Decerebration induced by surgical transection of cerebral ganglion of crayfish

Background: Since the neural structures of the crayfish brain closely resemble their equivalent in the mammals. This can be suggested by observing the similarity that exists in the brain divided by the surgical transection of the crayfish brain in which the protocerebrum remains attached to the first two cranial nerves, findings also described by Frederic Bremer in 1935 in cats with cerebral transection.Methods: Total 11 Adult male crayfish were trained to respond with defense reflex, the animals were placed in water at 0°C, remained without any movement, and subsequently through a small incision of 3 mm in diameter in the medial antero region and dorsal cephalothorax region, a surgical section of the cerebral ganglion was performed. Immediately after surgery, metal microelectrodes were implanted to collect the activity of the photoreceptors and visual fibers.Results: Once the defense reflex begins to recover in previously decerebrated crayfish, it means that it shows signs of reconnection. The isolated protocerebrum with the deutocerebrum olfactory lobe remain alive for several days and the neuronal connections were reestablished, as measured throughout the bilateral defense activity. The defense reflex was observed in all animals and then recovered after surgery.Conclusions: The crayfish is an excellent model to work the visual activity, all coding of visual information was suppressed in de-cerebrated crayfish. The recovery of the neural disconnection is observed from 40 days, where the defence reflex appears again before visual stimuli.

Thoracic limb salvage by fibular free flap

The treatment of most fractures of the ulna and radius is usually performed by anatomical reduction and internal fixation, when damage is extensive and local soft tissue cannot provide a complete wound coverage, locoregional flaps present a suitable reconstructive benefit. A 35-year-old male patient suffered an exposed diaphysio-metaphyseal fracture with multi-fragmented distal radius. The patient was evaluated during a 10-day period at the National Institute of Rehabilitation, where the osteosynthesis material and a severe infectious process with necrosis were identified. Necrosectomy of the posterior compartment and removal of the osteosynthesis material was performed, a skin defect of approximately 22x16 cm was observed with a bone gap of 6 cm of radius and ulna. a fibula-free flap is placed to correct the skin defect and an external fixative used for bone alignment. The fibular free flap presents an excellent therapeutic alternative in the resolution of bone gaps with extensive skin defect. Whenever a trained microsurgery team is available, current scales of limb injury should be considered but not utilized for therapeutic approach, always trying to shift amputation as the first option, to the very last one of them.

Use of advanced flap and microsurgery techniques in the resolution of mediastinitis as a complication of cardiac surgery

In the majority of cases, mediastinitis is a potential complication in any cardiac surgical procedure. The objective of this case report is to accurately describe how the combination of microsurgery and soft tissue flaps can be an effective therapeutic alternative in the treatment of mediastinitis as a complication of cardiac valve replacement. Female 63-year-old patient with a background of obesity, hypertension and extense cardiac interventions, she was programmed for necrosectomy with left pectoralis flap technique. Mediastinitis, although a rare complication of the sternotomy performed in cardiac surgery, occurring in 1-2%, carries a high mortality rate.  Early diagnosis of mediastinitis after cardiac surgery requires high clinical suspicion, initially making the diagnosis may be difficult, risk factors should be considered. An early surgical approach can reduce the morbidity and mortality of this condition. The pectoralis flap should be considered as a safe therapeutic option.

Angiosome study of the first digital feet space, for reconstruction of the digital tip

Background: The concept of angiosome explains the anatomical variations that exist between the vessels of different regions of the body and helps to understand the contributions of arterial blood supply to the skin and adjacent structures, dividing the human body into three-dimensional vascular blocks.Methods: This was an observational and descriptive study. In both lower extremities of 5 corpses with adequate tissue preservation in the operating room attached to the teaching area of the National Institute of Forensic Sciences in Mexico City. Angiosome study of the medial neurocutaneous flap of the second toe of both feet was performed.Results: The average, in centimeters, of the surface of the flaps was 1.57 cm x 2.47 cm, the average diameter of the inter-metatarsal digital artery was 1.1 millimeters and the average diameter of the veins draining the angiosome was 1.4 millimeters. The most constant anatomy was that of the nerve, which was present in all cases, with the digital nerve forming the neurosome of the flap.Conclusions: To obtain optimal results in microsurgery transfers, it is necessary to have a technique that is quick for harvesting the flap and with adequate systematization so as not to injure the neurovascular bundle, this is achieved through complete anatomical knowledge, without forgetting the main variants.