An unexpected long-term complication of genital burn in a child: Secondary cryptorchidism.

Genital and perineal burns are rare and challenging injuries with serious long-term complications. Involvement of the testes is a sign of severity. There is limited knowledge in the literature about the management of complications and testes involvement in genital and perineal burns. In this report, we present the case of an 8-year-old boy with secondary cryptorchidism due to burn contracture who was treated by increasing the scrotal volume by Z-plasties, skin graft, and orchidopexy.

Effect of reduction mammoplasty on the pulmonary function tests.

INTRODUCTION: Bilateral breast reduction surgery is the surgical treatment of bilateral breast hypertrophy. This is one of the most common breast surgery requested by women, and performed by plastic surgeons. The reasons that patients want this surgery are to re-size sagging breasts aesthetically, and to get rid of somatic symptoms such as shoulder, chest, back, and neck pain. We believe that the objective positive effects of breast reduction surgery exist beside aesthetic. In our study, our aim is to elicit positive effects of surgery on lungs, if there are, by making pulmonary function test and carbon monoxide diffusion test before surgery and after 6 months of surgery. MATERIALS AND METHODS: Thirty patients agreed to participate in the study. Study is completed with 19 patients. Pulmonary function test and carbon monoxide diffusion test were made to all patients in preoperative and 6 months of postoperative period. Lung roentgenogram of all patients was performed and height, weight, body mass index were measured. Saturation level was measured. RESULT: There was a meaningful increase in FEV1 and FVC values in the postoperative period in comparison with pulmonary function test performed in preoperative period. DLCO in postoperative period decreased meaningfully as compared to the preoperative period. CONCLUSIONS: Breast reduction surgery seems to have positive effects on pulmonary function test values and relaxes patients clinically. Patients with big breasts should be evaluated from this perspective if they apply chest diseases clinic with shortness of breath.

Three-Dimensional (3D) Columellar Strut Graft in Rhinoplasty.

Background: Nasal tip surgery is the most important and most difficult step of an aesthetic rhinoplasty operation. Various suture and grafting techniques have been described for adequate tip rotation and projection in nasal tip surgery. Objectives: The author describes his technique of "three-dimensional (3D) columellar strut graft" in nasal tip surgery. Methods: Each patient is treated using the open technique rhinoplasty. The author's technique uses a 3D dorsal columellar strut with a special anatomy in the shape of a Y- on a horizontal plane. When the dorsal columellar strut is placed in a way to maintain the interdomal angle, this technique perfectly stabilizes the lower lateral cruses (LLCs) that have been shaped with cephalic dome suture (CDS). Results: A retrospective analysis of 78 patients, who underwent 3D columellar strut graft technique, were included in the study. The mean follow-up period was 15 months. All of the patients were satisfied with their tip shapes. Conclusions: The 3D dorsal columellar strut graft technique is an easily administered technique with reliable outcomes. The purpose of this graft is to support the reshaped LLCs with a perfect anatomic alignment. It does not require any additional cartilaginous graft in patients undergoing a reduction of the dorsum. Level of Evidence: 4.

Facial Actinomycosis Mimicking a Cutaneous Tumor.

Actinomycosis is a chronic granulomatous infection that commonly occurs in the cervicofacial region. Although Actinomcyes is an element of the normal oral flora, infections of the facial skin are very rare because of the entirely endogenous habitation of the organism. The authors report a case of facial actinomycosis, which mimicked a cutaneous tumor both clinically and surgically in a 44-year-old woman with chronic renal failure and Hepatitis C viral infection. The majority of cases can be treated with long-term antibiotics. However, a treatment-resistant abscess, a fistula, or postsurgical excision of the mass formation that are infected can be treated with antibiotics as soon as possible, and recurrence of infection is prevented. The treatment should consist of conservative surgery to obtain a firm histological diagnosis and to drain any collections.

Effect of Concentrated Growth Factor on Survival of Diced Cartilage Graft.

BACKGROUND: Diced cartilage grafts are important in rhinoplasty for raising the dorsum and eliminating dorsal irregularities. The most common problems with the use of diced cartilage are wrapping and cartilage resorption. OBJECTIVES: To histopathologically investigate and compare the viability of diced cartilage grafts wrapped with concentrated growth factor, fascia and fenestrated fascia, or blood glue. METHODS: Cartilage grafts were harvested from the ears of 10 New Zealand White rabbits and diced into 0.5 to 1 mm3 pieces. The grafts were divided into five groups for comparison: (1) bare diced cartilage; (2) diced cartilage wrapped with fascia; (3) diced cartilage wrapped with fenestrated fascia; (4) diced cartilage wrapped with concentrated growth factor (CGF); and (5) diced cartilage wrapped with blood glue. Each of the five grafts was autologously implanted into a subcutaneous pocket in the back of each rabbit. Three months later, the rabbits were sacrificed and the implants were harvested and examined histopathologically. RESULTS: Nucleus loss, calcification, inflammation, and giant cell formation differed significantly between the CGF group and both fascia groups. Chondrocyte proliferation was the highest in the CGF group. Nucleus loss rates were similar between the fascia and fenestrated fascia groups. CONCLUSIONS: Our findings suggest that CGF improves the viability of diced cartilage grafts, while fascia hampers it. Punching holes in the fascia does not improve diced cartilage graft viability and neither does blood glue wrapping.

Effectiveness of Palatal Mucosa Graft in Surgical Treatment of Sub-Glottic Stenosis.

OBJECTIVES: Mucosal free grafts may be successfully applied in many surgical interventions. This study aims at investigating the feasibility of palatal mucosa graft in sub-glottic field in an animal model. METHODS: This randomized prospective controlled study was conducted with an animal model. Sub-glottic inflammation was created in 15 adult rabbits in each group and sub-glottic stenosis surgery was applied thereafter. The rabbits in group 1 (control group) underwent segmental resection, partial cricoidectomy, and trachea-thyroid cartilage anastomosis; the rabbits in group 2 underwent segmental resection, cricoplasty, and crico-tracheal anastomosis using free buccal mucosa graft; and the rabbits in group 3 underwent segmental resection, cricoplasty, and crico-tracheal anastomosis using free palatal mucosa graft. Re-stenosis was evaluated after 42 days. RESULTS: The percentages of stenosis were 27%±20%, 40%±20%, and 34%±23% for group 1, 2, and 3, respectively and the difference was not statistically significant (P=0.29). Intensive and tight fibrosis was observed in 2 rabbits (13%) in group 1, in 5 rabbits (33%) in group 2, and in 3 rabbits (20%) in group 3. There was not a statistically significant difference between groups (P=0.41). Excessive inflammation was observed in 3 rabbits (20%) in group 1, in 7 rabbits (47%) in group 2, and 3 rabbits (20%) in group 3. There was no a statistically significant difference between groups although inflammation rate was higher in the rabbits which underwent buccal mucosa graft (P=0.18). CONCLUSION: The surgical treatments applied with free mucosa graft reduced anastomosis tension through enabling anastomosis to the distal of cricoid instead of thyroid cartilage. Free palatal mucosa grafts may be used in sub-glottic field, one of the most challenging fields of trachea surgery, due to ease of application and rapid vascularization.

Survival of Minced Cartilage Grafts with Comparison Surgicel(®) Original and Fibrillar.

BACKGROUND: Cartilage grafts are commonly used in nasal surgery for structural and/or esthetic purposes. The viability of cartilage grafts has been investigated in many forms since the use of cartilage grafts in surgical procedures. OBJECTIVES: The objective of this study was to investigate the viability of minced cartilage grafts and whether there is a difference between grafts wrapped in Surgicel(®) Original and Surgicel Fibrillar. METHODS: A total of ten New Zealand rabbits were used for the study. Cartilage grafts were harvested from one side ear. Four groups were formed. Group 1: minced cartilage graft wrapped in Surgicel Fibrillar; Group 2: minced cartilage graft wrapped in Surgicel Original; Group 3: bare minced cartilage graft; and Group 4: bare diced cartilage graft. Four small subcutaneous pockets were made in the backs of the rabbits, and the grafts were placed in these pockets. All of the rabbits were sacrificed at the end of 3 months, and the samples were collected. The sections were stained with hematoxylin and eosin (H&E), toluidin blue, safranin-O, masson trichrome, and glial fibrillary acidic protein immunohistochemical. All specimens were assessed histopathologically under a light microscope. RESULTS: There was no statistically significant difference between the Surgicel Fibrillar and Surgicel Original groups with respect to any of the parameters. Bone formation, calcification, inflammation, fibrosis, and basophilia were similar in all groups, with no significant difference among them. In the Surgicel Fibrillar and Surgicel Original groups, a heavy chondrocyte nucleus loss accompanied by a minimal peripheral proliferation was observed. CONCLUSIONS: The viability of bare minced cartilage grafts was found to be similar to that of bare diced cartilage in this study. Minced cartilage grafts can be used in the correction of minor dorsal defects and irregularities in persons with thin nasal skins, especially in primary and revision rhinoplasty. Although there is no statistically significant difference between the Surgicel Fibrillary and Surgicel Original groups, we think that, if it is necessary to use oxidized regenerated cellulose, it should be in the fibrillar form. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

The Use of the PlasmaBlade and Acellular Dermal Matrix in Rhinophyma Surgery: A Case Report.

BACKGROUND: Rhinophyma is a rare, disfiguring disease characterized by a slow progressive overgrowth of the soft tissue of the nose associated with end-stage severe acne rosacea. OBJECTIVE: We present a case of severe rhinophyma treated successfully using PlasmaBlade and acellular dermal matrix with split-thickness skin graft. METHODS: This procedure combines deep excision with PlasmaBlade followed by coverage with an acellular dermal matrix for dermal substitution and split-thickness skin graft. RESULTS: Functional and aesthetic results were satisfactory. CONCLUSION: We offer a new approach to surgical treatment of rhinophyma. Total excision of phymatous tissue and single session replacement of epidermal-dermal components is an effective treatment for patients with severe rhinophyma, resulting in satisfactory functional and aesthetic outcome. This combined treatment modality prevents the recurrence of rhinophyma. It should be considered an appropriate alternative in cases of severe rhinophyma.