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    Dicle Üniversitesi yanık merkezinde 2011-2020 yılları arasında tedavi edilen yanık hastalarının epidemiyolojik olarak incelenmesi
    (Dicle Üniversitesi Tıp Fakültesi, 2022) Akkoç, Mehmet Fatih; Özdemir, Mehmet
    Amaç: Bu çalışmanın amacı 2011 yılının Ocak ayından 2020 yılının Aralık ayı bitimine kadar, yanık merkezimizde tedavi edilen yanık hastalarına ait kayıtların epidemiyolojik olarak incelenmesidir. Yöntemler: Bu tanımlayıcı ve kesitsel türdeki çalışma Dicle Üniversitesi Tıp Fakültesi Hastanesi Yanık Merkezinde, retrospektif olarak gerçekleştirildi. 2011-2020 yılları arasında yanık vakaları elektronik hasta kayıtlarından elde edildi ve incelendi. İstatistiksel analizler Statistical Package for Social Sciences for IBM 25 paket programı ile yapıldı. Veri değerlendirmesinde tanımlayıcı istatistik yöntemleri (sayı, yüzde ve aritmetik ortalama vb) ve ki kare testi kullanıldı. Bulgular: Çalışmamızın örneklemini oluşturan 3227 yanık hastasının %55,3’ü 1-5 yaş aralığında ve %52,5’inin erkek olduğu belirlendi. Vakaların %42,7’si 2011-2013 yılları arasında gerçekleşmiştir. Yanıkların %64,1’inin sıcak sıvı yanığı, %50,4’ünün ikinci derece yanık olduğu saptandı. En fazla yanık vakası 2011-2013’te görülmüş ve vakalar 2020’ye doğru azalma göstermiştir. Yanık yaralanmasından en çok etkilenen yaş aralığının 1-5 arası ve en yüksek oranda yanık nedeninin sıcak sıvılar olduğu belirlendi (χ2 =5,560, p<0,01). Sonuç: Yanık vakalarına ait özelliklerin incelenmesi bütünüyle önlenmesi için temel teşkil eder. Bu bağlamda çalışmamızın verileri önemli bir bilgi kaynağı olma özelliğine sahiptir. Yanık hastalarının çoğunlukla 1-5 yaş aralığındaki çocuklarda meydana gelmesi ebeveynlerin desteklenmesi ve çocuk bakımında yardım gereksinimi olduğuna dikkat çekmektedir.
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    The effects of lockdown measures due to COVID-19 pandemic on burn cases
    (Wiley, 2020) Akkoç, Mehmet Fatih; Bülbüloğlu, Semra; Özdemir, Mehmet
    In this study, it was aimed to investigate the effects of lockdown measures implemented due to COVID-19 on aetiology, sociodemographic characteristics, and clinical status of burn cases. This study was carried out retrospectively at the Burn Unit of Dicle University Medical Faculty Hospital. The burn cases during the COVID-19 outbreak were compared with those of the previous 2 years. Statistical analyses were carried out using the IBM SPSS (Statistics Package for Social Sciences) Statistics 25. Descriptive statistics, independent samples t-test, Kolmogorov-Smirnov test, and Shapiro-Wilk test were used for data evaluation. Results were evaluated at 95% confidence interval and P < .05 significance level. It was determined that burn cases were reduced by half during the COVID-19 compared to the previous 2 years. Despite the increase in the number of third-degree burns and surgeries, it was determined that the length of hospital stay decreased by an average of two thirds. Hot liquids have been identified as the most important cause of burns in all years. New studies should be conducted in order to examine the social dimension of COVID-19 pandemic in burn cases and to prevent these cases completely. The short hospital stay preferred by clinicians after COVID-19 and possible problems that may arise should be investigated.
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    Examining the perceived stress and body image in burn patients: A cross-sectional study
    (John Wiley and Sons Inc, 2023) Uyar, Betül; Akkoç, Mehmet Fatih; Bülbüloğlu, Semra; Yılmaz, Resul
    This study aimed to examine the perceived stress and body image in burn patients and the relationship between these two variables. This is a descriptive and cross-sectional study. The study included total of 144 patients who had burn injuries, received treatment in a research and training hospital and were scheduled to be discharged. The data were collected prospectively by the researchers, using descriptive methods, Kruskal Wallis test, paired samples t test, and Pearson's correlation analysis. Of the patients, 59% were between the ages of 18 and 35 years, 68.1% were male, 65.3% had second-degree burns, 77.1% had burn surfaces ranging between 10% and 20% of their body, and 54.9% had autograft surgery. The burn patients aged 51 years and over had higher perceived stress than younger patients, and the difference between them was statistically significant (P < 0.05). As the percentage of burn surface increased, the perceived stress increased, and the perceived body image weakened (P < 0.05). The burn patients with autograft surgery had lower perceived stress and higher perceived body image than those without autograft surgery, and the difference between them was statistically significant (P < 0.01). This study found an inverse relationship between perceived stress and body image in burn patients, which was affected by the percentage of burn surface and autograft surgery. Relevant interventions are suggested to increase perceived body image in burn patients and reduce their perceived stress.
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    An experimental study on the effect of platelet-rich plasma application on skin graft healing
    (Ortadoğu Reklam Tanıtım Yayıncılık, 2022) Gülsün, Niyazi; Akkoç, Mehmet Fatih; Kapı, Emin; Selçuk, Caferi Tayyar; Bozkurt, Mehmet; Akpolat, Veysi; Çelik, Yusuf; Alabalık, Ulaş; Yıldız, İsmail
    Objective: There is new information increasingly added about wound healing, which is one of the most complex physiological processes. In this study, it is aimed to evaluate the effect of plateletrich plasma on the wound healing process in pursuit of creation of skin defect on the back skin of the rat and application of graft to it. Material and Methods: The study was planned on 30 randomly selected inbred Sprague-Dawley rats. In the rats in the experimental group, 3x2 cm full-thickness skin defect was created after the back area was shaved. The skin taken from the defected area was thinned and turned into a full-thickness skin graft and sutured again to the area where it was taken. Platelet-rich plasma was applied under the graft to the rats in the 1st group, and physiological saline was applied to the 2nd group. The 3rd group did not undergo any surgical procedure, and it was created as the control group. Results: Significant differences were observed in glucose, lactate, glycerol, and pyruvate values in the tissue in Group 1, compared to other groups. In the histopathological evaluation, a significant decrease was detected in the rate of inflammation and edema in the Group 1, in comparison with the other groups. Conclusion: Based on the data obtained from this study, it was taken into consideration by us that platelet-rich plasma application is a method that can be applied in addition to the classical wound care, especially in the cases with wound healing problems.
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    First-week analysis after the Turkey earthquakes: Demographic and clinical outcomes of victims
    (Cambridge University Press, 2023) Sarı, Hıdır; Özel, Mehmet; Akkoç, Mehmet Fatih; Şen, Abdullah
    Background: During a major earthquake, escape attempts or collapsed buildings can result in injury, disability, and even death for victims. The aim of this study is to examine the demographic characteristics, clinical outcomes, and injuries of victims admitted to the emergency department within the first week after an earthquake. Methods: This is a retrospective observational study conducted on earthquake victims who were admitted to the emergency services of a tertiary medical faculty and a training and research hospital in the city of Diyarbakir, located in the Southeastern Anatolia Region of Turkey, from February 6 through February 12, 2023. Results: Of the eligible 662 earthquake victims, the mean age was 10.66 (SD = 4.78 [min 0, max 17]) in children, 36.87 (SD = 4.78 [min 18, max 63]) in adults, and 72.85 (SD = 5.83 [min 65, max 84]) in the elderly. Women constituted 52.8% of the victims, 19.7% were children, and 8.0% were elderly. Sixty-one percent (61.0%) of earthquake victims were admitted to emergency services in the first three days following the disaster; 37.7% of all victims were transferred from other affected cities to Diyarbaklr. In all, 80.2% of the victims were admitted as survivors to the emergency services (36.8% were rescued under rubble, 40.1% with injuries while attempting to escape the earthquake, and 3.3% with nontraumatic reasons) and 19.8% were deceased under rubble. The majority of the 131 deceased victims were women (52.7%), 20.6% were children, and 7.6% were elderly. An estimated 38.3% of victims were hospitalized (20.9% in the ward and 17.4% in the intensive care unit [ICU]). For all age groups that survived under the rubble, the extremities were most injured (53.6% for children, 53.1% for adults, and 55.5% for the elderly). Of adult survivors, 26.6% needed only fluid therapy, renal replacement treatment (hemodialysis) was required 20.7%, and 11.8% required amputation. Of children survivors under the rubble, renal replacement treatment (hemodialysis) was required for only four, seven required amputation, and 12 needed only fluid resuscitation for crush injury. Of elderly survivors, two needed only fluid therapy, renal replacement treatment (hemodialysis) was required for two, and no amputation was required. Six patients survived under the rubble and died in the ICU. Conclusion: The definition of the demographic characteristics and clinical outcomes of earthquake patients is critical to the development of preparedness, response, and recovery policies for future disasters.
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    İnhalasyon ve spinal anestezinin deneysel sıçan kas-deri flep modellerinde mikrodolaşıma etkilerinin karşılaştırılması
    (2016) Akkoç, Mehmet Fatih; Bozkurt, Mehmet
    Amaç: Flep cerrahisi sonrası flep mikrodolaşımını olumlu yönde etkilediği ileri sürülen spinal anestezinin farklı kas-deri fleplerinde mikrodolaşıma etkileri incelenecektir. Metod: Çalışmada 35 adet rat beş gruba ayrıldı.Birinci grup iskemi oluşturulmayan kontrol grubu,ikinci grup inhalasyon anetezisi altında TRAM flep kaldırılan grup, üçüncü grup spinal anestezi altında TRAM flep kaldırılan grup, dördüncü grup inhalasyon anestezisi altında gluteus maksimus kaldırılan grup, beşinci grup ise spinal anestezi altında gluteus maksimus kaldırılan grup olarak planlandı.Tüm gruplarda 0., 7.,14, ve 28. günlerde deriden O2 saturasyonu ölçüldü. Deney sonunda intrakardiyak yoldan kan alınarak tüm ratlar sakrifiye edildi. Alınan kanlarda MDA, TAS ve TOS değerleri ölçüldü. Flep dokularından histopatolojik inceleme için örnekler alındı. Alınan örneklerde ödem, konjesyon, nekroz, inflamasyon, kanama, hyalinizasyon, nükleer santralizasyon ve fibrozis alanları değerlendirildi ve parametreler çalışma sonunda bulgular (+), (++), (+++), (++++) şeklinde sınıflandırılıp dereceleme yapıldı. Bulgular istatistiksel olarak değerlendirildi. Bulgular: Biyokimyasal değerlendirmede MDA değerlerinin 1-2; (p=0.002), 1-3 (;p=0.004) 1-4; (p=0.001), 2-5; (p=0.002), 3-5; (p=0.005), 4-5; (p=0.002) gruplarına anlamlı olarak farklılık gösterdiği buna göre hem spinal hem de inhalasyon anestezisi uygulanan ve TRAM flep kaldırılan gruplarda MDA düzeyleri kontrol grubuna göre anlamlı olarak artmıştır. Gluteus maksimus flebi kaldırılan gruplarda ise sadece inhalasyon anestezisi verilen grupta MDA düzeylerinde anlamlı yükselme tesbit edilmiştir. TAS değerleri, inhalayon anestezisi uygulanarak TRAM flep kaldırılan grupta ve spinal anestezi uygulanıp gluteus maksimus flebi kaldırılan grupta ve anlamlı olarak yükselmiştir. Ayrıca kaldırılan farklı flepler arasında aynı anestezik yöntem kullanıldığı halde farklı sonuçlar elde edilmiştir. Şöyle ki; inhalasyon anestezisi uygulanan ve TRAM flep eleve edilen grupta TAS değerleri aynı anestezik yöntem kulanılan fakat gluteus maksimus flebi kaldırılan gruba göre anlamlı olarak yüksek bulunmuştur. Spinal anestezi uygulanan gruplarda ise gluteus maksimus flebi kaldırılan grupta TAS değerleri anlamlı olarak yüksek bulunmuştur. Bir başka anlamlı fark da 4. ve 5. gruplar arasında tesbit edilmiştir. Gluteus maksimus flebi kaldırılan ve spinal anestezi uygulanan grupta TAS değerleri aynı flep kaldırılan ve inhalasyon anestezisi uygulanan gruba göre anlamlı olarak yüksek bulunmuştur. 1-2; p=0.024, 1-5; p<0.001, 2-4; p=0.023, 3-5; p=0.002, 4-5; p<0.001. TOS değerleri ile ilgili yapılan istatiksel analizlere göre; 2. ve 4. Gruplar arasında anlamlı farklılık görüldü. Buna göre TOS değerleri, inhalasyon anestezisi uygulanan TRAM flep kaldırılan grupta aynı anestezi yöntemi uygulanan fakat gluteus maksimus flebi kaldırılan gruba göre anlamlı olarak yüksek bulundu. Yapılan histopatolojik çalışmalar ve bunların analizi sonucu kontrol grubu ile TRAM flep kaldırılan her iki grup arasında anlamlı farklılık olduğu ve bu gruplarda hyalinizasyonun arttığı görüldü. Sonuç: Çalışmadan elde edilen bulgular sonucunda kullanılan anestezik yöntemin flep mikrodolaşımını etkilediği fakat yapılan flebin lokalizasyonunun da önemli olduğu tesbit edildi.
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    Investigation of morbidity, length of stay, and healthcare costs of inpatient paediatric burns
    (Wiley, 2024) Sarı, Hıdır; Akkoç, Mehmet Fatih; Kılınç, Zehra; Çok, Fatma Nur Dayanır; Özel, Mehmet; Özel, Volkan
    Burn injuries are the third most common cause of death in children due to trauma. Hospitalizations related to burn injuries are common. Prolonged hospitalization associated with burn treatment can result in increased resource utilization, leading to higher costs. Thus, it is essential to investigate these areas to reduce costs. The study investigated the morbidity and length of hospital stay of paediatric burn patients, as well as calculated the social security costs of hospitalization and treatment. The retrospective observational descriptive study examined the medical records of 774 paediatric patients treated in a burn intensive care unit at a tertiary medical faculty hospital between 01 March 2019 and 31 March 2022. The invoice records of payments made by the Social Security Institution to the hospital in return for health services provided to patients were examined. The healthcare costs were calculated. A total of 57.6% of the participants were boys and 79.2% were between the ages of 1-4. About 90% of the cases involved burns with a total body surface area ( TBSA) of less than 20% and a 2nd-degree burn depth. Scalding was the most common cause of burns ( 88.2%). Among all patients, the mortality rate was 2.1% (n = 16). The mean length of hospital stay was 10.29 +/- 9.59 days. The mean cost per day was 212.02 +/- 190.94 US dollars ($US), and the cost per 1% TBSA was 241.70 +/- 301.32 $US. According to the causes of burn injury, the mean cost of electricity was 5000.77 +/- 8101.85 $US, fire 4818.02 +/- 5852.22 $ US, and chemical 3285.49 +/- 4503.2 $US were observed in the first 3 ranks respectively. According to this study, paediatric burn cases occur due to preventable causes, and even though the mortality rate was low, the severity of burns, TBSA%, and presence of complications caused prolonged lengths of hospital stays, which caused social security costs to rise.
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    Investigation of red cell distribution width as a prognostic criterion in severe burns
    (Wiley, 2021) Akkoç, Mehmet Fatih; Bülbüloğlu, Semra
    This study was conducted to examine red cell distribution width (RDW) as a prognostic criterion in severe burns. The study is a descriptive correlational study and was carried out retrospectively. Patients with high RDW and low albumin values among severe burn injuries in the burn unit of a university hospital constituted half of the sample. Severe burns with RDW within normal range and a prognostic criterion for which albumin level normal and closest to normal accounted for the other half. RDW and albumin values were compared with the clinical results of patients with severe burns. IBM SPSS (Statistical Package for the Social Sciences) Statistics 25 was used for data analysis. Of the burn patients, 38.33% were between the age of 65-80, 51.67% were men, and 92.5% had third-degree burns. The mean albumin level of the patients was 2.39 +/- 0.34 g/dL, and the mean RDW level was 18.47 +/- 6.15%. The length of the stay in the intensive care unit was 13.45 +/- 7.83 days, and the duration of central venous catheter use was 23.41 +/- 8.25 days. High RDW and low albumin values were found to be associated with death, length of stay in the intensive care unit, and more blood transfusion. High RDW and hypoalbuminemia significantly affect the clinical results of severe burns. Both parameters are effective in determining the clinical course of burn patients, the length of hospital stay, presence of catheters and medication treatment protocol.
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    Investigation of the monocyte/high-density lipoprotein ratio as a prognostic criterion in burn patients
    (John Wiley and Sons Inc, 2023) Akkoç, Mehmet Fatih; Bülbüloğlu, Semra; Kapı, Emin; Bayram, Mehmet; Gurgah, Tuba
    In this study, it was aimed to investigate the monocyte/high-density lipoprotein ratio as a prognostic criterion in adult burn patients. A descriptive and cross-sectional method was adopted in this study. The sample included 177 patients with burn injuries. This study was conducted in a research and training hospital in Turkey. Data were collected by the researchers in the burn unit. Descriptive methods, Kruskal–Wallis, Mann–Whitney U, ROC curve, and correlation analyses were used for the statistical analyses of the data. While 66.1% of the patients were second-degree burn patients, 96.6% of all patients recovered and were discharged from the hospital, and the rest died. In this study, the monocyte/high-density lipoprotein ratios of the patients decreased as their clinical condition worsened. The mean C-reactive protein value of the patients was 8.52 ± 5.02 on the 7th day. A statistically significant correlation was found between an increase in monocyte counts and a decrease in high-density lipoprotein concentrations at the 24th hour, 3rd day and 7th day after the burn (p < 0.01). The monocyte/high-density lipoprotein ratio can be considered a biomarker in the identification and follow-up of sepsis and morbidity durations in burn patients. A low monocyte/high-density lipoprotein ratio in burn patients can provide an insight into the severity of sepsis.
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    Investigation of two new grafting techniques for dorsal augmentation rhinoplasty: An experimental study with New Zealand white rabbits
    (Springer, 2024) Özdemir, Mehmet; Akkoç, Mehmet Fatih; Tunik, Selçuk
    Introduction Cartilage is an important source in supporting the structure of the nose for dorsal augmentation rhinoplasty. However, it is known that its viability is not always on the ideal level. Various wrapping materials are used to increase the strength of cartilage. Donor site morbidity, which develops following the harvesting of both cartilage and fascia as one such cover material, has attracted interest in recent years. Objective In this study, we aimed to investigate the potential of dermis and tendon autografts as alternatives to fascia and cartilage. Material and Method The sample of the study included 16 New Zealand white rabbits. The right auricular cartilage of all rabbits was amputated, and it was transformed into diced cartilage autografts. The dermis autografts from the right gluteal areas of the rabbits were deepithelialized, and lumbosacral fascia autografts were harvested from the same incision. Additionally, the Achilles tendon of each rabbit was harvested and transformed into diced tendon autografts. Four different autografts were embedded under the skin of each rabbit from 4 different pouches opened in the back of the rabbit. These autografts included diced cartilage alone (Intervention 1), fascia-wrapped cartilage (Intervention 2), dermis-wrapped cartilage (Intervention 3) and fascia-wrapped tendon (Intervention 4) autografts. Results Intervention 1 had the most irregular appearance, the outcomes in Intervention 4 were volumetrically smaller and softer. Connective tissue formed between the diced pieces in all interventions, and it was observed that the dermis and fascia had a capsule-like appearance, and their viability was preserved. The differences between the initial and final measurements of the volumes of interventions 1, 2 and 3 were statistically significant (p < 0.05). There was no significant difference between the initial and final volumetric measurements of intervention 4 (p > 0.05). More peripheral proliferation was observed in the interventions of fascia-wrapped and dermis-wrapped diced cartilage compared to the other interventions. The intervention including fascia-wrapped diced tendon grafts had displayed more fibrosis, fragmentation and collagen fibers, while it showed a lower amount of elastic fiber. There were no significant differences among the intervention in terms of other histological parameters. Conclusion Tendon autografts may be a good option for dorsal augmentation rhinoplasty as they are easily harvested and have minimal donor site morbidity. Dermis autograft usage is more advantageous than fascia usage in terms of accessibility and convenience.
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    Medial canthus reconstruction with a propeller skin flap from the nasolabial fold region
    (Wolters Kluwer Medknow Publications, 2023) Akkoç, Mehmet Fatih; Özdemir, Mehmet; Bayram, Mehmet; 0000-0002-5714-0499
    Introduction: The propeller flap taken from the nasolabial flap is well suited for the medial canthal reconstruction. The propeller flap used in one-stage reconstruction is suitable for maintaining the normal concavity of the medial canthus; however, sometimes, the use of the propeller flap can lead to various complications. Aim: In this research article, we aimed to investigate the results of repairing the medial canthus defect using a propeller flap from the nasolabial fold. Materials and Methods: This study was a descriptive and cross-sectional research. We performed this retrospective study with the participation of 37 patients with medial canthal defects who underwent surgical treatment at a research and training hospital in the past 3 years. Data were obtained from the electronic medical records. In patients with medial canthal defects, the results of patients reconstructed with a propeller flap taken from the nasolabial fold were observed. Results: Of the patients, 37.8% were between 65 and 74 years old, and 59.5% were male. 83.8% of the medial defects resulted from the excision of basal cell carcinoma. After repair of the medial canthal defect, venous stasis developed in 8.1% of patients and trapdoor deformity in 13.5% of patients. Patients who developed venous stasis recovered without intervention, and those with trapdoor deformity underwent surgical intervention again. Smokers had a higher risk of venous stasis, and women had a higher risk of developing trapdoor. Conclusion: Successful patient outcomes after surgery are very important in the repair of medial canthal defects. The use of the propeller flap has produced excellent results. However, it is very important to stop smoking during the perioperative process. We recommend more detailed studies in larger sample groups on the development of the trapdoor in women. We conclude that the propeller flap taken from the nasolabial fold is effective and safe in the medial canthal reconstruction.
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    Prevalence, patient characteristics and treatment selection associated components of maxillofacial fractures: A clinical study
    (2022) Kapı, Emin; Özdemir, Mehmet; Akkoç, Mehmet Fatih
    The etiology of maxillofacial fractures is closely related to society and lifestyles, cultural structure, and social values. Various methods are used in maxillofacial fracture surgery, and these methods are determined aesthetically and functionally. In our study, it was aimed to examine in detail the prevalence, patient characteristics, and treatment approach of patients with maxillofacial fractures. This study was carried out retrospectively, based on the records of patients with maxillofacial fractures treated in the last 10 years in our clinic. Descriptive statistics, t-test, and Kolmogorov-Smirnov test were used in data evaluation. The results were evaluated at a 95% confidence interval with a significance level of p<0.05. The total of 700 patients were examined. Most of the patients were between 0 and 30 years old, and their distribution is as follows; 21.9% of them were 0-10 years old, 24.7% of them were 11-20 years old and 24.4% of the patients were 21-30 years old. A total of 700 patients were included in the sample group. It was found that 29.1% of the patients developed maxillofacial fractures due to traffic accidents and 41.7% due to falling from a height. Intermaxillary fixation was applied to 32.1% of the patients, and open reduction internal fixation was applied to 60.7% (n=424) of the patients as a treatment method. Maxillofacial fractures are an important public health problem. Education and preventive practices should be planned at the community level. High-speed causing traffic accidents and not using seat belts should be avoided. Breaking the culture of sleeping on the terrace, specifically to the region where the study was conducted, may be effective in preventing traumas caused by falling from a height. The selection of appropriate treatment methods based on age and psychosocial parameters is very important in determining treatment options.