Cir Cir
-
The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. ⋯ As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.
-
Infection with the SARS-CoV-2 virus and the development of all manifestations of COVID-19, predisposes to arterial and venous thromboembolic disease. The coagulation system can be activated by various viruses, including SARS-CoV-2. ⋯ Treatment is aimed at the prevention, early detection and timely interventions of all coagulation disorders generated by COVID-19. The recommended anticoagulant is low molecular weight heparin, taking into account creatinine clearance, and if major invasive procedures will be performed, unfractionated heparin is a safe option.
-
Review Case Reports
Case report of patient blood managment guided by rotational thromboelastometry in Mexico and literature review.
Thromboelastometry evaluates viscoelastic changes in the coagulation process. It offers a graphic representation of the formation of the coagulum, its stability and the presence of lysis. ⋯ The rotational thromboelastometry is a diagnostic tool that graphs the functionality of the clot, for a directed and individualized management of the coagulopathy associated with bleeding.
-
Review Case Reports
Penile and scrotal lymphedema associated with hidradenitis suppurativa: Case report and review of surgical options.
Lymphedema is the result of an alteration of the lymphatic drainage, and its most common worldwide cause is filariasis. In our practice usually is associated to neoplasic, inflammatory and granulomatous processes, radiotherapy, hydroelectrolytic disbalances, and idiopathic. It can affect any part of the body, including the penis and scrotum. ⋯ Surgical treatment consisted of total excision of the skin and subcutaneous tissue to Buck's fascia. Split thickness skin grafts were used to cover the defect. The result was satisfactory both functionally and aesthetically.
-
Patients with peritoneal carcinomatosis (PC) of gastric origin have a poor prognosis of life with an average survival of 1-3 months. Systemic chemotherapy has improved the survival of those patients with gastric metastatic cancer at 7-10 months. However, this benefit could not be reproduced in those patients with PC. ⋯ In addition, unresectable location would make a patient a poor candidate for cytoreduction and HIPEC. Optimally, those with positive peritoneal cytology alone could benefit most. However, the role of cytoreductive surgery and HIPEC in patients with PC of gastric origin has not yet been clarified.