Anatomic Areas of Lipoframing in Breast Surgery.

Breast lipoframing is a concept in breast surgery that encompasses the often-overlooked aspects of the mammary glands, such as the surrounding structures and adipose tissue within the thorax. By acknowledging the interplay between these components and recognizing the need for their simultaneous treatment, breast lipoframing aims to optimize surgical aesthetic outcomes. This article proposes a comprehensive definition of the surrounding mammary fat tissue by delineating the specific areas of the breast involved in the lipoframing technique. It presents a retrospective analysis of 554 female patients, revealing only one case of seroma and three cases of hematoma. Furthermore, we explore the application of liposuction as a means to effectively treat these areas and achieve superior results.

Complex upper limb reconstruction using dorsoepigastric flap. Case report of a convenient resource.

INTRODUCTION: Dorsoepigastric flap (DF), first described by. Haddad and Jimenez, is a variant of the classic lattisimus dorsi musculocutaneous flap that only utilizes a minimum quantity of muscle tissue, through which the vascular pedicle passes by. It has been used primarily as an acceptable alternative in mammary reconstruction when the use of thoraco abdominal muscles is not viable, and offers several advantages such as adequate flap volume with generous cutaneous island dimensions and functional preservation of the latissimus dorsi. PRESENTATION OF A CASE: We report the case of a 12 year old male, who suffered a left upper limb injury secondary to high power firearm shot. He presented extensive damage to the skin, soft tissues and bone structures and was treated with primary reconstruction using DF and peroneal grafts. Three years later, a shoulder prosthesis was placed to improve limb function with unobjectionable results. CONCLUSION: DF is a useful resource that has been merely used in the context of complex upper limb reconstruction, and must be considered essential in the repertoire of the reconstructive surgeon when facing traumatic defects of the upper extremity.

Campañas de reconstrucción mamaria en Guanajuato, México / Breast reconstruction campaigns in Guanajuato, México

La reconstrucción mamaria se considera en la actualidad una parte integral del tratamiento del cáncer de mama, ya que otorga a la mujer calidad de vida, mejora de su imagen corporal y con ello, una mejora de su forma de percibir su enfermedad. En México, el cáncer de mama ocupa el primer lugar en neoplasias malignas en las mujeres y solamente una tercera parte de las que lo padecen se someten a una reconstrucción mamaria. Lamentablemente las instituciones de salud del país, así como los recursos materiales y humanos en el sector público, son insuficientes para cubrir el proceso de reconstrucción mamaria en esta población, por lo que tras al tratamiento oncológico, es muy común encontrar pacientes no reconstruidas en nuestro medio. Por esta razón, decidimos crear una organización altruista que, mediante la organización de campañas anuales, logra apoyar a las mujeres guanajuatenses que no tienen la oportunidad de recibir un tratamiento completo tras sufrir un cáncer de mama

Breast reconstruction is currently considered an integral part of the treatment of breast cancer, since it gives quality of life, improves the body image of women and thus improves their way of perceiving their disease. In México, breast cancer occupies the first place in malignant neoplasms in women and only one third of those who suffer from it are reconstructed. Unfortunately the health institutions of the country, as well as the material and human resources in the public sector, are insufficient to cover the process of mammary reconstruction in this population, so that after the oncological treatment, it is very common to find patients not reconstructed in our region. For this reason, we decided to create an altruistic organization that, through the creation of annual campaigns, manages to support women from Guanajuato who do not have the opportunity to receive a complete treatment after breast cancer

[Abnormalities in cervical smears stored in plastic bags: potential cause of false negatives]. / Alteraciones en citologías cervicales almacenadas en un medio ambiente húmedo: causa potencial de falsos negativos.

INTRODUCTION: Cervical smear is the most economic and efficient diagnostic tool for the screening of cervical cancer. However, since plastic bags have been used in Guanajuato to transport and store smears, we have observed cytological abnormalities which difficult the diagnosis and lead to false negatives. OBJECTIVE: To describe those abnormalities. METHODS: Out of 340 women registered in a primary care center in Mexico, 68 were selected through systematic random sampling during 2007. A cervical smear was obtained and placed on two slides. The first sample was allowed to dry but the second one was placed into the plastic bag immediately after fixation. After 15 days all the smears were stained with the Papanicolaou technique. A certified pathologist, blinded about the variable of study, interpreted the samples according to the Bethesda system, and evaluated the presence of necrosis, edema, holes, and opportunistic microorganisms. RESULTS: Of the 68 smears exposed to a humid storage, 36 (53%) were inadequate for diagnosis (Fisher's exact probability < 0.001). From them, 36 (53%) had holes or lagoons, 34 (50%) had edema, 31 (46%) had necrosis, and 15 (22%) had fungus. On the other hand, the 68 dried cervical smears were all adequate for diagnosis and none had the changes or cytological abnormalities. CONCLUSION: The humid transport and storage of cervical smears produced abnormalities in the normal morphology that could lead to false negative results. The guideline for the handling of cervical smears must stress the importance of allowing the smears to dry completely after fixation and before storing them in plastic bags.