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A Ruiz-Razura

Publications and source records attributed to A Ruiz-Razura.

18 recordsLinked to original sources
PubMed2000

Creating long-term benefits in cleft lip and palate volunteer missions.

The authors present their experience with 15 years of organizing cleft lip and palate surgical volunteer missions in Latin America. The history, basic principles, and objectives of Operation San Jose, a volunteer goodwill program from Christus St. Joseph Hospital in Houston, Texas, are covered. This report addresses the different problems encountered and solutions found. Following the principles set by Operation San Jose, CIRPLAST is a Peruvian foundation for plastic surgery that travels to remote areas in Peru, operating on patients with cleft lip and palate deformities. This report highlights the importance of working with local plastic surgeons and their residents, and emphasizes that the program should be organized by and the operations performed by accredited plastic surgeons and with the auspices and support of the national plastic surgery society and the local medical board. Operation San Jose promotes the creation of long-term benefits by offering a program to teach local surgeons cleft lip and palate repair techniques and to set up guidelines to organize local surgeons so that they can continue this effort by treating their own patients in their own countries.

Child↗
PubMed2000

Endoscopic approach for the resection of forehead masses.

Over the past several years, surgery aided by the endoscope has come into favor for a number of reasons. Because it is minimally invasive surgery, it has less morbidity, thus, reduced postoperative pain and complications. It results in earlier mobilization and shorter hospitalization, and most importantly, it contributes to an improved cosmetic appearance as a result of a shortened incision line concealed within the hairline in most cases. We have proposed an alternative approach to the surgical resection of forehead masses by means of the endoscope, which has proven to be useful not only for diagnosis but also as a therapeutic tool for the removal of forehead lesions. This report described the clinical experience with the removal of forehead masses in four patients. The cases illustrated the feasibility and ease of resecting a variety of forehead masses with excellent cosmetic results. We hope that more plastic surgeons will use the proposed technique and will continue to explore the safe limits of endoscopic plastic surgery.

Adult↗
PubMed1995

Comparative study between acute intraoperative arterial elongation and the use of the interpositional vein graft for arterial reconstruction.

This study compares the acute intraoperative arterial elongation technique with the interposition vein-graft method for the closure of small arterial gaps that cannot be repaired by undermining alone. Ten conditioned female mongrel dogs were divided into two groups: a vein graft interposition group and an acute expansion-elongation group. In ten cases, a 25-mm segment of the superficial femoral artery was excised. The resultant defect, measuring 45 to 60 mm, was repaired by an interpositional graft of a comparable size segment of the superficial femoral vein. In ten other cases, a same-size defect was repaired by a tension-free end-to-end anastomosis, following acute intraoperative arterial elongation. The animals were explored at various intervals. Overall results revealed a 100 percent patency rate with the acute expansion-elongation group vs. 80 percent with the vein-graft interposition group. The versatility, time saving, and ease of technique, plus previous clinical experience, is encouraging enough to recommend this method for the sound repair of small arterial defects in clinical cases.

Anastomosis, Surgical↗
PubMed1994

Application of the 3M microvascular anastomotic device in non-vascular tubular structures.

In this study, the 3M microvascular anastomotic system was utilized for the first time to perform an end-to-end anastomosis in a non-vascular tubular structure, which was compared to the conventional microvascular suture method. The bicornuate rat uterus was the preferred structure because of its anatomic similarity to the human fallopian tube. Thirty Sprague-Dawley rats underwent 3M and conventional end-to-end anastomoses of their bicornuate uteri. At different intervals, the animals were explored and biopsies were taken for examination under light microscopy. Overall patency rate with the 3M technique was 68 percent vs. 96 percent with the conventional technique. Complication rates were 40 percent with the 3M device and 12 percent with the conventional method. This study concludes that, if this method is to be used on non-vascular tubular structures, further modifications to the system and additional research are mandatory, in order to recommend this technique for clinical application.

Anastomosis, Surgical↗
PubMed1994

Acute intraoperative arterial elongation: histologic, morphologic, and vascular reactivity studies.

This study focuses on the histomorphologic damage produced by an acute elongation process, as well as on quantifying the alterations in arterial contractility following the application of this technique. Light microscopy and scanning electron microscopy studies were prepared from expanded and non-expanded pig superficial femoral arteries (SFA) harvested immediately following expansion, and again at 24- and 72-hr intervals. Histologically, the expanded vessels showed minor, patchy, endothelial slough, but not fragmentation of the internal or external elastic lamina. At 24 hr, the endothelium showed reactive changes, but no evidence of smooth-muscle necrosis of the tunica media was observed. At 72 hr, healing of the endothelium was evident by SEM. Similar specimens, also from the SFA, were harvested and placed in organ chambers immediately following expansion and 24 hr later, to measure contractility when exposed to alpha-adrenergic agonists. The vessels were exposed to the contractile agonists, phenylephrine and 5-hydroxytryptamine, which evoked similar concentration-dependent increases in tension in both the expanded group and the controls. From these observations, the authors conclude that acute intraoperative elongation of arteries results in only minor endothelial damage, without affecting the inherent contractility of the vessel wall.

Anastomosis, Surgical↗
PubMed1993

Clinical applications of acute intraoperative arterial elongation.

This study reports four clinical cases in which acute intraoperative, extraluminal, arterial elongation was utilized. This technique was developed to facilitate end-to-end anastomoses across vascular defects traditionally bridged with vein grafts. In the reported cases, arterial defects, ranging from 17 to 25 mm, were closed primarily following the application of this technique. Follow-up, ranging from 3 to 34 months, has demonstrated patency in all cases. The authors believe this technique can be used clinically as a reliable alternative to vein grafting for the reconstruction of certain arterial defects.

Adolescent↗
PubMed1992

CO2 laser-assisted repair of esophageal lacerations.

This study was designed to evaluate the feasibility of CO2 laser-assisted repair of esophageal injuries. Nine-millimeter longitudinal incisions were made in the cervical esophagus of 40 Sprague-Dawley rats. The rats were divided into two groups. Twenty rats in Group 1 had their incisions closed in two layers (mucosa and muscularis) with the I.L. Med Unilase microsurgical CO2 laser (LAREL), using 80 mW of power with a spot size of 200 mu (power density = 255). Twenty rats in Group 2 had their incisions closed in two layers using 8-0 Vicryl conventional suture technique (CST). Postoperatively, an intraluminal methylene blue injection evaluated patency and leakage. Histologic analysis was performed at 3 days, 2 weeks, 1 month, and 6 months. Patency rates of LAREL and CST were comparable. No fistulas or strictures were found with either technique. Laser-assisted repair of esophageal lacerations (LAREL) was found to be faster and easier than CST. The question arises whether small esophageal tears can be safely repaired through the endoscope. This study demonstrates the feasibility of tissue welding the esophagus. Further research is mandatory to study the applicability of this technique in the clinical setting.

Animals↗
PubMed1992

Acute intraoperative arterial lengthening for closure of large vascular gaps.

This study demonstrates the feasibility of acute extraluminal expansion to elongate arteries intraoperatively in order to overcome defects too large to be repaired primarily. Twenty Sprague-Dawley rats were divided into two groups: an expander-elongation group and a nonexpanded control group of 10 rats each. Arterial resections were performed ranging from 6 to 22 mm. A miniaturized tissue expander was used to stretch vessels in three consecutive cycles over a 15- to 20-minute period (expander-elongation group). Defects twice as long as those which could be overcome by mobilization alone (nonexpanded control group) could be closed following the application of this technique without thrombosis. Initial laboratory findings and the application of this method in a clinical case are presented.

Anastomosis, Surgical↗
PubMed1990

Laser-assisted microsurgical anastomoses in traumatized blood vessels.

Technological advances have made CO2 laser-assisted microvascular anastomoses (LAMA) feasible. This study seeks to compare results of LAMA versus CSMA (conventional suture microsurgical anastomosis) in traumatized vessels. Using a rat model, femoral arteries and veins were either crushed and transected or divided by avulsion and then repaired by either LAMA or CSMA. LAMA resulted in higher patency rates than CSMA at early postoperative observation periods. With time, the patency rates improved in both groups and, by the end of the study, the patency rates were equivalent. These findings indicate that the laser technique may be a better option when working with traumatized vessels because of the critical nature of early patency rates. The improved results may be due to a reduction of suture material at the anastomotic site when using the laser technique. Some physiologic aspects of vessel thrombosis, recanalization, and the role of collateral circulation are discussed.

Anastomosis, Surgical↗
PubMed1989

The laser-assisted end-to-side microvascular anastomosis.

A simple method of performing the laser-assisted end-to-side microvascular anastomosis was devised. This technique was tested on 150 Sprague-Dawley rats in two separate series of experiments. In the first, end-to-side anastomoses were performed on the iliac artery under the normal tension due to the elastic recoil of severed vessels. Four stay sutures were placed 90 degrees apart, and the intervals were "spot welded" with a low-wattage CO2 microsurgical laser unit. The patency rate (96 percent) was equivalent to that found in a control group utilizing the conventional all-suture method (92 percent), but there was a significantly higher aneurysm rate (44 versus 11 percent). In a second model, an arterial bypass with very low anastomotic tension was performed around an obstruction created in the carotid artery. This model resulted in turbulent flow but low anastomotic tension. Here the laser-anastomosis patency rate was 98 percent, versus 42 percent for the conventional all-suture method. The placement of fewer sutures in association with turbulent flow in this model may account for the improved patency rate. The avoidance of excessive tension at the anastomotic site reduced the incidence of aneurysms to a negligible level.

Anastomosis, Surgical↗
PubMed1989

Microvascular access to the uveal tract in the rabbit eye for ocular pharmacologic studies.

Drug delivery to the eyes is quite inefficient regardless if the drugs are administered topically or intravenously. It is known that less than 1% of topically instilled drug can be absorbed into the eyes while even less of intravenously injected drugs reach the eyes. A research model has been developed in this study which allows delivery of drugs effectively to uveal and anterior structures of the eye. This experimental model allows drugs to be delivered to the eye via cannulation of and retrograde flow through the valveless vortex veins. In addition, the superficial branch of the vortex vein (draining the ciliary body and iris) or the deep branch (draining the choroid plexus of the retina) can be selectively cannulated to suit the researcher's needs. Finally, this procedure minimizes systemic drug actions which otherwise would complicate interpretation of experimental results. This model can be used for in vivo laboratory studies on (a) metabolic and physiological processes of the uveal tract in the eye, and (b) drug delivery to selective tissues of the uveal tract in the eye. Dose-response relationships of pilocarpine and timolol to lower intraocular pressure were demonstrated with this model.

Animals↗
PubMed1988

Bursting strength in CO2 laser-assisted microvascular anastomoses.

Iliac artery end-to-end anastomoses were performed in 42 Sprague-Dawley rats, divided into seven groups, to determine the welding effects of CO2 laser radiation in microvascular anastomoses. Conventional suture techniques were performed on right iliac arteries, and left iliac arteries were anastomosed with a laser-assisted technique. Bursting strength and diameters of the anastomotic sites were measured at different intervals (from one day to five weeks) post surgery. The anastomotic patency rate was 100 percent in both groups, and the aneurysm rate was only 2 percent in the laser group. Bursting strength was low at one and three days post surgery in both groups; then, it increased gradually until both groups could withstand higher than physiologic pressures. Results of high patency rates, low aneurysm formation, and the ability to withstand pressures higher than physiologic, suggest that the laser-assisted anastomotic technique can play an important role in microvascular surgery.

Anastomosis, Surgical↗
PubMed1988

Nipple reconstruction: the S flap.

A one-stage procedure to reconstruct the nipple-areola complex is presented, with special attention given to nipple volume and projection using local dermis-fat flaps. The preliminary results have been very encouraging.

Breast↗
PubMed1985

Free tongue composite graft for correction of a vermilion defect.

A case report of hemangioma of the vermilion border treated with excision and free composite tongue graft is presented. A technique of lip reconstruction utilizing a composite tongue graft in one step has been described. It constitutes an improvement over the tongue pedicle flap technique, which has been hitherto used and requires two stages. The indications and limitations of the technique have been discussed.

Adolescent↗