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ABSTRACT: Axial pattern flaps are characterized by a single vascular pedicle that supplies the whole flap and carry the danger of flap loss. For this reason, monitoring and early identification of vascular perfusion is important for flap prognosis. The most commonly used method for flap monitoring is clinical assessment, but it has certain limitations. The bioelectrical properties of tissues can be affected by ischemic conditions, and a preliminary study showed that the bioelectrical resistance of blood was decreased under thrombotic conditions. In this controlled study, the resistance values of the axial flaps were calculated during thrombosis. A total of 28 rats were randomly divided into a control group (n = 14) and an experimental group (n = 14). Axial flaps were elevated based on the inferior epigastric pedicle. For the ischemic group, microvascular clamps were placed in the ischemic group to produce artificial thrombosis from day 1 of the experiment. Bioelectrical resistance was measured every 30 minutes for the first 6 hours and then daily after that. The resistance values from the ischemic group decreased progressively, and 150 minutes after the clamping, the difference became statistically significant (P < 0.05). The results showed that the assessment of flap resistance is a valuable tool and may allow early recognition of a compromise in the vascular system before clinical signs become obvious.
The Journal of craniofacial surgery 05/2011; 22(3):1083-6. · 0.81 Impact Factor
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ABSTRACT: Ear reconstruction with autologous tissues and creating a natural-appearing ear is a difficult, multistage surgical procedure. Problems, such as a thick skin or an inadequate cartilage-flap relationship, may cause obliteration of the framework details. A nonsurgical technique to improve auricular definition is described.
Twenty-six patients with reconstructed ears due to inadequate auricular definition were enrolled in the study. To achieve a better auricular shape, triamcinolone acetonide injections up to 4 sessions were applied. Results of injections were evaluated by improvement of ear contours, quality of detail, frequency of injections, and complications. In addition, histopathologic studies were carried out in 8 patients.
The results were satisfactory. Significant recovery was observed in auricular definition in all patients. There were no major complications observed as a result of the use of steroids during the long follow-up period, suggesting that our technique was safe.
The solution to unfavorable results of a primary auricular reconstruction generally requires extremely difficult and challenging procedures. In selected patients, triamcinolone injections may be a remedy and may be helpful in avoiding complex surgical procedures.
The Journal of craniofacial surgery 02/2010; 21(2):375-8. · 0.81 Impact Factor
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Dermatologic Surgery 08/2008; 34(7):935-8. · 1.80 Impact Factor
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Dermatologic Surgery 02/2008; 34(1):97-9. · 1.80 Impact Factor
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ABSTRACT: Telangiectasias are superficial cutaneous vessels that are visible to human eye and are present as a dilated venule, capillary, or arteriole. They are a common cause of concern, especially when located in face. Sclerotherapy is among the treatment alternatives, but facial telangiectasias are less responsive than those located on the leg.
To show the effectiveness of silicone gel sheet in improving the results obtained by sclerotherapy in facial telangiectasias.
Between 1998 and 2003, 32 patients were treated with sclerotherapy and silicone gel sheet (group 1). Twenty-six patients were treated with sclerotherapy and cotton ball (group 2), and 30 patients were treated only sclerotherapy (group 3). Patients were evaluated for 12 weeks for the degree of improvement and side effects. All complications, side effects, and number of sessions were also recorded at each follow-up visit. The number of sessions is limited to six. After the final follow-up visit, the photographs taken of each treatment site at baseline and at final visit were reviewed in a double-blinded manner based on a 0 to 4 scale by two physicians.
Fifty one of the 88 patients showed improvement totally. In the silicone sheet-sclerotherapy group, 22 of the 36 patients showed improvement. In the sclerotherapy-cotton ball group, 14 of the 26 patients showed improvement, and in the sclerotherapy-only group, 15 of the 30 patients showed improvement completely within the 12 weeks. The patients treated with sclerotherapy-silicone gel sheet (group 1) had more improvement than the other groups.
Combining silicone gel sheeting to sclerotherapy increases the success rate in treating facial telangiectasias, especially facial subunits, which have bone support.
Dermatologic Surgery 04/2004; 30(3):373-7. · 1.80 Impact Factor
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ABSTRACT: Different techniques are being used in treatment of split-thickness skin graft donor sites; however, there is not a widely accepted method established for these partial-thickness wounds. It is well known that honey has been very effective in the treatment of various types of wounds, but there is not any information about the usage of honey as split-thickness skin graft donor site dressing in the literature.
To evaluate and compare the effectiveness of honey-impregnated gauzes, hydrocolloid dressings, and as a conventional dressing, saline-soaked gauzes for skin graft donor sites.
This is a nonrandomized, prospective, open-label (noncontrolled), side-by-side comparison trial of various options that are available for second-intention healing of donor site for split-thickness skin grafts. Eighty-eight patients who underwent skin grafting were observed using two different groups. In the first group, the donor site was divided into two equal halves, with each half being treated with honey-soaked gauzes and the other half with paraffin gauzes (group 1A), hydrocolloid dressings (group 1B), and saline-soaked gauzes (group 1C) alternatively. In the second group, two separate donor sites were formed, with one of them being treated with honey-impregnated gauzes (groups 2A-C) and the other one treated with either paraffin gauzes (group 2A), hydrocolloid dressings (group 2B), or saline-soaked gauzes (group 2C). The healing time, rate of infection, and sense of pain were evaluated. RESULTS. : In the treatment of split-thickness skin graft donor sites, honey-impregnated gauzes showed faster epithelization time and a low sense of pain than paraffin gauzes and saline-soaked gauzes. There was no significant difference between honey-impregnated gauzes and hydrocolloid dressings with regard to epithelization time and sense of pain.
The use of honey-impregnated gauzes is effective, safe, and practical. Honey can be an alternative material for the split-thickness skin graft donor site treatment.
Dermatologic Surgery 03/2003; 29(2):168-72. · 1.80 Impact Factor
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Plastic & Reconstructive Surgery 10/2002; 110(3):993-4. · 3.38 Impact Factor
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Plastic & Reconstructive Surgery 08/2002; 110(3):993-994. · 3.38 Impact Factor
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ABSTRACT: : Gigantomastia, characterized by massive breast enlargement during adolescence or pregnancy, is thought to be caused by an abnormal and excessive end organ response to a normal hormonal milieu. The amputation technique with the free nipple-areola graft is the mainstay for severe macromastia, but it has been criticized because it results in a flattened, nonaesthetic breast with poor projection. This report presents two sisters with unusual, excessive breast enlargement.
: The measured distance from the sternal notch to the nipple was 50 cm for the first case and 55 cm for the second case. The free nipple graft transplantation based on the vertical mammoplasty technique was used, and an average of 4,200 g of breast tissue per breast was removed. To increase breast projection, superior dermoglandular flaps were used
: The follow-up period was 24 months. The patients had long-lasting, pronounced breast mound projection, and the level of satisfaction for both cases was very high.
The ideal geometric structure of the breast is rather conical, and the authors believe that reshaping the breast tissue in a vertical plane using the vertical mammoplasty technique may be more effective in the long term and may provide better projection.
Aesthetic Plastic Surgery 29(3):205-9. · 1.41 Impact Factor
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ABSTRACT: This study investigated the effectiveness of makeup camouflage procedures for patients who have experienced social problems because undesirable ecchymoses and edemas after aesthetic surgery, The impacts of camouflage procedures for such patients also were studied.
For this study, 46 rhinoplasty patients were divided into two groups: postoperative camouflage makeup was used for 23 patients, whereas the other 23 patients were assessed as the control group, Additionally, 18 blepharoplasty patients also were divided into two similar camouflage and control groups.
The State-Trait Anxiety Inventory test given to the patients postoperatively indicated that postoperative makeup provided positive effects for patients.
The current clinical study investigated the effects of cosmetics on the psychological state of patients during the postoperative period and included the application of camouflage makeup for postrhinoplasty and postblepharoplasty patients with edemas and ecchymoses. Psychologically, the patients felt better.
Aesthetic Plastic Surgery 29(3):190-4. · 1.41 Impact Factor
