Evaluation of Diced Cartilage Grafts Shaped with Three-Dimensionally-Printed Bioresorbable Polycaprolactone Molds.

BACKGROUND: The main problem with the use of diced cartilage grafts is related to the difficulties encountered in shaping the graft and unpredictible graft resorption. The aim of this study was to evaluate the permanence and viability of diced cartilage grafts shaped with the help of biodegradable, three-dimensionally-printed polycaprolactone molds. METHODS: Three groups were studied in each of the eight rabbits: block cartilage (group 1), diced cartilage (group 2), and diced cartilage shaped with polycaprolactone molds (group 3). A total of 24 cartilage grafts were obtained at the end of the 12-week follow-up period, and 10 different histopathologic parameters were analyzed in each cartilage graft. RESULTS: Diced cartilages shaped with a three-dimensionally-printed polycaprolactone mold showed increased regeneration potential of chondrocytes, vascularization, and collagen production. Use of polycaprolactone molds did not cause any additional risk of inflammation, fibrosis, or metaplastic bone formation. CONCLUSIONS: In this study, it has been shown that three-dimensionally-printed polycaprolactone molds can be used safely in shaping diced cartilage grafts. In light of this study, it will be possible to produce hybrid grafts that can be used safely in many operations such as nasal reconstruction, rhinoplasty, auricle reconstruction, and repair of orbital floor fractures with the help of molds produced in more complex ways. CLINICAL RELEVANCE STATEMENT: Three-dimensionally-printed polycaprolactone molds can be used to shape diced cartilages in the areas of both aesthetic and reconstructive surgery.

Hydrogen-rich saline reduces tissue injury and improves skin flap survival on a rat hindlimb degloving injury model.

BACKGROUND: Degloving injuries represent a challenge in plastic surgery. The aim of this study is to acknowledge the protective effects of hydrogen-rich saline (HRS) solution on a rat hindlimb degloved skin flap. METHODS: Twenty-one Sprague-Dawley rats were divided into three groups (control, saline and HRS). Degloving injury model was established, and flaps were sutured back following 5 min of ischemia. The control group did not receive any treatment. The saline group received intraperitoneal physiological saline (10 ml/kg) and the HRS group received intraperitoneal HRS solution (10 ml/kg) postoperatively and daily for 5 days after the operation. Skin samples were obtained for histological, immunohistochemical and biochemical evaluations. RESULTS: Inflammation was lower in the HRS compared with saline (p = 0.02) and control (p = 0.004) groups. Edema was lower in the HRS compared with saline (p = 0.02) and control (p = 0.001) groups. Malondialdehyde (MDA) level was lower in the HRS than the control group (p = 0.01). Total antioxidant level was higher in the HRS compared with saline (p = 0.009) and control (p = 0.03) groups. Total oxidant level was lower in the HRS than the control group (p = 0.02). Oxidative stress index was lower in the HRS compared with saline (p = 0.001) and control (p = 0.0001) groups`. Vascular proliferation was higher in the HRS compared with the control group (p = 0.01). CONCLUSION: Repeated HRS injections after trauma increased the viability of skin flap in rat degloving injury model by decreasing local tissue injury, due to its antioxidant, anti-inflammatory and angiogenic effects.

Comparison of venous repair results using either arterial or vein grafts in a crush-avulsion injury model

Background/aim: Venous insufficiency after replantation or revascularization is one of the most common causes of limb loss in either the short or the long term. The aim of this study was to evaluate the results of a new technique to overcome venous insufficiency. Materials and Methods: A crush-avulsion type of injury was formed in the femoral veins of rats of 3 separate groups. In the control group, primary repair was applied to the damaged veins and the remaining 2 groups were repaired with either an arterial graft or a vein graft. The success rates of anastomosis were then compared. Results: In the control group the patency rate was 25% in the 2nd hour, 12.5% on the 2nd day, and 12.5% on the 10th day. The patency rate in the vein group was 87.5% in the 2nd hour, 50% on the 2nd day, and 37.5% on the 10th day, whereas the patency rates in the artery group were 100% in the 2nd hour, 87.5% on the 2nd day, and 75% on the 10th day. Conclusion: Microsurgery requires experience and patience. It can be considered that the use of arterial grafts for venous repair in replantation after crush-avulsion type amputations can increase the success rate of replantation.

Beneficial effects of Salvia miltiorrhiza in the healing of burn wounds: an experimental study in rats.

INTRODUCTION: Burn healing is a complicated process and very few treatments can positively alter its effects. The aim of this study was to investigate the effects Salvia miltiorrhiza (SM -Danshen), a traditional Chinese medicine, on burn wound healing. MATERIAL AND METHODS: Twenty rats were included in this study and divided into two groups. 3 × 2 cm wide burn areas were created in the dorsal skin of all the animals with thermal contact. Intraoral 1 ml/day saline and 1 g/kg/day SM were given in control and experiment groups, respectively. Fourteen days following the burn injury burn zones were evaluated with indocyanine green-SPY imaging device, and multiple samples were collected for histopathological evaluation. Standard photographs were taken for the evaluation of necrotic skin areas. RESULTS: Neovascularization was increased in the SM group when compared with the control group (p = 0.0406). SPY studies revealed a meaningful increase in the tissue perfusion in the SM group (p = 0.0286). The average amount of necrotic area in the control and experiment group on the postoperative 14th day was 71.6% (±16.51) and 42.5% (±10.64) respectively (p = 0.0002). CONCLUSION: Our study shows that SM can decrease the amount of necrosis in burn wounds by increasing tissue perfusion and neovascularization.

The efficacy of the hemostatic agent Ankaferd blood stopper on end-to-end unilateral sleeve fish-mouth anastomosis.

OBJECTIVE: The aim of this study was to examine if the application of Ankaferd Blood Stopper (ABS) reduces the number of sutures and therefore reduces anastomosis completion time in a unilateral end-to-end sleeve fish-mouth anastomosis model. METHODS: Femoral artery end-to-end unilateral fish-mouth anastomosis models were created from the right and left femoral arteries of 14 male Wistar albino rats (weight: 250 to 300 grams) and divided into 2 equal groups. Rats in Group A received ABS and Group B was the control group. Rats were further divided into equal 2 subgroups, and anastomoses of rats in Group 1A and 1B were explored on the 7th day and on the 14th day in Group 2A and 2B. The groups were compared for anastomosis completion time, macroscopic and microscopic patency, existence of microaneurysm and inflammatory response. RESULTS: In the ABS group (1A and 2A), mean anastomosis completion time was 13:00±1.50 minutes, and 18:56±2.5 minutes in the control groups (1B and 2B). This difference was statistically significant (p=0.001). CONCLUSION: Ankaferd Blood Stopper may be used to reduce the number of sutures and shorten the completion time of artery-to-artery anastomosis of arteries with small diameter and low blood flow rate.

Marjolin ulcer: clinical experience with 34 patients over 15 years.

BACKGROUND: Malignancies that arise from scars are referred to as Marjolin ulcers. The association between chronic ulcers and squamous cell carcinomas is well established. There are many case reports in the literature regarding Marjolin ulcer; however, randomized controlled clinical series that describe a thorough evaluation of these patients are rarely encountered. OBJECTIVE: We present our clinic's 15 years of experience with 34 Marjolin ulcer patients and their treatment modalities. METHODS: A retrospective analysis of 302 squamous cell carcinoma patients who were treated in the plastic surgery department between 1997 and 2011 was performed. Thirty-four (10.3%) histopathologically confirmed Marjolin ulcer patients were further analyzed. RESULTS: Although burn scars represented 77% of the patients in the present study, unstable scars that formed following traffic accidents and fistula tracts are also among the commonly encountered etiologies. Based on our observations, squamous cell carcinoma, in addition to malignant melanoma and verrucous carcinoma, is frequently observed in cases of Marjolin ulcers. CONCLUSION: If the goal is to eradicate this clinical entity, all of the chronic ulcers that fail to heal require biopsies at regular intervals. Large excisional margins, lymphadenectomies in cases of palpable lymph nodes, and a well-defined oncology protocol are all essential in treating Marjolin ulcer.