Skin graft of contralateral aesthetic unit for reconstruction of the upper eyelid: case report and literature review

Eyelids represent a complex structure; its principal function is to provide physical and immunological barrier. The complexity of this structure lies in the blinking and in the range of movement they carry out respecting the integrity of the cornea. The objective of this study is to provide a surgical alternative with minimal morbidity for the reconstruction of the upper eyelid, as well as to present the available tools for the treatment of this complex area of the facial anatomy. We present the case of a female patient of 62 years, with 50% of necrosis on the surface of the upper eyelid and infection data, surgical management was initiated with debridement, systemic antibiotic therapy and negative pressure system device, once the infectious process was resolved and according to the principles of reconstruction by aesthetic subunits, it was decided to reconstruct 100% of the subunit affected by a skin graft of total thickness of the contralateral eyelid through a blepharoplasty with good aesthetic-functional results. The reconstruction of the eyelids should be managed by a plastic surgeon, taking into account the principles of the aesthetic subunits, optimally the donor tissue should have similarity with the tissue to be reconstructed, with respect to the size, color and flexibility, to obtain an adequate aesthetic and functional result

Sacrococcygeal giant hemangiopericytoma: a rare presentation and management

Hemangiopericytoma is a tumor derivated from the mesenchymal cells that surround the capillary of blood vessels. It has a several anatomic localization and clinic scenarios, it´s presentation with a media in the 6th decade; an early diagnostic and treatment represents a better clinic scenario for the patient. The next article presents a case report of a 51 years old man with a tumor localized in the sacrococcygeal space, with big dimensions that limited his daily activities without other symptomatology, image studies with no evidence of distant progression. Surgical resection was performed, removing mass depending from mayor and minor gluteus, achieving an immediate reconstruction with a satisfactory aesthetic and functional result. The authors presented this rare case due to the lack of published information and how it can be treated to achieve good results

Pediatric nasal reconstruction with frontal flap: a case report

Authors presented the case of a 4-year-old male patient who suffered a dog bite on his face with partial amputation of the nasal tip, managed at another institution conservatively, so that one year after the injury he came for the nasal deformity. A frontal flap was performed for reconstruction achieving excellent results, coverage was achieved with similar characteristics of the skin as color and texture. The patient had a follow-up of 5 years with an appropriate course. Authors presented the case due to few reports in the literature of its use in children, where it can be observed that it is an excellent reconstructive tool

Versatility of the estlander flap: upper lip, lower lip and comissure reconstruction due to a dog bite

Background: Dog bites continue to be a frequent cause for plastic and reconstructive services in the world. The grand majority of these cases affect the head and neck area; and more often than not they involve the commissure and the lips. The latter leading to an increased level of difficulty and a substantial decrease on the posibilities for a successful reconstruction. This case report focuses on the exploration of the Abbe-Estlander flap as an efficient alternative in most of these cases.Methods: We present two clinical cases involving dog bites where the affected area of both patients was estimated to be one third of the total volume of the lip. Both patients required emergency reconstructive surgery. An Estlander flap was successfully performed in both instances. The purpose of the article is to share the results and motivate the medical community to continue to use this method as a strong avenue for an effective recovery.Results: After two months of the surgery, the team followed up with both patients and they were satisfied with the results. Patient A presented adequate healing of the wound; a lack of alignment of the mucocutaneous rim and rounding of the commissure was observed. Phonation, oral continence without any leakage and complete closure of the lip were also part of the recovery assessment. Patient B presented adequate healing of the wound, phonation and medium oral continence with occasional leakage of liquids and incomplete closure.Conclusions: The Abbe-Estlander flap is still an excellent reconstructive alternative for upper and lower lip reconstruction where the affected area is up to one third of the total volume. As long as the commissure involvement represents minimum difficulty, both aesthetic and functional objectives can be successfully attained using this flap

Mucosa-associated lymphoid tissue lymphoma of the appendix stump: a case report

Primary lymphomas of the appendix occur in 0.015% of all gastrointestinal lymphomas. The most common manifestation is acute appendicitis secondary to luminal obstruction. The most common is immunophenotype B low-grade non-Hodgkin lymphoma. A 53-year-old male, with a previous three-week surgical history due to acute appendicitis, histopathological report of acute appendicitis and lymphoid hyperplasia. Later, he was admitted, with abdominal pain in the right iliac fossa, an abdominal ultrasound and simple abdominal tomography were performed, with suspicion of residual abscess. Surgical intervention is decided, observing paracecal tumor in the emergency site of the appendix, the tumor is removed. Pathological study that reports an appendicular base infiltrated by mucosa-associated lymphoma. The diagnosis of appendicular tumors is mostly, intraoperatively incidental. It is necessary to have the diagnostic possibility when performing an appendectomy, since it changes the prognosis and treatment of the patient

Pancreatic window and open necrosectomy; a surgical alternative for walled-off pancreatic necrosis in a second level hospital in Mexico

Walled-off pancreatic necrosis is defined as a necrotic collection with a defined wall, which generally occurs in 15% of patients in the fourth week after acute pancreatitis. Actually, open surgery is reserved for selected cases, with minimally invasive treatments such as image-assisted percutaneous drainage or endoscopic ultrasound being the procedures of choice. However, in developing countries the open approach continues to be an effective therapeutic alternative. We present the case of a 47-year-old male patient with no significant history who developed severe acute pancreatitis secondary to hypertriglyceridemia and who later developed walled-off pancreatic necrosis as a late complication. As a treatment, a debridement of the necrotic tissue with marsupialization was performed using the bradley III technique, secondary to the procedure, a pancreatic fistula was developed. After 8 weeks of hospitalization, in which he had a favourable response to surgical treatment, with spontaneous closure of the fistula without complications. Surgical management of late complications of acute pancreatitis remains controversial. Although minimally invasive procedures are the first option nowadays, in developing countries, open necrosectomy remains a good option for the treatment of these types of complications