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Biomedical subjects

J R Benito

Publications and source records attributed to J R Benito.

8 recordsLinked to original sources
PubMed2000

Is the reversed fourth dorsal metacarpal flap reliable?

We have carried out a study to determine if a flap based on vessels in the fourth metacarpal space could be used safely. We studied ten fresh cadaver specimens and used the flap in nine patients. In the anatomical study, we confirmed the presence of a suitable artery in nine out of the ten hands, arising from a piercing artery at the metacarpal bases, running distally under the fascia. The pivot point is located at the metacarpal heads, where the artery anastomoses to palmar branches and dorsal digital branches. In the clinical setting, the flap was reliable in eight patients. There was one case of flap necrosis. The flap seems to be reliable but several technical points are stressed to avoid complications.

Cadaver↗
PubMed1999

Primary amyloidosis presenting as extensor tenosynovitis.

Primary amyloidosis is a systemic disease. Amyloid arthropathy is an invalidating and uncommon form of presentation, but tenosynovitis is even rarer as the first sign of the disease. We report herein a case of unilateral amyloid deposit in the synovium of the extensor tendons of the hand, which was the first manifestation of a primary amyloidosis.

Aged↗
PubMed1999

[Cat-scratch disease: series of 14 cases. The diagnostic usefulness of serology].

BACKGROUND: Disease by cat scratch (CSD) is a syndrome characterized by regional adenopathies following cat scratch or bite. Despite knowing the etiologic agent of the same, there is still controversy in the diagnosis of the syndrome in daily clinical practice. MATERIALS AND METHODS: The cases of CSD diagnosed from 1990 to 1997 with positive serology for Bartonella henselae performed by indirect immunofluorescence were reviewed. RESULTS: In 13 out of the 14 patients studied direct contact with cats was reported. Lymph node involvement corresponded to the following regions: axillary (57%), inguinal (28%), epitroclear (21%), cervical (14%), and periauricular (7%). In 35% of the cases, several territories were involved. In 3 patients the adenopathies were fluctuating. Eleven anatomopathologic studies were performed with 6 diagnoses of granulomatous adenitis, 3 reactive adenitis and 2 purulent adenitis. The serology for Bartonella henselae was positive in all the patients with a range of 1/64-1/256. The evolution was favorable in all the patients. DISCUSSION: Interpretation of the results of serology should be cautions and always related to the clinical and epidemiological picture of the patient. This technique should be considered as another criteria in the diagnosis of cat scratch disease to the detriment of the cutaneous test.

Adolescent↗
PubMed1998

Reconstruction of pharyngostomes with a modified deltopectoral flap combining endoscopy and tissue expansion.

The problem of pharyngostomic closure is difficult to solve, as evidenced by the large number of techniques described. The authors present the reconstruction of pharyngostomes by using Bakamjian's deltopectoral flap modified by the use of endoscopically introduced expanders for those patients in whom other techniques of choice (such as vascularized free flaps) have failed or are inapplicable either because of previous radiotherapy or because of local conditions. Bakamjian's deltopectoral flap, previously expanded with an expander coated with a partial-thickness skin graft and introduced endoscopically, allowed the authors to lift the flap in one operation to close the pharyngostome. This method provides the two walls of the pharynx (the skin graft as the inner aspect and the skin flap as the outer aspect), and the donor deltopectoral area is covered and epithelialized due to the skin graft. Thus by means of endoscopic expansion we use a nonaggressive technique to increase the surface area of the donor site and to increase its vascularization (delay phenomenon). Because the expander was coated with the graft, the authors were able to cover the anterior wall of the pharyngostome and the donor site in one surgical step.

Aged↗
PubMed1998

Transconjunctival herniation of orbital fat.

The authors present 3 patients with subconjunctival fat prolapse treated at their oculoplastic unit. Albeit rare, orbital fat is a well-recognized entity, and is described in the literature as being associated with trauma and surgery. The 3 patients reported herein, however, presented with no history of trauma or surgery. This condition is produced by herniation of the intraconal fat between the conjunctiva and the sclera, presumably due to dehiscence of the Tenon's capsule. Differential diagnosis should be made with lacrimal gland ptosis, lacrimal gland tumors, and lymphoid tumors.

Adipose Tissue↗
PubMed1997

Tissue expansion with endoscopy.

Tissue expansion is a time-honored technique in plastic surgery. However, while it is possible to rectify quite severe problems, the technique is not free of complications (e.g., extrusion) and, moreover, it can be a lengthy procedure, often taking months. Endoscopy is increasingly being used in plastic surgery and has the advantage that large areas can be dissected using only small incisions. However, in endoscopic plastic surgery the main problem is the lack of an optical cavity. This means that special retractors are needed to keep skin and fat tissue lifted. This paper describes a technique for the placement of tissue expanders during endoscopy. Incisions are not made in the area that is to be expanded and, thus, there is no risk of extrusion and tissue expanders can be fully inflated intraoperatively. A further advantage is that the procedure reduces patient discomfort to a minimum.

Adult↗
PubMed1997

Carpal tunnel release with short incision.

A new approach for carpal tunnel release is presented. By means of a specially designed guide, it is possible to completely section the carpal ligament with a short incision without damaging the carpal contents. When the retinaculum has been sectioned and the guide removed by means of three Senn-Miller retractors, one proximally and two laterally, the median nerve is seen perfectly. We performed an anatomic study to determine where the incision should be made to avoid injuring the vascular arch, the cutaneous palmar branch of the median nerve, and the ulnar nerve. We present the results obtained in 112 patients followed up for 1 year. Complaints about tenderness of the scar disappeared, and by the end of the study, patients had regained 126 percent of their preoperative grip strength. All patients were able to use their hands shortly after the operation, and after 3 weeks, all of them returned to work. We think that by using this approach we combine the advantages of the "endoscopic" technique (minimal scar, no tenderness, and early recovery) with those of the classic open technique (exploration of the carpal contents).

Adult↗