Person: SAÇAK, BÜLENT
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SAÇAK
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BÜLENT
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Publication Open Access Effect of the pandemic on surgical procedures in a tertiary care hospital: A retrospective review(2022-09-01) SAÇAK, BÜLENT; KESİMER, MEHMET DENİZ; ŞAHİN, BAHADIR; UĞURLU, MUSTAFA ÜMİT; SAKAR, MUSTAFA; YUMUŞAKHUYLU, ALİ CEMAL; Ozkan M. C. , SAÇAK B., KESİMER M. D. , ŞAHİN B., UĞURLU M. Ü. , Sirzai E. Y. , SAKAR M., Aykut A., Cicek I., YUMUŞAKHUYLU A. C.Objective: The aim of this study was to examine the impact of performing surgeries with necessary precautions and to evaluate demographic characteristics of operated patients during novel coronavirus-2019 (COVID-19) pandemic and the infection rates during hospitalization and within 14 days after surgery.Publication Metadata only Gluteal yağ greftlemesinin tarihçesi(Arc Yayınları, 2021-01-01) SAÇAK, BÜLENT; Saçak B.Publication Open Access Continuous hemoglobin measurement during frontal advancement operations can improve patient outcomes(2022-12-01) SARAÇOĞLU, AYTEN; ABDULLAYEV, RUSLAN; SAÇAK, BÜLENT; AYKAÇ, ZEYNEP ZUHAL; SAKAR, MUSTAFA; Saraçoğlu A., Abdullayev R., Sakar M., Saçak B., Incekoy F. G., Aykac Z.Massive hemorrhage in pediatric cranioplasty operations may necessitate blood transfusion, which may cause many complications. Radical-7 Pulse CO-Oximeter (Massimo Corporation, Irvine, CA) can provide continuous hemoglobin concentration (SpHb) measurements noninvasively. In this study, we aimed to evaluate the effects of SpHb measurement on perioperative transfusion management and postoperative patient outcomes. For this retrospective case-control study, we collected the data of pediatric patients undergoing fronto-orbital advancement surgery for plagiocephaly and trigonocephaly between 2018 and 2021. Perioperative SpHb monitoring was performed for patients in the SpHb Group. Other patients that were managed conventionally were considered as the control group (C Group). The data on patients\" demographic and clinical characteristics, intraoperative hemodynamic and laboratory variables such as blood gases, intraoperative blood losses, the amount of the transfused blood products, the length of postoperative intensive care unit (ICU) stay, and the duration of hospital stay were collected. The data of 42 patients were collected, and 29 of these patients were males (69%). In 16 of the patients, SpHb monitoring was performed. The demographic, clinical, and perioperative hemodynamic characteristics of the patients were comparable between the groups. Compared to the C Group, the SpHb Group had significantly lower perioperative packed red blood cell (PRBC) transfusion (136.3 +/- 40.1 vs. 181.5 +/- 74.8 mL, P = 0.015), less postoperative drainage (125.3 +/- 47.7 vs. 185.8 +/- 97.6 mL, P = 0.013), and shorter ICU stay (37.1 +/- 12.0 vs. 64.8 +/- 24.9 h, P < 0.001). There was a positive correlation between the amount of PRBC transfusion and the length of ICU stay (r = 0.459, P = 0.003). Patients with perioperative continuous SpHb measurement have lower intraoperative PRBC transfusion, less postoperative bleeding, and shorter ICU stay. When necessary, SpHb, together with clinical judgment and laboratory confirmation, can be used in decision-making for perioperative PRBC transfusion.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 A new method for quantification of frontal retrusion and complex skull shape in metopic craniosynostosis: a pilot study of a new outcome measure for endoscopic strip craniectomy(2022-06-01) SAÇAK, BÜLENT; ERDOĞAN, ONUR; BAYRİ, YAŞAR; DAĞÇINAR, ADNAN; SAKAR, MUSTAFA; SÖNMEZ, ÖZCAN; SAKAR M., Haidar H., SÖNMEZ Ö., ERDOĞAN O., SAÇAK B., BAYRİ Y., DAĞÇINAR A.OBJECTIVE The objective of this study was to propose a new skull outline–based method to objectively quantify complex 3D skull shapes and frontal and supraorbital retrusion in metopic craniosynostosis using 3D photogrammetry. METHODS A standard section from 3D photogrammetry, which represents the trigonocephalic shape, was used in this study. From the midpoint of the area of this section, half diagonals were calculated to the skull outline at 5° increments in the anterior half of the head. These half diagonals were used to create a sinusoidal curve, and the area under the sinusoidal curve (AUC) was used to represent the mathematical expression of the trigonocephalic head shape. The AUC from 0° to 180° (90° from the midline to each side) was calculated and is referred to as AUC0→180. The AUC from 60° to 120° (30° from the midline to each side) was also calculated and is referred to as AUC60→120. A total of 24 patients who underwent endoscopic strip craniectomy and 13 age- and sex-matched controls were included in the study. The AUC values obtained in patients at different time points and controls were analyzed. RESULTS The mean preoperative AUC60→120 and AUC0→180 in the patients were significantly lower than those in control individuals. The increase in both AUC60→120 and AUC0→180 values is statistically significant at the discontinuation of helmet therapy and at final follow-up. Receiver operating characteristic curve analysis indicated that AUC60→120 is a more accurate classifier than AUC0→180. CONCLUSIONS The proposed method objectively quantifies complex head shape and frontal retrusion in patients with metopic craniosynostosis and provides a quantitative measure for follow-up after surgical treatment. It avoids ionizing radiation exposurePublication Metadata only Distribution of plastic, reconstructive and aesthetic surgery professionals in Turkey: According to provinces(2014-01-01) SAÇAK, BÜLENT; SAÇAK B., Tuncer F. B., Numanoglu A.Plastic, Reconstructive and Aesthetic Surgery (PRAS) is a unique surgical specialty because of its broad area of expertise and its tendency for multidisciplinary work. In this study, through the cross-sectional data obtained from Turkish Statistical Institute and the Ministry of Health, ratios of plastic surgery professionals per population in each province in Turkey has been calculated and compared. The overall ratio of PRAS professionals per 100,000 populations is 1.05 in Turkey. In the analysis made according to the provinces, the highest ratio of PRAS professionals has been found in Ankara (1.99/100,000). In the highly populated cities, PRAS professional ratio is 1.2 in average, whereas the same ratio is 0.7 in average in low-population cities (p<0.001). Based on the results of the present study, the distribution of PRAS professionals in Turkey shows a great diversity across the provinces. The results of this cross-sectional, descriptive, original study are very valuable in terms of keeping a light on health and education policies regarding plastic and reconstructive surgery.Publication Open Access Modified distal anastomosis between colon and thoracic esophagus for hypopharynx reconstruction using free colon flap: A comparison study(2020-09-01) SAÇAK, BÜLENT; Chilgar R. M., Nicoli F., Baljer B., Ciudad P., Manrique O. J., Sacak B., Orfaniotis G., Chen H.Background: Free colon flap is the preferred method of hypopharynx reconstruction when the defect is substantial, or simultaneous voice reconstruction is planned. Most of the complications in free colon flaps are located at the anastomosis between colon and thoracic esophagus due to size mismatch of the lumen. We present our experience comparing a modified anastomosis technique and a conventional anastomosis technique at the distal end of interposed colonic segment. Methods: In this retrospective review, 94 patients, divided into two groups, underwent hypopharynx reconstruction. Group A (18 patients), conventional anastomoses between colon and thoracic esophagus was performed, while in Group B (76 patients), underwent the modified method of anastomosis. Results: The average follow-up period was 46 months in group A and 54 months in group B. Fistula formation was found in 2 patients from Group A, and 1 patient from Group B. Strictures were observed in 4 patients from Group A, and 1 patient from Group B. Difference between both groups regarding complications of leakage and stricture formation was statistically significant (p < 0.05). Conclusion: Modified method for anastomosis between colon and thoracic esophagus was found to be effective in the reduction of complications associated with the use of a free colon flap for hypopharyngeal reconstruction. Further advances of this technique could gain momentum in the future.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.