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Öğe A comprehensive analysis of subungual melanomas in a tertiary center: Is amputation outmoded?(2023) Mammadov, Vasif; Yeğin, Mehmet Emre; Topaloglu, Ege; Gur, Ersin; Tiftikcioğlu, Yigit Özer; Gürler, TahirAim: Subungual melanoma is a rare entity. The literature lacks information about its treatment. Alternative treatments exist; amputation or wide local excision (WLE), with or without sentinel lymph node biopsy (SLNB). This study discusses the classical approach for subungual melanoma and compares it with the alternatives. Materials and Methods: A retrospective analysis of subungual melanoma cases between 2008 and 2020 in a tertiary center was done. Results: Thirteen patients were found to have subungual melanoma. Amputation and SLNB were the treatment of choice in 12 patients with invasive diseases. In one patient with a in-situ illness, WLE and SLNB were applied. Mean Breslow thickness was found to be 4.2 mm. The preoperative evaluation showed no signs of metastases in 10 patients, and these patients had SLNB. Two patients had pathological lymph node characteristics in the preoperative evaluation and had elective lymph node dissection (ELND) without SLNB. The mean follow-up was six years, and seven patients died during the follow-ups. Six patients died of natural causes, while one died of systemic disease. Conclusion: Subungual melanoma is a disease that can be controlled with amputation. WLE can be used in in-situ melanomas, but amputation is still a good choice for invasive illnesses.Öğe Did COVID outbreak influence our management of skin tumors?(2022) Yeğin, Mehmet Emre; Gür, Ersin; Yeğin, Ecem Esma; Tiftikçioğlu, Yigit OzerAim: COVID pandemic forced new medical protocols. COVID precautions also changed surgical algorithms causing a change in medical costs. This study aims to clarify COVID-era medical costs and underlying reasons for patients with Head & Neck (H&N) area skin tumors. Materials and Methods: Patients which were operated for H&N tumors in our clinic before and during the COVID outbreak were retrospectively analyzed per sex, age, etiology, PPE usage, treatments, and total costs. Statistical analysis was done for any significant changes. Results: A total of 127 patients of which 70 were operated before (G1) and 57 were operated after (G2) the COVID out-break for H&N tumors were evaluated. Mean ages were 69,94 years for G1 and 65,56 for G2. 28 BCC and 42 SCC patients were in G1 and 11 BCC and 46 SCC patients were in G2. In G1, 69 wide excisions, 44 skin graft, 17 skin flaps, 6 lymph node dissections (LNDs) were done. In G2, 56 wide excisions, 30 skin grafts, 9 skin flaps, 6 LNDs, 5 free flaps were done. G1 patients were hospitalized for a median of 2 days, while G2 patients were hospitalized for a median of 3 days. Median costs were $261,42 in G1 and $624.84 in G2. Statistical analysis with Mann-Whitney-U and Chi-Square tests revealed significant difference only between the costs. When disposable PPE was excluded, the median cost of G2 became $539.84 (G3). Statistical difference between G1 and G3 was found to be insignificant. Conclusion: COVID changed the etiology of our patient groups. However, our treatment protocols, hospitalization lengths, and costs remain the same. Our patient profile and treatment protocols remain similar, but COVID precautions add an extra burden.Öğe Saçlı deri defektlerinin serbest flepler ile rekonstrüksiyonu(2023) Gür, Ersin; Kuybulu, Turgut Furkan; Bekir, Hamit Hakan; İbrahimli, Nargiz; Yeğin, Mehmet Emre; Ateş, Gizem Şule; Tiftikcioğlu, Yigit ÖzerAmaç: Saçlı deri; kalvaryum kemiklerinin üzerini örtmesi ve vücutta herhangi başka bir alanda bulunmayan saç içermesi gibi önemli görevlere sahiptir. Fonksiyonel ve estetik önemi nedeniyle saçlı deri rekonstrüksiyonu plastik cerrahların sıklıkla ilgilendiği özel bir konu haline gelmiştir. Serbest flepler saçlı deri rekonstrüksiyonu için uzun zamandır güvenli bir şekilde kullanılmasına rağmen ideal flep konusunda literatürde bir fikir birliğine ulaşılamamıştır. Çalışmamızda saçlı deri rekonstrüksiyonlarındaki serbest flep tecrübelerimizi sunmayı amaçladık. Gereç ve Yöntem: 2018-2021 yılları arasında toplam 7 hastada (3 kadın, 4 erkek) 8 serbest flep ile saçlı deri rekonstrüksiyonu uygulandı. Hastaların yaşları 8 – 73 arasındaydı. Serbest flep tercihlerimiz arasında 4 latissimus dorsi kas-deri flebi, 3 anterolateral uyluk flebi ve 1 vertikal rektus abdominis muskulokutan flebi yer almaktaydı. Alıcı damar olarak olarak temporalis süperfisiyalis, temporalis süperfisiyalisin frontal dalı, oksipital damarlar, fasiyal damarlar ve trapezius kasının uygun çapta perforatörü kullanıldı. Bulgular: Serbest latissimus dorsi kas-deri flebi yapılan 1 hastada venöz tromboz görüldü. Tüm girişimlere rağmen flep kurtarılamadı. Komplikasyon olarak 1 hastada donör alanda seroma ve 1 hastada alıcı alanda dehissans görüldü. Ek komplikasyon veya flep kaybı gözlenmedi. Sonuç: Serbest flepler geniş ve/veya kompozit saçlı deri defektlerinde kullanışlı seçeneklerdir. Teknik zorluklarına rağmen, perforatör fleplerin avantajlarından dolayı saçlı deri rekonstrüksiyonunda ilk tercih olabileceğini düşünmekteyiz. Latissimus dorsi kas-deri flebi, ilk flebin başarısızlığı durumunda kurtarıcı bir alternatif olarak kullanılabilir.Öğe Superior Thyroid Artery of MLS-preserved Cadavers: A New Microsurgery Training Model(2020) Yeğin, Mehmet Emre; Çelik, Servet; Bilge, Okan[No Abstract Available]
