Introducción. La úlcera de presión (UP) es una patología común de observar y afecta mayormente a pacientes adultos mayores (PAM) postrados y pacientes con secuelas neurológicas. En la atención domiciliaria del PAM por el Padomi de Essalud, las denominadas UP se encuentran dentro de las patologías más frecuentes. Objetivo. El presente estudio busca evaluar la eficacia del método autolítico seco (MAS) en el tratamiento de las UP. Material y método. El presente es un estudio prospectivo de tipo ensayo clínico aleatorizado a simple ciego. La muestra son PAM postrados con diagnóstico de UP, atendidos por el Padomi de Essalud entre los años 2008 y 2012. Ambos tratamientos han sido evaluados con base en el tiempo de cicatrización de las lesiones. Resultados. Dos grupos de 50 PAM cada uno, con 123 y 112 UP, respectivamente, han sido tratados por un equipo interdisciplinario del P...

Introducción. Diferentes técnicas quirúrgicas para el tratamiento de las fisuras palatinas han sido descritas hasta la actualidad mostrando buenos y malos resultados. La técnica de dos colgajos (Bardach) es la técnica más utilizada en Estados Unidos, sin embargo, esta presenta algunas limitaciones. Objetivo. Presentar los resultados quirúrgicos obtenidos en el tratamiento de las fisuras palatinas unilaterales con una nueva técnica quirúrgica: la palatoplastia de un colgajo. Material y método. El presente es un estudio descriptivo. Se describe una nueva técnica quirúrgica utilizada desde el año 2007 por nosotros y los resultados quirúrgicos obtenidos de 316 pacientes con fisura unilateral completa fueron operados con la técnica de un colgajo entre los años 2007 al 2014. Resultados. El cierre anatómico de los paladares fisurados operados se obtuvo en un 94.31 % de los caso...

The current classifications for cleft lip and palate are descriptions of the components involved in the cleft but, they don’t consider the severity of its distortion. The severity of the cleft is one of the most important elements to be considered in the presurgical planning. The use of presurgical orthopedy and modifications of classic surgical techniques, are examples of individual management of the more severe forms of cleft lip. This work shows the design of a new classification of cleft lip based in degrees of severity of the three cleft lip and palate components: nasal, lip and palate. The methodology used was the revision of surgical results obtained from 1043 cleft lip and palate patients operated by us, under the protocol design based in this severity’s classification between 1996 and 2005. We did the estimation of the surgical results through the number of cases with major su...

Introduction: The anatomy of bilateral cleft lip is different for each patient, and many authors have described modifications of the traditional repairing techniques in order to achieve more individualized designs and better results. The techniques described by Millard and Mulliken are probably the most commonly used all over the world for repairing bilateral cleft lip; however, there are some short-comings when trying to repair asymmetric forms of bilateral cleft lip. So, we designed this technique aiming to correct asymmetry in bilateral cleft lip. This technique is based on a double advancement and lateral rotation concept placing the scars over the natural lines between the esthetic subunits of the upper lip. Matherial and Methods: This is a retrospective and descriptive study based on a case series. We present a new technique used for surgical repair of bilateral cleft lip...

Introduction: A common problem during medical training in surgical areas like plastic surgery, is the absence of proper methods to obtain the necessary surgical skills to address the different pathologies related to this field. The medical training is performed in educational hospitals in Lima, however the methods are limited to the observation or assistance and don't let to the doctor obtain adequate competences to repair surgically this pathology once they finish their training. Material and Methods:This is a descriptive study for the development of the used methodology and a co relational study to evaluate the results obtained with the methodology. This is a quasi experimental study. It is used to third year plastic surgery training surgeons from San Marcos University of Lima and has been done in children with complete unilateral cleft lip attended in Regional Hospitals from Ministry ...

Introduction: The anatomy of labial fissure is different for each patient, and many authors have described modifications of the traditional techniques aiming at obtaining individualized designs with less incisions and better results. Reichert-Millard’s technique is perhaps the surgical approach most frequently used by surgeons all over the world for the management of labial fissures; however, there are some limitations when using this method when trying to obtain an individual design of the fissure to be repaired. Consequently, some modifications for Millard’s approach on the basis of the Lima Outreach Center severity classification and the shape of the nasal filter were proposed. Objective: To propose a combination of Millard’s and Reichert’s approaches based on the natural lines of the lips and the severity of the labial fissure, while trying to obtain a more individ...

Back ground. The pressure sore is a common disease and affects mainly elderly people and patients with neurological sequels. In the domiciliary medical attention of the elderly patient made by Padomi from Essalud, the pressure sores are one of the most common pathologies. Objective. This study aimed to evaluate the effectiveness of dry autolytic method in the treatment of pressure ulcers. Methods. This is a prospective randomized simple-blind clinical trial study. The sample is composed by elderly patients with diagnostic of pressure sore, attended by Padomi from Essalud between 2008 to 2012. Both treatments have been evaluated based in the time of healing of the lesions. Results. Two groups of 50 patients with 123 and 112 pressure sores respectively have been treated by an interdisciplinary team from Padomi of Essalud between 2008 to 2012. This study have found statistical significant d...

Background: The anatomy of the cleft lip is different for each patient and many authors have been described modifications of traditional techniques in order to obtain a more individual design and better results. Millard’s technique is probably the most common surgical technique used by surgeons around the world, however there are some short-comings to repair more severe forms of unilateral cleft. In that way, we have developed a new technique which corrects the medíal and lateral lip segment’s deficiency in unilateral cleft lip. This technique is based on a double rotation advancement concept placing the scars over the natural lines between the aesthetic subunits of the upper lip. Material and method: This is a retrospective study. This article presents a new technique for unilateral cleft lip repair used by us in 250 patients. In order to evaluate the efficacy of this techn...

Introduction: Several reports about facial artery anatomy have been published in the literature, however none of such studies has ever been performed in our country. Flaps based on the facial artery, like those described by Pribaz in 1992, are a good alternative for the management of severe palatal fistula management. On the other hand, the reconstruction of facial wounds after skin cancer resection is commonly needed, and it requires selected surgical techniques in order to improve facial cosmetics and functioning in our patients. In this paper we describe our experience using these flaps and we propose a modification for the technique. Objetives: show the anatomical variants in facial artery anatomy in Peruvian cadavers and their application in facial flap surgery based on this artery. Material and method: This is an analytic and descriptive study. 24 half-faces from 12 ...

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

Introduction: The anatomy of bilateral cleft lip is different for each patient, and many authors have described modifications of the traditional repairing techniques in order to achieve more individualized designs and better results. The techniques described by Millard and Mulliken are probably the most commonly used all over the world for repairing bilateral cleft lip; however, there are some short-comings when trying to repair asymmetric forms of bilateral cleft lip. So, we designed this technique aiming to correct asymmetry in bilateral cleft lip. This technique is based on a double advancement and lateral rotation concept placing the scars over the natural lines between the esthetic subunits of the upper lip. Matherial and Methods: This is a retrospective and descriptive study based on a case series. We present a new technique used for surgical repair of bilateral cleft lip in 125 pa...

Introduction: A common problem during medical training in surgical areas like plastic surgery, is the absence of proper methods to obtain the necessary surgical skills to address the different pathologies related to this field. The medical training is performed in educational hospitals in Lima, however the methods are limited to the observation or assistance and don't let to the doctor obtain adequate competences to repair surgically this pathology once they finish their training. Material and Methods:This is a descriptive study for the development of the used methodology and a co relational study to evaluate the results obtained with the methodology. This is a quasi experimental study. It is used to third year plastic surgery training surgeons from San Marcos University of Lima and has been done in children with complete unilateral cleft lip attended in Regional Hospitals from Ministry ...

La anatomía de la fisura labial es diferente para cada paciente y varios autores han descrito modificaciones de técnicas tradicionales en la búsqueda de obtener un diseño más individual con mejores resultados. La técnica de Millard es probablemente la técnica quirúrgica más usada por los cirujanos alrededor del mundo en el manejo de la fisura labial unilateral, sin embargo existen algunas limitaciones en esta técnica en fisuras completas con deficiencia de tejidos en el segmento lateral. En ese sentido, se diseño la presente técnica que busca corregir de manera paralela la deficiencia en el segmento lateral de la fisura labial unilateral completa. Esta técnica se basa en una doble rotación y avance localizando las cicatrices sobre las líneas naturales del labio entre las unidades estéticas del mismo. El presente estudio evalúa la simetría labial obtenida con el uso de e...

Background: Secondary nose deformity after unilateral cleft lip repair is a common problem. Loss of tip projection on the cleft side of unilateral cleft lip nasal deformity can be difficult to correct due to lack of adequate support. The purpose of this study is to evaluate the surgical outcome after using V-Y-Z plasty to address unilateral cleft lip nasal deformities. Methods: A cross-sectional study of one surgeon's outcome of 58 performed primary complete unilateral cleft lip nasal deformity repairs. All these patients met the study criterion of having anthropometric measurements at the cleft and non-cleft side of the nose performed at least 1 year postoperatively. Results: Since 2012, 32 consecutive patients have undergone primary anatomical repair of the cleft nasal deformity in patients with a complete unilateral cleft. We have not found statistically significant differences betwee...

Introducción. Diferentes técnicas quirúrgicas para el tratamiento de las fisuras palatinas han sido descritas hasta la actualidad mostrando buenos y malos resultados. La técnica de dos colgajos (Bardach) es la técnica más utilizada en Estados Unidos, sin embargo, esta presenta algunas limitaciones. Objetivo. Presentar los resultados quirúrgicos obtenidos en el tratamiento de las fisuras palatinas unilaterales con una nueva técnica quirúrgica: la palatoplastia de un colgajo. Material y método. El presente es un estudio descriptivo. Se describe una nueva técnica quirúrgica utilizada desde el año 2007 por nosotros y los resultados quirúrgicos obtenidos de 316 pacientes con fisura unilateral completa fueron operados con la técnica de un colgajo entre los años 2007 al 2014. Resultados. El cierre anatómico de los paladares fisurados operados se obtuvo en un 94.31 % de los caso...

Palatal necrosis after palatoplasty in patients with cleft palate is a rare but significant problem encountered by any cleft surgeon. Few studies have addressed this disastrous complication and the prevalence of this problem remains unknown. Failure of a palatal flap may be attributed to different factors like kinking or section of the pedicle, anatomical variations, tension, vascular thrombosis, type of cleft, used surgical technique, surgeon's experience, infection, and malnutrition. Palatal flap necrosis can be prevented through identification of the risk factors and a careful surgical planning should be done before any palatoplasty. Management of severe fistulas observed as a consequence of palatal flap necrosis is a big challenge for any cleft surgeon. Different techniques as facial artery flaps, tongue flaps, and microvascular flaps have been described with this purpose. This revie...

Background: The 2-flap palatoplasty technique is actually the approach most commonly used in the United States for cleft palate repair. This is a one-time surgery that enables closure under minimal tension, lowering rates of subsequent fistula development. However, its primary disadvantage is potential detriment to maxillary growth (due to extent of dissection on both sides of the cleft and raw lateral surfaces). Since 2007, a surgical technique using only one mucoperiosteal flap from the noncleft side has been performed by us, reducing the extent of the surgery and its potential nondesirable effects over the palate. The purpose of this study is to evaluate the utility of this technique for unilateral cleft palate repair. Methods: This is a retrospective, simple-blinded cohort study between 2 groups of 120 patients each with unilateral cleft palate who were operated on using the 2-flap a...

Background: This study describes a 20-year experience of treating patients with unilateral cleft lip. During this time, various techniques were used including Millard's technique and its modification and two types of geometrically designed procedures. The study objective was to compare surgical outcomes of different surgical techniques for unilateral cleft lip repair. Materials and methods: This is a retrospective audit of outcomes after unilateral cleft lip repair performed by a single surgeon since 1995. Of the 827 patients who underwent surgery, 277 met the criterion of having anthropometric measurements performed ≥1 year postoperatively. The patients were stratified into three groups according to cleft severity: incomplete, complete with less deficiency (3-6 mm difference between cleft and non-cleft lip height) and complete with more deficiency (>6 mm difference between cleft and n...

Introduction: The anatomy of labial fissure is different for each patient, and many authors have described modifications of the traditional techniques aiming at obtaining individualized designs with less incisions and better results. Reichert-Millard’s technique is perhaps the surgical approach most frequently used by surgeons all over the world for the management of labial fissures; however, there are some limitations when using this method when trying to obtain an individual design of the fissure to be repaired. Consequently, some modifications for Millard’s approach on the basis of the Lima Outreach Center severity classification and the shape of the nasal filter were proposed. Objective: To propose a combination of Millard’s and Reichert’s approaches based on the natural lines of the lips and the severity of the labial fissure, while trying to obtain a more individ...

Back ground. The pressure sore is a common disease and affects mainly elderly people and patients with neurological sequels. In the domiciliary medical attention of the elderly patient made by Padomi from Essalud, the pressure sores are one of the most common pathologies. Objective. This study aimed to evaluate the effectiveness of dry autolytic method in the treatment of pressure ulcers. Methods. This is a prospective randomized simple-blind clinical trial study. The sample is composed by elderly patients with diagnostic of pressure sore, attended by Padomi from Essalud between 2008 to 2012. Both treatments have been evaluated based in the time of healing of the lesions. Results. Two groups of 50 patients with 123 and 112 pressure sores respectively have been treated by an interdisciplinary team from Padomi of Essalud between 2008 to 2012. This study have found statistical significant d...