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    Effect of Gentamicin-absorbed Collagen in Wound Healing in Pilonidal Sinus Surgery: a Prospective Randomized Study
    (Sage Publications Ltd, 2010) Yetim, I.; Ozkan, O. V.; Dervisoglu, A.; Erzurumlu, K.; Canbolant, E.
    Pilonidal sinus is a common disease that causes the loss of many working hours, but treatment is variable and problematic. The effect of gentamicin-absorbed collagen on healing, infection and recurrence, and length of hospital stay were examined after pilonidal sinus surgery. Patients undergoing surgical treatment for pilonidal sinus were randomly assigned into two groups each of 40 patients. Both groups were treated with excision and primary closure under local anaesthesia. Group 1 (control) received oral antibiotics for 7 days post-operatively. In group 2, prior to wound closure, gentamicin-absorbed collagen sponges were placed on the sacral fascia and these patients did not receive oral post-operative antibiotic therapy. Patients in group 2 had a significantly shorter mean wound healing time, significantly lower infection and recurrence rates, and a significantly shorter hospital stay than those in group 1. It is concluded that implantation of a gentamicin-containing collagen sponge on the wound area in pilonidal sinus decreased the rates of infection and recurrence, and shortened the hospital stay.
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    Effect of Local Gentamicin Application on Healing and Wound Infection in Patients with Modified Radical Mastectomy: a Prospective Randomized Study
    (Sage Publications Ltd, 2010) Yetim, I.; Ozkan, O. V.; Dervisoglu, A.; Erzurumlu, K.; Canbolant, E.
    This study investigated the effects of Gentacoll implants on healing in patients (n = 44) undergoing modified radical mastectomy and axillary dissection. Group I, the Gentacoll group (n = 22), underwent surgery followed by insertion of 10 x 10 x 0.5 cm Gentacoll implants (280 mg collagen sponge plus 200 mg gentamicin sulphate) into the axillary area and under the flap area of the breast before wound closure. Group II, the control group (n = 22), underwent surgery without the application of Gentacoll. Neither group received oral or parenteral post-operative antibiotic therapy. Outcome measures included wound infection, seroma formation, total drainage volumes, drain removal time and duration of hospital stay. Postoperative infection rate, seroma formation, drainage volumes and duration of hospital stay were significantly reduced in the Gentacoll group compared with the control group. In conclusion, the application of Gentacoll significantly improved postoperative outcomes in patients undergoing modified radical mastectomy.
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    Is advanced age a significant risk factor for laparoscopic cholecystectomy?
    (Edizioni Minerva Medica, 2010) Yetim, I.; Dervisoglu, A.; Karakose, O.; Buyukkarabacak, Y.; Bek, Y.; Erzurumlu, K.
    Aim. There have been a few reports about the outcome of laparoscopic cholecystectomy (LC) in the elderly patients. The aim of this study was to assess if morbidity and mortality may be increased in the geriatric patients because of high incidence of co-morbidity. Methods. From November 2000 to January 2009, 146 patients aged 60 years and older who underwent LC were reviewed. Patients were placed into two groups by ages: Group A (age = 60-74 years, N.=126), Group B (age >= 75, N.=20). Results. One hundred forty six patients underwent LC for benign gallbladder disease during this study period There was no difference in operative time, ASA, distribution of sex between the two groups. Most patients were treated with LC for symptomatic cholelithiasis (82.5%) in both groups. There were sixty eight cases (53.96%) in the Group A and 14 (70%) patients in the Group B had co-morbid diseases (P>0.005). Conversion rates and morbidity was not different significantly according to ages for either group (P>0.05). The rate of conversion to OC was 9.5% in the Group A and 5% in the Group B. Five complications were occurred in the four patients. There was only one bile duct injury in the Group A. Conversion rates and postoperative complications were not affected by gender and co-morbid diseases (P>0.05) in our study whereas acute cholecystitis were found as a risk factor for conversion to open surgery and complications according to the cases preoperatively diagnosis (P=0.001). Conclusion. LC should be recommended with acceptable morbidity and mortality in the elderly. Morbidity and conversion to OC are not increased with advanced age even in the extremely elderly patients. Acute cholecystitis is correlated with a high risk factor for morbidity and conversion to OC.