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    Can polyglactin mesh be used for prevention of seroma after mastectomy: an experimental study
    (Springer Wien, 2014) Yeniay, L.; Unalp, O. V.; Uguz, A.; Unver, M.; Karaca, A. C.; Sezer, T. O.; Yoldas, T.; Demir, H. B.; Zekioglu, O.; Kapkac, M.; Yilmaz, R.
    Background Seroma formation is still a common problem in breast surgery. Seroma formation is associated with morbidity and financial loss. Fibrin glue was used in several studies for solution, but the results were controversial. On the other hand surgical meshes are promising to prevent the seroma formation. Methods A total of 48 female Sprague-Dawley rats were randomly assigned to four groups. Each underwent radical mastectomy, axillary lymph node dissection, and disruption of the dermal lymphatic vessels. Group 1 is the control group (n = 12). In group 2 (n = 12), 1 x 1 cm polyglactin 910 mesh (Vicryl, Ethicon Johnson&Johson USA) is placed over the chest wall under the skin flaps prior to closure. The animals in group 3 received 0.5 mL fibrin glue (Baxter Healthcare Ltd. United Kingdom) topically throughout the wound before the closure (n = 12). The animals in group 4 (n = 12) received 0.5 mL fibrin glue topically throughout the wound, and 1 x 1 cm polyglactin 910 mesh is placed under the skin flaps prior to the closure. Full thickness tissue samples from both the chest wall and the skin were harvested. The harvested tissue samples were evaluated by a single pathologist in a blind fashion. Results The mean seroma volume of the control group was 1.536 mL whereas the mean seroma volume of the groups 2, 3, and 4 were 1.189, 0.438, and 0.556 respectively. Mean seroma volume was significantly lower, adhesion index and foreign body reaction were higher in group 4. Conclusion Although various studies show controversial results to prevent the seroma formation. This experimental study is an evidence that fibrin glue and polyglican mesh reduce seroma with increasing inflammatory reaction.
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    Effect of COVID-19 pandemic on general surgery trauma surgeries: a single-center, retrospective cross-sectional study
    (Verduci Publisher, 2023) Demir, H. B.; Kircicegi, S.; Okut, G.
    OBJECTIVE: This study aims to assess the impact of trauma surgeries performed in our clinic before and during the COVID-19 pandemic on surgical indications, procedure types, perioperative course, and final outcomes.PATIENTS AND METHODS: We conducted a retrospective single-center clinical study. The study group (n=88) comprised trauma patients who presented to the emergency department during the COVID-19 pandemic and underwent emergency surgeries. The control group (n=115) consisted of trauma patients who sought emergency care and underwent surgeries in the same period of the previous year, before the pandemic. We compared the number of patients, demographic data, clinical findings, diagnoses, and surgical interventions.RESULTS: The study group exhibited a 13.3% decrease in the number of patients compared to the control group during the COVID-19 pandemic. The study group and control group had similar age and gender distributions. The study group had a lower rate of surgical intervention. Among the study group, liver laceration was the most common diagnosis in 19 patients (7.4%), compared to 30 patients (11.7%) in the control group. Mortality rates were 1.0% in the study group and 2.0% in the control group. There were no significant differences in mortality (p=0.632) or patient diagnoses (p=0.357) between the COVID-19 pandemic and control periods. CONCLUSIONS: This study demonstrates a decline in the number of trauma patients admitted to the hospital and undergoing surgery during the COVID-19 pandemic. The pandemic has affected the management of patients requiring urgent surgical intervention, resulting in a lower rate of surgical procedures in the study group. However, despite the preference for medical treatment in trauma patients, surgical interventions remain necessary for appropriate indications.
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    Evaluation of Cases of Graft Nephrectomy After Graft Loss in Patients With Renal Transplantation
    (Elsevier Science Inc, 2018) Ustun, M.; Alci, E.; Budak, S.; Demir, H. B.; Yucel, C.; Sen, S.; Yilmaz, M.; Toz, H.
    Introduction. Renal transplantation is undoubtedly considered the best renal replacement therapy. Graft nephrectomy can be performed in patients with renal transplantation because of complications associated with the failed graft. We aimed to retrospectively investigate the characteristics of patients who underwent graft nephrectomy. Materials and Methods. Between January 2000 and November 2013, the records of 757 patients who had renal transplantation in Ege University Faculty of Medicine Hospital Nephrology-Transplantation outpatient clinic were examined. Sixty-four patients who underwent graft nephrectomy were included in the study. Patients were divided into 2 groups according to the timing of graft nephrectomy. The group of 30 patients who underwent graft nephrectomy in the first 56 days after the renal transplantation was referred to as the "early group" and the group of 34 patients who underwent graft nephrectomy after 56 days was referred to as "late group." Results. In our study, we found the body mass index to be significantly higher in those with early graft loss (P = .02). We found that there was a difference between the groups in terms of sex (P = .012). When the mortality and morbidity rates after graft nephrectomy were examined, mortality was observed in 3 of the 64 patients in the study and morbidity in 1 patient. Conclusion. According to our study, the body mass indices and ages of the subjects who need early graft nephrectomy are higher. However, male sex was significantly more prevalent in patients who underwent graft nephrectomy in the late period compared with the early period.