Browsing by Author "Atik, Bekir"

Now showing 1 - 20 of 52

Amputations in Eastern Turkey (Van): a Multicenter Epidemiological Study
(Turkish Assoc Orthopaedics Traumatology, 2008) Dogan, Ali; Sungur, Ibrahim; Bilgic, Serkan; Uslu, Mustafa; Atik, Bekir; Tan, Onder; Akpinar, Fuat
Objectives: The indications for amputations vary among countries and different regions depending on many factors. This study was designed to evaluate amputations performed in the province of Van and to determine specific causes of amputations associated with geographical and. cultural characteristics of the region. Methods: A total of 475 amputations were performed in 440 patients (345 males, 95 females; mean age 28.5 years; range 3 months to 85 years) in medical institutions of Van between 1995 and 2005. The patients were evaluated with respect to age and sex, etiology, side and level of amputations, and surgical interventions performed. Results: Amputations were the most common in the 21 to 30-year age group with 109 patients. Pediatric patients below the age of 10 years accounted for 13.4%. Of all the amputations, 218 (45.9%) involved the upper extremity, and 257 (54.1%) involved the lower extremity. Amputations were right-sided in 223, left-sided in 188 patients, and 29 patients underwent multiple amputations. Trauma was the most common cause of amputations (n=177, 40.2%), with leading etiologies as gunshot injuries (n=45), land mine (n=3.3) and hand grenade (n=7) blasts. Other frequent indications apart from traumatic causes were diabetes mellitus (n=86), congenital diseases (n=33), and peripheral vascular disease (n=30). Causes more specific to regional characteristics were tandoor burns (n=7), mistreatment by traditional bonesetters (n=3), and frostbites (n=3). Replantation was performed in 24 patients, of which 15 (62.5%) were successful. Conclusion: Our region features gunshot injuries and land mine blasts as the most common traumatic causes of amputations.
Calculation of Flap or Defect Size - Response
(Lippincott Williams & Wilkins, 2007) Atik, Bekir; Tan, Onder
A Case Report of a Patient With Cleft Palate Carrying the Risk of Tetraplegia
(Alliance Communications Group Division Allen Press, 2011) Isik, Daghan; Guner, Savas; Avcu, Serhat; Goktas, Ugur; Atik, Bekir
Spondyloepiphyseal dysplasia congenita (SEDC) is an inherited disorder of bone growth that results in short-trunk dwarfism, skeletal abnormalities, disorders in vision and hearing, atlanto-axial instability, and cleft palate. This important anomaly of the cervical vertebrae carries the risk of tetraplegia during cleft palate operations. In this case report, we discuss a case of spondyloepiphyseal dysplasia congenita, the perioperative and postoperative measures, and the risk of tetraplegia.
Clinical Outcomes of Suture Delay in Forehead Flap
(Lippincott Williams & Wilkins, 2012) Isik, Daghan; Kiroglu, Faruk; Isik, Yasemin; Goktas, Ugur; Atik, Bekir
The delay phenomenon is a surgical procedure performed to raise a wider skin flap and to improve the survival of skin flaps. Surgery, chemicals, sutures, and lasers can be used for the delay procedure. In this study, delayed forehead flaps created by suturing were used for coverage of nasal skin defects in eleven patients. In 7 patients, the cross-paramedian forehead flap was used to increase the extent of flap lengthening. In the first session, suture delay was performed on both sides of the forehead flap margin. In the second session, the flap was elevated and sutured to its new position, 7 to 10 days after the initial surgery. All flaps were completely viable, and patient satisfaction was optimal in all cases. The positive effect of surgical delay on flap survival has been shown in experimental and clinical studies. However, experimentally, suture delay or chemical delay procedures have been shown to be beneficial in flap survival only. Suture delay seems to be an inexpensive, effective, easily performed, a traumatic, and safe technique, especially among patients with systemic diseases such as diabetes or cardiovascular diseases, smoking patients who may lose the flap, or patients who need very wide and long flaps.
Comparison of Techniques for Long-Term Storage of Fat Grafts: an Experimental Study
(Lippincott Williams & Wilkins, 2006) Atik, Bekir; Ozturk, Gurkan; Erdogan, Ender; Tan, Onder
Background: Absorption of autologous fat graft in the recipient area necessitates recurrent fat transplantation. Harvesting extra tissue during the first operation and storing it for future use is considered a solution to this problem. Methods: Fat tissue was removed from the inguinal region of 40 Swiss albino mice, which were arranged into four equal groups, and treated as follows: immediately transplanted to the donor animal; dry frozen; immersed in glycerol; or frozen in liquid nitrogen. The grafts that were frozen or immersed in glycerol were stored at -35 degrees C for 6 months and then transplanted to their original donors. Transplantations were performed by injecting the fat under the scalp. Viability of the fat tissue was evaluated with the MTT reduction test before transplantation, and histology of the transplanted tissue was examined at the end of the study. Results: The viability and histology of grafts frozen in liquid nitrogen were similar to those of fresh tissue, whereas with other methods the grafts had a considerable loss of viability during storage that was reflected in the low number of adipocytes and high proportion of vacuolar and fibrotic areas. Conclusion: Freezing fat grafts in liquid nitrogen and storing them at -35 degrees C is an effective way of preserving tissue for future use, with clear superiority over other methods.
Comparison of the Fistula Risk Associated With Rotation Palatoplasty and Conventional Palatoplasty for Cleft Palate Repair
(Lippincott Williams & Wilkins, 2014) Kahraman, Ahmet; Yuce, Serdar; Kocak, Omer Faruk; Canbaz, Yasin; Guner, Sukriye Ilkay; Atik, Bekir; Isik, Daghan
The aims of the cleft palate repair techniques are to reduce the velopharyngeal insufficiency risk and oronasal fistula development to minimal levels without affecting the maxillofacial development. In this article, we present a retrospective study comparing the conventional palatoplasty techniques with the new technique of rotation palatoplasty for the risk of development of oronasal fistula. Materials and Methods: Of the 100 patients who were operated on because of cleft palate between the years 2002 and 2008, 12 patients had Furlow palatoplasty, and 88 patients received the Veau-Wardill-Kilner (V-Y pushback) operation (group C). A total of 67 patients who were operated on between 2008 and 2011 had rotation palatoplasty (group R). Results: One hundred patients were men, and 67 were women. Among all the patient groups, 22.8% were classified as Veau 1, 24.6% were classified as Veau 2, 37.1% were classified as Veau 3, and 15.6% were classified as Veau 4. The rate of fistula was found to be 17.7% in all patients. Fistula development was found in 6% of the patients in group R (4/67) and in 18% of the patients in group C (18/100). The difference between group R and group C regarding the number of patients who developed fistula was statistically significant (P = 0.011). Conclusions: The Veau classification of the cleft palate affects the risk of fistula development, and the risk for fistula after rotation palatoplasty is lower than that associated with the V-Y pushback technique.
Effect of Brow Lifting Using Botulinum a Toxin on Upper Eyelid Height in Patients With Ptosis Undergoing the Frontal Sling Technique
(Lippincott Williams & Wilkins, 2013) Isik, Daghan; Tekin, Hakan; Karadag, Remzi; Bilgili, Serap Gunes; Atik, Bekir
In this study, brow lifting with botulinum A toxin was performed on patients whose ptosis was corrected using the frontal sling technique, and the effects of this application on ptosis were investigated. Seven patients ( with 12 eyelids) on whom the frontal sling procedure was performed using a tensor fascia lata graft were enrolled in the study. The patients underwent brow lifting using botulinum A toxin. Digital photographs of the patients were obtained before and 21 days after botulinum A injection. In digital imaging analysis, although a statistically significant elevation was detected in the eyelids and brows of the patients following botulinum A injection, it did not to lead to a significant difference in the degree of lagophthalmos. In the current study, this procedure was found to reduce the degree of ptosis without increasing the degree of lagophthalmos in patients who had previ-ously undergone ptosis correction using the frontal sling.
The Effects of Exogenous Melatonin on Peripheral Nerve Regeneration and Collagen Formation in Rats
(Academic Press inc Elsevier Science, 2011) Atik, Bekir; Erkutlu, Ibrahim; Tercan, Mustafa; Buyukhatipoglu, Hakan; Bekerecioglu, Mehmet; Pence, Sadrettin
Background. Peripheral nerve damage that requires surgical repair does not result in complete recovery because of collagen scar formation, ischemia, free oxygen radical damage, and other factors. To date, the best treatment method has not yet been determined. In this study, we designed an experimental peripheral nerve injury model, and researched the possible effects of melatonin hormone, based on evidence of its strong antioxidant and cell-protective effects via mimicking the effects of calcium channel blockers. Materials and Methods. We randomized 24 healthy female albino rats into three groups: the pinealectomy group, melatonin group, and control group. In the pinealectomy group, craniotomy, pinealectomy, sciatic nerve transection, and coaptation were performed, and 0.9% NaCl was injected intraperitoneally. In the melatonin group, craniotomy (without pinealectomy), sciatic nerve dissection, and coaptation were performed, and melatonin was injected intraperitoneally, instead of NaCl. In the control group, craniotomy (without pinealectomy), sciatic nerve dissection and coaptation, and intraperitoneal NaCl injection were performed. In each group, nerve recovery was evaluated histologically, functionally, and electrophysiologically. Functional and electrophysiologic evaluations were conducted before surgery and at 4 and 12 wk. Results. At 4 wk, no significant difference was observed between the groups. However, at 12 wk, significant electrophysiologic and functional improvement was observed only in the melatonin group. Conclusions. Melatonin seems to have a beneficial effect on nerve recovery. However, this effect is not effective at physiologic doses. Future comparative studies with melatonin versus other nerve-regenerating agents are necessary to determine the clinical utility of melatonin hormone. (C) 2011 Elsevier Inc. All rights reserved.
Effects of Lidocaine Infiltration on Cost of Rhinoplasty Made Under General Anesthesia
(Lippincott Williams & Wilkins, 2011) Goktas, Ugur; Isik, Daghan; Kati, Ismail; Atik, Bekir; Soyoral, Lokman
This study aimed to compare the effects of combined and noncombined lidocaine with adrenaline infiltration in general anesthesia (GA) procedures, in which the standard anesthesia depth is monitored by Bispectral Index monitoring, on minimum alveolar concentration (MAC) levels and the costs. Following approval by the local ethics committee, an American Society of Anesthesiologists physical status I-II group of 40 adult patients for whom elective rhinoplasties under GA were planned was divided into 2 double-blind randomized groups. In group 1, GA and lidocaine + adrenaline were administered, whereas in group 2, only GA and adrenaline were administered. All the patients who had been taken to the operation room underwent electrocardiography and measurements of the peripheral oxygen saturation, end-tidal carbon dioxide, heart rate, mean blood pressure, and Bispectral Index monitoring. Using the operation time and the MAC% values, the total consumed inhalation agent amounts were calculated, and the cost difference was determined. The mean blood pressure values were lower in group 1 (P < 0.05). In group 1, the MAC% was 20.83% lower than that of group 2; the consumed desflurane amount was 20.29%, and the cost was 20.29% lower than that of group 2 (P G 0.05). In rhinoplasties under GA, the lidocaine + adrenaline combination infiltration not only decreased inhaled anesthetic requirement and cost but also supported the hemodynamic stability. In addition, surgical satisfaction increased in the lidocaine + adrenaline group because of small number of agitated patients during the recovery period.
Eldeki Yumuşak Doku Defektlerinin Rekonstrüksiyonunda Kasık Flebi Deneyimlerimiz
(2016) Öksüz, Mustafa; Işık, Dağhan; Yüce, Serdar; Ersöz, Muhammet Eren; Koçak, Ömer Faruk; Kahraman, Ahmet Nedim; Atik, Bekir
Amaç: Pediküllü kasık flebi uzun süredir elin rekonstrüktif cerrahisinde önemli rol oynamaktadır. Bu çalışmada, eldeki yumuşak doku defektlerinin rekonstrüksiyonunda pediküllü kasık flebi kullanılan olgular literatür eşliğinde değerlendirilerek sunuldu.Gereç ve Yöntemler: Çalışmaya 2010-2014 yılları arasında Plastik, Rekonstrüktif ve Estetik Cerrahi Anabilim Dalı'nda el defektleri için kasık flebi kullanılan olgular dahil edildi. Yaş, cinsiyet, defekt nedeni, lokalizasyonu, kasık flebi büyüklüğü, verici saha kapatılma yöntemi, flep ayrılma zamanı, eşlik eden tedaviler ve komplikasyonlar gözden geçirildi. Bulgular: On üç erkek, yedi kadın olmak üzere toplam 20 hastada 22 kasık flebi kullanıldı. Kasık flebi sekiz hastada parmak amputasyonu ve degloving yaralanma sonrası ampute parçayı kapatmak için, üç hastada el ve parmak ezilme yaralanmasına bağlı defekt, bir hastada yanığa bağlı parmaklarda doku defekti, 5 hastada yanık sekeline bağlı ekstansiyon kontraktürü, üç hastada yanık sekeline bağlı fleksiyon kontraktürü nedeniyle kullanıldı. Hiçbir olguda flep kaybı olmadı.Sonuç: Pediküllü kasık flebi el defektlerinin rekonstrüksiyonunda önemli bir yeri olan güvenli, kolay uygulanabilen uygun vakalarda akılda bulundurulacak iyi bir alternatifdir
Evaluation of Dynamic Magnetic Resonance Imaging in Assessing Velopharyngeal Insufficiency During Phonation
(Lippincott Williams & Wilkins, 2008) Atik, Bekir; Bekerecioglu, Mehmet; Tan, Onder; Eflik, Omer; Davran, Ramazan; Arslan, Halil
Background: Velopharyngeal insufficiency (VPI) expresses the structural and neuromuscular disorder of soft palate and pharyngeal walls inhibiting the normal functions of velopharyngeal (VP) sphincter mechanism. In this study, efficacy of dynamic magnetic resonance imaging in the diagnosis of VPI is investigated. Materials and Methods: A total of 32 cases, 16 controls and 16 cleft palates, were included in this study. T1 fast spin echo-weighted imaging during rest, dynamic investigations with True-fast imaging with steady-state precession sequence during /sss/ and /mmm/ phonations were performed. Results: During /sss/ phonation, complete closure was observed in the control group, whereas mean VP opening was 4.11 cm(2) preoperatively and 0.21 cm(2) postoperatively in the cleft palate group. In the postoperative period, only 3 patients did not have complete closure. In the second operations, performed 6 months later, only muscle repair was done. All 3 had complete closure. Conclusions: In cleft palate cases with delayed diagnosis, appropriate application of muscle repair will be sufficient for anatomic repair of VPI without any extra procedures. In addition, dynamic magnetic resonance imaging is an objective, noninvasive, reliable, and effective modality that may be used in the diagnosis and treatment of VPI without any extra investigations.
Extensive Skin Calcifications in an Infant With Chronic Renal Failure: Metastatic Calcinosis Cutis
(Wiley, 2006) Tan, Onder; Atik, Bekir; Kizilkaya, Ali; Ozer, Erdener; Kavukcu, Salih
Calcinosis cutis, one of the rare manifestations of systemic calcinosis, is characterized by the deposition of calcium and phosphate salts in the skin. Metastatic calcinosis, usually a late complication of chronic renal failure, arises from increased calcium or phosphate levels in the serum or both. Both sexes and all ages may be affected; however, cutaneous involvement is uncommon, particularly in children. We present the youngest patient, to our knowledge, with end-stage renal disease and cutaneous metastatic calcification resulting from secondary hyperparathyroidism. A 2-month-old infant presented to the pediatric service with anuria and uremia. A renal biopsy specimen showed chronic tubulo-interstitial nephritis. Indurated, firm, tender reddish papules were localized to both lower limbs, and extensive irregular nodules and plaques with ulceration and white stony contents were localized to the right upper limb. Topical antibiotic ointment was applied to the skin lesions to prevent secondary infection. However, acute peritonitis developed during peritoneal dialysis, and death occurred as a result of sepsis.
The Forehead Flap With Subdermal Pedicle
(Medknow Publications & Media Pvt Ltd, 2012) Isik, Daghan; Sarici, Murat; Garca, M. Fatih; Canbaz, Yasin; Atik, Bekir
Objective: Although the forehead flap is an axial flap, in contrary to the other axial flaps, its use as an island flap is not popular. The aim of this study is to present the patients in whom the forehead flaps with subdermal pedicle were used. Methods: The forehead flap with subdermal pedicle was used for 7 patients aged between 45 and 65 years. All patients were operated with the diagnosis of skin cancer. Four and two of the lesions were in the nasal and medial canthal regions, respectively. The lesion was involved nasal dorsum and medial chantal region together in one patient. The forehead flap was used with subdermal pedicle in all patients. The second session in which the flap was divided was performed 3 weeks after the first session. Results: Flap loss was not observed in any patients and basal cell skin cancer was diagnosed in the histopathological examination of all lesions. In five patients, within 3 months, reduced or completely dissolved depression was noted in the donor area of the flaps. Conclusion: The use of forehead flap as an island flap does not affect flap vascularity and provide less scar formation in the donor area.
Fournier Gangreni'nde Rekonstrüktif Aklaşımlarımız: 27 Hastada Retrospektif Bir Çalışma
(2007) Tan, Önder; Ergen, Duygu; Atik, Bekir
Fournier gangreni olarak bilinen perine ve genital bölgenin nekrotizan fasiiti nadir fakat yaşamı tehdit eden bir olgudur. Hastalığın tedavisi cerrahi debritman, parenteral antibiyoterapi ve oluşan defektin rekonstrüksiyonunu içerir. Günümüzde mortalite oranı halen % 15-50 arasındadır. Bu çalışmada Fournier Gangreni nedeni ile tedavi edilmiş yaşları 18 ile 81 yıl arasında değişen 26'sı erkek toplam 27 hasta retrospektif olarak değerlendirildi. Debritman ve antibiyoterapi sonrası oluşan doku defektleri 17 hastada kısmi kalınlıkta deri greftleri (tek başına, primer onarım ya da fleplerle birlikte), 8 hastada uyluk flepleri ile, 4 hastada ise kasık flebi ile kapatıldı. 5 hastada tek başına yada diğer yöntemlerle birlikte primer onarım yapıldı. Erkek hastaların hiçbirine orşiektomi uygulanmadı. Ortalama izlem süresi 7.7 aydı.Ameliyat sonrası 3 hasta (% 11.1) kaybedildi. Hiçbir hastada rekürrensle karşılaşılmadı. Uyluk flebi yapılan 1 hastada kısmi nekroz, 1 hastada sütür hattında kısmi ayrılma, greft uygulanan 1 hastada ise kısmi greft kaybı gelişti, tümü konservatif yöntemlerle sekonder olarak iyileşti. Tüm hastalar normal günlük aktivitelerine ve cinsel işlevlerine döndüler. Fournier gangreninde, erken ve agresif multidisipliner yaklaşımlarla mortalite oranları azaltılabilmekte; uygun rekonstrüktif girişimlerle kabul edilebilir estetik ve fonksiyonel sonuçlar elde edilebilmekte; ve hastaların yaşam standartları yükseltilebilmektedir. İyi bir rekonstrüksiyon tedavinin başarısını direkt etkilediği için günümüzde plastik cerrahi belirleyici bir rol oynamaktadır.
Gestational Gigantomastia After the Breast Reduction Surgery: a Case Report
(Medknow Publications & Media Pvt Ltd, 2011) Isik, Daghan; Kurdoglu, Zehra; Canbaz, Yasin; Tekin, Hakan; Atik, Bekir
Gestational gigantomastia is a rare and complex disorder characterized by massive enlargement of breasts during pregnancy and resulting in tissue necrosis, ulceration, infection. In most cases, gigantomastia is caused by an excess of circulating hormones or by the hypersensitivity of mammary tissue to normal hormone stimulation. Medical therapies to treat gestational gigantomastia are unpredictable in outcome. Breast reduction or mastectomy with delayed reconstruction is the preferred surgical procedure. If the mother is considering future pregnancies, mastectomy offers the lowest risk of recurrence. The present case with gestational gigantomastia is a patient who was underwent breast reduction using with free nipple reduction technique after the previous pregnancy.
Giant Clinodactyly and Macrodactyly of the Hand Associated With Carpal Tunnel Syndrome
(informa Healthcare, 2014) Dogan, Ali; Kalender, A. Murat; Atik, Bekir; Karabulut, Samet; Sebik, Ahmet
Macrodactyly is a rare congenital deformity of the extremities, and with clinodactyly is even rarer. Both conditions may also be associated with a lipofibromatous hamartoma of the median nerve. We report an adult woman with clinodactyly and macrodactyly of the fourth and fifth fingers of her left hand associated with a carpal tunnel syndrome.
Giant Peripheral Primitive Neuroectodermal Tumor of the Mons Pubis: a Case Report
(Springer Heidelberg, 2011) Isik, Daghan; Kurdoglu, Zehra; Ozen, Suleyman; Tekes, Lutfi; Aktar, Safak; Atik, Bekir
Groin Flap Experience in the Reconstruction of Soft Tissue Defects of the Hand
(Medknow Publications & Media Pvt Ltd, 2016) Yuce, Serdar; Oksuz, Mustafa; Ersoz, Muhammet Eren; Kocak, Omer Faruk; Kahraman, Ahmet; Isik, Daghan; Atik, Bekir
Objective: Pediculated groin flap has been playing an important role in hand reconstructive surgery for a long time. In this study, the cases where pediculated groin flap in the reconstruction of soft tissue defects of the hand was used are presented in terms of literature. Material and Methods: The cases included in the study where a groin flap was used for hand defects between 2010 and 2014 in the Plastic, Reconstructive, and Aesthetic Surgery Department. The age, gender, reason of defect, its localization, groin flap size, donor area closure method, flap separation time, other treatments, and complications were thoroughly examined. Results: Twenty-two groin flaps were used in 13 male and 7 females. It was used to close the amputated part in 8 patients as a result of finger amputation and degloving injury, in 3 patients as a result of hand and finger crush defect, in 1 patient as a result of burn finger defect, in 5 patients for extension contracture, and in 3 patients for flexion contracture due to burn sequel. Flap loss was not recorded in any of the cases. Conclusion: Pediculated groin flap is a good alternative that can be easily and safely used in suitable cases and has an important place in the reconstruction of hand defects.
Hunter's Technique Without Hunter's Rod
(Acta Medica Belgica, 2012) Atik, Bekir; Sarici, Murat; Kalender, Ali Murat; Isik, Daghan; Aydin, Osman Enver
Silicon rods initially advocated by Hunter have been widely used in two-stage flexor tendon reconstruction. Two-stage tendoplasty is an expensive procedure; with the addition of the high cost of rods, it is still more expensive. An experimental study investigated cheaper alternatives to silicon rods, but no clinical studies seem to have been reported so far. This study involved 17 patients undergoing two stage flexor tendon grafting. In all fingers, silicon urinary catheters were used as tendon prosthesis. The Wehbe et al modification of the Boyes and Stark classification was used for preoperative classification and Strickland formulation and Buck-Gramcko criteria for postoperative analysis. This clinical study showed that comparable clinical results and proper pseudosheaths for tendon grafting with similar histological and physical features can be obtained using a silicon urinary catheter which is fifty times less costly than Hunter's rod.
Investigation of Skin Cancer in the Geriatric Age Group
(Gunes Kitabevi Ltd Sti, 2014) Yuce, Serdar; Oksuz, Mustafa; Ersoz, Muhammed Eren; Kahraman, Ahmet; Isik, Daghan; Atik, Bekir
Introduction: With the increase in lifespan, age related diseases including cancer also increase. With this in mind, in our study we evaluated treatment methods and results of patients who were older than age 65 and operated for skin cancer in the Plastic Surgery Clinic. Material and Method: Patients older than age 65 who were operated between 2010 and 2014 for skin cancer in the Department of Plastic Surgery were included in our study. Age, gender, diagnosis, localization, operation, lymph node dissection and additional treatments were analysed. Results: 91 geriatric patients with skin cancer were detected. The average age of patients was 74.4 years. 47 (51.65%) patients were female; 44 patients (48.35 %) were male. With respect to diagnosis, 58 (63.74%) had basal cell carcinoma, 27 (29.67%) had squamous cell carcinoma, and in 6 (6.59%) patients cutaneous melanoma was detected. A review of surgical operations showed that 22 (24.17%) patients had lesion excision + primary suturation, 19 (20.88%) had lesion excision + graft repair, 48 (52.75%) had lesion excision + local flap repair, and 2 (2.20%) had amputation. Conclusion: In recent years, skin cancer, especially the incidence and mortality of cutaneous melanoma, has been seen more frequently in elders, compared to younger patients. In health controls, the mortality of skin cancer may be reduced by taking into account the geriatric age group.