ABSTRACT
This study aims to compare the use of Bemiparin vs Enoxaparin in patients undergoing microvascular head and neck reconstruction, analyzing the incidence of flap thrombotic complications and local bleeding that could compromise the flap survival. This is an observational study on a group of 204 patients who underwent a microvascular flap for head and neck reconstruction at the Oral and Maxillofacial Surgery Department of Ramon y Cajal Hospital in Madrid, Spain. A group of 67 patients was treated according to a protocol for postoperative prophylaxis of thromboembolism with Bemiparin, which was compared with data collected retrospectively from a group of 137 patients treated with Enoxaparin. We evaluated the incidence of thrombotic complications in the microvascular anastomoses and the incidence of postoperative bleeding events. The flap success rate was 91% in patients treated with Bemiparin, and 91,2% in the group of Enoxaparin (p = 0.963). One major bleeding event was recorded in the Bemiparin group, while 18 events were observed in the Enoxaparin group (p=0.008). Only the type of thromboprophylactic treatment (Bemiparin vs Enoxaparin) was related to presenting major bleeding (p = 0.007). Therefore, Bemiparin is useful in the thromboembolic prophylaxis in patients with microvascular head and neck reconstructions, providing a lower risk of major bleeding than Enoxaparin.
Subject(s)
Thromboembolism , Thrombosis , Venous Thromboembolism , Venous Thrombosis , Anticoagulants/adverse effects , Enoxaparin/therapeutic use , Heparin, Low-Molecular-Weight , Humans , Postoperative Complications/drug therapy , Postoperative Hemorrhage/chemically induced , Postoperative Hemorrhage/prevention & control , Retrospective Studies , Thromboembolism/prevention & control , Thrombosis/chemically induced , Venous Thromboembolism/etiology , Venous Thromboembolism/prevention & control , Venous Thrombosis/etiologyABSTRACT
La invasión de los senos paranasales por hongos o rinosinusitis fúngica es una enfermedad relativamente infrecuente que puede manifestarse como distintos cuadros clínicos, en función de la agresividad del microorganismo causante, la edad y las enfermedades asociadas del paciente. Presentamos 2 casos de rinosinusitis fúngica no invasiva en pacientes inmunocompetentes, donde se observan imágenes radiológicas de bolas fúngicas intrasinusales de una inusual radioopacidad metálica. Realizamos una revisión de la literatura de las rinosinusitis fúngicas, con el objetivo de actualizar la terminología y clasificación de estos cuadros y revisamos la descripción de las bolas fúngicas intrasinusales (AU)
The invasion of the paranasal sinuses by fungi, or fungal rhinosinusitis, is a relatively uncommon disorder that may present as different clinical pictures depending on the aggressiveness of the microorganism responsible, age and other illnesses associated with the patient. Two cases are presented on two immunocompetent patients with non-invasive fungal rhinosinusitis, in whom sinus fungal balls of unusual metallic radio-opacity were observed in the X-ray images. A literature review was performed on fungal rhinosinusitis, with the aim of updating the terminology and classification of these clinical pictures, as well as a review on the description of sinus fungal balls (AU)
