[Mechanical venous microanastomosis using a double ring eversion system in reconstructive surgery]. / Microanatomose mécanique veineuse par double éversion sur anneaux en chirurgie réparatrice.

INTRODUCTION: The major complications of free flap surgery are anastomotic obstructions. The coupler, mechanical anastomosis using a double ring eversion system, yields higher venous patency rates than sutured anastomoses, and requires less operating time. We present our initial experience with this coupler in free flap surgery. MATERIAL AND METHODS: We conducted this retrospective study between November 2011 and June 2012. We focused on complications having occurred in the first 10 patients having undergone free flap reconstruction (11 flaps) with end-to-end venous anastomosis using this coupler. Five flaps were used to fill cervico-facial defects in carcinologic surgery: one for mandibular osteoradionecrosis, one for cranioplasty coverage, one for cranial base reconstruction, two for skin defects in lower limb (heel, leg). One was an antebrachial radial flap, four anterolateral thigh flaps, five fibular flaps, and one latissimus dorsi flap. Fifteen veins were anastomosed. The diameters of the couplers used were 2.5 mm (3/15), 3 mm (6/15), and 3.5 mm (6/15). RESULTS: There were no venous complications. One flap failed because of arterial ischemia. DISCUSSION: The coupler is a fast and reliable alternative to usual sutures in free flap reconstructions, for head and neck as well as for limbs.

[Epidemiology of congenital malformations in Bolivar City, Venezuela. Analysis of the consanguinity factor]. / Epidemiología de las malformaciones congénitas en Ciudad Bolívar, Venezuela. Análisis del factor consanguinidad.

The proportion of consanguineous matings and average inbreeding coefficients were established and compared in a sample of families with incidence of malformed newborns or stillborns as well as in paired normal controls. All children were born at the Ruiz y Páez Hospital in Ciudad Bolívar between april 1978 and june 1990. The samples included 2406 normal newborns (No), 2403 malformed newborns (Ma) and 50 malformed stillborns. The second sample was subdivided into 1934 with a single malformation (Mo), 315 with polimalformations (Po), 77 cases with Down syndrome (Do) and 77 with malformations of the central nervous system (SNC). Statistically significant differences were found in the frequency of consanguineous matings for the Ma, Po and Do groups when compared to the No group. A higher proportion of first cousins matings among parents of the Po and Do groups was found at F = 1/16, F = 1/64 and 1/32, in that order. A statistically significant absence of type I first cousins matings and a non significant predominance of type II first cousins matings were found, which might be pointing out to particular ways of mating behavior in this population, related to socio-cultural custom. Average F values for the No group were found to be similar to others reported for Venezuelan and Latin-American populations. Studies like this, help in providing basic parameters for the venezuelan population genetics.

Some variables of the craniofacial complex in a Venezuelan population of Negroid ancestry.

A total of 226 individuals (101 males and 125 females), from La Sabana, a Venezuelan Negroid isolate, with ages between 8 and 60 years, were studied in order to characterize the population for its craniofacial variables and to study the behavior of these variables in relation to age and sex. The variables studied were grouped in three categories: direct cephalometric variables, which included 6 measurements taken directly on the individuals; indirect cephalometric variables, which included 18 measurements (9 angular and 9 linear), taken on lateral head films; and dental variables, which included 9 measurements taken from dental models. In general the direct variables showed the lowest coefficients of variation (CV), suggesting homogeneity within this sample. They were followed by the dental and the indirect variables, which had the highest CV values. In order to detect age and sex effects on the variables, sex and age group comparisons were performed with Student t tests. A greater proportion of significant differences were found among the direct variables, indicating that age and sex have more influence on this group of variables than upon the other two. Comparisons of our sample from La Sabana, with samples from African Negroid, Caucasoid, and Amerindian population show that La Sabana individuals have a craniofacial pattern basically Negroid, as we expected, although some contribution from Caucasoides and especially Amerindians is also suggested in our data.