Equivalence in Color-coded Duplex Sonography Parameters before Complex Microsurgery.

Background: Color-coded duplex sonography (CCDS) is a widely proposed noninvasive diagnostic tool in microsurgery. CCDS has been applied to lower extremity salvage cases to define appropriate blood flow velocity criteria for achieving arterial success in diabetic foot and complex microsurgery cases. This study aimed to compare the success ratio of free flaps when using CCDS versus cases where CCDS was not used. Methods: We included complex microsurgery cases from 2019 to 2021. These cases were subsequently categorized into two groups: group A consisted of cases where CCDS parameters were applied, whereas group B comprised cases where CCDS was not performed at all. Results: The study encompassed 14 cases (11 men and three women). The age range varied from 23 to 62 years, with an average age of 42. Using CCDS analysis and planning demonstrated improved outcomes in comparison with cases where CCDS was not performed, albeit without statistical significance (P = 0.064). Conclusions: The application of CCDS proves to be beneficial in the realm of microsurgery. Although not achieving statistical significance, our data imply that CCDS utilization holds promise for enhancing microsurgical procedures.

Initial Histological Evaluation of a Novel Dura Mater Graft Based on Capsule Granulation Harvested From Subcutaneous Tissue: Experimental Model.

INTRODUCTION: Autografts are useful but unfortunately are limited in big dural defects, in such cases, synthetic implants have been recommended. Extensive evidence in the literature suggests that sometimes synthetic implants had high rates of complications like infections. This paper aims to present a novel dura matter graft based on capsule granulation tissue harvested from subcutaneous space as a dura substitute and its histological findings. MATERIALS AND METHODS: Wistar rats between 240 and 430 grams of both genders were included. First stage procedure introducing silicon spheres in the subcutaneous tissue. Second stage procedure 4 weeks later harvested de capsule granulation tissue that contain them. Then a craniectomy was performed to create a dura mater defect. This defect was reconstructed with the granulation tissue was placed onlay the defect. After another 4 weeks the subjects were euthanized and sent to an external pathology unit for analysis with validated integration scales. RESULTS: A total of 5 subjects were included (3 males and 2 females) with weight between 240 and 430 grams. Only 2 outcome out of 6 scales had significance difference between the samples: adhesions P = 0.011 and integration P = 0.006. CONCLUSIONS: The histological findings shown that capsule granulation graft is a compatible, autologous compatible substitute for dura mater. It has a great potential of full integration and an acceptable grade of adhesions.

Evaluation of Predictive Values of an Automatic Device Measuring Oximetry in Free Flaps.

Free-flap monitoring is challenging to perform in some centers. It requires the availability of trained health care personnel for 24 hours a day and seven days a week. Many methods had been proposed for flap monitoring, and none of them are superior to clinical evaluation. This study aimed to present a murine model to evaluate the accuracy (sensitivity, specificity, and the positive or negative predictive values) of a device. Wistar rats weighing 240-490 g were included for intervention and data collection. A murine model of left inferior epigastric vessel flaps was implemented. Intermittent pedicle clamping was performed to calculate the accuracy of the device that detects flow obstruction. The general variables studied were age, weight, and gender. The sensitivity, specificity, and negative or predictive values were calculated. The results showed a sensitivity of 97%, a specificity of 95% with a positive predictive value of 95%, and negative predictive value of 97%. The sensitivity and specificity showed excellent results within the range of clinical security. We require more data to analyze the multiparameter monitoring to see if it is feasible and cost-effective.

Time Reduction by Prebending Osteosynthesis Plates Using 3D-Printed Anatomical Models, In Patients Treated With Open Reduction and Internal Fixation.

INTRODUCTION: The incidence of facial bones fractures is 18 to 32 for each 100,000 inhabitants. The most affected population are young working people. Fractures are most commonly caused by assaults and motor vehicle accidents. Its cost of care reaches 1.06 billion dollars. Premodeling osteosynthesis plates with anatomical models can decrease surgical time, bleeding, and increase patient satisfaction. This study aims to evaluate the impact of premodeled osteosynthesis plates, using anatomical models in patients with facial fractures. MATERIAL AND METHODS: Patients with facial fractures treated by open reduction and internal fixation were included-Group A without premolding plates and Group B with premolding. The variables studied were: age, sex, etiology of the fractures, number of fractures, among other variables that reflect the quality of the results. RESULTS: A total of 17 osteosynthesis plates were included in 6 patients. The age was 22 to 47 years; all patients were male. The maximum surgery time was 129 to 300 minutes. The average time to start work was 4.8 weeks. When comparing the variables between the groups, we found no difference between the groups for bleeding P = 0.24, the start of work P = 0.19, the time of surgery P = 0.082, or for osteosynthesis time P = 0.15. There was only a significant difference in patient satisfaction, P = 0.04. CONCLUSIONS: The evidence collected shows that premodeling the plates only improves patients' satisfaction among facial fractures treated by open reduction and internal fixation.

Enfermedad de Ollier de presentación bilateral. Reporte de un caso y revisión de la literatura / Bilateral presentation of the Ollier's disease. A case report and literatura review

Los osteocondromas o endocondromas son tumores benignos de cartílago hialino maduro que crecen en las metáfisis de los huesos tubulares de la mano, y son lesiones primarias solitarias o múltiples. Cuando los encondromas aparecen en la infancia, en forma múltiple y sin un patrón hereditario conocido, se denomina enfermedad de Ollier. En esta enfermedad, la afección tiene un predominio unilateral, que compromete principalmente manos y pies. El presente caso es de un paciente de 18 años con enfermedad de Ollier desde los dos años de edad con afección de manos y pies, el cual acude a nuestro servicio con una severa deformidad y disfuncionalidad de antebrazo y mano derecha. El paciente se manejó con una amputación estético funcional de los dedos cuarto y quinto, así como resección de los encondromas de los dedos segundo y tercero de la mano derecha. A diferencia de los pocos casos reportados en la literatura de enfermedad de Ollier con afección de manos, este paciente, evolucionó con recidivas sin regresión ni autolimitación, afectando, finalmente a las cuatro extremidades.