AMAÇMaksillofasiyal kırığı bulunan hastalar, bu travmaya eşlik eden kafa travması geçirme konusunda yüksek risk altın-dadırlar. Bu hastalarda kafa travmasının erken anlaşılma-sı hastanın sağkalımı ve iyileşmesi için kritik öneme sahiptir. GEREÇ VE YÖNTEMOcak 2006 ile Eylül 2009 tarihleri arasında hastanemizin acil servisine maksillofasiyal kırık nedeniyle gönderilen 246 hastanın kayıtları geriye dönük olarak tarandı. Hastaların yaş, cinsiyet, maksillofasiyal travmanın nedeni, tipi, yerleşimi ve kafa travması analiz edildi. BULGULARHastaların yaşlarının ortalaması 23,61±16,75 idi (%83,3 erkek, %16,7 kadın). Kraniyal yaralanma maksillofasiyal travmalı 38 hastada gözlendi. Hastalar arasında tek yüz kemiği kırığı bulunanlarda kafa travması riski çoklu kırıklı hastalara göre 3,44 kat daha az gözlenirken (p<0,001), yüz kemiği çoklu kırılan hastalarda kafa travması geçirme riski anlamlı derecede artmıştı (p<0,001). İçinde nazal kemik, maksiller kemik, mandibular kemik ve frontal bölge kırığı bulunan hastalarda kafa travması riski önemli derecede artmıştı (p<0,05 her bir grupta). SONUÇÇoklu yüz kemik kırığı bulunan hastalarda klinik bulguları olmasa dahi kafa travması yönünden araştırılmaları gerekir.Anahtar Sözcükler: Maksillofasiyal travma; kafa travması; yüz kemik kırığı.

The short-term and the long-term effects of abdominoplasty on the respiratory function of healthy adults are not known because of a lack of studies on this subject. Theoretically one might suggest that abdominoplasty can cause respiratory decompensation resulting from musculofascial plication, which reduces the respiratory reserve by decreasing intra-abdominal volume and diaphragmatic excursion. This prospective study was performed to evaluate the short-term effects of abdominoplasty on the pulmonary function of 14 consecutive otherwise healthy subjects. Calculation of the body mass index, measurement of the waist circumference, and the distance from xiphoid to umbilicus, and spirometry were performed for each subject preoperatively, and they were repeated at 10 and 30 days after the operation. The mean values of body mass index (p < 0.001), waist circumference (p < 0.05), and the distance from xiphoid to umbilicus (p < 0.001) were all decreased significantly by postoperative day 10. Comparison of the spirometric measurements showed a significant improvement in the mean forced vital capacity (p < 0.01) on day 30 postoperatively, whereas the mean forced expiratory volume in first second did not change throughout the study period. The authors conclude that abdominoplasty could improve pulmonary function in healthy subjects by increasing the forced vital capacity.

The island volar advancement flap seems to be a safe and useful procedure for thumb reconstruction. Providing a 1.5 cm of extra flap advancement, this new procedure enables us 1-stage closure of considerably large defects and is a critical achievement in thumb reconstruction.

Small meningomylocele defects can be closed primarily. Other repair techniques are required for closure of meningomyelocele defects of >5 cm. In this anomaly, in which random or musculocutaneous flaps are usually used, the technique for skin defect closure should have the following criteria: a safely harvested flap with good blood supply; minimal morbidity in the donor site; closure with adequate thickness to protect the underlying neural structure; and a repair to prevent leakage of cerebrospinal fluid. The dorsal intercostal artery perforator flap is a new perforator flap with a large skin island that can be used safely in the dorsal region. In this article, repair of large skin defects due to myelomeningocele has been attempted using a dorsal intercostal artery perforator flap, and the results are discussed.