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Background Carpal tunnel syndrome has attracted attention as an occupational disease due to the dramatic increase on its magnitude, and its prevalence in the general population, who's has been reported from a 0.6 to 3.4%. Currently, there are various techniques for its approach. However, there is great controversy when it comes to establishing which of the methods is the most beneficial. The objective of this study was to compare the efficacy of the mini-transverse incision against the traditional longitudinal technique in treatment of carpal tunnel syndrome. Materials and methods A series of cases is presented, prospectively included, of patients with a diagnosis of carpal tunnel syndrome, who are beneficiaries of a government hospital. We present a series of cases with a diagnosis of carpal tunnel syndrome, which were performed with two different techniques. Both techniques were evaluated by comparing the recovery and work reintegration times, as well as the decrease in pain and the absence of complications. Results A total of 8 patients operated with a minimal incision and 9 with a traditional reduced incision were studied. Significant differences were shown in the days taken to return to work, with a median of 17.5 (q25-q75 14–21) days for mini-transverse incision group and of 28 (q25-q75 21–28) days for the longitudinal traditional incision group ( p = 0.002). Likewise, differences were obtained in the visual analogue pain scale during the first week of evaluation 4 vs 7 ( p = 0.000), in contrast to complications where there were no differences at all. Conclusion The results obtained corroborate a greater efficacy of the mini-transverse incision technique, in reducing disability times. This favors the health institution to reduce the costs of rehabilitation and for the patient to have a prompt work reintegration. It is suggested to strengthen the scientific evidence that supports the use of this technique by exploring other areas such as functional status or long-term benefits.

Desarrollo de un melanoma primario dentro de un injerto de espesor total de piel; reporte de un caso Development of a primary melanoma within a full-thickness skin graft; a case report

INTRODUCTION: Intestinal occlusion represents a frequent cause of medical attention in the emergency department, within the current management guidelines it is well established that conservative treatment should be used as the first option. Gastrograffin® has been recommended to be used as a contrast agent as a predictor of successful conservative management; however, it is not usually available for use in public hospitals in our country. OBJECTIVE: To determine whether oral low-osmolarity water-soluble contrast (LOWS) is useful in identifying patients with bowel obstruction who will have a good response with conservative management. MATERIAL AND METHODS: Prospective, non-randomized, cohort study conducted in patients over 18 years of age, who presented with a diagnosis of intestinal obstruction. A nasogastric tube was placed for gastric emptying and intestinal decompression. After 6 hours, improvement was assessed by the decrease in nasogastric tube output and contrast medium was administered. Bolus LOWS 50cc were used and followed up radiologically. Surgical management was considered lacking contrast 24 hours after administration. RESULTS: In 41 cases we observed adequate passage of contrast and in 7 cases it did not reach the colon, in which case surgical exploration was indicated. Of the 41 patients with adequate clearance, 7 underwent surgery because of continued symptomatology. A PPV of 100% and NPV of 82.92% were calculated. The rate of complications is closely related to the need for surgical intervention, the degree of contamination of the abdominal cavity and hospital stay, there were no adverse events associated with the use of LOWS.

Background Macrocystic lymphatic malformation is a rare benign skin disorder, especially the anogenital area, which covers less than .5% of the reported cases. It can cause vesicular and papular lesions on the face, trunk, extremities, and, less frequently, anogenital areas. Although there are currently several therapeutic options, surgical excision is the most widely used, considering the lowest recurrence rate. Case presentation In this article, we describe the case of a 15-year-old male patient who presented with herpetiform skin lesions, corresponding to the diagnosis of macrocystic lymphatic malformation, in the lower region of the right buttock. After confirmation of the diagnosis by histopathology, surgical excision was performed with a tensor fascia lata graft, with successful aesthetic and functional results. Conclusions Considering the diagnosis of macrocystic lymphatic malformation is of utmost importance, although its presence is unusual, to differentiate it from other herpetiform lesions. Despite the existence of multiple approaches today, definitive treatment with surgical extraction is necessary, both to improve the cosmetic aspect and to prevent associated complications. It is suggested that histopathological and imaging diagnostic tools be used as a routine element, in order to increase therapeutic success, as well as decrease the risk of recurrences. Evidence-based medicine ranking Level IV