Comparison of the flap survival with ischemic preconditioning on different pedicles under varied ischemic intervals in a rat bilateral pedicled flap model.

The study was undertaken to search whether pedicle selection for ischemic preconditioning (IP) and duration of global ischemia applied after IP influenced efficacy of IP on flap viability in epigastric adipocutaneous island flap with bilateral pedicles in rat model. In total, 159 rats were divided into one control and three (primary, secondary, or bilateral pedicle) IP treatment groups. IP was performed on different pedicles by three cycles of 10 minutes of pedicle clamping and 10 minutes of release.

Lower extremity soft tissue reconstruction with free flap based on subscapular artery.

Objectives: The purpose of our study was to evaluate the results of the reconstruction of the lower extremity defects with free flaps based on the subscapular artery.

Methods: Between January, 1998 and December, 2008, 51 patients (mean age 26 years; 16 female and 35 male) presenting with a lower extremity defect underwent a reconstructive surgery with flaps based on the subscapular vascular system. Thirty-seven percent of the defects were located in the crus, 19% in the sole, 16% in the heel, and 14% in the dorsum of the foot.

Anastomosis with fish-mouth technique using fibrin glue.

Researchers have made numerous attempts to shorten anastomosis duration since Jacobson first used the term microvascular surgery in 1960. However, none of these alternatives has its combination of facility, low cost, reliability, durability, and high success rate. This study aimed to shorten the anastomosis duration, especially in operations that require multiple anastomoses, and the authors performed experimental anastomoses with the fish-mouth technique using fibrin glue.

The practice of plastic surgery in emergency trauma surgery: a retrospective glance at 10,732 patients.

Background: The number of patients applying to the emergency Plastic and Reconstructive Surgery outpatient clinic varies considerably depending on the sociocultural profiles of societies. Due to the abundance of anatomic regions comprising the targets of this field of specialization, plastic surgery is continuously gaining in importance in emergency traumatology.

Methods: In this study, 10,732 patients admitted to the outpatient clinic of Emergency Plastic Surgery in Şişli Etfal Training and Research Hospital were evaluated retrospectively regarding etiology, sex, age distribution, injury characteristics, and treatment.

Repair of a wide lower extremity defect with cross-leg free transfer of latissimus dorsi and serratus anterior combined flap: a case report.

Composite tissue loss in extremities involving neurovascular structures has been a major challenge for reconstructive surgeons. Reconstruction of large defects can only be achieved with microsurgical procedures. The success of free flap operations depends on the presence of healthy recipient vessels.

Use of wide bipedicled pericranial flap in anterior scalp reconstruction.

Pericranial flap is a composite flap involving the periosteum of the skull with its overlying loose areolar tissue termed subgaleal fascia. The multiple blood supply of the pericranial tissue enables this versatility, with a rich, anastomosing arterial supply from the supraorbital, supratrochlear, superficial temporal, posterior auricular, and occipital vessels. Thus, the shape, size, and location of the pericranial flap could be altered as long as a sufficient pedicle width could be fashioned to maintain a blood supply.

A retrospective study on the epidemiology and treatment of maxillofacial fractures.

Background: Maxillofacial injuries constitute a substantial proportion of cases of trauma. This descriptive analytical study assesses the cause, type, incidence, and demographic and treatment data of maxillofacial fractures.

Methods: A retrospective study on maxillofacial traumas was carried out in the Department of Plastic and Reconstructive Surgery at Sişli Etfal Hospital (Istanbul, Turkey) between January 1, 2000 and December 31, 2005.

Stereolithographic volume evaluation of healing and shaping after rhinoplasty operations.

Nasal edema and volume changes are unavoidable processes during the healing period after rhinoplasty. Various applications were reported regarding the prevention of early edema; however, the literature shows no study focused on the course of the nasal edema and volume changes up-to-date. We aimed to study the nasal volume changes during the first year of postoperative healing period and to form a recovery and volume change diagram with the obtained data.

Nipple reconstruction with bipedicled dermal flap: a new and easy technique.

Background: Nipple reconstruction is the last step in breast reconstruction. An entirely satisfying breast reconstruction can be achieved only with a symmetrically placed and ideally shaped nipple-areola complex. Several techniques and modifications have been described for nipple-areola reconstruction but long-term projection loss is still a problem in nipple reconstruction.

Use of rapid prototyping in prosthetic auricular restoration.

Reconstructing auricular defects is a challenging task for facial reconstructive surgeons. Although autologous reconstruction is the first choice for reconstruction, there may be circumstances of inconvenience such as previously attempted surgery, radiotherapy, systemic conditions, or patient's wish. Auricular restorations with facial prosthesis have produced promising results, but there are still problems to be tackled for improved results.

Reconstruction of complicated scalp defect via skin traction.

Management of an open wound is a problem frequently faced, with skin defects that cannot be closed primarily. Functional and aesthetic outcome could be improved if primary approximation of skin in these large defects were possible. Primary closure may be assisted using the viscoelastic properties of the skin.

A new glabellar flap modification for the reconstruction of medial canthal and nasal dorsal defects: "flap in flap" technique.

Background: In considering periorbital reconstructive options, the goals of reconstruction are to obtain functional and esthetic results. At the medial canthus, reconstruction should maintain the normal concavity of the canthus without distortion of the surrounding tissues and should maintain normal eyebrow contour and symmetry. The authors represent their flap in flap technique that provides normal concavity of the canthus and does not cause any complex and undesirable scars.

A novel approach for the reconstruction of medial canthal and nasal dorsal defects: frontal hairline island flap.

Medial canthal and dorsal nasal defects after surgery have been a challenging problem for surgeons and patients. The main purpose in reconstruction is not solely covering the defects with similar skin and soft tissue, but also causing minimal donor-area morbidity. The authors described an elliptical fashioned frontal island flap at the level of the frontal hairline, nourished by the vascular network composed of supraorbital and supratrochlear arteries, then carried subcutaneously to the defect area at medial canthus and upper nose.

[Electrophysiologic and histopathologic evaluation of peripheral nerve regeneration at different nerve segments and with different repair techniques].

Objectives: We compared the electrophysiologic and histopathologic results of early primary nerve repair and grafting of transections made at different levels.

Methods: Twenty-two male Sprague-Dawley rats were divided into three groups. In one group (distal group, n=8), the right sciatic nerve was transected near the proximal segment of, and in another (proximal group, n=7) at 15 mm proximal to, its branching.

Lower lip reconstruction with local neuromusculocutaneous advancement flap.

Various reconstruction techniques, using the remaining lip or the adjacent cheek tissue, have been described for the repair of lower lip defects. With these techniques, microstomia, commissural distortion, functional insufficiency, and sensorial loss might be observed. The authors describe a technique of lower lip reconstruction with preservation of neuromuscular tissue as a single-stage procedure.

A new technique for medial canthal tendon fixation.

Traumas resulting from naso-orbitoethmoidal fractures and tumor surgery of the medial canthal region may cause orbital dystopia. A variety of techniques with many disadvantages, such as detachment and high cost, has been described for reattachment of medial canthal tendon. We present a new technique, namely, unitransnasal canthoplasty, which is easy to apply, cheap, and reliable.

A useful tool for intraoperative photography: underwater camera case.

The use of cameras in the operating room is increasing. However, there is not always a free person or an assistant who is familiar with your camera. In order to take faster and high quality photographs in the operating room, we use under water camera cases.

Biomechanical comparison of a new technique of mandibular angle fractures: biplanar and bicortical superior proximal 3 holes and bicortical inferior plate fixation.

Miniplates have been used for mandibular angle fractures during the past 2 decades. The technique of placing single miniplate at the upper border based on the tension lines of the fracture was proposed by Michelet and Champy. The need for a second miniplate to be applied to the lower mandible has been discussed recently.

A new technique in nipple reconstruction: dome technique with double pedicle.

Background: One of the main steps for satisfactory breast reconstruction is symmetrical nipple reconstruction in an ideal position and projection. Various techniques, using cartilage, bone, fat, and even hydroxyapatite crystals, have been proposed to overcome projection loss in late term.

Method: We present a new nipple reconstruction technique performed in 6 cases.

Reconstruction of the urethral defects with autologous fascial tube graft in a rabbit model.

Aim: To investigate the feasibility of the autologous fascia graft in urethra defect reconstruction.

Methods: In 24 adult male rabbits, a standardized defect (17 mm) was created within the midportion of each urethra. Two-cm long fascial tube grafts were interposed between the cut ends of the urethra.

Reconstructing wide palatomaxillary defects using free flaps combining bare serratus anterior muscle fascia and scapular bone.

Purpose: Wide palatomaxillary defects, mostly after tumor resections, can cause severe functional and esthetic problems. Although prosthetic obturator devices or local flaps are mostly adequate for uncomplicated small-size defects, free flaps are preferred for a 3-dimensional multitissue reconstruction of more complicated defects. Regarding the anatomical structure of the palatomaxillary region, the flap must be thin enough to separate the oral and nasal cavities while not compromising palatal function, yet rigid enough for adequate dental restoration.

A new nerve-muscle unit model for peripheral nerve studies in rats.

Ischiatic, femoral and tibial nerves are commonly utilized in the studies of peripheral nerve surgery in rats. The authors present a new nerve-muscle unit model in which the nerve is distal enough to minimize morbidity and the muscle is convenient for all electromyographic studies. Twenty-five Wistar-Albino rats were used.

Sialoblastoma: a congenital epithelial tumor of the salivary gland.

Sialoblastoma is a rare congenital epithelial tumor of the salivary gland that is diagnosed at birth or shortly thereafter with significant variability in histologic range and clinical course; hence, for an individual case, it may be difficult to predict the most appropriate therapy [Cancer 1972;30:459-69; Pediatr Pathol 1988;8:447-52; Br J Plast Surg 2000;53(8):697-699]. We report the case of a 4-year-old girl who had a widely spreading sialoblastoma of the left cheek. We were obligated to widely resect the tumor including the trunk of the facial nerve, superior part of the left maxilla, and the zygoma.