Máscara termoplástica recubierta de silicona para el manejo de la cicatriz hipertrófica facial / Silicone coated thermoplastic mask for management of hypertrophic facial scars

Resumen Las quemaduras secundarias a agresión física con intención de desfigurar, torturar o incluso asesinar, se han convertido en un motivo de consulta común en el siglo XXI, siendo Bangladesh el país con la más alta incidencia en el mundo. Colombia es uno de los países con mayor incidencia a nivel de Latinoamérica. La mayoría de las lesiones ocurre en áreas expuestas como el rostro y se acompaña de graves secuelas físicas, estéticas y funcionales. Se realiza la presentación de caso de una paciente de 35 años con quemaduras de tercer grado en región frontal, periocular, malar bilateral, nasal, labial superior y pabellón auricular derecho, manejada con injertos de piel, quien posteriormente desarrolla cicatriz hipertrófica. Se describe el tratamiento con máscara termoplástica elaborada por los profesionales tratantes, con cubierta interna de silicona, fabricada sobre molde a medida y ajustada con bandas elásticas; integrando en un único dispositivo removible, cómodo y de bajo costo, diferentes alternativas terapéuticas que logran modular efectivamente el proceso de cicatrización y por su simplicidad favorecen la adherencia al tratamiento, la cual es indispensable para obtener resultados satisfactorios. MED.UIS.2020;33(3): 49-58

Abstract Burns secondary to physical aggression with the intention of disfiguring, torturing or even murdering, have become a common reason for consultation in the 21st century, with Bangladesh being the country with the highest incidence in the world. Colombia is one of the countries with the highest incidence in Latin America. Most injuries occur in exposed areas such as the face and are accompanied by serious physical, aesthetic and functional sequelae. We present the case of a 35-year-old patient with third degree burns in the frontal, periocular, bilateral malar, nasal, upper labial and right ear region, managed with skin grafts, who later developed a hypertrophic scar. The treatment with a thermoplastic mask made by the treating professionals is described, with an internal silicone cover, made on a custom mold and adjusted with elastic bands; integrating in a single removable, comfortable and low-cost device, different therapeutic alternatives that manage to effectively modulate the healing process and, due to their simplicity, favor adherence to treatment, which is essential to obtain satisfactory results. MED.UIS.2020;33(3): 49-58

Aderência de bactérias em ligaduras ortodônticas e desinfecção com uso de colutórios / Bacteria adhesion on orthodontics ligatures and disinfection using mouthwash

Uma higiene bucal deficiente favorece o acúmulo de placa bacteriana e o início de inflamação gengival. O uso de aparelhos ortodônticos tem um grande impacto sobre a microbiota bucal porque fornece sítios extras de adesão bacteriana. O uso de substâncias químicas vem sendo empregado com o objetivo de inibir a formação de biofilme dental, crescimento bacteriano e a adesão de bactérias às superfícies. O presente estudo comparou a aderência de bactérias em ligaduras da marca Morelli® e OrthoSource® e a potencial desinfecção pelos colutórios: Plax Ice®, Listerine Vanilla Mint®, Malvatricin®, Periogard® e Solução de Clorexidina 0,12% + Óleos essenciais (produto manipulado, Fleming Farmácia de Manipulação). As ligaduras foram encubadas em suspensão multibacteriana e imersas nos agentes químicos. Após a semeadura e contagem de UFC/mL, os resultados foram avaliados estatisticamente. Não houve diferença significativa na aderência de bactérias ao compararmos as duas marcas (p>0.05) e houve grande eficácia na desinfecção com o uso dos colutórios Periogard® e Listerine Vanilla Mint® (p<0.05). O uso em Ortodontia dos colutórios pode ser útil na prevenção da formação de biofilme dental e uma alternativa para a pré-desinfecção das ligaduras

Deficient oral hygiene favors biofilm formation and outset of gingival inflammation. The use of orthodontic appliances has an important impact on the oral microbiota once it provides additional sites of bacterial adhesion. Chemicals have been employed in order to inhibit the formation of biofilm, bacterial growth, and adhesion of bacteria to surfaces. This study compared the adherence of bacteria on Morelli™ and OrthoSource™ elastic ligatures and potential disinfection by mouthwashes: Plax Ice™, Listerine Vanilla Mint™, Malvatricin™, Periogard™ and chlorhexidine solution 0.12% + essential oils (Fleming Farmácia de Manipulação, Ponta Grossa - PR). Ligatures were incubated in multibacterial suspension and soaked in the chemicals. After platting on agar and obtaining the number of cfu/mL, results were evaluated statistically. No significant difference in bacterial adherence was observed when compared the two brands (p>0.05) and disinfection with the mouthwashes was very effective, mainly with Periogard™ and Listerine Vanilla Mint™ (p<0.05). The use of mouthwashes may be useful in the prevention of biofilm formation in dental braces, as well as an alternative for disinfecting the ligatures prior to installation.

Supervivencia de un implante de silastic para cúpula radial en localización atípica / Survival of a silastic implant for radial cupula in atypical localization / Survie d´un implant de silastic pour coupule radiale en localisation atypique

Las prótesis de silastic en un principio fueron creadas para aliviar y resolver el dolor en las afecciones de pequeñas articulaciones como las interfalángicas, los huesos del carpo, del codo, etc., en los pacientes con artritis reumatoidea. En este trabajo se utilizó una prótesis de cúpula radial en la articulación astragaloescafoidea del pie para sustituir el escafoides necrosado que además le producía mucho dolor al paciente como consecuencia de una fractura de dicho hueso. La sustitución del escafoides por la prótesis de silastic dio muy buenos resultados.

The silastic protheses were created at first to relieve pain in the affections of small joints, such as the interphalangeal joints, the bones of the carpus, of the elbow, etc., and in the patients with rheumatoid arthritis. A prosthesis of radial cupula was used in the astragaloscaphoid articulation of the foot to replace the necrotic scaphoid that produced a lot of pain as a consequence of a fracture of this bone. The replacement of the scaphoid by the silastic prothesis gave good results.

Au début, les prothèses de silastic ont été créées pour soulager et supprimer la douleur dans les affections de petites articulations telles que les interphalangiennes, les os du carpe, du coude, etc., chez les patients atteints d´arthrite rhummatoïde. Dans ce travail, une prothèse de coupole radiale a été utilisée dans la articulation astragalo-scaphoïdienne du pied pour remplacer le scaphoïdenécrosé, entraînant en outre beacoup de douleur au patient en conséquence d´une fracture de cet os. La sustitution du scaphoïde par la prothèse de silastic est parvenue à de très bons résultats.