Researcher:
Sezgin, Billur

Profile Picture
ORCID

Job Title

Faculty Member

First Name

Billur

Last Name

Sezgin

Name

Name Variants

Sezgin, Billur
Sezgin Kızılok, Billur

Email Address

Birth Date

Filters

2015 - 2019162020 - 20227

Advanced Search

Filter by

Settings

Researcher Of Publications: search.filters.isAuthorOfPublication.bce5d7cf-4ad3-486d-bcda-af07ac0c75f8

Search Results

Now showing 1 - 10 of 23
  • Placeholder
    PublicationMetadata only
    A practical method for accurate coordination between the plastic surgeon and the pathologist: the clockwork technique
    (Korean Soc Plastic & Reconstructive Surgery, 2018) N/A; N/A; N/A; N/A; N/A; N/A; N/A; Sezgin, Billur; Kapucu, İrem; Yenidünya, Bahar Güliz; Bulutay, Pınar; Armutlu, Ayşe; Özmen, Selahattin; Yavuzer, Cahit Reha; Faculty Member; Researcher; Undergraduate Student; Teaching Faculty; Teaching Faculty; Faculty Member; Other; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 133762; 327602; N/A; N/A; 133565; 133567; 125951; N/A
    Cooperation between the surgeon and the pathologist is essential for the correct diagnosis and treatment of skin tumors [1]. Precise communication between these two specialties allows for the precise evaluation of the tumor borders by the pathologist, which in turn reduces the amount of unnecessary tissue removed, thereby improving functional preservation and the aesthetic outcomes of surgery. Although not every skin tumor excision requires a high level of interdisciplinary interaction, the location and the type of tumor are key elements that can make such a collaboration necessary. This is especially true for tumors located near critical facial aesthetic subunits such as the eyelids, nostrils, and mouth, and for locally aggressive tumors that spread in unpredictable patterns. Mohs micrographic surgery (MMS) is an alternative to conventional surgery in such cases, and allows tissue preservation to be maximized without compromising adequate surgical excision of the tumor [2]. MMS remains an effective, yet not commonly accessible option, as it can only be performed by pathologically trained surgeons. Nevertheless, regardless of the surgical method, establishing the orientation of the specimen is always critical, and accuracy in this regard can be achieved by various techniques, such as using sutures in different lengths or color codes for each side. Surgeons may use hand-drawn pictures, printed maps of the areas in question, and photographs to guide the patholoCOMMUNICATION A practical method for accurate coordination between the plastic surgeon and the pathologist: The clockwork technique Billur Sezgin1 , Irem Kapucu1 , Guliz Yenidunya1 , Pinar Bulutay2 , Ayse Armutlu2 , Selahattin Ozmen1 , Reha Yavuzer1 Departments of 1 Plastic, Reconstructive, and Aesthetic Surgery and 2 Pathology, Koc University School of Medicine, Istanbul, Turkey Correspondence: Billur Sezgin Department of Plastic, Reconstructive, and Aesthetic Surgery, Koç University Hospital, Maltepe Mh., Davutpasa cad. No 4, Topkapı, 34010 Zeytinburnu, Istanbul, Turkey Tel: +90-850-250-8250–20201, Fax: +90-0442-232-5300, E-mail: bsezgin@ku.edu.tr This article was presented as a poster at the 38th Congress of the Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons on 27–30 October, 2016 in Antalya,Turkey. gist. Tissue nicks or poly-angulated drawings can also be used to improve the orientation [3]. These markings are especially useful when determining the need for re-excision; thus, precision is key for minimizing further tissue loss while obtaining tumor-free margins. We present an easily applicable technique that has been developed to increase the precision of surgical margin evaluation in various skin tumors. The ‘clockwork technique’ uses a clock face template for the orientation of the specimen. This method ensures accurate coordination between the surgeon excising the tumor and the pathologist who guides the surgeon in re-excision until tumor-free margins are achieved. The first step is to determine the type of the lesion via biopsies if necessary, as the safety margin will be adjusted according to the characteristics of the primary tumor. Lesions involving facial subunits may be an exception, as the required margin may not be planned accordingly in certain critical locations. The second step is to outline the approximate borders of the visually apparent tumor and to draw a safety margin that will serve as the clock face for the orientation of the specimen. Then, the periphery of the circle is numbered through 12 as in a clock (Fig. 1). The hourly markings go through both the excised specimen and the healthy tissue, so that the surgeon knows which part of the excised tissue corresponds to which ‘hour.’ The lesion is excised as a complete circle and a single suture is placed at a pre-determined hourly interval as a guide if the marking is disrupted. After microscopic examination, the pathologist can state which hour slice corresponds to a tumor-positive margin, and further excision can be carried out only in the area of that hour slice. Plastic surgeons need to work very meticulously alongside pathologists, as every millimeter of skin preserved can be used to achieve better aesthetic and functional outcomes. The clockwork technique can be applied to any type and size of lesion. It is also beneficial for tumors that have unpredictable growth patterns, where it is not possible to agree on a standard optimal safety margin, such as dermatofibrosarcoma protuberans. Moreover, in areas where aesthetic and functional preservation are concerns, it helps to preserve more healthy tissue, as further re-excision can be carried out in only onetwelfth of the excisional border. In conclusion, this technique is advantageous because it is an easily applicable and fast method that facilitates optimal communication between the surgeon and pathologist regarding specimen borders, allowing precise re-excisions that can be limited to intervals corresponding to one-twelfth of the surgical margin.
  • Placeholder
    PublicationMetadata only
    Use of an epidermal growth factor-infused foam dressing in a complicated case of Adams-Oliver syndrome
    (Ma Healthcare Ltd, 2017) Şibar, Serhat; Fındıkçıoğlu, Kemal; Şencan, Ayşe; Emmez, Hahn; Baykaner, Khan; N/A; N/A; Sezgin, Billur; Özmen, Selahattin; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 133762; 125951
    Adams-Oliver syndrome is a rare disorder with varying degrees of scalp and cranial bone defects as well as limb anomalies, which can range from mild to more pronounced manifestations. In mild cases, closure of these defects can be achieved with a conservative approach. However, surgical closure is recommended in cases where the defect is extensive and includes cranial involvement. Several complicated cases of Adams-Oliver syndrome have been reported, in which flap failures were encountered and other alternatives had to be used to close critical scalp defects. Here, the case of a 4-year-old child with Adams-Oliver syndrome and a complex cranial defect with exposed titanium mesh is described. The patient was successfully treated with epidermal growth factor (EGF) infused foam dressings and subsequent split-thickness skin grafting. The EGF has been highlighted for its essential role in dermal wound repair through the stimulation of the proliferation and migration of keratinocytes, and showed accelerated wound healing when used in partial or full-thickness skin wounds.
  • Placeholder
    PublicationMetadata only
    The efficacy of vibration anesthesia on reducing pain levels during lip augmentation: worth the buzz?
    (Oxford Univ Press Inc, 2017) Güney, Kırdar; N/A; N/A; Sezgin, Billur; Yavuzer, Cahit Reha; Faculty Member; Other; School of Medicine; School of Medicine; 133762; N/A
    Background: Lip augmentation procedures have increased drastically in the last years as patients seek to enhance the shape and size of their lips with dermal fillers. One of the main concerns faced with these procedures is the pain inflicted through injections. On the other hand, many different techniques have been introduced for the reduction of pain while performing office-based minimal invasive procedures. Objectives: This study aims to determine the analgesic effect of vibration anesthesia during lip augmentation procedures and to evaluate its overall effect on the comfort of patients. Methods: A split-lip study was designed in a randomized fashion for 25 lip augmentation patients who received hyaluronic acid fillers with or without with a concurrent vibration stimulus on either half of their lips. Patients were asked to score the pain that they felt during lip injections on a scale from 0 to 10 (0 being no pain and 10 being the worst pain ever felt) for either lip half. The pain scores were then analyzed for significance. Results: The overall pain score on the vibration-assisted side was 3.82 +/- 1.73 while the pain score for the side with no vibration was 5.6 +/- 1.76 (P < 0.001). Twenty-three patients (92%) felt less pain with the addition of vibration while, interestingly, 2 patients (8%) stated that they felt an increase in pain levels on the vibration-treated side. Conclusions: Vibration devices can be a safe and effective tool for lowering pain levels in patients undergoing lip augmentation with hyaluronic acid fillers.
  • Placeholder
    PublicationMetadata only
    Iatrogenic pressure sores: primum non nocere
    (Wiley-Blackwell, 2016) Bulam, Hakan; Özel, Bora; N/A; Sezgin, Billur; Faculty Member; School of Medicine; Koç University Hospital; 133762
    An iatrogenic wound can be defined as a wound that is attained during or as a result of medical treatment provided by a health care giver. A study by Lee et al. reported that the most common iatrogenic injuries that are referred to plastic surgeons are extravasation injuries, followed by cast-induced injuries and vasopressor-induced necrosis 1. Pressure sores can also be identified within the iatrogenic wound spectrum, as a majority of such wounds occur during treatment in a medical facility and is regarded as a serious complication of hospitalisation 2. Stationary positioning and the subsequent altered tissue perfusion along with a compromised nutritional status are among the main factors that lead to decubitus ulcers, and universal precautions are taken in order to minimise the risk 3. Several iatrogenic wounds have been referred to us, mainly unconventional pressure sores in patients undergoing medical treatment in different branches. We believe that the main reason behind the occurrence of these wounds in the wards is the lack of attention given to areas distant to the area of primary pathology. One dramatic case of an iatrogenic pressure sore was a 61-year-old male patient who presented with circumferential penile necrosis following the rigorous taping of an external urinary catheter after colon surgery (Figure 1). However, the necrosis was superficial, and the patient was treated with debridement followed by skin grafting. Another unusual case of an iatrogenic pressure sore was a 42-year-old female patient who presented with a linear ulcer in her left popliteal area due to thromboembolic sock compression following gastric surgery (Figure 2). Her wounds were also treated with debridement and local wound care.
  • Placeholder
    PublicationMetadata only
    Free serratus fascia flap for reconstruction of soft tissue defects involving the distal upper and lower extremity
    (Lippincott Williams and Wilkins, 2020) Tuncer, Serhan; Şencan, Ayşe; Sarı, Alper; N/A; Sezgin, Billur; Faculty Member; School of Medicine; 133762
    Background: Free fascial flaps are widely used for the reconstruction of defects located on the distal extremities as they provide thin yet durable soft tissue coverage. The serratus anterior fascia flap stands out from other fascial flap alternatives as it has optimal anatomical properties that can provide ideal coverage in a wide range of reconstructive challenges. The purpose of this study was to present our experience with the serratus anterior fascia flap in a variety of complex soft tissue defects. Methods: A retrospective review was conducted on patients who underwent reconstruction with the free serratus anterior fascia flap for complex soft tissue defects involving the distal extremities. Results: Complex soft tissue defects of 13 patients were reconstructed using the free serratus fascia flap. No major postoperative complications such as flap loss, dehiscence, infection, or hematoma were encountered in any of the patients. All of the patients demonstrated durable and harmonious long-term flap coverage that facilitated movement without any signs of scar contractures and tendon adhesions at the site of reconstruction. Conclusions: The serratus anterior fascia flap demonstrates versatility and stability for the closure of complex distal extremity defects. It creates thin yet durable coverage that facilitates underlying tendon gliding while providing harmony with the natural contours of these anatomic areas and has low donor site morbidity, making it a primary choice in the reconstruction complex soft tissue defects involving the hands and feet.
  • Placeholder
    PublicationMetadata only
    Reconstruction of an omphalocele defect in an infant with combined polypropylene and oxidized regenerated cellulose mesh and rotation flaps
    (Logos Yayıncılık, 2015) Tuncer, Serhan; Özen, Onur; Şibar, Serhat; N/A; Sezgin, Billur; Faculty Member; School of Medicine; 133762
    Treatment alternatives in pediatric patients with omphalocele are largely based on the extent of the defect, gestational age and accompanying disorders. Primary closure can be the treatment of choice for small defects yet it is not preferred in larger defects as this procedure may result in an uncontrollable increase in intraabdominal pressure. A case of omphalocele that was previously operated was consulted to the plastic surgery department because of anterior abdominal wall defect developed following intraabdominal reduction by the pediatric surgery department. In this case report repair of the defect with polypropylene - oxidized regenerated cellulose mesh in combination with double-opposing rotational flaps is presented. / Omfalosel olgularında tedavi seçenekleri defektin çapına, gestasyonel yaşa ve eşlik eden anomalilere bağlı olarak değişmektedir. Küçük defektlerde primer kapama söz konusu olabilirken, orta ve geniş çaplı defektlerde karın içi basıncının kontrol edilememesi nedeniyle primer kapama-dan uzaklaşılmaktadır. Omfalosel nedeniyle pediatrik cer-rahi bölümünde opere olan ve intraabdominal redüksiyonu takiben karın ön duvarında doku defekti ile başvuran bir olgunun kombine polipropilen ve okside rejenere selüloz içerikli yama ve karşılıklı rotasyon flepleri ile onarımı sunulmuştur.
  • Placeholder
    PublicationMetadata only
    Setup of columellar height with costal cartilage graft modification in a patient with binder syndrome
    (European Society of Plastic, Reconstructive and Aesthetic Surgery, 2016) Aral, Mübin; Küçüker, İsmail; Uygur, Halil Şafak; Sezgin, Billur; Özmen, Selahattin; Doctor; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; Koç University Hospital; N/A; 133762; 125951
    Binder syndrome is an uncommon disorder of unknown etiology. It is characterized by hypoplasia of the nose and maxilla and altered morphology of the associated soft tissue. We present a surgical technique for setting up the columellar height in a patient with Binder syndrome. / Binder sendromu, etiyolojisi tam olarak bilinmeyen nadir bir bozukluktur. Burun-maksiller hipoplazi ve eşlik eden yumuşak doku anomalileriyle karakterizedir. Bu çalışmada Binder sendromlu bir olguda kolumellar yüksekliğin ayarlanmasında kullandığımız cerrahi teknik sunulmaktadır.
  • Placeholder
    PublicationMetadata only
    Animal-inflicted open wounds in rural Turkey: lessons learned and a proposed treatment algorithm for uncertain scenarios
    (Wiley, 2015) Ljohiy, Mbaraka; Gür, Sultan Tuna Akgöl; N/A; Sezgin, Billur; Faculty Member; School of Medicine; 133762
    Uncertainty in the management of animal-inflicted injuries, especially in rural settings, usually results in a general approach to leave all wounds to heal with secondary intention, which can lead to unsightly scarring and functional loss. This study focusus on different circumstances dealt with by plastic surgeons in a rural setting in Turkey and aims to configure what the general approach should be through an analysis of a wide spectrum of patients. Between June 2013 and December 2014, 205 patients who presented to the emergency department for animal-inflicted injuries were retrospectively analysed. Patients who consulted for plastic surgery were included in the analysis to determine which wounds require further attention. Patients with past animal-inflicted injuries who presented to the outpatient plastic surgery clinic with concerns such as non-healing open wounds or cosmetic or functional impairment were also evaluated. Statistical analysis demostrated a significantly lower rate of infection encountered in animal-inflicted open wounds (AIOWs) of patients who consulted for plastic surgery from the emergency department than those who presented to the outpatient clinic (P < 005). The main concern in the management of animal-inflicted wounds is their potential for infection, but this does not mean that every wound will be infected. The most important factor is being able to distinguish wounds that have a higher potential for infection and to select the type of wound management accordingly. An algorithm has been proposed as a guidance for the management of AIOWs, which covers the approach towards both domestic and stray animal-inflicted injuries.
  • Placeholder
    PublicationMetadata only
    Fat grafting to the face with adjunctive microneedling: a simple technique with high patient satisfaction
    (Tubitak Scientific and Technical Research Council Turkey, 2018) N/A; N/A; Sezgin, Billur; Özmen, Selahattin; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 133762; 125951
    Background/Aim: Even though new techniques are emerging to overcome the inconsistent long-term viability of fat grafts, current methods for increasing fat graft survival are not routinely adaptable to all clinical environments. The purpose of this study was to determine the efficacy of microneedling as an adjunct to fat grafting to the face. Materials and Methods: Twenty-two patients that underwent fat grafting to the face with adjunctive microneedling were evaluated in terms of improvement in facial skin quality and facial volume and their results were compared to those in 18 patients that underwent fat grafting without microneedling. The evaluation was conducted with a modification of the Global Aesthetic Improvement Scale at the postoperative third month. Results: All patients that underwent fat grafting and microneedling demonstrated "much improvement" in skin quality and volume at the postoperative third month while "improvement" was noted in patients that underwent fat grafting alone. The difference between skin quality and volume improvement scores was found to be significantly in favor of the patients that received adjunctive microneedling. Conclusion: Fat grafting to the face with adjunctive microneedling is a practical and potentially mutual-acting technique that can be used both for its significant effect on increasing fat graft survival and improving skin quality.
  • Placeholder
    PublicationMetadata only
    The effects of oral mucosa-derived heterotopic fibroblasts on cutaneous wound healing
    (Elsevier Sci Ltd, 2021) N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Sezgin, Billur; Tatar, Sedat; Karahüseyinoğlu, Serçin; Şahin, Gizem Nur; Ergün, Yağmur; Meriç, Gizem; Ersoy, Kaan; Faculty Member; Faculty Member; Faculty Member; PhD Student; Master Student; Undergraduate Student; Undergraduate Student; School of Medicine; N/A; School of Medicine; Graduate School of Health Sciences; Graduate School of Health Sciences; School of Medicine; N/A; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 133762; N/A; 110772; N/A; N/A; N/A; N/A
    An intriguing observation that has recently found support through clinical and experimental studies is that wounds of the oral mucosa tend to display faster healing and result in less scarring than in the skin. We aimed to investigate the potential of heterotopic oral mucosal fibroblasts in cutaneous wounds while determining the main differences between wounds conditioned with either the oral mucosa or dermis-derived human fibroblasts. A total of 48 nude mice were divided into four groups: control, sham, dermal fibroblast (DF), and oral fibroblast (OF). Fibroblasts were isolated, cultured, and seeded onto fibrin scaffolds for transfer to full-thickness dorsal wounds. Cell viability, wound area, healing rate, vascularization, cellular proliferation, dermal thickness, collagen architecture, and subtypes were evaluated. Both cell groups had a viability of 95% in fibrin gel prior to transfer. None of the wounds fully epithelialized on day 10, while all were epithelialized by day 21, which resulted in scars of different sizes and quality. Healing rate and scars were similar between the control and sham groups, whereas fastest healing and least scarring were noted in the OF group. Dermal thickness was highest in the DF group, which was also supported by highest levels of collagen types I and III. Proliferative cells and vascular density were highest in the OF group. DF result in healing through a thick dermal component, while oral fibroblasts result in faster healing and less scarring through potentially privileged angiogenic and regenerative gene expression.