flap following tumor excision between June 2016 and January 2019 were included in this study. The patients were aged between 20 and 68 years. Patients were evaluated with regard to age, gender, etiology, defect side and size, flap size, number of perforators, and complications. Results: Two patients were operated on for squamous cell carcinoma, one for Marjolin's ulcer, two for malignant melanoma, two for malignant fibrous histiocytoma, and five for dermatofibrosarcoma. Defect sizes ranged between 8 cm × 7 cm and 12 × 10 cm. The smallest flap size was 13 cm × 7 cm and the largest flap size was 21 cm × 10 cm. Nine flaps were raised from the single perforator, and three flaps were raised from two perforators. Venous congestion was seen in one patient postoperatively. There was no flap loss, infection, hematoma, suture detachment, and limitation of hip and knee movements in the patients. Conclusions: The pedicled perforator flaps are elevated over the major perforators located close to the defect in many parts of the body. Thus, low surgical morbidity is achieved, and surgery time is decreased. Furthermore, as in this study, preserving the muscles and preventing the functional deficits in the movement hip joint the body's major joint of the body, reveal the importance of using coxal region perforator flaps for reconstruction in ambulatory patients.
目的:由于转子区复杂的解剖结构，重建的选择相对有限。本研究旨在提出一种独特的重建股骨粗隆缺损的方法，该方法使用了一个髋部穿支皮瓣和几何规划来规范皮瓣。对象和方法:本研究纳入2016年6月至2019年1月12例股骨粗隆缺损患者，这些患者在肿瘤切除术后采用髋部穿支皮瓣修复。患者年龄在20至68岁之间。评估患者的年龄、性别、病因、缺损的侧面和大小、皮瓣大小、穿支数量和并发症。结果:鳞状细胞癌2例，马卓林溃疡1例，恶性黑色素瘤2例，恶性纤维组织细胞瘤2例，皮肤纤维肉瘤5例。缺陷尺寸在8厘米× 7厘米到12厘米× 10厘米之间。最小皮瓣尺寸为13 cm × 7 cm，最大皮瓣尺寸为21 cm × 10 cm。从单个穿孔器中取出9个皮瓣，从两个穿孔器中取出3个皮瓣。1例患者术后出现静脉充血。患者无皮瓣丢失、感染、血肿、缝线脱离、髋关节和膝关节活动受限。结论:带蒂穿支皮瓣可在靠近缺损部位的主要穿支上方升高。因此，手术发病率低，手术时间缩短。此外，在本研究中，保留肌肉和防止运动髋关节(人体的主要关节)的功能缺陷，揭示了在门诊患者中使用髋区穿支皮瓣进行重建的重要性。
{"title":"A novel technique for trochanteric region soft-tissue reconstruction: coxal region perforator flaps","authors":"Soysal Bas, M. Durgun","doi":"10.4103/tjps.tjps_90_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_90_20","url":null,"abstract":"Aims: Due to the complex anatomical structure of the trochanteric region, the options for reconstruction are relatively limited. This study aims to present a unique reconstruction of trochanter defects using a coxal region perforator flap and geometric planning to standardize the flaps. Subjects and Methods: Twelve patients with trochanteric defects that had been repaired with coxal region perforator flap following tumor excision between June 2016 and January 2019 were included in this study. The patients were aged between 20 and 68 years. Patients were evaluated with regard to age, gender, etiology, defect side and size, flap size, number of perforators, and complications. Results: Two patients were operated on for squamous cell carcinoma, one for Marjolin's ulcer, two for malignant melanoma, two for malignant fibrous histiocytoma, and five for dermatofibrosarcoma. Defect sizes ranged between 8 cm × 7 cm and 12 × 10 cm. The smallest flap size was 13 cm × 7 cm and the largest flap size was 21 cm × 10 cm. Nine flaps were raised from the single perforator, and three flaps were raised from two perforators. Venous congestion was seen in one patient postoperatively. There was no flap loss, infection, hematoma, suture detachment, and limitation of hip and knee movements in the patients. Conclusions: The pedicled perforator flaps are elevated over the major perforators located close to the defect in many parts of the body. Thus, low surgical morbidity is achieved, and surgery time is decreased. Furthermore, as in this study, preserving the muscles and preventing the functional deficits in the movement hip joint the body's major joint of the body, reveal the importance of using coxal region perforator flaps for reconstruction in ambulatory patients.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":"11 1","pages":"33 - 37"},"PeriodicalIF":0.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89198738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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