Aims: The aim of facial reanimation isto restore facial symmetry in spontaneous, mimic, and emotional movements. One of the important reconstructive treatment options in patients with long-term facial paralysis is free muscle transfers. The first stage in two-stage muscle transfers is the cross facial nerve graft (CFNG). In this study, our aim is to investigate the importance of Tinel's sign and EMG in the selection of patients who have had CFNG due to long-term facial paralysis and who can undergo muscle transfer repair and investigate the effectiveness of these methods. Patients and Methods: Ten patients who underwent crossfacial nerve grafting for long-term facial nerve paralysis between 2012 and 2018 were prospectively included in the study. Results: No complications were observed during the operation and follow-up of the patients. The reliability of EMG is lower than the Tinel's sign when making a muscle transfer decision in patients who undergo CFNG. Conclusions: In conclusion, the etiology of facial paralysis (severity of injury in traumatic paralysis), age of patients, comorbid conditions, surgical experience, postoperative physical therapy process and patient compliance play an active role in providing reinnervation.
{"title":"Determination of facial reanimation patients who can be transferred muscle after crossfacial nerve graft","authors":"Nijat Majidov, O. Akdağ, M. Sutcu, Z. Tosun","doi":"10.4103/tjps.tjps_26_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_26_21","url":null,"abstract":"Aims: The aim of facial reanimation isto restore facial symmetry in spontaneous, mimic, and emotional movements. One of the important reconstructive treatment options in patients with long-term facial paralysis is free muscle transfers. The first stage in two-stage muscle transfers is the cross facial nerve graft (CFNG). In this study, our aim is to investigate the importance of Tinel's sign and EMG in the selection of patients who have had CFNG due to long-term facial paralysis and who can undergo muscle transfer repair and investigate the effectiveness of these methods. Patients and Methods: Ten patients who underwent crossfacial nerve grafting for long-term facial nerve paralysis between 2012 and 2018 were prospectively included in the study. Results: No complications were observed during the operation and follow-up of the patients. The reliability of EMG is lower than the Tinel's sign when making a muscle transfer decision in patients who undergo CFNG. Conclusions: In conclusion, the etiology of facial paralysis (severity of injury in traumatic paralysis), age of patients, comorbid conditions, surgical experience, postoperative physical therapy process and patient compliance play an active role in providing reinnervation.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81017673","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}
Intraosseous epidermoid cyst is a rare nonneoplastic lesion. It's usually caused by a trauma which places the epidermal fragments inside the bone. 31-year-old female patient was presented with a mass in the distal phalanx of the 3rd digit of the right hand. The histological examination following the excision of the cyst revealed intraosseous epidermoid cyst. Histopathological features, patient demographics, history, treatment, and prognosis of this rare case are presented.
{"title":"Intraosseous Epidermoid Cysts in Distal Phalanx","authors":"G. Toplu, Dinçer Altınel, C. Leblebici, M. Serin","doi":"10.4103/tjps.tjps_25_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_25_21","url":null,"abstract":"Intraosseous epidermoid cyst is a rare nonneoplastic lesion. It's usually caused by a trauma which places the epidermal fragments inside the bone. 31-year-old female patient was presented with a mass in the distal phalanx of the 3rd digit of the right hand. The histological examination following the excision of the cyst revealed intraosseous epidermoid cyst. Histopathological features, patient demographics, history, treatment, and prognosis of this rare case are presented.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86104864","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, M. Kara, Fethiye Damla Menku Ozdemir, H. Uzun, Ö. Gököz, A. Aksu
Background: Upper extremity tumors (UETs) and their treatment may impair hand functions. Successful prediction of the histopathological examination before surgery will speed up the treatment process. The aim of this study is to determine the frequency and prediction accuracy of tumors encountered in the upper extremity. Patients and Methods: Records of patients operated for UETs between January 2010 and December 2019 were reviewed. Patient gender, initial complaint, the anatomic region of the tumor, comorbidities predisposing to malignancy, method of biopsy, preliminary diagnosis and predicted malignancy status after initial examination, definitive histopathological diagnosis, and malignancy status were extracted retrospectively. Prediction accuracy rates were calculated for each tumor group. Chi-square analysis was used for comparative analysis of prediction accuracy rates between cutaneous pigmented versus soft-tissue lesions and patients with/without a predisposition to malignancy. Results: The study included 416 pathological specimens from 290 patients. The most common tumors of the upper extremity were lipoma (20%), ganglion cyst (10.1%), and epidermoid cyst (5.8%). After pathological evaluation, 23 specimens were diagnosed as malignant (5.5%) and 32 specimens as premalignant (7.7%). The prediction of malignancy status was accurate in 390 specimens (93.7%). Soft-tissue sarcomas (67.7%) and vascular lesions (58.1%) have the lowest accuracy rates among all tumors. Conclusion: Definitive diagnosis and malignity status can be predicted after the initial examination in the majority of the cases. However, imaging studies or incisional biopsies are needed for soft-tissue sarcomas, vascular tumors, or tumors of patients with a predisposing condition to malignancy.
{"title":"Demographics and prediction accuracy of upper extremity tumors: A 10-year retrospective study","authors":"G. Ustun, M. Kara, Fethiye Damla Menku Ozdemir, H. Uzun, Ö. Gököz, A. Aksu","doi":"10.4103/tjps.tjps_7_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_7_21","url":null,"abstract":"Background: Upper extremity tumors (UETs) and their treatment may impair hand functions. Successful prediction of the histopathological examination before surgery will speed up the treatment process. The aim of this study is to determine the frequency and prediction accuracy of tumors encountered in the upper extremity. Patients and Methods: Records of patients operated for UETs between January 2010 and December 2019 were reviewed. Patient gender, initial complaint, the anatomic region of the tumor, comorbidities predisposing to malignancy, method of biopsy, preliminary diagnosis and predicted malignancy status after initial examination, definitive histopathological diagnosis, and malignancy status were extracted retrospectively. Prediction accuracy rates were calculated for each tumor group. Chi-square analysis was used for comparative analysis of prediction accuracy rates between cutaneous pigmented versus soft-tissue lesions and patients with/without a predisposition to malignancy. Results: The study included 416 pathological specimens from 290 patients. The most common tumors of the upper extremity were lipoma (20%), ganglion cyst (10.1%), and epidermoid cyst (5.8%). After pathological evaluation, 23 specimens were diagnosed as malignant (5.5%) and 32 specimens as premalignant (7.7%). The prediction of malignancy status was accurate in 390 specimens (93.7%). Soft-tissue sarcomas (67.7%) and vascular lesions (58.1%) have the lowest accuracy rates among all tumors. Conclusion: Definitive diagnosis and malignity status can be predicted after the initial examination in the majority of the cases. However, imaging studies or incisional biopsies are needed for soft-tissue sarcomas, vascular tumors, or tumors of patients with a predisposing condition to malignancy.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80520151","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: The aim of this study was to evaluate the reliability of the upper breast border (UBB) in determining the new location of the nipple and to objectively analyze long-term nipple position compared to pre-operative markings. Patients and Methods: Thirty-eight patients (76 breasts) patients who underwent superomedial pedicle, reverse-T scar breast reductions and who had long-term (>12 months) follow-up data were included. The sternal notch to the nipple, nipple to inframammarian fold (N-IMF), nipple to chest midline, and areola diameter were measured and recorded at the time of preoperative, markings, and long-term follow-up visit. Statistical Analysis Used: The differences in measurements were compared using a paired, two-tailed T-test, and a P < 0.05 was considered statistically significant. Results: The average follow-up time was 17.9 months (range 12–41 months). The nipple was located, on average, 0.95 cm lower on postoperative assessment compared to preoperative marking (P = 0.060). The nipple was located, on average, 0.75 cm lateral on postoperative assessment compared to preoperative marking (P < 0.001). The average postoperative increase in the N-IMF distance between marking and the long-term follow-up visit was 1.75 cm (P < 0.001). The areola diameter was increased 0.21 cm on postoperative assessment compared to preoperative marking (P < 0.001). Conclusions: The nipple position moved down and the N-IMF distance was greater than planned. However, the nipple was usually located at the area of the greatest projection of the breast due to almost equal elongation of the superior and inferior poles. The outcome of breast reduction procedures in which the postoperative nipple position is planned using the UBB was good.
目的:本研究的目的是评估上乳边界(UBB)在确定乳头新位置方面的可靠性，并客观分析与术前标记相比的长期乳头位置。患者和方法:38例(76个乳房)行上内侧蒂逆行t型瘢痕缩胸术，长期随访(>12个月)。在术前、标记和长期随访时测量并记录胸骨切迹至乳头、乳头至乳下褶(N-IMF)、乳头至胸部中线和乳晕直径。统计学分析方法:测量值的差异采用配对双尾t检验进行比较，P < 0.05为有统计学意义。结果:平均随访时间17.9个月(12 ~ 41个月)。与术前标记相比，术后评估乳头位置平均低0.95 cm (P = 0.060)。与术前标记相比，术后评估乳头的位置平均外侧0.75 cm (P < 0.001)。术后N-IMF标记距离与长期随访距离平均增加1.75 cm (P < 0.001)。术后评价乳晕直径较术前标记增加0.21 cm (P < 0.001)。结论:乳头位置下移，N-IMF距离大于计划。然而，乳头通常位于乳房最突出的区域，因为上下极的伸长几乎相等。乳房缩小手术的结果，其中术后乳头位置计划使用UBB是好的。
{"title":"Use of the superior breast border landmark for planning reduction mammoplasty: Objectively analysis with long-term follow-up period","authors":"C. Demir, E. Yaşar, M. Asadov, M. Alagöz","doi":"10.4103/tjps.tjps_31_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_31_21","url":null,"abstract":"Aims: The aim of this study was to evaluate the reliability of the upper breast border (UBB) in determining the new location of the nipple and to objectively analyze long-term nipple position compared to pre-operative markings. Patients and Methods: Thirty-eight patients (76 breasts) patients who underwent superomedial pedicle, reverse-T scar breast reductions and who had long-term (>12 months) follow-up data were included. The sternal notch to the nipple, nipple to inframammarian fold (N-IMF), nipple to chest midline, and areola diameter were measured and recorded at the time of preoperative, markings, and long-term follow-up visit. Statistical Analysis Used: The differences in measurements were compared using a paired, two-tailed T-test, and a P < 0.05 was considered statistically significant. Results: The average follow-up time was 17.9 months (range 12–41 months). The nipple was located, on average, 0.95 cm lower on postoperative assessment compared to preoperative marking (P = 0.060). The nipple was located, on average, 0.75 cm lateral on postoperative assessment compared to preoperative marking (P < 0.001). The average postoperative increase in the N-IMF distance between marking and the long-term follow-up visit was 1.75 cm (P < 0.001). The areola diameter was increased 0.21 cm on postoperative assessment compared to preoperative marking (P < 0.001). Conclusions: The nipple position moved down and the N-IMF distance was greater than planned. However, the nipple was usually located at the area of the greatest projection of the breast due to almost equal elongation of the superior and inferior poles. The outcome of breast reduction procedures in which the postoperative nipple position is planned using the UBB was good.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81091716","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}
A. Gokkaya, M. Gorgu, Ertuğrul Karanfil, Jehat Kızılkan
We report the case of a histologically confirmed primary cutaneous marginal zone B-cell lymphoma (PCMZL), which was treated by surgical excision. PCMZL is the second-most common type of primary cutaneous lymphoma, including cells of the marginal zone, lymphoplasmacytic cells, and plasma cells. Treatment options include surgery, radiotherapy, topical therapy, corticosteroids, chemotherapy, rituximab, and antibiotics. After treatment, local recurrence may occur but metastasis is extremely rare. Tumor prognosis shows an indolent course with a 5-year disease-free survival rate approaching 97%–99%. We present the case of a woman aged 69 who was diagnosed with PCMZL for a pruritic, erythematous lesion with an undefined border on the upper left leg.
{"title":"Primary cutaneous marginal zone lymphoma","authors":"A. Gokkaya, M. Gorgu, Ertuğrul Karanfil, Jehat Kızılkan","doi":"10.4103/tjps.tjps_15_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_15_21","url":null,"abstract":"We report the case of a histologically confirmed primary cutaneous marginal zone B-cell lymphoma (PCMZL), which was treated by surgical excision. PCMZL is the second-most common type of primary cutaneous lymphoma, including cells of the marginal zone, lymphoplasmacytic cells, and plasma cells. Treatment options include surgery, radiotherapy, topical therapy, corticosteroids, chemotherapy, rituximab, and antibiotics. After treatment, local recurrence may occur but metastasis is extremely rare. Tumor prognosis shows an indolent course with a 5-year disease-free survival rate approaching 97%–99%. We present the case of a woman aged 69 who was diagnosed with PCMZL for a pruritic, erythematous lesion with an undefined border on the upper left leg.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89117109","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}
Phyllodes tumors of the breast are rare, occurring for <1% of all breast tumors. The name “phyllodes,” is from the Greek language and means “leaflike.” This tumor refers to the fact that its cells grow in a leaflike arrangement. Another name for this tumor is cystosarcoma phyllodes and tends to grow rapidly, but they rarely spread outside the breast. This lady who underwent an aggressive management which includes mastectomy, axillary clearance, reconstruction with a flap followed by chemotherapy and radiotherapy. With that, we can conclude that an aggressive stance on these tumors ensures a good prognosis.
{"title":"Aggressive management of a giant malignant phyllodes with lung metastasis","authors":"L. Sian, A. Jagwani","doi":"10.4103/tjps.tjps_24_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_24_21","url":null,"abstract":"Phyllodes tumors of the breast are rare, occurring for <1% of all breast tumors. The name “phyllodes,” is from the Greek language and means “leaflike.” This tumor refers to the fact that its cells grow in a leaflike arrangement. Another name for this tumor is cystosarcoma phyllodes and tends to grow rapidly, but they rarely spread outside the breast. This lady who underwent an aggressive management which includes mastectomy, axillary clearance, reconstruction with a flap followed by chemotherapy and radiotherapy. With that, we can conclude that an aggressive stance on these tumors ensures a good prognosis.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78220408","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: It's a widely accepted fact that social media platforms have revolutionized the way human beings communicate. Nevertheless, there is little evidence describing how the plastic surgery community has adopted social media. Aims and Objectives: This study aims to identify through objective data the social media activity of the members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons, their purpose and methods of use, and their opinion on the risks and violations in social media. Materials and Methods: An anonymous survey containing 26 questions on the use of social media was distributed to members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons and prevalent patterns of social media implementation were elucidated. Results: 88.9% of respondents were social media users and 56.95% of the users were using social media both for personal and professional posts. Reasons for using social media included the beliefs that they can accurately inform their patients (55,89%), communicate effectively with the patients (48,48%), and that they can raise awareness among patients (47,47%). 28,96% reported that it is an effective tool in promoting and advertising their practice. Most respondents (54,70%) stated that social media had positive effects on their practice, whereas 44,95% percent reported that it had neither a positive nor a negative impact. Conclusions: This study depicts current patterns of social media use by plastic surgeons, including motivations driving its implementation and impressions on its impact. Many feel that social media are an effective marketing tool that generates increased exposure and referrals. A small number of surgeons have experienced negative repercussions from social media involvement. There is a definite oversight to ensure ethical use of social media platforms throughout the plastic surgery community. Continuing discussion regarding these matters should be ongoing as the experience with social media in plastic surgery evolves.
{"title":"Social media behavior in plastic surgery practice in Turkey","authors":"Deniz Emuler, M. Ayhan","doi":"10.4103/tjps.tjps_11_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_11_21","url":null,"abstract":"Background: It's a widely accepted fact that social media platforms have revolutionized the way human beings communicate. Nevertheless, there is little evidence describing how the plastic surgery community has adopted social media. Aims and Objectives: This study aims to identify through objective data the social media activity of the members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons, their purpose and methods of use, and their opinion on the risks and violations in social media. Materials and Methods: An anonymous survey containing 26 questions on the use of social media was distributed to members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons and prevalent patterns of social media implementation were elucidated. Results: 88.9% of respondents were social media users and 56.95% of the users were using social media both for personal and professional posts. Reasons for using social media included the beliefs that they can accurately inform their patients (55,89%), communicate effectively with the patients (48,48%), and that they can raise awareness among patients (47,47%). 28,96% reported that it is an effective tool in promoting and advertising their practice. Most respondents (54,70%) stated that social media had positive effects on their practice, whereas 44,95% percent reported that it had neither a positive nor a negative impact. Conclusions: This study depicts current patterns of social media use by plastic surgeons, including motivations driving its implementation and impressions on its impact. Many feel that social media are an effective marketing tool that generates increased exposure and referrals. A small number of surgeons have experienced negative repercussions from social media involvement. There is a definite oversight to ensure ethical use of social media platforms throughout the plastic surgery community. Continuing discussion regarding these matters should be ongoing as the experience with social media in plastic surgery evolves.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79936531","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":"Treatment of degloving injury of the hand using the free latissimus dorsi muscle flap: Long-term functional results","authors":"C. Demir, E. Yaşar, M. Alagoz","doi":"10.4103/tjps.tjps_10_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_10_21","url":null,"abstract":"","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75940297","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 : 2021-10-01DOI: 10.4103/tjps.tjps_130_20
A. Tufan, R. Tartar, Banu Yigit, E. Baran, H. Eren, B. Citgez
Necrotizing fasciitis (NF) is an infectious disease, which is characterized by rapidly progressive necrosis of the skin, subcutaneous tissue, and fascia. The skin is involved in the late stage of the disease. It is a very rare but a life-threatening condition if it is not diagnosed early and treated promptly. Comorbidities and concomitant medications should be carefully considered when managing patients with NF. We present the case of a 92-year-old patient with diabetes mellitus diagnosed with NF that spreads to lower abdomen, bilateral inguinal region, and pubic area after applying a depilatory cream to the mons pubis and the area just below the pubic bone. Rapidly and aggressive surgical debridement of the necrotic tissue was applied and negative pressure wound therapy was immediately applied with a vacuum-assisted closure device (VAC). Broad-spectrum antibiotics were used to treat infection. After several VAC therapy applications during the treatment period, the final stage of the treatment was the reconstruction of the resulting defect with split-thickness skin graft. Early and aggressive debridement, broad-spectrum antibiotherapies constitute the mainstay of treatment. Concurrently, serial debridement and rapidly intervention also shorten healing time and hospital stay.
{"title":"Necrotizing fasciitis as a complication of depilatory cream","authors":"A. Tufan, R. Tartar, Banu Yigit, E. Baran, H. Eren, B. Citgez","doi":"10.4103/tjps.tjps_130_20","DOIUrl":"https://doi.org/10.4103/tjps.tjps_130_20","url":null,"abstract":"Necrotizing fasciitis (NF) is an infectious disease, which is characterized by rapidly progressive necrosis of the skin, subcutaneous tissue, and fascia. The skin is involved in the late stage of the disease. It is a very rare but a life-threatening condition if it is not diagnosed early and treated promptly. Comorbidities and concomitant medications should be carefully considered when managing patients with NF. We present the case of a 92-year-old patient with diabetes mellitus diagnosed with NF that spreads to lower abdomen, bilateral inguinal region, and pubic area after applying a depilatory cream to the mons pubis and the area just below the pubic bone. Rapidly and aggressive surgical debridement of the necrotic tissue was applied and negative pressure wound therapy was immediately applied with a vacuum-assisted closure device (VAC). Broad-spectrum antibiotics were used to treat infection. After several VAC therapy applications during the treatment period, the final stage of the treatment was the reconstruction of the resulting defect with split-thickness skin graft. Early and aggressive debridement, broad-spectrum antibiotherapies constitute the mainstay of treatment. Concurrently, serial debridement and rapidly intervention also shorten healing time and hospital stay.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74732941","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}
Tuberculous tenosynovitis, formerly known as compound palmar ganglion, is a rare condition that presents usually as chronic painless swelling, tenosynovitis, and sometimes with compressive neuropathy. Approximately 10% of all extrapulmonary manifestations of tuberculosis involve the musculoskeletal system and among them, involvement of the wrist and hand is a very rare condition. It is really important to manage this condition before it spreads to the underlying bones causing osteomyelitis and destruction. Here, we are going to report two cases both presenting with a painless swelling and restriction of movement of their wrists for more than 6 months. In physical examination, one of the patients had also numbness over median nerve territory. After imaging, biopsies, cultures, and histopathological examinations, wrist swelling was considered as tuberculous tenosynovitis and appropriate anti-tuberculosis treatment was started.
{"title":"Tuberculous Tenosynovitis of the wrist: A rare presentation of extra-pulmonary tuberculosis and delays in diagnosis","authors":"Can Ekinci, A. Koçman, Salih Surun, C. Çetįn","doi":"10.4103/tjps.tjps_23_21","DOIUrl":"https://doi.org/10.4103/tjps.tjps_23_21","url":null,"abstract":"Tuberculous tenosynovitis, formerly known as compound palmar ganglion, is a rare condition that presents usually as chronic painless swelling, tenosynovitis, and sometimes with compressive neuropathy. Approximately 10% of all extrapulmonary manifestations of tuberculosis involve the musculoskeletal system and among them, involvement of the wrist and hand is a very rare condition. It is really important to manage this condition before it spreads to the underlying bones causing osteomyelitis and destruction. Here, we are going to report two cases both presenting with a painless swelling and restriction of movement of their wrists for more than 6 months. In physical examination, one of the patients had also numbness over median nerve territory. After imaging, biopsies, cultures, and histopathological examinations, wrist swelling was considered as tuberculous tenosynovitis and appropriate anti-tuberculosis treatment was started.","PeriodicalId":42065,"journal":{"name":"Turkish Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85587242","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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