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    Evaluation of Pediatric Fingertip Injuries Using Etiology, Demographics and Therapy
    (KARE PUBL, 2020) Karakas, Ali Ozgur; Yuce, Erkan
    Objectives: In this study, 354 pediatric cases were evaluated and treated at the emergency service department due to fingertip injuries in a four years period. The data were studied using etiology, demographics, treatment and complications. This study aims to draw attention to fingertip injuries that are very common in childhood and to help developing preventive strategies. Methods: Of the 354 patients, 191 were boys and 163 were girls. Their ages ranged from six months to 17 years. These patients were studied concerning sex, injured hand and fingers, injury mechanism, injury zone, selected treatment modalities and complications. All interventions were performed under local anesthesia at the emergency service department. Patients were discharged on the same day. Results: In our study group, the male patients (54%) were more affected than the girls (46%). It was observed that the right hand (65.3%) was much more vulnerable to the injury than the left hand (34.7%). It was determined that the most injured fingers were middle fingers in the 136 (38.4%) of the patients, followed by the ring finger (33.9%). Injury was most frequent at five years old patient group. The most frequent type of injury was crush type injuries with a rate of 83.3%, and among crush type injuries, the most common mechanism was trapping of fingers in the doors or windows. While many of these injuries required surgical intervention, appropriate patients were treated with wound care and secondary wound healing. Conclusion: In childhood, hand injuries are quite frequent and fingertip injuries constitute the majority of these entities. These childhood injuries lead to significant functional, aesthetic and psychological sequelae in these patients. The knowledge about the etiology, distribution and mechanisms of these injuries will enable the development of preventive measures in this regard.
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    Neutrophil Elastase Inhibitor Increases Flap Survival in Experimental Degloving Injuries
    (Kare Publ, 2020) Yuce, Erkan; Sevim, Kamuran Zeynep; Kiyak, Medeni Volkan; Yildiz, Kemalettin; Dagdelen, Daghan; Irmak, Fatih; Karsidag, Semra
    Objectives: Degloving hand injuries have generally been viewed as among the most difficult of injuries to manage due to the extensive nature of associated damage. The traditional approach to the circumferentially degloved segment of problematic flap viability has been to resuture the flap and to wait and see. However, the waiting period or the specific hemorheological protocol remains uncertain. This study aims to acknowledge if Sivelestat, known to ameliorate ischemia-reperfusion injury, enhances the survival of avulsed flaps in a hind limb degloving model of rats and to compare Sivelestat's effects to Pentoxifylline. Methods: In this study, total flap area (cm2), area of necrosis in the flap (cm(2)), and the ratio between the necrotic and total areas (percentage) were determined. Angiogenesis among the groups was documented with CD31, anti-PECAM staining. TUNEL assay was performed to allow the visualization of cell nuclei containing fragmented DNA, a typical feature of apoptosis. Results: The findings obtained in this study showed that Sivelestat administered at 10 mg/kg/hour dosage will inhibit the ischemia-reperfusion injury more pertinently than Pentoxifylline, which exerts only hemorheological effects. Conclusion: The anti-inflammatory effects of Sivelestat will be beneficial for decreasing the early complications of degloving injury, such as inflammation, sepsis, and edema, better than Pentoxifylline, which exerts only hemorheological effects.