Browsing by Author "Erdem, A"

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    The use of titanium clips in septal surgery for correction and strengthening
    Manavbasi, YI; Kerem, H; Erdem, A
    Permanent correction of septal deformities is one of the most difficult and controversial subjects in aesthetic nasal surgery. The main reasons for failure in most of the corrective procedures are either not to weaken the septal cartilage enough to straighten it, or to treat the septum too radically causing iatrogenic deformities or predisposing it to new deformities postoperatively. Our approach to correct septal deformities relies on the principle of strengthening/reinforcing the septal cartilage (with or without some weakening maneuvers to correct the deformities beforehand) with application of titanium hemoclips at some critical locations in septum. Eighty-seven patients operated on between 2007 and 2009 are included in this study. Thirty-six of these patients had combined septo-nasal deformities while the remaining 51 had solely septal deformities. In 30 patients with septo-nasal deformity the technique was proven to be successful. The remaining 6 patients of this group had axial nasal deformity (rather than intrinsic septal problems) and did not respond to our technique successfully. Within four years of follow up, we did not encounter any recurrences, infections, ulcerations or exposure in the mucosa covering the titanium clips. None of the titanium clips were required to be removed for any reasons. (C) 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
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    A New Dynamic External Fixation Method in Finger Replantations and Toe-To-Hand Transfers
    Yildiz, K; Kerem, H; Karaaltin, MV; Erdem, A; Ozdemir, A; Ergun, SS; Guneren, E
    Objective: This study presents a simple and versatile finger fixation method facilitating rehabilitation in the early period and better functional results in replantation and toe-to-hand transfer patients. Methods: In 12 patients, bone fixations were performed by using a dynamic external finger fixator system. The duration of fixations was recorded. The potential complications, such as non-union, pain, joint stiffness, infection of pins, inadequate stabilization, and swelling, were documented. Subjective pain scale was applied on each patient, and the level of satisfaction of patients was examined. Results: All finger transfers and replantations were achieved. The mean time of bone fixation was 11.6 minutes (9 to 20 min.). Nonunion associated with fixation and infection did not occur. Whereas 8 patients were satisfied with the functional results, 3 replantation cases and 1 toe-to-hand transfer patient were dissatisfied. In the assessment of the appearance of the finger, 2 replantation cases and 4 toe-to-hand transfer patients (50% of all cases) were dissatisfied. Conclusion: We are convinced that this dynamic external fixation system, including versatile advantages, such as arranging earlier finger motion, having a simple and quick learning process, reducing the operation time, being able to be used as contributing material in anastomosis, and having fewer complications, can be successfully used in replantations and toe-to-hand transfers.
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    Comparison of Clinical Outcomes between Single- and Multiple-Perforator-Based Free Thoracodorsal Artery Perforator Flaps: Clinical Experience in 87 Patients
    Karaaltin, MV; Erdem, A; Kuvat, S; Çavdar, G; Kerem, H; Baghaki, S; Canter, HI; Özdemir, A
    Background: Although thoracodorsal artery perforator flaps have not gained popularity in the reconstructive era, the results of recent studies regarding the vascularity of thoracodorsal artery perforator flaps are promising. In the present study, the authors aimed to determine the clinical outcomes of free multiple-perforator versus single-perforator thoracodorsal artery perforator flaps. Methods: Eighty-seven patients with various defects underwent reconstruction with free thoracodorsal artery perforator flaps. The flap was used for upper extremity reconstruction in 43 patients (49.4 percent), for head and neck reconstruction in 16 patients (18.4 percent), and for lower extremity reconstruction in 28 patients (32.2 percent). Of the 87 flaps, 48 (55.2 percent) were based on a single perforator, whereas 39 flaps (44.8 percent) were based on multiple perforators. The single-and multiple-perforator-based thoracodorsal artery perforator flaps were compared regarding clinical outcomes and morbidity. Results: The morbidity rate was found to be significantly higher in the single-perforator-based group. Of the patients in the single-perforator group, seven patients had transient venous congestion, five were heparinized and treated with leeches for permanent venous congestion, six had partial necrosis, and one had total necrosis. In the multiple-perforator-based group, two patients had transient venous congestion, and no partial or total necrosis was observed. Conclusion: Despite the fact that dominant perforators may often be absent, this study showed that a multiple-perforator-based thoracodorsal artery perforator flap may be more reliable with safe vascularity compared with a single-perforator-based flap. (Plast. Reconstr. Surg. 128: 158e, 2011.)