Background: Since the description of superficial fascia flap harvesting, a new window of opportunity has been open in obese patients, where a higher subcutaneous thickness of tissue is present. To our knowledge, the impact of body mass index on superficial fascial flaps has not been reported. Methods: We recruited 122 patients from April 2019 to January 2020. From these patients, the 3 most common thinned flaps were selected: the superficial circumflex iliac perforator flap; the anterolateral thigh flap at the perforator A, B, and C; and the thoracodorsal flap. Two vertical measures were registered: the distance from the skin to the superficial fascia, and from this point to the deep fascia. Results: The average flap measurement presented here was within the range, as previous clinical studies. The superficial fatty layer thickness in the superficial circumflex iliac perforator and anterolateral thigh flap was somewhat similar in thickness between overweight and obese patients, showing a minimal increase with higher body mass index. The anterolateral thigh flap was found thicker among women, and no statistical difference was shown between age groups in any of the flaps. Conclusions: A better understanding of the fat layers’ thickness will result in better planning, minimizing secondary debulking procedures, decreasing operative time, and reducing general complications among obese patients. Thus, a better understanding of flap structure and physiology in obese patients will lower complications and give more predictable results.

Introduction:The incidence of facial bones fractures is 18 to 32 for each 100,000 inhabitants. The most affected population are young working people. Fractures are most commonly caused by assaults and motor vehicle accidents. Its cost of care reaches 1.06 billion dollars. Premodeling osteosynthesis plates with anatomical models can decrease surgical time, bleeding, and increase patient satisfaction. This study aims to evaluate the impact of premodeled osteosynthesis plates, using anatomical models in patients with facial fractures. Material and Methods: Patients with facial fractures treated by open reduction and internal fixation were included-Group A without premolding plates and Group B with premolding. The variables studied were: age, sex, etiology of the fractures, number of fractures, among other variables that reflect the quality of the results. Results: A total of 17 osteosynthesis plates were included in 6 patients. The age was 22 to 47 years; all patients were male. The maximum surgery time was 129 to 300 minutes. The average time to start work was 4.8 weeks. When comparing the variables between the groups, we found no difference between the groups for bleeding P ¼ 0.24, the start of work P ¼ 0.19, the time of surgery P ¼ 0.082, or for osteosynthesis time P ¼ 0.15. There was only a significant difference in patient satisfaction, P ¼ 0.04. Conclusions:The evidence collected shows that premodeling the plates only improves patients' satisfaction among facial fractures treated by open reduction and internal fixation.

3D printing has been used for teaching purposes. Creating models for simulating surgeries. Gong et al presented a workflow for digital planning for surgery and Rendon et al previously presented a low-cost method with acceptable precision.  This paper aims to present a case where 3D printing surgical planning was applied for bone graft shape and dimensions. A 16-year-old female patient with a history of bilateral cleft lip and palate has received 6 surgical interventions to treat her congenital pathology. She begins orthodontic management at the age of 6 years and is referred to the plastic surgery service 10 years later, presenting oral and nasal fistula on the nasal floor with mainly liquid leakage. A bone graft was taken and applied from the patient's left iliac crest. the iliac crest is taken and the bone graft is molded Assisted with 3D printed model which is fixed in the premaxilla with a 14-hole linear plate. We proposed a new application for low-cost 3D printed models. Patient specific models have applications in cleft palate bone grafting. We present a case and more studies are required to measure variables as time, graft integration, and patient satisfaction.

Introduction: Autografts are useful but unfortunately are limited in big dural defects, in such cases, synthetic implants have been recommended. Extensive evidence in the literature suggests that sometimes synthetic implants had high rates of complications like infections. This paper aims to present a novel dura matter graft based on capsule granulation tissue harvested from subcutaneous space as a dura substitute and its histological findings. Materials and Methods: Wistar rats between 240 and 430 grams of both genders were included. First stage procedure introducing silicon spheres in the subcutaneous tissue. Second stage procedure 4 weeks later harvested de capsule granulation tissue that contain them. Then a craniectomy was performed to create a dura mater defect. This defect was reconstructed with the granulation tissue was placed onlay the defect. After another 4 weeks the subjects were euthanized and sent to an external pathology unit for analysis with validated integration scales. Results: A total of 5 subjects were included (3 males and 2 females) with weight between 240 and 430 grams. Only 2 outcome out of 6 scales had significance difference between the samples: adhesions P ¼ 0.011 and integration P ¼ 0.006. Conclusions: The histological findings shown that capsule granulation graft is a compatible, autologous compatible substitute for dura mater. It has a great potential of full integration and an acceptable grade of adhesions.

Introduction: Zone I extensor tendon lesion accompanies an avulsion fracture of the bone insertion. A common complication of traditional pull-out is the necrosis of the site of the button in the finger pad. Zhang described an alternative way of anchoring the cerclage to the Kirschner Wire (K-wire) to relieve the pressure in the finger pad. He describes the use of wire cerclage, for fracture reduction. The objective of this paper is to perform a comparison between wire and nylon using Zhang pull-out technique. Material and methods: We performed a cohort study comparing Nylon versus Wire in Zhang technique. Comparing cosmetic satisfaction, stiffness, residual pain, and Crawford scale. Results: When comparing the outcomes between both groups, we found no statistical difference in cosmetic satisfaction (p = 0.285), stiffness (p = 0.460), and residual pain (p =1.000), overall complications (p = 1.000), or Crawford scale (p = 1.000). We only found a significant statistical difference in pain when removing the cerclage, being greater in Group B (p = 0.008). Conclusions: We found no significant outcome difference between nylon and wire cerclage. However, at the time of removing it, patients experience less pain.