Browsing by Author "Isik, Daghan"

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A Case of Wooden Foreign Body Retained in the Calcaneus
(Professional Medical Publications, 2011) Guner, Savas; Ceylan, M. Fethi; Isik, Daghan; Guner, S. Ilkay; Ediz, Levent
Detection of wooden foreign bodies in the extremities still remains a problem despite the developments in imaging methods. Direct X-Rays, ultrasonography, computed tomography and magnetic resonance imaging are utilized for detection of foreign bodies in the body. In this report, we have presented a case in which no findings suggestive of a foreign body were detected on ultrasonography and magnetic resonance imaging, and which underwent a surgical intervention with the prediagnosis of osteomyelitis of the calcaneus.
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 Classification Systems for Congenital Melanocytic Nevi
(Wiley-blackwell, 2010) Turkmen, Arif; Isik, Daghan; Bekerecioglu, Mehmet
BACKGROUND Congenital melanocytic nevi (CMNs) are found in approximately 1% of newborn infants, but these represent only a small proportion of the total population of nevi. They vary widely in size, from a small spot to a large area. Later in childhood, these lesions become thickened, verrucous, and hairy. Giant CMNs predispose to malignant melanoma, with a reported incidence of 2% to 31%. OBJECTIVE To compare three different classification methods of the CMNs to determine which is most accurate. PARTICIPANTS AND METHODS Sixty patients were included in the study (34 male, 26 female), with an average age of 17.4 (range 3-32). The nevi were evaluated using three different classification methods: total area of the nevus (in cm2), greatest nevus dimension, and percentage of nevus surface area to total patient body surface area. An appropriate treatment procedure for each case was applied, and participants were followed from 1997 to 2007. RESULTS Malignant transformation was noted in 15.4% of participants with congenital nevi, which was confirmed histopathologically after excision. CONCLUSION We recommend the calculation of total nevus area as the most useful method for assessment of the risk of developing melanoma in a CMN. The authors have indicated no significant interest with commercial supporters.
Comparison of Dartos Flap and Dartos Flap Plus Spongioplasty To Prevent the Formation of Fistulae in the Snodgrass Technique
(Springer, 2011) Bilici, Salim; Sekmenli, Tamer; Gunes, Mustafa; Gecit, Ilhan; Bakan, Vedat; Isik, Daghan
The aim of our study was to evaluate the role of paraurethral spongial tissue plus dartos flap using an additional urethral cover to prevent fistula formation in patients who underwent surgery with the Snodgrass technique. A retrospective study was performed on 161 patients aged 10 months to 15 years who underwent midpenile and distal hypospadias repair using the Snodgrass technique. The patients were assigned to one of two groups. In Group I (75 patients), the neourethra was covered with the dartos flap, and in Group II (86 patients), the neourethra was covered with the dartos flap plus spongioplasty. Urethral fistulae were encountered in six cases (8%) in Group I, and no fistulae were encountered in Group II. The use of corpus spongiosum as an intermediate layer in urethral coverage, combined with the dartos flap, reduces the likelihood of fistula formation. This procedure can be applied easily and effectively to prevent the formation of fistulae.
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.
Congenital Lateral Cleft Palate of Unknown Etiology
(Lippincott Williams & Wilkins, 2015) Kahraman, Ahmet; Yuce, Serdar; Kocak, Omer Faruk; Canbaz, Yasin; Isik, Daghan
The term cleft palate (CP) refers to midline defects extending from the prealveolar ark to the uvula, and these defects present with varying degrees. CP may be complete, incomplete, unilateral, bilateral, or submucosal. It is often observed with cleft lip (CL). In various studies, the incidence of isolated CP has been reported as 1.3 to 25.3 per 1000 births. 1,2 As a result of deterioration of the anatomical structure of the palate, illnesses such as regurgitation, respiratory tract infections, otitis, and speech disorders may occur. These defects are often observed in the midline and are rarely laterally localized. Cleft palates with lateral localization are outside the natural midline cleft closure line and cause clinical complaints similar to other types of CP. Two cases of laterally localized CP have previously been published in the literature. 3,4 The case presented here is the third known case to be reported.
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.
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.
The Effects on Complications and Myopathy of Different Voltages in Electrical Injuries
(Turkish Assoc Trauma Emergency Surgery, 2011) Karadas, Sevdegul; Gonullu, Hayriye; Oncu, Mehmet Resit; Isik, Daghan; Canbaz, Yasin
BACKGROUND The purpose of this study was to investigate the demographic and clinical characteristics of electrical injuries, laboratory findings, complications, and mortality and morbidity rates of these injuries. METHODS Patients with electrical injuries admitted to the emergency department between January 2006-2010 were retrospectively analyzed. The cases were evaluated by age, gender, source of electrical power (low-high voltage), seasonal distribution, ECG changes, laboratory findings, clinical care units, complications, and mortality rate. RESULTS Eighty-four (57.1%) of the cases were exposed to low-voltage electricity (Group I), while 63 (42.9%) of the cases were exposed to high-voltage electricity (Group II). The majority of cases with electrical injuries were aged 26-45 years. Thirty of the women (85.7%) were wounded by low-voltage while 58 of the men (51.8%) were wounded by high-voltage electricity. Alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine kinase, and CK-MB levels were higher and the level of calcium was lower in Group II. Complications (pathologies due to fall from high levels, cardiac dysrhythmias, compartment syndrome) and the mortality rate were higher in Group II. CONCLUSION In cases with high-voltage electrical injuries, cardiac complications, complications due to fall from high levels and the mortality rate increase in conjunction with the degree of the muscle damage.
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.
Foreign Body in the Breast: Tip of a Drain
(Medknow Publications & Media Pvt Ltd, 2010) Isik, Daghan; Tekes, Lutfi; Guner, Ilkay
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 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.
Investigating the Effect of Korean Red Ginseng on the Viability of Random-Pattern Skin Flaps in Rats
(Lippincott Williams & Wilkins, 2017) Tekin, Hakan; Tekin, Gonul; Bulut, Gulay; Sargon, Mustafa Fevzi; Isik, Daghan
Objective: This experimental study investigated the efficacy of Korean Red Ginseng (KRG) extract in reducing the partial losses of random flaps. Method: Forty Wistar Albino rats were randomly distributed into 4 groups as (A) control group, (B) stress group, (C) oral KRG group, and (D) intraperitoneal KRG group. The modified McFarlane flap of 9 x 3 cm with a caudal pedicle was harvested from the back of the rats in all the groups. Korean Red Ginseng was administered to groups C and D at standard doses for 10 days. After 10 days, the flaps were removed in all groups and were examined macroscopically, histopathologically, histochemically, and biochemically. The results were statistically analyzed and compared among the groups. Results: The flap necrosis rates were significantly lower in groups C and D compared with groups A and B (P < 0.05). The vascular density, antioxidant activity, and hypoxia-inducible factor-1 alpha levels were significantly higher in the groups C and D compared with the groups A and B (P < 0.05). Although vascular density, hypoxia-inducible factor-1 alpha, and catalase levels were negatively correlated with the flap necrosis rates, there was a significantly positive correlation between malondialdehyde and necrosis rates. Conclusions: Korean Red Ginseng increases the viability of random pattern skin flaps, resulting in reduced rates of distal necrosis. Korean Red Ginseng has antioxidant activity and increases neovascularization.
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.
Is the Coexistence of Intraoral Synechia and Cleft Palate Anomaly a Sequence
(Lippincott Williams & Wilkins, 2012) Garca, Mehmet Fatih; Goktas, Ugur; Isik, Yasemin; Isik, Daghan
Intraoral synechia is a rarely seen intraoral anomaly. As a result of intraoral synechiae, fusion of the palatal shelves may be prevented because of the abnormal interposition of the tongue. Hence, cleft palate anomaly accompanies intraoral synechiae in many patients. The main problem for these patients is the inadequate oral opening for feeding. Flexible nasopharyngeal examination before intubation may help the anesthetist for simple excision of synechiae in the newborn period. In this article, a newborn who had a congenital synechia between the mandible and the maxilla has been presented, and the etiopathogenesis of intraoral synechia and the importance of flexible nasal endoscopy before endotracheal intubation are discussed.
Kutlay Technique for Hypospadias Repair
(Springer, 2012) Gecit, Ilhan; Isik, Daghan; Pirincci, Necip; Bilici, Salim; Gunes, Mustafa; Canbaz, Yasin; Kocak, O. Faruk
Although many techniques have been described, new techniques with a wide range of therapeutic options are needed. The Kutlay technique is a novel technique that is based on the reconstruction of the neourethra with two horizontal meatal-based skin flaps. In the present study, the data of 31 patients who underwent surgery with the Kutlay technique are presented. Thirty-one patients with hypospadias with an average age of 5.6 years who did not have previous hypospadias repair were operated on with the Kutlay technique. Ten patients had chordee. Among those patients, three patients were circumcised. The patients were followed up for 4-13 months (average, 9.3 months). During the follow-up period, a fistula was observed in only one patient. None of the patients developed neourethral dehiscence, meatal stenosis, urethral stricture, wound infection, penile torsion, hematoma, or persistent or recurrent chordee. On uroflowmetry studies, the maximum flow rate of the patients was approximately 10.5 ml/s (range, 6-17 ml/s). The patients were observed to void with a single straight urinary stream in a forward direction. The Kutlay technique is a technique that is easily applied in patients with chordee and that provides a low risk of fistulas and acceptable functional and esthetic results. The factors that reduce the risk of fistula are the lack of the superposition of the suture lines of the skin and the urethra, the reconstruction of the urethra with well-vascularized flaps, and the replacement of the neourethra in its appropriate location through the tunnel created in the glans.