Septorhinoplasty is one of the most challenging aesthetic and functional procedures for surgeons. Nasal tip surgery (to refine the nasal tip) is a compulsory stage of rhinoplasty. Dome division is a technique used for nasal tip surgery, especially for over projection and under projection of the nasal tip. The technique has been modified since the idea was first introduced. Fistula complication after rhinoplasty has rarely been reported. However, we had a 25-year-old male patient admitted to our clinic with a lesion on his left nasal tip that had been there for six months. The physical examination showed there was an erythematous, raised and non-healing lesion. When performing this patient’s septorhinoplasty, we noticed nasal cutaneous fistula resulting from chronic nasal skin damage due to a sharp, improperly cut and unfinished end of the lower lateral cartilage. Thus, for this case, we are reporting nasal tip cutaneous fistula, a long-term complication of incorrectly performed dome division surgery.
{"title":"A rare complication after rhinoplasty: Nasal-cutaneous fistula","authors":"Uğur Horoz, A. Tellioğlu","doi":"10.4103/tjps.tjps_47_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_47_21","url":null,"abstract":"Septorhinoplasty is one of the most challenging aesthetic and functional procedures for surgeons. Nasal tip surgery (to refine the nasal tip) is a compulsory stage of rhinoplasty. Dome division is a technique used for nasal tip surgery, especially for over projection and under projection of the nasal tip. The technique has been modified since the idea was first introduced. Fistula complication after rhinoplasty has rarely been reported. However, we had a 25-year-old male patient admitted to our clinic with a lesion on his left nasal tip that had been there for six months. The physical examination showed there was an erythematous, raised and non-healing lesion. When performing this patient’s septorhinoplasty, we noticed nasal cutaneous fistula resulting from chronic nasal skin damage due to a sharp, improperly cut and unfinished end of the lower lateral cartilage. Thus, for this case, we are reporting nasal tip cutaneous fistula, a long-term complication of incorrectly performed dome division surgery.","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":"77607502","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}
Microtia-anotia is a congenital anomaly of the ear encountered commonly by a plastic and reconstructive surgeon. Although it may be seen as an isolated condition, microtia-anotia may be part of a syndrome such as mandibulofacial synostosis. A very rare condition however is the preaxial acrofacial synostosis, or Nager syndrome (NS), with which the plastic and reconstructive surgeon may not be familiar. Less than 100 NS cases have been reported to date, mostly including major mandibulofacial anomalies. We hereby report the first case from the Mediterranean region of a late microtia-anotia exhibiting specific anomalies resembling a mild form of NS. Through systemic examination, we also identified in combination a cardiac anomaly (ventricular noncompaction cardiomyopathy) that has not been previously linked to this syndrome in the literature, hence the first report of this cardiac anomaly in NS. Level of Evidence: Level IV, case report.
{"title":"Acrofacial dysostosis with microtia-anotia: Nager syndrome in reconstructive plastic surgery","authors":"A. Oreroğlu, Ilker Usçetin, M. Akan","doi":"10.4103/tjps.tjps_39_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_39_22","url":null,"abstract":"Microtia-anotia is a congenital anomaly of the ear encountered commonly by a plastic and reconstructive surgeon. Although it may be seen as an isolated condition, microtia-anotia may be part of a syndrome such as mandibulofacial synostosis. A very rare condition however is the preaxial acrofacial synostosis, or Nager syndrome (NS), with which the plastic and reconstructive surgeon may not be familiar. Less than 100 NS cases have been reported to date, mostly including major mandibulofacial anomalies. We hereby report the first case from the Mediterranean region of a late microtia-anotia exhibiting specific anomalies resembling a mild form of NS. Through systemic examination, we also identified in combination a cardiac anomaly (ventricular noncompaction cardiomyopathy) that has not been previously linked to this syndrome in the literature, hence the first report of this cardiac anomaly in NS. Level of Evidence: Level IV, case report.","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":"76186919","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: Plastic, reconstructive, and esthetic surgeons and practitioners associated with medical tourism actively use social media platforms to disseminate or receive information on medical technologies and developments, professional news, and academic productions, as well as to advertise, promote, or even educate the public about their professions. The present study analyzes the perspectives of plastic, reconstructive, and esthetic surgery residents on social media use in this context. Subjects and Methods: A survey consisting of 14 multiple-choice questions was administered to plastic surgery residents who were continuing their specialty training. Statistical Analysis: Research data were evaluated using SPSS 20.0. Normality assumptions were checked for the variables, and cross tables and Chi-square statistics were used to evaluate the differences between groups. P = 0.05 or less was considered significant in all tests. Results: This study found that most plastic surgery residents did not have professional social media accounts, possibly owing to a hesitation to open a professional social media account during residency training. Consistent with the literature, most plastic surgery residents thought that social media use was a professional necessity that requires further training. Plastic surgeons must learn to use social media tools for patient education, advertising, and defense from inaccuracy. Formulating legal regulations in accordance with residents' attitudes has become a necessity in the changing world. Conclusions: Plastic surgeons lag behind in the ever-increasing competition for attention, and they must find a way of using social media tools for patient education, advertising, and defense from inaccuracy.
{"title":"The attitudes of plastic, reconstructive, and esthetic surgery residents toward social media usage","authors":"Ç. Çiçek, M. Akkurt, G. Filinte","doi":"10.4103/tjps.tjps_59_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_59_22","url":null,"abstract":"Aims: Plastic, reconstructive, and esthetic surgeons and practitioners associated with medical tourism actively use social media platforms to disseminate or receive information on medical technologies and developments, professional news, and academic productions, as well as to advertise, promote, or even educate the public about their professions. The present study analyzes the perspectives of plastic, reconstructive, and esthetic surgery residents on social media use in this context. Subjects and Methods: A survey consisting of 14 multiple-choice questions was administered to plastic surgery residents who were continuing their specialty training. Statistical Analysis: Research data were evaluated using SPSS 20.0. Normality assumptions were checked for the variables, and cross tables and Chi-square statistics were used to evaluate the differences between groups. P = 0.05 or less was considered significant in all tests. Results: This study found that most plastic surgery residents did not have professional social media accounts, possibly owing to a hesitation to open a professional social media account during residency training. Consistent with the literature, most plastic surgery residents thought that social media use was a professional necessity that requires further training. Plastic surgeons must learn to use social media tools for patient education, advertising, and defense from inaccuracy. Formulating legal regulations in accordance with residents' attitudes has become a necessity in the changing world. Conclusions: Plastic surgeons lag behind in the ever-increasing competition for attention, and they must find a way of using social media tools for patient education, advertising, and defense from inaccuracy.","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":"83616309","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}
Yasith Mathangasinghe, DJ Anthony, Joel Arudchelvam, MH S. Perera, TM A. Tennakoon, PC Deshapriya, T Muhunthan
To the Editor, We read the article by Acharya et al.[1] describing a case of high bifurcation of the brachial artery (HBBA) with interest. The brachial artery usually bifurcates into its terminal branches, the radial and ulnar arteries, slightly distal to the elbow joint. However, it is not uncommon for this bifurcation to occur proximally. The reported prevalence of HBBA is 12.3%.[2] HBBA is associated with a higher incidence of the failure of arteriovenous fistula creation.[3] The functional patency rate of arteriovenous fistulae at 12 months created in patients with HBBA is less (53.4%) than the normal brachial artery (74.5%).[3] Moreover, the superficial radial artery, which is associated with the HBBA, may pose a high risk for iatrogenic cannulation injuries, particularly in patients undergoing hemodialysis.[4] Even though the vascular mapping is recommended before the arteriovenous fistula creation, it is not uncommon to perform this procedure based on anatomical landmarks,[5] particularly in resource-poor settings. Thus, we intended to assess the prevalence of HBBA in Sri Lanka. This study was approved by the institutional ethics review committee. We randomly selected 20 cadavers (10 males and 10 females) with no history of trauma involving upper limbs, vascular instrumentation, or arteriovenous fistula creation. We dissected 20 upper limbs and measured the length of a line drawn perpendicularly from the intercondylar line to the brachial artery bifurcation using a Vernier caliper. We also measured the length of the brachial artery from the lower border of the teres major to its bifurcation using a measuring tape. The mean length of the brachial artery was 23.3 (range: 15.4–29.3, standard deviation [SD] = 3.7) cm. One cadaveric female left upper limb demonstrated HBBA 4.8 cm proximal to the level of the intercondylar line [Figure 1]. The mean distance from the intercondylar line to the bifurcation of the brachial artery was 3.7 cm (range: 4.8 cm proximal to the intercondylar line to 6.1 cm distal to the line, SD = 2.3). We did not observe previously reported other common anatomical variations of the brachial artery, such as the superficial brachial artery, accessory brachial artery, brachioradial artery, or brachioulnar artery.Figure 1: High bifurcation of the brachial artery in a female cadaver. The point of bifurcation is indicated by the blue arrow. The intercondylar line is shown by the dashed lineIn conclusion, we report that HBBA in our population is not uncommon. Since a significant proportion of the population may have an HBBA, vascular mapping is essential before arteriovenous access creation. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
{"title":"High bifurcation of the brachial artery and its implications for arteriovenous fistula construction","authors":"Yasith Mathangasinghe, DJ Anthony, Joel Arudchelvam, MH S. Perera, TM A. Tennakoon, PC Deshapriya, T Muhunthan","doi":"10.4103/tjps.tjps_77_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_77_22","url":null,"abstract":"To the Editor, We read the article by Acharya et al.[1] describing a case of high bifurcation of the brachial artery (HBBA) with interest. The brachial artery usually bifurcates into its terminal branches, the radial and ulnar arteries, slightly distal to the elbow joint. However, it is not uncommon for this bifurcation to occur proximally. The reported prevalence of HBBA is 12.3%.[2] HBBA is associated with a higher incidence of the failure of arteriovenous fistula creation.[3] The functional patency rate of arteriovenous fistulae at 12 months created in patients with HBBA is less (53.4%) than the normal brachial artery (74.5%).[3] Moreover, the superficial radial artery, which is associated with the HBBA, may pose a high risk for iatrogenic cannulation injuries, particularly in patients undergoing hemodialysis.[4] Even though the vascular mapping is recommended before the arteriovenous fistula creation, it is not uncommon to perform this procedure based on anatomical landmarks,[5] particularly in resource-poor settings. Thus, we intended to assess the prevalence of HBBA in Sri Lanka. This study was approved by the institutional ethics review committee. We randomly selected 20 cadavers (10 males and 10 females) with no history of trauma involving upper limbs, vascular instrumentation, or arteriovenous fistula creation. We dissected 20 upper limbs and measured the length of a line drawn perpendicularly from the intercondylar line to the brachial artery bifurcation using a Vernier caliper. We also measured the length of the brachial artery from the lower border of the teres major to its bifurcation using a measuring tape. The mean length of the brachial artery was 23.3 (range: 15.4–29.3, standard deviation [SD] = 3.7) cm. One cadaveric female left upper limb demonstrated HBBA 4.8 cm proximal to the level of the intercondylar line [Figure 1]. The mean distance from the intercondylar line to the bifurcation of the brachial artery was 3.7 cm (range: 4.8 cm proximal to the intercondylar line to 6.1 cm distal to the line, SD = 2.3). We did not observe previously reported other common anatomical variations of the brachial artery, such as the superficial brachial artery, accessory brachial artery, brachioradial artery, or brachioulnar artery.Figure 1: High bifurcation of the brachial artery in a female cadaver. The point of bifurcation is indicated by the blue arrow. The intercondylar line is shown by the dashed lineIn conclusion, we report that HBBA in our population is not uncommon. Since a significant proportion of the population may have an HBBA, vascular mapping is essential before arteriovenous access creation. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.","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":"135444778","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}
Yasemin Aydinli, Burak Kaya, YanadAbou Monsef, Abdullah Eyidogan
Background: The most critical issues in tendon healing include tendon adhesions and a loss of tendon strength. Adhesions result from fibrotic tissues developing in both surrounding tissues and tendons. Materials and Methods: Twenty-four rats were divided into two groups. Their Achilles tendons were cut 4 mm proximal to the calcaneal insertion and sutured with 6 / 0 monofilament nonabsorbable sutures. In the control group, saline solution was applied to the surgical field. In the experimental group, pirfenidone was applied to the surgical field locally and given orally for each rat to provide both local and systemic effects for 14 days following surgery. After a gait analysis, rats were sacrificed during the 4th postoperative week, and macroscopical, histopathological, and biomechanical analyses were performed. Results were compared with the statistical analyses. Results: The macroscopic scores of the experimental group were significantly higher than the control group (P = 0.007). The Achilles functional index scores were not significantly different between the two groups (P = 0.55). Histopathological scores were substantially closer to healthy tendons in the experimental group (P = 0.004). Biomechanically, the force required to rupture the tendons and tendon stiffness was significantly greater in the experimental group than in the control group (P = 0.028 for both). Conclusion: This study shows that tendons healed better with pirfenidone treatment.
{"title":"Effect of pirfenidone on tendon healing","authors":"Yasemin Aydinli, Burak Kaya, YanadAbou Monsef, Abdullah Eyidogan","doi":"10.4103/tjps.tjps_24_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_24_23","url":null,"abstract":"Background: The most critical issues in tendon healing include tendon adhesions and a loss of tendon strength. Adhesions result from fibrotic tissues developing in both surrounding tissues and tendons. Materials and Methods: Twenty-four rats were divided into two groups. Their Achilles tendons were cut 4 mm proximal to the calcaneal insertion and sutured with 6 / 0 monofilament nonabsorbable sutures. In the control group, saline solution was applied to the surgical field. In the experimental group, pirfenidone was applied to the surgical field locally and given orally for each rat to provide both local and systemic effects for 14 days following surgery. After a gait analysis, rats were sacrificed during the 4th postoperative week, and macroscopical, histopathological, and biomechanical analyses were performed. Results were compared with the statistical analyses. Results: The macroscopic scores of the experimental group were significantly higher than the control group (P = 0.007). The Achilles functional index scores were not significantly different between the two groups (P = 0.55). Histopathological scores were substantially closer to healthy tendons in the experimental group (P = 0.004). Biomechanically, the force required to rupture the tendons and tendon stiffness was significantly greater in the experimental group than in the control group (P = 0.028 for both). Conclusion: This study shows that tendons healed better with pirfenidone treatment.","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":"135444794","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}
Aim: This study includes the evaluation of 84 implants removed after an average of 10 years from 42 patients who underwent augmentation mammoplasty and augmentation mastopexy at various centers over a 20-year period. Patients and Methods: Implants from patients who were all women aged between 28-60 years were evaluated after an average of 10 years following breast implantation. Preoperative physical examination, ultrasound examination and magnetic resonance imaging (MRI) were performed. Breast implants were removed from 42 patients for various reasons. The capsules and the free fluid removed with the implants underwent pathological and cytological evaluation. 84 implants that were removed were evaluated and scored for rupture, gel leakage, presence of air in the gel, changes in shell structure, and base deformities. Implants without any deformity were given a full score of 10, while score reduction was made according to various types of deformities seen in other implants. The average score of each implant brand was compared to other brands. Results: Rupture was observed in 23 of a total of 84 implants, while implant deformities such as gel leakage, air presence in the gel, decreased elasticity, base deformity and thinning of the shell were also present. Among all, 16 implants received a full score. The durability of the implants in the human body and the damage they received were classified according to their scores. Those with a score of eight and above were classified as high, those with a score between 6-8 were classified as medium, and those with a score of less than six were classified as implants with low endurance. Most of the implants evaluated here had low to medium endurance. The volume of one of the ruptured implants was 200 mL, while the rest ranged from 275-400 mL. Bilateral rupture was observed in one patient with a McGhanR implant, which had stayed in the human body the longest (15 years). Apart from this, all ruptures in other cases were unilateral. In some of the implants of EurosiliconeR(three implants), McGhanR(two implants), NatrellaR(one implant), RofilR(one implant) and PolytechR(one implant), it was observed that the implant shell was completely torn, fragmented and disintegrated, and the gel was diffused into the capsule. Shell decay was much higher especially in EurosiliconeR, RofilR and McGhanR brands. The durability of the implants was classified according to their scores. High endurance implants were those with a score of eight and higher: MentorR, SilimedR, MotivaR, and ArionR. Medium endurance implants were those with a score between 6-8: EurosiliconeR, PolytechR, McGhanR, and NatrellaR. Low endurance implants were those with a score of six and lower: RofilR and PipR. Conclusions: Occurrence of rupture and various complications increase in implants especially after 10 years. Often from certain brands, particularly the high-volume implants, rupture more easily in time. Close follow-up should be planned for patients wh
{"title":"Evaluation of different breast implants for rupture and durability after implantation","authors":"Safvet Ors","doi":"10.4103/tjps.tjps_29_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_29_22","url":null,"abstract":"Aim: This study includes the evaluation of 84 implants removed after an average of 10 years from 42 patients who underwent augmentation mammoplasty and augmentation mastopexy at various centers over a 20-year period. Patients and Methods: Implants from patients who were all women aged between 28-60 years were evaluated after an average of 10 years following breast implantation. Preoperative physical examination, ultrasound examination and magnetic resonance imaging (MRI) were performed. Breast implants were removed from 42 patients for various reasons. The capsules and the free fluid removed with the implants underwent pathological and cytological evaluation. 84 implants that were removed were evaluated and scored for rupture, gel leakage, presence of air in the gel, changes in shell structure, and base deformities. Implants without any deformity were given a full score of 10, while score reduction was made according to various types of deformities seen in other implants. The average score of each implant brand was compared to other brands. Results: Rupture was observed in 23 of a total of 84 implants, while implant deformities such as gel leakage, air presence in the gel, decreased elasticity, base deformity and thinning of the shell were also present. Among all, 16 implants received a full score. The durability of the implants in the human body and the damage they received were classified according to their scores. Those with a score of eight and above were classified as high, those with a score between 6-8 were classified as medium, and those with a score of less than six were classified as implants with low endurance. Most of the implants evaluated here had low to medium endurance. The volume of one of the ruptured implants was 200 mL, while the rest ranged from 275-400 mL. Bilateral rupture was observed in one patient with a McGhanR implant, which had stayed in the human body the longest (15 years). Apart from this, all ruptures in other cases were unilateral. In some of the implants of EurosiliconeR(three implants), McGhanR(two implants), NatrellaR(one implant), RofilR(one implant) and PolytechR(one implant), it was observed that the implant shell was completely torn, fragmented and disintegrated, and the gel was diffused into the capsule. Shell decay was much higher especially in EurosiliconeR, RofilR and McGhanR brands. The durability of the implants was classified according to their scores. High endurance implants were those with a score of eight and higher: MentorR, SilimedR, MotivaR, and ArionR. Medium endurance implants were those with a score between 6-8: EurosiliconeR, PolytechR, McGhanR, and NatrellaR. Low endurance implants were those with a score of six and lower: RofilR and PipR. Conclusions: Occurrence of rupture and various complications increase in implants especially after 10 years. Often from certain brands, particularly the high-volume implants, rupture more easily in time. Close follow-up should be planned for patients wh","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":"76665512","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}
AhmetHamdi Sakarya, Orkun Uyanik, Murat Karabagli, MehmetVeli Karaaltin
Background: The aim of this study is to establish an in vivo large mammalian model that can form the basis for future immunosuppression research, nerve recovery research, surgical applicability, and training studies. Materials and Methods: An 18-month-old, 40 kg, curly breed sheep was used. A whole-eye autotransplantation was planned, including the upper and lower eyelids, lacrimal gland, and extraocular muscles. Intracranial intervention and inclusion of the bone segment were not considered. The frontozygomatic approach was used in the operation. Circulation was established by anastomoses of the internal ophthalmic vein and artery with elongated superficial temporal artery and vein with vein grafts. The optic nerve was repaired last. Blood circulation and the retina were checked by means of postoperative bleeding and indirect ophthalmoscope. Results: Using the internal carotid system, circulation of the entire eye and its appendages was achieved in the early period. The frontozygomatic approach facilitated nerve and vessel repairs and therefore shortened the ischemia time (16 min). Although circulation was established in the retina, local bleeding foci were detected. Pupillary, corneal, and palpebral reflexes could not be obtained from the animal. The animal died on the 10th day. Circulation of the autotransplanted tissue was present at this time, including the eyelids and appendages of the eye. Conclusion: The composite whole-eye autotransplantation model was successfully planned in vivo in a large mammal, the sheep, without the need for intracranial intervention, and by including all of the eye attachments based on the internal ophthalmic artery.
{"title":"A sheep whole-eye autotransplantation model","authors":"AhmetHamdi Sakarya, Orkun Uyanik, Murat Karabagli, MehmetVeli Karaaltin","doi":"10.4103/tjps.tjps_14_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_14_23","url":null,"abstract":"Background: The aim of this study is to establish an in vivo large mammalian model that can form the basis for future immunosuppression research, nerve recovery research, surgical applicability, and training studies. Materials and Methods: An 18-month-old, 40 kg, curly breed sheep was used. A whole-eye autotransplantation was planned, including the upper and lower eyelids, lacrimal gland, and extraocular muscles. Intracranial intervention and inclusion of the bone segment were not considered. The frontozygomatic approach was used in the operation. Circulation was established by anastomoses of the internal ophthalmic vein and artery with elongated superficial temporal artery and vein with vein grafts. The optic nerve was repaired last. Blood circulation and the retina were checked by means of postoperative bleeding and indirect ophthalmoscope. Results: Using the internal carotid system, circulation of the entire eye and its appendages was achieved in the early period. The frontozygomatic approach facilitated nerve and vessel repairs and therefore shortened the ischemia time (16 min). Although circulation was established in the retina, local bleeding foci were detected. Pupillary, corneal, and palpebral reflexes could not be obtained from the animal. The animal died on the 10th day. Circulation of the autotransplanted tissue was present at this time, including the eyelids and appendages of the eye. Conclusion: The composite whole-eye autotransplantation model was successfully planned in vivo in a large mammal, the sheep, without the need for intracranial intervention, and by including all of the eye attachments based on the internal ophthalmic artery.","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":"135444783","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}
Selim Safalı, A. Ozdemir, Mehmet Karaoglan, E. Ertaş, M. Acar
Context: The management of tissue defects of the olecranon after fractures of this region is challenging. Most cases require local or free flaps to obtain both soft-tissue reconstruction and wide range of motion of the elbow joint. Aim: The aim of this study is to describe the results of reconstruction of fracture-associated skin defects on the olecranon with posterior interosseous artery (PIA) flap. Settings and Design: We present our experience of using antegrade PIA flap for soft-tissue coverage of the olecranon region after fracture surgery. Materials and Methods: We retrospectively evaluated 11 cases who underwent reconstruction of the olecranon for soft tissue defect with PIA flap. We evaluated the extent of the soft-tissue defects and the harvested flaps, fracture fixation techniques, complications, patients' demographics, partial or total flap lost, number of perforators, time to reconstruction after injury, esthetic looking of reconstructed area, and donor site coverage. Results: The study included 11 patients (7 males and 4 females). The mean age was 35 years. The mean defect size was 15.4 cm2. The mean flap size was 20 cm2. Plates were used in six cases, tension band wiring in three cases, and external fixators in two cases for fracture fixation. Ten flaps survived completely. There was partial flap necrosis in one flap due to venous congestion. Infection, hematoma, and distal neurological deficits were not observed. Minimal morbidity occurred since the donor site was primarily closed in eight cases and skin graft in three cases. Good cosmetic outcome was achieved in all cases. We detected one perforator in one case, two perforators in five cases, three perforators in four cases, and four perforators in one case. Conclusion: Reconstruction with PIA flap is an effective, useful, and simple surgical technique for soft-tissue coverage on the olecranon region. The procedure involves a single step surgery, low donor site morbidity, and good cosmetic outcomes.
{"title":"Reconstruction of fracture associated skin defects on olecranon with antegrade posterior interosseous artery flap","authors":"Selim Safalı, A. Ozdemir, Mehmet Karaoglan, E. Ertaş, M. Acar","doi":"10.4103/tjps.tjps_50_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_50_22","url":null,"abstract":"Context: The management of tissue defects of the olecranon after fractures of this region is challenging. Most cases require local or free flaps to obtain both soft-tissue reconstruction and wide range of motion of the elbow joint. Aim: The aim of this study is to describe the results of reconstruction of fracture-associated skin defects on the olecranon with posterior interosseous artery (PIA) flap. Settings and Design: We present our experience of using antegrade PIA flap for soft-tissue coverage of the olecranon region after fracture surgery. Materials and Methods: We retrospectively evaluated 11 cases who underwent reconstruction of the olecranon for soft tissue defect with PIA flap. We evaluated the extent of the soft-tissue defects and the harvested flaps, fracture fixation techniques, complications, patients' demographics, partial or total flap lost, number of perforators, time to reconstruction after injury, esthetic looking of reconstructed area, and donor site coverage. Results: The study included 11 patients (7 males and 4 females). The mean age was 35 years. The mean defect size was 15.4 cm2. The mean flap size was 20 cm2. Plates were used in six cases, tension band wiring in three cases, and external fixators in two cases for fracture fixation. Ten flaps survived completely. There was partial flap necrosis in one flap due to venous congestion. Infection, hematoma, and distal neurological deficits were not observed. Minimal morbidity occurred since the donor site was primarily closed in eight cases and skin graft in three cases. Good cosmetic outcome was achieved in all cases. We detected one perforator in one case, two perforators in five cases, three perforators in four cases, and four perforators in one case. Conclusion: Reconstruction with PIA flap is an effective, useful, and simple surgical technique for soft-tissue coverage on the olecranon region. The procedure involves a single step surgery, low donor site morbidity, and good cosmetic outcomes.","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":"73568879","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":"The relationship between etiology-fracture type and plate fixation-complications in zygomatic fractures: A retrospective analysis","authors":"M. Sonmez, R. Unlu","doi":"10.4103/tjps.tjps_78_22","DOIUrl":"https://doi.org/10.4103/tjps.tjps_78_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":"74956465","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":"Turkish validation of the TRANS-questionnaire in trans men undergoing mastectomy","authors":"Yavuz Tuluy, Merve Unsal, Emin Sır, A. Aksoy","doi":"10.4103/tjps.tjps_2_23","DOIUrl":"https://doi.org/10.4103/tjps.tjps_2_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":"89955338","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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