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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 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 Basal Cell Carcinoma in a Child(Hindawi Ltd, 2011) Kuvat, Samet Vasfi; Gucin, Zuhal; Keklik, Baris; Ozyalvacli, Gulzade; Basaran, KaracaBasal cell carcinoma is the most commonly seen nonmelanoma skin cancer which is rarely encountered in the childhood period. An 11-year old child was admitted to our clinic due to an erythematous and a slightly pigmented lesion with a 3 x 4 cm diameter on his posterior scalp. Macroscopically, the lesion was excised with a 10mmsafetymargin. Pathologic examination revealed a basal cell carcinoma. No symptoms or signs of a syndrome were observed both in the patient and his family.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 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 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 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 Conservative Treatment of a Patient with Epidermolysis Bullosa Presenting as Bart Syndrome: A Case Report(Hindawi Ltd, 2010) Kuvat, Samet Vasfi; Bozkurt, MehmetWe presented a case of a newborn male with aplasia cutis congenita on the lower limb. The case was treated with conservative method. As for the conservative treatment, daily hydrodebridement with 1/200 diluted povidone-iodine and serum physiologic was performed, followed by closure of the wound with a dexpanthenol + chlorhexidine + fusidic acid-impregnated sterile gauze bandage. the followup that occured after three weeks, the wound was completely epithelialized, but a hypopigmented scar remained in the limb.Öğe Conservative Treatment of Displacement Mandibular Third Molar(Lippincott Williams & Wilkins, 2010) Oezalp, Burhan; Kuvat, Samet Vasfi; Emekli, Ufuk[Abstract Not Available]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 The effect of hyperbaric oxygen therapy on the survival of random pattern skin flaps in nicotine-treated rats(Elsevier Sci Ltd, 2012) Selcuk, Caferi Tayyar; Kuvat, Samet Vasfi; Bozkurt, Mehmet; Yasar, Zeki; Gulsun, Niyazi; Ilgezdi, Savas; Ula, MahmutPrevious studies have shown that nicotine increases the risk of necrosis in skin flaps. We investigated the effect of hyperbaric oxygen (HBO2) treatment on the survival of random skin flaps in nicotine-treated rats. Thirty-two SpragueeDawley rats were divided into four groups with eight rats in each group. Group 1 (n=8) was the control, group 2 (n=8) received HBO2 treatment without being exposed to nicotine, group 3 (n=8) received nicotine and group 4 (n=8) received HBO2 treatment with exposure to nicotine. The rats in the nicotine-treated groups were prepared by treating them with nicotine for 28 days. At the end of the 28th day, standard McFarlane-type random skin flaps were lifted from the backs of all the rats. In groups 2 and 4, HBO2 treatment started at the 30th min following the surgery and continued once a day for 7 days. The flap survival rates and histopathological evaluation results related to neovascularisation and granulation tissue formation were significantly better in the HBO2-treated groups (groups 2 and 4) than in the groups that did not receive HBO2 treatment (groups 1 and 3) (p < 0.05). The flap survival rates, neovascularisation and granulation tissue formation were highest in group 2 and lowest in group 3 (p <= 0.001). No significant difference was observed between group 4, which received HBO2 treatment with nicotine exposure, and the control group (group 1) (p > 0.05). In conclusion, our study demonstrates that HBO2 treatment has a positive effect on flap survival in nicotine-treated rats. (C) 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.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 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 Foreign body penetrations of hand and wrist: a retrospective study(Turkish Assoc Trauma Emergency Surgery, 2013) Hocaoglu, Emre; Kuvat, Samet Vasfi; Ozalp, Burhan; Akhmedov, Anvar; Dogan, Yunus; Kozanoglu, Erol; Mete, Fethi SarperBACKGROUND Despite significant practical knowledge and experience on foreign body penetration injuries to the hand and/or wrist, deficient management and complications can still be encountered, and ignorance of its causative and eventual social aspects unfortunately is a substantial fact. This study aims to cover the clinical and social properties and the management of these kinds of injuries. METHODS A retrospective analysis of 86 patients requiring evaluation and treatment in a Hand Surgery Division of a university hospital was performed. RESULTS The median age was 32 (min: 4, max: 63). Industrial workers constituted the largest occupational group (n=22, 25.6%). Twenty-three (26.7%) of the cases were elective admissions. Thirteen (15.1%) patients had various comorbidities, and five (5.8%) had psychiatric diagnoses at the time of the injury. The index finger was the most frequent site of injury (n=29, 33.7%). General anesthesia was not necessary for the management of 94.2% of the cases. In 26 (30%) of the patients, neural, tendinous or osseous damage was observed. Twenty-four (30%) patients were included in a postoperative hand physiotherapy program. CONCLUSION The practically well-known general features of the issue and those aspects that may still be overlooked currently are reevaluated herein, in light of our observational data.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 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 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 Pediyatrik yanık olgularının periferik kan yaymasında hücresel morfolojik değişiklikler ve komplikasyonlarla ilişkisi(2011) Baykan, Halit; Kuvat, Samet Vasfi; Bozkurt, Mehmet; Karakol, Perçin; Özel, Abdülkadir; Kapı, EminAMAÇ Yanık olgularında mortalite ve morbidite erken tanı ile azaltılabilir. Sepsis gibi yanık komplikasyonlarının erken tanısı için çok sayıda belirteç kullanılır. Bu çalışmada, yanık olgularında sayısal/morfolojik granülosit anormallikleri ve komplikasyonlar arasındaki ilişki araştırıldı. Bu sayede, yanık ilintili komplikasyonlar için histopatolojik belirteç/ lerin ortaya konulması amaçlandı. GEREÇ VE YÖNTEM Kasım 2006 ve Kasım 2009 yılları arasında hastanede yatırılan 32 pediatrik yanık olgusu çalışmaya dahil edildi. Toplam 192 tam kan sayımı ve periferal kan yayması sonuçları karşılıklı analiz edildi. Bulgular, beyaz kan hücresi sayımı, periferal kan yayması değişiklikleri (immatür granüler hücreler, toksik granülasyon, granül ve Döhle cisimciklerinin görünümü) ve bakteriyemi, sepsis, yara enfeksiyonu, ileri anemi ve greft kaybı gibi komplikasyonlar arasındaki olası korelasyonun saptanmasında kullanıldı. BULGULAR Beyaz kan hücresi sayısındaki değişiklikler ve immatür granüler hücrelerin görülmesinin komplikasyonlar için tanısal belirteç olarak kullanımı uygun değildir. Bununla beraber, toksik granülasyon, granül ve Döhle cisimciği görülmesi ile komplikasyonla karşılaşılması arasında istatistiksel olarak anlamlı korelasyon bulunmaktaydı (p: 0,0001<, 0,041, 0,001). SONUÇ Toksik granülasyon, granül ve Döhle cisimciğinin, yanık ilintili komplikasyonların tahmininde yardımcı olabileceği görünmektedir. Bundan dolayı, periferik kan yaymaları gelecek komplikasyonların tahmininde uygun tetkiklerdir.
