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    BÖLGE YANIK MERKEZİ YOĞUN BAKIM ÜNİTESİ’NDE TOKSİK EPİDERMAL NEKROLİZİS’Lİ HASTALAR
    (2014) Kuzucuoğlu, Tamer; Saraçoğlu, Ayten; Demirhan, Recep; Erhan, Tuncay; Yakupoğlu, Sezer; Ersoy, Burak
    Amaç: Toksik epidermal nekrolizis (TEN) sepsis ve ölümle sonuçlanan potansiyel hayatı tehdit edici, ender görülen bir hastalıktır. Bu çalışmanın amacı hastanemiz yanık ünitesine kabul edilen 12 TEN hastasına ait mortalite oranı, ilişkili komorbiditeler, klinik ve epidemiyolojik karakteristiklerini belirlemektir. Yöntem: Yanık yoğun bakım ünitesine kabul edilen TEN tanısı konulmuş 12 hasta çalışmaya dahil edildi. Hastaların yaş, cinsiyet, ilaç kullanımı, cilt yanık hasarının derinliği ve yüzdesi, APACHE II skorları, cerrahi girişimler, hastanede kalış süresi, mekanik ventilasyon süresi, komplikasyonlar, mortalite ve morbidite oranları retrospektif olarak dökümante edildi. Hastaların mortalite oranlarının belirlenmesinde Scorten Skalası kullanıldı. Bulgular: Ortalama yaş 35±5,7 yıldı. Erkek hastaların kadınlara oranı 5:7 idi ve ortalama APACHE II skoru 15,4±3,2 idi. Epidermal ayrılma vücut yüzey alanının %75’inden fazla, median hasta yatış süresi 17±1,2 gündü. Bir hastada parasetamol ve etodolak, 3 hastada fenitoin alım öyküsü bulunmaktaydı. TEN semptomları bir başka hastada antitüberküloz tedavisi sonucunda, 4 hastada da sultamisilin tedavisini takiben ortaya çıktı. Diğer hastaların etyolojisi bilinmiyordu. Median mekanik ventilasyon destek süresi 3,2±0,7 gündü. Mortalite oranı %16,6 (2/12) idi. Sonuç: TEN hastaları yüksek mortalite riskinden dolayı değişik yaklaşımlar ve tedavi stratejileri gerektirirler. Sorumlu ilacın erken dönemde belirlenerek kesilmesinin ve bir yanık merkezinde özel destekleyici tedavi ortamının oluşturulmasının toksik epidermal nekroliziste mortalite oranını düşüreceği kanısına varılmıştır.
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    COMBINATION OF LIPOSUCTION WITH ARTHROSCOPIC CARTILAGE SHAVER FOR THE TREATMENT OF GYNECOMASTIA
    (Medknow Publications & Media Pvt Ltd, 2014) Ersoy, Burak; Akoz, Tayfun
    Introduction: Surgical intervention is the most effective treatment modality for adult male patients with longstanding gynecomastia. Various surgical techniques for the correction of gynecomastia were described in the literature. This study was designed to introduce the combination of conventional liposuction with arthroscopic cartilage shaver for the correction of gynecomastia and to evaluate the cosmetic results following surgery. Materials and Methods: Thirteen consecutive patients with a mean age of 27.6 years (range 19-43 years) underwent a combined approach that included liposuction and arthroscopic cartilage shaver. A comparison of the combination modality with other surgical alternatives and the analysis of the end-results were performed. Results: The combination modality was performed in 13 patients, all diagnosed with bilateral gynecomastia. The average volume of aspirated breast tissue was measured as 348 cc. Follow-up periods ranged in duration from 7 to 13 months (on average 10.6 months). Apart from a case with postoperative unilateral hematoma formation no other complication was encountered. One of the patients underwent reoperation because of under-resection. All of the patients had aesthetically pleasant results. Conclusion: Although gynecomastia is a benign condition it nevertheless is able to give rise to serious emotional disturbances; thus gynecomastia constitutes one of the most prevalent reasons for cosmetic surgical interventions. The combination treatment using liposuction and an arthroscopic cartilage shaver in selected cases diagnosed with stage IIa/IIb gynecomastia is an effective treatment alternative for gynecomastia with minimal scar formation.
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    Comparison of Bone Prefabrication with Vascularized Periosteal Flaps, Hydroxyapatite, and Bioactive Glass in Rats
    (THIEME MEDICAL PUBL INC, 2015) Ersoy, Burak; Bayramicli, Mehmet; Ercan, Feriha; Sirinoglu, Hakan; Turan, Pinar; Numanoglu, Ayhan
    Background Periosteal flaps possess osteoprogenitor cells and an osteoinductive potential that can be further augmented by combination with a biodegradable scaffold; therefore, various osteoconductive and osteostimulative biomaterials are frequently combined with periosteal flaps in studies of bone prefabrication. An experimental study was designed to determine and compare the contribution of bioactive glass and hydroxyapatite to osteoneogenesis in rats when combined with a periosteal flap. Materials and Methods In 60 Sprague Dawley rats, saphenous artery periosto-fasciocutaneous island flaps were transposed to abdomen. In group 1, the flap was left alone, in group 2, an empty artificial pocket made of Gore-Tex (W. L. Gore & Associates, Inc.; Flagstaff, AZ) was sutured onto the periosteal layer, and in groups 3 and 4, the pocket was filled with bioactive glass and hydroxyapatite, respectively. Following sampling for histological analysis, a 4-point scoring system was used to grade inflammatory cell infiltration, osteogenesis, angiogenesis, and cell migration into the bioactive material. Results The combination of the periosteal flap with any of the bioactive materials resulted in significantly higher percentages of animals exhibiting osteogenesis (80% in hydroxyapatite group and 93.3% in the bioactive glass group; p = 0.0000528) and angiogenesis. Comparison of the bioactive material groups revealed that a significantly higher proportion of animals in the bioactive glass group exhibited moderate or severe inflammation (80 vs. 20%; p = 0.002814). Conclusion Periosteal flaps prefabricated with hydroxyapatite or bioactive glass in rats exhibit osteogenic capacities that are not dependent on direct bone contact or proximity to vascular bony tissue. The innate capacity of the periosteal flap when utilized alone for osteoneogenesis was found to be rather insufficient.
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    An easy and noninvasive technique for harvesting split thickness skin grafts in rats
    (ELSEVIER SCI LTD, 2016) Ersoy, Burak; Ersoy, Gulcin Sahin
    Skin graft studies in rats constitute a valuable adjunct to scientific human experimentations, however the harvesting of split thickness skin graft poses a challenge to the researcher due to the presence of panniculus carnosus tissue in rat skin. This striated muscle tissue renders significant laxity and mobility to the skin layer, greatly interfering with the process of skin graft harvest. In order to fixate the rat skin and limit its flexibility various techniques and modifications have been described, which mostly rely on the use of subdermal implanted templates. These methods are therefore time consuming, with an additional exposure to surgical stress and wounds. A new and simple technique is presented which offers a rapid and reliable alternative to the existing methods of split thickness skin graft harvesting without any additional invasive procedure or extra instruments other than the researchers hands and a dermatome. (C) 2015 Elsevier Ltd and ISBI. All rights reserved.
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    Etanercept protects myocutaneous flaps from ischaemia reperfusion injury: An experimental study in a rat tram flap model
    (TAYLOR & FRANCIS LTD, 2016) Ersoy, Burak; Cevik, Ozge; Cilingir, Ozlem Tugce
    Background Being an inevitable component of free tissue transfer, ischemia-reperfusion injury tends to contribute to flap failure. TNF- is an important proinflammatory cytokine and a prominent mediator of the ischemia-reperfusion injury. Etanercept, a soluble TNF- binding protein, has shown anti-inflammatory and anti-apoptotic effects in animal models of renal and myocardial ischemia-reperfusion injury. We have designed an experimental study to investigate the effect of etanercept on myocutaneous ischemia-reperfusion injury on transverse rectus abdominis myocutaneous flap model in rats.Methods Twenty-four male Sprague-Dawley rats were divided into 3 groups: In group 1 (sham), the TRAM flap was raised and sutured back without further intervention. In group 2 (control), the flap was raised and the ischemia-reperfusion protocol was followed. In group 3, etanercept (10 mg/kg, i.v.) was administered 10 minutes before reperfusion. At the end of the reperfusion period, biochemical and histolopathological evaluations were performed on serum and tissue samples.Results In the etanercept group the IMA and 8-OHdG levels (p=0.005 and p=0.004, respectively) were found significantly lower, and the GSH and SOD levels (p=0.01 and p<0.001, respectively) significantly higher in comparison to the control group. The histopathological analysis has revealed a lower degree of hyalinization, degenerated muscle fibers and nuclear change in the etanercept group compared to the control group.Conclusion The results of our experimental study indicate that etanercept offers protection against ischemia-reperfusion injury in skeletal muscle tissue, enhancing the TRAM flap viability. The ability of etanercept to induce ischemic tolerance suggests that it may be applicable in free-flap surgery.
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    Kongre Bildirilerinin Kaderi Nedir? TPRECD 31. Ulusal Kurultayında Sunulan Sözel ve Poster Bildirilerin Uluslararası Yayına Dönüştürülme Oranları
    (2016) Ersoy, Burak
    Amaç: Kongrelerde sunulan sözel ve poster bildiriler, en güncel bilimsel verilerin paylaşımı ve deneyimlerin aktarımını sağlayan önemli bir araç olarak kabul edilmekte ancak bu bildirilerin büyük bir kısmı bilimsel dergilerde yayına dönüştürülememektedir. Bu çalışmanın amacı, TPRECD 31. Ulusal Kurultayı'nda sunulan bildirilerin yabancı yayına dönüştürülme oranlarının saptanması ve yayına dönüşen bildirilerle ilişkili çeşitli değişkenlerin analiz edilmesidir.Gereç ve Yöntemler: PubMed veritabanı taranarak hakemli dergilerde yayınlanan ve 2009 ulusal kurultayında sunulmuş bildirilere uyan yayınlar saptandı. Tüm bildiriler için bildiri tipi, konu başlığı, birinci yazara ait kurum adı ve tipi; yayınlanmış bildiriler için ayrıca yayınlanma süresi, dergi adı ve etki faktörü, birinci isim değişikliği, yazar isimlerinde değişiklik olup olmaması kaydedildi. Elde edilen veriler ki-kare, Mann-Whitney U ve Kruskal Wallis testleri kullanılarak analiz edildi. Bulgular: Kurultayda sunulan toplam 569 bildiriden 96 tanesi (%16,8) beş yıl içinde uluslararası hakemli dergilerde yayınlanmıştır. Bu yayınlardan 21 tanesi kurultay öncesi döneme aitken geri kalan 75 bildiri için ortalama yayınlanma süresi 22±16,3 ay (1-57 ay) olarak tespit edilmiştir. Sözel bildirilerin yayın olma oranı poster bildirilere kıyasla anlamlı derecede daha yüksektir (%30,5'e karşılık %13,3; p
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    A new flap design for release of parallel contracture bands: Dual opposing five-flap z-plasty
    (ELSEVIER SCI LTD, 2014) Ersoy, Burak
    Skin contractures secondary to burn and other types of trauma can be encountered on almost every part of human body, best addressed by a custom treatment protocol tailored for each patient. Skin graft, local flap as well as distant flap options are available, each with intrinsic advantages and disadvantages. In the presence of weblike contracture the utilization of local tissue, when available, is a prefered approach for a relatively better appearance through a reasonably simpler surgical intervention, compared to skin graft applications and distant flap options. Among many other techniques and modalities utilized for this purpose, the dual opposing five-flap z-plasty method which is a novel method designed as a modification of the paired five-flap z-plasty technique promises to be a useful treatment option for the release of parallel contracture bands with satisfactory results in selected patients. (C) 2014 Elsevier Ltd and ISBI. All rights reserved.
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    A New Perspective for Spreader Graft Use in Severely Deviated Septum: Is Septal Continuity an Obligation for a Stable and Straight Nasal Septum?
    (THIEME MEDICAL PUBL INC, 2016) Sirinoglu, Hakan; Yesiloglu, Nebil; Ersoy, Burak
    Severe septal deviation is a challenging deformity usually treated using aggressive surgical methods, and extracorporeal septoplasty (ECS) is a commonly used method for this issue. However, this method has severe risks and complications such as the recurrent deformity or nasal saddling. In this article, we present an alternative solution to ECS procedure for the correction of severe septal deviation. Sixteen patients with severe c- or s-shaped septal deviation with a mean age of 26.5 years were included in the study. The entire deviated part of the septal cartilage was resected as a vertical block creating a full-thickness defect between the most cranial and caudal parts of the septal cartilage. After that, two spreader grafts were placed bilaterally facilitating the septal integrity and leaving the full-thickness septal defect unchanged. The surgical results were evaluated using the preoperative and postoperative facial photographs and patient satisfaction was determined using nine relevant questions of DAS-59 scale. The only complication observed in the follow-up period of 19 months was hanging columella deformity which was corrected at the postoperative first year. The mean length of the resected septal segment was 12.4 mm. The mean length of the resultant septal cartilage defect after the vertical resection was 5.9 mm. The mean length of the placed spreader grafts was 25.6 mm. The comparison of the preoperative and postoperative photographs showed significant improvement of the nasal contour and considerable correction of the septal deviation. The statistical evaluation of the answers given to the questions of the DAS-59 scale clearly demonstrates that a significant degree of patient satisfaction was achieved. Severe septal deviation may be successfully corrected by full-thickness resection of the deviated part and reconstruction with bilateral spreader grafts with a low risk of postoperative complications.
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    Soft-tissue osteoma of the thenar eminence
    (TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2017) Ersoy, Burak
    The development of osteoma in soft tissues without a direct contact with the adjacent osseous and articular structures is a very rare event. The involvement of the hand is even rarer, with only two previous cases reported so far. A 25- year-old man presented with a painless solid mass in the thenar region of his right palm, which appeared almost 2 years ago and showed a progressive enlargement in the last months. Under regional anesthesia an excisional biopsy was performed and the histopathological evaluation of the lesion confirmed the diagnosis of soft tissue osteoma. The postoperative follow-up period was uneventful without any complication or recurrence. Following a brief period of hand physiotherapy the patient has returned to normal daily activities. (c) 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B. V. This is an open access article under the CC BY-NC-ND license.
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    Tip-Oriented Closed Rhinoplasty Built on Septocolumellar Suture and a New Caudal Septal Graft Technique
    (LIPPINCOTT WILLIAMS & WILKINS, 2016) Tezel, Erdem; Ersoy, Burak
    Background: A beautiful and appealing nose receives the greatest contribution from the nasal tip subunit, which should be regarded as the primary center of attention during a rhinoplasty procedure. In achieving the desired shape and position of the nasal tip during closed rhinoplasty, the septocolumellar suture functions as the major determinant together with the caudal portion of the septal cartilage, which has a significant influence on the versatility of the septocolumellar suture. The purpose of this study was to present the analysis of the indications, the technical steps, and the advantages of caudal septal graft and septocolumellar suture utilization in closed rhinoplasty. Methods: The septocolumellar suture with or without the caudal septal graft combination procedure has been performed in 2286 patients via a closed rhinoplasty approach. Intraoperatively, the septal cartilage at hand was thoroughly evaluated and one of the 5 types of caudal septal grafts was used when necessary. After the establishment of a strong and straight septal cartilage with sufficient height and length, 4 different septocolumellar sutures in a specific order were used to modify the relationship between the lower lateral cartilages and the nasal septum. Results: Of the 2286 cases, 1837 (80.3%) were primary and 449 (19.7%) secondary rhinoplasties, which have been followed up for 9 to 48 months. The caudal septal graft was combined to the septocolumellar suture in 621 (27.1%) patients. Of the caudal septal grafts, 69.7% were used for primary rhinoplasty cases, and 30.3% for secondary rhinoplasties. At the 18th month postoperatively, tip projection was found to be satisfactory for 98% of the patients. Conclusions: The septocolumellar suture combined with caudal septal graft in closed rhinoplasty substantially facilitates the achievement of a cosmetically and functionally pleasing end result, bringing the solution for a wide array of problems such as short nose, supratip deformity, nasolabial angle change, or columellar bowing. Nevertheless, the technique has a steep learning curve; therefore, a meticulous preoperative evaluation should be exerted, a precise surgical planning should be prosecuted, and an excessive reduction of the nasal tip or exaggerated columellar retraction should be avoided.
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    Tümör rezeksiyonu sonrası oluşan orta yüz defektlerinin onarımında nazolabial V-Y ilerletme flebinin kullanımı
    (Maltepe Tıp Dergisi, 2016) Ersoy, Burak; Aköz, Tayfun
    Amaç: Nazolabiyal V-Y ilerletme flebi, orta ve ileri yaş grubu hastalarda tümör rezeksiyonu sonrasında sıklıkla karşılaşılan orta yüz defeklerinde, özellikle de malar, infraorbital, mediyal kantal ve lateral nasal bölgelerin rekonstrüksiyonunda sık olarak tercih edilen bir lokal kutanöz flep alternatifidir. Bu çalışmada, orta yüz bölgesinde cilt tümörü nedeniyle opere edilen hastalarda oluşan doku defektlerinin nazolabiyal V-Y ilerletme flebiyle rekonstrüksiyonu sunulmuştur. Gereç ve Yöntem: 2013-2014 yılları arasında yaşları 52 ile 68 arasında değişen 7 hastada cilt tümörü rezeksiyonunu takiben orta yüz bölgesinde ortaya çıkan doku defekti nazolabiyal V-Y ilerletme flebiyle rekonstrükte edildi. Elde edilen sonuçlar fonksiyonel ve estetik açılardan değerlendirildi ayrıca hastaların yaşı, cinsiyeti, patolojik tanısı, rezeksiyon sonucunda oluşan defektin lokalizasyonu ve boyutları kaydedildi. Bulgular: Ortalaması 10 ay (8-13 ay) olan takip süresinin sonunda hastaların tamamının elde edilen fonksiyonel ve kozmetik sonuçtan memnun oldukları kaydedildi ve hiçbir olguda reoperasyon ihtiyacı oluşmadı. Bir hastada gelişen parsiyel dezepitelizasyon takibe alındı ve pansumanlarla iyileşti. Bir diğer hastada saptanan tuzak (‘trapdoor') deformitesi tek seans intralezyoner steroid enjeksiyonu uygulanarak tedavi edildi. Sonuç: Nazolabiyal V-Y ilerletme flebi, özellikle orta yaş ve üzeri hastalarda tümör rezeksiyonu sonucunda ortayüzde oluşan doku defektlerinin onarımında tercih edilebilecek güvenilir ve etkin bir tedavi seçeneğidir.
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    What is the Ultimate Fate of Presented Abstracts? Conversion Rates of Presentations to International Publications from the 31st National Congress of Plastic, Reconstructive, and Aesthetic Surgery
    (MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) Ersoy, Burak
    Objective: Oral and poster presentations held at national congresses are regarded as important means for sharing of latest scientific data and personal experiences. However, many ideas shared at annual conferences fail to be published. The objective of this study was to examine the publication rate of presentations held at the 31st National Congress of the Turkish Society of Plastic Reconstructive and Aesthetic Surgeons and to analyze various factors associated with publication. Material and Methods: The PubMed database was searched for peer-reviewed publications, corresponding to abstracts presented at the 2009 congress. For all abstracts, parameters including presentation type, topic, institution, author details, publication time, journal name, and impact factor were recorded. Collected data were analyzed using chi-square, Mann-Whitney U, and Kruskal-Wallis tests for statistical significance. Results: In five years 16.8% of 569 proceedings were published in international peer-reviewed journals. The mean time to publication following the congress was 22 months (1-57 months) for 75 presentations, whereas 21 proceedings had been published prior to the congress. Compared with posters, the publication rate for oral presentations was significantly greater (30.5% vs. 13.3%; p< 0.001). The type of institution had no significant effect on the publication rate. Conclusion: The overall publication rate for the 31st National Plastic Surgery Congress was found to be similar with other Turkish-based studies, but was somewhat lower than that of international counterparts. The significant difference found between the publication rates of oral and poster presentations was interpretted as a positive sign demonstrating a relatively higher level of scientific value and appeal.