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Öğe Combination of rhomboid flap and double Z-plasty technique for reconstruction of palmar and dorsal web space burn contractures(Elsevier Sci Ltd, 2015) Sari, Elif; Tellioglu, Ali Teoman; Altuntas, Nurgul; Seven, Ergin; Ozakpinar, Hulda RifatBackground: Web space contractures after a burn can cause severe impairments in hand function along with esthetic deformities. In this study we present our experience with the combined treatment technique consisted of rhomboid flap and double Z-plasty for palmar and dorsal web space contractures. Materials and methods: Combined rhomboid flap and double Z-plasty was performed in eight patients with eleven web space contractures occurred after burn. The average follow-up was 10.9 months. Results: The average age of 8 patients was 16.3 years. The average duration of burn contractures was 6 years (range 1-13 years). The right third web of the patients was the most common contracted web space. In the postoperative period hematoma, infection, partial or total flap loss was not observed in any patient. Web and hand function and esthetic appearance of web spaces were satisfactory in the late postoperative period. Conclusion: Rhomboid flap combined with a double Z-plasty technique was an effective choice for the treatment of palmar and dorsal web space contracture after burn. (C) 2014 Elsevier Ltd and ISBI. All rights reserved.Öğe Comparison of Subciliary Approaches in Orbito-Zygomatic Fractures: Skin Flap Versus Skin-Muscle Flap(Lippincott Williams & Wilkins, 2015) Ozakpinar, Hulda Rifat; Sari, Elif; Tellioglu, Ali Teoman; Sandikci, Mert Muhittin; Inozu, Emre; Seven, Ergin; Karamursel, SebatBackground:Because of the complications of classical subciliary incision, some modified subciliary approaches have been described in recent literature.Objectives:The aim of this study was to compare 2 commonly used subciliary approaches according to development of postoperative complications (scar formation, and ectropion).Materials and Methods:Ninety patients were included in this retrospective study. Subciliary skin flap technique (SF group) was performed to 39 patients, while the others were operated by using skin-muscle (stepped) flap technique (SMF group). Fitzpatrick skin types, genders, ages, scar scores, and ectropion scores of the patients also were recorded.Results:The mean age of the patients was 39.3 (18-99) years, and the mean follow-up period was 2.1 (1-6) years. Fitzpatrick skin-type levels were between 2 and 4 (median=3). No difference was found between 2 groups in terms of age, follow-up period, and Fitzpatrick skin-type levels. However, the scar values of the SMF group were significantly lower than the SF group statistically. Also, there was no significant difference between males and females in SF and SMF groups in terms of scar and ectropion formation. On the other hand, scar values were lower in SMF groups rather than SF group in males. Although ectropion values were not different between SF and SMF groups in females, ectropion values of SMF group were significantly lower than SF group in males statistically.Conclusion:Subciliary skin-muscle (stepped) flap technique can be more reliable than subciliary skin flap technique for approach to orbitozygomatic fractures.Öğe Diclofenac and metamizol in postoperative analgesia in plastic surgery(2001) Saray, Aydın; Büyükkoçak, Ünase; Cinel, İsmail; Tellioglu, Ali Teoman; Oral, UğurBackground: Postoperative pain relief after major surgery cannot be achieved with opioids alone in all patients without respiratory depression or other significant drawbacks. Modern medical practice, therefore, dictates the use of alternative analgesic agents as an adjunct or substitute to minimize the deleterious effects and to facilitate an earlier return to work and daily activities. Diclofenac and metamizol inhibit prostaglandin synthesis, thus attenuate the peripheral nociceptive sensitization caused by the surgical trauma. This investigation was conducted to determine the potency of diclofenac compared with metamizol in the control of postoperative pain after various plastic surgical operations under general anesthesia. Methods: A multiple-dose, randomized, double-blind clinical trial composed of one hundred and sixty-six patients was conducted. Group M patients received 1 g intramuscular metamizol (every 8 hours) and Group D patients received 75 mg intramuscular diclofenac (every 12 hours). Additional analgesia requirements were recorded and meperidine was used as the complementary analgesic when needed. Plain was assessed by visual analogue scores. Platelet count and bleeding time analyses were performed preoperatively and on the first postoperative day. Results: Metamizol decreased the additional analgesia requirement during the 18 hours following surgery. This was also associated with significantly lower pain scores. There was no significant difference between the patients receiving either metamizol or diclofenac in terms of pain scores, additional request for analgesia and frequency of side effects from the 18th until the 48th hour postoperatively. However, the use of diclofenac was associated with reduced side effects, though a reduction in platelet number and prolongation of bleeding time was noted in the majority of the patients receiving diclofenac. Conclusions: Metamizol is significantly superior to diclofenac for the reduction of postoperative pain after plastic surgery in the first 18 hours after plastic surgery procedures and reduces the need for additional analgesia.Öğe Estimated beginning time of local anesthesia effectiveness in forced cold air application: A preliminary study(Taylor & Francis Inc, 2016) Sari, Elif; Sandikci, Mert Muhittin; Bakar, Bulent; Tellioglu, Ali TeomanBackground: The literature has reported that forced cold air anesthesia decreases the discomfort effect of various laser therapies. The aim of this preliminary study was to determine the average beginning time of the local anesthetic effect of the forced cold air application when it is applied to all body surfaces except the face. Materials and methods: A total of 52 participants (26 females and 26 males) were included in this study. During application of the forced cold air, the beginning time of local anesthesia effectiveness for each volunteer was determined by giving painful stimuli. The results were then analyzed statistically. Results: The mean beginning time value of the local anesthesia was 52.88 (ranging between 30 and 60) seconds in the female group and 56.34 (ranging between 30 and 60) seconds in the male group. The mean beginning time value of the local anesthesia was 54.61 (ranging between 30 and 60) seconds in both genders. There was no statistical difference between the two groups (Z = - 0.834, p = 0.404). Conclusion: Forced cold air anesthesia-which is a quick, safe, cost-effective, and practical local anesthesia method-seems to be useful and effective when used alone in laser treatment.Öğe Interrupted or continuous-intradermal suturing? Statistical analysis of postoperative scars(Deri Zuhrevi Hastaliklar Dernegi, 2014) San, Elif; Ozakpinar, Hulda Rifat; Tellioglu, Ali TeomanBackground and Design: Postoperative scar development is an important problem for patients treated in plastic surgery clinics. Most patients think that continuous intradermal suturing is superior to interrupted suturing because they assume that it creates less scarring. We evaluated scars that form following intradermal and interrupted suturing. This article presents our controlled study that objectively compared the scars on patients faces using a wound evaluation scale. Materials and Methods: Thirty-five patients, who had undergone operations on the bilateral cheeks, were included in this study. Thirty patients were female; five patients were male. Their mean age was 40.05 years. The average scar evaluation time after surgery was 9.05 months. Elliptical excisions were made on the lesions under local anesthesia. The incisions on the right cheeks were sutured with 6/0 monofilament nonabsorbable sutures using the continuous intradermal suturing technique. The left cheek incisions were sutured with same sutures using the interrupted suturing method. Results: The patients were evaluated 7-11 months after operation (mean: 9.05 months) using the Stony Brook Scar Evaluation Scale. A Related Samples T-test was used for statistical evaluation of the differences between the suturing techniques. No significant differences were noted in scar formation between the two suturing methods (p>0.05). Conclusion: We found no differences in scar formation between the two frequently used suturing techniques studied here. We believe that the suturing technique is a less important determinant of scar formation than are other factors.Öğe Intranasal Extramucosal Access: A New Access for Lateral Osteotomy in Open Rhinoplasty(Lippincott Williams & Wilkins, 2016) Tellioglu, Ali Teoman; Sari, Elif; Ozakpinar, Hulda Rifat; Eryilmaz, Tolga; Inozu, Emre; Sen, Tulin; Tekdemir, IbrahimBackground and Objective: Different accesses have been used to perform lateral osteotomies in rhinoplasty. All of them have some disadvantages. The aim of this paper was to report a new access to overcome drawbacks of the other techniques in lateral osteotomy during open rhinoplasty. Methods: An anatomical study was designed to search possibility of intranasal extramucosal access (open sky access) for the lateral osteotomy in open rhinoplasty. It was performed directly on the lateral wall of piriform aperture, and then possible advantages of this technique were investigated. Five fixed cadavers were used for this purpose. No drawbacks were observed during procedure in cadavers. Then the same procedure was performed in 23 consecutive rhinoplasty patients. Nineteen operations were primary and 4 operations were secondary. Median oblique osteotomies were added to the procedure in all patients. The mean follow-up was 17 months. Results: Intranasal extramucosal access during lateral osteotomy was easily performed in all patients. Hemorrhage due to angular vessel injury was not occurred during intraoperative period. Edema and ecchymosis was minimal. Intranasal examination did not show any sign for nasal mucosal tearing in all patients. Residual bone spurs or bone irregularities were not observed in any patients. Conclusion: Intranasal extramucosal access that produces precise, predictable, and reproducible aesthetic and functional results could also provide better exposure during lateral osteotomy. Additionally, open sky access minimizes scars because it does not need additional incisions on the skin and mucosa. Protection of the internal periosteum of the nasal bones may be the main advantages of this technique.Öğe New autologous material for the frontalis suspension technique: superficial temporal fascia(Ijo Press, 2016) Sari, Elif; Ozakpinar, Hulda Rifat; Tellioglu, Ali Teoman…Öğe A rare type of burn injury due to butane gas inhalation(Turkish Assoc Trauma Emergency Surgery, 2017) Seven, Ergin; Horoz, Ugur; Sari, Elif; Ozakpinar, Hulda Rifat; Sandikci, Mert Muhittin; Inozu, Emre; Tellioglu, Ali TeomanBACKGROUND: Abusive inhalation of butane gas is becoming a serious public health problem among teenagers and young adult population; however, there has been little reporting on explosion burns associated with abuse of butane cigarette lighter fluid. METHODS: Retrospective study was conducted of 22 patients who were burned in last 2 years in explosion of butane gas, a flammable, odorless, and colorless aliphatic hydrocarbon. RESULTS: Details of sociodemographic profile of the patients, any underlying psychiatric illness, alcohol abuse, depth of burn injury, any associated injury, duration of hospitalization, and percentage of burned area were recorded and analyzed. CONCLUSION: All of the patients were young men, and most had superficial burn injury. Hospital stay ranged from 0 to 11 days. All of the patients were treated with conservative management.Öğe Topographical anatomy of the dorsal branch of the ulnar nerve and artery: a cadaver study(Springer France, 2011) Cavuşoğlu, Tarık; Özden, Hilmi; Cömert, Ayhan; Yazıcı, İlker; Acar, Halil İbrahim; Tellioglu, Ali Teoman; Tekdemir, İbrahimPurpose The surgical anatomy of the dorsal branch of the ulnar nerve and artery on the dorsal aspect of the hand is important in design of neurocutaneous flaps for reconstructive surgery and serves as a donor site for nerve grafts. In this study, the course, location, and diameter of the dorsal branches of the ulnar nerve and artery were studied from anatomical and reconstructive perspectives. Methods Upper limbs of 14 (7 left and 7 right) and 22 formalin-preserved adult cadavers (15 left and 7 right) were dissected in two different centers. Results The diameters of the ulnar nerve, artery, and their dorsal branches were measured at selected reference points. The distances to specific anatomical landmarks were also measured, during their courses from the proximal forearm towards the middle phalanges of the 4th and 5th fingers. Conclusions Our data may facilitate the design of neurocutaneous flaps nourished from the dorsal branches of the ulnar nerve and artery, and may aid in the harvesting of nerve grafts from the dorsal branch of the ulnar nerve, and provide a safe surgical approach to the dorsum of the hand.Öğe Turn-in folding of the cephalic portion of the lateral crus to support the alar rim in rhinoplasty(Springer, 2007) Tellioglu, Ali Teoman; Çimen, KadirBackground: The hypoplastic, weak lateral crus of the nose may cause concave alar rim deformity, and in severe cases, even alar rim collapse. These deformities may lead to both aesthetic disfigurement and functional impairment of the nose. Methods: The cephalic part of the lateral crus was folded and fixed to reinforce the lateral crus. The study included 17 women and 15 men with a median age of 24 years. The average follow-up period was 12 months. For 23 patients, the described technique was used to treat concave alar rim deformity, whereas for 5 patients, who had thick and sebaceous skin, it was used to prevent weakness of the alar rim. The remaining 4 patients underwent surgery for correction of a collapsed alar valve. Results: Satisfactory results were achieved without any complications. Conclusions: Turn-in folding of the cephalic portion of lateral crus not only functionally supports the lateral crus, but also provides aesthetic improvement of the nasal tip as successfully as cephalic excision of the lateral crura.Öğe The Versatile Facial Artery Perforator-Based Nasolabial Flap in Midface Reconstruction(Lippincott Williams & Wilkins, 2015) Durgun, Mustafa; Ozakpinar, Hulda Rifat; Sari, Elif; Selcuk, Caferi Tayyar; Seven, Ergin; Tellioglu, Ali TeomanIntroduction: Defects in the lower two thirds of the face occur due to trauma, tumoral masses, or infections. In this study, repairs of various defects located in the midface using facial artery perforator-based nasolabial flaps are presented. Patients and Methods: Between January 2009 and June 2013, 15 patients with defects in the lower two thirds of the face or the intraoral region underwent repairs with facial artery perforator-based nasolabial flaps. The etiology was malignant skin tumor excisions in 11 patients, infection in 2 patients, and trauma in 2 patients. Among the patients, 10 were male and 5 were female. Their mean age was 65.1 (range: 20-86) years. The mean duration of follow-up was 14 (7-24) months. The defects were located at the upper lip, cheek, lower lip, intraoral region, and the nasal area. The size of the defects varied between 10 x 10mm and 40 x 50 mm. All the flaps were prepared as perforator flaps. The flap donor area was primarily closed. Results: No partial or total flap loss was observed in any of the flaps. The flap donor areas healed without problem. Full patient satisfaction was achieved both aesthetically and functionally. Conclusion: The nasolabial perforator flap has certain advantages such as the 1-stage application, repair using a similar tissue, a wider rotation arc around the pedicle compared to the other regional flaps, and the primary closure of the donor area. Based on these characteristics, itis an ideal alternative for the repairs of the defects located in the lower two thirds of the face or the intraoral region.
