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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 cm2 (25 - 250 cm2). 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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Psychotherapy Research and the Study of the First Person Experience

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Psychology Research 2014年第1期4卷 17-24页

作者： Ps. ricardo pulido Universidad alberto Hurtado Santiago Chile

Over the last years, the first person methodologies have been transformed into a valid and significant alternative, different from the classic quantitative and qualitative methods. In contrast with other perspectives, the first person approach considers that the subject is able to observe and give a direct account of his subjective process. However, this process, far from being spontaneous and automatic, requires a phenomenological training. The article discusses the notion of "the first person" starting with the works of Varela and Husserl"s Phenomenology. We will review the principal procedures of this methodology and we will describe examples of this kind of research in the field of psychopathology, highlighting the contributions that this approach may provide in order to close the gap between practice and research.

关键词：心理现象学病理学

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Post-transplant biliary complications using liver grafts from deceased donors older than 70 years:Retrospective case-control study

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世界胃肠外科杂志:英文版(电子版) 2023年第8期15卷 1615-1628页

作者： Carlos Jimenez-Romero Iago Justo-Alonso Pilar del Pozo-Elso alberto Marcacuzco-Quinto Cristina Martín-Arriscado-Arroba Alejandro Manrique-Municio Jorge Calvo-pulido Alvaro García-Sesma ricardo San Román Oscar Caso-Maestro Unit of HPB Surgery and Abdominal Organs Transplantation `12 de Octubre´University HospitalMadrid 28041Spain Clinical Research Unit(I+12) `12 de Octubre´University HospitalMadrid 28041Spain Department of Radiology `12 de Octubre´University HospitalMadrid 28041Spain

BACKGROUND The shortage of liver grafts and subsequent waitlist mortality led us to expand the donor pool using liver grafts from older *** To determine the incidence,outcomes,and risk factors for biliary complications(BC)in liver transplantation(lT)using liver grafts from donors aged>70 *** Between January 1994 and December 31,2019,297 lTs were performed using donors older than 70 *** excluding 47 lT for several reasons,we divided 250 lTs into two groups,namely post-lT BC(n=21)and without BC(n=229).This retrospective case-control study compared both *** Choledocho-choledochostomy without T-tube was the most frequent technique(76.2%in the BC group vs 92.6%in the non-BC group).Twenty-one patients(8.4%)developed BC(13 anastomotic strictures,7 biliary leakages,and 1 nonanastomotic biliary stricture).Nine patients underwent percutaneous balloon dilation and nine required a Rouxen-Y hepaticojejunostomy because of dilation *** incidence of post-lT complications(graft dysfunction,rejection,renal failure,and non-BC reoperations)was similar in both *** were no significant differences in the patient and graft survival between the ***,only three deaths were attributed to *** female donors were protective factors for BC,donor cardiac arrest was a risk *** The incidence of BC was relatively low on using liver grafts>70 *** could be managed in most cases by percutaneous dilation or Roux-en-Y hepaticojejunostomy,without significant differences in the patient or graft survival between the groups.

关键词： Older liver liver transplant Biliary complications Biliary strictures Septuagenarian donors Octogenarian donors

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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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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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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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Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

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Cellular & Molecular Immunology 2021年第9期18卷 2128-2139页

作者： alberto Pérez-Gómez Joana Vitallé Carmen Gasca-Capote Alicia Gutierrez-Valencia María Trujillo-Rodriguez Ana Serna-Gallego Esperanza Muñoz-Muela María de los Reyes Jiménez-leon Mohamed Rafii-El-Idrissi Benhnia Inmaculada Rivas-Jeremias Cesar Sotomayor Cristina Roca-Oporto Nuria Espinosa Carmen Infante-Domínguez Juan Carlos Crespo-Rivas alberto Fernández-Villar Alexandre Pérez-González luis Fernando lópez-Cortés Eva Poveda Ezequiel Ruiz-Mateos JoséMiguel Cisneros Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-ledesma Juan Carlos Crespo-Rivas Eduardo Márquez JoséManuel lomas Claudio Bueno Rosario Amaya JoséAntonio lepe Jerónimo Pachón Elisa Cordero Javier Sánchez-Céspedes Manuela Aguilar-Guisado Almudena Aguilera Clara Aguilera Teresa Aldabo-Pallas Verónica Alfaro-lara Cristina Amodeo Javier Ampuero María Dolores Avilés Maribel Asensio Bosco Barón-Franco lydia Barrera-pulido Rafael Bellido-Alba Máximo Bernabeu-Wittel Candela Caballero-Eraso Macarena Cabrera Enrique Calderón Jesús Carbajal-Guerrero Manuela Cid-Cumplido Yael Corcia-Palomo Juan Delgado Antonio Domínguez-Petit Alejandro Deniz Reginal Dusseck-Brutus Ana Escoresca-Ortega Fátima Espinosa Nuria Espinosa Michelle Espinoza Carmen Ferrándiz-Millón Marta Ferrer Teresa Ferrer Ignacio Gallego-Texeira Rosa Gámez-Mancera Emilio García Horacio García-Delgado Manuel García-Gutiérrez María luisa Gascón-Castillo Aurora González-Estrada Demetrio González Carmen Gómez-González Rocío González-león Carmen Grande-Cabrerizo Sonia Gutiérrez Carlos Hernández-Quiles Inmaculada Concepción Herrera-Melero Marta Herrero-Romero luis Jara Carlos Jiménez-Juan Silvia Jiménez-Jorge Mercedes Jiménez-Sánchez Julia lanseros-Tenllado Carmina lópez Isabel lópez Álvaro lópez-Barrios luis F.lópez-Cortés Rafael luque-Márquez Daniel Macías-García Guillermo Martín-Gutiérrez luis Martín-Villén JoséMolina Aurora Morillo María Dolores Navarro-Amuedo Dolores Nieto-Martín Francisco Ortega María Paniagua-García Amelia Peña-Rodríguez E Clinical Unit of Infectious Diseases Microbiology and Preventive MedicineInstitute of Biomedicine of Seville(IBiS)Virgen del Rocío University HospitalCSICUniversity of SevilleSevilleSpain Department of Medical Biochemistry Molecular Biologyand ImmunologySchool of MedicineUniversity of SevilleSevilleSpain Pneumology Service Galicia Sur Health Research Instituto(IIS Galicia Sur)SERGAS-UVigoVigoSpain Infectious Diseases Unit Department of Internal MedicineComplexo HospitalarioUniversitario de VigoIIS Galicia SurSERGAS-UVigoVigoSpain Group of Virology and Pathogenesis Galicia Sur Health Research Institute(IIS Galicia Sur)-Complexo Hospitalario Universitario de VigoSERGAS-UVigoVigoSpain Unit of Infectious Diseases Microbiologyand Preventive MedicineVirgen del Rocío University HospitalSevilleSpain Institute of Biomedicine of Seville(IBiS) Virgen del Rocío University Hospital/CSIC/University of SevilleSevilleSpain Medico-Surgical Unit of Respiratory Diseases Virgen del Rocío University HospitalSevilleSpain Unit of Emergencies Virgen del Rocío University HospitalSevilleSpain Intensive Care Unit Virgen del Rocío University HospitalSevilleSpain Department of Medicine University of SevilleSevilleSpain Cardiology and Cardiovascular Surgery Unit Virgen del Rocío University HospitalSevilleSpain Rheumatology Unit Virgen del Rocío University HospitalSevilleSpain Internal Medicine Unit Virgen del Rocío University HospitalSevilleSpain Digestive and Hepatobiliary Unit Virgen del Rocío University HospitalSevilleSpain Neurology and Clinical Neurophysiology Unit Virgen del Rocío University HospitalSevilleSpain Endocrinology and Nutrition Unit Virgen del Rocío University HospitalSevilleSpain Urology and Nephrology Unit Virgen del Rocío University HospitalSevilleSpain Unit of Clinical Investigation and Clinical Trials Virgen del Rocío University HospitalSevilleSpain

Severe Acute Respiratory Syndrome Coronavirus(SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity *** cells(DCs)play a key role in the defense against viral infections,for instance plasmacytoid DCs(pDCs),have the capacity to produce vast amounts of interferon-alpha(IFN-α).In COVID-19 there is a deficit in DC numbers and IFN-αproduction,which has been associated with disease *** this work,we described that in addition to the DC deficiency,several DC activation and homing markers were altered in acute COVID-19 patients,which were associated with multiple inflammatory ***,previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+myeloid DCs and pDCs seven months after SARS-CoV-2 ***,the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients,while no restoration of integrinβ7 and indoleamine 2,3-dyoxigenase(IDO)levels were *** findings contribute to a better understanding of the immunological sequelae of COVID-19.

关键词： SARS-CoV-2 COVID-19 Dendritic cell long-COVID

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