Evaluation of the impact of a protocol for immediate vulvar reconstruction after vulvectomy.

Vulvar cancers are usually diagnosed at an advanced stage and require wide surgical resections in the form of vulvectomy. Immediate vulvar reconstruction can potentially reduce the reoperation rate and postoperative complications. With this objective, we introduced a protocol for immediate vulvar reconstruction. This study, five years after its introduction, assesses the impact of this intervention on the postoperative evolution of vulvectomy patients. In January 2017 we introduced a protocol for immediate vulvar reconstruction that considered four criteria of high risk for postoperative dehiscence. Patients who meet the criteria were reconstructed at the time of the vulvectomy. To assess the impact of the protocol, we prospectively registered all included patients over a 5 years period (2017-2022). As a control group, we reviewed the vulvectomised patients at our centre from January 2012 to January 2017 (5 years) who would have met the protocol. No statistically significant differences were found in the epidemiological data (age, diabetes mellitus diagnosis, and obesity diagnosis) or in the tumour characteristics (tumour size). We obtained a statistically significant difference in the incidence of complications and need for reintervention, in favour of the reconstruction group. Our study shows the medical and economic benefits for vulvar cancer patients of immediate vulvar reconstruction.

Development of an integrative algorithm for the treatment of various stages of full-thickness burns of the first commissure of the hand.

Burns of the first commissure of the hand can evolve into an adduction contracture of the thumb. We decided to conduct a review of the existing literature on the treatment of full-thickness burns of the first commissure in order to develop a treatment algorithm that integrates the various currently available procedures. A search of the existing literature was conducted, focusing on the treatment of a burn of the first commissure in its chronic and acute phases. A total of 29 relevant articles were selected; 24 focused exclusively on the chronic contracture stage, while 3 focused exclusively on the acute burn stage, and 2 articles studied both stages. A therapeutic algorithm for full-thickness burns of the first commissure of the hand was developed. With this algorithm we sought to relate each degree and stage of the burn with a treatment.

Spanish transcultural adaptation of the Leuven Itch Scale.

Itching is one of the most frequent symptoms, and most resistant to treatment, relating to scar formation after burns. The Leuven Itch Scale is a questionnaire which has been validated for use in burns, analysing different clinical dimensions of pruritus. However, until now there was no Spanish version available for use with Spanish-speaking patients. This article presents the process of the academic translation of the questionnaire in order to obtain a Spanish version, and the final version of the questionnaire. We followed a translation/back-translation methodology with a final pilot test on a sample of burn patients. The final result fills a major gap in the quality-of-life questionnaires available in Spanish.

Flash visually evoked potentials in the newborn and their maturation during the first six months of life.

The aim of this paper has been to obtain normative data for the major components of the visually evoked potentials obtained by flash stimulus (F-PEV) in the newborn, and to analyse the evolution of these responses during the first 24 weeks of life. In order to do so, F-VEP were recorded in 109 normal full-term newborn infants. Fifty-five of these infants were also studied longitudinally at 4, 8, 12 and 24 weeks. We recorded responses in all newborns. A great morphological variability was observed. P2 was the only component present in all of these infants. Early components, which were always present from the fourth week of life on, were recorded in 34% of the newborns. There were significant differences according to waking/sleep state. At 24 weeks the most characteristic response was a triphasic waveform with clear negative-positive-negative components at 67.9, 110 and 158.3 ms. The morphological variability observed in the F-PEV of the newborn and the presence of early components in some cases, suggest differences in the maturation of the specific and unspecific visual system at birth. The study of these responses provides us with information about certain aspects of visual maturation. The relative stability of P2 response of the newborn and of the early negative components later on, made them the most useful components to be used in paediatric clinical work . The latency of P2 in the newborn is the parameter that showed lower variability, and therefore the most suitable one to establish normative data.