Banu Karapolat’s research while affiliated with Kanuni Sultan Süleyman Training and Research Hospital Istanbul and other places

Pilonidal sinus, especially in young males, is one of the most common diseases of the sacrococcygeal region. Although many surgical techniques have been described for pilonidal sinus disease (PSD), high recurrence rates and patient satisfaction are still controversial with regard to the ideal treatment modality. In this study, we aimed to compare the complications in Primary excision, Limberg flap, elliptical rotation flap and karydakis techniques used in patients with pilonidal sinus disease. The patients who were diagnosed with Pilonidal sinus and underwent surgery between January 2012 and January 2017 were retrospectively analysed from our hospital database. Patients in whom the Primary repair, Limberg flap, elliptical rotation flap and karydakis flap repair performed were divided into four groups. The groups were compared in terms of their demographic characteristics, length of hospitalization, seroma formation, surgical site infections, wound dehiscence, flap necrosis, sensory loss and recurrence. There were 107 patients in the primary group, 70 in the Limberg flap group, 72 in the elliptical rotation flap group and 45 in the karydakis flap group. There was a statistically significant difference between the groups in terms of the length of hospitalization (p < 0.001). The maximum length of hospitalization period was observed in the Limberg group and was 2.06 ± 0.95 days. The minimum duration of hospitalization was 1.00 ± 0.00 days in the karydakis group. Wound site infection was observed mostly in the primary group with 15% frequency, whereas this higher ratio was significant when compared with Elliptical Rotation flap and Karydakis flap groups (p = 0.010, 0.024 respectively). There was no statistically significant difference between the groups in terms of wound dehiscence, flap necrosis, sensory loss and recurrence. There is no consensus on the ideal surgical technique selection for PSD. Our study revealed that wound infection is common in patients undergoing Primary repair and that there is a difference in terms of length of hospitalization for different techniques. We expect the factors we investigate to be a guide for the surgeons.

Introduction: The use of topical antibiotics on wound healing has been a matter of debate for many years because of the effectiveness. Objective: The aim of this study is to investigate the potential effects of topical nitrofurazone, an antibacterial agent, on the healing of full-thickness skin defects created in a laboratory setting. Materials and methods: A total of 42 adult male Sprague Dawley rats were divided into 2 groups: group A (control group; n = 21) and group B (nitrofurazone group; n = 21). Circular full-thickness skin defects about 1 cm x 1 cm in size were formed in the left thoracoabdominal regions of all rats. Local physiological saline was applied to the wound once daily in the control group, and a thin layer of nitrofurazone cream was applied to the wound topically once daily in the nitrofurazone group. The defect sizes of all rats were photographed at baseline and days 3, 7, and 10 of the experiment, and wound size reduction was measured macroscopically on the computer to calculate the healing rates. A total of 7 rats from each group were euthanized on days 3, 7, and 10, and their defected regions were resected. The removed specimens were evaluated histopathologically and scored for inflammatory cells, collagen accumulation, granulation tissue formation, reepithelization, and features of the skin defect (eg, layers of the skin affected, size, whether it involves any abscess-necrosis). Statistical significance was set at P ⟨ .05. Results: The healing rate had higher values in group B at days 7 and 10 of the experiment (P ⟨ .001). A comparison of the group scores showed that there were statistically significant differences in favor of group B. No statistically significant difference was found between the 2 groups with respect to granulation tissue formation. Conclusions: Topically applied nitrofurazone produced positive effects accelerating the wound healing process.

Background: The diagnosis of acute appendicitis is a clinical challenge. Clinical scoring systems and radiological examinations are used to assist in diagnosis. Methods: We reviewed 106 patients between January 2016 and January 2018 who presented with right iliac fossa pain and underwent appendectomy. Their Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores were calculated and abdominopelvic ultrasonography (USG) was performed before they were operated with a prediagnosis of acute appendicitis. RIPASA scores and USG findings were compared to the histopathological results of appendectomy specimens. Results: The histopathological examinations showed that all of the 100 (94.3%) patients whose RIPASA scores were 7 and more had acute appendicitis and the six (5.7%) patients whose scores were less than 7 had no appendicitis. When the appendectomy specimens of the 70 patients who had been diagnosed with acute appendicitis with USG were examined histopathologically, 69 (98.6%) patients were confirmed to have acute appendicitis. Acute appendicitis was found in 18 (81.8%) of the 22 patients whose appendixes could not be visualized with USG. Acute appendicitis was found in eight (88.9%) of the nine patients who had been reported normal with USG. Conclusion: RIPASA scores should be calculated for all patients who are suspected of having acute appendicitis and for those with a RIPASA score of 7 and more, surgery should be highly recommended without USG.

Introduction: Being a rare benign vascular tumor of the spleen, Littoral cell angioma involves multiple focal nodules in the spleen and splenectomy is used for both definitive diagnosis and treatment. Patients and methods: A 30-year-old male patient presented to our clinic with the complaints of intermittent abdominal pain and fever. In physical examination, splenomegaly was found and he was further evaluated with ultrasonography, tomography and magnetic resonance imaging that have revealed multiple solid mass lesions of various sizes in his spleen. The patient was administered open splenectomy and recovered uneventful. Results: After histopathological and immunohistochemical analyses of the splenectomy material, he was diagnosed with Littoral cell angioma. Conclusions: For a timely diagnosis, Littoral cell angioma should be considered among the initial diagnoses in patients who were found to have splenomegaly in their physical examination and multiple masses in the spleen in radiological tests.

Introduction: Being one of the scoring systems used in the diagnosis of acute appendicitis, the RIPASA score can be used easily with a high diagnostic accuracy. Objective: To evaluate the possible relationship between RIPASA scores and the histopathological examination results of appendectomy materials. Materials and methods: This study retrospectively reviews 242 patients who were operated in our clinic between January 2016 and January 2018 with a prediagnosis of acute appendicitis, and the RIPASA scores calculated in the preoperative period were compared to the histopathological examination results of the appendectomy specimens. Results: The patients consisted of 124 (51.2%) females and 118 (48.8%) males. The ages of the patients ranged from 15 to 81 years. The patients were divided into 3 groups based on their RIPASA scores as low-score (4-7), intermediate-score (7.5-11.5), and high-score (12 and over) groups. There were 20 (52.6%) catarrhal-stage appendicitis cases and 17 (44.7%) normal appendixes in the low-score group; there were 70 (83.3%) catarrhal-stage appendicitis cases, 9 (10.7%) suppurative-stage appendicitis cases, 4 (4.8%) gangrenous-stage appendicitis cases, and 1 (1.2%) perforated appendicitis case in the intermediate-score group. In the high-score group, there were 53 (44.2%) suppurative-stage appendicitis cases, 51 (42.5%) gangrenous-stage appendicitis cases, 11 (9.2%) perforated appendicitis cases, and 5 (4.2%) catarrhal-stage appendicitis cases. A strong positive correlation was found between the RIPASA scores of the patients and the pathological stage of appendicitis (r=0.889; p<0.001). Conclusion: The RIPASA scoring system can make a correct and prompt diagnosis of acute appendicitis including its possible pathological stage without any need for a computed tomography.

Introduction: Scar endometriosis (SE) is a rare pathology that develops in the scar tissue formed on the anterior abdominal wall usually after a cesarean section. There have been instances of women presenting to emergency or general surgery clinics with abdominal pain due to SE. Materials and methods: This study retrospectively reviews 19 patients who were operated on in our clinic between January 2010 and January 2017 with a prediagnosis of SE and were reported to have SE based on their pathology results. Results: The mean age of the patients was 30.8 years (range: 20-49 years). The body mass indexes of 12 (63.2%) patients were ≥ 25. All patients had a history of cesarean section and 9 (47.4%) patients had undergone cesarean section once. With the exception of one patient who had her SE localized in her inguinal region, all patients had a mass localized on their anterior abdominal wall neighboring the incision and complained about cyclic pain starting in their premenstrual periods. The complaints began 2 years after their cesarean section in 10 (52.6%) patients. Mostly abdominal ultrasonography was used for diagnostic purposes. The lesions were totally excised and the SE diagnosis was made through a histopathological examination in all patients. No postoperative complications or recurrences were seen in any of the patients. Conclusion: Suspicion of SE is essential in women of reproductive age who have a history of cesarean section and complaints of an anterior abdominal wall mass and a pain at the scar site that is associated with their menstrual cycle. An accurate and early diagnosis can be established in such patients through a careful history and a good physical examination and possible morbidities can be prevented with an appropriate surgical intervention.