Browsing by Author "Karacalar, Ahmet"

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Allogeneic substitute for fingernails
(Springer-Verlag, 1999) Cihantimur, Bülent; Karacalar, Ahmet; Özcan, Mesut; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstruktif Cerrahi Anabilim Dalı.; 6507065211; 7004405636; 7102067678
In situations where the nail plate is missing or too severely damaged, an allogeneic substitute is used from non-replantable amputated fingers. Twenty-four nail bed injuries in 22 patients were treated by this method. Twenty out of 24 injuries had good results, two fair results, and two poor results.
Arterialized venous flap for skin coverage and revascularization of the hand
(Springer-Verlag, 1998-06) Karacalar, Ahmet; Özcan, Mesut; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstruktif Cerrahi Anabilim Dalı.; 7004405636; 7102067678
Axial bilobed flap based on the median and medial superficial sural arteries: A case report
(Informa Healthcare, 2001-06) Karacalar, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı.; 7004405636
The anatomy of the sural artery has been adequately described, but its applications are constantly evolving. Based on pre-existing anatomical studies, an axial bilobed flap based on the median and medial superficial sural arteries was developed and used in one patient for the reconstruction of a contracture of the popliteal area. The main advantages of this flap are that the donor site is closed primarily, it provides an adequate amount of healthy and pliable skin with an excellent blood supply and no chance of contraction, and it is an easy technique.
The axial bilobed flap for burn contractures of the axilla
(Elsevier Science, 2000) Güner, Hüseyin; Karacalar, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı/El Cerrahisi Anabilim Dalı.; 7004405636
The axial bilobed flap, based on the transverse and descending branches of the circumflex scapular artery, was used to successfully reconstruct burn contractures of the axilla. The main advantages of this flap are that the donor site is closed primarily, it provides an adequate amount of healthy and pliable skin with an excellent blood supply and no chance of contraction, and it is an easy technique. In this paper, two cases are presented.
Cerrahi 'Delaying'in nörovenöz fleplerin yaşayabilirliğine etkisi
(Uludağ Üniversitesi, 2000) İdil, Oytun; Karacalar, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı/El Cerrahisi Bilim Dalı.
'Nörovenöz flepler', plastik cerrahide son yıllarda kabul görmüş yeni bir kavramdır. Bu flepler bir kütanöz sinir ve buna eşlik eden bir satellit arter yada arteriyole dayalı olarak kaldırılırlar. Düşük akımlı flepler oldukları için genellikle, 3x5 cm., 2x4 cm gibi ufak boyutlarda planlanmalıdırlar. Bu durum, bu fleplerin en büyük dezavantajlarını oluşturur. Nörovenöz fleplerde flep boyutunun ve flep yaşayabilirliğinin, cerrahi 'delaying' uygulanarak artırılıp artırılamayacağını araştırmak amacıyla bu çalışma planlandı. Ağırlıkları 250 gram olan, 5 aylık, toplam 20 adet dişi 'wistar' cinsi laboratuvar sıçanında çalışıldı. Sıçanların inguinal bölgelerinden inferior epigastrik arter, sinir ve vene dayalı 3x3 cm. boyutlarında toplam 40 cilt flebi planlandı. Bu 40 flep; yirmisi deney grubunu, yirmisi kontrol grubunu oluşturmak üzere iki gruba ayrıldı. Deney grubunu oluşturan 20 flebe ilk seansta cerrahi 'delaying' uygulandı. 'Delaying' sırasında fleplerin pedikülündeki inferior epigastrik arter bağlandı. Böylece flepler nörovenöz flep haline getirildi. Bu hali ile fleplerin pedikülünde epigastrik sinir, ven ve sinir ve vene eşlik eden satellit arterioller bulunmaktadır. 'Delaying'den bir hafta sonra ikinci seans gerçekleştirildi. Bu seansta flepler total olarak kaldırılıp tekrar yerlerine sütüre edildiler. Beş gün sonra denek sıçanlar periton içine verilen yüksek doz sodyum pentotal ile öldürüldüler. Fleplerin yaşayan alanları milimethk kağıtlar ile ölçüldü, cilt ve pediküllerinden biyopsiler alındı. Kontrol grubunu oluşturan 20 flebe 'delaying' uygulanmadı. Bu flepler tek bir seansta kaldırıldılar ve pediküllerindeki inferior epigastrik arter bağlandı. Böylece bu flepler nörovenöz flep haline getirilmiş ve 'delaying' uygulanmadan kaldırılmış oldular. Aradan 5 gün geçince denekler periton içine verilen yüksek doz sodyum pentotal ile öldürüldüler ve fleplerin yaşayan alanları milimetrik kağıtlar ile ölçüldü, cilt ve pediküllerinden biyopsiler alındı. Deney ve kontrol gruplarından alınan bu ölçümlerin 'student t' testi ile istatistik değerlendirmesi yapıldı. 'Delaying' uygulanan fleplerde, 'delaying' uygulanmayanlara göre istatistik olarak anlamlı derecede daha fazla flep alanının yaşadığı görüldü (p<0.5). Ayrıca fleplerden alınan cilt ve pedikül biyopsileri de karşılaştırmalı olarak histopatolojik açıdan değerlendirildi. 'Delaying' uygulanan fleplerde cilt ve pediküllerindeki arteriyol ve venüllerin ileri derecede genişlemiş olduğu görüldü. Bu çalışmanın sonuçları ışığında 'delaying'in, nörovenöz fleplerin yaşayabilirliklerini ve boyutlarını artırmak amacıyla klinikte de uygulanabileceği izlenimi edinildi.
Chemical burns due to blood pressure cuff sterilized with ethylene oxide
(Elsevier, 2000) Karacalar, Serap Akın; Karacalar, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı/El Cerrahisi Bilim Dalı.; 7004405636
This paper reports two unusual instances of ethylene oxide burns that were caused by the blood pressure cuff sterilized with ethylene oxide. It is suggested that the mechanical compression caused by the blood pressure cuff facilitated penetration of ethylene oxide residues into tissues and contributed to the degree of tissue damage.
Combined treatment of digital degloving injuries: A case report
(Wiley, 1998) Karacalar, Ahmet; Özgenel, Yeşim; Özcan, Mesut; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı/El Cerrahisi Bilim Dalı.; 7004405636; 6507827420; 7102067678
In a digital degloving injury of four fingers, a combined treatment of tripedicle dermal flap, free hemipulp web flap, and skin graft was used. The functional and cosmetic results of the hand were satisfactory, The patient had an excellent sensory recovery in the free hemipulp web flap and did not complain of any disability from the donor site.
Combined use of axillary block and lateral femoral cutaneous nerve block in upper-extremity injuries requiring large skin grafts
(W B Saunders Co-Elsevier, 1998) Karacalar, Ahmet; Karacalar, Serap; Uçkunkaya, Nesimi; Şahin, Şükran; Özcan, Berin; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstruktif Cerrahisi Anabilim Dalı.
An axillary block and lateral femoral cutaneous nerve block combination was used in 11 patients with upper-extremity injuries requiring large skin grafts. In our experience, this block combination was highly successful. All but one of the patients obtained excellent pain relief (mean visual analog pain scores, 0.2) that required no narcotic analgesics or sedatives. There were no systemic or neurologic side effects attributed to the local anesthetic drugs. We believe that combining an axillary block and a lateral femoral cutaneous nerve block is a clinically useful and effective technique and an excellent anesthetic alternative for procedures requiring large grafts for the upper extremity.
Combined use of V-Y advancement flap and rotation flap
(Lippincott Williams & Wilkins, 2000) Karacalar, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı/El Cerrahisi Bilim Dalı.; 7004405636
Delay in neurovenous flaps-Experimental and clinical experience
(Lippincott Williams & Wilkins, 2004-11) Demir, Ahmet; Güneren, Ethem; Şimşek, Tekin; Karacalar, Ahmet; İdil, Oytun; Özcan, Mesut; Uludağ Üniversitesi/Tıp Fakültesi.; 6508226102; 7102067678
The objective of this study was to examine the effects of the standard surgical delay in the flaps based on the cutaneous branches of the vascular axis around a superficial sensory nerve. The delay procedure was experimentally tested in rats and subsequently used in patients. In the experimental study, the survival of a delayed inferior epigastric neurovenous flap was compared with that of a nondelayed inferior epigastric neurovenous flap. One type of clinically applicable delay pattern (standard bipedicled technique) was employed. A 3 X 3 cm flap was raised in 20 female Wistar rats assigned randomly to 2 groups. Each group consisted of 20 flaps. The standard bipedicled delay pattern increased the percentage survival of the delayed inferior epigastric neurovenous flap. The survival percentage of the delayed flaps was 59.8 ± 185.0 (P < 0.5). The histologic findings of the skin revealed that our delay procedure enhanced the perfusion of the flap by dilating the arterial network. Stimulated by our experimental findings, we used the island bipedicled surgical flap delay or combined strategic-standard delay in the distally pedicled sural flap successfully on 9 cases.
The distally based ulnar artery forearm flap supplied by the dorsal carpal arch
(Lippincott Williams & Wilkins, 1998) Karacalar, Ahmet; Özcan, Mesut; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı/El Cerrahisi Bilim Dalı.; 7004405636; 7102067678
It is accepted that the ulnar artery forearm flap is dependent on the integrity of the palmar arches for ulnar arterial backflow and the patency of both radial and ulnar arteries. A patient is presented who demonstrates the successful use of the ulnar artery forearm flap supplied by the dorsal carpal arch via the dorsal branch of the ulnar artery. In this patient, the ulnar artery was damaged distal to the dorsal branch of the ulnar artery. A distally based ulnar forearm was dissected up to the dorsal branch of the ulnar artery and pivoted around this branch. This flap survived completely with no postoperative problem.
Effect of surgical denervation on the viability of inferior epigastric neurovenous flaps in the rat
(Lippincott Williams & Wilkins, 2000) Karacalar, Ahmet; Öztürk, Hülya; Özcan, Mesut; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstruktif Cerrahisi Anabilim Dalı.; A-1992-2016; 7004405636; 57225374877; 7102067678
The purpose of this study was to examine how the inferior epigastric neurovenous flap in the rat reacts to surgical denervation, The survival of a denervated flap was compared with that of an innervated flap. A 2 x 2-cm flap was raised in 30 female Wistar rats assigned randomly to six groups of 10 rats each: group 1, innervated neurovenous flap; group 2, denervated neurovenous flap, acute model; group 3, denervated neurovenous flap, chronic model; group 4, innervated inferior epigastric island flap; group 5, denervated inferior epigastric island flap, acute model; and group 6, control, composite graft. Acute denervation produced a significant decrease in the survival of the inferior epigastric neurovenous flap (p < 0.05), The surviving area of the innervated flaps decreased from 94 +/- 14% (mean +/- standard deviation) to 16 +/- 34% by acute denervation, Chronic denervation was effective in decreasing flap necrosis in these flaps (survival, 99 +/- 5%), There were no differences between the average viable area of the standard inferior epigastric flap in the denervated and innervated groups.
Free arterialized venous flap for the reconstruction of defects of the hand: New modifications
(Thieme Medical Publ Inc, 1994) Özcan, Murat; Karacalar, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi.
Arterialized venous flaps were used in 13 cases for reconstruction of defects in the hand. The flap was used as a fascial venous flap in three cases, and as a sensory venous flap in three cases. In three cases, the flap was designed as an ipsilateral pedicled flap, similar to a standard free flap, instead of as a contralateral pedicled type. Ten flaps survived completely. Two flaps underwent superficial necrosis, with viable subcutaneous-tissue layers.
Free extended double hemipulp transfer
(Springer-Verlag, 1999) Karacalar, Ahmet; Özcan, Mesut; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı/El Cerrahisi Bilim Dalı.; 7004405636; 7102067678
Free extended double hemipulp flap was used succesfully to reconstruct volar defects of the fingers in three cases. This flap was planned in the same fashion as a first web space flap, except that the volar part of the web was preserved. Free extended double hemipulp flap offers a durable, septate and sensate skin cover for large volar defects of the fingers. It has the added advantages of transferring two flaps on one pedicle.
Free rectus abdominis muscle flap with plantar skin graft - A combined method of aesthetic and functional reconstruction of the heel
(Informa Healthcare, 2004-09) Özcan, Mesut; Karacalar, Ahmet; Özbek, Serhat; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı.; AAH-5441-2021; 7004405636; 7005245657; 7102067678
A 16-year-old girl presented with a contusion of the left calcaneus that was treated by combined free rectus abdominis muscle flap and plantar skin graft. The main advantages of this procedure are that it replaces weight-bearing skin of the heel with histologically similar skin from the instep, and the fibrofatty pad of the heel with muscle; it provides a good cosmetic result in the heel, and the scars of the donor site are well-hidden.
Liposuction of the kneecap area under tourniquet: A superdry procedure
(Springer, 1998) Karacalar, Ahmet; Özcan, Mesut; Uludaǧ Üniversitesi/Tip Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı.
In this paper, we report our experience and describe the technique of liposuction under tourniquet. This technique facilitates liposuction in the kneecap area and makes it bloodless. The approach described is effective and necessitates a relatively brief intraoperative and postoperative period, with inherently less morbidity. We obtained satisfactory results using this simple procedure.
Longitudinally-split radial forearm flap
(Informa Healthcare, 2005-04) Özcan, Mesut; Karacalar, Ahmet; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstruktif Cerrahi Anabilim Dalı.; 7102067678; 7004405636
We have applied the split flap concept to a distally-pedicled radial forearm flap to cover separate dorsal defects of the fingers in two cases. The rationale is that there are the vascular plexuses inside and around the sensory nerve that permit surgical splitting of the flap. In the split design, the first segment is supplied by the radial artery itself. The second segment is supplied by the neurocutaneous artery of the medial cutaneous nerve.
A modified reversed digital island flap incorporating the proper digital nerve
(Lippincott Williams & Wilkins, 2000) Karacalar, Ahmet; Şen, Cenk; Özcan, Mesut; Uludaǧ Üniversitesi/Tıp Fakütesi/Plastik ve Rekonstruktif Cerrahi Anabilim Dalı.
A standard reversed digital artery flap is based on the digital artery and vena comitantes alone, leaving the proper digital nerve intact. In the authors' opinion, in situations in which the fingertip pulp is lost completely, it is unnecessary to leave the nerve in situ, Using their technique, the proper digital nerve is included in the pedicle, The pedicle is raised as a monobloc of fatty tissue containing the small veins important for drainage. The proper digital nerve in the flap is sutured to the stump of the opposite proper digital nerve. They found this flap to be very reliable, and quite easy and quick to raise. A patient is presented and discussed in detail.
Nasal sarcoidosis
(Lippincott Williams & Wilkins, 1998) Karacalar, Ahmet; Özcan, Mesut; Uludağ Üniversitesi/Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı/El Cerrahisi Bilim Dalı.; 7004405636; 7102067678
The neurovenous (or adiponeurovenous) epigastric flap in the rat
(Springer, 2000) Karacalar, Ahmet; Oytun, İdil; Kahveci, Zeynep; Özcan, Mesut; Uludağ Üniversitesi Tıp Fakültesi/Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı.; 7004405636; 6508226102; 6603395784; 7102067678
This study was carried out in order to investigate the survival of the neurovenous flap in 30 Wistar rats. An inferior epigastric flap model was used. In addition to this, a preliminary study was performed to assess small vessels in the loose areolar tissue of the neurovascular pedicle in six rats. Although failing to reach statistical significance, our best results were noted in the groups where the vascular axis in the perivascular tissue was included in the flap. The vascular axis of the epigastric nerve did not support a flap survival.