Double V-Y Flap to Cover the Fingertip Injury: New Technique and Cases.

The volar V-Y flap is used in transverse or dorsal oblique amputations in fingertip injuries; however, its use is contraindicated in patients with volar oblique amputations and cannot advance distally enough to cover the defect. The aim of this report is to describe a technique of double V-Y flap to cover fingertip defects in which a simple V-Y flap is not enough. This technique allows advancement between 30% and 50% farther than the original, simple V-Y flap. Report of cases a series of fingertip amputation covered with this technique. This technique was performed in 7 patients between 25 and 64 years old, with transverse, volar and dorsal oblique defects in the fingertip. The advancing of the flap was between 3 and 5 mm. There were no infections or necrosis of the flaps. In all patients there were acceptable aesthetic results with 2-point discrimination between 4 and 6 mm in the proximal flap and up to 10 mm in the distal flap with a minimum follow-up of 6 months. With this double V-Y flap, we have seen a good coverage even in volar oblique amputation. In addition, it is possible to advance up to 5 mm more with this second V-Y flap without compromising the vitality of the flap. It is a simple and reproducible technique that can be used on any finger, with good results, without flap necrosis.

Localización inusual del carcinoma epidermoide: a propósito de un caso / Unusual location of squamous cell carcinoma: report of a case

El carcinoma epidermoide es una proliferación maligna de células epidérmicas que muestra características variables de la epidermis suprabasal normal; es el tumor mas frecuente de las zonas de piel expuesta a los rayos solares y mucosas, en personas mayores alrededor de los 60 años, con incidencia superior en el sexo masculino en una proporción de 10:1, y moderada probabilidad de causar metástasis. Además de la luz solar hay otros factores predisponentes implicados en su aparición como son la inmunosuperación en pacientes que han sido sometidos a quimioterapia o trasplantes de órganos, por lo que se ha visto su aparición en pacientes más jóvenes. El caso que se presenta se trata de una paciente femenina de 55 años de edad, sin antecedentes de exposición prolongada a los rayos de luz ultra violeta, ni traumático conocido en el área de la lesión.

Carcinoma epidermoid is a wicked proliferation of epidermal cells that shows variable characteristic of the epiderms normal suprabasal; it is the tumor but it frequents fron the areas of exposed skin to the solar and mucous rays, in grown-ups around the 60 years, with superior incidence in the masculine sex in a proportion of 10:1, and moderate probability of causing metastasis. Besides the solar light there are other factors predisposing implied in their appearance like they are the inmunosupresión in patients that have been subjeted to chemotherapy or transplants of organs, for what one has seen their appearance in younger patients. The case that is presented is a 55 year-old femenine patient, without records of lingering exhibition to the rays of light ultra violet, neither traumatic well-known in the the area of the lesion.

A few considerations regarding enhancement of arterialized skin flap survival.

An arterialized skin flap is defined as a flap harvested from the anterior and distal third of the forearm over a venous pathway. It is composed essentially of skin, subcutaneous tissue, and the subdermal plexus of the veins. The flap is perfused at the recipient side by a donor artery at one end and is connected to one or more regional veins at the opposite end. Since it depends on an atypical blood perfusion, leading to edema, epidermolysis, or even some degree of skin necrosis during the immediate postoperative procedure, this skin flap is considered to have a torpid evolution. This article includes some considerations regarding the enhancing of the arterialized skin flap survival, based on our clinical and laboratory experience after its transplantation. The design, construction of its arterial afferent phase, construction of its venous efferent phase, and monitoring are discussed.

Sindrome del nevo azul en tetina de goma / Blue rubber nevus syndrome

El sindrome del nevo azul en tetina de goma, Síndrome de Bean, o Blue rubber bleb nevus es una rara entidad consistente en la presencia de malformaciones vasculares múltiples( hemangioma cavernoso) en piel y órganos internos, principalmente aparato digestivo. Complicaciones como sangrado gastrointestinal, anemia i coagulop'atías, han sido documentadoas. Se comunica el caso de una niña de 12 años con "Sindrome del nevo azul en tetina de goma", que presento anemia y cuyo diagnóstico se realizó por biopsia y endoscopía digestiva(au)

Sindrome del nevo azul en tetina de goma / Blue rubber nevus syndrome

El sindrome del nevo azul en tetina de goma, Síndrome de Bean, o Blue rubber bleb nevus es una rara entidad consistente en la presencia de malformaciones vasculares múltiples( hemangioma cavernoso) en piel y órganos internos, principalmente aparato digestivo. Complicaciones como sangrado gastrointestinal, anemia i coagulopatías, han sido documentadoas. Se comunica el caso de una niña de 12 años con "Sindrome del nevo azul en tetina de goma", que presento anemia y cuyo diagnóstico se realizó por biopsia y endoscopía digestiva(au)