Abstract
Giriş: Çocuklarda gastrointestinal sistemin sağlam tutulamadığı çeşitli durumlarda kolostomi yapılabilir. Geleneksel kolostomi kapatma yaklaşımları ciddi estetik kaygılara neden olabilir. Yara kapanma problemlerini önlemek ve kozmetik olarak daha iyi sonuçlar elde etmek için eliptik eksizyon, S-şekilli flep, M-şekilli flep veya Z-plasti gibi yeni yöntemler kullanılabilir. Bu çalışmada daha kabul edilebilir kozmetik sonuçlar sağlayabilecek kolostomi kapatma tekniklerini değerlendirmek istedik.
Materyal ve Metod: Mayıs 2017 ile Aralık 2017 tarihleri arasında opere edilen 24 kolostomi hastası çalışmaya dahil edildi. Hastalar prospektif olarak değerlendirildi ve randomize edildi. Çalışma süresince 12 hastaya konvansiyonel metod (CM) (Grup 1), diğer 12 hastaya new metod (NM) (Grup 2) uygulandı. Cilt iyileşmesi ve cilt izindeki sonuçlar belirli periyotlarda değerlendirildi ve fotoğraflandı. Kapatma tekniğinde kör olan 3 cerrahtan fotografik sonuçları iyileşme ve son skar açısından değerlendirmeleri istendi. Elde edilen veriler istatistiksel olarak incelendi.
Bulgular: Ortalama yaşı 19 (Aralık: 6 – 36) ay olan 24 (14 erkek – 10 kadın) hasta çalışmaya dahil edildi. Ameliyat sonrası cilt kapanması ve görünümü Grup 2'de Grup 1'e göre anlamlı olarak daha iyiydi (p<1).
Sonuç: NM kullanılarak kolostominin primer kapatılması sırasında oluşan “köpek kulak” deformitesinin CM kullanılarak önüne geçilebilir. Ayrıca Yeni Yöntemlerin kullanılması hem hasta hem de ebeveynlerde ameliyat için ciddi kozmetik ve estetik kaygıların giderilmesinde faydalı olabilir.
References
- Agorio C, Magliano J, Brewer JD, Bazzano CI. (2015). Double M-plasty for Excisional Biopsy of Suspected Melanoma. Actas dermo-sifiliograficas, 107(2), 164-165.
- Demirogullari B, Yilmaz Y, Yildiz GE, Ozen IO, Karabulut R, Turkyilmaz Z, Sonmez K, Basaklar AC, Kale N. (2011). Ostomy Complicatıons In Patients With Anorectal Malformations. Pediatric Surgery International, 27(10), 1075.
- Kishi K, Nakajima H, Imanishi N. (2008). A New Dog Ear Correction Technique. Journal Of Plastic, Reconstructive & Aesthetic Surgery, 61(4), 423-424.
- Liu H, Yu N, Shi J, Hu X, Lv X, Han Y. (2015). A new modified S-plasty for skin defect closure. Aesthetic Plastic Surgery, 39(1), 100-105.
- Sebastian S, Bang RH, Padilla SR. (2009). A Simple Approach To The S-Plasty In Cutaneous Surgery. Dermatologic Surgery, 35(8), 1277-1279.
- Soomro BA, Solangi RA, Siddiqui MA. (2010). Colostomy in Children: Indications and Complications. Pakistan Journal of Medical Sciences, 26(4), 883-886.
- Wisco OJ, Wentzell MJ. (2009). When an M is a V: Vector Analysis Calls for Redesign of the M-Plasty. Dermatologic surgery, 35(8), 1271-1276.
- Zitelli JA. (1990). TIPS For A Better Ellipse. Journal Of The American Academy Of Dermatology, 22(1), 101-103.
Abstract
Background: Colostomy can be performed in various cases in which the gastrointestinal tract cannot be kept intact in children. Conventional colostomy closure approaches can cause serious aesthetic concerns. In order to avoid wound closure problems and to obtain cosmetically better results, new methods such as elliptical excision, S-shape flap, M-shape flap or Z-plasty can be used. In this study, we would like to assess the colostomy closure techniques which can provide more acceptable cosmetic results.
Material and Method: 24 colostomy patients who were operated between May 2017 and December 2017 include to study. Patients were evaluated prospectively and randomized. During study period, 12 patients were treated with CM (Group 1) whereas other 12 patients were treated with NM (Group 2). Results in skin healing and skin scar were assessed and photographed in certain periods. 3 surgeons, who were blind in closure technique, were asked to assess the photographic results in terms of healing and final scar. The data obtained was statistically reviewed.
Results: 24 (14 male – 10 female) patients with a mean age of 19 (Range: 6 – 36) months were included in the study. Following surgery, skin closure and appearance in Group 2 was significantly better than Group 1 (p<1).
Conclusion: By using NM, “dog-ears” deformity which forms during primary closure of colostomy using CM can be avoided. In addition, using New Methods can be beneficial in eliminating the severe cosmetic and aesthetic concerns in both patients and parents for the surgery.
References
- Agorio C, Magliano J, Brewer JD, Bazzano CI. (2015). Double M-plasty for Excisional Biopsy of Suspected Melanoma. Actas dermo-sifiliograficas, 107(2), 164-165.
- Demirogullari B, Yilmaz Y, Yildiz GE, Ozen IO, Karabulut R, Turkyilmaz Z, Sonmez K, Basaklar AC, Kale N. (2011). Ostomy Complicatıons In Patients With Anorectal Malformations. Pediatric Surgery International, 27(10), 1075.
- Kishi K, Nakajima H, Imanishi N. (2008). A New Dog Ear Correction Technique. Journal Of Plastic, Reconstructive & Aesthetic Surgery, 61(4), 423-424.
- Liu H, Yu N, Shi J, Hu X, Lv X, Han Y. (2015). A new modified S-plasty for skin defect closure. Aesthetic Plastic Surgery, 39(1), 100-105.
- Sebastian S, Bang RH, Padilla SR. (2009). A Simple Approach To The S-Plasty In Cutaneous Surgery. Dermatologic Surgery, 35(8), 1277-1279.
- Soomro BA, Solangi RA, Siddiqui MA. (2010). Colostomy in Children: Indications and Complications. Pakistan Journal of Medical Sciences, 26(4), 883-886.
- Wisco OJ, Wentzell MJ. (2009). When an M is a V: Vector Analysis Calls for Redesign of the M-Plasty. Dermatologic surgery, 35(8), 1271-1276.
- Zitelli JA. (1990). TIPS For A Better Ellipse. Journal Of The American Academy Of Dermatology, 22(1), 101-103.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research Articles |
| Authors | |
| Publication Date | August 30, 2023 |
| Submission Date | December 25, 2021 |
| Published in Issue | Year 2023 Volume: 16 Issue: 2 |
Van Health Sciences Journal (Van Sağlık Bilimleri Dergisi) başlıklı eser bu Creative Commons Atıf-Gayri Ticari 4.0 Uluslararası Lisansı ile lisanslanmıştır.
