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    The Effect of Hyperbaric Oxygen Treatment on the Healing of Burn Wounds in Nicotinized and Nonnicotinized Rats
    (Oxford Univ Press, 2013) Selcuk, Caferi Tayyar; Ozalp, Burhan; Durgun, Mustafa; Tekin, Alicem; Akkoc, Mehmet Fatih; Alabalik, Ulas; Ilgezdi, Savas
    The importance of oxygen in wound healing and the negative effects of cigarette smoking have been demonstrated in various studies. In this study, our aim was to investigate the effect of hyperbaric oxygen (HBO2) treatment on wound healing in nicotinized and nonnicotinized rats. The study was conducted on 32 Sprague Dawley rats. The rats were divided into four groups, with eight rats in each: group 1, nonnicotinized rats; group 2, nonnicotinized rats treated with HBO2; group 3, nicotinized rats; and group 4, nicotinized rats treated with HBO2. To prepare the nicotinized groups, the rats were given nicotine for 28 days. At the end of day 28, standard, deep, second-degree to third-degree burns were created on the rats. The HBO2-treated groups underwent HBO2 treatment once a day for 7 days after the creation of the burn damage. All rats were killed 21 days after injury, and the burns were subjected to macroscopic, histopathological, and microbiological evaluation. During this evaluation, the smallest necrotic areas and the lowest rate of fibrosis were observed in group 2. The largest necrotic areas and the highest inflammation and fibrosis rates were observed in the nicotine-treated group 3. When the nicotinized and nonnicotinized groups were compared separately, there was a significant difference in favor of the groups treated with HBO2. Bacterial growth was the highest in the nicotinized group 3, whereas no statistically significant difference was observed among the other groups. We conclude that HBO treatment accelerates the recovery of burn wounds and provides more effective healing by reducing the development of scars both in nicotinized and nonnicotinized rats.
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    Effectiveness of reverse first dorsal metatarsal artery flap for reconstruction of distal foot in electrical injuries
    (Elsevier Sci Ltd, 2025) Ozdemir, Mehmet; Akkoc, Mehmet Fatih; Selcuk, Caferi Tayyar; Erbatur, Serkan
    Introduction: The severity of electrical injuries depends on the voltage, the duration of exposure to current, and the trajectory of the current through the body. The reconstruction for defects caused by electric current is a difficult process. Objective: The purpose of this study is to investigate the effectiveness of the reverse first dorsal metatarsal artery (FDMA) flap in the reconstruction of distal foot injuries caused by electric currents. Method: This is an observational and descriptive study. Reverse FDMA flaps were used in 21 patients with defects in the distal of their feet as a consequence of electrical injuries, and their outcomes were observed. Descriptive statistical methods were used in the analyses of the data. Results: While 57.1 % of the patients were between 18 and 35 years old, 3 patients were children, and 81 % of the patients were male. The site of the defect was the right sole/dorsum in 33.4 % of the cases and the right great toe in 28.6 %. Twenty patients (95.6 %) were exposed to high-voltage electric current. The dimensions of the defects of 42.9 % of the patients were 5-8 cm x 2-4 cm. Wound dehiscence was seen in 1 diabetic patient, and superficial flap necrosis developed in a young male patient with no health problems other than his electrical injury. Angiography was not performed on any patient. Conclusion: The reverse FDMA flap is a safe and effective method for the reconstruction for electrical injuries developing in the distal foot in which one-stage surgery is sufficient. We recommend the usage of the reverse FDMA flap for the closure of soft tissue defects caused by electrical injury in the sole, dorsal region of the foot, and great toes.
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    The effectiveness of shock indices on prognosis in burn patients admitted to the emergency department
    (Turkish Assoc Trauma Emergency Surgery, 2023) Icer, Mustafa; Gunduz, Ecan; Akkoc, Mehmet Fatih; Polat, Dicle; Ozkan, Halime; Bayrak, Tugce; Goger, Silan
    BACKGROUND: Shock index (SI) is the ratio of heart rate (HR) to systolic blood pressure (SBP); modified SI (MSI) is the ratio of HR to mean arterial pressure; age SI (ASI) is age multiplied by SI; reverse SI (rSI) is the ratio of SBP to HR; and rSIG is rSI multiplied by Glasgow Coma Scale Score (rSIG). Studies have proven that shock indices are good tools in predicting mortality. This study aimed to evaluate the sensitivity of the shock indices SI, MSI, ASI, rSI, and rSIG in predicting mortality in burn patients. METHODS: This is a retrospective cross-sectional study. The vital signs of the patients were recorded and their shock indices were calculated at the time of emergency department admission. The effectiveness of the shock indices SI, MSI, ASI, rSI, and rSIG in predictRESULTS: A total of 913 patients were enrolled. rSIG and MSI were the shock indices with the highest area under the curve (AUC) values in predicting mortality in the burn patients. The AUC values of rSIG and MSI were 0.829 (95% CI: 0.739-0.919, P<0.001) and CONCLUSION: Vital signs are easily recorded and shock indices are easily calculated at the time of admission of burn patients to the emergency department; they also effectively predict mortality. rSIG and MSI are the best mortality predictors among the shock indices examined in this study.
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    Examining the Plastic Surgery Treatments Applied to Upper Extremities of Kahramanmaraş Earthquake Victims with Crush Injury
    (Wolters Kluwer Medknow Publications, 2025) Akkoc, Mehmet Fatih; Ozdemir, Mehmet; Ozel, Volkan
    Aim: This study aims to examine earthquake-related upper extremity orthopedic injuries, and in our clinic, the plastic, reconstructive, and esthetic treatment methods applied to them after the two biggest earthquakes in Kahramanmara & scedil;, Turkey. Materials and Methods: This is a descriptive cross-sectional study and was conducted with 38 earthquake victims who were treated at the plastic, reconstructive, and esthetic surgery unit of a medical school health and research hospital in the Southeast Anatolia region of Turkey. Patient data were obtained retrospectively from electronic medical records, and descriptive statistical methods, Chi-square test, and post hoc were used for data analysis. Results: Of the earthquake victims, 55% were between 18 and 35 years old, 68% were female, 63% underwent plastic, reconstructive, and esthetic surgery due to upper extremity injuries, 50% had skin grafting, and 15% had amputation. In addition, 18.4% of the earthquake victims underwent surgery 3 times, and 13% were operated on 7 times. Conclusion: Careful attention should be paid to the treatment of upper extremity injuries that occur during major earthquakes. Delayed or inadequate interventions can result in amputation, highlighting the importance of plastic, reconstructive, and esthetic surgeons in disaster response teams. If possible, conservative treatment should be preferred for fractures in disaster environments. Amputation should always be the last treatment option for crush injuries. In cases requiring surgery, time should not be wasted.
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    HIGH VOLTAGE UPPER EXTREMITY ELECTRICAL BURNS REPAIR WITH GROIN FLAP
    (Medknow Publications & Media Pvt Ltd, 2012) Selcuk, Caferi Tayyar; Bozkurt, Mehmet; Durgun, Mustafa; Ozalp, Burhan; Kapi, Emin; Akkoc, Mehmet Fatih
    Background: Upper extremities are significantly affected by high-voltage electrical injuries. In this study, the repair of the upper extremity tissue defects due to high-voltage electrical injuries using groin flaps is discussed. Methods: Ten patients who developed upper extremity tissue defects following high-voltage (> 1000 V) electrical injuries between April 2009 and October 2011 were enrolled in our study. All the patients underwent reconstructions with pedicled groin flaps. All the patients were male. The areas on which the reconstructions were performed were hand and wrist areas where structures like the bones, tendons and nerves are accessible. The separation of the pedicles was performed on days 20-27 (average period: 23 days) after the pedicle ligation examination revealed no problems. Result: Adequate soft tissue coverage was obtained in all patients following the reconstruction. All the flaps healed without problem. No donor area morbidity was observed. No articular rigidity related to the operation was observed in any of the patients. Conclusion: We are of the opinion that in soft tissue defects that form in the upper extremities subsequent to high-voltage electrical injuries, when local flaps or free tissue transplants are risky or inapplicable, reconstruction with pedicled groin flaps constitutes an ideal treatment alternative.
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    Investigation of the relationship of growth hormone, insulin-like growth factor (IGF)-1, and IGF-binding protein-3 levels with graft viability in autograft-transplanted pediatric patients with major burns
    (Elsevier, 2022) Akkoc, Mehmet Fatih; Kapi, Emin; Bozkurt, Mehmet; Karakol, Percin
    Background: In our study, we investigated graft viability, Growth Hormone (GH), Insulin-like growth factor (IGF)1, and IGF-binding protein (IGFBP)-3 in autograft-transplanted pediatric major burn cases.Methods: This descriptive study was conducted with the participation of pediatric patients with major burn wounds. The laboratory data and characteristics of the patients were accessed retrospectively, and the obtained data were recorded in the data form developed by the researchers. In the analysis of the data, descriptive statistical methods, chi-squared test, Wilcoxon signed-rank test, one-way ANOVA, and post hoc analyses were used.Results: The sample of our study consisted of 93 pediatric major burn patients with a total burnt body surface area of more than 20%. It was found that 65.59% of the patients were between the ages of 1 and 5, 63.43% of them were in the 41-55 percentile range, 58.06% had a hot liquid burn, 74.2% had a second-degree burn, 60.21% had a burn percentage in the range of 21-40 of their total body surface area. It was determined that the GH and IGF-1 levels of the patients who experienced loss after graft transplantation remained below the normal value in the first 14 days, and the differences in the GH and IGF-1 values between the patients with good functioning grafts and those with graft loss were statistically significant (p < 0.01). It was found that the IGFBP-3 value remained low on the 14th day in the patients with good functioning grafts, and the difference in the IGFBP-3 values between the patients with good functioning grafts and those with graft loss was statistically significant (p < 0.05).Conclusion: Today, it is known that the parameters of GH, IGF-1, and IGFBP-3 are related to many problems. However, no study examining their relationships with graft viability in autograft-transplanted pediatric patients with major burns was encountered. Our study may be the first to determine that changes in these three laboratory parameters negatively affect the healing of burn wounds.
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    Reconstruction for Skin Defects Occurring due to Resection of Midface Malignancies with Cervicofacial Advancement-Rotational Flap
    (Springer India, 2024) Akkoc, Mehmet Fatih; Ozdemir, Mehmet; Bayram, Mehmet; Bulbuloglu, Semra
    ObjectiveThis study aims to present surgical experience and clinical outcomes regarding the reconstruction for malignancy-induced midfacial skin defects using varying patterns of cervicofacial advancement-rotational flaps (CARFs).MethodsThis is a descriptive study, and 25 patients with midfacial skin defect participated in this study. Defect repair was performed using CARF and descriptive statistics were used in data analysis.ResultsThe CARF was designed over perforators arising from branches of the anterior-based external carotid artery in all patients. 48% of the patients developed midfacial skin defects due to basal cell carcinoma, and 40% due to squamous cell carcinoma. Two patients developed ectropion, one patient developed base positivity, and one patient developed necrosis distal to the flap.DiscussionThe CARF has a good pattern and minimal tension, thus closing midface skin defects without bunching. The reconstruction for midfacial skin defects with CARF decreases both functional and aesthetic morbidity and improves patient outcomes.