Person: SAÇAK, BÜLENT
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SAÇAK
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BÜLENT
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Publication Open Access Evaluation of residual tumors and recurrence rates of malignant melanoma and non-melanoma skin cancer of head and neck region(MARMARA UNIV, FAC MEDICINE, 2019-10-31) SAÇAK, BÜLENT; Durmus Kocaaslan, Fatma Nihal; Alakus, Ali Conor; Sacak, Bulent; Celebiler, OzhanObjective: In this study, we aimed to evaluate residual tumors and recurrence rates of malignant melanoma (MM) and a nonmelanoma skin cancer of (NMSC) head and neck region. Patients and Methods: Medical data of a total of 398 lesions of 323 patients who underwent surgical excision for a basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM) were retrospectively analyzed. All patients were classified according to age, sex, location of the tumor, histopathological diagnosis, lesion diameter, excision diameter, surgical margin status, and residual lesions and recurrence rates. Results: There were 244 lesions (61.3%) in 189 males and 154 lesions (38.7%) in 134 females. The most common type of skin cancer was BCC in 268 lesions (67%), followed by SCC in 122 (31%), and MM in eight (2%), respectively. Recurrence was seen in 3% of the NMSC cases and in 25% of the MM cases. There was a statistically significant correlation between the histopathological diagnosis and recurrence rates. Compared to NMSC, MM cases had a higher risk for recurrence (p=0.029). Conclusion: Our study results suggest that recurrence is associated with the localization and type of the tumor, but not with the age or sex of the patient.Publication Open Access Optimizing survival of large fibula osteocutaneous flaps for extensive full-thickness oromandibular defects: A two-stage approach with temporary orocutaneous fistula(2019-03-01) SAÇAK, BÜLENT; Ciudad P., Huang T. C., Manrique O. J., Agko M., Adabi K., Nicoli F., Sacak B., Kiranantawat K., Moran S. L., Chen H.Introduction: Composite and large head and neck defects requiring extensive skin-mucosa coverage are often reconstructed by combining flaps. Herein, we present a simple and reliable twostage fibula osteocutaneous (FOC) flap technique to improve the survival of a large skin paddle for oromandibular reconstructions. Methods: From October 2011 to September 2016, 47 patients with through-and-through oromandibular defects were reconstructed using FOC flaps with large skin paddles. To ensure optimum survival of skin paddles, temporary orocutaneous fistula were left in place and closed during the second stage operation via de-epithelialization of the skin paddle and suturing of mucosa. Demographic data, operative details, and postoperative complications were recorded. Results: The skin paddle dimensions ranged from 20 to 31.5 cm in length and 12 to 17 cm in width with an average area of 430.4 cm2 (range 300–504). The average time between the two stages and hospital stay were 10 days and 14 days, respectively. Complications at the donor site included wound dehiscence (n = 3, 6.4%), partial skin graft loss (n = 3, 6.4%) and hematoma (n = 2, 4.3%). Recipient site complications included two (4.3%) early postoperative venous congestions that resolved after elevation and three (6.4%) partial skin flap necrosis (less than 5% surface area). All complications resolved with bedside conservative management. There was only one take-back for evacuation of recipient site hematoma (2.1%) but no flap loss. Conclusion: Two-staged large skin paddle FOC flaps can simplify reconstruction of extensive oromandibular defects by improving the reliability of the sizable skin paddle and negating the need for a second flap.Publication Open Access Potential use of transferred lymph nodes as metastasis detectors after tumor excision(2015-07-01) SAÇAK, BÜLENT; Nicoli F., Ciudad P., Lim S. Y., Lazzeri D., D'Ambrosia C., Kiranantawat K., Chilgar R. M., Sapountzis S., Sacak B., Chen H.Due to the fact that it reliably results in positive outcomes, lymph node flap transfer is becoming an increasingly popular surgical procedure for the prevention and treatment of lymphedema. This technique has been shown to stimulate lymphoangiogenesis and restore lymphatic function, as well as decreasing infection rates, minimizing pain, and preventing the recurrence of lymphedema. In this article, we investigate possible additional benefits of lymph node flap transfer, primarily the possibility that sentinel lymph nodes may be used to detect micrometastasis or in-transit metastasis and may function as an additional lymphatic station after the excision of advanced skin cancer.Publication Open Access Assessment of Tissue Perfusion Following Conventional Liposuction of Perforator-Based Abdominal Flaps(KOREAN SOC PLASTIC & RECONSTRUCTIVE SURGERY, 2017-03-15) SAÇAK, BÜLENT; Dogan, Zeynep Deniz Akdeniz; Sacak, Bulent; Yalcin, Dogus; Pilanci, Ozgur; Tuncer, Fatma Betul; Celebiler, OzhanBackground The effect of liposuction on the perforators of the lower abdominal wall has been investigated in several studies. There are controversial results in the literature that have primarily demonstrated the number and patency of the perforators. The aim of this study was to determine the effect of liposuction on the perfusion of perforator-based abdominal flaps using a combined laser-Doppler spectrophotometer (O2C, Oxygen to See, LEA Medizintechnik). Methods Nine female patients undergoing classical abdominoplasty were included in the study. Perforators and the perfusion zones of the deep inferior epigastric artery flap were marked on the patient's abdominal wall. Flap perfusion was quantitatively assessed by measuring blood flow, velocity, capillary oxygen saturation, and relative amount of hemoglobin for each zone preoperatively, after tumescent solution infiltration, following elevation of the flap on a single perforator, and after deep and superficial liposuction, respectively. Results The measurements taken after elevation of the flap were not significantly different than measurements taken after the liposuction procedures. Conclusions The liposuction procedure does not significantly alter the perfusion of perforator-based abdominal flaps in the early period. The abdominal tissue discarded in a classic abdominoplasty operation can be raised as a perforator flap and has been demonstrated to be a unique model for clinical research.Publication Open Access Reply to comment on: Ileocecal vascularized lymph node transfer for the treatment of extremity lymphedema: A case report(2018-09-01) SAÇAK, BÜLENT; Ciudad P., Manrique O. J., Agko M., Huang C., Chang W., Delgado B R., Reynaga C., Sacak B., Chen H.Publication Open Access Two-suture fish-mouth end-to-side microvascular anastomosis with fibrin glue(2012-07-01) SAÇAK, BÜLENT; Sacak B., Tosun U., Egemen O., Sucu D. O., Ozcelik I. B., Ugurlu K.The most decisive step during free tissue transfers and replantation surgery may be respected as microvascular anastomosis. The conventional end-to-side anastomosis technique with simple interrupted sutures is well established and proven to be successful. On the other hand, conventional technique can be time consuming and can cause vascular thrombosis, vessel narrowing, and foreign-body reactions. Search for a more rapid and secure alternative to conventional technique is carried on. In this study, we defined a new technique for end-to-side anastomosis with fish-mouth incisions and application of fibrin glue and compared our results with those we obtained with conventional end-to-side anastomosis. We evaluated end-to-side anastomosis of carotid arteries of a total number of 64 Wistar-Albino rats. In control group (n = 32), conventional anastomoses with 8 to 10 sutures were performed. In experimental group (n = 32), fish-mouth incisions were applied first on the recipient artery, followed by performing anastomosis with only 2 corner sutures and applying commercially available fibrin glue. Time taken to perform the anastomosis was significantly shorter with the experimental group (P = 0.001), whereas early and late patency and aneurysm rates were comparable to those achieved with control group. Histological evaluation did not point out any significant differences between the groups. We have defined a rapid and safe alternative technique of end-to-side anastomosis with the use of fibrin glue. This method may be an alternative especially where multiple anastomoses are required or where it is difficult to approach anastomotic line, as it is easily performed, rapid, safe, and not involving any complex equipments.Publication Open Access Absence of the ileocolic artery: Microsurgical implications in reconstruction of the esophagus with the free ileocolon flap(2016-02-01) SAÇAK, BÜLENT; Orfaniotis G., Sacak B., Nicoli F., Ciudad P., Gesakis K., Lee C. Y., Chen H. C.Publication Open Access Expanding the applications of “Y-shaped” vein grafts in microsurgery(2015-09-01) SAÇAK, BÜLENT; Orfaniotis G., Maruccia M., Sacak B., Ciudad P., Lima A., Chen H.Publication Open Access Feasibility and Complications in Concomitant Lung Resection With Minimally Invasive Repair of Pectus Excavatum(2015-08) SAÇAK, BÜLENT; Bilgi, Zeynep; Ermerak, Nezih Onur; Bostancı, Korkut; Saçak, Bülent; Batırel, Hasan Fevzi; Yüksel, MustafaPublication Open Access Interdigital pilonidal sinus, report of two cases(2016) SAÇAK, BÜLENT; Yalcin, Dogus; Tekin, Burak; Sacak, Bulent; Ayranci, Gulcicek; Erbarut, Ipek