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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 Birinci basamak yanık tedavisinde altın standartlar(Dicle Üniversitesi Tıp Fakültesi, 2009) Zor, Fatih; Ersöz, Nail; Külahçı, Yalçın; Kapı, Emin; Bozkurt, MehmetDünyada her yıl 2.5 milyon insan yanıktan etkilenmektedir. Ülkemizde bu konuyla ilgili kesin bir veri tabanı bulunmamaktadır. Ancak son zamanlarda Türkiye’de yanık epidemiyolojisi ile ilgili sağlıklı istatistiksel veriler elde edilmeye çalışılmaktadır. Yanık yaralanması sonrasında miyokard infarktüsü, kalp yetmezliği, akut hipertansiyon, endokardit, tromboemboli, pulmoner ödem, pnömoni, solunum yetmezliği, böbrek yetmezliği, gastrik ülser, ileus, sepsis, koagülopati, anemi gibi çok çeşitli komplikasyonlar gözlenebilir. Bazı komplikasyonlar önlenebilir ya da tedavi edilebilir özelliktedir. Bu nedenle yanık olgularında ilk basamak tedavide alınacak tedbirlerin önemi oldukça büyüktür. Deri, vücut yüzeyinde oluşan fark edilmeyen sıvı kaybını önleyen bir bariyerdir. Akut yanıklı olgularda, deri yüzeyi kaybına bağlı olarak ısı kaybı ortaya çıkar. Bu olgularda, vücut sıcaklığının korunmasına yönelik girişimler önem taşır. Ayrıca sıvı resusitasyonu oldukça önemlidir. Yanıklı olgularda bir diğer özellik, akut dönemde hasarlı dokuların enfeksiyona oldukça yatkın olmasıdır. Yanık bakımı ve tedavisi, oldukça zor ve kompleks prosedürler içerir. Bu bakımdan, yanık olgularının tedavisi titiz ve multidisipliner yaklaşımlar gerektirmektedir.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 the effects of inhalation, epidural, spinal, and combined anesthesia techniques on rat cremaster muscle flap microcirculation(Wiley, 2010) Bozkurt, Mehmet; Kulahçı, Yalçın; Zor, Fatih; Şen, Hüseyin; Açıkel, Cengiz Han; Deveci, Mustafa; Türegün, Murat; 0000-0002-6836-2732; 0000-0002-5851-0711; 0000-0001-5699-4305Background: This experimental study was designed to investigate and compare the effects of different anesthesia techniques on rat cremaster muscle flap microcirculation. Methods: Fifty male Sprague-Dawley rats (130-150 g body weight) were divided into five experimental groups containing ten animals each. Group I, group II, and group III were designated as inhalation, epidural, and spinal anesthesia groups, respectively. Group IV was designated as a combination group for inhalation and epidural anesthesia. Group V was a combination group of inhalation and spinal anesthesia. Results: Group III and group V showed significant increases in the number of rolling and sticking leucocytes and in RBC volume (peripheral stasis) when compared with group I. Blood flow and velocity significantly increased without peripheral stasis in groups II and IV when compared with group I. Although there was no statistically significant difference in the numbers of rolling, sticking, and transmigrating leucocytes or in functional capillary perfusion, group IV had better flow hemodynamics in the peripheral microcirculation when compared with group I. Conclusions: The inhalation and epidural anesthesia combination was determined to be the ideal anesthesia technique for improved peripheral microcirculation. Spinal anesthesia, either separately or in combination with inhalation anesthesia, has adverse effects on microcirculation.Öğe Epidural needle for recipient site preparation in hair restoration surgery(Wiley, 2011) Zor, Fatih; Kulahci, Yalcin; Sever, Celalettin; Bayram, Yalcin; Benlier, Erol; Bozkurt, MehmetBackground The mini- and micro-grafting method is still one of the most current treatment methods for male pattern baldness and female androgenic alopecia. The preparation of the recipient area with 16G needle has been reported in the literature. However, during the insertion of grafts, the neighboring grafts tend to `pop out'. The study presents our experience in the hair implantation for recipient site preparation with 16G epidural needle. Methods The 16G epidural needle was used during preparation of the recipient field in eight patients. Approximately 500 micrografts were grafted in each patient to reconstruct the anterior hairline. Results During insertion of the micrografts, almost none of the previously inserted grafts tended to `pop out'. The anterior hairline of the patients was natural without obvious scarring. The mean follow-up period of these patients was 1.5 years. The amount of graft survival was found to be satisfactory. Conclusion According to the surgeon's clinical observations, application of this technique was found to be easier than standard needle techniques. It can be used by inexperienced surgeons. Use of epidural needle for recipient hole preparation works well in reducing the popping out, and the curved fashion of the holes reduced the angle of the hair follicle.Öğe The management of pit viper envenomation of the hand(2008) Bozkurt, Mehmet; Külahçı, Yalçın; Zor, Fatih; Kapı, Emin; 0000-0002-6836-2732; 0000-0002-5851-0711Snakebites are common among the rural population of developing countries. The severity of venomous snakebites depends on several factors, including the location of the bite, the amount of venom injected, and the effectiveness of the initial therapy. Snakebites frequently occur in the extremities with approximately two thirds of envenomations occurring in the upper extremities. In this study, we presented 12 cases of hand reconstruction after Vipera snakebites and discussed how to minimize functional loss and maximize hand rehabilitation. Twelve patients bitten by Vipera between 2001 and 2006 were included in this study. Groin flaps were performed in three cases, full-thickness grafts in two cases, thenar flaps in three cases, and cross finger flaps in three cases. With medical management, spontaneous healing occurred in one case. We prefer to use flaps on the volar site of the hand and, if the bone is not exposed, full-thickness grafts on the dorsal site of the hand. We also recommend starting rehabilitation of the hand early.Öğe MICROSURGERY AND ANESTHESIA(Medknow Publications & Media Pvt Ltd, 2009) Kulahci, Yalcin; Bozkurt, Mehmet; Sen, Huseyin; Zor, Fatih; Ekinci, Safak; Uygur, Fati; Sever, CelalettinIn reconstructive microsurgery the use of free flap techniques has brought a new dimension to the repair of soft and bone tissue defects. The free-flap procedure is time-consuming and requires special skills of the surgical team as well as adequatelly controlled anesthesia in patients. However there are still arguments in decision making of optimal anesthesia techniques and anesthetics in microsurgery. The aim of this article is to review the topic from the surgeon and anesthetist point of view and expand the researchers' horizons for future research in microsurgery and anesthesia.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.Öğe Önkolda nekrotizan fasyit: Olgu sunumu ve literatür taraması(2006) Bozkurt, Mehmet; Benlier, Erol; Külahçı, Yalçın; Zor, FatihNekrotizan fasiit yumuşak dokuların infeksiyon, lokal iskemi ve lokal defans sisteminin azalması sonucu oluşan ve bu kısır döngünün devam ederek doku nekrozuna yol açmasını ifade eden şiddetli bakteriyel infeksiyonudur. Genellikle yaşlılarda, öz bakımı problemli olan hastalarda ve immün sistem defekti olan kişilerde rastlanılan bir infeksiyondur. Nekrotizan fasiit olgularına lokalizasyon olarak en sık genital bölge ve abdomende rastlanılmakla birlikte burada sunulan olguda hem yaş hem de infeksiyonun lokalizasyonu çok rastlanılmayan bir özellik göstermektedir. Bu makalede, herhangi bir sistemik rahatsızlığı olmayan ancak kronikself-mutilasyon (jiletle kendini yaralama) nedeni ile yaralanma bölgesinde lokal immün sistem hasarı oluşmuş ve buna bağlı gelişen nekrotizan fasiit olgusu sunulmuştur.Öğe Reconstruction of the Lower Lip in Van der Woude Syndrome(Lippincott Williams & Wilkins, 2009) Bozkurt, Mehmet; Kulahci, Yalcin; Zor, Fatih; Kapi, Emin; Yucetas, AltanVan der Woude syndrome (VWS) is a congenital disease characterized by labial cysts, accessory salivary glands, congenital lower lip pits, fistula, and paramedian sinuses, and is often accompanied by cleft lip and palate. VWS is an autosomal dominant craniofacial syndrome, which represents only lower lip pits due to variable gene expression. The principles of VWS surgery include excision of lower lip pits and accessory glands, reconstruction of the lip and nose, and correction of accompanying anomalies. In this article, we present a technique with dermal allograft reconstruction to prevent deformities after excision of the accessory gland in the lower lip pit.Öğe REVERSE FLOW FOREARM FLAP: POSTERIOR INTEROSSEOUS FLAP: REVIEW OF THE ANATOMY, SURGICAL TECHNIQUE AND LITERATURE(Medknow Publications & Media Pvt Ltd, 2007) Benlier, Erol; Bozkurt, Mehmet; Kulahci, Yalcin; Zor, FatihReverse flow posterior interosseous flap is a good alternative to reverse-flow forearm flaps such as ulnar and radial artery flaps. Up to date lots of detailed anatomical dissections especially about its pedicle variations have been performed by researchers since it was described. In the literature, reverse flow posterior interosseous flap has been used for soft and bone tissue defects of the hand and wrist in large clinical series. Under these experiences and our clinical experiences, reverse flow posterior interosseous flap has been reviewed and its position in the upper extremity reconstruction is discussed.Öğe Ters akımlı bir önkol flebi: Posterior interosseöz flep: Anatomi, cerrahi teknik ve literatürün gözden geçirilmesi(2007) Zor, Fatih; Bozkurt, Mehmet; Külahçı, Yalçın; Benlier, ErolTers akımlı posterior interosseöz flep (TAPİF), ters akımlı radial ve ulnar önkol fleplerine iyi bir alternatiftir. Flebin ilk tanımlandığı yıllardan günümüze kadar birçok araştırmacı tarafından özellikle flebin pedikül varyasyonlarına ait detaylı anatomik diseksiyonlar gerçekleştirilmiştir. Flep literatürde, el ve el bileğinin yumuşak ve kemik doku defektlerinin onarımında oldukça geniş sayılabilecek olgu serilerinde kullanılmıştır. Bu çalışmalardan elde edilen tecrübeler ve kendi klinik tecrübelerimizin ışığında TAPİF yeniden gözden geçirilerek üst ekstremite rekonstrüktif cerrahisindeki yeri tartışılmıştır.Öğe Van der Woude sendromlu olgularımızın soyağacında genetik penetransın analizi: Beş olgu sunumu(2010) Kapı, Emin; Kuvat, Samet Vasfi; Bozkurt, Mehmet; Külahçı, Yalçın; Zor, Fatih; Benlier, Erol; Balkan, MahmutVan der Woude sendromu labial kistler, aksesuvar tükürük bezleri, alt dudakta çukurluk, fistül veparamedyan sinüslerle karakterize, sıklıkla yarıkdudak ve damakla birliktelik gösteren doğuştan biranomalidir. Bu hastalık en sık görülen sendromikyarık anomalisidir. Hastalık kraniofasyal morfogenezin etkilendiği tek gen anormalliği ile karakterizedir.Hastalık kromozom 1q32-41 kromozomu ile bağlantılı olarak otozomal dominant kalıtımlıdır. Bunarağmen gen ekspresyonunun değişkenliğindendolayı sendrom, bazı bireylerde sadece alt dudaktasinüslerle kendini gösterebilir. Bu yazıda Van derWoude sendromlu beş olgunun soyağacının genetikpenetrans analizi sonuçları güncel literatür bilgileriışığında sunuldu.
