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Öğe Camouflaging Cleft Lip Scar Using Follicular Unit Extraction Hair Transplantation Combined with Autologous Fat Grafting(LIPPINCOTT WILLIAMS & WILKINS, 2018) Akdağ, Osman; Evin, Nuh; Karameşe, Mehtap; Tosun, ZekeriyaBackground: The scar that occurs after cleft lip surgery poses a serious cosmetic problem. One of the methods used to solve this problem in adult male patients is hair transplantation. However, satisfactory results with this method cannot always be achieved because of possible graft loss. The corrective feature of fat grafting has been reported in many studies. The authors' aim with this report is to share their results with hair transplantation combined with fat grafting in patients with cleft lip. Methods: This study included 20 patients who had both a scar and alopecia in the cleft lip area. The patients underwent fat grafting from the periumbilical region by means of miniature liposuction harvesting cannulas. Three months after fat injection, hair transplantation was performed with hair from the submental area and scalp using the folliculate unit extraction technique. Patients were followed for 12 months. Survival rate of transplanted hair and patient satisfaction were analyzed after the procedures. Results: After this camouflaging technique with fat grafting and hair transplantation, the scar was hidden quite well. The graft survival rate was also better compared with results from similar studies. Patient and observer satisfaction results with the scar tissue were significantly improved, which was confirmed statistically. Conclusions: This study demonstrates that this combined camouflaging technique is a very effective treatment in male patients with cleft lip who have serious secondary upper lip scars. The authors present a series of patients treated with this technique, which resulted in a high level of patient satisfaction.Öğe Columellar Scar Perception in Open Rhinoplasty. Interplay of Scar Awareness, Body Cathexis and Patient Satisfaction(SPRINGER, 2017) Yagmur, Çağlayan; Ak, Sertaç; Engin, Murat Sinan; Evin, Nuh; Kelahmetoğlu, Osman; Akbaş, Hayati; Demir, AhmetOpen and closed approaches for rhinoplasty have individual advantages and disadvantages; however, the resultant columellar scar of the open approach is directly considered as a disadvantage. This study focuses on the columellar scar awareness and its implications on overall satisfaction of the patients after open rhinoplasty. A total of 91 patients who have undergone open rhinoplasty were included in this study. A written questionnaire algorithm consisting of 4 sequential questions was applied. Except for the first question [Do you have any scar(s) caused by any trauma, operation or any other reason on your face?], every question was answered on a scale from 1 to 5. The respondents were given the 25-question "Modified Body Cathexis Scale (MBCS)"and their scars graded using the "Columellar Scar Assessment Scale" (CSAS). The data were statistically interpreted. Of the 91 open rhinoplasty patients, 12 of them responded with a "yes" to the first question reporting their columellar scars. There was no significant difference with regards to patient satisfaction regarding these patients (p > 0.05). However, those who reported the scar yielded a significantly lower MBCS scores. 9 patients declared that they exerted effort to conceal their scars. Those who concealed their scars and those who did not yielded a significant difference in patient satisfaction. The CSAS scores of those who reported the columellar scar were significantly higher than those who did not. Our study suggests that MBSC can be a valuable tool for determining the impact of outcomes from the patient's standpoint, and awareness of the columellar scar is not related to patient satisfaction but with bodily perception.Öğe Pediyatrik Olgularda Yanığa Bağlı Baş Boyun Bölgesi Deformitelerinin Kolajen-Elastin Matriks Kullanılarak Tek Aşamalı Cerrahi Tedavisi(2017) Yağmur, Çağlayan; Evin, Nuh; Engin, Murat Sinan; Şimşek, Tekin; Küçüker, İsmail; Demir, AhmetAmaç: Pediyatrik olgularda yanığa bağlı ciddi baş boyun deformitelerinin düzeltilmesi, sınırlı tam kalınlıkta deri grefti verici sahası, sınırlı flep seçeneği ve ekspander yerleştirilmesindeki kısıtlılıklar gibi teknik zorluklar nedeniyle zorlayıcı olabilmektedir. Bu çalışmada pediyatrik olgularda yanığa bağlı oluşan baş boyun deformitelerinin kollajen elastin matriks (Matriderm) kullanılarak tek aşamalı cerrahi tedavisine yönelik tecrübemiz aktarılmaktadır.Gereç ve Yöntemler: Toplam olgu sayısı sekiz (dört kız, dört erkek) idi. Hastaların yaşları iki ile 11 arasında değişmekteydi. Tüm olgular sadece tek bir bölge için opere edildiler. Kontraktürlerin serbestlenmesi ve/veya geniş aşırı/uygunsuz skarların eksize edilmesini takiben oluşan doku eksiklikleri kollajen elastin matriks (Matriderm) ile kombine şekilde uygulanan kısmi kalınlıkta deri grefti (KKDG) ile onarıldı. Sonuçların estetik ve fonksiyonel değerlendirmesi muayene ve fotoğraflama ile yapıldı. Elde edilen fonksiyonel ve estetik sonuçlar fotoğraf ve muayene yöntemiyle değerlendirildi.Bulgular: Deformiteler kontraktürler ve/veya aşırı dermal skarlaşma şeklindeydi. Üç hastada deformite yüzde, beş hastada deformite boyundaydı. Matriderm üzerine uygulanan kısmi kalınlıkta deri greftleri uygun esneklik ve doku uyumuna ulaştı. Tüm kontraktürler problemsiz şekilde iyileşti. İki hasta minör greft kaybı (sırasıyla %5 ve %12) nedeniyle tekrar opere edildi.Sonuç: Bu çalışmada elde ettiğimiz veriler doğrultusunda kollajen elastin matriks (Matriderm) ile kombine şekilde uygulanan kısmi kalınlıkta deri greftinin, sınırlı cerrahi seçeneğin olduğu "yanık sonrası pediyatrik baş-boyun deformitelerinin rekonstrüksiyonunda" uygun bir seçenek olabileceğini ileri sürüyoruz.Öğe Post-Burn Skin Deformities of the Face and Neck Region in Pediatric Patients: Single-Stage Treatment Using Collagen Elastin Matrix(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2017) Yagmur, Çağlayan; Evin, Nuh; Engin, Murat Sinan; Şimşek, Tekin; Küçüker, İsmail; Demir, AhmetObjective: Treating severe post-burn deformities of the face and neck region in pediatric populations is challenging because of technical difficulties (e.g., limited full thickness skin graft donor site, limited flap options, unavailability for expander placement) and increased donor site morbidity (e.g., related to flap and graft donor sites). In this study, we present the single-stage treatment of severe post-burn skin deformities of the face and neck region in pediatric patients using collagen-elastin matrix (Matriderm (R)) combined with partial thickness skin grafts. Material and Methods: The total number of cases was eight (four females, four males), and the ages were between two and 11 years. All cases were operated on for only one region. Following the release of contractures and/or excision of wide excessive/unfavorable dermal scars, defects were reconstructed using collagen-elastin matrix (Matriderm (R)) combined with partial-thickness skin grafts. The final functional and aesthetic results were evaluated using photography and examination. Results: The deformities were in the form of contractures and/or excessive dermal scarring. The involved regions were the face (n=3) and neck (n=5). The grafts yielded favorable plication and texture, and no recurrence of excessive dermal scarring was observed. All contractures healed unproblematically. Two patients were re-operated on for regrafting caused by minor graft loss (5% and 12% of the total area, respectively). Conclusion: In this study, we observed that collagen elastin matrix combined with partial-thickness skin grafts provides a favorable option for the treatment of pediatric late post-burn complications in the face and neck region with limited surgical options.
