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Now showing 1 - 3 of 3
  • PublicationMetadata only
    Simplifying Free Nipple Graft Mammoplasty in Postmenopausal Obese Patients using Inferior Dermaglandular Flap
    (2021-06-01T00:00:00Z) Kelahmetoglu, Osman; ÇAMLI, MEHMET FATİH; ÜNAL, Mustafa; Yagmur, Caglayan; Firinciogullari, Remzi; GÜNEREN, Ethem; ÇAMLI, MEHMET FATİH; ÜNAL, MUSTAFA; GÜNEREN, ETHEM
    Breast hypertrophy causes medical problems ranging from back and neck pain to dermatitis creating a demand for breast reduction surgery along with aesthetic and psychological reasons. Free-nipple-graft breast reduction surgery is a safeguard procedure for patients who are at risk for nipple necrosis with pedicled techniques but has a disadvantage of resultant flat breasts with poor projection. Study included twenty-three postmenopausal women who underwent breast reduction with inferior pedicled dermaglandular flap and free-nipple-grafting, between September 2015 and January 2020. A rectangular 8 x 10 cm inferior-pedicled dermaglandular flap was dissected and anchored to the thoracic wall for better projection and upper pole fullness. All patients had at least one comorbidity. Visual analog scale was evaluated at 1-3 months. Mean age of the patients was 54.08 SD 4.65 years, and mean body mass index (BMI) was 33.56 SD 2.53. Mean follow-up period was 10.56 SD 5.6 months. Mean SN-N distance was 37.45 SD 3.77 and 38.86 SD 3.91 cm for right and left breasts, respectively. Mean resection weight was 1373 SD 440 g. Wound dehiscence was seen in 3 patients (13.0%) and treated medically. No other complications, including total nipple areolar complex (NAC) loss, were seen. Mean visual analog scale score for patient satisfaction was 7.7. All patients were satisfied with their final breast shapes. Utilizing inferior dermaglandular pedicled flap technique with free-nipple-graft breast reduction mammaplasty provides better nipple projection and a more aesthetically pleasing breast shape and contour. It helps achieve an effortless preoperative planning and a straightforward procedure with high patient satisfaction in postmenopausal obese women.
  • PublicationMetadata only
    Traumatic Avulsion of Upper Eyelid Skin Following Surgery in a Patient With Multiple Myeloma and Amyloid Light-chain Amyloidosis
    Multiple myeloma (MM) is a common hematologic malignancy. Primary systemic amyloidosis or amyloid light-chain (AL) amyloidosis is a rare disease. PURPOSE: This article presents the case of a patient with MM and AL amyloidosis who experienced a severe case of medical adhesive-related skin injury. CASE STUDY: A 64-year-old man with MM, AL amyloidosis, and diabetes presented with a necrotic wound on his left heel that required surgical debridement. The patient experienced a traumatic avulsion of the right upper eyelid skin during the removal of the corneal abrasion preventive tape as well as traumatic avulsion of the left upper eyelid skin while the patient-s face was being cleansed. The avulsed right upper eyelid skin above the tarsus was repaired with a full-thickness skin graft. The partly avulsed left upper eyelid skin was repositioned, and an excisional biopsy was taken. Both upper eyelids healed uneventfully. The biopsy specimen revealed increased amyloid deposition in the dermis, subcutaneous tissue, and areas surrounding the veins and sweat glands. CONCLUSION: This case illustrates the increased risk of medical adhesive-related skin injury and other skin damage in patients with MM and AL amyloidosis. In these patients, the use of tape should be avoided to prevent intraoperative corneal abrasion.
  • PublicationMetadata only
    Free ALT Perforator Flap in Nonobese Patients: The Recontouring of Soft Tissue Defects Around Foot
    (2021-09-01T00:00:00Z) Kelahmetoglu, Osman; MEHDIZADE, TURAN; ÜNAL, Mustafa; Keles, Musa Kemal; GÜNEREN, Ethem; MEHDIZADE, TURAN; ÜNAL, MUSTAFA; GÜNEREN, ETHEM
    Background The anterolateral thigh (ALT) perforator flap is well-described and versatile option for reconstruction of soft tissue defects around foot and ankle. This retrospective review was performed for reconstruction of soft tissue defects around foot with ALT perforator flaps in patients with normal and overweight body mass index (BMI). Methods Between January 2016 and November 2020, ALT flaps were used in 30 patients for foot defects. Results Etiologic factors were trauma (18 patients), diabetic foot ulcer (6 patients), tumor (3 patients), infection (2 patients) and burn contracture (1 patient). Mean body mass index (BMI) value was 24.9 +/- 4.1 (17-30). Mean flap dimension was 145 +/- 86 (40-420) cm(2). Recipient vessels were anterior tibial artery in 17 patients (56%), posterior tibial artery in 12 patients (40%), reversed flow dorsalis pedis artery in 1 patient (3.3%). In 24 patients (80%), 2 vein anastomoses were done. Debulking were applied in two patients (6.6%). Donor area was grafted in four patients (13.3%). Mean flap score was 1.25 +/- 0.5. Mean flap thickness was 10 +/- 2 (7-14) mm. Visual Analogue Scale (VAS) score was 7.75 +/- 1.04 (6-10). The patients were followed up for a mean of 14 +/- 11 (1-30) months. Conclusion We think that ALT flap is still reliable and precious option because it provides ideal soft tissue reconstruction by means of recontouring of foot in nonobese patients.