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1.
Rev. cuba. angiol. cir. vasc ; 18(1): 107-113, ene.-jun. 2017. ilus
Artigo em Espanhol | LILACS, CUMED | ID: biblio-844810

RESUMO

Los injertos de piel por método de Davis se caracterizan por ser injertos cutáneos autólogos con características especiales que comparten de otros tipos de injertos y que a su vez lo diferencian de ellos, tales como su grosor, el cual a nivel central es de mayores proporciones, pero que paulatinamente se adelgaza hacia la periferia con un diámetro alrededor de tres milímetros, facilitando su prendimiento. Debido a la gran resistencia que presentan son de mucha utilidad en áreas sometidas a traumas externos, como en pacientes portadores de pie diabético a los cuales se les haya realizado algún tipo de amputación menor, especialmente a nivel transmetatarsiano. A pesar de la sencillez y utilidad de esta técnica quirúrgica, continúa subutilizada debido a su poca difusión, lo que ocasiona su desconocimiento. Por lo anterior se considera de interés su publicación. Se presenta el caso de un paciente diabético tipo 2 e hipertenso de largo tiempo de evolución de ambas enfermedades. Es ingresado en el Servicio de Angiopatía Diabética con el diagnóstico de pie diabético neuroinfeccioso. Se le realizó desbridamiento quirúrgico con amputación de los dedos e injerto libre de piel por el método de Davis. La evolución y resultados fueron satisfactorios. El injerto de piel por este método constituye una buena opción para aquellos pacientes portadores de pie diabético que necesiten de cobertura cutánea, con baja morbilidad y excelentes resultados en aquellos pacientes en los que no se pueda realizar un colgajo en primera instancia(AU)


Davis´s skin grafting method is autologous skin graft with special characteristics that are similar to other types of grafting but some others make it different such as thickness which is at the central area thicker, but it gradually becomes thinner toward the peripheral area, with a 3 mm diameter, thus facilitating the engraftment. Due to its great resistance, this type of graft is very useful in areas under external traumas such as patients with diabetic foot who have undergone some kind of minor transmetatarsal amputation. Despite de simplicity and usefulness of this surgical technique, it remains underutilized since it is poorly publicized and practically unknown. This is the reason why it is interesting to provide information about it. Here is a type 2 diabetic and hypertensive patient who had suffered from both diseases for a long period of time. He was admitted to the diabetic angiopathy service and diagnosed with neuroinfective diabetic foot. He was performed surgical debridement with amputation of toes and free skin graft by using Davis' method. The results and the recovery were satisfactory. Skin grafting by Davis' method is a good choice for those patients with diabetic foot in need of cutaneos cover, with low morbidity rate and excellent results in patients who cannot be treated with a flap as a first option(AU)


Assuntos
Humanos , Transplante de Pele/métodos , Transplante de Pele/reabilitação , Diabetes Mellitus
2.
Rev. cuba. angiol. cir. vasc ; 18(1)ene.-jun. 2017. ilus
Artigo em Espanhol | CUMED | ID: cum-67143

RESUMO

Los injertos de piel por método de Davis se caracterizan por ser injertos cutáneos autólogos con características especiales que comparten de otros tipos de injertos y que a su vez lo diferencian de ellos, tales como su grosor, el cual a nivel central es de mayores proporciones, pero que paulatinamente se adelgaza hacia la periferia con un diámetro alrededor de tres milímetros, facilitando su prendimiento. Debido a la gran resistencia que presentan son de mucha utilidad en áreas sometidas a traumas externos, como en pacientes portadores de pie diabético a los cuales se les haya realizado algún tipo de amputación menor, especialmente a nivel transmetatarsiano. A pesar de la sencillez y utilidad de esta técnica quirúrgica, continúa subutilizada debido a su poca difusión, lo que ocasiona su desconocimiento. Por lo anterior se considera de interés su publicación. Se presenta el caso de un paciente diabético tipo 2 e hipertenso de largo tiempo de evolución de ambas enfermedades. Es ingresado en el Servicio de Angiopatía Diabética con el diagnóstico de pie diabético neuroinfeccioso. Se le realizó desbridamiento quirúrgico con amputación de los dedos e injerto libre de piel por el método de Davis. La evolución y resultados fueron satisfactorios. El injerto de piel por este método constituye una buena opción para aquellos pacientes portadores de pie diabético que necesiten de cobertura cutánea, con baja morbilidad y excelentes resultados en aquellos pacientes en los que no se pueda realizar un colgajo en primera instancia(AU)


Davis´s skin grafting method is autologous skin graft with special characteristics that are similar to other types of grafting but some others make it different such as thickness which is at the central area thicker, but it gradually becomes thinner toward the peripheral area, with a 3 mm diameter, thus facilitating the engraftment. Due to its great resistance, this type of graft is very useful in areas under external traumas such as patients with diabetic foot who have undergone some kind of minor transmetatarsal amputation. Despite de simplicity and usefulness of this surgical technique, it remains underutilized since it is poorly publicized and practically unknown. This is the reason why it is interesting to provide information about it. Here is a type 2 diabetic and hypertensive patient who had suffered from both diseases for a long period of time. He was admitted to the diabetic angiopathy service and diagnosed with neuroinfective diabetic foot. He was performed surgical debridement with amputation of toes and free skin graft by using Davis' method. The results and the recovery were satisfactory. Skin grafting by Davis' method is a good choice for those patients with diabetic foot in need of cutaneos cover, with low morbidity rate and excellent results in patients who cannot be treated with a flap as a first option(AU)


Assuntos
Humanos , Transplante de Pele/métodos , Transplante de Pele/reabilitação , Pé Diabético/complicações , Diabetes Mellitus
3.
Environ Sci Technol ; 51(9): 4887-4896, 2017 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-28399629

RESUMO

Measurements of chemical and physical parameters made before and after sealing of culverts in the railroad causeway spanning the Great Salt Lake in late 2013 documented dramatic alterations in the system in response to the elimination of flow between the Great Salt Lake's north and south arms. The flow of denser, more-saline water through the culverts from the north arm (Gunnison Bay) to the south arm (Gilbert Bay) previously drove the perennial stratification of the south arm and the existence of oxic shallow brine and anoxic deep brine layers. Closure of the causeway culverts occurred concurrently with a multiyear drought that resulted in a decrease in the lake elevation and a concomitant increase in top-down erosion of the upper surface of the deep brine layer by wind-forced mixing. The combination of these events resulted in the replacement of the formerly stratified water column in the south arm with one that was vertically homogeneous and oxic. Total mercury concentrations in the deep waters of the south arm decreased by approximately 81% and methylmercury concentrations in deep waters decreased by roughly 86% due to destratification. Methylmercury concentrations decreased by 77% in underlying surficial sediment, whereas there was no change observed in total mercury. The dramatic mercury loss from deep waters and methylmercury loss from underlying sediment in response to causeway sealing provides new understanding of the potential role of the deep brine layer in the accumulation and persistence of methylmercury in the Great Salt Lake. Additional mercury measurements in biota appear to contradict the previously implied connection between elevated methylmercury concentrations in the deep brine layer and elevated mercury in avian species reported prior to causeway sealing.


Assuntos
Lagos , Mercúrio , Biota , Monitoramento Ambiental , Sedimentos Geológicos , Compostos de Metilmercúrio , Utah , Água , Poluentes Químicos da Água
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