IndrajithK Sudhy, SheikhSarfraz Ali, Imran Ahmad, Mohd Yaseen
Introduction: Dermatofibrosarcoma protuberance (DFSP) is an uncommon soft-tissue tumor with low-to-intermediate-grade malignancy, characterized by relatively slow but progressive growth and a high propensity for recurrence. Recurrence is probably due to initial conservative excision without an adequate margin of clearance. We here share our analysis of 22 recurrent DFSP cases treated in our institute. Materials and Methods: A retrospective study of 22 consecutive patients with recurrent DFSP who were treated surgically with a minimum 4 cm margin in the host institution over the past 10 years was performed, with special emphasis on outcome and disease-free survival, as well as the rate of recurrence over a mean follow-up 47.12 months. Results: The clinicopathological features and results were reviewed. Wide local excision resulted in the eradication of the disease in all the patients, with disease-free survival throughout the study duration. Conclusion: The results of this study and a review of the literature support the notion that aggressive surgical resection with disease-free margin is the key to successful treatment in the absence of chemotherapy or radiotherapy and offers an excellent probability of cure. The accumulated data also confirm that patients with DFSP should be followed up for extensive periods to be vigilant as a late recurrence can occur.
{"title":"Recurrent dermatofibrosarcoma protuberance: A single-center analysis","authors":"IndrajithK Sudhy, SheikhSarfraz Ali, Imran Ahmad, Mohd Yaseen","doi":"10.4103/tjps.tjps_30_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_30_23","url":null,"abstract":"Introduction: Dermatofibrosarcoma protuberance (DFSP) is an uncommon soft-tissue tumor with low-to-intermediate-grade malignancy, characterized by relatively slow but progressive growth and a high propensity for recurrence. Recurrence is probably due to initial conservative excision without an adequate margin of clearance. We here share our analysis of 22 recurrent DFSP cases treated in our institute. Materials and Methods: A retrospective study of 22 consecutive patients with recurrent DFSP who were treated surgically with a minimum 4 cm margin in the host institution over the past 10 years was performed, with special emphasis on outcome and disease-free survival, as well as the rate of recurrence over a mean follow-up 47.12 months. Results: The clinicopathological features and results were reviewed. Wide local excision resulted in the eradication of the disease in all the patients, with disease-free survival throughout the study duration. Conclusion: The results of this study and a review of the literature support the notion that aggressive surgical resection with disease-free margin is the key to successful treatment in the absence of chemotherapy or radiotherapy and offers an excellent probability of cure. The accumulated data also confirm that patients with DFSP should be followed up for extensive periods to be vigilant as a late recurrence can occur.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135444785","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 : 2023-01-01DOI: 10.4103/tjps.tjps_107_20
B. Sezgin, Salih Kavuncu, Sedat Tatar
{"title":"Crohn's disease of the vulva: A unique presentation with an unconventional treatment approach","authors":"B. Sezgin, Salih Kavuncu, Sedat Tatar","doi":"10.4103/tjps.tjps_107_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_107_20","url":null,"abstract":"","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74888734","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}
S. Erdost, Arzu Ari, C. Yalcin, Esma Demirezen, Serkan Melenkis, Y. Aydin
{"title":"Parental stress status in families with a baby with cleft lip and/or palate","authors":"S. Erdost, Arzu Ari, C. Yalcin, Esma Demirezen, Serkan Melenkis, Y. Aydin","doi":"10.4103/tjps.tjps_4_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_4_23","url":null,"abstract":"","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83918392","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}
{"title":"Modern plague in clinics, assessing the body dysmorphic disorder","authors":"A. Eyuboglu, Umit Yilmaz, Hazal Aktas, T. Isken","doi":"10.4103/tjps.tjps_71_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_71_22","url":null,"abstract":"","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91170214","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}
{"title":"“Anchored urethral glanular advancement technique” as a simple new technique for distal penile hypospadias in properly selected cases","authors":"AliAhmed Hasan, Mohamed Elyounsi, M. El-shazly","doi":"10.4103/tjps.tjps_11_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_11_23","url":null,"abstract":"","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88984699","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}
Primary cutaneous apocrine carcinoma (PCAC) of the scrotum is an unwonted neoplasm that predominantly occurs in areas with high-density apocrine glands. However, the incidence of scrotal PCAC is uncommon. Further, the pagetoid phenomenon is a rare feature of PCAC involving malignant cells infiltrating the epidermis. We present a rare case of scrotal PCAC in an elderly patient who presented with a slow-growing scrotal lesion. A physical examination identified an ulcerated globular mass at the right scrotum with ipsilateral inguinal lymphadenopathy, and a biopsy confirmed the diagnosis of apocrine carcinoma. In addition, imaging studies revealed features of lymph nodes and bone metastasis. Subsequently, a wide local excision was performed. The clinical features of PCAC are not distinctive; thus, histopathology and immunohistochemistry are paramount to confirm the diagnosis. The ideal treatment to achieve clear margins is tumor excision, while other treatment modalities such as chemotherapy, targeted antibody therapy, and radiotherapy are not established.
{"title":"Primary cutaneous apocrine carcinoma of scrotum with pagetoid phenomenon","authors":"P. Khoo, A. Wen, S. Chai","doi":"10.4103/tjps.tjps_46_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_46_22","url":null,"abstract":"Primary cutaneous apocrine carcinoma (PCAC) of the scrotum is an unwonted neoplasm that predominantly occurs in areas with high-density apocrine glands. However, the incidence of scrotal PCAC is uncommon. Further, the pagetoid phenomenon is a rare feature of PCAC involving malignant cells infiltrating the epidermis. We present a rare case of scrotal PCAC in an elderly patient who presented with a slow-growing scrotal lesion. A physical examination identified an ulcerated globular mass at the right scrotum with ipsilateral inguinal lymphadenopathy, and a biopsy confirmed the diagnosis of apocrine carcinoma. In addition, imaging studies revealed features of lymph nodes and bone metastasis. Subsequently, a wide local excision was performed. The clinical features of PCAC are not distinctive; thus, histopathology and immunohistochemistry are paramount to confirm the diagnosis. The ideal treatment to achieve clear margins is tumor excision, while other treatment modalities such as chemotherapy, targeted antibody therapy, and radiotherapy are not established.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72463075","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}
{"title":"Medial canthus reconstruction with a propeller skin flap from the nasolabial fold region","authors":"M. Akkoç, Mehmet Ozdemir, Mehmet Bayram","doi":"10.4103/tjps.tjps_26_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_26_23","url":null,"abstract":"","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83370351","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}
Purpose: Achievement of the correct alignment of malpositioned mandibular segments with displaced condyles and soft-tissue contraction is relatively challenging in patients requiring secondary mandibular reconstruction. The aim of this study was to demonstrate the utility of virtual surgical planning (VSP) and forward engineering with computer-aided design (CAD)/computer-aided manufacturing (CAM) technology in late secondary mandibular reconstruction. Patients and Methods: The study sample included 14 patients aged 18–74 years and treated between 2012 and 2017 using secondary segmental mandibular reconstruction. VSP was used for precise condylar location in each mandibular segment, and cutting guides enabled forward engineering in cases treated with vascularized fibular bone grafts. Rapid medical prototyping of the mandible and/or CAD/CAM of temporary fixation guides were used in the remainder of cases for forward engineering purposes. Results: VSP and CAD/CAM technology reduced the amount of bone removed for reconstruction, decreased surgical time, increased intraoperative precision, and improved postoperative functional and esthetic outcomes. Conclusions: VSP allows seamless secondary mandibular reconstruction with fibular free tissue transfer, and utilization of combinations of mandibular and fibular cutting guides or temporary fixation templates allows for precise and efficient surgical reconstruction through forward engineering. Rapid medical prototyping of custom-made temporary mandibular fixation apparatus can be an alternative method for situations where the cutting guides and permanent fixation plates cannot be manufactured or where free fibular transfer is not the preferred treatment option.
{"title":"Contribution of virtual surgical planning, computer-aided design, and computer-aided manufacturing to delayed mandibular reconstruction","authors":"Majid Ismayilzade, HalilIbrahim Canter, Kemalettin Yildiz, KahramanBerkhan Yilmaz, Muhtar Gurol, MehmetVeli Karaaltin, Ahmet Kirazoglu, Ethem Guneren, MustafaEngin Cakmakci","doi":"10.4103/tjps.tjps_12_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_12_23","url":null,"abstract":"Purpose: Achievement of the correct alignment of malpositioned mandibular segments with displaced condyles and soft-tissue contraction is relatively challenging in patients requiring secondary mandibular reconstruction. The aim of this study was to demonstrate the utility of virtual surgical planning (VSP) and forward engineering with computer-aided design (CAD)/computer-aided manufacturing (CAM) technology in late secondary mandibular reconstruction. Patients and Methods: The study sample included 14 patients aged 18–74 years and treated between 2012 and 2017 using secondary segmental mandibular reconstruction. VSP was used for precise condylar location in each mandibular segment, and cutting guides enabled forward engineering in cases treated with vascularized fibular bone grafts. Rapid medical prototyping of the mandible and/or CAD/CAM of temporary fixation guides were used in the remainder of cases for forward engineering purposes. Results: VSP and CAD/CAM technology reduced the amount of bone removed for reconstruction, decreased surgical time, increased intraoperative precision, and improved postoperative functional and esthetic outcomes. Conclusions: VSP allows seamless secondary mandibular reconstruction with fibular free tissue transfer, and utilization of combinations of mandibular and fibular cutting guides or temporary fixation templates allows for precise and efficient surgical reconstruction through forward engineering. Rapid medical prototyping of custom-made temporary mandibular fixation apparatus can be an alternative method for situations where the cutting guides and permanent fixation plates cannot be manufactured or where free fibular transfer is not the preferred treatment option.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135444781","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}
Introduction: Pilonidal cyst disease is characterized by chronic abscess, discharge, and sinus openings. The anal sphincter functions of the patients, who previously undergone recurrent surgical treatment, were compared using a surgical approach. Patients were divided into two groups by whether perianal soft tissues were preserved in the surgery. Materials and Methods: Between 2014 and 2019, 21 male patients who had either undergone insufficient surgery or had complications with multiple sinus openings applied to our clinic. Excision and reconstruction of the patients were performed. The coccyx, dorsal part of sacrum, anococcygeal raphe, and ischiorectal fossa were additionally included in the excision for patients with biopsy reports of squamous cell carcinoma. All patients underwent rectoanal manometry to evaluate anal sphincter function. Preoperative, postoperative 5th week, and 6th-month anal manometry results were recorded and analyzed by the Shapiro − Wilk test and independent t-test. Results: The anal sphincter function regresses in the 5th week after the reconstruction and improves in the 6 month. The results of the independent t-test, which were used to compare the anal manometry results for each group, showed that the difference in the anal sphincter pressure of the two groups was statistically significant (P < 0.05). If the perianal soft tissues were excised, anal sphincter manometry shows poor results. Discussion: The anal sphincter function, which regresses in the 5th week after the reconstruction and improves in the 6 months, depends on the scar tissue occurring in the perianal connective tissue, while the softening caused by the maturation of the scar in the last phase of wound healing improves the function.
{"title":"Does surgical treatment for complicated pilonidal cyst disease in the sacral region affect anal sphincter functions","authors":"M. Akyurek, Caghan Benli, M. Kaya, Ali Surmeli","doi":"10.4103/tjps.tjps_44_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_44_22","url":null,"abstract":"Introduction: Pilonidal cyst disease is characterized by chronic abscess, discharge, and sinus openings. The anal sphincter functions of the patients, who previously undergone recurrent surgical treatment, were compared using a surgical approach. Patients were divided into two groups by whether perianal soft tissues were preserved in the surgery. Materials and Methods: Between 2014 and 2019, 21 male patients who had either undergone insufficient surgery or had complications with multiple sinus openings applied to our clinic. Excision and reconstruction of the patients were performed. The coccyx, dorsal part of sacrum, anococcygeal raphe, and ischiorectal fossa were additionally included in the excision for patients with biopsy reports of squamous cell carcinoma. All patients underwent rectoanal manometry to evaluate anal sphincter function. Preoperative, postoperative 5th week, and 6th-month anal manometry results were recorded and analyzed by the Shapiro − Wilk test and independent t-test. Results: The anal sphincter function regresses in the 5th week after the reconstruction and improves in the 6 month. The results of the independent t-test, which were used to compare the anal manometry results for each group, showed that the difference in the anal sphincter pressure of the two groups was statistically significant (P < 0.05). If the perianal soft tissues were excised, anal sphincter manometry shows poor results. Discussion: The anal sphincter function, which regresses in the 5th week after the reconstruction and improves in the 6 months, depends on the scar tissue occurring in the perianal connective tissue, while the softening caused by the maturation of the scar in the last phase of wound healing improves the function.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82639389","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: Reconstruction in cases of head and neck burns requires more complex approaches than other burns. The affected areas are often evaluated late in head neck burns and the functional structure of the anatomical region is not taken into consideration during the reconstruction. Subjects and Methods: We performed the review of 98 patients who were admitted for full-thickness head and neck burns and followed up at the Burn Center from 2016 to 2022. Demographic data (age and gender), details of the burn injuries (etiology, affected anatomical area, and percentage of the total body surface area [TBSA]), and preferred surgical interventions were examined retrospectively. Results: The mean age of the patients whose data were examined retrospectively was 27.03 (11 months–41 years). None of the patients in the present study had isolated scalp or facial burns, although all had accompanying burns to the torso and the upper or lower extremities. All patients needed a procedure that required anesthesia in the operating, and all of them underwent multiple operations or multiple procedures in a single session. Conclusion: In patients with high percentages of burnt areas to the TBSA, full-thickness scalp and facial burns are treated secondarily. Therefore, such patients consult their physicians for problems that are difficult to reconstruct in the late periods. The affected areas of full-thickness scalp and facial burns should be divided into functional and nonfunctional units, and early reconstruction should be applied in accordance with the algorithm.
{"title":"Principles of simple to complex reconstruction and management of full-thickness head and neck burns","authors":"Cagla Cicek","doi":"10.4103/tjps.tjps_31_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_31_23","url":null,"abstract":"Aims: Reconstruction in cases of head and neck burns requires more complex approaches than other burns. The affected areas are often evaluated late in head neck burns and the functional structure of the anatomical region is not taken into consideration during the reconstruction. Subjects and Methods: We performed the review of 98 patients who were admitted for full-thickness head and neck burns and followed up at the Burn Center from 2016 to 2022. Demographic data (age and gender), details of the burn injuries (etiology, affected anatomical area, and percentage of the total body surface area [TBSA]), and preferred surgical interventions were examined retrospectively. Results: The mean age of the patients whose data were examined retrospectively was 27.03 (11 months–41 years). None of the patients in the present study had isolated scalp or facial burns, although all had accompanying burns to the torso and the upper or lower extremities. All patients needed a procedure that required anesthesia in the operating, and all of them underwent multiple operations or multiple procedures in a single session. Conclusion: In patients with high percentages of burnt areas to the TBSA, full-thickness scalp and facial burns are treated secondarily. Therefore, such patients consult their physicians for problems that are difficult to reconstruct in the late periods. The affected areas of full-thickness scalp and facial burns should be divided into functional and nonfunctional units, and early reconstruction should be applied in accordance with the algorithm.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135444776","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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