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   2018| April-June  | Volume 26 | Issue 2  
    Online since April 13, 2018

 
 
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ORIGINAL ARTICLES
Measurement of epidermis, dermis, and total skin thicknesses from six different body regions with a new ethical histometric technique
Pembe Oltulu, Bilsev Ince, Naile Kokbudak, Sidika Findik, Fahriye Kilinc
April-June 2018, 26(2):56-61
DOI:10.4103/tjps.TJPS_2_17  
Introduction: Although it is important to know the normal values of dermis, epidermis, or total skin thicknesses (ST) for some drugs and vaccine research, skin-related clinical investigations, and skin transfer operations used in plastic surgery, it would not be ethical to take new biopsies from healthy volunteers to measure their ST. This study aims to describe a new ethical histometric technique for the measurement of skin layers and to determine the mean ST of some major body regions in the people living in our region. Materials and Methods: A total of 180 skin samples from six major body regions of 90 males and 90 females were enrolled in the study. The measurements were performed histometrically from appropriate skin samples obtained from the pathology archive. The samples were classified according to the six different parts of the body (scalp, abdomen, back, dorsum of foot, dorsum of hand, and the breast). Results: The mean epidermal thickness ranged from 76.9 ± 26.2 to 267.4 ± 120.6 μm. The thickest epidermis was found in the dorsum of foot in women (267.4 ± 120.6 μm) while the thinnest was found in the breast in women (76.9 ± 26.2 μm). The mean dermal thickness ranged from 2115 ± 946.4 to 5888 ± 2422.3 μm. The thickest dermis was found in the breast in men (5888 ± 2422.3 μm), while the thinnest dermis was found in the dorsum of hand in women (2115 ± 946.4 μm). Conclusions: Human ST varies according to ethnic origin. It was determined that the dermis and epidermis of Anatolian people are thicker than that of the previously reported other ethnic groups. The skin pathology archive can be used to create maps of the body's skin structure.
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The effects of breast reduction on sexual activity
Meltem Ayhan Oral, Cem Aslan, Murat Tuzuner, Ersin Aksam, Fatma Buse Kilin Capkinoglu, Demet Gulpek
April-June 2018, 26(2):62-66
DOI:10.4103/tjps.TJPS_4_18  
Background: Patients with macromastia sometimes claim that their sexual life is negatively affected from the hypertrophic breasts. The intention of this prospective study is to evaluate the effects of breast reduction surgery on sexual satisfaction, marital adjustment, and the psychological condition of patients. Materials and Methods: The experimental group (n = 25) consisted of patients who had undergone surgery for macromastia, while the control group (n = 23) consisted of matched patients with similar demographic features. Using questionnaires, the respondents from the experimental group were evaluated for their body image perception, self-esteem, anxiety and depression status, sexual satisfaction, and marital adjustment both before surgery and 12 months after surgery. The same questionnaires were administered to the patients in the control group. Results: A comparison of the pre- and postoperative scores from the questionnaires revealed that the women in the experimental group observed an improvement in their body image perception and self-esteem and a decrease in their levels of anxiety and depression. There was no significant change between the pre- and post-operative scores of the experimental group in the sexual satisfaction index. Between the experimental group and the control group, a statistically significant difference was seen only for preoperative anxiety levels. Conclusion: Reduction mammoplasty had a favorable effect on the self-esteem, body image perception, depression, and anxiety but had no impact on sexual satisfaction of the patients. Level of evidence: Level II, Evidence obtained from well-designed controlled trials without randomization.
  4,224 285 -
Surgically treating hidradenitis suppurativa that does not respond to medical treatment
Musa Kemal Keles, Ugur Horoz, Ergin Seven, Sebat Karamursel, Ali Teoman Tellioglu
April-June 2018, 26(2):67-70
DOI:10.4103/tjps.TJPS_6_17  
Objective: Hidradenitis suppurativa is a chronic inflammatory disease of the skin involving the infundibular terminal follicles in the areas of the body containing apocrine glands. The pathology leads to purulent drainage and pain, abscesses, hypertrophic scars, and sinus formation in the affected areas. Treatment options for the disease include retinoid, antibiotics, antiandrogens, immunosuppressive agents, laser therapy/phototherapy, and surgery. This study aimed to assess the results of surgical treatment in patients who could not be treated medically. Materials and Methods: This study reviewed twenty patients who did not heal with medical treatment in the last 5 years. Results: Defect reconstructions were performed using grafts on eight patients, flaps on five patients, and primary closure on seven patients. One patient had a long-term recurrence. Conclusion: In the researchers' experience with different reconstruction methods and the wide excision of the disease, clinically satisfactory results can be achieved in cases that do not heal with medical treatment.
  2,507 227 -
Reconstruction of finger composite defects with perforator free flap from the superficial palmar branch of radial artery
Alper Aksoy, Emin Sir, Daghan Dagdelen, Meliha Kasapoglu Aksoy
April-June 2018, 26(2):44-49
DOI:10.4103/tjps.TJPS_7_17  
Background: Relatively rare scarce number of flaps are used to repair composite defects occurring as a consequence of finger injuries. The main objective in this study is reconstruction of the composite defects of the fingers to share in our study; we aimed to transfer our the experience with the use of the free perforator flap of the radial artery superficial palmar branch (SUPBRA). Materials and Methods: A total of 10 (three women and seven men; age between range, 18 and 47 years) patients who had undergone free composite SUBPRA flap reconstruction, operations between 2010 and 2013 were included in the study. Defect sizes ranged between from 2 cm × 3 cm to 3 cm × 5 cm. The patients were followed up postoperatively for a median an average period of 11.5 (six-18 months) months. All patients were assessed with static and dynamic two-point discrimination tests, Semmes-Weinstein monofilament test, cold intolerance test, time of returning to work, the active total range of motion of the injured fingers, cosmetic appearance of the donor/recipient sites and were also assessed for neuroma the development of neuroma on the donor site. Results: All composite free flaps survived completely, and the follow-up duration was 11.5 months. The average median operative time was 194 min (180–260 min) and the patients returned to their work their normal life after an average of 13 weeks (11–21). Any complication concerning with donor sites and wrist movements when primary closures were performed was observed. Conclusion: Free SUBPRA flap can be elevated from ipsilateral extremity under regional anesthesia which can be easily used for the reconstruction of composite defects with an advantage of providing a relatively hairless and thinner coverage. Therefore, it can be a perfect alternative for the repair of composite tissue defects encountered in the practice of hand surgery.
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An assessment of the effects of serum vitamin d levels on snoring in patients who have undergone septorhinoplasty
Bilsev Ince, Mehmet Emin Sakarya, Mehmet Dadaci
April-June 2018, 26(2):50-55
DOI:10.4103/tjps.TJPS_14_18  
Background/Aim: The aim of the study was to determine the clinical and radiological effects of septorhinoplasty and the change in serum Vitamin D levels on snoring. Patients and Methods: Sixty patients who attended with complaints of snoring, difficulty in breathing through the nose, and nasal deformity were included in this prospective study. Patients who only underwent septorhinoplasty were defined as Group 1, patients who underwent septorhinoplasty and were administered Vitamin D were defined as Group 2, and patients who were administered Vitamin D without undergoing septorhinoplasty were defined as Group 3. Results: In Groups 2 and 3, changes in the anteroposterior diameter of the air column, column of the airspace, and thickness of the soft palate and the uvula were statistically significant. Snoring decreased significantly at every postoperative follow-up in all three groups. This decrease was significantly higher in Group 2 than in Groups 1 and 3. Conclusions: We determined that one reason for snoring may be Vitamin D deficiency. Replacement of Vitamin D with removal of the upper respiratory tract problems may prevent snoring in patients with snoring and Vitamin D deficiency.
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CASE REPORTS
A new method for elbow arthrodesis for soft-tissue coverage: The use of biceps brachii muscle flap
Soysal Bas, Sercin Bas, Utku Uyan, Mustafa Durgun
April-June 2018, 26(2):77-80
DOI:10.4103/tjps.TJPS_29_18  
Elbow arthrodesis is a rarely applied and difficult procedure that is performed to reduce extremity pain and prevent amputation in various clinical states. Infection, nonunion, plate-screw exposition, and skin loss are the major complications of this procedure. In this report, a new reconstruction technique with biceps brachii muscle flap was presented in a case of elbow arthrodesis performed with three operations.
  1,722 197 -
EDITORIAL
How to calculate journal impact factor?
Cenk Demirdover
April-June 2018, 26(2):43-43
DOI:10.4103/1300-6878.230148  
  1,486 256 -
CASE REPORTS
A rare case in Turkey: Cutaneous myiasis after traveling
Mehmet Solmaz, Soner Karaali, Hasan Utkan Aydin, Hayri Omer Berkoz
April-June 2018, 26(2):81-83
DOI:10.4103/tjps.TJPS_30_18  
Cutaneous myiasis is a localized infectious disease which affects humans and vertebrate animals. Most common causes of cutaneous myiasis worldwide are dipterous larvae of “Dermatobia hominis” and “Cordylobia anthropophaga.” Clinical presentations include nodules, ulcers, creeping eruption, and wound infections which may be localized anywhere on skin including trunk, scalp, and extremities. Here, we present a 30-year-old female patient consulted to our clinic who presented with erythematous lesions on her lower extremities after a visit to South America. According to her travel history, laboratory and imaging results, she was diagnosed with cutaneous myiasis. Etiology, clinical presentation, and surgical treatment options of myiasis, which is very rare in Turkey, are discussed.
  1,572 147 -
Utilization of a perforator flap for stump closure of the fifth digit
Daghan Dagdelen, Alper Aksoy, Selami Serhat Sirvan
April-June 2018, 26(2):71-73
DOI:10.4103/tjps.TJPS_21_18  
There is an obvious need for alternative local flaps in digital reconstruction, especially where soft-tissue residuum is limited as in the fifth digit. A 42-year-old female patient presented to our emergency room with her left fifth finger amputated at the level of the middle phalanx and extensive second-degree deep burn wounds in the hand dorsum and the dorsal finger after a hot-press accident in the workplace. We would like to share a case of fifth digit soft-tissue reconstruction done using a perforator propeller flap based on ulnar palmar digital artery.
  1,441 188 -
Unexpected synchronous diagnosis of papillary thyroid carcinoma in a patient with lower lip squamous cell carcinoma
Mert Calis, Veysel Murat Isik, Mustafa Gurhan Ulusoy, Nezih Sungur, Ugur Kocer
April-June 2018, 26(2):74-76
DOI:10.4103/tjps.TJPS_28_18  
The presentation of differentiated thyroid carcinoma occurring as a second primary associated with head and neck squamous cell carcinoma is quite unusual. Here, we present an unexpected synchronous diagnosis of two independent head and neck malignancies. A 78-year-old male with a rapidly growing, firm, and ulcerated lesion on the lower lip was referred to our clinic. Positron emission tomography-computed tomography scan performed for systemic screening demonstrated a dense hypermetabolic activity located in the right thyroid lobe, suggesting a second malignancy. Fine-needle aspiration cytology of the right thyroid gland performed to differentiate the presence of a metastatic lesion, or primary thyroid cancer was compatible with malign cytology related to papillary thyroid carcinoma. Multiple malignancies may be diagnosed synchronously in the head and neck region and these patients with multiple malignant lesions should be evaluated carefully before being accepted as metastatic.
  1,357 144 -
LETTER TO THE EDITOR
Extracorporeal liposuction technique for lipofilling after standard abdominoplasty procedure
Alper Geyik, Cenk Demirdover, Haluk Vayvada
April-June 2018, 26(2):84-85
DOI:10.4103/tjps.TJPS_6_18  
  1,279 174 -