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    Complex Scalp and Calvarium Defects After Giant Basal Cell Carcinoma Excision: Management, Challanges, Outcomes
    (Lippincott Williams & Wilkins, 2018) Ozcan, Utku; Akyurek, Mustafa; Arslan, Emrah
    Giant basal cell carcinoma (GBCC) is defined as a tumor >= 5 cm in diameter. GBCC of scalp usually requires extended resection of soft tissues, calvarium, and dura. In this study, we present 5 patients with GBCC of head, who underwent a single-stage combined scalp, calvarium, and dural reconstruction. Herein, we aim to discuss reconstruction methods, cerebrospinal fluid (CSF) leakage, duration of hospital stay, and tumor recurrency. Peroperative and postoperative follow-ups, defect areas, and performed calvarium reconstruction methods of 5 patients, who underwent complex scalp and calvarium reconstruction after GBCC between year 2010 and 2017, were retrospectively maintained. We studied reconstruction methods, CSF leakage, duration of hospital stay, and tumor recurrency. All patients undergone single-stage reconstruction. Avarge duration of hospital stay was 15 days. Titanium mesh was used in 3 patients and methyl methacrylate was used in 2 patients for calvarium reconstruction. CSF leakage was seen in patients who underwent calvarium reconstruction with titanium mesh. Tumor recurrence occured next to calvarium in 1 patient who undergone calvarium reconstruction with methyl methacrylate. CSF leakage and duration of hospital stay may induce morbidity of this oncoplastic procedure. The fact of longer hospital stay of patients reconstructed with titanium mesh might be a new data presented in this study. These parameters can be related with the method of calvarium reconstruction.
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    MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER
    (Galenos Publ House, 2025) Akyurek, Mustafa; Kaya, Berkay; Bolca, Anil
    Objective: To analyze the demographic features, etiological factors, clinical profiles, and treatment outcomes of patients with chronic lower extremity wounds managed at a tertiary wound care center. Materials and Methods: A retrospective review was conducted on 783 patients treated for chronic lower extremity wounds between May 2014 and January 2022. Patient demographics, comorbidities, wound etiology, microbiological data, histopathological findings, and treatment modalities were evaluated. Patients with trauma-related wounds or incomplete follow-up were excluded. Results: The mean age was 62.1 years, with females comprising 32% of the cohort. Diabetes was the leading cause of chronic lower extremity wounds (68.6%), followed by PAD in non-diabetic patients (21%), venous insufficiency (5.6%), and stasis dermatitis (3%). Pyoderma gangrenosum and drug reactions represented less common etiologies. Among diabetic foot ulcer patients, 55% were Wagner Grade 1-2, while 45% were Grade 3 or higher. Smoking prevalence was 74%, and associated with longer healing times. Wound closure was achieved via skin grafting in 58% of cases, secondary intention in 21%, and amputation in 12%. Negative pressure wound therapy was employed in 15% of cases. Staphylococcus aureus, Enterococcus spp., and Pseudomonas spp. were the most commonly isolated pathogens. Pyoderma gangrenosum was histologically confirmed in 6 patients. Conclusions: Diabetes and PAD remain the predominant etiologies of chronic lower extremity wounds. High smoking prevalence, delayed referrals, and advanced Wagner grades at presentation underscore the importance of early multidisciplinary intervention and standardized treatment protocols. The judicious use of negative pressure wound therapy, tailored antibiotic stewardship, and consideration of non-infectious etiologies in non-healing wounds are vital. Nationwide multicenter prospective studies are needed to develop uniform strategies for reducing the clinical and economic burden of chronic lower extremity wounds. a multidisciplinary approach are essential to improving outcomes and reducing the risk of limb loss.
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    The effects of human amniotic membrane on silicone related capsule formation in rats
    (Taylor & Francis Ltd, 2020) Akyurek, Mustafa; Orhan, Erkan; Aydin, Mehmet Serif; Uysal, Omer; Karsidag, Semra
    Silicone breast implants are commonly used materials in plastic surgery for breast augmentation and reconstruction and the most severe complication of silicone implants are capsule contraction which occurs in 40% of patients. The aim of our study is to evaluate how the amniotic membrane alters the capsule formation effects of silicone 24 wistar rats were used in the study. We placed a bare silicone block into the left side (Subgroup A) and single layer amniotic membrane coated silicone block into the right side (Subgroup B) of the rats back. The rats were then separated into three groups and in group 1 rats were euthanized after 3 weeks, in group 2 after 12 weeks and in group 3 after 24 weeks. Then capsule thickness, fibroblast and lymphocyte cell counts were evaluated for each sample. In Group 2 and group 3, the capsule thickness in Subgroup B was detected to be statistically significantly lower than that in Subgroup A. In Group 1, 2, and 3, the lymphocyte count in the capsule tissue taken from Subgroup B was lower than Subgroup A but the difference was not statistically significant. In Group 2 and 3, the fibrocyte count detected in the capsule tissue in Subgroup B was found to be statistically significantly lower than Subgroup A. the amniotic membrane was demonstrated to reduce capsule thickness by the antifibrinolytic effect in our study.