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Öğe A devastating cause of burns: Synthetic cannabinoid abuse(2021) Karatan, Berrak; Yamak, KamilObjective: Synthetic cannabinoids are human-made chemicals that are agonists of cannabinoid receptors. Globally, they have been marketed illegally for their psychoactive effects since the 2000s. The first synthetic cannabinoid traffic in Turkey was detected in the early 2010s. Since then, their psychiatric and psychological complications have become a growing concern. Bonzai, a common form of synthetic cannabinoid in our country, has varying mind-altering effects, from depression to euphoria. This altered state of mind makes users prone to trauma. Herein, we present our experiences of Bonzai-related burn cases. Materials and Methods: A total of 12 patients were referred to the Plastic Surgery, Orthopedics, and Traumatology Clinics between January 2018 and December 2020. Results: Their ages ranged from 18 to 57 years (average age: 33.5 years). The total burn surface area ranged from 2% to 40%. Five patients had been operated on due to burn injuries; all of these patients had complications and secondary surgeries. Two patients were lost after admission to the hospital, and three patients were lost during follow-up. Only one patient was verified to be clean from drugs after discharge from the hospital. Conclusions: We aim to point out the alarming danger of this synthetic drug, which can affect all ages and walks of life.Öğe The impact of the informed consent process on the anxiety levels of patients undergoing rhinoplasty(Lippincott Williams & Wilkins, 2022) Aysel, Abdulhalim; Uz, Uzdan; Karatan, Berrak; Aydin, Enes; Erdogan, Esin; Yilmaz, Fatih; Muderris, TogaySeptorhinoplasty is one of the most common elective surgical procedures in otolaryngology. The present study aimed to evaluate the anxiety levels of patients who underwent septorhinoplasty at different times, compare the information methods, and determine the understanding of the informed consent through recall rates of the complications explained in the informed consent process. The patients were divided into the following 2 groups: Group 1 (giving information 14 days before the surgery) and Group 2 (giving information 3 days before the surgery). For the preoperative anxiety measurement, the State anxiety scale of the State-Trait Anxiety Inventory (STAI) was used. All patients were asked to recall the complications they remembered from the consent form on the day before the surgery. Each group has consisted of 25 patients. No significant difference was found between the STAI-1 and STAI-2a anxiety scores between groups. In Group 1, the STAI-2b anxiety score was significantly lower than the STAI-1 and STAI-2a scores (P < 0.05). In Group 2, the mean score of STAI-2b was not significantly higher than the STAI-1 and STAI-2 scores (P > 0.05). When the STAI-2b scores of the two groups were compared, the scores of Group 2 were significantly higher (P < 0.05). The most commonly remembered complications were bruising and swelling in both of the groups. In conclusion, the authors believe that long-term cooperation between the surgical team and the patient will reduce the anxiety levels of the patients and increase patients' satisfaction, resulting in a significant reduction in the amount of potential legal processes. Level of Evidence: 2Öğe Managing severe postburn wrist flexion contracture by proximal row carpectomy and abdominal interpolation flap(Sage Publications Inc, 2022) Karatan, Berrak; Yamak, KamilIntroduction: Postburn upper extremity contractures can greatly diminish the quality of life. To successfully manage these contractures and achieve successful functional outcomes, an optimal surgical method should be planned to address all affected tissues on the extremities. Conventional soft tissue transfers after releasing the contracture, such as skin grafts or flaps, may be insufficient. In addition to capsulotomy, tendon release, and lengthening procedures, more aggressive modalities may be indicated. Methods: In this retrospective study, patients who developed wrist flexion deformities due to burn injuries and underwent proximal row carpectomy and abdominal interpolation flaps were included. Results: Between January 2019 and June 2020, 5 patients underwent surgery using this technique. All patients were male, 2 had thermal burns, 2 had electrical burns, and 1 had chemical burns. Preoperatively, all patients had severe flexion deformities ranging from 70 degrees to 85 degrees. There were no postoperative complications, and stable wrists with a good and functional alignment were achieved, although the preoperative and postoperative range of motion differences were limited, where a postoperative range of motions were ranging from 5 to 15 in terms of extension, 15 to 20 in terms of flexion. Preoperative QuickDash scores were between 79.5 and 95.5, postoperative scores ranged from 25 to 36.4. Conclusion Proximal row carpectomy shortens the length of the wrist, resurfaces the wrist joint, and provides a release in tendons and other soft tissues. Together with soft tissue transfer, this technique can be used for severe wrist flexion contractures.Öğe Modified bilateral fasciaperichondrial flap for prominent ear correction(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2023) Aysel, Abdulhalim; Karatan, Berrak; Ergun, Ugurtan; Muderris, TogayObjective: Various techniques have been described in the literature for prominent ear correc-tion. These cartilage-preserving or cartilage-shaping techniques have their own advantages and disadvantages. We aim to achieve aesthetic and stable results with low complication rates using combinations of these methods. Herein, we present our results of prominent ear surgery with a modified bilateral fasciaperichondrial flap in combination with concha-mastoid and concha-scaphal sutures.Methods: Patients whose surgeries included a modified bilateral fasciaperichondrial flap for prominent ear deformities were included in the study. Patients' demographic data, pre-and postoperative Concha-Mastoid Angle (CMA) and upper-middle Helix-Mastoid Distances (HMD), follow-up time, complications, secondary operations, and postoperative Visual Analogue Scale (VAS) results were evaluated. With a postauricular fish-mouth incision, the bilateral fasciaperi-chondrial flap was planned into two: proximal-and distal-based. They were then elevated from the cartilage subperichondrially on the proximal side and supraperichondrially on the distal side. Concha-scaphal sutures were used to form an antihelical rim along with concha-mastoid sutures to reduce the concha-mastoid angle. Conchal cartilage resection was done if needed. Then, the bilateral fasciaperichondrial flaps were sutured together to cover the concha-mastoid and concha-scaphal sutures.Results: Between May 2017 and May 2021, 32 ears of 17 patients were operated on due to promi-nent ear deformity. No hematoma or infection was observed in any patient, and there were no instances of recurrence, suture exposure, hypertrophic scars, or keloids. The satisfaction level of all patients was 8.2 +/- 0.9 points on average according to the VAS. In the anthropomet-ric measurements, a statistically significant difference was found between preoperative and postoperative sixth month CMA and HMD values.Conclusion: A combination of suture techniques and a modified bilateral fasciaperichondrial flap may be used in prominent ear cases, with low recurrence rates and high patient satisfaction. Level of evidence: III.(c) 2022 Associacao Brasileira de Otorrinolaringologia e Cirurgia C ' ervico-Facial. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).Öğe Surgical burr-assisted lateral osteotomy technique in septorhinoplasty(Lippincott Williams & Wilkins, 2022) Aysel, Abdulhalim; Karatan, Berrak; Müderris, TogayAchieving aesthetic and functional results in rhinoplasty requires meticulous techniques, and postoperative edema, ecchymosis, and pain can deteriorate the desired outcomes. Different osteotomy techniques are defined to have optimal outcomes while reducing edema, ecchymosis, and pain. In this study, the authors compared conventional and power-assisted surgical burr osteotomy techniques in terms of early postoperative complications. Patients who underwent primary open septorhinoplasty were included in the study and were divided into 2 groups. The first group had lateral endonasal osteotomy with conventional guided osteotomes, and the second group had lateral osteotomy with surgical round burr. Edema and ecchymosis scoring systems were used on the postoperative first, third, and seventh day to evaluate postoperative edema and ecchymosis, and the visual analog scale was used to evaluate pain severity on the postoperative period. Out of 70 patients who had undergone septorhinoplasty, 36 received conventional osteotomy and 34 received surgical round burr osteotomy. Periorbital ecchymosis scores were significantly lower in the second group on the postoperative first, third, and seventh days. The periorbital edema scores were significantly lower in the second group on the first postoperative day but no difference was found between postoperative days 3 and 7. Also, the pain scores were significantly lower in the second group. Osteotomy with surgical round burr yields less ecchymosis, edema, and pain in the early postoperative period than conventional osteotomy in primary septorhinoplasty patients.Öğe Total nasal reconstruction with pre-laminated, super-thin anterolateral thigh flap: A case report(Wiley, 2021) Bali, Zülfükar Ulaş; Karatan, Berrak; Parspancı, Aziz; Tuluy, Yavuz; Keçeci, Yavuz; Yoleri, LeventMany techniques for nasal reconstruction have been described to achieve aesthetically and functionally favorable results. Local tissues, specifically the forehead flap, provide the best tissue match with the nose. However, when local tissue donor sites are limited, alternative options such as free tissue transfers should be considered. Herein, we describe a case of a 72-year-old male patient who had a total nasal and left malar defect reconstructed with a two-staged, pre-laminated, super-thin anterolateral thigh (ALT) flap. The patient's nasectomy was performed 15 years ago. The adjacent left malar defect was due to recent squamous cell carcinoma excision. Local tissues were unavailable for reconstruction due to previous tumor excisions. For the 8.5 x 5 cm defect, a 12.5 x 8 cm ALT flap was planned, with 7.5 x 8 cm for nasal reconstruction and 5 x 4 cm for malar reconstruction. During the first stage, a super-thin fascial ALT flap was raised without dissecting the perforators, and the nasal skeleton was laminated between these two flaps. Costal cartilages were harvested for the nasal skeleton and positioned between the suprafascial and the fascial ALT flaps. During the second stage, two perforators were dissected to the pedicle on the pre-laminated flap, and the flap was divided from the donor site. The nasal skeleton was fixed and anastomosis with the facial vessels was established. After both stages, no complications were observed. After one month, a revision surgery was performed to enhance the transition between the reconstructed nose and the cheek, and improve the nasal projection. Postoperatively, after one year, the patient had a stable nasal reconstruction with good breathing. Prelaminated, super-thin ALT flaps provide the advantages of a wide and versatile donor site and an acceptable donor site scar. They may be an option for patients who are not amenable to traditional reconstruction methods.Öğe Yanıkta plastik cerrahi ve rekonstrüksiyon(2022) Karatan, BerrakYanıklar, ciddi morbidite ve mortaliteye sebep olabilen yaralanmalardır. Günümüzde gelişmiş yanık tedavileri ile yanığa bağlı bu morbidite ve mortalite oranları düşse de, yanık hastalarında fonksiyonel ve estetik kayıplar hala önemli bir sorun olarak karşımıza çıkmaktadır. Yanık hastalarında cilt ile ilgili komplikasyonlar, eklemler ve organların hareketlerini engelle mekte, ağrı ile birlikte ciddi şekil bozuklukları ve kontraktürlere sebep olmaktadır. Yanık yaralan malarından sonra erken dönemde debridman, greftleme ve fizik tedavi ile kontraktürlerin görüme sıklığı ve rekonstrüksiyon ihtiyacı azalmaktadır. Yanık rekonstrüksiyonu, kraniyofasiyal cerrahiden el cerrahisine, mikrocerrahiden nakillere kadar Plastik Cerrahi’nin her alanını kapsamaktadır. Rekonstrüksiyonda kontraktür açılması ve deri grefti uygulaması gibi cerrahilerin yanı sıra mikrocerrahi girişimler gibi komplike operasyonlar gerekebilmektedir. Teknolojinin ilerlemesi ile birlikte, yeni geliştirilen dermal iskeletler, bazı hastalarda komplike girişimlerin yerine geçmiş; lazer uygulamalarıyla ciddi hipertrofik skarlarda yüz güldürücü sonuçlar elde edilmiştir
