ABSTRACT
Las complicaciones oftalmológicas en las cirugías dermatológicas son poco frecuentes. A pesar de ello, todo cirujano debe tener un conocimiento básico del reconocimiento, la prevención y el tratamiento de las cuatro complicaciones que se abordan en este artículo incluido en la serie «Seguridad en procedimientos dermatológicos». La primera complicación a tratar es el daño ocular por irritantes químicos, una situación habitual dadas las sustancias irritantes empleadas en quirófano y las localizaciones anatómicas donde se puede producir la intervención (región ciliar, región palpebral ). En segundo lugar, se aborda el daño ocular por láser, una complicación donde la prevención (utilización de gafas o lentillas protectoras) a lo largo de toda la intervención es esencial. Otra complicación a tener en cuenta debido a la proximidad de algunas intervenciones quirúrgicas al globo ocular es la punción traumática accidental. En cuarto y último lugar, se abordará el vasoespasmo o embolismo arterial retiniano por fármacos o materiales de relleno. Dicha complicación es infrecuente, pero es recomendable saber reconocerla para realizar un tratamiento precoz evitando una situación de ceguera permanente (AU)
Ophthalmological complications are uncommon in dermatologic surgery. Nonetheless, all surgeons should know the basics of recognizing, preventing, and treating the 4 complications addressed in this article from the series Safety in Dermatologic Procedures. The first complication that surgeons should be familiar with is eye damage due to chemical irritants. This is a common complication in operating rooms given the presence of irritant substances and the performance of procedures in the eyebrow and eyelid region. The second complication is laser-induced eye damage. In this case, eye protection with safety glasses or eye caps is crucial. The third complication is accidental eyeball perforation, which can occur during certain surgical procedures. The fourth and final complication is retinal artery vasospasm or embolism due to drugs or filler materials. This complication is rare but important to recognize, as early treatment can prevent permanent blindness (AU)
Subject(s)
Humans , Dermatologic Agents/adverse effects , Dermatologic Surgical Procedures/adverse effects , Cosmetic Techniques/adverse effects , Eye Injuries/etiology , Eye Injuries/prevention & control , Eye Diseases/etiology , Eye Diseases/prevention & control , Severity of Illness IndexABSTRACT
Ophthalmological complications are uncommon in dermatologic surgery. Nonetheless, all surgeons should know the basics of recognizing, preventing, and treating the 4 complications addressed in this article from the series Safety in Dermatologic Procedures. The first complication that surgeons should be familiar with is eye damage due to chemical irritants. This is a common complication in operating rooms given the presence of irritant substances and the performance of procedures in the eyebrow and eyelid region. The second complication is laser-induced eye damage. In this case, eye protection with safety glasses or eye caps is crucial. The third complication is accidental eyeball perforation, which can occur during certain surgical procedures. The fourth and final complication is retinal artery vasospasm or embolism due to drugs or filler materials. This complication is rare but important to recognize, as early treatment can prevent permanent blindness (AU)
Las complicaciones oftalmológicas en las cirugías dermatológicas son poco frecuentes. A pesar de ello, todo cirujano debe tener un conocimiento básico del reconocimiento, la prevención y el tratamiento de las cuatro complicaciones que se abordan en este artículo incluido en la serie «Seguridad en procedimientos dermatológicos». La primera complicación a tratar es el daño ocular por irritantes químicos, una situación habitual dadas las sustancias irritantes empleadas en quirófano y las localizaciones anatómicas donde se puede producir la intervención (región ciliar, región palpebral ). En segundo lugar, se aborda el daño ocular por láser, una complicación donde la prevención (utilización de gafas o lentillas protectoras) a lo largo de toda la intervención es esencial. Otra complicación a tener en cuenta debido a la proximidad de algunas intervenciones quirúrgicas al globo ocular es la punción traumática accidental. En cuarto y último lugar, se abordará el vasoespasmo o embolismo arterial retiniano por fármacos o materiales de relleno. Dicha complicación es infrecuente, pero es recomendable saber reconocerla para realizar un tratamiento precoz evitando una situación de ceguera permanente (AU)
Subject(s)
Humans , Dermatologic Agents/adverse effects , Dermatologic Surgical Procedures/adverse effects , Cosmetic Techniques/adverse effects , Eye Injuries/etiology , Eye Injuries/prevention & control , Eye Diseases/etiology , Eye Diseases/prevention & control , Severity of Illness IndexABSTRACT
Ophthalmological complications are uncommon in dermatologic surgery. Nonetheless, all surgeons should know the basics of recognizing, preventing, and treating the 4 complications addressed in this article from the series 'Safety in Dermatologic Procedures'. The first complication that surgeons should be familiar with is eye damage due to chemical irritants. This is a common complication in operating rooms given the presence of irritant substances and the performance of procedures in the eyebrow and eyelid region. The second complication is laser-induced eye damage. In this case, eye protection with safety glasses or eye caps is crucial. The third complication is accidental eyeball perforation, which can occur during certain surgical procedures. The fourth and final complication is retinal artery vasospasm or embolism due to drugs or filler materials. This complication is rare but important to recognize, as early treatment can prevent permanent blindness.
ABSTRACT
BACKGROUND AND OBJECTIVES: Recent reports have described the successful use of propranolol to treat severe hemangiomas of infancy. The few case series that have been reported, however, have included only a small number of patients. The aim of this study was to describe the results of oral propranolol treatment for severe hemangiomas of infancy in terms of treatment outcome and the occurrence of adverse events. PATIENTS AND METHODS: A descriptive, observational study was undertaken in a series of children with severe hemangiomas of infancy seen in the pediatric dermatology unit at Hospital Universitario Virgen del Rocío in Seville, Spain between July 2008 and December 2009. Patients were included if they had hemangiomas in the proliferative phase or involuting lesions with substantial residual deformity. All children were treated with oral propranolol (2 mg/kg/d) and followed until September 2010. Epidemiologic characteristics were analyzed along with treatment response at 3, 6, 9, 12, and 18 months; adverse events were also recorded at those times. RESULTS: Thirty-six hemangiomas were treated in 28 patients. Propranolol treatment was effective in all cases, with a good or complete response in 88.2% at 6 months. Effects were apparent within a few hours of treatment, which was effective in both growing and involuting hemangiomas. In ulcerated hemangiomas, the mean healing time was 61 days. Adverse events were mild and self-limiting. Only 2 patients discontinued treatment due to hypotension. CONCLUSIONS: In the majority of cases, oral propranolol produced rapid and sustained improvements in hemangiomas of infancy and shortened the natural course of the disease with few side effects. However, no significant reductions in symptoms or healing time were observed in ulcerated hemangiomas.
