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Management of Complex Wounds with Dermal substitute Assisted by a Negative Pressure system

Modern Plastic surgery 2023年第4期13卷 95-105页

作者： Cuahutémoc Márquez Espriella Ruiz Garza Jorge Gerardo Barbosa Villarreal Fernando Dávila Díaz Rodrigo Cuervo Vergara Marco Antonio Campollo López Ana Priscila Gutierrez Alvarez Mauricio Chama Naranjo Alfredo garcía corral jesús ricardo Pérez Benítez Omar Alberto Pulido López ricardo Alberto Jaimes Duran Edwing Michel Garibaldi Bernot Mauro Cortes Aguilar Carlos Manuel garcía Córdova Carlos Emiliano Camacho Rodriguez Hayah Camacho Rodriguez Hayah Martinez Villalobos Claudia Nallely Ochoa Contreras Erick Cesar Randall Cruz soto Herrera Lozano Luis Arturo Department of Plastic and Reconstructive surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Introduction: The standard treatment for complex wound care is autografting. The advent of dermal substitutes has provided a novel tool for the preparation of the bed to be grafted. However, most types of dermal matrices require the application of a skin graft a second time. Currently, other strategies have been developed to improve the vascularization process, such as negative pressure wound therapy (NPWT), which has been reported to reduce the time required for vascular growth and dermal matrix integration and thus achieve a shorter waiting period for autologous graft application. The present study aims to evaluate the effectiveness and safety of dermal matrix management associated with NPWT in the treatment of complex wounds. Methods: seven patients with a diagnosis of complex wounds were enrolled in this study between July 1, 2015, and June 31, 2016. After debridement and having an adequate wound bed, patients who met the criteria for the application of combined therapy were treated with dermal substitutes and a negative pressure system. The percentage of graft integration into the wound bed, complications, length of hospital stay, and duration of therapy were analyzed. Results: The mean age was 42.5 ± 16 (39 - 54) years old;three women and four men were included in the study. The approximate size of skin loss was 120.7 ± 75 cmsup>2sup> (25 - 250 cmsup>2sup>). The combined therapy of dermal matrix plus NPWT was instituted in all cases for a period of 14 days. There were no complications, with 100% graft integration in 6 of 7 cases. Patients were discharged after a mean hospital stay of 5.4 days. Conclusions: This study demonstrates that the utilization of combined dermal matrix plus NPWT therapy can be performed safely and effectively in patients with complex wounds with low complication rates and a short hospital stay.

关键词： Negative Pressure Wound Therapy Complex Wound Dermal Matrix Wound Therapy

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Evaluation of Ocimum basilicum *** Different Concentrations of K^(+)as an Inhibitor of Pathogenic Bacterial strains

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Phyton-International Journal of Experimental Botany 2021年第2期90卷 533-541页

作者： Mercedes Georgina Ramírez-Aragón Victoria Jared Borroel-garcía Ramón Valenzuela-soto ricardo David Valdez-Cepeda Francisco Javier Wong-corral JoséLuis garcía-Hernández Universidad Politécnica de Gómez Palacio Gómez Palacio35120México Universidad Autónoma Chapingo Centro Regional Universitario Centro-NorteZacatecasZac.Universidad Autónoma de ZacatecasFacultad de MatemáticasZacatecas98053México Departamento de Investigación y Posgrado en Alimentos Universidad de SonoraHermosillo83000México Facultad de Agricultura y Zootecnia Universidad Juárez del Estado de DurangoGómez Palacio34000México

The extraction of bioactive compounds has become one of the most interesting areas of modern *** therapeutic reasons,it´s important to obtain antimicrobial agents from natural *** objective of the present study was to determine the inhibitory effect of ethanolic extract of basil(Ocimum basilicum *** Rubin)subjected to different concentrations of potassium(K^(+))on the activity of three bacterial strains that are pathogens in *** was evaluated by inhibition surface and these results were compared to two antibiotics:Gentamicin(GE)and Ciprofloxacin(CPF)for their efficacy against each bacterial *** variables presented significant difference(p≤0.05).According to the results,basil extract evaluated showed positive antibacterial activity against the three strains of Pseudomonas aeruginosa,Listeria monocytogenes and staphylococcus aureus on Mueller Hinton *** was observed highest inhibition areas of different diameters(15.3 mm,21.3 mm and 21.6 mm respectively)when the extract used was obtained from the plants with the highest concentration of potassium(13 mmol L-1).These values were even superior to the highest values showed on the treatments with the antibiotic gentamicin.

关键词： Basil inhibition potassium secondary metabolites antibiotics

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Breast Reconstruction: Does It Worth to start If the Patient Is Not sure to Take All the Process Along?

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Journal of Biosciences and Medicines 2022年第8期10卷 201-209页

作者： jesús ricardo garcía-corral José Martínez-Lopez Rodrigo Davila-Diaz Blanca Arambula-sanchez Marco Cuervo-Vergara Fernando Barbosa-Villarreal Daniel De Luna Ana Priscila Campollo Lopez Fernando Isaac Recio Espana Alfredo Chama Naranjo Jaime garcía Alejandro Costa David Flores-soto selina Marioni-Manriquez Patricia Lopez-Medellin Erika Barlandas-Quintana Edgar Guillen-Martinez steve Rodriguez-Alanis Cuahutemoc Marquez Departamento de Cirugía Plástica y Reconstructiva Hospital Central Sur de Alta Especialidad PEMEX Mexico City Mexico

Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAsT-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psych

关键词： BREAsT-Q Breast Reconstruction satisfaction Index Quality of Life Breast Cancer Patient’s Decision Making

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surgical Complications in Breast Reconstruction: Assessment and Associations

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Journal of Biosciences and Medicines 2023年第6期11卷 171-181页

作者： Daniel De-Luna-Gallardo Jaime Aron garcía-Espinoza Cuahútemoc Márquez-Espriella Blanca Yadira Arámbula-sánchez Marco Antonio Cuervo-Vergara Rodrigo Dávila-Diaz ricardo garcía-corral Fernando Barbosa-Villarreal Fernando Isaac Recio-España Alberto Ignacio Cahuana-Quispe Plastic and Reconstructive surgery Department Central South High Specialty Hospital of Petróleos Mexicanos Mexico City Mexico Plastic and Reconstructive surgery Department Petróleos Mexicanos North Central Hospital Mexico City Mexico

Introduction: Breast cancer represents a pathology that generates catastrophic impact and has recently increased its incidence and survival due to timely diagnosis and treatment. Therefore, improving the quality of life of cancer survivors has become a priority, offering reconstructive procedures that reduce complications, costs, hospital stay, and optimize resources. Material and methods: 264 patients reconstructed with autologous tissue (TRAM flap and latissimus dorsi) and alloplastic (breast tissue expander—breast implant and direct breast implant) were included. Variables such as demographic, anthropometric, and histologic type were collected. Results: 62% were reconstructed through the use of alloplastics and 38% with autologous tissue. The risk factors related to a greater probability of immediate postoperative complications (surgical site infection, surgical wound dehiscence and reconstruction failure) were obesity (OR: 2.1, CI: 1.5 - 2.7), preoperative radiation (OR: 1.89, CI: 1.75 - 1.92), arterial hypertension (OR: 1.2), Diabetes Mellitus (OR: 1.78) and smoking (OR: 1.31). Conclusions: The reconstructive process is complex and influenced by patient factors, surgeon experience and the hospital center. However, when choosing the reconstructive strategy, risk factors present in each patient must be considered, since radiation and obesity present a greater probability of postoperative complications.

关键词： Breast Cancer Breast Reconstruction Obesity Radiotherapy TRAM

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Managament Wound Healing: The Importance of a Wound Clinic in Hospital Centers

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Modern Plastic surgery 2023年第4期13卷 118-125页

作者： Alfredo Chama Naranjo Cuahutémoc Márquez Espriella Alberto Ignacio Cahuana Quispe Barbosa Villarreal Fernando Ana Priscila Campollo López Mauricio Gutiérrez Álvarez Carlos Emiliano garcía Córdova jesús ricardo garcía corral Cuervo Vergara Marco Antonio Jorge Luis Rosales Becerra Dávila Díaz Rodrigo Edgar Alan Guillen Martínez Marín Canto Miguel Eduardo Luis Arturo Herrera Lozano Ochoa Contreras Erick Cesar Martinez Villalobos Claudia Nallely Cruz soto Randall Camacho Rodriguez Hayah ricardo Alberto Pulido López Edwing Michel Jaimes Durán Department of Plastic and Restrictive surgery Hospital Central Sur de Alta Especialidad Pemex Mexico City Mexico

Background: In clinical practice, acute and chronic wounds continue to be a challenge. Unfortunately, wound care is often inadequate or inappropriate. The implementation of wound clinics involving an interdisciplinary team for wound care and treatment yields favorable clinical outcomes as well as a reduction in economic expenses due to a higher rate of healing, a decrease in hospital stays, and a reduction in the number of readmissions. The establishment of wound clinics enhances the utilization of diagnostic, preventive, and therapeutic resources, improving the quality of life of patients and facilitating their reintegration into their normal lives. The objective is solely to describe the importance of wound clinics in the medical profession. Methods: A retrospective literature search was conducted to include articles no more than 10 years old that reported measures or results of the study in order to perform a literature review and describe the importance of wound clinics in medical practice. Results: A total of 7 articles were obtained with the inclusion criteria, the most recent being from the year 2023 and the oldest from 2013. Conclusion: An important area for improvement in the healthcare industry is the management and treatment of complex wounds. The establishment of wound clinics offers comprehensive and specialized care for both acute and chronic complex wounds with the goal of enhancing secondary illness patients’ prevention, treatment, and rehabilitation.

关键词： Wound Clinic Pressure Ulcer Chronic Wound Wound Healing Quality of Life

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Epidemiology of Fingertip Injuries at south Central Hospital Petróleos Mexicanos “Pemex” with a Review of the Literature

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Journal of Biosciences and Medicines 2023年第6期11卷 182-195页

作者： Fernando Barbosa-Villarreal Cuahutémoc Márquez-Espriella Erika Barlandas-Quintana Ana Priscila Campollo-López Mauricio Gutiérrez-Álvarez Carlos Emiliano garcía-Córdova jesús ricardo garcía-corral Alfredo Chama-Naranjo ricardo Alberto Pulido-López Patricia Llizette López-Medellín Edgar Alan Guillen-Martínez Jonathan steve Rodríguez-Alaníz Edwing Michel Jaimes-Duran Carlos Manuel Cortes-Aguilar Mauro Garibaldi-Bernot Omar Alberto Pérez-Benítez Miguel Eduardo Marín-Canto Luis Arturo Herrera-Lozano Héctor Manuel suarez-Ortega Alejandro Cruz-Zarate Department of Plastic and Reconstructive surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Background: The hand is an essential component for performing our daily tasks;as a result, injuries to the fingertip are frequently seen. Accurate evaluation and treatment of fingertip injuries are essential to avoiding long-term disability, job loss and psychological issues. No matter the injury classification system, maintaining finger length, regaining sensation, and improving appearance are the three main objectives of treatment. The objective of this research was to outline the epidemiology of fingertip injuries treated between 2021 and 2022 at a highly specialized referral hospital in Mexico City. Methodology: This investigation is cross-sectional, retrospective, and observational. From January 2021 to December 2022, 60 patients with a diagnosis of fingertip injury from the south Central Hospital “Pemex” were included. The descriptive statistical analysis was performed using sPss29. Results: 60 patients were included, 27 (45%) were women and 33 (55%) were men. Allen’s classification was able to classify only 19 patients, of which 18 (94.7%) had a type 1 classification and one (5.26%) had a type 2 classification. 10% of patients experienced complications, which included 2 patients with surgical site infections (3.3%), 3 patients with persistent pain (5%), and 1 patient (1.6%) with graft rejection. Conclusions: There are currently insufficient epidemiological data on hand and wrist injuries and its effects on labor in Mexico. Fingertip injuries require particular care in order to prevent complications and long-term damage. The creation of national registries could help with the creation of reference manuals for the care of hand and wrist injuries in our nation.

关键词： Fingertip Fingertip Injuries Epidemiology

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Quality of Life in Women with Endometriosis Pelvic Pain Treated with the Levonorgestrel-Releasing Intrauterine system

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Open Journal of Obstetrics and Gynecology 2015年第3期5卷 167-172页

作者： René Cortés Flores Evangelina Briones Lara Luis Carlos Quintana corral ricardo Alberto Isacc Chaib Luis Oswaldo de la O. Pérez Oscar Armando González Díaz Raúl Cortés Flores Obstetrics and Gynecology Hospital UMAE 23 “Dr. Ignacio Morones Prieto” Mexican Institute of Social Security Monterrey Mexico

Objective: To evaluate the quality of life in patients with endometriosis pelvic pain before and after the application of the levonorgestrel-releasing intrauterine system (LNG-IUs). Design: Open non-comparative study. setting: Obstetrics and Gynecology Hospital at Monterrey, Mexico. sample: 29 women aged 18 to 40 years with pelvic pain associated with endometriosis confirmed by laparoscopy. Methods: After laparoscopy but before LNG-IUs insertion (basal visit) and 6 months afterwards, modified Endometriosis Health Profile (EHP-30) was applied. Main outcomes measures: size of change of questionnaire scores, need of additional analgesic therapy and adverse effects. statistical Analysis: Differences in the questionnaire scores before and after intervention were analyzed by student t-test. Results: Final analysis set included 29 women aged 31.7 ± 4.7 years years. The AsRM surgical staging of endometriosis was mild in 19.3 moderate in 13.7 and severe in 76% of the patients. The general perception of quality of life improved from 52 at baseline to 98% at six months (p se events were mild in nature, 19 patients reported no adverse events during the study (65.5%). Two patients (6.9%) required the use of concomitant therapy with non-steroidal analgesics for relief of pain. Conclusion: The application of LNG-IUs in patients with pelvic pain associated with endometriosis improved significatively all aspects related with quality of life as measured with Endometriosis Health Profile (EHP-30). We concluded that LNGIUs may be an effective and convenient therapeutic alternative for the management of pain associated with endometriosis.

关键词： Quality of Life Endometriosis Chronic Pelvic Pain Levonorgestrel-Releasing Intrauterine system LNG-IUs EPH-30 Questionnaires

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successful Management of a Complicated Ulcer Caused by Autoimmune Vasculitis, with sildenafil Citrate in a Patient with Primary Antiphospholipid syndrome and Transient steroid-Induced Diabetes Mellitus: A Case Report and Literature Review

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Journal of Diabetes Mellitus 2014年第3期4卷 189-193页

作者： Fernando Grover-Paez Leonel garcia-Benavides Ernesto German Cardona-Munoz Carlos Gerardo Ramos-Becerra jesus ricardo garcia-corral Carlos Enrique Medina-garcia Guillermo Adrian Alanis-sanchez sylvia Elena Totsuka-sutto Institute of Experimental and Clinical Therapeutics Department of PhysiologyUniversity Center of Health SciencesUniversity of GuadalajaraGuadalajaraMexico

Antiphospholipid syndrome (APs) is a prothrombotic condition that can affect both the venous circulation and the arterial system. The deep veins of the lower extremities and cerebral blood flow are the most common sites of venous and arterial thrombosis, respectively. skin ulceration and gangrene may be associated with an active vasculitis in patients with APs. These kinds of ulcers are considered intractable because healing is difficult to achieve. Using steroids as immunesuppressant therapy is still a basic part of managing APs and vasculitis. Nevertheless, in the presence of steroid-induced diabetes mellitus, the priority is to achieve faster wound healing, because of the potential complications that can develop due to metabolic dysfunction and augmented vulnerability to infection. Until recently, there were few reports demonstrating the benefits of the use of adjuvant phosphodiesterase-5 inhibitors like sildenafil citrate in different clinical entities with courses like Raynaud’s phenomenon, scleroderma, and resistance to vasodilator therapy. We present the first report demonstrating the additional benefit of sildenafil citrate for the integration of grafts in a patient with steroid-induced diabetes and APs who had ulcers due to vasculitis resistant to the usual vasodilator therapy.

关键词： Autoimmune Vasculitis sildenafil Citrate steroid-Induced Diabetes Mellitus Primary Antiphospholipid syndrome

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Description of the Factors Associated with Trigger Finger in Patients Treated at Petroleos Mexicanos “Pemex”

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Journal of Biosciences and Medicines 2023年第7期11卷 151-159页

作者： Fernando Barbosa-Villarreal Cuahutémoc Márquez-Espriella Rodrigo Dávila-Díaz Marco A. Cuervo-Vergara Blanca Y. Arambula-sánchez Alberto I. Cahuana-Quispe Victor A. Esquivel-Chávez Carlos E. garcía-Córdova Ana P. Campollo-López Mauricio Gutierrez-Alvarez jesus R. garcía-corral Alfredo Chama-Naranjo Daniel de Luna-Gallardo ricardo A. Pulido-López Isaac F. Recio-España Esteban I. Campos-serna Carlos I. Navarro-Delgadillo José C. Martínez-López Victor H. Avalos-Gómez Alejandro Cruz-Zarate Department of Plastic and Reconstructive surgery Hospital Central Sur Petróleos Mexicanos Mexico City Mexico

Background: The trigger finger, also known as stenosing tenosynovitis of the flexor tendon, is a common cause of hand disability;This can result in significant limitations in certain daily living activities. It is possible to treat this condition with conservative or surgical methods. Methods: This is a retrospective, observational, cross-sectional and descriptive study. The source population consisted of all patients with a diagnosis of trigger finger who had been treated in the department of plastic and reconstructive surgery of our institution between 2020 and 2023. The primary objective of this study is to determine the prevalence and characterize the clinical and surgical characteristics of the population affected by trigger finger in our hospital. Results: The total population was 237 patients, of which 165 were women (70%) and 72 men (30%). The most affected hand was the right hand, with a total of 158 patients (67%). In the right hand, the middle finger was the most affected (45%). Of the 237 patients, 80 of them had obesity (34%), 86 had type 2 diabetes mellitus (36%), 95 had systemic arterial hypertension (40%). Open technique was performed in 190 (80%) patients, while percutaneous technique was performed in 47 (20%) of them. Conclusion: The female sex was twice as frequent, and the middle finger and thumb were the most affected. Most of the patients received surgical treatment with open approach and percutaneous approach in 20% of them.

关键词： Trigger Finger Tendinopathy

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