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Öğe Body Fat Composition and Weight Changes After Double-Jaw Osteotomy(Lippincott Williams & Wilkins, 2010) Kuvat, Samet Vasfi; Guven, Erdem; Hocaoglu, Emre; Basaran, Karaca; Marsan, Gulnaz; Cura, Nil; Emekli, UfukNutritional problems might be observed after surgical procedures. In this study, body weight and fat composition changes have been investigated in dentofacial deformity patients after the double-jaw osteotomy procedure. Thirty Angle class 3 patients operated on with double-jaw osteotomies during the period of March 2006 to July 2008 were included in the study. Interocclusal splints were applied continuously in the first 2 weeks after surgery, whereas intermittent splint was used for the next 2 weeks. Patients were analyzed before surgery and on the first month after surgery with the help of Tanita Composition Analyzer 310 bioimpedance method for weight, fat mass, and fat-free mass values. Results were evaluated statistically with the paired-sample test using SPSS version 13.0. Although significant results were obtained in female patients before surgery (weight [P = 0.011], body mass index [BMI; P = 0.012], fat mass [P = 0.010], and fat-free mass [P = 0.051, not significant]), none of the values were significant for male patients (P = 0.747, P = 0.747, P = 0.645, and P = 0.803, respectively). Weight gain was observed in 9 patients (30%). In contrast, weight gain was not seen in underweight patients. No sex differences in terms of weight gain/loss and fat composition have been observed. Interocclusal splint in female patients operated on with double-jaw osteotomies might cause nutritional deficiency in the first month after surgery. This eventually causes fat and weight loss, which may lead to poor wound healing and recovery later.Öğe Combined superior crescentic total glandular augmentation mastopexy: report of 37 cases(Springer, 2012) Guven, Erdem; Sakinsel, Ali; Basaran, Karaca; Yazar, Memet; Bozkurt, Mehmet; Kuvat, Samet Vasfiof periareolar, donut, or crescentic patterns for augmentation mastopexy in mild to moderate ptosis cases are minimally invasive (short scar) options. In this article, we report a modified version of the classical crescentic technique of augmentation mastopexy, namely, superior crescentic total glandular augmentation mastopexy. Thirty-seven patients with (a) breasts having mild to moderate ptosis (Regnault grades I-II), (b) breasts requiring less than 3 cm of nipple-areola elevation, and (c) mild skin elasticity were included in the study. During surgery, the mean size of 290 cc of silicon gel-filled implants were placed. The mean follow-up was 39 months ranging from 6 and 58 months. None of the patients had disastrous complications such as skin or nipple-areola necrosis. Poor scar healing and areolar asymmetry were the main problems encountered during follow-up. Ptosis recurrence (n= 1), and capsular contracture (n= 1) were the main reasons for revision surgery (5.4%). Five patients were re-operated on due to complications and implant change requirements (13.5%, total revisions). Mean suprasternal notch-nipple distance was recorded as 20.8 cm (19.3-22.4 cm) postoperatively. After an average time of 39 months, this distance was found to be 21.2 cm (20.1-23.2 cm) (the case with the recurrent ptosis was excluded). Superior crescentic total glandular augmentation mastopexy has yielded satisfactory results in patients with mild to moderate breast ptosis; therefore, it seems to be a valuable option in terms of minimally invasive augmentation mastopexy techniques.Öğe Facial contour reconstruction with temporoparietal prelaminated dermal-adipose flaps(Churchill Livingstone, 2010) Guven, Erdem; Kuvat, Samet Vasfi; Aydin, Hasan Utkan; Yazar, Memet; Emekli, UfukAim: Compared with those for free-fat grafts, resorption rates for vascularized adipose tissue transfers are very low. We analysed benefits of transfer of dermal-adipose grafts after prelamination upon the temporal fascia in reconstruction of facial contour defects. Patients and methods: Among 8 patients operated on between 2005 and 2008, facial contour anomalies had resulted from trauma in 5, while the remaining 3 had abnormalities with a congenital, postinfectious, or iatrogenic aetiology. In the first-stage operation, a dermal-adipose graft was taken from the inguinal region and prelamination upon the superior surface of the temporal fascia. After 5.5 months, the prelaminated dermal-adipose-fascial flap was raised as an island flap, passed through a subcutaneous tunnel in the temporal region, and set into the defect site. Results: Satisfactory cosmetic results were achieved in all patients. Except for a temporary frontal nerve palsy in 1 patient, no early or late complications resulted from this procedure. Conclusion: Prelamination of dermal-adipose grafts upon the temporoparietal fascia is useful in reconstruction of soft tissue defects requiring volume augmentation. (C) 2009 European Association for Cranio-Maxillo-Facial SurgeryÖğe AN INTERESTING COMPLICATION OF SUPERIOR GLUTEAL ARTERY PERFORATOR FLAP DONOR SITE: STRIAE(Medknow Publications & Media Pvt Ltd, 2009) Guven, Erdem; Basaran, Karaca; Ozden, Burcu Celet; Kuvat, Samet Vasfi; Topalan, Murat[Abstract Not Available]Öğe A new technique for aesthetic removal of benign skin lesions, the North Star procedure(Springer, 2011) Yazar, Memet; Kuvat, Samet Vasfi; Yazar, Sevgi; Bicer, Ahmet; Guven, ErdemMany types of local flaps are commonly used for the repair of circular skin defects. In this paper, we described that the North Star design is useful for aesthetic removal of benign skin lesions.Öğe Our Treatment Approaches in Head-Neck Injuries Caused by Animal Bites(Lippincott Williams & Wilkins, 2011) Kuvat, Samet Vasfi; Bozkurt, Mehmet; Kapi, Emin; Karakol, Percin; Yacsar, Zeki; Guven, ErdemSeveral approaches exist for the treatment of animal attacks targeting the head and neck region. The treatment options and timing vary depending on the animal species, the nature of the defect, and the experience of the surgeon. In this study, early surgical treatment options used in head-neck injuries caused by domesticated or wild animal attacks are presented. We consider 12 patients who were admitted to our clinic between June 2006 and May 2010 with head-neck injuries caused by animal attacks. Tissue defect had developed in 10 patients due to half-wild dog bite and in 2 patients due to wolf bite. The ages of the patients ranged from 3 to 45 years (mean, 21.3 years). Among the patients included in the study, 4 had facial injury, 3 had ear, 3 had scalp, 1 had eye, and 2 had nose injuries. In all patients, early surgical reconstruction was performed after irrigation, antisepsis, and debridement. Concurrent rabies and tetanus prophylactic antibiotherapy program was started. Infection or surgical complications were not observed in any of the patients. Rabies symptoms were determined in one of the quarantined dogs under surveillance. There were no positive findings in the patient bitten by the dog. The surgical treatment results from all patients were at satisfactory levels. As a result, it is observed that, in the treatment of head and neck injuries resulting from animal bites, early acute approach has replaced the traditional long-term treatment. We believe that debridement and early surgical reconstruction used in combination with medical support and prophylactic treatment are the best treatment method.Öğe Reduction Mammaplasty Using Bipedicled Dermoglandular Flaps and Free-Nipple Transplantation(Springer, 2010) Guven, Erdem; Aydin, Hulya; Basaran, Karaca; Aydin, Utkan; Kuvat, Samet VasfiSecondary revisions due to deflation, flattening, and ptosis have been the major concerns after free-nipple breast reduction procedures. This study used a new modification of the standard technique known as the bipedicled dermoglandular flap method to reduce reoperation rates. A total of 24 patients were treated with the bipedicled dermoglandular free-nipple method between the years 2004 and 2008. The mean patient age was 45.6 years, and the average body mass index (BMI) was calculated as 27.8 kg/m(2). In contrast to the standard technique, the superior dermoglandular flap was fixed as backfolded, whereas the inferior flap was fixed directly to the pectoralis fascia together with the superior flap with polydiaxanone sutures. An average breast tissue volume of 1,736 g was removed. One case of seroma and one case of partial nipple graft loss (8%) were observed in the follow-up period. The patients were followed for an average of 32.4 months. Complications such as deflation, flattening, and Regnault's mild (1st degree), moderate (2nd degree), and severe (3rd degree) ptosis were not observed. However minimal glandular ptosis was observed in four cases (16.6%). Central peripheral minimal hypopigmentation was observed in five cases. None of these complications required reoperation. Bipedicled dermaglandular flap modification of conventional free-nipple reduction mammaplasty is a new option for reducing the probable complications of the standard technique.Öğe Swelling and Elongated Uvula with Unilateral Vocal Cord Paralysis after General Anesthesia(Aves, 2014) Ozalp, Burhan; Guven, Erdem; Aydin, HulyaSwelling and elongated uvula and vocal cord paralysis are very rare complications of general anesthesia. This report illustrates that these rare complications might occur together after general anesthesia. An adult male patient was operated for glomus tumor in left hand middle finger and six hours after the operation acute respiratory distress was diagnosed. There was no drug allergy in his medical history and breathing difficulty had not been observed after the operation which had been performed under general anesthesia ten years ago. Medical therapy with dexamethasone combined topical epinephrine was applied and complete recovery was obtained without surgery.Öğe Treatment of post-burn upper extremity, neck and facial contractures: report of 77 cases(Turkish Assoc Trauma Emergency Surgery, 2010) Guven, Erdem; Ugurlu, Alper Mete; Hocaoglu, Emre; Kuvat, Samet Vasfi; Elbey, HuseyinBACKGROUND Post-burn contractures severely deteriorate life quality. We aimed to present our treatment protocols for post-burn sequelae and the contractures that cause functional limitations. METHODS Seventy-seven cases with post-burn contracture were treated in our clinic. Post-burn contractures occurring after a burn injury affected the upper extremity, face and neck in 60, 17 and 6 cases, respectively. Skin grafts, local flaps such as advancement flaps, Z-plasties, K-plasties, regional flaps such as posterior interosseous flap, tissue expanded flaps, and free flaps were used according to the severity of the contractures. RESULTS In one patient with type II axillary contraction, recurrence was seen. Full range of motion was achieved in the 3.6-year follow-up period in elbow contractures. Eight of 71 phalangeal joint contractures recurred. Two patients underwent reoperation for neck contracture recurrences. CONCLUSION Excellent results were seen with prefabricated flaps, which were used for the facial reconstruction.Öğe Z-Shaped Asymmetric Hump Resection and Unilateral Osteotomy for Treatment of Deviated Noses(Lippincott Williams & Wilkins, 2010) Guven, Erdem; Sakinsel, Ali; Kuvat, Samet Vasfi; Saglam, OmerNumerous techniques have been described to correct deviated nose deformities. This article discussed the Z-shaped asymmetric hump resection combined with unilateral osteotomy. Fifty-eight cases that we operated between 2003 and 2009 for deviated nose deformity were included in the study. In this study, septoplasty was performed in all patients, and hump was resected Z-shaped whereas osteotomy was carried out in a unilateral low to low fashion. Edema and periorbital ecchymosis were minimal on the nonosteotomy side in early postoperative period in all cases, and deviation was noted to be satisfactorily corrected in the late postoperative period. Three cases were reoperated in late stage for mucosal synechiae and 1 case for a new postoperative trauma (6.8% revision). Z-shaped asymmetric hump resection combined with unilateral osteotomy is one of the minimally traumatic methods that can safely be used to correct deviated nose.
