Biomedical subjects
Jorge de la Torre
Publications and source records attributed to Jorge de la Torre.
Three-dose vs extended-course clindamycin prophylaxis for free-flap reconstruction of the head and neck.
BACKGROUND: Twenty-four hours of perioperative antibiotics provides effective prophylaxis for most head and neck cancer resections. Many reconstructive surgeons have been hesitant to apply this standard to free-flap reconstruction of the head and neck. This prospective clinical trial compared short-course and long-course clindamycin prophylaxis for wound infection in patients with head and neck cancer undergoing free-flap reconstruction. METHODS: Seventy-four patients were randomized to receive short-course (3 doses) or long-course (15 doses) clindamycin perioperatively. Wound infections, fistulas, and other postoperative complications were documented by faculty surgeons who were blinded as to treatment group. RESULTS: The differences in wound infections and other complications were statistically insignificant. No other independent predictors of wound complications emerged in this series of patients. CONCLUSIONS: Short-course clindamycin is as effective as long-course clindamycin in preventing wound infections after free-flap surgery for head and neck ablative defects.
Retrospective review of the internal Doppler probe for intra- and postoperative microvascular surveillance.
The purpose of this review was to evaluate the utility of the 20 MHz microvascular implantable Doppler probe for free-tissue transfer, both intra- and postoperatively. Over a 15-month period, the Doppler probe was used in a total of 260 anastomoses, including 118 arterial and 142 venous microanastamoses. In these 260 anastomoses, there were six false positive results and eight true positives, resulting in one flap loss. The free flap success rate was 99 percent, the re-exploration rate was 8 percent, and the salvage rate was 83 percent. The internal Doppler offers an easy and reliable way to monitor microvascular free-tissue transfer both intra- and postoperatively. This study demonstrates the continued increase in survival, as well as salvage, of free-tissue transfer.