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[The chondromucosal graft. Its use in the correction of entropion caused by tarsoconjunctival cicatrix, trichiasis and distichiasis].

The use of chondromucosal grafts is the classical treatment for reconstruction of the eyelids, whereas these grafts are less employed for correction of tarso-conjunctival scars due to either disease or surgery. The ideal nasal graft is the triangular cartilage, as its mucosa is more delicate and more adhesive than that of the septum, and it separation and positioning do not involve any problems if certain rules are followed. The technique appears attractive to us, as it is simple to perform, there is a lack of postoperative complications and it is logical (replacing a pathological tissue or a missing tissue by an identical one, keeping the lids framework). It appears to be not enough employed in trachomatous entropion (both eyelids being generally affected). However, the technique is useful: during first intention surgery (whether associated or not with tarsectomy); in all cases of recurrence, where it appears to be the only worthwhile treatment (trachomatous eyelids already operated upon by another method, tarsectomy alone).

Cartilage↗

[Delivery conduction in patients with cicatrix of a prior cesarean section. Pilot study].

INTRODUCTION: In the clinical practice there is an increasing number of patients with a previous cesarean section. OBJECTIVE: 1. The description of the evolution of patients with previous cesarean section and the possibility of a vaginal delivery. 2. To compare, in patients in labor, a pharmacological approach (ocitocic conduction and peridural anesthesia) vs a spontaneous evolution. METHOD: -a clinical, random and prospective study. We analyze: age, parity, cause of previous cesarean section, obstetrical conditions at the moment of hospitalization, route of delivery, maternal and neonatal complications and days of hospitalization. ANALYSIS: univariable with single frequency and bivariable with contingency table (chi2) and comparison of means (T test). RESULTS: Incoming to the study of 81 cases. Sixteen per cent were operated on without labor. Eighty four per cent (n-68) were separated randomly into two groups: 26 pharmacologically managed and 42, with a spontaneous approach. Within the first group, 84.6% delivered vaginally; the latter group, 88.1%, delivered vaginally. The only variable with a statistically significant difference was the greater cervical dilatation in the spontaneous grop at the moment of hospitalization. CONCLUSION: The probability of vaginal birth after cesarean section is 72.8%, which increases to 86.7% in labor spontaneously initialized. The active management doesn't differ in this study, which has a 10% of power, of spontaneously management.

Adult↗

[Cutaneous cicatrix: natural course, anomalies and prevention].

Improving scar quality has become a major concern for surgeons. Although good skin suturing is of primordial important, the healing process varies greatly from one patient to another and the risk of hypertrophic or keloid scar evolution is currently unpredictable. Local massage and above all post-operative compression using compressive garments and sheets of silicon are an efficient methods of counteracting the proliferative phase which occurs during the first few months. In severe cases, particularly in burn patients, high-pressure springwater hydrotherapy to reduce scar contracture has proved to be effective. The current trend is to decrease the risk of bad scars in the immediate post-traumatic, post-operative stage in order to obtain the best possible scar initially and thus avoid revision surgery.

Adult↗