<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0376-7892</journal-id>
<journal-title><![CDATA[Cirugía Plástica Ibero-Latinoamericana]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. plást. iberolatinoam.]]></abbrev-journal-title>
<issn>0376-7892</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0376-78922024000100012</article-id>
<article-id pub-id-type="doi">10.4321/s0376-78922024000100012</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Experiencia en reconstrucción con colgajos libres en Medellín, Colombia; análisis de 567 casos]]></article-title>
<article-title xml:lang="en"><![CDATA[Free flap reconstruction experience in Medellin, Colombia; analysis of 567 cases]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jiménez-Cotes]]></surname>
<given-names><![CDATA[Evert Armando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gallego-Gónima]]></surname>
<given-names><![CDATA[Sabrina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ciro-Ossa]]></surname>
<given-names><![CDATA[Carolina María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="Ab"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Antioquia  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de París  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Francia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de la Sabana  ]]></institution>
<addr-line><![CDATA[Chía ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="A3b">
<institution><![CDATA[,Universidad de Antioquia Departamento de Cirugía Plástica, Maxilofacial y De La Mano ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2024</year>
</pub-date>
<volume>50</volume>
<numero>1</numero>
<fpage>53</fpage>
<lpage>64</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0376-78922024000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0376-78922024000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0376-78922024000100012&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción y objetivo. La reconstrucción con colgajos libres ha evolucionado gracias a los avances en dispositivos de magnificación, técnica microquirúrgica y un mejor entendimiento de la vascularización de los tejidos. En centros de alta complejidad reconstructiva, el éxito de los colgajos libres es superior al 90%; sin embargo, existen muchos factores que pueden influir en la pérdida de un colgajo, aumentando la morbilidad de los pacientes y los costos de la atención en salud. El objetivo del presente estudio es describir las características sociodemográficas, clínicas y quirúrgicas de los pacientes a los que se les realizaron colgajos libres en 3 instituciones de salud de la ciudad de Medellín, Colombia, en un periodo de 5 años (2017 y 2021).  Material y Método. Estudio analítico de corte trasversal revisando 1103 registros médicos que incluye el análisis de 567 pacientes. Obtuvimos la información de las historias clínicas institucionales con las que creamos una base de datos diseñada para la investigación. Realizamos análisis exploratorio entre la pérdida de los colgajos y las posibles variables clínicas independientes. Estimamos la Razón de Odds y los intervalos de confianza del 95% entre cada variable independiente y la pérdida del colgajo.  Resultados. El sitio más frecuente de reconstrucción en la población de estudio fue el miembro inferior. Encontramos un 22% de complicaciones mayores, siendo la más frecuente la infección del sitio operatorio. La tasa de pérdida de colgajos fue del 20.2% y el hallazgo intraoperatorio más frecuentemente asociado con el fallo del colgajo fue la trombosis de la anastomosis arterial. El consumo de cigarrillos, el tiempo quirúrgico, la transfusión intraoperatoria de hemoderivados y la necesidad de evaluación vascular con angiotomografía, se relacionaron significativamente con la pérdida de los colgajos libres. El número de anastomosis venosas no se relacionó con la pérdida de los colgajos. Identificamos como factores protectores el uso postoperatorio de antiagregante plaquetario, la reconstrucción oncológica inmediata y las reconstrucciones realizadas en el hospital 1. La mortalidad reportada fue del 2.8%.  Conclusiones. En nuestro estudio, la pérdida de colgajos libres fue más frecuente que lo reportado en la literatura mundial; por lo tanto, y de acuerdo con lo encontrado, creemos que es necesario implementar en nuestro medio estrategias que disminuyan su presentación y minimicen la morbilidad en los pacientes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background and objective. Free flap reconstruction has evolved thanks to advances in magnification devices, microsurgical techniques, and a better understanding of tissue vascularization. In high-complexity reconstructive centers, success rates exceed 90%; however, numerous factors can influence free flap failure, increasing patient morbidity and imposing additional costs to the health care system. The aim of the present study was to describe the sociodemographic, clinical, and surgical characteristics of patients who underwent reconstructive surgery with free flaps at 3 health care institutions in the city of Medellín, Colombia, in a 5-year period (2017 y 2021).  Methods. An analytical cross-sectional, multicenter study was conducted, reviewing 1103 medical records, with 567 patients included in the analysis. Information was obtained from institutional medical records, feeding a database designed specifically for the study. An exploratory analysis was performed between flap loss and potential independent clinical variables. Odds ratios and 95% confidence intervals were estimated for each independent variable and flap loss.  Results. In this patient population, the lower limb was the most frequent recipient site. The total percentage of major complications was 22%, being the most common the surgical site infection. The failure rate in free flap reconstruction was 20.2% and the most consistent intraoperative finding in failed flaps was arterial thrombosis. Cigarette smoking, surgical time, intraoperative transfusion, and the need for preoperative vascular evaluation with angio-scan were significantly associated with free flap loss. The number of venous anastomoses was not related free flap loss. The use of postoperative antiplatelet agent, immediate oncological reconstruction and reconstructions performed in hospital 1 were identified as protective factors. A mortality of 2.8% was reported.  Conclusions. The loss of free flap sis a frequent complication in our city; therefore, it is necessary to implement strategies and care protocols that reduce complications and morbidity in patients.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Colgajo libre]]></kwd>
<kwd lng="es"><![CDATA[Fallo colgajos libres]]></kwd>
<kwd lng="es"><![CDATA[Complicaciones colgajos libres]]></kwd>
<kwd lng="en"><![CDATA[Free flap]]></kwd>
<kwd lng="en"><![CDATA[Free flap failure]]></kwd>
<kwd lng="en"><![CDATA[Free flap complications]]></kwd>
</kwd-group>
</article-meta>
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<article-title xml:lang=""><![CDATA[Mortality Within 30 Days After Head and Neck Free Flap Reconstruction: A Systematic Review]]></article-title>
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