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Cirugía Plástica Ibero-Latinoamericana

versão On-line ISSN 1989-2055versão impressa ISSN 0376-7892

Resumo

DOMINGUEZ-ZAMBRANO, A. et al. Actual status of adyuvant disease in México and some case examples. Cir. plást. iberolatinoam. [online]. 2013, vol.39, n.4, pp.399-405. ISSN 1989-2055.  http://dx.doi.org/10.4321/S0376-78922013000400010.

Management of modeling disease, produced by the infiltration of strange substances is complicated, because of the different sites where the material can be infiltrated, in addition of the depth of the infiltration. They have been proposed various types of surgical procedures which include wide resection and reconstruction with local flaps or microsurgical procedures. Because our hospital is a referral center, we receive patients with complications from the injection of different substances, among which they figure vegetable oil, animal and mineral oils, and polymethylmethacrylate. This review was made from 2008 to 2011 and includes all the patients that held its treatment at the General Hospital of Mexico because of this disease. We are also presenting some representative cases. We reviewed a total of 177 patients in 3 years which have been attended by complications secondary to the infiltration of strange substances with an age range of 17 to 73 years, 128 female and 49 male. According to the anatomical region the infiltrated areas were buttocks (53.6 %), breast (29.39 %) legs (9.03 %), face (5.09 %) and hips (2.89 %). The most frequent substance was mineral oil, followed by vegetal oil, but most of the patients didn't know it. The average time to present symptoms since initial infiltration was 8.8 years. In 11.86 % there was cutaneous loss and 23.72 % needed surgical treatment with lumbar perforator flap for buttocks and mastectomy and reconstruction with dorsal or TRAM flaps with or without implants. In 135 cases only was necessary medical treatment. There were 2 deaths due to sepsis caused by Pseudomonas aeruginosa The imaging study used to quantify the degree of extension were ultrasound and MRI. To conclude, we believe that the management of these patients becomes a medical challenge and there is not yet a satisfactory treatment. In surgical treatment, complete resection of the foreign material is effective, unless it is a mutilating procedure that occasionally required the use of flaps or grafts for reconstruction. The use of sub-atmospheric pressure systems optimize and accelerate the treatment of this kind of patients.

Palavras-chave : Modelling disease; Adjuvant disease; Granulomas; Vacuum assisted therapy.

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