Plastic Surgery

EDITORIAL
	The plagiarism	p. 1
	Cenk Demirdover DOI:10.4103/1300-6878.249406
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REVIEW ARTICLE
	A general evaluation of stem cell studies and human cloning from the ethical, faith, and legal perspective	p. 3
	Cemal Alper Kemaloglu, Fatih Birtek DOI:10.4103/tjps.tjps_46_18   Stem cell and cloning studies bear promising potential in the field of regenerative medicine with their exciting and innovative features. The wide range of applications of these cellular treatments and their permanent repairing qualities foretell that a completely different scientific paradigm is emerging for the future. However, satisfactory insight has not yet been developed with respect to the moral status and legal aspects of these studies. Furthermore, their potentially untoward side effects are not understood well enough to compare with the benefits they provide for human life. In general, attempts are made to place the subject in a pattern composed of the sanctity of life, the unique characteristics of being an individual, the boundaries drawn by beliefs, and the basic principles of law. This article will discuss the benefits of stem cell and cloning studies as well as their undeveloped medical, ethical, religious, and legal aspects.
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ORIGINAL ARTICLES
	Inferior gluteal artery perforator flap for closure of sacral defects after pilonidal sinus surgery	p. 9
	Zulfikar Ulas Bali, Anvar Ahmedov, Burak Ozkan, Mustafa Mazican, Yavuz Kececi DOI:10.4103/tjps.tjps_36_18   Introduction: The aim of the current study was to introduce the use of the inferior gluteal artery perforator flap (IGAPF) as a new alternative surgical technique for closure of sacral defects after pilonidal sinus surgery. Patients and Methods: Inferior gluteal artery perforators were used on 15 male patients operated in the plastic and reconstructive surgery department of our tertiary care centers between March 2014 and May 2017. Age, size of the defect, duration of follow-up, complications, and recurrence rate were assessed. Results: The average age was 30.2 (range: 17–54) years, and the mean duration of follow-up was 8.2 (range: 7–16) months. No recurrence was detected within the follow-up period, and the only remarkable complication reported was total flap necrosis attributed to venous congestion in one patient. The mean size of the defects after excision was 21.6 cm2. Conclusion: Our preliminary results imply that IGAPF can be a safe and effective alternative for closure of large defects after pilonidal sinus surgery. Further controlled trials on larger series are warranted to establish the advantages and disadvantages of this alternative technique.
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	Complicated fingertip defects: Clinical approach to their reconstruction and the flaps that can be used in emergency settings	p. 14
	Ozay Ozkaya Mutlu, Ozlem Colak, Ahmet Dilber, Derya Bingol, Onur Egemen DOI:10.4103/tjps.tjps_43_18   Aim: Numerous flaps have been described for the reconstruction of complicated defects of the fingertip. The aim of this study was to evaluate our experience on flaps that can be used in emergency settings, and analyze the outcomes of these procedures. Materials and Methods: A retrospective analysis of 81 patients, who presented to the emergency unit with complicated fingertip defects between 2009 and 2014 and in whom replantation was deemed unsuitable due to various reasons including crush or avulsion type of injury mechanism, absence of the amputated part, or unrepairable vascular injury in the amputate, was carried out. Results: Eighty-nine flaps were performed in 81 patients. The defects were repaired with V-Y advancement flaps in 57% (45 patients – 51 fingers) of the defects, kite flap in 15% (13 patients – 13 fingers), cross-finger flap in 12% (11 patients – 11 fingers), Kutler flap in 6% (4 patients – 5 fingers), digital artery perforator flap in 6% (4 patients – 5 fingers), and thenar flap in 4% (4 patients – 4 fingers) of the injuries. One patient operated with the digital artery perforator flap, and one other operated with the kite flap, developed partial flap necroses. There were no other complications. Conclusion: Functional and esthetic restoration of soft tissues in the fingers is possible with the use of appropriate flaps and meticulous surgical technique.
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	Epidemiological and localization characteristics of non-melanoma skin cancers: Retrospective analysis of 400 cases	p. 19
	Siddika Findik, Orkun Uyanik, Mahmut Altuntas, Zeynep Altuntas DOI:10.4103/tjps.tjps_45_18   Aim: In this study, it was aimed to investigate the epidemiological and localization characteristics of the patients diagnosed with nonmelanocytic skin cancer (NMSC). Materials and Methods: Histopathologic results of patients diagnosed with NMSC in the Pathology Department of Necmettin Erbakan University, Meram School of Medicine, between 2007 and 2017 were retrospectively reviewed. The age, sex, tumor type, and localization of the patients were investigated. Results: A totals of 400 patients diagnosed with NMSC were identified. 220 of the patients were male (55%) and 180 were female (45%). The male to female ratio was 220/180 (1.22). The age range was 10–105-year-old and the mean age was 67.8. Basal cell carcinoma (BCC) was found in 263 patients (65%), squamous cell carcinoma (SCC) in 114 patients (28%) and baso SCC (BSCC) in 12 patients (3%). BCC and SCC were observed together in 9 patients. BCC was most commonly detected in the nasal region with (31%) 82 patients (50%). SHC was most commonly detected in the lower lip region with 26 patients (22%). The localization of the BSCC was most common in the nasal region with 6 patients (%50). The rate of BCC/SCC in the nasal region was 82/11. The BCC/SCC ratio in the extremity region was 4/14. Conclusion: In our region, the most frequent histopathologic diagnosis was found BCC in patients prediagnosed with NMSC, and most cases were seen in male patients. In cases of BCC a BSCC, the most common tumor localization was nose area while it was lower lip area in SCC cases. In addition, BCC and BSCC were not detected in the lower lip.
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	A retrospective analysis of tandoor burn injuries in Eastern Anatolia	p. 23
	Nese Kurt Ozkaya, Safak Aktar, Said Algan, Huseyin Akkaya DOI:10.4103/tjps.tjps_47_18   Aims: This study was to determine the severity of the tandoor burns in a city in Eastern Anatolia and to attract attention for the prevention of tandoor burns. Subjects and Methods: A retrospective evaluation was made of the registration data of burns hospitalized. A record was made of patient variables including burn type, age, gender, socioeconomic status, and amputation site and level. Statistical Analysis Used: Descriptive statistics were used to summarize the data, and results were reported as number and percentage. Categorical variables were evaluated with the Chi-square test. P < 0.05 was considered statistically significant. Results: To emphasize the importance of tandoor burns, the data were classified as tandoor (8.8%) and other types of burns (91.2%). Tandoor burns were the fourth-most common cause of burn. While the rate of amputation in other burn types was 1.26%, the amputation rate was 9.09% in tandoor burns. In the 0–3 years of age group, the percentage of tandoor burns was significantly higher. In respect of tandoor burns, more amputations were performed on children than on adults. Conclusions: Tandoor is used in many places in the world for various purposes (as sociocultural habits, cooking, and warming, especially in low-socioeconomic areas). Increasing protective measures in the use of tandoor may be useful for reducing the amputations due to tandoor burns and its possible long lifetime consequences. Because, unfortunately, tandoor burns are a significant cause of amputations in children-foot amputations in particular.
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CASE REPORTS
	An unusual dog bite in an infant with penetrating brain injury and scalp loss	p. 30
	Sheerin Shah, Hanish Bansal, Rajinder K Mittal, Ashwani K Chaudhary, Sanjeev Uppal, Ramneesh Garg, Soheb Rafique, Jagminder Singh DOI:10.4103/tjps.tjps_52_18   The spectrum of bites varies from superficial scraches till deep avulsion of tissues. Children especially infants , because of inherent inability to defense against dogs , are more liable to get their bites. We report an interesting case of dog bite in a 5 months old infant.
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	A progressed case of Stewart–Treves syndrome in a patient with chronic idiopathic lymphedema in the lower extremity	p. 33
	Mehmet Ozdemir, Muhammed Sulaiman Sultany, Ercan Celikkaleli, Burhan Ozalp DOI:10.4103/tjps.tjps_58_18   Angiosarcomas are uncommon malignant tumors that arise from vascular endothelial cells with poor prognosis. Stewart–Treves syndrome (STS) is a type of cutaneous angiosarcoma that develops in chronic lymphedema. Although the majority of lymphangiosarcomas arise from areas of lymphedema as a consequence of lymph node dissection in radical mastectomy, it has also occurred in other causes of lymphedema. In the pathophysiology of lymphangiosarcoma, impairment of the local immune response and induced angiogenesis are emphasized. A 69-year-old male patient with a previous diagnosis of chronic lymphedema in his left lower limb presented with STS and widespread metastases. The patient refused the treatment for lymphedema and ignored the lesion due to its innocuous appearance. In addition, during the presentation, he had Stage 4 disease and, therefore, he was not a candidate for curative operative treatment. Early tumor resection or limb amputation has the best outcomes in the treatment.
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	Recalcitrant desmoid tumor of the abdominal wall: A reconstructive dilemma	p. 36
	Prakash Chandra Kala, Ranjit Kumar Sahu, Ramkaran Choudhary, Ashok Puranik DOI:10.4103/tjps.tjps_64_18   Desmoid tumors are slow-growing benign tumors. These tumors infiltrate surrounding tissues but not malignant and associated with women of fertile age, especially during and after pregnancy. We report a young male patient with a recurrent desmoid tumor of the anterior abdominal wall who underwent resection four times earlier. The patient had a history of four-time operation over the same site for the same disease. Preoperative evaluation included thorough clinical examination with abdominal ultrasound. The histology revealed a desmoid tumor. Primary surgical resection and immediate reconstruction of abdominal defect were performed.
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LETTER TO THE EDITOR
	Role of tumor-infiltrating lymphocytes in melanoma	p. 39
	Yasemin Benderli Cihan DOI:10.4103/tjps.tjps_49_18
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