Objective:The objective of this study was to evaluate the usefulness of premedication with 75 mg pregabalin orally to reduce the degree of pre-operative anxiety in patients scheduled for plastic surgery procedures. Method: A controlled randomized double-blind clinical trial that analyzed two groups of patients: 75 mg pregabalin tablet (Pg) against placebo tablet (Pl). Efficacy was assessed using the visual anxiety scale (VAS) with two measurements, the first without medication and the second 70 min after the drug was taken. Results: One hundred patients were evaluated, 50 received pregabalin and 50 placebo, baseline VAS score showed an general average of 4.6 ± 1.9 points, significantly higher in the Pg group (Pg 5.2 ± 2.1 points vs. 4.1 ± 1.6 points Pl; p = 0.0035). The VAS score after premedication was 3.9 ± 2.1 points, significantly lower in the Pg group (Pg 3.2 ± 1.6 points vs 4.6 ± 2.3 Pl points, p = 0.0006). Conclusion: Premedication 75 mg pregabalin orally decreases the degree of pre-operative anxiety in adult patients scheduled for plastic surgery procedures.

We report the case of a 28-year-old woman with pain in the dorsal and lumbar spine of 2 years of evolution with a history of acne treatment with isotretinoin for 6 years. The findings by computed tomography showed skeletal vertebral hyperostosis. The use of vitamin A and its derivatives, such as isotretinoin, has been associated to the development of skeletal hyperostosis, and its severity seems to be related to the duration of treatment. Currently, the use of this drug is widespread in young patients with acne, even without medical prescription, unaware of the effects it can cause at the osteoarticular level.

Introducción: La reconstrucción de la pared abdominal con grandes defectos suele representar un desafío quirúrgico, sobre todo cuando los defectos son recurrentes y tienen un gran tamaño que dificulta la utilización de tejidos adyacentes para un cierre adecuado. La pared abdominal anterior se divide en tres regiones para su reconstrucción; superior, media e inferior. De acuerdo con cada región se han descrito diferentes técnicas de reconstrucción de pared, como la separación de componentes musculoaponeuróticos de la vaina de los rectos abdominales, el colgajo del músculo recto abdominal con o sin isla cutánea, el colgajo dependiente del músculo dorsal ancho y colgajos musculares o músculocutáneos del muslo para reconstruir el tercio inferior del abdomen, llamado colgajo anterolateral de muslo (ALT, por sus siglas en inglés). El ALT se ha convertido en una buena alternativa para los grandes defectos recurrentes en cualquiera de los tercios debido a su gran versatilidad. Caso clínico: Presentamos el caso de un paciente de 50 años con un defecto de pared abdominal, pérdida de dominio y exposición de material protésico (malla). Tenía el antecedente quirúrgico de colecistectomía abierta, necrosectomía por pancreatitis aguda con manejo de abdomen abierto (incisión en línea media supra-infraumbilical) e intento de reparación del defecto abdominal en dos ocasiones con colocación de malla (que se encontraba expuesta). El defecto existente se desmanteló y resecó en bloque desde el interior de la pared abdominal, dejando bordes aponeuróticos sanos, quitando todo el tejido cicatricial, la malla y los bordes cutáneos enfermos. Se realizó la reconstrucción de la pared abdominal con ALT con un componente de fascia lata con anastomosis a vasos epigástricos superiores, de manera exitosa. Actualmente no hay evidencia de recurrencia del defecto herniario tras 1 año de seguimiento. Discusión/conclusión: El objetivo de este trabajo es describir el ALT con componente de fascia lata con anastomosis a los vasos epigástricos superiores como una buena alternativa para reconstruir defectos de pared complejos del tercio superior del abdomen.

Introduction: Reconstruction of the abdominal wall with major defects usually represents a surgical challenge, especially in cases where the defects are recurrent and have a large size that avoids the use of adjacent tissues for an adequate closure. According to each region the abdomen topography is divided into three regions: upper, middle and lower. Several reconstructive alternatives have been described according to the affected area of the abdomen that include the separation of the muscularis aponeurotic components of the abdominal rectus sheath, the flap of the rectus abdominus muscle with or without cutaneous island, the flap dependent on the dorsal muscle and muscular or musculocutaneous thigh flaps to reconstruct the lower area of the abdomen which is called anterolateral thigh (ALT) flap. The ALT flap has become the best option for large recurrent defects in any of the thirds due to its great versatility. Case report: We present the case of a 50-year-old patient with an abdominal wall defect, loss of domain and exposure of prosthetic material. Patient had a surgical history of open cholecystectomy, necrosectomy due to acute pancreatitis with open abdomen management and attempted repair of the abdominal defect twice with mesh placement. The abdominal wall was reconstructed with an ALT free flap with a fascia lata component with anastomosis to superior epigastric vessels in a successful manner. Nowadays patient remains without evidence of recurrence of the hernia at 1 year follow-up. Discussion/conclusion: The aim of this paper is to illustrate the ALT flap with a fascia lata component anastomosed to the superior epigastric vessels as a good option to reconstruct complex defects of the upper third of the abdomen.