CIRUGÍA PLÁSTICA, ESTÉTICA Y RECONSTRUCTIVA
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Item "COMPLICACIONES QUIRÚRGICAS EN PACIENTES INTERVENIDOS POR FRACTURAS FACIALES EN EL HOSPITAL TEODORO MALDONADO CARBO EN EL PERIODO ENERO 2015 HASTA ENERO(2018-05) Rivas Rivas, Santiago Eduardo; Bodero, CarlosTraffic accidents, interpersonal violence, gunshot wounds, and rapid deceleration mechanisms that push the face against blunt objects or the steering wheel result in facial fractures. Its timely treatment is important as it has been considered an important cause of morbidity. The objective of this research was to analyze the complications that occurred during the surgical act in interventions due to facial trauma fractures, the determination of the mechanisms that occurred, and the identification of osteosynthesis complications and the most frequent surgical complication was established. . The study was carried out at Teodoro Maldonado Carbo Hospital during the period January 2015 to January 2017 using a descriptive and retrospective design, which showed the following results: The fracture of the middle facial third was the most frequent, prevailing with 54.5%, followed by the lower third with a percentage of 37.5; in a minority, 8% corresponded to the upper third. The maxillary facial fracture reconstruction procedure to which the patients were subjected was the most frequent osteosynthesis with plaque and the majority of patients corresponded to the male sex, and the age group of 16 to 29 years predominated. According to the causal mechanism of fracture that prevailed was the accident by motorcycle followed by blunt trauma and in minor percentages represented the automobile accident, injury by firearm and falls. Eight patients presented surgical complications, of which 5 cases were dueto complications within the Osteosynthesis, 62.5% of the total patients were operated, while 25% presented complications of the osteotomy and 12.5% corresponding to 1 case. of complication of the cerclage. Of the patients, 5.6% had a complication by osteosynthesis technique, corresponding to extrusion, asymmetry and vasculonerviosa lesion. Of the patients who underwent osteotomies, 4.5% corresponded to 2 people, presenting as a complication the undesired and the incomplete osteotomy, respectively. Key words: Facial fractures, maxillofacial surgery, Le fort, surgical complications, osteotomy, osteosynthesis, reductions.Item EFICACIA DEL COLGAJO DORSAL ANCHO EN CIRUGÍA MAMARIA EN EL HOSPITAL ONCOLÓGICO SOLCA GUAYAQUIL EN EL PERIODO 2015-2016(2016-12) Vergara Olvera, Andrés Gustavo; Chalen Zambrano, Sandra AngélicaBreast reconstruction is one of the surgical techniques that gives the most satisfaction to a mastectomized cancer patient. With the advent of breast reconstruction techniques for each patient selected as the use of autologous flaps, the possibilities of complications were reduced and the benefits of aesthetic appearance increased. A number of reconstruction techniques are known today but we must be guided by the most reliable, useful and reflecting less evidence of sequelae at the end of the reconstruction. The present investigation is of a descriptive type carried out in the cancer hospital of Solca de Guayaquil in the period 2015-2016, where the wide dorsal flap was used to reconstruct the chest wall, and breasts immediately or late according to the general conditions of the patient . Taken as a reference, 20 oncological patients who underwent mastectomies coverage were: radical mastectomies, mastectomies of cleaning, SSM (skin sparing mastectomies), NSM (nipple skin mastectomies), for which the indication for the use of the flap was very Varied: coverage, filling and replacement of tissues. The data were taken from the statistical service of the Solca Hospital of Guayaquil, clinical histories, surgical records, postoperative controls were performed by means of a data collection sheet. The results showed that the patients comprised an age limit between 35 and 56 years; the complications presented were 10% which XV was resolved favorably. Patients presented an excellent satisfaction level of 80%, which was achieved using a 5-character Likert scale.Item RECONSTRUCCION DE PUNTA NASAL ENTRE COLGAJOS MEDIO FRONTAL Y NASOGENIANO EN EL HOSPITAL SOLCA GUAYAQUIL, DIC-2012 A MAR-2015(2015) Orellana González, Antonio Fabián; Leone Pignataro, MarioAt the level of the nasal tip is not only important the complete exeresis of the injury but subsequent to the implementation of reconstruction coverage, in this study, two took the naso labial flaps and front means that we provide a fabric very similar in texture , color and thickness. Objetives: Evaluate the aesthetic result, functionality and complications in the reconstruction of nasal tip between naso labial flaps and front in facial skin oncology. Methodology: A descriptive, longitudinal, observational, non-probability, study of 67 patients nasal tip reconstruction were performed with naso labial flaps or median forehead flap in Guayaquil SOLCA hospital was performed. Results: The median forehead flap was less hassle, better functionality, and better cosmetic result, naso labial flap for minor functionality were higher complications and aesthetic result was only good for individuals in the study. Conclusions: despite having more surgical time, have more intraoperative bleeding the median forehead flap had a very good reconstruction of nasal tip aesthetic result, and the nasolabial was just good. Another plus was that the average front flap had fewer complications. Recommendations: Patient assessment will determine the type of flap used, according to the surgeon's experience and condition of each patient will be important to give good coverage with a good thinning is nasolabial regardless flap or median forehead flapItem TRACCIÓN DE LA FASCIA DE SCARPA PARA MEJORAR EL CONTORNO CORPORAL EN LIPOMINIABDOMINOPLASTIA TIPO II EN MUJERES INTERVENIDAS EN CLÍNICA PARTICULAR DE LA CIUDAD DE GUAYAQUIL DE 1 DE JULIO DEL 2012 A 30 DE JUNIO DEL 2015(2015) Cedeño Álava, Angélica María; Borja Zavala, FranciscoThe reconstruction of the abdominal contour through abdominoplasty, is one of the procedures generated in greater patient satisfaction. With the advent of liposuction and the combination of both procedures (abdominoplasty + liposuction) has made great strides in improving the abdominal contour. Proper diagnosis of abdominal deformities to use a specific surgical technique for each type of abdominal currently proposed. This research is descriptive, retrospective, held at a private clinic in the city of Guayaquil in the period from 1 July 2012 to 31 June 2015, taking as sample 65 women with abdominal deformity type II and who underwent to type II with traction Lipominiabdominoplastia Scarpa's fascia, which will improve body contour through scar less than 25 centimeters and proper firmness of the abdominal wall without plication abdominal muscles. The data were collected from medical records, surgical records and postoperative assessments that are in the database of the private clinic where the study was conducted, obtaining as results the age range that prevailed was 21-35 years 66.1%, with two pregnancies at diagnosis in 41.5% of cases, the presence of previous abdominal scar Pffanestiel type in 52.3% of patients, and with a body mass index (BMI) less than 30. The complications were seroma and hypertrophic scar in 10.8%. The results were satisfactory in 98% of patients evaluated by a Likert scale of five points.Item VENTAJAS DE LA TÉCNICA DE LA “TIRA” DE CUERO CABELLUDO EN EL TRATAMIENTO DE LA ALOPECIA ANDROGENÉTICA EN EL SEXO MASCULINO PERÍODO 2014 – 2015, EN UN CENTRO PRIVADO DE TRASPLANTE CAPILAR EN GUAYAQUIL(2015) Juan Carlos, Delgado Quiroz; Ortega Peña, Luis AlfredoLa calvicie hereditaria o alopecia androgenética es una patología que afecta a gran parte de la población masculina. El tratamiento quirúrgico de la calvicie es un procedimiento que va en aumento en nuestro medio, sin embargo no se cuenta con estadísticas exactas de los resultados en los centros donde se realiza el trasplante capilar. La falta de conocimiento acerca de las opciones quirúrgicas para el tratamiento de la calvicie, hace que muchos de los pacientes se vean afectados en su autoestima y masculinidad, siendo esto causa que no se integren plenamente a su entorno social y familiar. El objetivo de este trabajo es mostrar las ventajas que tiene la técnica de la tira de cuero cabelludo en el tratamiento de la alopecia androgenética en el sexo masculino, comparándola con otra opción de tratamiento. Se trata de un estudio descriptivo, retrospectivo, con una muestra de 39 pacientes que se realizaron trasplante capilar con la técnica de la tira de cuero cabelludo, en un centro privado de la ciudad de Guayaquil, desde el 01 de enero del 2014 al 30 de junio del 2015. Los datos del presente trabajo se obtuvieron de las historias clínicas que reposan en el archivo del centro quirúrgico privado, se introdujeron en una hoja electrónica y se tabularon. Se utilizó la escala de Likert para medir el grado de satisfacción de los pacientes respecto al procedimiento. Los resultados mostraron: la edad promedio fue de 40 años. Los estadios 3 y 5 de la escala Norwood representaron el 68,2% de la muestra. Al 82% se le solucionó su problema de calvicie en una sola sesión. Tiempo quirúrgico promedio entre 4 a 6 horas. Tamaño de tira de cuero cabelludo menor a 20 cm. El 25,6% presentó complicaciones, resueltas en forma conservadora. El 96% de los XII pacientes calificó con alto grado de satisfacción la técnica de la tira como tratamiento de la calvicie. Se concluyó que la técnica de la tira presenta ventajas respecto a la técnica FUE, entre ellas el uso de implantes pequeños y grandes, lo que se traduce en menos horas de trabajo y bajo porcentaje de complicaciones. Esto a su vez se reflejó en el alto grado de satisfacción manifestado por los pacientes, por lo que se recomienda como primera opción del tratamiento quirúrgico de la alopeciaItem VERSATILIDAD DEL COLGAJO PROPELAR PARA COBERTURA EN ZONAS DE FLEXO – EXTENSIÓN EN PACIENTES QUEMADOS EN EL HOSPITAL PEDIÁTRICO “DR. ROBERTO GILBERT ELIZALDE” JUNIO 2014 – JUNIO 2015(2015) Loor Brocell, Gabriel Enrique; Delgado Panchana, Mario GonzaloAntecedentes: Las complicaciones de índole funcional en pacientes secuelares quemados son motivo de limitaciones para dichos pacientes en su vida cotidiana; para el cirujano plástico representa un reto devolver en su integridad total la función motriz a la articulación. Se decidió introducir la técnica de colgajos propelares en zonas de flexión – extensión en la Unidad de Quemados del Hospital Roberto Gilbert Elizalde, con la intención de acelerar el tiempo de recuperación devolviendo la totalidad funcional del paciente, optimizando el número de intervenciones quirúrgicas para conseguir este fin. Objetivos: Establecer la versatilidad del colgajo propelar para cobertura en zonas de flexo-extensión en pacientes quemados en el Hospital Roberto Gilbert Elizalde entre junio 2014 y junio 2015. Metodología: Se realizó un estudio descriptivo, prospectivo, con una muestra no probabilística por conveniencia en 12 pacientes pediátricos que presentaron quemaduras a nivel de zonas de flexo-extensión presentando retracción de las áreas mencionadas. Análisis estadístico: Se utilizó documentación del paciente pre y postquirúrgico, observación de resultados quirúrgicos con documentación fotográfica y seguimiento mensual. La información obtenida se procesó en frecuencias simples con porcentajes para variables cualitativas y cuantitativas. Resultados: El colgajo propelar devolvió la totalidad del rango de movimiento en flexión y extensión en la totalidad de los casos, demostrando ser el método de elección en estas zonas especiales. Palabras clave: colgajo propelar, zonas de flexión – extensión, movimiento, retracción, complicacionesItem EVOLUCIÓN DE LA SINTOMATOLOGIA EN LA DESCOMPRESIÓN DEL NERVIO MEDIANO A NIVEL DE LA MUÑECA POSTCIRUGÍA EN EL AREA DE CIRUGÍA PLÁSTICA DEL HOSPITAL TEODORO MALDONADO CARBO, 2014-2015(2015) Roby Cevallos, Yngheborth del Carmen; Bodero León, CarlosCarpal Tunnel Syndrome is a pathology not very well known by the patients, is overlook and allows the progress of it up to the point of functional dissability, and in many cases, including days off work. If this pathology is evaluated early in its evolution with sensitivity, pain, paresthesia, strength and muscular atrophy tests it can have a surgical treatment that is simple and in a ambulatory setting, it can avoid symptoms, complications and secuelae. This reasearch objective was to evaluate the symptoms of Carpal Tunnel Syndrome before and after the surgical procedure, which involves the decompression of the Median nerve with a follow up in 3 and 6 months. This study was an observational type, random and progressional . It include a group of patients that were seen in the outpatient clinic of the Plastic Surgery Department at the IESS Hospital Teodoro Maldonado Carbo, with an stablished diagnosis of Carpal Tunnel Syndrome but without any surgical procedure done. The conclusion was that the symptoms can be control and show a progressively improvement after the decompression of the Median nerve, providing satisfaction to the patient and allowing daily tasks. The recommendation is to give prevention of this pathology, requesting to the appropiate health authorities to provide a closer health control to the patients, and train physicians from the public and private system for early detection and triage.Item ALTERNATIVASQUIRÚRGICAS PARA RECONSTRUCCIÓN DE DORSO NASAL EN RINOPLASTIA SECUNDARIA ESTÉTICA, UTILIZADAS EN PACIENTES PARTICULARES EN GUAYAQUIL DURANTE EL PERÍODO DEL 01 DE JUNIO 2014 AL 31 DE JULIO DEL 2015(2015) Duran Jaramillo, María Carmen; Miranda Zavala, Jorge ALa reconstrucción del dorso nasal es un reto para el cirujano plástico porque con un pequeño error, los pacientes pueden tener anatomía alterada y su estado psicológico afectado por una rinoplastia fallida. Es importante discurrir las diferentes alternativas quirúrgicas, el grado de satisfacción de los pacientes a estas opciones y, por ser una cirugía de alta complejidad, determinar si la especialidad del médico que realiza la rinoplastia primaria influye en la prevalencia de una rinoplastia secundaria. La presente investigación es de tipo descriptivo, longitudinal, realizada en una Clínica Particular de Guayaquil durante trece meses. La muestra constituyó un grupo de 60 pacientes a quienes se les realizo rinoplastia secundaria con reconstrucción del dorso nasal con las siguientes técnicas: limado de dorso nasal 17%; colocación de injerto libre de fascia del temporal 6%; injerto de cartílago auricular cubierto por fascia del temporal 67% y la colocación de injerto costal más fascia el 10% los casos. La alteración de la anatomía nasal constituyó en el 83% de las causas de rinoplastia secundaria. El grado de complacencia luego de la cirugía de reconstrucción fue satisfactorio y muy satisfactorio en el 88% de los pacientes. No se presentaron complicaciones y hubo sólo un caso de reintervención por insatisfacción. El 67% de las rinoplastias primarias no fueronrealizadas por profesionales especialistas en cirugía plástica reconstructiva y estética. En conclusión, las técnicas descritas son replicables con buenos resultados, con materiales autólogos y un buen grado de satisfacción entre sus usuarios. Se recomienda promover estas alternativas quirúrgicas para reconstrucción de dorso nasal en rinoplastia secundaria dado sus excelentes resultados y mínimas complicacionesItem ELECCIÓN DE REVESTIMIENTO DE IMPLANTES MAMARIOS CON COLGAJO TORACODORSAL TIPO HOLMSTRÖM VERSUS USO DE EXPANSOR TISULAR EN RECONSTRUCCIÓN MAMARIA POST MASTECTOMÍA POR CÁNCER EN PACIENTES DEL HOSPITAL “DR. TEODORO MALDONADO CARBO”, GUAYAQUIL, 2014.(2015) Montalván Rodríguez., Ginelda Verónica; Guevara Vivero, Diego CristóbalBreast reconstruction is a very important part if cancer’s therapy. Due to the surgical techniques diversity, they should be chosen in an assertive and individual way according to the characteristics of each patient to to achieve excellent results. A descriptive, longitudinal and observational study to establish a comparison between the unilateral thoracodorsal fasciocutaneous flap (Holmström) versus the use of tissue expander as options to cover retropectoral implant, in 29 women with delayed breast reconstruction after mastectomy in "Dr. Teodoro Maldonado Carbo" Hospital , at Guayaquil, operated between January to December, 2014. The average age was 50 years. The first group included the Holmström flap (39.9%) and the second, tissue expander (62.1%). The group number one comprised age range between 40-49 years (17.2%) and the second was between 50 and 59 (24.1%). The elapsed time between mastectomy and breast reconstruction was less than three years with the flap (20.7%) and the expander was between 3-5 years (37.9%). 37,8% of the perioperative visits was in the Holmström group (1-4 visits) and 37.8% was in the second group (> 5 visits). All the complications occurred with tissue expander because of valvular failure (3.4%) and capsular contracture (3.4%). Finally, the degree of satisfaction with the Holmström flap was excellent (72.7%). Conclusion: Due to all these advantages, the Holmström flap is an excellent option to cover breast implants in reconstructive procedures.Item MAMOPLASTIA DE SIMETRIZACIÓN: TÉCNICAS PARA CORRECCIÓN DE ASIMETRÍA CONTRALATERAL EN RECONSTRUCCIÓN MAMARIA EN MUJERES ATENDIDAS EN HOSPITAL “TEODORO MALDONADO CARBO”, GUAYAQUIL, 2014(2015) Suárez Ruíz, Eloisa Vanessa; Guevara Vivero, Diego CristóbalPost-mastectomy breast reconstruction due to cancer, in Ecuador, has increased. However, there isn’t exact statistics of symmetrization mammaplasty in the “Teodoro Maldonado Carbo” Hospital. The lack of knowledge about breast symmetrization’s techniques, reduces the possibility to get back harmony to the female thoracic contour, lost self-esteem and femininity which will improve the quality of life. OBJECTIVE: To describe breast symmetrization techniques for contralateral breast asymmetry, in women with previous unilateral breast reconstruction. METHODS: A descriptive, retrospective study in 26 women with history of unilateral breast reconstruction to whom were performed a correction of the contralateral asymmetry at the “Teodoro Maldonado Carbo” Hospital, in Guayaquil, from January 1st to December 31st 2014. RESULTS: Average age of the group was 50 years. 76,9% of reconstructions merited simultaneous symmetrization with no complications. Mastopexy was the most used symmetrization technique (61,6%). The degree of post-symmetrization’s satisfaction was 63,9% according to the shape, size, symmetry, NAC position and scars. CONCLUSION: Breast augmentation, reduction mammaplasty and/or mastopexy are safe and successful symmetrization techniques to correct an evident asymetry caused by the reconstructed one. RECOMMEDATION: To inform to every mastectomized women, the need to correct the contralateral assimetry and also, to investigate the influence of other breast reconstruction techniques on the symmetrization mammaplasty’s results. KEY WORDS: Breast symmetrization, contralateral breast asymmetry, contralateral breast correction, breast reconstructionItem ALOGENOSIS IATROGÉNICA TRATAMIENTO CLÍNICO Y QUIRÚRGICO DE LAS COMPLICACIONES EN MUJERES ATENDIDAS EN CLÍNICA PRIVADA, GUAYAQUIL 2012-2015(2015) Vizueta Cajo, Ana Yacqueline; Borja Zavala, FranciscoLa Alogenosis iatrogénica es potencialmente perjudicial para la salud, produce en la mayoría de casos deformaciones irreversibles con ulterior necrosis en el sitio de aplicación, el desconocimiento de esta enfermedad y de sus complicaciones por parte de las personas que se aplican sustancias modelantes y del inadecuado manejo por parte del personal médico, conllevan a complicaciones más severas y de difícil resolución, desencadenando en una pésima calidad de vida; sin que hayan estadísticas ni estudios acerca de las complicaciones y el tratamiento de las mismas en nuestro país. OBJETIVO: Describir el tratamiento clínico y quirúrgico de las complicaciones de la Alogenosis iatrogénica en mujeres atendidas en una clínica privada de Guayaquil, en el período 2012-2015. METODOLOGIA: Se realizó un estudio descriptivo, retrospectivo, con una muestra no probabilística por conveniencia en 30 mujeres que presentaron complicaciones de la Alogenosis iatrogénica en diferentes regiones corporales. ANALISIS ESTADÍSTICO: Se utilizaron las historias clínicas de las pacientes y protocolos operatorios. La información obtenida se procesó en frecuencias simples con porcentajes para variables cualitativas y cuantitativas. RESULTADOS: La edad promedio fue 39 años; el 85% de las pacientes desconocían la enfermedad y sus complicaciones. El Intrusismo médico (63%) fue el mayor responsable de las aplicaciones. La sustancia más utilizada fue la Silicona líquida (87%). Las complicaciones predominantes fueron las tardías (97%), siendo los granulomas los más frecuentes con un 40%. El tratamiento más aplicado fue el Clínico con un 40%. El grado de satisfacción respecto al resultado según el tratamiento aplicado fue Excelente en el 65%.Item RESULTADO DE CIRUGÍA ABIERTA EN EL SÍNDROME DE TÚNEL CARPIANO MEDIANTE BLOQUEO DEL NERVIO MEDIANO A NIVEL DE LA MUÑECA, EN EL HOSPITAL TEODORO MALDONADO CARBO DE LA CIUDAD DE GUAYAQUIL, AGOSTO 2014 – FEBRERO 2015(2015-10) Villao Alvarado, Alex; Bordero León, CarlosCarpal Tunnel Syndrome is a frequent entity. Women are the most affected between the fourth to sixth decade. It has a close relationship with work activity especially those that exert additional pressure on the carpal tunnel. The surgical treatment of this disease can be performed using a nerve block to the affected limb at the level of the brachial plexus, or by blocking the median nerve at the wrist. An investigation was conducted at the Hospital Teodoro Maldonado Carbo in Guayaquil, during the months of August 2014 to February 2015, in order to determine the benefits obtained with open surgery Carpal Tunnel Syndrome by blocking the median nerve at the wrist. The study formed part of a descriptive, prospective, longitudinal type. A nonprobabilistic sample of 31 patients was taken. The main results showed that the total operating time was 33 minutes on average; recovery time of patients was 46 days on average; it did not show any associated complications with the blocking the median nerve at the wrist It was concluded that open surgery in the Carpal Tunnel Syndrome by blocking the median nerve at the wrist, is effective for treatment, in which no complications occurred , and it was done in a short time with what are reduced hospital costs in a specific entityItem EFICACIA DEL PLASMA RICO EN PLAQUETAS UTILIZADO EN EL TRATAMIENTO DE LAS SECUELAS DE QUEMADURA, CICATRICES HIPERTRÓFICAS Y QUELOIDES, EN PACIENTES PEDIÁTRICOS MENORES DE 14 AÑOS DE EDAD EN LA UNIDAD DE QUEMADOS DEL HOSPITAL DE NIÑOS DR. ROBERTO GILBERT E, EN EL PERIODO ENERO – DICIEMBRE DE 2015.(2016-09) Ramos Vargas, Rudy Rubén; Delgado Panchana, Mario GonzaloThe aftermath of burn, hypertrophic and keloid scars are a challenge for the plastic surgeon, so in the Children's Hospital Roberto Gilbert E, is being used for several years, the platelet-rich plasma to treat these scars. Despite the use by years of this treatment at Children's Hospital Roberto Gilbert E it has not been proven scientifically its effectiveness in reducing hypertrophic scars and keloids especially there is uncertainty about its effectiveness compared to other treatments that meet the same purpose. The effective cure of scars and keloids is of great importance in the patient taking into account their functional, cosmetic and psychological impact. The general objective arises describe the results of treatment with platelet-rich plasma from the aftermath of burn, hypertrophic scarring and keloid in pediatric patients under 14 years of age, treated at the Burn Unit of Children's Hospital Roberto Gilbert E, in the period January-December 2015 The methodology used was a descriptive study with prospective and longitudinal section, performed in the burn unit of Roberto Gilbert Hospital, with a sample of non-probabilistic for convenience. The study is developed with the results of 50 patients, where the information is compiled, was obtained as a result, the wound was the most commonly Hypertrophic with 84%, the location was in upper extremities with 36%, had prior treatment with presoterapia 86%, complications occurred in 6% and efficiency was evident in 96% of patients. xvii In conclusion, it was shown that the platelet-rich plasma was an appropriate response in the treatment of hypertrophic scars and keloids, regular checks were performed, and the subsequent combination of zetaplastias and intralesional triamcinolone, increase efficiency, and combined therapy acupressure, as a recommendation, sensitize families and patients, who come to the following treatment infiltration PRP, and controls with physical therapy and rehabilitation respective controls.Item EFICACIA DE LA RECONSTRUCCIÓN MAMARIA CON EXPANSIÓN DE PIEL EN PACIENTES HOSPITAL ONCOLÓGICO SOLCA GUAYAQUIL 2013 – 2015.(2016) Mendoza Andrade, Mariano; Jurado Bambino, AntonioOncological pathology in Ecuador is in second place in the epidemiological profile, and within context, 35.8% per 100,000 women corresponds to breast Cancer in women also shown significantly as a cause of death. In moderate and advanced patients suffering from this disease stages, the ideal treatment is mastectomy, which most often supplemented with adjunctive treatments for the security offered to any recurrence. The reconstruction, post-cancer treatment, breast consists of two phases: First phase: consists in placing a skin expander, so that this sufficient skin. Second phase: it based on the placement of a breast prosthesis for the purpose of achieving similarity to a standard breast; although in some cases the only expanspor directly or prothesis, prior assessment of amount of skin in that area is placed. Following a mastectomy, reconstruction with expanders is one of the most recommended techniques because it offers volume expansion and opportunity dermal skin in length is able to accommodate a prothesis, provided better symmetry and breast aesthetics. This study was conducted in Guayaquil Solca Hospital during the period 2013-2015 in order to determine the effectiveness of breast XII reconstruction with skin expansion. I was part of the general description of the variables: age, staging of cancer in patients with breast reconstruction with expander, surgical time placement expander breast skin to the placement of breast prostheses, length of hospital stay, complications in breast reconstruction with skin expander. The main results of this research included 50 patients whose main results are: increased frequency of breast reconstruction with skin expansion occurs in the age groups 30 to 39 and 40 to 49 years with 30% in each group; the cancer stage IIB that was prioritized in the (38%) of patients; In 54% of patients used surgical time was 2 to 3 hours; while the time elapsed since placing expander to change prothesis was de7 to 10 months in 36% of patients, followed by 22% in the period was 11 to 14 months and 8% reached more than 15 months ; 96% of patients had a hosptalaria stay less than 24 hours; Complications 18% of patients with hematomas are located; 22% seromas and 22% exposure or alteration of the expander, and skin involvement related to the placement of the expander 22%, while dehisencia suture 11%, finally the results of breast reconstruction with expander were mostly good (24%) and very good (68%). Conclusion: Due to the advantages of breast reconstruction using expanders, is considered good surgical alternative to improve the volume, breast symmetry and harmonyItem RECONSTRUCCIÓN CON COLGAJOS EN MEJILLA Y LABIO EN PACIENTES ONCOLÓGICOS DEL HOSPITAL SOLCA-MATRIZ(2016-12) Lissette Graciela, Flores ParedesObjectives: To describe the surgical techniques most commonly used in reconstruction with local flaps on the cheek or lip of oncology patients at Juan Tanca Marengo Oncological Hospital SOLCA- Guayaquil Matrix from January 2013 to May 2016. Recognize common epidemiological factors in patients with carcinoma of cheek or lip. To evaluate the degree of functional and aesthetic satisfaction of the patients reconstructed in cheek and lip with local flaps. Methods: Non-experimental design, transversal, descriptive type, quantitative method. In the Juan Tanca Marengo Cancer Hospital SOLCA- Matriz Guayaquil, between January 2013 and May 2016, of patients presenting with malignant tumors of the lip and cheeks. A sample of 59 patients was constructed. Results: The slightly more affected male sex was 51%; The most frequent ages of presentation were between the 81 to 90 years (27.1%) followed by the 70 to 80 years (25.4%), totaling 52.5%. Patients with 90% mestizo skin. Basal cell carcinoma had the highest histological incidence with 61%; Of the cheek malar region was the most vulnerable sector with 68%. The postoperative complication reached 7% of which the operative site dehiscence is the frequent one. The most used surgical technique was the Mustardé cervicofacial flap with 21.3% in cheek and in the lips it was the Karapandzic flap with 33.3%. The degree of satisfaction of his physical appearance was of 66.7% of very satisfied and satisfied in cheek. 100% recovered normal cheek function. 16.7% reported sequelae such as ectropion on cheeks. On lips the satisfaction rated as very satisfactory was 61%, and the functional alterations 39%. Conclusions: The results obtained in the integral reconstruction of cheek were satisfactory in the majority of cases in their appearance aesthetically and functionally. As for the lips presented an improvement of the physical appearance notable referring certain IX functional alterations for future corrections. Recommendation: Develop a protocol for the detection, diagnosis and treatment of skin cancer of the cheek and lip anatomical units.Item RESULTADOS DE LA RECONSTRUCCIÓN PALPEBRAL POSTERIOR A LA EXÉRESIS DE CARCINOMA BASOCELULAR EN EL HOSPITAL DE SOLCA DE ENERO DEL 2013 A DICIEMBRE 2015(2016-09) Carrera Cabanilla, Eddy; Jaramillo, PriscilaActualmente, la extirpación quirúrgica se considera la terapia más efectiva para los carcinomas basocelulares debido a sus altas tasas de curación. La biopsia periocular puede provocar la extirpación de amplias áreas de los párpados y/o de las vías lagrimales, y su restauración puede causar, en mayor o menor medida, alteraciones estético-funcionales, tales como: cicatrices, triquiasis, retracción palpebral, ptosis, epífora crónica, entropión, ectropión, queratitis, úlceras corneales por exposición e incluso perforación ocular.Item MAMOPLASTIA REDUCTORA EN HIPERTROFIA MAMARIA CON USO DE COLGAJO LATERAL INTERNO ATENDIDAS EN EL HOSPITAL TEODORO MALDONADO CARBO DURANTE EL PERIODO ENERO 2013 - ENERO 2015(2016-10) Aldaz Lozada, Alex Fernando; Guevara Vivero, Diego CristóbalIn the surgical technique of breast reduction with internal lateral flap used in this group of patients of this studio, excess tissue is not removed until the end of the operation, allowing more filling or emptying of the content, if deemed necessary, this avoids the asymmetry. a suture for submammary incision is made, starting from the ends to prevent the ends from deforming and also relaxes the central point is that supports more stress, therefore, is expected a favorable aesthetic result. In the Plastic and Reconstructive Surgery Hospital Teodoro Maldonado Carbo, this surgery is performed relatively frequently, without surgical outcomes have been assessed in any previous study. In order to evaluate the results of breast reduction surgery for breast hypertrophy with use of the surgical technique of the internal lateral flap, made in the Regional Hospital "Teodoro xii Maldonado Carbo" during the period January 2015 to January 2016, a study was done observational descriptive cutaway in a total of 40 surgically intervened patients, selected with non-probability sampling for convenience, being main results that the average age of the patients in the sample was 44 years, the average body mass index was 38. A patients I was extracted on average 608 grams of hypertrophic breast tissue diagnosis of breast hypertrophy important. The total sample, 2 patients were reoperated for presenting a hematoma. No data that indicate breast asymmetry, necrosis, nipple inversion or infection in the study sample were found. Patients remained hospitalized 2 days in most cases. conclusion states that the reduction mammoplasty breast hypertrophy with use of the surgical technique of internal lateral flap is a procedure that offers aesthetic results and fewer complications in patients with significant to severe breast hypertrophy. Recommendations: performing breast reduction surgery for breast hypertrophy is recommended to use the surgical technique of internal lateral flap in patients with significant to severe breast hypertrophy. xiii