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Öğe An Alternative Approach to Avoiding the Whistling Deformity After Cleft Lip Surgery: Dermal Flap and Irregular Z-Plasty(Lippincott Williams & Wilkins, 2010) Bozkurt, Mehmet; Kapi, Emin; Kuvat, Samet VasfiThe whistling deformity is characterized by tissue loss in the medial tubercle of the lips after cleft lip repair. Vermilion deficits can be treated by performing upper-lip flaps, Z-plasties, V-Y plasty techniques, and tongue flaps or grafts. However, the debate continues as to which of these is the most effective procedure. In this study, the combination of dermal flap derived from lateral mucosal flap and irregular Z-plasty repair is proposed as an alternative approach for the repair of vermilion deformities. Fourteen patients who presented to our clinic with cleft lip deformities between April 2008 and December 2009 underwent modified Millard repair, Mohler repair, or Mulliken method to successfully treat 9, 3, and 2 patients, respectively. At the end of the study, it was observed that all cases resulted in a favorable postoperative cosmetic appearance. Consequently, we believe that this technique is an alternative approach that could be applied to cleft lip patients with vermilion deformity.Öğe An Alternative Flap Choice in Penis Skin Defects: Preputial Mucosal Flap(Elsevier Science Inc, 2009) Bozkurt, Mehmet; Zor, Fatih; Kulahci, Yalcin; Kapi, Emin; Karakol, PercinIn this study, the authors present their experience with preputial mucosal flap usage for reconstruction of full-thickness skin loss of the penis in a patient with scald injury and discuss the possible treatment modalities in penile skin defects. During the 2-year follow-up period, no complication was encountered, and the patient healed uneventfully. UROLOGY 74: 1344-1346, 2009. (C) 2009 Published by Elsevier Inc.Öğe An Alternative Frontalis Suspension Technique Triband Suspension-A Modified Garcia's Procedure(Lippincott Williams & Wilkins, 2011) Benlier, Erol; Bozkurt, Mehmet; Kulahci, Yalcin; Kapi, Emin; Sahin, CihanBlepharoptosis surgery is one of the most common oculoplastic procedures, and the aim is to clear the visual axis. Many surgical techniques for the correction of ptosis have been described and performed, but the operative approach is based on the extent of eyelid excursion, the amount of levator function, and the degree of ptosis. In this study, the frontalis sling procedure with triband suspension was performed on 32 eyelids of 23 patients. All the patients had visual loss because of blepharoptosis with only 0 to 3 mm of measurable levator function. Postoperatively, the palpebral fissure was increased in all the patients. The purpose of this study was to report the use of a modified frontalis sling procedure for congenital ptosis patients with minimal to no levator function. In conclusion, this modified frontalis sling technique if used maximizes the frontalis muscle, creating sufficient eyelid elevation, with stable effect over time.Öğe Antioxidant support in composite musculo-adipose-fasciocutaneous flap applications: An experimental study(Taylor & Francis Ltd, 2014) Bozkurt, Mehmet; Kapi, Emin; Kulahci, Yalcin; Gedik, Ercan; Ozekinci, Selver; Isik, Fatma Birgul; Celik, YusufFree radicals are chemicals that play roles in the etio-pathogenesis of ischaemia-reperfusion injury. Various antioxidants have been used in an attempt to mitigate the damage induced by these chemicals. In the present study, the antioxidative effects of grape seed extract (proanthocyanidin), tomato extract (lycopene), and vitamin C (ascorbic acid) on a composite re-established-flow inferior epigastric artery based rectus abdominis muscle-skin flap model on which experimental ischaemia was induced were investigated. The rats have been administered antioxidants for 2 weeks prior to the surgery and for 2 more weeks thereafter. Macroscopic, histopathological, and biochemical analyses were carried out at the decision of the experiment. It was found that flap skin island necrosis was significantly reduced in the proanthocyanidin, lycopene, vitamin C groups (p < 0.001). Statistical analyses showed significant decreases in inflammation, oedema, congestion, and granulation tissue in the proanthocyanidin and lycopene groups compared to the vitamin C and control groups (p < 0.001). When the viability rates of fat and muscle tissues were examined, significant improvements were found in the proanthocyanidin and lycopene groups in comparison to the other groups (p < 0.001). Serum antioxidant capacity measurements revealed significant differences in the lycopene group compared to all other groups (p < 0.001). It is concluded that lycopene and proanthocyanidin are protective antioxidants in rat composite muscle-skin flap ischaemia-reperfusion models.Öğe The association between cellular morphological changes in peripheral blood smear and complications in pediatric burn cases(Turkish Assoc Trauma Emergency Surgery, 2011) Bozkurt, Mehmet; Kuvat, Samet Vasfi; Kapi, Emin; Karakol, Percin; Ozel, Abdulkadir; Baykan, HalitBACKGROUND Mortality and morbidity in burn cases can be reduced with early diagnosis. Many markers are used for early diagnosis of burn complications like sepsis. In this current study, the relationship between numerical/morphologic granulocyte abnormalities and complications was investigated in pediatric burns. It was aimed to introduce histopathologic marker(s) for burn-related complications. METHODS Thirty-two pediatric burn cases hospitalized between December 2006 and December 2009 were included in the study. A total of 192 complete blood count and peripheral blood smear results were analyzed comparatively. Findings were used to identify any correlation among white blood cell count and peripheral blood smear changes (the appearance of immature granular cells, toxic granulation, purple granules and Dohle bodies) and complications such as bacteriemia, sepsis, wound infections, severe anemia, and graft failure. RESULTS White blood cell count changes and the appearance of immature granular cells were not suitable for use as a diagnostic marker for complications. Nevertheless, there was a statistically significant correlation between the appearance of toxic granulation, purple granules and Dohle bodies and subsequent complications (p: < 0.0001, 0.041, 0.001, respectively). CONCLUSION Toxic granulation, purple granules and Dohle bodies appear to be helpful in predicting burn-related complications. Therefore, peripheral blood smear is a suitable test for predicting future complications.Öğe Bolster Implementation of Custom-Made Plaster in the Reconstruction of Cleft Lip Nose(Lippincott Williams & Wilkins, 2011) Kapi, Emin; Bozkurt, Mehmet; Kuvat, Samet Vasfi[Abstract Not Available]Öğe Burn Injuries Related to Liquefied Petroleum Gas-Powered Cars(Lippincott Williams & Wilkins, 2008) Bozkurt, Mehmet; Kulahci, Yalcin; Zor, Fatih; Kapi, EminLiquefied petroleum gas (LPG), which is used as a type of fuel, is stored as a liquid under high pressure in tanks. Immediate and sudden explosion of these tanks can release a large amount of gas and energy into the environment and can result in serious burns. In this study, the cases of 18 patients injured due to LPG burns in five incidents were examined, along with their epidemiologic features. The authors also investigated the causes of the LPG tank explosions. Inhalation injury was present in 11 cases with varying degrees of severity, and 7 patients subsequently required mechanical ventilation. The explosions resulted from weakening of the tank wall (n = 2), crash impact (n = 2), and gas leakage from the tank (n = 1). LPG-powered cars are becoming more popular because of their lower operational costs. However, LPG tanks can be hazardous in the event of a tank explosion. Burns caused by explosions of the LPG tanks in cars have significant mortality and morbidity. This danger must be taken into account and public awareness must be increased. (J Burn Care Res 2008;29:897-901)Öğe Comparison of Effects of Pulsed Electromagnetic Field Stimulation on Platelet-Rich Plasma and Bone Marrow Stromal Stem Cell Using Rat Zygomatic Bone Defect Model(Lippincott Williams & Wilkins, 2015) Kapi, Emin; Bozkurt, Mehmet; Selcuk, Caferi Tayyar; Celik, Mehmet Salih; Akpolat, Veysi; Isik, Fatma Birgul; Bozarslan, Beri HocaogluBackground Reconstruction of bone defects that occur because of certain reasons has an important place in plastic and reconstructive surgery. The objective of the treatments of these defects was to reinstate the continuity of tissues placed in the area in which the defect has occurred. In this experimental study, the effect of pulsed electromagnetic field stimulation on platelet-rich plasma (PRP) and bone marrow stromal cell, which propounded that they have positive impact on bone regeneration, was evaluated with the bone healing rate in the zygomatic bone defect model enwrapped with superficial temporal fascia. Methods After creating a 4-mm defect on the zygomatic bone of the experiments, the defect was encompassed with a superficial temporal fascial flap and a nonunion model was created. After surgery, different combinations of the PRP, bone marrow stromal cell, and electromagnetic field applications were implemented on the defective area. All the experiments were subjected to bone density measurement. Results The result revealed that the PRP and pulsed electromagnetic field implementation were rather a beneficial and an effective combination in terms of bone regeneration. Conclusions It was observed that the superficial temporal fascial flap used in the experiment was a good scaffold choice, providing an ideal bone regeneration area because of its autogenous, vascular, and 3-dimensional structures. As a result, it is presumed that this combination in the nonhealing bone defects is a rather useful treatment choice and can be used in a reliable way in clinical applications.Öğe A Comparison of the Effects of Epidural and Spinal Anesthesia With Ischemia-Reperfusion Injury on the Rat Transverse Rectus Abdominis Musculocutaneous Flap(Lippincott Williams & Wilkins, 2013) Acar, Yusuf; Bozkurt, Mehmet; Firat, Ugur; Selcuk, Caferi Tayyar; Kapi, Emin; Isik, Fatma Birgul; Kuvat, Samet VasfiThe purpose of this study is to compare the effects of spinal and epidural anesthesia on a rat transverse rectus abdominus myocutaneous flap ischemia-reperfusion injury model. Forty Sprague-Dawley rats were divided into 4 experimental groups: group I (n = 10), sham group; group II (n = 10), control group; group III (n = 10), epidural group; and group IV (n = 10), spinal group. After the elevation of the transverse rectus abdominus myocutaneous flaps, all groups except for the sham group were subjected to normothermic no-flow ischemia for 4 hours, followed by a reperfusion period of 2 hours. At the end of the reperfusion period, biochemical and histopathological evaluations were performed on tissue samples. Although there was no significant difference concerning the malonyldialdehyde, nitric oxide, and paraoxonase levels in the spinal and epidural groups, the total antioxidant state levels were significantly increased, and the total oxidative stress levels were significantly decreased in the epidural group in comparison to the spinal group. The pathological evaluation showed that findings related to inflammation, nuclear change rates and hyalinization were significantly higher in the spinal group compared with the epidural group. Epidural anesthesia can be considered as a more suitable method that enables a decrease in ischemia-reperfusion injuries in the muscle flaps.Öğe Current Concepts in the Management of Marjolin's Ulcers: Outcomes From a Standardized Treatment Protocol in 16 Cases(Oxford Univ Press, 2010) Bozkurt, Mehmet; Kapi, Emin; Kuvat, Samet Vasfi; Ozekinci, SelverMarjolin's ulcer is a malignant lesion observed in chronic wounds and in areas where the integrity of the skin is compromised because of any one of several reasons. The aim of this study was to define etiology, topography, and histopathology for Marjolin's ulcer and its surgical management. Sixteen cases were diagnosed and treated as Marjolin's ulcers. The mean age was 57.1 years (range, 32-85 years) and 15 of the patients (93.75%) had history of ulcer of 30 years or more. In 10 cases (62.5%), Marjolin's ulcer occurred after a flame burn and in 6 cases (37.5%) after a scalding burn injury. In six cases (37.5%), there was history of chronic trauma due to contact with the clothing. Primary lesions were at the leg, gluteal region, thigh, scalp, trunk, and hand in four (25%), three (18.7%), two (12.5%), two (12.5%), three (18.7%), and two (12.5%) cases, respectively. Amputation was carried out to treat two cases, and repair of the defects with partial-thickness skin grafting was performed in 14 cases after tumor resection on the skin. Superficial inguinal lymph node dissections were performed in four cases with tumor in the thigh and a positive inguinal lymph node. Squamous cell carcinoma was diagnosed in 14 cases (87.5%) and basal cell carcinoma in two cases (12.5%) postoperatively. The authors conclude that diagnosis and surgical planning based on the recent literature must be carried out even more intensively to improve the prognosis of Marjolin's ulcer. (J Burn Care Res 2010; 31: 776-780)Öğe Cytogenetic and clinical features of a 13 year old male with trisomy 8(Georg Thieme Verlag Kg, 2012) Balkan, Mahmut; Fidanboy, Mehmet; Ozmen, Cihan; Ozbek, M. Nuri; Otcu, Selcuk; Kapi, Emin; Budak, TurgayTrisomy 8 is a relatively rare chromosomal abnormality. The majority of cases present with the mosaic form. Regular trisomy 8 is usually lethal and frequently results in miscarriage, while those with trisomy 8 mosaicism are more likely to survive. We report clinical observations and cytogenetic studies of a 13-year-old male with regular trisomy 8 and compared with those of other known cases of trisomy 8. The most discriminating findings for this condition are skeletal anomalies, restricted articular function, and speech problems. Our results are in agreement with those of previous studies for trisomy 8.Öğe Evaluation of the sufficiency of pedicled temporoparietal fascial flap on rat head and neck defects: detailed anatomical study(Sage Publications Inc, 2014) Kapi, Emin; Bozkurt, Mehmet; Kuvat, Samet Vasfi; Selcuk, Caferi TayyarThe temporoparietal flap containing the temporal fascia has a wide spectrum of applications in head and neck surgery. The aim of this study is to demonstrate a temporoparietal fascial flap model that can be used in various head and neck defects in rats. Ten male Sprague-Dawley rats weighing 250-300 g were used in this study. Temporoparietal fascial flaps were elevated with the axial pedicle from the rats using microsurgical techniques. The arc rotations of the flaps on the pedicles were examined and the dimensions of the defects these flaps could cover were identified. The flaps were observed to be the right size for use with defects of the occipital, temporal and mastoid regions, ear, facial nerve and the mandible. The temporoparietal fascial flap is an experimental flap model, which can be useful in experimental studies related to complex head and neck defects.Öğe GLUTEAL NECROSIS DUE TO DIAPER PRESSURE: CASE REPORT(Medknow Publications & Media Pvt Ltd, 2011) Kapi, Emin; Bozkurt, MehmetWe encounter fewer cases of pressure sores in the pediatric age group when compared to adults. There are often problems such as additional systemic disease, immobility and sensory impairment in the pediatric case in which the pressure sore develops. In the cases in which there are not such problems, the pressure sore development emerges due to unfamiliar reasons. At this study, the case in the infantile period in which the pressure sore develops in the gluteal area after diaper usage is presented. The case has been hospitalized and debridement has been applied to the gluteal necrotic tissue defect, after the wound care program repairment with partial thickness skin graft has been implemented. Parents taking care of the baby have to make tiny distinctions in order to solve the problem of the baby reacting abnormally because the baby does not have the ability to talk or of any reason. As monitored in our case, the parents of the baby a part of whose body was under pressure were late to find a solution and the necrotic defects occurred has affected baby's health negatively. On the other hand, such carelessness cause problems that parents would be held responsible juridically and cause problems to impose penal sanctions. Therefore the role of the media and social organizations essential for educating and raising the awareness of the parents about this case is important. In the literature review we have made, we have not come across with any parameter about the pressure sore developing due to diaper pressure in babyhood. Therefore, our case is rather interesting in terms of its unusual etiology.Öğe 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 FatihBackground: 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.Öğe Impact of para-neurologic and para-mental premorbidities on burn injury patients(Turkish Assoc Trauma Emergency Surgery, 2011) Bozkurt, Mehmet; Kapi, Emin; Gedik, Ercan; Kuvat, Samet VasfiBACKGROUND The aim of this article was to determine whether there are differences in the progression, mortality and morbidity of these premorbid patients compared to normal burn injury patients. METHODS In this study, 26 premorbid cases (8 males, 18 females; mean age: 30.8 years; range: 3-74 years) hospitalized in the Dicle University Burn Center between July 2007 and November 2009 were evaluated. RESULTS Appreciation of the pathophysiological basis of the premorbidity in burn patients is important. When the treatment for premorbid burn patients is planned, the associated co- or premorbidity must be kept in mind. To improve the outcome of the treatment, considerable attention must be paid to these patients. CONCLUSION This article gives an overview of the current literature regarding premorbid patients in the Turkish population and draws attention to this specific topic.Öğe 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, PercinBackground: 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.Öğe Is Early Nasal Shaping With a Limited Alar Base Incision Possible in the Repair of Cleft Lips?(Lippincott Williams & Wilkins, 2016) Kapi, Emin; Bozkurt, Mehmet; Ozer, Torun; Celik, Mehmet YusufThe repair of cleft lips has an important place in plastic and reconstructive surgery. In the treatment of these deformities, the aim was to restore the normal lip morphology in the cleft area as well as repairing any coexisting nasal deformities. Various methods are in use for this purpose. One of the most commonly employed surgical methods is Millard repair. However, this method may lead to additional scarring in the alar base on the cleft side subsequent to the incision. In this study, the results obtained from a group who have been applied alar base incisions during the modified Millard repair are compared to a group who have undergone intranasal wide dissections. The patients enrolled in the study were randomized into 2 groups. The first group were applied the modified Millard repair. In the second group, the rotation, advancement, and C-flaps were prepared according to Millard surgical repair technique; however, instead of an alar base and nasofacial groove incision on the cleft side, a nasal and maxillary supraperiosteal wide dissection was made through the incision in the mucosa of the nostril. The intranasal dissection performed during the study was observed to provide the targeted outcome and a more satisfactory cosmetic result through the modified Millard repair. In conclusion, the authors are of the opinion that the limited alar base incision and the wide supraperiosteal dissection performed in patients with cleft lips is an alternative method that can be employed in a wide range of patients.Öğe MARJOLIN'S ULCERS WHICH TRANSFORMED TO SQUAMOUS CELL CANCER LEADING TO AMPUTATION OF THE EXTREMITIES: CASE REPORTS AND OVERVIEW(Medknow Publications & Media Pvt Ltd, 2009) Bozkurt, Mehmet; Kapi, EminMarjolin's ulcers commonly arise on chronic wounds, irritated skin areas and have a potential to transform into squamous cell skin cancer (SCC). These lesions have a poor prognosis and differentiation when transformed into squamous cell cancer. When transformed to squamous cell cancer this malignant skin tumor can cause recurrent metastasis and death. This condition had shows a variety of curative treatment modality. Amputation can be a surgical treatment in cases that have positive lymph node and bone invasion. Herein, we present two cases with skin squamous cell cancer involving the left cubital area and posterior thigh arising from the burn scar leading to extremity amputation.Öğe Multiple Carcinoma in Situ (Bowen's Disease) Presenting Atypical Location of Case Atypical Bowen(Derman Medical Publ, 2010) Bozkurt, Mehmet; Kapi, Emin; Gulsun, Niyazi[Abstract Not Available]Öğe N-butyl-2-cyanoacrylate (Indermil) usage for controlling oozing bleeding during surgery in a case of neurofibromatosis type 1(Springer, 2008) Bozkurt, Mehmet; Kulahci, Yalcin; Zor, Fatih; Kapi, EminThe use of the topical tissue adhesive N-butyl-2-cyanoacrylate (Indermil (TM), Tyco Healthcare Group LP, Norwalk, CT, USA) in a 22-year-old male with neurofibromatosis type 1 who was admitted to the emergency room because of uncontrollable bleeding is presented. The topical tissue adhesive was applied to the bleeding from the neurofibromatous tissue. Oozing from the tissue stopped within seconds. Vascular abnormalities associated with neurofibromatosis type 1 must be kept in mind during excision of neurofibroma from the head and neck region. Tissue adhesive may be used in emergency situations such as the case presented here.
