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Atalay S, Coruh A, Deniz K. Stromal vascular fraction improves deep partial thickness burn wound healing. Burns 2014; 40:1375-83. [PMID: 24572074 DOI: 10.1016/j.burns.2014.01.023] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 01/22/2014] [Accepted: 01/23/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The practice of early burn wound excision and wound closure by immediate autologous skin or skin substitutes is the preferred treatment in extensive deep partial and full-thickness burns. To date there is no proven definite medical treatment to decrease burn wound size and accelerate burn wound healing in modern clinical practice. Stromal vascular fraction is an autologous mixture that has multiple proven beneficial effects on different kinds of wounds. In our study, we investigated the effects of stromal vascular fraction on deep partial-thickness burn wound healing. METHODS In this study, 20 Wistar albino rats were used. Inguinal adipose tissue of the rats was surgically removed and stromal vascular fraction was isolated. Thereafter, deep second-degree burns were performed on the back of the rats by hot water. The rats were divided into two groups in a randomized fashion. The therapy group received stromal vascular fraction, whereas the control group received only physiologic serum by intradermal injection. Assessment of the burn wound healing between the groups was carried out by histopathologic and immuno-histochemical data. RESULTS Stromal vascular fraction increased vascular endothelial growth factor, proliferating cell nuclear antigen index, and reduced inflammation of the burn wound. Furthermore, vascularization and fibroblastic activity were achieved earlier and observed to be at higher levels in the stromal vascular fraction group. CONCLUSIONS Stromal vascular fraction improves burn wound healing by increasing cell proliferation and vascularization, reducing inflammation, and increasing fibroblastic activity.
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Research Support, Non-U.S. Gov't |
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100 |
2
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Ozyazgan I, Günay GK, Eskitaşçioglu T, Ozköse M, Coruh A. A New Proposal of Classification of Zygomatic Arch Fractures. J Oral Maxillofac Surg 2007; 65:462-9. [PMID: 17307594 DOI: 10.1016/j.joms.2005.12.079] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2005] [Revised: 12/06/2005] [Accepted: 12/29/2005] [Indexed: 10/23/2022]
Abstract
PURPOSE Among facial fractures, zygomatic arch fractures occur rather frequently. Facial fractures have recently been classified in fine detail according to computed tomographic findings. Nevertheless, there exists no classification of the zygomatic arch fracture, which has a physiognomically important place, to provide guidance for treatment. We aimed to make a detailed classification of zygomatic fractures in various shapes, which does not exist in the literature, and to form an algorithm for treatment. PATIENTS AND METHODS A total of 451 patients with zygomatic arch fractures treated in our clinic from 1987 through 2004 were assessed retrospectively from the treatment viewpoint together with radiological and clinical findings. RESULTS At the end of this assessment, arch fractures were divided into 2 groups: 1) isolated fractures in which the zygomatic arch alone broke, and 2) combined fractures in which the zygomatic arch broke together with the other facial bones. Isolated fractures were also divided into 2 subgroups as A) 2 fractures in the arch, and B) more than 2. Isolated arch fractures with more than 2 fracture lines were also classified as V-shaped fractures where fragments are partially reduced and those where fragments are displaced. As for combined fractures, they were subgrouped as A) single fracture in the arch, and B) plural. Plural fractures were further classified within their own group, also according to whether fragments were displaced or not. CONCLUSION In the 2 fractures and V-shaped fracture subgroups of isolated fractures, preservation of fragments in reduced position was satisfactory during the closed reduction and afterwards. As for those with more than 2 fractures of isolated arch fractures, they required open reduction and internal rigid fixation. The same treatment was used in combined zygomatic arch fractures where there were more than one displaced fractures. In addition to classification, we formed an algorithm to guide us in treatment based on our series.
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32 |
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Coruh A. Distally Based Perforator Medial Plantar Flap: A New Flap for Reconstruction of Plantar Forefoot Defects. Ann Plast Surg 2004; 53:404-8. [PMID: 15385780 DOI: 10.1097/01.sap.0000112287.56354.f8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In this article the author describes 2 cases of a distally based perforator medial plantar flap that were transferred successfully from the nonweight-bearing instep region to the weight-bearing plantar forefoot (defects, 8 x 5 cm and 6 x 5 cm respectively). This flap is nourished solely by perforators of the medial plantar vessels. The advantages of this flap are the protection of the vascular supply of the foot (because both posterior tibial and medial plantar vascular systems are preserved), anterograde flow of the vascular supply (which gives an additional advantage of expecting less venous insufficiency compared with reverse-flow flaps), no dependence on retrograde vascular communications, minimal donor site morbidity, and transport of structurally similar tissues to the plantar forefoot.
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Tosun Z, Esmaoglu A, Coruh A. Propofol-ketamine vs propofol-fentanyl combinations for deep sedation and analgesia in pediatric patients undergoing burn dressing changes. Paediatr Anaesth 2008; 18:43-7. [PMID: 18095965 DOI: 10.1111/j.1460-9592.2007.02380.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to compare propofol-ketamine (PK) and propofol-fentanyl (PF) combinations for deep sedation and analgesia in pediatric burn wound dressing changes. METHODS Thirty-two ASA physical status II and III inpatients with a second degree total burn surface area ranging from 5% to 25% were studied in a randomized, double blind fashion. Heart rate, systolic arterial pressure, peripheral oxygen saturation, respiratory rate and Ramsey sedation scores of all patients were recorded perioperatively. Patients were randomly assigned to receive either PK or PF: PK group (n = 17) received 1 mg.kg(-1) ketamine + 1.2 mg.kg(-1) propofol, and PF group (n = 15) received 1 microg.kg(-1) fentanyl + 1.2 mg.kg(-1) propofol for induction. Additional propofol (0.5-1 mg.kg(-1)) was administered when the patients showed discomfort in both groups. If the patient showed discomfort and/or increase in heart rate or systolic arterial pressure, despite additional propofol dose, additional bolus of 0.5-1 mg.kg(-1) ketamine or 0.5-1 microg.kg(-1) fentanyl was administered. RESULTS There were no significant differences in heart rate, systolic arterial pressure, peripheral oxygen saturation, respiratory rate and sedation scores during the procedure between the groups. Restlessness during the procedure was seen in seven (47%) patients in Group PF and one (5.9%) patient in Group PK (P = 0.013). CONCLUSIONS Both propofol-ketamine and propofol-fentanyl combinations provided effective sedation and analgesia during dressing changes in pediatric burn patients. But propofol-ketamine combination was superior to propofol-fentanyl combination because of more restlessness in patients given propofol-fentanyl.
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Comparative Study |
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Abstract
Objective Among the rarest of the craniofacial clefts is the Tessier no. 4 cleft; and hence little has been published about its management and treatment. Complete forms of the cleft yield poor surgical results because of the shortened oculoalar and oculo-oral distance and inadequate soft and bony tissue. Multiple sequential corrective operations are required. A primary early concern is the protection of the eye, particularly in severe forms in which corneal exposure occurs. This article presents two cases of Tessier no. 4 clefts, one unilateral and the other bilateral, and discusses the problems encountered during their surgical and postoperative managements.
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Ozyazgan I, Eskitaşçioğlu T, Baykan H, Coruh A. Repair of Traumatic Orbital Wall Defects Using Conchal Cartilage. Plast Reconstr Surg 2006; 117:1269-76. [PMID: 16582799 DOI: 10.1097/01.prs.0000208301.69547.8b] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The authors' aim was to investigate the efficiency of conchal cartilage grafts in defective orbital wall fractures, which are encountered isolated or in combination with other orbitozygomatic fractures. The authors assessed, for this purpose, the follow-up results of patients treated by using conchal cartilage grafts. METHODS Ten patients who had defective orbital wall fractures and were treated by using conchal cartilage graft among those treated for facial fractures in the authors' clinic were included in the study. The wall defects in the patients were detected either with preoperative radiologic images or with orbital exploration performed to look for a possible defect accompanying the fracture with orbital extension during the operation. In all patients (four isolated and six combined orbital fractures), who had defects varying from 100 to 400 mm, conchal cartilage grafts were adapted to the defect. In the postoperative follow-up, Hertel exophthalmometry was also performed together with clinical examination so that enophthalmos that might develop as a complication could be assessed. RESULTS In the postoperative period, cartilage graft was palpated slightly in two patients at the edge of the infraorbital rim. Limitation in eye movement, diplopia, and enophthalmos did not occur in our patients, except for one who reported to us 1 year after the primary trauma. No complication in the donor area was observed. CONCLUSIONS Conchal cartilage could be considered one of the autogenous materials among those materials suitable for the repair of defective orbital wall fractures that are not oversized. It has the advantages of being adequate for reconstruction of the fracture, easy to obtain, easily adaptable to the orbital walls, and having minimum morbidity at the donor site.
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7
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Abstract
A retrospective multifactorial epidemiological study of 742 patients admitted to Erciyes University Medical Faculty Burn Unit during a 7-year period between 1996 and 2002 is presented. The overall male-to-female ratio was 1.88:1. The highest-risk age group of burn injuries was 0 to 6 years (48.6%), with the greatest number of injuries occurring to children who were 2 to 3 years of age. Seasonal variations had no influence on the increased number of admissions to the burn unit. Scalding was the major cause of pediatric burns. Flame burns were the most frequent cause of burns in adults and the second-leading cause in children. Seventy-eight of the 742 patients died, with a mortality rate of 7.8 % in children and 12.6% and 19.23% in adult males and females, respectively. The overall mortality rate was 10.5%.
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Eskitascioglu T, Ozyazgan I, Coruh A, Gunay GK, Altiparmak M, Yontar Y, Dogan F. Experience of 80 Cases with Fournier's Gangrene and 'Trauma' as a Trigger Factor in the Etiopathogenesis. ULUS TRAVMA ACIL CER 2014; 20:265-74. [DOI: 10.5505/tjtes.2014.67670] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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9
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Coruh A, Tosun Z, Ozbebit U. Close Relative Intermingled Skin Allograft and Autograft Use in the Treatment of Major Burns in Adults and Children. ACTA ACUST UNITED AC 2005; 26:471-7. [PMID: 16278560 DOI: 10.1097/01.bcr.0000185114.59640.b4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Major burns still continue to pose problems of inadequate auto skin closure. Patients suffering severe burns lack adequate skin graft donor site. We present the results of 17 major adult and pediatric burns that we applied close relative intermingled skin allograft and autograft in the course of treatment. The extent of burn injury ranged from 40%-70% total body surface are (TBSA). Seven patients survived and 10 patients died. Mean percent TBSA of the dead and surviving patients were 55.5 +/- 11.16 (range, 40-70) and 55.0 +/- 4.08 (range, 50-60) respectively. Mean age of the dead and surviving patients were 16.1 +/- 13.77 (range, 2-42) and 11.1 +/- 6.74 (range, 2-21), respectively. We present a safe and satisfactory means of effective alternative treatment to resurface major burns in case of limited auto skin graft donor site without exposure to bacteria, human immunodeficiency virus, and hepatitis virus when keratinocyte culture facilities and skin banks are not available.
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Eskitascioglu T, Oyazgan I, Coruh A, Gunay GK, Yontar Y, Altipamak M. Fractures of the mandible: a 20-year retrospective analysis of 753 patients. ULUS TRAVMA ACIL CER 2013; 19:348-56. [DOI: 10.5505/tjtes.2013.56313] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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11
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Coruh A, Akcali Y, Ozcan N, Ekmekcioglu O. Modified pudendal thigh flap for perineoscrotal reconstruction: A case of Leriche syndrome with rapidly progressing Fournier’s gangrene. Urology 2004; 64:1030. [PMID: 15533507 DOI: 10.1016/j.urology.2004.05.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2004] [Accepted: 05/26/2004] [Indexed: 10/26/2022]
Abstract
We present the first report of Leriche syndrome associated with Fournier's gangrene. We used a modified pudendal thigh flap in the treatment of an extensive perineoscrotal soft-tissue defect successfully. We propose this new robust flap as an addition to the existing reconstructive armamentarium and draw attention to the coexistence of Leriche syndrome and Fournier's gangrene.
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Eskitascioglu T, Coruh A, Ozyazgan I, Gunay GK. Salvage of Venous Congested Flaps by Simple Methods. Plast Reconstr Surg 2006; 117:344-6. [PMID: 16404318 DOI: 10.1097/01.prs.0000192625.45163.3a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19 |
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Yucel B, Coruh A, Deniz K. Salvaging the Zone of Stasis in Burns by Pentoxifylline: An Experimental Study in Rats. J Burn Care Res 2019; 40:211-219. [DOI: 10.1093/jbcr/irz005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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14
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Coruh A. Pectoralis major musculocutaneous flap with nipple-areola complex in head and neck reconstruction: preliminary results of a new modified method. Ann Plast Surg 2006; 56:413-7. [PMID: 16557075 DOI: 10.1097/01.sap.0000202889.09833.34] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pectoralis major musculocutaneous flap remains the workhorse tool for head and neck reconstruction. Flap failure in head and neck reconstruction is a devastating complication with a high morbidity and mortality. Inclusion of nipple-areola complex on the skin paddle stabilizes the blood circulation in the skin island of the pectoralis major musculocutaneous flap. A modified use of pectoralis major musculocutaneous flap with nipple-areola complex on the skin island was performed in 11 male patients in head and neck reconstructions with success without partial or total skin island necrosis. We recommend the inclusion of nipple-areola complex on the skin island of the pectoralis major musculocutaneous flap in head and neck reconstructions to increase the blood supply of the skin paddle. We concluded that the skin island of the pectoralis major musculocutaneous flap might include the areola and nipple complex in patients with large defects of the head and neck, which stabilize the blood circulation in the skin island.
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Case Reports |
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15
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Eskitascioglu T, Dogan F, Sahin G, Ozkose M, Coruh A, Ozyazgan I. An extraordinary chemical burn injury cause: buttercup a report of five cases. Burns 2007; 34:727-30. [PMID: 17624679 DOI: 10.1016/j.burns.2007.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Accepted: 01/29/2007] [Indexed: 11/21/2022]
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Case Reports |
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5 |
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Journal Article |
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17
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Yontar Y, Tatar S, Aydin A, Coruh A. Delayed Primary Closure of Traumatic Tension Wounds Using Plastic Straps and Kirschner Wires. Plast Surg (Oakv) 2019; 27:29-37. [PMID: 30854359 DOI: 10.1177/2292550317750147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Tension of the wound edges should be overcome with precise surgical planning, which is recognized as one of the major contributors to local complications by compromising circulation of the wound edges. In this article, it was aimed to present the clinical results of a surgical technique, in which the plastic straps and Kirschner wires are used for delayed primary closure of traumatic tension wounds. Depending on the assessment of the wound localization, wound dimension, and mobility of adjacent soft tissue, the technique was performed in 9 patients with a male to female ratio of 8:1. Gunshot injury was the leading cause (n = 5), and in most cases, the wounds were located at the lower extremities (n = 6). The mean time between performing the technique and closing the wound primarily and the mean hospitalization time were 4.8 ± 1.1 and 13.5 ± 3.9 days, respectively. In each case, wound closure and healing were achieved successfully without any serious complications. The presented technique provides advantages of using a low cost as well as a very simple equipment, improved and reliable stability during tightening process due to self-locking feature of the plastic straps, no donor site morbidity, short operating time with low rate of post-operative complications, and short hospitalization time. We recommend using this invaluable technique reliably for the treatment of traumatic tension wounds. However, further studies are needed for better evaluation of cosmetic and functional outcomes of the presented technique.
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Coruh A, Abaci K, Gunay GK. Effect of Topical Nitroglycerine on the Survival of Ischemic Flow-Through Venous Flaps in Rabbits. J Reconstr Microsurg 2004; 20:261-6. [PMID: 15088211 DOI: 10.1055/s-2004-823114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to investigate the effect of transdermal nitroglycerin on the survival of an ischemic one-vein flow-through venous flap (FTVF) model in the rabbit ear. Fifteen New Zealand white male rabbits were randomly divided into three groups: Group 1 (n = 5, 10 flaps)- no dressing on the operative wound; Group 2 (n = 5, 10 flaps)-occlusive film dressing group [polyurethane semipermeable membrane (Op-Site)]; and Group 3 (n = 5, 10 flaps)- transdermal nitroglycerine pad (Novartis-Nitroderm TTS 5 mg) on the wound. Nitroderm TTS and the occlusive film dressing were changed daily postoperatively for 3 days. The percentage of the surviving area and the mean extent of the surviving area to the axial vein were calculated on the postoperative 14 (th) day. Necrotic and surviving areas of flaps were consistent with histopathologic findings. Group 3 (83 percent +/-10.46, 17.4 +/- 3.0 mm) had larger flap surviving areas and longer distances to the axial vein than Group 1 (60 percent +/-15.29, 11.8 +/- 4.3 mm) and Group 2 (58 percent +/-10.25, 12.8 +/- 2.8 mm). The difference was statistically significant ( p < 0.05). This study demonstrated that postoperatively applied transdermal nitroglycerine significantly increased the ischemic FTVF survival area and the survival width to the axial vein.
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Yontar Y, Esmaoglu A, Coruh A. Retrospective analysis of burn injuries caused by hot milk in 159 pediatric patients: 14 years of experience in a burn unit. ULUS TRAVMA ACIL CER 2014; 20:281-5. [PMID: 25135023 DOI: 10.5505/tjtes.2014.41027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The aim of this study was to investigate the hot milk burns among the pediatric patients and to compare our experiences with similar studies in the literature. METHODS A 14-year retrospective study was conducted on 159 pediatric patients with hot milk burn who hospitalized at the Burn Unit of Erciyes University Medical Faculty. RESULTS There were 81 male and 78 female patients with a male to female ratio of 1.03:1. The mean age of the patients was 2.7±1.6 years. The initial injury was immersion in 59.7% of the patients and spillage in 40.3%. The mean burned body surface area of the patients was 18.6±10.8%. Twenty-two percent of the patients had moderate, and 78% had major burn trauma. Forty-nine percent of the patients received burn wound debridement and reconstruction with auto-skin grafts. Our burn unit's mortality rate was 1.5% among 542 pediatric patients with hot water, and 5.6% among 159 pediatric patients with hot milk burn during the same period, respectively. CONCLUSION Hot milk burns should be considered as separately from other hot liquid burns which do not contain fat such as water, tea, and coffee. Physical and chemical properties of milk because of its high content of fat give rise to more tissue destruction, increased morbidity and mortality.
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Yontar Y, Coruh A, Severcan M. K-wire assisted split-thickness skin graft harvesting from the anterior trunk. Burns 2016; 42:222-229. [DOI: 10.1016/j.burns.2015.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/11/2015] [Indexed: 11/28/2022]
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Coruh A. High Voltage Electric Burn Repair of the Forehead by Reverse Flow Temporalis Muscle Flap. J Burn Care Res 2020; 40:373-376. [PMID: 30805601 DOI: 10.1093/jbcr/irz024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/12/2018] [Accepted: 02/21/2019] [Indexed: 11/13/2022]
Abstract
Repairing soft tissue defects of the forehead which exposes the bare bone is a dilemma with few reconstructive techniques for plastic surgeons. Forehead is an important aesthetic unit of the face which is covered with the glabrous skin. Due to the relative lack of similar mobile tissue locally, reconstruction of large soft tissue defects of the forehead region by local flaps is demanding. Temporalis muscle flap does not reach to the midline of the forehead region because of the insufficient length of the deep temporal vascular system. During the transfer of the muscle, only a small volume and size of the muscle can reach to the defect, remaining most of the muscle bulk in the pedicle and a relatively limited arc of rotation, thus a small volume of usable tissue at the distal portion of the flap. We successfully used reverse flow temporalis muscle flap for the purpose of eliminating the above-mentioned disadvantage of temporalis muscle flap in a 23-year-old male patient who sustained a high-voltage electrical burn resulting 12 × 8 cm left forehead defect exposing the bare bone.
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Review |
5 |
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Coruh A, Dagdelen F, Soyuer I. Effect of topical angiotensin II on prelaminated flaps in rats and evaluation of angiogenesis with an immunohistochemical marker. ACTA ACUST UNITED AC 2009; 38:65-9. [PMID: 15202663 DOI: 10.1080/02844310310016278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The effects of a single topical dose of angiotensin II (AII) on prelamination of flaps were investigated in rats using an immunohistochemical marker. Ninety rats were randomly divided into three groups (n = 30 in each). The control group were given nothing; the vehicle group were given only carboxymethyl cellulose, and the treatment group were given topical AII with carboxymethyl cellulose between the flap and the skin graft. According to the day of evaluation of vascularisation, each group was randomly divided into three sub-groups on days 4, 7, and 14 (n = 10 in each). Paraffin sections of the tissues were cut at the flap-graft interface and stained immunohistochemically with factor VIII-related antigen (FVIIIRAg). Capillaries and venules that stained were counted. The number of vessels in the groups on day 4 were similar, but by day 7 the number of vessels was significantly greater in the treatment group than the other two. The number of vessels in the treatment group on day 14 was greater than in the other two groups, but not significantly so. We conclude that a single topical dose of AII increases the vascularisation at the flap and skin graft interface by angiogenesis.
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Unverdi OF, Coruh A. Effects of microneedle length and duration of preconditioning on random pattern skin flaps in rats. J Plast Reconstr Aesthet Surg 2020; 73:1758-1767. [PMID: 32473851 DOI: 10.1016/j.bjps.2020.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 03/13/2020] [Accepted: 03/25/2020] [Indexed: 12/14/2022]
Abstract
To date, the surgical delay of skin flaps is the most common and reliable method that increases skin flap survival. In this study, we aimed to increase skin flap viability using preconditioning by microneedling. Seventy-two Sprague Dawley rats were randomly divided into control, surgical flap delay (SFD), and four microneedling groups (7 or 14 days of preconditioning with 0.5 mm or 1 mm needles). Modified McFarlane flaps were raised on the back of rats. In Group I, a caudal pedicled skin flap was raised and the flap survival rate was assessed on postoperative day 14. In the SFD group, a bipedicled flap was created and after 14 days of surgical delay, all skin flaps were raised. In the microneedling groups, 0.5 mm or 1 mm needles were used for 7 or 14 days. The flap survival rates of all microneedling and SFD groups were significantly higher than the control group. The plasma levels of vascular endothelial growth factor (VEGF) did not significantly differ between groups, but the VEGF level of skin samples in the SFD group was higher than the control group. The vessel counts of all microneedling and SFD groups were statistically higher than the control group in all skin samples taken before raising the flaps, but skin samples taken 14 days after raising the skin flap did not show any difference between groups. We showed that preconditioning by microneedling can be used to improve the viability of critical ischemic skin flaps at a level similar to surgical delay.
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Journal Article |
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Ture Z, Unuvar GK, Esmaoglu A, Ulu-Kilic A, Coruh A, Doganay M. Severe and complicated soft tissue infections: a single-centre case series. J Wound Care 2023; 32:492-499. [PMID: 37572342 DOI: 10.12968/jowc.2023.32.8.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To assess the demographic and clinical characteristics, laboratory findings, and economic burden of patients with a diagnosis of complicated skin and soft tissue infection (cSSTI). METHOD The demographic and clinical characteristics, laboratory findings, surgical interventions, cost of treatment, and outcome of patients diagnosed with cSSTIs between January 2017 and December 2019 were retrospectively analysed. RESULTS A total of 24 patients with cSSTIs were included in the study. The median age was 53 (22-85) years, and 14 (58%) were female. The most common comorbidity was diabetes (54%). On admission, 75% of patients presented with sepsis, and 70% had a high-grade Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score. The causative microorganism was isolated from 21 (87%) patients, and the multidrug resistance rate of Gram-negative bacteria was 50%. The median number of debridements was 3 (1-12). In all, 11 patients were followed up in the intensive care unit, and the mortality rate was 29%. The presence of confusion (p=0.025), causative Gram-negative microorganisms (p=0.009), hyponatraemia (p=0.034), the need for intensive care (p=0.001), anti-meticillin-resistant Staphylococcus aureus antibiotics (p=0.023) and the rate of antibiotic changes during treatment (p=0.019) were significantly higher in the non-survival patient group. Hyponatraemia was a significant independent risk factor for mortality (p=0.048). The median cost of per-patient treatment was $9453 USD in the non-surviving and $1536 in the surviving group. CONCLUSION It is important to know possible factors and local resistance rates at the beginning of empirical antibacterial and surgical treatment. The presence of hyponatraemia, sepsis and a high LRINEC score can be considered to be the mortality predictors.
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Daloglu OO, Unal MC, Kemaloglu CA, Bolatturk OF, Ozyazgan I, Tanriverdi F, Coruh A, Kelestimur F. Evaluation of pituitary function and metabolic parameters in patients with traumatic maxillofacial fractures. J Endocrinol Invest 2024; 47:2477-2485. [PMID: 38503991 PMCID: PMC11392989 DOI: 10.1007/s40618-024-02349-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/21/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE This study was designed to assess the pituitary functions of patients with traumatic maxillofacial fractures and compare the results with healthy controls. METHODS Thirty patients (mean age, 38.14 ± 14.15 years; twenty-six male, four female) with a traumatic maxillofacial fracture at least 12 months ago (mean 27.5 ± 6.5 months) and thirty healthy controls (mean age, 42.77 ± 11.36 years; twenty-five male, five female) were included. None of the patients were unconscious following head trauma, and none required hospitalization in intensive care. Basal pituitary hormone levels of the patients were evaluated. All patients and controls had a glucagon stimulation test and an ACTH stimulation test to evaluate the hypothalamic-pituitary-adrenal axis and the GH-IGF-1 axis. RESULTS Five of thirty patients (16.6%) had isolated growth hormone (GH) deficiency based on a glucagon stimulation test (GST). The mean peak GH level after GST in patients with hypopituitarism (0.54 ng/ml) was significantly lower than those without hypopituitarism (7.01 ng/ml) and healthy controls (11.70 ng/ml) (P < 0.001). No anterior pituitary hormone deficiency was found in the patients, except for GH. CONCLUSION Our study is the first to evaluate the presence of hypopituitarism in patients with traumatic maxillofacial fractures. Preliminary findings suggest that hypopituitarism and GH deficiency pose significant risks to these patients, particularly during the chronic phase of their trauma. However, these findings need to be validated in larger scale prospective studies with more patients.
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