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Öğe Amputations in burn patients with a special emphasis on pediatric patients(Aves Yayıncılık, 2017) Özalp, Burhan; Calavul, AbdulkadirObjective: 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.Öğe 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, MirzaObjective: 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 exposureÖğe Deneysel sıçan yanık modelinde Epidermal Growth Faktör (EGF) ve Plateletten Zengin Plazma’nın (PRP) etkisi(2017) Calavul, Abdulkadir; Erbatur, SerkanGiriş ve amaç: Günümüzde yanık yarasının erken iyileşmesi için çeşitli yöntemlerle ilaçlar denenmektedir. Ancak yanık iyileşmesinde halen istenen etkiyi gösteren ilaç bulunmamaktadır. Bu amaçla plateletten zengin plazma ve büyüme faktörleri yara iyileşmesini arttırıcı ve yenileyici özelliklerinden dolayı tıbbın tüm alanlarında kullanılmaktadır. Bu deneysel çalışma plateletten zengin plazma(PRP) ve epidermal büyüme faktörü( EGF) ‘nün yanık yarası üzerine olan etkilerini araştırmak amacıyla yapılmıştır. Gereç ve yöntem: Dicle Üniversitesi Tıp Fakültesi Hastanesi Plastik Cerrahi Anabilim Dalı’nda yapılan bu çalışmada, genel anestezi altında 350-450 gr ağırlığında 12-16 haftalık 48 adet Spraque-Dawley türü erkek rat kullanıldı. PRP elde etmek için 8 adet rat kullanıldı. Kalan 40 rat randomizasyon listesine göre her grupta 10 rat olmak üzere 4 grup oluşturulduktan sonra sırtlarında 2*1 cm boyutunda 4 adet dişi olan tarak şeklindeki metal plaka ile tam kat yanık oluşturuldu. 1. grupta yer alan ratlar kontrol grubu olup her hangi bir uygulama yapılmadı. 2. grupta yer alan ratların sırtlarında oluşturulan yanık alanına sadece EGF uygulaması, 3. grupta yer alan ratların sırtlarında oluşturulan yanık alanına EGF + PRP, 4. grupta yer alan ratların sırtlarında oluşturulan yanık alanına ise sadece PRP uygulandı. EGF 75 µg/gün ve PRP yaklaşık 1,000,000 platelet/µl olacak şekilde intralezyonel ve perilezyonel enjeksiyon ile 0, 3, 7 ve 14. günlerde uygulandı. 21. günde ratlar sakrifiye edildi. 0, 3, 7, 14 ve 21. günlerde deneysel oluşturulan yanık alanlarından alınan örnekler formalin solüsyonuna aktarıldı. Gruplardan elde edilen preparatlar histopatolojik olarak incelendikten sonra istatistiki verilerle yorumlanıp karşılaştırıldı. Bulgular: Çalışma sonucunda plateletten zengin plazma uygulaması ile yara iyileşmesinin epidermis rejenerasyonu, granülayon, inflamasyon ve kıl folikül rejenerasyonu fazları arasında anlamlı ilişki bulunmuştur. Epidermal büyüme faktörü uygulaması ile yara iyileşmesinin epidermis rejenerasyonu, granülayon, inflamasyon ve kıl folikül rejenerasyonu fazları arasında anlamlı ilişki bulunmuştur. epidermal büyüme faktörü + plateletten zengin plazma kombine uygulaması ile yara iyileşmesinin epidermis rejenerasyonu, granülayon, inflamasyon ve kıl folikül rejenerasyonu fazları arasında anlamlı ilişki bulunmuştur. Epidermis rejenerasyonu açısından Grup 1, 3 ve 4’ün 7. 14. ve 21. günleri arasında istatiksel olarak anlamlı fark çıkmıştır. Granülasyon açısından Grup 1, 2 ve 3’ün 7. 14. ve 21. günleri arasında istatiksel olarak anlamlı fark çıkmıştır. İnflamasyon açısından Grup 1, 2 ve 4’ün 7. 14. ve 21. Günleri arasında istatiksel olarak anlamlı fark çıkmıştır. Kıl folikül rejenerasyonu açısından Grup 2, 3 ve 4’ün 7. 14. ve 21. günleri arasında istatiksel olarak anlamlı fark çıkmıştır. Sonuç: Üçüncü derece yanık oluşturulan ratlarda intralezyonel ve perilezyonel enjeksiyon yöntemiyle uygulana plateletten zengin plazma ve epidermal büyüme faktörünün yara iyileşmesi üzerine olumlu etkilerinin olduğu ve yara iyileşmesini hızlandırdığı sonucuna varılmıştır. Anahtar sözcükler: Yanık, Plateletten Zengin Plazma, Epidermal Büyüme FaktörüÖğe Immediate Reconstruction of a Soft-Tissue Defect in a Burn Patient whit a Peroforator-Based Propeller Flap: A Case Report(Wolters Kluwer Medknow Publications, 2017) Ozalp, Burhan; Ugurlu, Alper Mete; Calavul, Abdulkadir; Taskan, SinanSoft tissue reconstruction of the distal lower leg is a challenging issue for plastic surgeons. Immediate coverage of exposed anatomical structures with soft tissue after trauma prevents these structures from being infected, and this is very important for burn patients. Free flaps have recently been accepted as the gold-standard technique for ankle and foot reconstruction; however, this is changing with the increasing popularity of the perforator flaps. Today, perforator flaps are commonly performed for the reconstruction of the soft-tissue defects across the body. In this report, we want to present the reconstruction of a soft-tissue defect case using perforator-based propeller flap in a burn patient for immediate reconstruction. A 45-year-old male patient had a soft-tissue defect over the medial side of the ankle and foot due to a high-voltage electrical burn. The exposed bone tissue was covered with a propeller flap of 15x6 cm size, without any circulation problems during the postoperative period. In conclusion, we want to state that perforator-based propeller flaps are reliable, successful, and effective techniques for the immediate reconstruction of distal leg and foot. These flaps can be easily performed without requiring any microsurgical technique thus, they can be commonly performed by most of the plastic surgeons.Öğe Repairs of Large Defects of the Lower Lid and the Infraorbital Region With Suspended Cheek Flaps With a Dermofat Flap(Lippincott Williams & Wilkins, 2016) Selcuk, Caferi Tayyar; Erbatur, Serkan; Durgun, Mustafa; Calavul, AbdulkadirAfter the repair of large defects of the lower lid and the infraorbital region using larger flaps without adequate support, retractions of the lower lid may be observed due to the weight of the flap. In this study, the authors' aim is to present the outcome of the repairs they performed on large defect areas in the lower lid and the infraorbital region using cheek flaps suspended by a dermofat flap.The method was performed on 7 patients between 2011 and 2015. Among the patients, 4 were female, while 3 were male. The mean age of the patients was 61.3 (54-69) years. In all the patients, the defects were secondary to tumor excisions. The mean size of the defects was 4.4x5cm (4x4cm to 6x5cm). In all the patients, the repair of the defect was performed using the Mustarde flaps prepared in the subcutaneous plane. After the flap was advanced to the defect area, a dermofat flap was prepared from the part at the lateral canthal area and was sutured to the periosteum superiorly to the lateral canthus.Patient satisfaction and functionality was high during the long-term follow-up. While minimal scleral show occurred in 1 patient, the lid position was normal in the other patients.The authors are of the opinion that the method they used may reduce the risk of lid deformities that may develop with the cheek flaps used to repair large lid defects.
