OSMOTİK YUMUŞAK DOKU GENİŞLETİCİLERİN YERLEŞTİRİLMESİNDE TÜNEL VE FLEP TEKNİKLERİNİN KARŞILAŞTIRILMASI

Year 2019, Volume: 28 Issue: 1, 1 - 4, 01.04.2019

Ahmet Emin Demirbaş Erdem Kılıç Cihan Topan Alper Alkan

Abstract

Amaç: Yumuşak doku genişleticiler; tümör, defekt veya travma sonrası meydana gelen doku kayıplarının tamiri için komşu sağlıklı dokudan faydalanarak defektlerin onarılması amacı ile cerrahi branşlarda yaygın olarak kullanılmaktadır. Yumuşak doku genişleticiler ile ilgili yaşanan problemlerden biri doku genişleticinin doku altına yerleştirilmesinde doğru tekniğin seçimidir. Bu çalışmadaki amacımız osmotik yumuşak doku genişleti-cilerin doku altına yerleştirilmesinde kullanılan tünel ve flep tekniklerini koyun modelinde karşılaştırmaktır.

Gereç ve Yöntem: Bu çalışmada 14 adet erişkin koyun kullanıldı. Her biri 7’ şer adet koyundan oluşan tünel ve flep tekniğinin karşılaştırıldığı iki ayrı çalışma grup oluş-turuldu. Bu iki teknik; yumuşak dokuya ait nekroz, en-feksiyon ve yara bölgesinin açılması sonucu doku geniş-leticinin kaybı gibi komplikasyonlar yönüyle değerlendi-rildi.

Bulgular: Flep tekniği kullanılan ilk gruptaki toplam 14 adet doku genişleticiden 7 tanesi takip döneminde ağız içine yara kenarlarının bütünlüğünün bozulması sonucu ekspoze oldu. Bu grupta geriye kalan toplam 7 adet doku genişleticide iyileşme sorunsuz olarak gerçekleşti ve yumuşak doku genişlemesi sağlandı. Tünel tekniği kulla-nılan ikinci grupta ise iyileşme ve yumuşak doku geniş-lemesi sorunsuz bir şekilde gerçekleşti ve doku genişle-ticilerde herhangi bir kayıp yaşanmadı.

Sonuç: Osmotik yumuşak doku genişleticilerin tünel tekniği ile yerleştirilmesi ameliyat sonrası meydana ge-lebilecek komplikasyonları önlemede flep tekniğine göre daha başarılıdır.

Keywords

Osmotik yumuşak doku genişletici, tünel tekniği, flep tekniği

COMPARISON OF TUNNEL AND FLAP TECHNIQUES IN THE PLACEMENT OF OSMOTIC SOFT TISSUE EXPANDERS

Abstract

Purpose: Soft tissue expanders are widely used in surgical branches by utilizing adjacent healthy tissue near the defect area for the reconstruction of tissue loss after tumor, defect or trauma. One of the problems with soft tissue expanders is the selection of the right technique for placing the tissue expander under the tissue. We aim to compare tunnel and flap techniques which are used to place the osmotic soft tissue expanders in toothless keratinized soft tissue of sheep mandible.

Materials and Methods: 14 adult sheep were used in this study. Two separate study groups each consisting of 7 sheep were created to compare tunnel and flap technique. Flap and tunnel techniques were evaluated in terms of complications such as necrosis, infection of adjacent soft tissue and loss of tissue expander after surgery.

Results: 7 of a total 14 tissue expanders in the first group using flap technique were exposed to oral cavity due to the loss of the integrity of the wound edges during the follow-up period. In remaining 7 tissue expanders in the first group, it was observed that wound healing was uneventful, and soft tissue expansion was achieved without any problem. In the second group using tunnel technique, it was seen that wound healing and soft tissue expansion were uneventful in all the animals.

Conclusion: The use of tunnel technique for soft tissue expansion with osmotic tissue expanders is more successful than flap technique in preventing postoperative complications.

Keywords

Osmotic soft tissue expander, tunnel technique, flap technique

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