Background: Management of the burn injuries is still a problematic issue because the stasis zone may become necrotic. We hypothesized that udenafil, a potent phospodiesterase inhibitor, can be beneficial in burn treatment by enhancing the viability of the stasis zone. Methods: Fifteen Wistar rats were randomly divided into 3 groups. Comb burn injury model was conducted bilaterally on the back of rats in each subject. Group 1 received 1 mL/d of saline orally for 7 days. Group 2 received 10 mg/kg per day of udenafil for 7 days. Group 3 received 20 mg/kg per day of udenafil for 7 days. At the end of seventh day, gross morphological and histopathological samples of stasis zone survival were evaluated. Results: Histopathological examination of groups 2 and 3 revealed that the stasis zone was mostly viable. The mean necrotic area and severity of inflammation was significantly higher in the control group compared with the treatment groups. Significant differences were determined in treatment groups compared with control group in terms of vital stasis zone area and histopathological parameters. Conclusions: Udenafil treatment improved tissue survival on zone of stasis in. Future experimental studies should be conducted to develop zone of stasis treatment protocols combining udenafil with potent anti-inflammatory and antioxidant drugs.

Symptomatic breast hypertrophy has a significant impact on the quality of life of women. The amount of tissue to be excised may be preoperatively estimated by an experienced surgeon. However, this remains a subjective assessment. Accurate quantification of the amount of breast tissue to be resected in the preoperative period will be a guide for both patient information and the surgeon during the operation. The aim of this study is to develop a new method based on simple measurements that can accurately estimate the resection weight in the preoperative period in a wide range of patients undergoing reduction mammoplasty. The study was carried out between December 2016 and September 2018. With the determined drawing and measurement methods, a triangle was obtained by measuring the distances among the sternal notch (A) ? right nipple areola midpoint (B), sternal notch (A) -left nipple areola midpoint (C) and both inter-nipple areola (B-C). The height of this triangle (h) was found by measuring the distance between the sternal notch and the midpoint of both nipple areola levels. The amount of breast tissue to be resected for each breast was calculated by multiplying the distance between the sternal notch - nipple areola and the height of the large triangle. The formula may be expressed as AB x h for the right breast and AC x h for left breast. When the t values and significance levels of the beta coefficients of the independent variables were examined, the preoperative values were determined to be in accordance with the actual values after surgery (p <0.05). The values calculated before were calculated as the percentage of the actual values (91%). In other words, the R2 value showed that the calculated values were compatible with the actual values (R2=0.910). With the formula described herein, one may accurately estimate the amount of tissue to be resected in a wide range of patients undergoing reduction mammoplasty whose sternal notch-nipple distances are between 28 and 42cm. Additionally, because measurements for each breast are performed separately, breast asymmetry does not affect the results. In conclusion, the formula we devised is simple, applicable and has a high accuracy rate.

BACKGROUND: Management of the skin degloving injuries is still a problematic issue, and the avulsed part of the skin may become necrotic. We hypothesized that the anticoagulant pharmacological agents, fondaparinux and dabigatran may be beneficial in the treatment of degloving injuries by enhancing the viability of the reattached flap. METHODS: Twenty four Wistar rats were divided into three groups as follows: control group (Group 1), fondaparinux group (Group 2) and dabigatran group (Group 3). A model of a degloving injury on the tail of rats was developed in all groups. After 15 minutes, the avulsed flaps were sutured back. Group 1 received 1ml/day saline intraperitoneally for 10 days. Group 2 received 0.3 ml/kg/day fondaparinux intraperitoneally for 10 days. Group 3 received 30 mg/kg/day dabigatran orally for 10 days. At the end of the treatments, gross morphological and histopathological tail tissue survivals were evaluated. RESULTS: Histopathological examination of the fondaparinux and dabigatran groups revealed that the tail skin was mostly viable with mild inflammation. The mean necrotic length in tails and severity of inflammation was significantly higher in the control group compared to the fondaparinux and dabigatran groups (p<0.05). No statistically significant differences were noted between the fondaparinux and dabigatran groups in histopathologic evaluations. There was no significant difference in necrosis lengths and the other histopathological parameters between dabigatran and fondaparinux groups. CONCLUSION: Dabigatran and fondaparinux improved tissue survival in skin degloving injuries concerning gross morphological and histopathological findings. However, the findings of this study should be supported and improved by new experimental and especially clinical studies.

Aim: Soft-tissue defects in the hand and wrist are frequently encountered injuries that may occur due to trauma, burns, or other causes. We aimed to report our experiences in reconstruction of these defects using a radial artery perforator flap (RAPF). Materials and Methods: Eight patients who underwent surgery for reconstruction of the hand and wrist soft-tissue defects at our institution between December 2017 and December 2019 were included in the study. The patients were evaluated in terms of age, sex, etiology, flap size, defect region, and postoperative complications. Results: All defects were reconstructed by utilizing RAPF. The most common etiology of the defects was work-related accidents. The mean age of the patients was 40.4 (10–69) years. The mean flap size was 63.5 ± 14.76 cm². Six patients healed uneventfully, while we observed partial necrosis of the RAPF flap in one of the cases and a marginal epidermolysis in another. The donor sites were skin grafted in each patient. The patient where partial necrosis observed was re-operated for debridement and skin grafting subsequentially. The duration of follow-up of the patients was 6 months. Conclusions: Radial forearm perforator flap is a reliable and effective reconstructive option to reconstruct small to moderately sized defects of the hand and wrist.

Lagophthalmos, impairment of closing upper eyelids, can result from various reasons. However, lagophthalmus after a rhinoplasty is both unusual and frustrating. We report a patient experiencing lagophthalmos following rhinoplasty and its management.