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Sezgin, Billur,Sibar, Serhat,Bulam, Hakan,Findikcioglu, Kemal,Tuncer, Serhan,Dogan, Bilge Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.5
Background Disulfiram implantation is a widely used treatment alternative for alcohol abuse, yet reports on the surgical aspect of disulfiram implantation with respect to patient and drug-related treatment efficacy and wound complications are very limited. We present our clinical experiences with disulfiram implantation and discuss the surgical outcomes obtained with different anatomical planes for implantation. Methods Medical records of all patients referred to our clinic from the psychiatry department between 2007 and 2013 for disulfiram implantation were retrospectively analyzed. Implantation was carried out using 10 sterile Disulfiram tablets (WZF Polfa S.A.), each tablet containing 100 mg of disulfiram. The procedure was carried out by implanting the tablets randomly in either a subcutaneous or an intramuscular plane. The location and the plane of implantation and the complications were recorded for each patient and compared to determine the differences in the outcomes. Results A total of 32 implantation procedures were evaluated for this study. Twenty-five implants were placed in the intramuscular plane (78.2%), while seven implants were placed subcutaneously (21.8%). Exposure was encountered in three of the seven subcutaneous implants (42.9%), while no exposure was seen with the intramuscular implants. Incomplete absorption of the tablets was encountered in one patient with a previous subcutaneous implant who presented 1 year later for re-implantation as part of the continuation of therapy. Conclusions To overcome the issue of treatment continuation in the case of disulfiram therapy, which may be ceased due to frequently encountered wound complications, we believe that implantation in the subscapular intramuscular plane allows both uneventful healing and an out-of-reach implant location.
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Billur Sezgin,Serhat Sibar,Hakan Bulam,Kemal Findikcioglu,Serhan Tuncer,Bilge Dogan 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.5
Background: Disulfiram implantation is a widely used treatment alternative for alcoholabuse, yet reports on the surgical aspect of disulfiram implantation with respect to patientand drug-related treatment efficacy and wound complications are very limited. We presentour clinical experiences with disulfiram implantation and discuss the surgical outcomesobtained with different anatomical planes for implantation. Methods: Medical records of all patients referred to our clinic from the psychiatry departmentbetween 2007 and 2013 for disulfiram implantation were retrospectively analyzed. Implantationwas carried out using 10 sterile Disulfiram tablets (WZF Polfa S.A.), each tablet containing100 mg of disulfiram. The procedure was carried out by implanting the tablets randomly ineither a subcutaneous or an intramuscular plane. The location and the plane of implantationand the complications were recorded for each patient and compared to determine thedifferences in the outcomes. Results: A total of 32 implantation procedures were evaluated for this study. Twenty-fiveimplants were placed in the intramuscular plane (78.2%), while seven implants were placedsubcutaneously (21.8%). Exposure was encountered in three of the seven subcutaneousimplants (42.9%), while no exposure was seen with the intramuscular implants. Incompleteabsorption of the tablets was encountered in one patient with a previous subcutaneousimplant who presented 1 year later for re-implantation as part of the continuation of therapy. Conclusions: To overcome the issue of treatment continuation in the case of disulfiramtherapy, which may be ceased due to frequently encountered wound complications, webelieve that implantation in the subscapular intramuscular plane allows both uneventfulhealing and an out-of-reach implant location.
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Igde, Murat,Ozturk, Mehmet Onur,Yasar, Burak,Bulam, Mehmet Hakan,Ergani, Hasan Murat,Unlu, Ramazan Erkin Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.3
Background Microvascular anastomosis patency is adversely affected by local and systemic factors. Impaired intimal recovery and endothelial mechanisms promoting thrombus formation at the anastomotic site are common etiological factors of reduced anastomosis patency. Epigallocatechin gallate (EGCG) is a catechin derivative belonging to the flavonoid subgroup and is present in green tea (Camellia sinensis). This study investigated the effects of EGCG on the structure of vessel tips used in microvascular anastomoses and evaluated its effects on thrombus formation at an anastomotic site. Methods Thirty-six adult male Wistar albino rats were used in the study. The right femoral artery was cut and reanastomosed. The rats were divided into two groups (18 per group) and were systemically administered either EGCG or saline. Each group were then subdivided into three groups, each with six rats. Axial histological sections were taken from segments 1 cm proximal and 1 cm distal to the microvascular anastomosis site on days 5, 10, and 14. Results Thrombus formation was significantly different between the EGCG and control groups on day 5 (P=0.015) but not on days 10 or 14. The mean luminal diameter was significantly greater in the EGCG group on days 5 (P=0.002), 10 (P=0.026), and 14 (P=0.002). Intimal thickening was significantly higher on days 5 (P=0.041) and 10 (P=0.02). Conclusions EGCG showed vasodilatory effects and led to reduced early thrombus formation after microvascular repair. Similar studies on venous anastomoses and random or axial pedunculated skin flaps would also contribute valuable findings relevant to this topic.
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Murat İğde,Mehmet Onur Öztürk,Burak Yaşar,Mehmet Hakan Bulam,Hasan Murat Ergani,Ramazan Erkin Ünlü 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.3
Background Microvascular anastomosis patency is adversely affected by local and systemic factors. Impaired intimal recovery and endothelial mechanisms promoting thrombus formation at the anastomotic site are common etiological factors of reduced anastomosis patency. Epigallocatechin gallate (EGCG) is a catechin derivative belonging to the flavonoid subgroup and is present in green tea (Camellia sinensis). This study investigated the effects of EGCG on the structure of vessel tips used in microvascular anastomoses and evaluated its effects on thrombus formation at an anastomotic site. Methods Thirty-six adult male Wistar albino rats were used in the study. The right femoral artery was cut and reanastomosed. The rats were divided into two groups (18 per group) and were systemically administered either EGCG or saline. Each group were then subdivided into three groups, each with six rats. Axial histological sections were taken from segments 1 cm proximal and 1 cm distal to the microvascular anastomosis site on days 5, 10, and 14. Results Thrombus formation was significantly different between the EGCG and control groups on day 5 (P=0.015) but not on days 10 or 14. The mean luminal diameter was significantly greater in the EGCG group on days 5 (P=0.002), 10 (P=0.026), and 14 (P=0.002). Intimal thickening was significantly higher on days 5 (P=0.041) and 10 (P=0.02). Conclusions EGCG showed vasodilatory effects and led to reduced early thrombus formation after microvascular repair. Similar studies on venous anastomoses and random or axial pedunculated skin flaps would also contribute valuable findings relevant to this topic.
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