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    Amputations in burn patients with a special emphasis on pediatric patients
    (Aves Yayıncılık, 2017) Özalp, Burhan; Calavul, Abdulkadir
    Objective: Digit and extremity amputations are unwanted complications in burn injuries. Although some amputations cause only cosmetic and psychological problems in burn patients, they can lead to serious loss in functionality and impairment in the quality of life. The aim of this study was to investigate the epidemiologic features of amputations among burn patients in the southeastern region of Turkey. Materials and Methods: We conducted retrospective chart reviews of patients hospitalized in Dicle University Burn Center between January 2011 and January 2016 and evaluated patient demographics. Results: A total of 3315 (2063 male and 1252 female) patients were treated, and 41 patients (36 males and 5 females) with a mean age of 21.95 years (range: 3-58 years) underwent amputation. The amputation incidence was 1.23% over the 5-year period. In total, 19 of 41 patients were under 16 years, while 16 were male workers. There was a significant male dominance (p<0.05), with electrical burns being the most common etiological agent (p<0.001). The mean burned total body surface area was 12.4±7.9% (range: 2-60%), and major amputations were significantly higher (p<0.05) if the area exceeded 10%. Conclusion: Electrical burns were the most common etiological factor, and pediatric patients were the most affected group. Educating parents and taking safety measures for protecting children from electrical contact points are as important as educating workers for diminishing the incidence of electrical burn-related amputations.
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    The Demographics of patients with skin cancer who underwent surgery in Diyarbakır and performed surgical techniques
    (Dicle Üniversitesi Tıp Fakültesi, 2018) Özalp, Burhan; Calavul, Abdulkadir; Taşkan, Sinan; Yıldırım, Mirza
    Objective: The major factor for developing malignant skin cancers is sunlight exposure. This study aimed to evaluate the demographics of patients with skin cancers who underwent surgery in Diyarbakır where the population is exposed to more sunlight than most other Turkish cities. Methods: The medical records of patients who underwent surgery for malignant skin cancer excision between 2011 and 2016 were searched using University Hospital’s patient database program. Data about patients’ demographics, cancer features, and the surgical techniques performed were collected. Results: Over a 5-year period, 190 patients underwent surgical excision. The male to female ratio was 1.56, and the mean age was 65.8 ± 15.7 (range, 20-94) years. The most common skin cancer was basal cell carcinoma (n=138, 72.7%), followed by squamous cell carcinoma (n=45, 23.7%) and malignant melanoma (n=5, 2.6%). The most common surgery was primary excision, which was performed in 90 of 190 patients (47.36%); tissue reconstruction with a skin graft or flap surgery was required for the remaining 100 (52.63%), showing a significant difference (p<0.001). Conclusion: Basal cell carcinoma is the most common skin cancer, and less than half of the patients sought treatment immediately after they recognized the lesion. The public should be educated about skin cancers to increase early diagnosis and encourage timely treatment, thereby decreasing morbidity and mortality from skin cancer. Keywords: Skin cancer; basal cell carcinoma; squamous cell carcinoma; skin cancer surgery; sunlight exposure
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    Distally based subcutaneous veins for venous insufficiency of the reverse posterior interosseous artery flap
    (Wiley-Blackwell, 2016) Özalp, Burhan; Elbey, Hüseyin; Aydın, Atakan; Özkan, Türker
    BackgroundThe reverse posterior interosseous artery flap (PIAF) provides soft, thin, and pliable tissue for upper extremity reconstruction without sacrificing any major arteries of the hand. The authors performed a new technique that included one extra distally based subcutaneous vein within the pedicle to diminish venous insufficiency and they aimed to present the results of reconstruction with this technique. Patients and MethodsTwelve patients with a mean age of 30years (range 5-52years) underwent reverse PIAF surgery. The defects were located on the hand and wrist, with a mean area of 57.8cm(2) (range 20-99cm(2)). After the skin between the distal edge and the pivot point of the flap was elevated, the most reliable subcutaneous vein was chosen, chased, and included within the flap. ResultsThe average size of the PIAF was 6x5cm to 12x9cm (mean area: 64.4cm(2)) and the median follow-up time was 13months (range 4-16months). The mean quick Disabilities of the Arm, Shoulder and Hand (DASH) score was 21.4, indicating a low degree of disability. Of the 12 patients, ten were very satisfied and two were satisfied with the result of the reconstruction. All but one flap survived completely. One flap was nearly totally lost due to arterial insufficiency after hemodialysis. We observed no venous congestion or insufficiency in the patients. ConclusionsSubcutaneous veins may be reliable and useful for overcoming major drawbacks associated with reverse flow posterior interosseous artery flap and for diminishing flap loss due to venous insufficiency.
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    Free flap surgery in a patient with essential tremor
    (Wiley-Blackwell, 2014) Özalp, Burhan; Selçuk, Caferi Tayyar; Durgun, Mustafa
    Dear Sir, Tremor is the most common involuntary disease that is characterized by swinging of a body part caused by contraction of agonist and antagonist muscles in a sequential order.1 Free flap surgery needs immobilization for the high rates of success especially when there is a potential risk of pedicle torsion, kinking, or predictable pressure.2 Microsurgery including vascular anastomosis makes itself elegance to some factors like friction, tissue pressure, thrombosis, torsion, and mobilization.3 In this letter, we present a free flap surgery for reconstruction of soft tissue defect in a patient with essential tremor.
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    Yanık Hastasında Perforatör Tabanlı Pervane Flebi ile Acil Yumuşak Doku Rekonstrüksiyonu: Olgu Sunumu
    (2017) Calavul, Abdülkadir; Uğurlu, Alper Mete; Taşkan, Sinan; Özalp, Burhan
    Bacak distal bölgesinin yumuşak doku rekonstrüksiyonu plastik cerrahlar için zorlu bir konudur. Travma sonrası açığa çıkan anatomik yapıların kısa sürede yumuşak doku ile kapatılması, bu yapıları enfeksiyon gibi komplikasyonlardan korur ki, bu durum yanık hastaları için oldukça önemlidir. Serbest flepler yakın zamana kadar distal bacak bölgesinin rekonstrüksiyonunda altın standart yöntem olarak kabul edilmekteydi, ancak perforatör fleplerin giderek artan popülaritesi bu durumu değiştirmiştir. Günümüzde perforatör flepler alt ekstremite de dâhil, vücudun hemen her alanında yumuşak doku rekonstrüksiyonunda yaygın olarak uygulanmaktadır. Bu raporda, bir yanık hastasında perforatör fleple yapılan acil yumuşak doku rekonstrüksiyonunu sunmak istedik. 45 yaşında erkek hastada yüksek gerilim elektrik yanığına bağlı olarak ayak ve ayak bileği medial yüzünde yumuşak doku defekti mevcuttu. Açığa çıkan kemik dokusu 15x6 cm boyutunda perforatör tabanlı pervane flebi ile onarıldı, ameliyat sonrası dönemde flepte herhangi bir dolaşım sıkıntısına rastlanılmadı. Sonuç olarak ifade etmek isteriz ki, perforatör tabanlı pervane flepleri yanık nedeniyle oluşan distal bacak ve ayak yumuşak doku defektlerinin onarımında oldukça güvenilir, başarılı ve etkili bir onarım tekniğidir. Mikrocerrahi tekniğe gereksinim duyulmadığından plastik cerrahların çoğu tarafından yaygın bir biçimde ve kolaylıkla uygulanabilir.