Combined adipose mesenchymal stromal cell advanced therapy resolved a recalcitrant leg ulcer in an 85-year-old patient.

Venous leg ulcers (VLU) represent an uphill economic, health and social burden, aggravated in the elderly. Best-practice care interventions are often insufficient and alternative therapies need to be explored. Herein, we have treated for the first time a chronic VLU in an elderly patient by combining cell therapy and tissue engineering in the context of a compassionate use. The administration of allogeneic adipose-derived mesenchymal stromal cells (MSCs) embedded in a plasma-based bioengineered dermis covering the ulcer bed and also injected into the ulcer margins led to the complete closure of a 10-year recalcitrant VLU in an 85-year-old patient. Regenerative properties of MSCs might be boosted by the use of bioengineered matrices for their delivery.

Reparación de defecto de nervio femoral tras iatrogenia / Femoral nerve defect repair after iatrogenic injury

Las lesiones del nervio femoral, en su mayor parte, son secundarias a iatrogenia tras intervenciones quirúrgicas. Presentamos un caso de lesión del nervio femoral tras extirpación de un tumor retroperitoneal, con una recuperación funcional aceptable después de reparar el defecto nervioso con injertos de nervio sural. El defecto tenía 10 cm y la recuperación obtenida MRC (Medical Research Council) fue de 4/5. Consideramos que en estos casos, la reparación precoz es fundamental para obtener un resultado adecuado, incluso en situaciones en la que se necesitan largos injertos nerviosos

Femoral nerve injuries are mostly secondary to iatrogenic after surgical interventions. We present a case of lesion of the femoral nerve after the removal of a retroperitoneal tumor, with an acceptable functional recovery after repair of the defect with sural nerve grafts. The defect was 10 cm length and the recovery obtained MRC (Medical Research Council) was 4/5. We considerer that early repair is essential to obtain an acceptable result, even in situations of being necessary long nerve grafts

Erbium:YAG laser as a method of deepithelization in corrective and reductive breast surgery.

Deepithelization of the breast in breast ptosis surgery is important, being associated with risks which could affect the clinical outcome. The role of Er:YAG laser deepithelization was investigated. A total of 12 bilateral mammoplasties were performed, randomly assigned to 2 groups, one of experienced and one of less-experienced surgeons. Results were compared between the 2 groups of surgeons for scalpel deepithelization on one breast and the Er:YAG laser on the contralateral breast. No complications; less edema, pain, and erythema; and quicker wound healing were observed in the laser-deepithelized breasts, with a shorter operation time even for the less-experienced surgeons. The authors do not suggest that the Er:YAG laser should replace the scalpel in the hands of the expert surgeon for breast deepithelization in breast ptosis surgery, but the results of the study suggest that Er:YAG laser ablation is a safe, precise, effective and complication-free method.

Seguimiento del tratamiento con retinoides en niños con trastornos importantes de la queratinización / Follow-up of children with severe disorders of keratinization under retinoid therapy

Fundamento: los retinoides sistémicos son los fármacos de elección en el tratamiento de los trastornos graves de la queratinización. Objetivo: revisar la eficacia y los efectos secundarios del tratamiento con retinoides a largo plazo en niños con trastornos de la queratinización. Métodos: revisión retrospectiva del seguimiento de doce niños (cinco hombres y siete mujeres) con trastornos de la queratinización y tratados con retinoides orales (etretinato y/o acitretín) durante períodos de tiempo variables entre 7 y 68 meses. Resultados: todos los pacientes excepto uno mostraron mejoría de su enfermedad. Los efectos secundarios comunes (queilitis y sequedad cutánea) fueron casi constantes. Se produjeron elevaciones de las transaminasas en cinco pacientes, que se controlaron al pasar el tiempo o reducir la dosis. No se produjeron efectos secundarios óseos directamente atribuibles a la medicación. Conclusiones: los retinoides orales son eficaces y seguros en el manejo a largo plazo de los trastornos de la queratinización en los niños (AU)