Development of prebiotic yogurt with addition of green-banana biomass (Musa spp.).

This study evaluated the technological viability of yogurt with the addition of green-banana biomass (Musa spp.) considering the resistant starch (BBV) as a potential prebiotic ingredient and texture agent. Four yogurt formulations were prepared: control; 3% BBV; 5% BBV; and 10% BBV. They were subjected to analysis of resistant starch, lactose, fat, total dry extract, defatted dry extract, moisture, ash, proteins, pH and titratable acidity; syneresis analysis, instrumental texture and instrumental color. All four formulations met the requirements of the identity and quality regulation for fermented milks regarding the physicochemical and microbiological parameters. In the instrumental color analysis, in all treatments with added BBV, darkening was observed after 21 days, with a reduction of a* coordinate and an increase of b* coordinate. In the instrumental texture analysis, the yogurt in the Control treatment had the highest firmness (0.430 N) at 21 days among these treatments. Among the treatments with added BBV, the yogurt with 5% added BBV showed the best results for increasing the viability of lactic bacteria. It was found that yogurt with added BBV is a promising alternative in the elaboration of functional dairy products, adding value to the banana production chain by reducing the green fruit waste.

Stylomandibular False Ankylosis: An Unusual Complication After Vascularized Iliac Crest Flap for Mandibular Reconstruction.

Stylomandibular fusion is a poorly documented and rare complication of maxillofacial surgical procedures. This case report describes a patient presenting with stylomandibular false ankylosis following mandibular reconstruction. A 59-year-old female patient underwent segmental mandibular resection and reconstruction for a defect resulting from ameloblastoma surgery using an iliac crest free flap. A styloid fracture was detected postoperatively, and the patient was managed conservatively. In the third postoperative year, the patient presented with marked limitation of oral gape. A diagnosis of stylomandibular false ankylosis was made, and the patient underwent an ostectomy of the aberrant bone, with improved mouth opening. The abnormal union between the styloid process and the mandible is a previously unreported complication in the use of iliac crest free flaps. This case report emphasizes the importance of being vigilant for stylomandibular false ankylosis, especially when there is a restriction of oral aperture postoperatively following reconstructive procedures involving bone flaps.

A new pattern of cranial nerve injuries caused by unfavorable fractures during Le Fort I osteotomy.

Cranial nerve injury is a described complication of Le Fort I osteotomy technique. The authors present the case of a 45-year-old patient that underwent bimaxillary orthognathic surgery and suffered unfavorable skull base fractures, which resulted in cranial nerve injury of the II, III, IV, V, and VI nerves on the left side and of the V nerve on the right side, through different mechanisms. One of the mechanisms was cavernous sinus thrombosis, which was never described following Le Fort I technique in a non-cleft patient. The fracture pattern involved the foramen ovale and Meckel's cave, which was also never described after this technique. The resolution of the deficits at the final follow-up at 14 months was incomplete. Le Fort I osteotomy technique is considered a safe technique to correct dentofacial deformities, but serious complications can occur. Pterygomaxillary disjunction and down-fracture must be performed with the utmost care to avoid it.

Colgajo sural medial en la reconstrucción de miembro inferior / Medial sural artery perforator flap in lower extremity reconstruction

Introducción y objetivo: El colgajo de perforante de arterial medial sural (MSAP- medial sural artery perforator) fue descrito con un refinamiento del colgajo gastrocnemio medial. A pesar de su reciente historia, demuestra ventajas e indicaciones, principalmente en la reconstrucción de miembro inferior.Presentamos una serie retrospectiva de pacientes con defectos de tejidos blandos de miembro inferior reconstruidos con colgajo MSAP.Material y método.Presentamos 10 pacientes operados entre 2013 y 2018, 6 hombres y 4 mujeres, con edades entre los 27 y los 86 años.La principal etiología de los defectos fue traumática. Los defectos localizados entre el tercio distal del muslo y el tercio proximal de la pierna fueron cubiertos con colgajos pediculados, y los defectos distales con colgajos libres.Resultados.Las dimensiones medias de los colgajos fueron 6.35 cm de anchura por 10.9 cm de longitude y 9.9 cm de longitude del pedículo. Todos los colgajos menos 1 fueron elevados con una sola perforante.Excepto 1 caso de pérdida parcial del colgajo, no hubo complicaciones a corto plazo. Dos pacientes precisaron cobertura con injerto del área donante y el resto fueron cerrados directamente.El seguimiento medio fue de 22.8 meses y no hubo complicaciones en el área donante. Obtuvimos un cierre estable y estéticamente acceptable en todos los casos.Conclusiones.El colgajo MSAP es un colgajo fasciocutaneo fino y plegable que provee tejido similar al área del defecto con minima morbilidad del área donante.Sus características menos positivas incluyen una potencialmente laboriosa disección intramuscular y la posibilidad de congestion venosa ocasional. A pesar de ello, los buenos resultados y la satisfacción de los pacientes lo convierte en una elección apropiada en casos seleccionados de reconstrucción del miembro inferior. (AU)

Background and objective: The medial sural artery perforator (MSAP) flap was first described as a refinement of the medial gastrocnemius flap. Despite its recent history, it has already proven to have several advantages and indications, namely in lower extremity reconstruction.The authors present a retrospective case series with lower limb soft-tissue defects which were reconstructed with the MSAP flap.Methods.Between 2013 and 2018, 10 patients were operated on: 6 men and 4 women, ranging in age from 27 to 86 years.The main etiology of the defects was traumatic injury. The defects located between the distal third of the thigh and the proximal third of the leg were covered with pediculated flaps while the distal defects were covered with free flaps.Results.The mean flap dimensions were 6.35 cm width, 10.9 cm length, and 9.9 cm pedicle length. All flaps except 1 were raised with a single perforator.Apart from 1 case of partial free-flap loss, there were no short-term complications. Two patients required skin grafting of the donor site while the remaining were closed directly.The mean follow-up time was 22.8 months and there were no donor site complaints. A stable and aesthetically satisfactory coverage was obtained in all cases.Conclusions.The MSAP flap is a thin and pliable fasciocutaneous flap that can provide “like-with-like” tissue with minor donor site morbidity in lower limb reconstruction. Less positive characteristics include a potential laborious intramuscular dissection and occasional venous congestion. Still, the good results and satisfaction of the patients make this a wise choice in selected cases. (AU)

Negative pressure wound therapy for skin graft closure in complex pilonidal disease.

Pilonidal disease occurs in 26 in 100 000 people, affecting mainly men aged 20-30 years. It is treated by a variety of surgical techniques; however, there is a lack of consensus on the optimal choice of treatment for complex pilonidal disease. In addition, there is no consensus regarding care of the wound after surgery. Negative pressure wound therapy applied to open wounds following pilonidal disease surgery has been suggested as a way to decrease healing times and costs and is an emerging option for complex and or recurrent pilonidal disease. This study describes a case of complex pilonidal disease managed with local excision and negative pressure wound therapy followed by a split-thickness skin graft.