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Öğe Aesthetic reconstruction of large scalp defects by sequential tissue expansion without interval(Springer, 2004) Gürlek, A; Alaybeyoglu, N; Demir, CY; Aydogan, H; Bilen, BT; Öztürk, ATissue expansion is indicated in the reconstruction of various scalp defects when there is inadequate adjacent tissue to allow either primary closure of the defect or repair with a local flap. It is the most important armamentarium for aesthetic hair-bearing scalp reconstruction in cases of congenital or required defects. This technique was used sequentially without interval to achieve scalp reconstruction for 12 patients with a defect ranging from 30% to 75% of the scalp (average, 55%). For 12 patients, 32 expansion treatments were undertaken between September 1997 and January 2002. The 12 patients included 3 women, 4 men, and 5 children with a mean age of 20 years (range, 45 days to 36 years). All patients had more than one period of treatment. The most common conditions treated were burns (n = 7). trauma (n = 1), congenital naevi (n = 2), and male pattern baldness (n = 2). Reconstruction of 12 large scalp defects has been performed with a 3.1% rate of major complications. Results show that tissue expansion is a safe and efficient but time-consuming technique for aesthetic scalp reconstruction, especially in the case of sideburn scenario or large defects. There was no significant alteration in ratio of complications although tissue expansions were made sequentially.Öğe Correction of the crooked nose using custom-made high-density porous polyethylene extended spreader grafts(Springer, 2006) Gürlek, A; Ersoz-Ozturk, A; Celik, M; Firat, C; Aslan, S; Aydogan, HCorrection of the crooked or deviated nose, a complex cosmetic and functional problem, is a big challenge for the rhinoplasty surgeon. Although corrections using a wide range of surgical techniques to straighten the nose and maximize nasal function have been proposed, recurrence is very common because of cartilage memory and scar contracture. Therefore, to prevent recurrence and to maintain the correction of the septum, a permanent support that is stable and strong, with the ability to maintain its given shape after placement on one or both sides of the septum, is needed. For this purpose, the authors planned to use a pair of custom-made high-density porous polyethylene (HDPP) extended spreader grafts. In this study, the concept and technique of HDPP, composed of a nonresorbable alloplastic material for correction of the crooked nose, and the authors' experience using it, are presented. Currently, HDPP is readily available on the market as a thin plain sheet (0.85 x 38 x 50 mm) that can be cut to an appropriate size for spreader grafts. Ingrowths of fibrous tissue inside and around HDPP stabilize the upper lateral cartilages and septum in their new corrected position and maintain the corrected/straightened position. This material was used in 20 patients with crooked noses (9 with C-type and 11 with S-type noses). During a mean follow-up period of 18 months (range, 8-30 months), there were no complications, recurrences, or extrusions. Functional evaluation was performed using a visual analog scale before surgery and 6 months after surgery. Patients were asked to score their nasal breathing on a scale ranging from 0 to 100. The mean preoperative value was 32.50% +/- 11.18%, and the postoperative value was 88.75% +/- 8.71%. In conclusion, the use of custom-made HDPP extended spreader grafts is a safe, effective, reliable, and permanent method for correction of the crooked nose. In the long term, the authors believe that custom-made HDPP extended spreader grafts provide functional recovery and increased strength against further trauma or forces of scar contracture, and have the ability to prevent recurrence attributable to cartilage memory.Öğe An easy way of finding a vein in microsurgery(Lippincott Williams & Wilkins, 2003) Gürlek, A; Askar, I; Bilen, BT; Çelik, M; Fariz, A; Aydogan, H; Arslan, A[Abstract Not Available]Öğe Endoscopically assisted minimal laparotomy for jejunal harvest(Lippincott Williams & Wilkins, 2002) Gürlek, A[Abstract Not Available]Öğe Epidermoid carcinoma arising in chronic lymphedema(W B Saunders Co Ltd, 2003) Bilen, BT; Gürlek, A; Alaybeyoglu, N; Çelik, M; Aydin, NELymphangiosarcoma is a well recognized complication of chronic lymphedema, but epidermoid carcinoma is rarely seen. (C) 2003 Elsevier Ltd. All rights reserved.Öğe Grafting the nasal dorsum with tandem ear cartilage(Lippincott Williams & Wilkins, 2004) Gürlek, A; Aydogan, H; Askar, I[Abstract Not Available]Öğe Lengthening of the amputation stumps in hand by distraction osteogenesis(Medimond S R L, 2002) Gürlek, A; Inan, M; Bilen, BT; Aydogan, H; Ersöz, A; Çelik, M; Fariz, ADigital amputations have been seen commonly at the emergency services. Mutilation, functional, cosmetic and psychological problems occur when they can not be transplanted or failed after transplantation. Bone lengthening was carried out on 18 digital amputation stumps of 10 patients by distraction osteogenesis (Ilizarov's method) during the period of January 2000 to January 2002. Mean age was 14.2+/-8.1, ranging between 4 and 27 years. The average lengthening achieved 28.4 +/- 83 (15 - 50 mm). Distraction durations varied between 20 -70 (mean 35.2 +/- 8.3) and consolidation between 45 -120 days (mean 74.2 +/- 17.1). Two pin-tract infections, one bone fracture because of trauma, one early fusion of osteotomy and severe pain in two patients due to distraction were observed as complication. Distraction osteogenesis is very effective, simple, no necessity to donor area in the treatment of amputation stumps to get function; in spite of requiring long duration, patience and a good cooperation of both family and patient.Öğe Metastatic fibrosarcoma of the brain(Japan Neurosurgical Soc, 2004) Erguvan-Önal, R; Önal, Ç; Gürlek, A; Alkan, A; Erkal, HS; Mizrak, BA 45-year-old woman presented with an extremely rare metastatic fibrosarcoma of the brain manifesting as persistent headache. She had undergone surgery for a fibrosarcoma of the soft tissue of the thigh 2 months earlier. She had a history of previous surgery and radiotherapy for this tumor. She was somnolent with papilledema and left hemiparesis. Magnetic resonance imaging of the brain revealed a right frontal lesion with mass effect and heterogeneous enhancement. Computed tomography and scintigraphy showed multiple metastatic lesions of the lung. Right frontal craniotomy was performed for gross total removal of the yellowish-white tumor. Histological examination showed signs of epithelioid transformation based on positive staining for epithelial membrane antigen compared to the primary tumor. Postoperatively the patient was alert and the left hemiparesis improved. She refused radiotherapy or chemotherapy. Follow-up computed tomography showed multiple intracranial metastases. She died 5 months after the surgery.Öğe Salutary effects of radiopaque contrast media on the survival of random-pattern skin flaps in the rat(Wiley, 2004) Askar, I; Bozkurt, M; Oktay, MF; Gürlek, A; Keles, CThe radiopaque contrast medium diatrizoate, has a vasodilator effect so that it is used in sudden-deafness secondary ischemic injury. However, ischemic problems are encountered, especially when longer flaps are elevated. A longer flap also has ischemic and relatively ischemic tissue, and may obtain some benefit from contrast media. Forty male Sprague-Dawley rats, weighing about 350-400 g, were used, and randomly divided into four groups (n = 10 rats each group): group 1 was the control, group 2 the diatrizoate, group 3 the iopamidol, and group 4 the iothalamate group. A rectangular 3 x 10 cm caudally based dorsal skin flap was elevated, and sutured back to its original place. In the control group, no pharmacologic agent was administered. Sodium-meglumine-diatrizoate 10 mg/kg/day was administered parenterally in the first experimental group (diatrizoate group); iopamidol 10 mg/kg/day in the second experimental group (iopamidol group); and iothalamate sodium 10 mg/kg/day in the third experimental group (iothalamate group) for 7 postoperative days. On postoperative day 7, all flaps were photographed, and the area of flap survival was measured by using a polar planimeter. The results were statistically evaluated with the Kruskal-Wallis test and Mann-Whitney U-test (P = 0.05). The mean flap survival ranged from 79% in the iopamidol group to 83% in the diatrizoate group, and was significantly greater in all experimental groups (P < 0.05) compared to the control group (59%). There was no significant difference between experimental groups (P < 0.05). We believe that radiopaque contrast media have a beneficial effect in improving skin flap viability when distal flap necrosis is a potential complication of longer flaps. (C) 2003 Wiley-Liss, Inc.Öğe Straightening the crooked middle third of the nose(Amer Medical Assoc, 2005) Gürlek, A; Fariz, A; Celik, M; Ersöz-Öztürk, A; Arslan, A[Abstract Not Available]Öğe A total lower lip reconstruction with a composite radial forearm-palmaris longus tendon flap(Lippincott Williams & Wilkins, 2005) Gürlek, A; Aslan, A; Celik, M; Aydogan, H; Alaybeyoglu, N[Abstract Not Available]Öğe A transverse rectus abdominis myocutaneous (TRAM) flap for reconstruction of a large deformity in the buttock(Taylor & Francis As, 2005) Gürlek, A; Demir, CY; Askar, I; Aydogan, H; Alaybeyoglu, N; Coban, KA rectus abdominis myocutaneous flap has been used to repair the abdominal wall, chest wall, sternum, breast, and groin. We describe a patient in whom a large deformity in the buttock caused by a road crash was repaired with a transverse rectus abdominis myocutaneous (TRAM) flap. Distally-based TRAM flaps provide a good and reliable way of reconstructing the buttock. Its advantages are a long arc of rotation and well-vascularised bulky tissue that serve as a partition and promote quick healing of the defect. However, the flap is not the first choice for traumatic and infected wounds where fatty tissue is not desired.Öğe An unusual complication of septorhinoplasty -: Massive subarachnoid hemorrhage(Lippincott Williams & Wilkins, 2004) Koçak, A; Gürlek, A; Kutlu, R; Celbis, O; Aydin, NESeptorhinoplasty is a very common operation in the practice of plastic surgery and otolaryngology. We report a case with massive subarachnoid hemorrhage originating from carotid artery injury, following corrective septorhinoplasty. The carotid rupture is a very rare but life-threatening, major complication of nasal surgery. Therefore, surgeons performing surgery in this area should be very careful and aware of this entity. According to our knowledge, this is the fourth case report of a carotid artery injury following septorhinoplasty, but it is the first bilateral and lethal one in the literature.Öğe The use of high-density porous polyethylene as a custom-made nasal spreader graft(Springer, 2006) Gürlek, A; Celik, M; Fariz, A; Ersöz-Öztürk, AE; Eren, AT; Tenekeci, GThe concept and technique of using high-density porous polyethylene (HDPP), a nonresorbable synthetic material, for nasal spreader grafts, are presented. This material is thought to be particularly useful in revision (secondary or tertiary) rhinoplasty, in which internal valve collapse frequently is confronted and septal cartilage often is unavailable because it has been harvested for spreader or other grafts. Sold as a thin plain sheet (0.85 x 38 x 50 mm) that can be cut to an appropriate size for spreader grafts, HDPP is a ready-to-use material commercially available on the market. Because HDPP permits ingrowths of fibrous tissue inside and around, it is a nonabsorbable material that stabilizes the upper lateral cartilages in their new position and maintains the appropriate internal valve angle. The authors used this material for 15 patients undergoing secondary (n = 12) and tertiary (n = 3) rhinoplasty because of valvular collapse. During the mean follow-up period of 16 months (range, 8-30 months), neither complication nor recurrence of airway obstruction occurred.Öğe The use of suture cover as an internal nasal splint(Lippincott Williams & Wilkins, 2004) Gürlek, A; Çoban, K; Aydogan, H; Çelik, M; Aslan, A[Abstract Not Available]Öğe The versatility of the pudendal thigh fasciocutaneous flap used as an island flap(Lippincott Williams & Wilkins, 2002) Gürlek, A[Abstract Not Available]
