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Öğe A 20-Year Retrospective Analysis of Skin Cancers: Comparison of the First and Second Decades(Duzce Univ, Fac Medicine, 2020) Derebasinlioglu, Handan; Nemmezi Karaca, SanemObjective: The incidence of skin cancer increases day by day depending on environmental factors. Developing diagnostic and pathological methods provide correct typing of skin cancers. Methods: This retrospective analysis included patients who presented to and were scheduled for treatment at Sivas Cumhuriyet University Plastic Reconstructive and Aesthetic Surgery Clinic between January 1, 2000 and December 31, 2019 due to skin cancer and carcinoma in situ. The results were divided two groups as first ten years and second ten years. The groups were compared among themself in terms of cancer type, age, gender and localization. Results: 619 cases of 652 skin cancer and in situ carcinoma results were detected. When the groups were compared in terms of tumor types detected, there was a significant increase in MM, Bowen's disease, and rare NMSC subtypes other than SCC and BCC in the second decade (p<0.001). Comparison of NMSC and MSC rates between the groups showed that the incidence of MSC had increased significantly from 5.2% to 10% in the past 10 years (p<0,05). Conclusions: Rare Non-melanocytic skin cancer group includes many types of carcinoma, there are various treatment protocols. Furthermore, many members of this group are known to be more aggressive than Basal cell carcinoma and squamous cell carcinoma. There are no consensus especially for approaches targeting lymph nodes. Closely following is necessary for early detection of recurrences and metastases.Öğe A Novel Technique for Reconstruction After Abdominoperineal Resection: V-Y Partially De-epithelized Turnover Flap with Its Own Inherent Mesh-A Three-Case Report(Springer India, 2022) Derebasinlioglu, Handan; Yilmaz, SarperThe main goal in reconstructions of the pelvic base after abdominoperineal resection is to close the defect with a well-vascularized tissue and prevent herniation by providing sufficient perineum support. Neoadjuvant radiotherapy generally leads the surgeon to distant muscle flap options; however, in the absence of radiation history, the use of local flaps is reasonable if they are of sufficient quality. In this article, we present the use of a V-Y partially de-epithelized turnover flap, a modification of the V-Y advancement flap, with perineal repair accomplished through a mesh flap of dermis, eliminating the requirement for a biologic mesh. We think that our modified flap adequately supported the perineal floor by utilizing a well-vascularized dermal mesh flap and provided a tension-free closure by filling up the dead space using a partial turnover maneuver.Öğe A simple and effective method for reconstruction of perioral defects: the transverse V-Y advancement flap(Springer, 2022) Derebasinlioglu, HandanBackground The perioral region is the most important area for facial expression, after the periocular structures. For the reconstructions of this region, an aesthetic outcome is as important as functional results in terms of the patient's social life. The purpose of this study was to discuss the functional and aesthetic outcomes achieved with transversely advanced V-Y flaps in reconstructions of the perioral region. Methods The study included 17 patients in whom transverse V-Y advancement flaps were used to repair full-thickness perioral defects resulting from malignant tumor resection. The patients were evaluated in terms of functional and aesthetic outcomes, complications, and need for revision surgery. To evaluate postoperative outcomes, a control group with no history of surgical interventions to the lips or perioral region was selected. Measurements of the lower and upper lips, mouth opening height, and mouth opening width were obtained from the controls and postoperatively from the patients. Results Lower lip reconstruction was performed in 13 patients (76.4%) and upper lip reconstruction was performed in 4 patients (23.5%). Total lower lip reconstruction was performed in 3 patients. Postoperative measurements were statistically equivalent to those of individuals with no surgical history. No cosmetic deformity formation or microstomia which require surgical treatment were observed in any of our patients. Conclusions This technique is a simple, useful, functional method with short procedure time and satisfying aesthetic outcomes for patients with total or partial lower and upper lip defects. Level of evidence: Level IV, therapeutic study.Öğe Age distribution of mandibular fractures and concomitant injuries(Springer, 2022) Derebasinlioglu, Handan; Cankorkmaz, LeventBackground Facial fractures can be accompanied by various injuries to other parts of the body. These associated and concomitant injuries worsen the prognosis of facial trauma, as they may cause functional disabilities or mortality. The aim of this study was to evaluate the distribution and features of mandibular fractures and concomitant injuries according to the age group. Methods Patients who underwent surgery for mandibular fracture were retrospectively screened from the hospital information system. The patients' age, sex, etiology of injury, and any non-mandibular facial and skull fractures and concomitant injuries were evaluated. Results A total of 141 patients were included. The patients ranged in age from 1 to 76 years with a mean (SD) age of 29.06 (16.47) years. Only dentoalveolar arch fractures differed according to age (p = 0.036). The prevalence of dentoalveolar arch fractures was significantly higher in patients under 18 years of age than in patients between 18 and 59 years of age. There were no statistically significant differences in rates of concomitant facial, skull fractures, or other body injuries according to age (p > 0.05). Conclusions Despite the physiological and anatomical differences between the pediatric and adult patients, they did not make any difference in terms of mandible fractures and injuries concomitant with these fractures.Öğe An Effective Option for the Repair of Facial Defects: V-Y Advancement Flaps and Modifications(Dergipark Akad, 2020) Derebasinlioglu, Handan; Yilmaz, Sarper; Uzunoglu, Kadriye IpekObjective: V-Y advancement flaps are pliable local flaps that can be used in nearly every part of the body with relatively minimal technical difficulty. These flaps provide the best color and quality match, especially in the facial region. With effective planning, donor site morbidity can be acceptable, even on the face. Methods: The results of 38 patients who underwent 53 V-Y advancement flap facial reconstructions were analyzed retrospectively. The defects were evaluated according to their anatomical region, etiology, postoperative complications, and final aesthetic results. Results: V-Y advancement flaps were used for defects that were either not amenable to primary repair or had a high risk of cosmetic distortion. The defects were located in the cheek (9 patients), nasolabial fold (7 patients), nose (6 patients), forehead (5 patients), preauricular area (3 patients), infraorbital region (3 patients), lower lip (1 patients), gingivobuccal sulcus (2 patients), and medial canthal region (2 patients). In 32 patients, the primary pathology was malignant tumor (22 basal cell carcinomas, 9 epidermoid carcinomas, 1 malignant eccrine poroma). Etiologies of the other patients' defects were benign tumors (n=2), traumatic wounds (n=2), and contractures (n=2). Conclusions: Despite the widespread use of V-Y flaps in surgical practice, the technique continues to demonstrate additional advantages, particularly in facial reconstruction. They are not only applicable for medium and small defects, but can be used for all defects with sufficient surrounding tissue. They enable various modifications and the elevation of multiple flaps.Öğe Analysis of Basal Cell Carcinoma and Squamous Cell Carcinoma according to Nasal Subunit Location(Thieme Medical Publ Inc, 2021) Derebasinlioglu, Handan; Ozkaya, Nese KurtThe nose is highly vulnerable to skin cancers due to the unavoidable sun exposure. The most common localization of skin cancers on the face is nose. Although the nose appears to be a single structure, it comprises many aesthetic units with different histological and anatomical properties. Our aim was to determine the relationship between the prevalence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), histologically and anatomically distinct nasal subunits. The study included patients who underwent excision and repair due to BCC or SCC of the nose. The lesions were classified according to their location in the following topographic subunits: tip, alar lobule, dorsum, sidewall, and medial canthal region. Patients were analyzed according to age, sex, topographic subunit, tumor type, and repair technique. There was no statistically significant difference in tumor location according to etiology ( p >0.05). The alar subunit was the most common location of BCC, while the dorsum was the most common location for SCC. There is no statistical relationship between the two most common skin cancers, BCC and SCC, and the aesthetic subunits of the nose. The only factor associated with the reconstruction method used was the subunit in which the tumor was located.Öğe Coincidence of Malignant Melanoma and an Incidently Discovered Parotid Mass Presenting a Diagnostic Challenge(LIPPINCOTT WILLIAMS & WILKINS, 2018) Derebasinlioglu, Handan; Yilmaz, SarperParotid masses coincided with skin tumors in head and neck region may represent a serious diagnostic challenge. Conventional imaging modalities such as computed tomography, magnetic resonance imaging may help to determine nature of the masses. Positron emission tomography - computed tomography imaging is reported to be useful for the detection of malignancy in the parotid gland. But in some situations all of them become insufficient. We present a case of cheek malignant melanoma with an incidentally discovered parotid mass during the investigation. We describe the problems experienced in the course of differential diagnosis and decision making in terms of surgical management. As a result, the most reliable diagnosis of suspicious parotid lesions accompanying head and neck melanomas comes from frozen section analyses. The other diagnostic tools are not reliable enough to allow a safe surgical plan in terms of regional treatment; however, the significance of positron emission tomography - computed tomography in distant metastasis investigation should always be kept in mind.Öğe Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps(Thieme Medical Publ Inc, 2021) Demiroz, Anil; Derebasinlioglu, Handan; Ercan, Alp; Arslan, Hakan; Aydin, Ovgu; Ekmekci, Hakan; Balci Ekmekci, OzlemBackground Ischemia-reperfusion injury plays an important role in flap failure. Ischemic preconditioning technique is the only proven method for preventing ischemia-reperfusion injury, but it is not used widely in daily practice because of difficulties such as prolonging the operation time, need for surgical experience, and increasing the risk of complications. This study has been performed with the assumption that piracetam may be a simple and inexpensive alternative to the preconditioning technique due to its antioxidant, antiaggregant, rheological, anti-inflammatory, antiapoptotic, cytoprotective, and immune modulating effects. Methods Thirty-two rats were divided into four groups and latissimus dorsi musculocutaneous flaps were raised. No extra procedure was applied, and no treatment was given to the control group. Four hours of ischemia was created by clamping the thoracodorsal pedicle in the second group. The animals in the third group were treated with 10minutes of ischemia and reperfusion periods as a preconditioning procedure before the 4hours of ischemia. Animals in the fourth group received systemic piracetam 30minutes before and 6 days after reperfusion. Nitric oxide and myeloperoxidase levels in serum and tissue, acute inflammatory cell response, and vascular proliferation in tissue were examined at the postoperative 24th hour and 10th day. Results Myeloperoxidase activity in both preconditioning and piracetam groups, was significantly lower than the ischemia-reperfusion group. Acute inflammatory cell response was similarly decreased in both preconditioning and piracetam groups compared with ischemia-reperfusion group. Tissue measurements of nitric oxide were also significantly higher in both preconditioning and piracetam groups than in the ischemia-reperfusion group. However, vascular proliferation increased in the preconditioning group, while it did not show any significant change in the piracetam group. Conclusion This study shows that systemic piracetam treatment provides protection against ischemia-reperfusion injury in musculocutaneous flaps and can offer a simple and inexpensive alternative to the preconditioning technique.Öğe Distribution of skin cancers of the head and neck according to anatomical subunit(Springer, 2022) Derebasinlioglu, HandanPurpose The skin tumors can occur on any part of the body, these anatomical subunits are considered prognostic factors for localized carcinomas. Tumor size is a prognostic criterion that also varies according to the anatomical location of these tumors. Head and neck region is the most common location. This study aimed to investigate the distribution of BCC, SCC, and MM in the anatomical subunits of the head and neck region and their relationships with these anatomical subunits. Materials and methods Patients who underwent surgery for BCC, SCC, BSCC and/or MM in the head and neck region. The head and neck region was divided topographically into the following subunits: scalp, forehead, orbital region, ear and periauricular region, cheeks, nose, perioral region, and neck. Patients were analyzed according to age, sex, and tumor location, type, and size. Results The SCC group was found to have significantly larger mean tumor size than the BCC group (p = 0.003). SCC was more frequently located in the perioral region (p = 0.001), BCC was more frequently located on the nose (p = 0.001), and MM was more frequently located on the forehead and scalp (p = 0.034, p = 0.49) when compared with the other types. BCC was more frequently located in the orbital region than SCC (p = 0.018) Conclusions In this study, we observed statistically significant differences in the distribution of BCC, SCC, and MM, the most common types of skin cancer, among the topographical subunits of the head and neck region.Öğe Evaluation of osteomyelitis in diabetic foot ulcers with bone(Cambridge Media, 2023) Derebasinlioglu, Handan; Aksoy, OnurPurpose Exposed bone and periosteal damage promote the adherence of pathogens to bone matrix components. Damage to the periosteum adversely affects bone perfusion and creates a more suitable environment for pathogens. The purpose of this study was to determine the prevalence of osteomyelitis among patients with diabetic foot ulcers with bone exposure and to identify the role of simple serological markers in the diagnosis of osteomyelitis in this patient group.Methods Patients who underwent amputation and debridement due to diabetes-related foot wound were included in the study. The pathology results were evaluated according to presence of osteomyelitis. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), complete blood count (CBC), platelet/lymphocyte ratio, neutrophil/lymphocyte ratio (NLR) and microbial growth were analysed.Results Patients with ESR of 79mm/h or lower had a 3.046-fold higher risk of osteomyelitis. The risk of osteomyelitis was 2.901-fold higher at lymphocyte percentages of 12.3% or higher. Patients with a neutrophil percentage of 78% or lower had a 3.010-fold higher risk of osteomyelitis. Patients with NLR of 6.02 or lower had a 2.901-fold risk of osteomyelitis. When ESR was evaluated with neutrophil percentage, lymphocyte percentage and NLR, the sensitivity was calculated as 86.76% for osteomyelitis.Conclusion We believe that the immune response caused by bone exposure to the environment is different than the immune response caused by soft tissue infection in the classical diabetic foot. The combined evaluation of multiple diagnostic parameters increases the sensitivity of osteomyelitis diagnosis.Öğe The effect of a silicone sheet on sciatic nerve healing in rats(Springer, 2023) Derebasinlioglu, Handan; Demirkazik, Ayse; Dogan, Inanc Cicek; Egilmez, H. Reyhan; Cam, Selim; Yeldir, NeseBackgroundFibrosis occurs during the healing process after nerve injury. Extraneural fibrosis occurs around the epineural sheath. Intraneural fibrosis occurs in the internal structure of the nerve. Prophylactic treatment with silicone gel sheets is effective in preventing severe scarring in the skin. Nerve action potential (NAP) recording is a well established, simple, and useful tool in the surgical treatment of nerve damage. Our aim in this study was to determine the effect of a silicone sheet on biophysical and histopathologic parameters when used in the treatment of peripheral nerve transection (neurotmesis) and crush injuries.MethodsThe study was conducted with 32 Wistar albino male rats. The rats in the neurotmesis and crush injury groups were divided into study and control groups. Before the injury and after 12 weeks, electrophysiological measurements were obtained. The sciatic nerve biopsy specimens were histopathologically evaluated.ResultsAfter 12 weeks, there was no statistical difference between pre- and post-injury Delta PP values in the PNR+SS group (p = 0.123). There was no statistically significant difference in post-injury Delta PP values between the CI and CI+SS groups (p = 0.201). The mean total histopathological score was significantly higher in the PNR+SS group than in the PNR group (p = 0.023).ConclusionsIn this rat model, a silicone sheet appears to have positive effects on peripheral nerve healing after primer repair and crush injury.Öğe The Effect of Dermal Suspension on Early Complications After Vertical Reduction Mammoplasty(Springer, 2022) Derebasinlioglu, Handan; Nemmezi Karaca, Sanem; Aksoy, OnurBackground Reduction mammoplasty is frequently performed in plastic surgery clinics. The vertical technique can be performed using several different pedicles, including superior, superomedial, medial, and lateral. For patients with large breasts, using a medial pedicle is recommended as a safer approach. Superficial wound dehiscence is common with all breast reduction techniques. Methods The present study compared early complications in patients who underwent reduction mammoplasty with superior pedicle, medial pedicle, or medial pedicle with dermal suspension performed by the same surgeon. The patients were evaluated in terms of age, weight, height, pedicle type and technique used for vertical reduction mammoplasty, resected tissue mass, suprasternal notch (SSN) to nipple-areola complex (NAC) distance, NAC transposition distance, and drain duration. Results Pairwise comparisons revealed that wound dehiscence along the inframammary fold (IMF) was significantly less frequent in the superior pedicle group than the medial pedicle without suspension group (p = 0.018). Although not statistically significant, using the suspension method in medial pedicle procedures reduced the rate of IMF wound dehiscence from 32.4 to 25%. Delayed IMF wound healing was associated with the amount of resected tissue (p = 0.004) but not with age, BMI, SSN-to-NAC distance, NAC transposition distance, or drain duration. Conclusion Suspending the medial pedicle from the chest wall reduced the rate of IMF wound dehiscence.
