Background:The profile of the general surgeon has changed, aiming to incorporate new skills and to develop new specialties. Aim: To assess the quality of postgraduate General Surgery training programs given by Chilean universities, the satisfaction of students and their preferences after finishing the training period. Material and methods: A survey with multiple choice and Likert type questions was designed and applied to 77 surgery residents, corresponding to 59% of all residents of general surgery specialization programs of Chilean universities. Results: Fifty five percent of residents financed with their own resources the specialization program. Thirty nine percent disagreed partially or totally with the objectives and rotations of programs. The opportunity to perform surgical interventions and the support by teachers was well evaluated. However, 23% revealed teacher maltreatment. Fifty six percent performed research activities, 73% expected to continue training in a derived specialty and 69% was satisfied with the training program. Conclusions: Residents considered that the quality and dedication of professors and financing of programs are issues that must be improved. The opportunity to perform surgical interventions, obtaining a salary for their work and teacher support are considered of utmost importance (Rev Méd Chile 2009; 137: 940-5). (
Radial forearm fl aps. Experience in ten patientsBackground: Radial forearm fl ap is extraordinarily versatile thanks to its irrigation by the radial artery and its minor pedicles. It provides assorted alternatives for the reconstruction of proximal or distal defects of the arm and can be used as a free fl ap in head, neck, posterior trunk region, lower limb, esophagus and penis. It allows the incorporation of bone, tendons, nerves and muscle for complex lesion repair. Aim: To report our experience with radial forearm fl ap. Patients and Methods: Ten patients aged 20 to 65 years (four women) are reported. The lesions repaired were traumatic in four, infectious in three, secondary to tumors in two (a squamous intra oral adenocarcinoma in both patients) and vascular in one patient. Results: No patient had a partial or total loss of the fl ap. Five patients required complementary dermo epidermic grafts in a second intervention. Mean hospital stay was 30 days. All patients reported a favorable degree of satisfaction with the procedure. Conclusions: Radial forearm fl aps are a good alternative for the repair of a great variety of lesions.
Coupler ® venous mechanic microanastomosis. An important technological contribution to microvascular surgery Aim: The aim of the present paper is to show the experience of the Plastic Surgery Division at the University of Chile Clinical Hospital, with the Coupler ® anastomotic device (Synovis Corp, Birmingham, AL) for venous microanastomoses in patients undergoing reconstructive microsurgery. Material and Methods: A retrospective review of 48 consecutive patients with free flaps between March 2009 and in February 2013. All microsurgical venous anastomoses were performed with the Coupler ® device and the arterial anastomoses with interrupted or continuous 9-0 or 10-0 nylon sutures. The collected data were: personal and medical patient information, location of the defect, flap used, vessels diameter, arterial anastomoses, Coupler ® used, time of anastomosis, postoperative complications, arterial and venous thrombosis. Results: A total of 48 free flaps were performed for reconstruction of lower extremity (n = 25, 52.1%); head-neck (n = 15, 31%); breast (n = 5, 10.4%
Validation of the Spanish version of the breast Q reduction and mastopexy module xxxxBackground: The Breast Q Reduction and Mastopexy Module evaluate breast related quality of life from the perspective of the patients. Body self-image, social performance, sexuality and physical symptoms are assessed. Aim: To translate the Breast Q Reduction and Mastopexy Module to Spanish and validate the translated version to be used in Chile. Material and Methods: The linguistic validation guidelines of the MAPI/TRUST Research institute were used and the survey was applied to six patients aged 29 ± 6 years with 14 ± 2 years of studies. The internal stability of the test was assessed using Cronbach alpha. Results: The mean body mass index of the patients was 25 ± 1 kg/m
RESUMENObjetivos: Evaluar la continencia urinaria a mediano plazo en las pacientes sometidas a cirugía de incontinencia urinaria con cinta suburetral transobturatriz (TOT) y comparar esta técnica con la técnica de Burch, Marion y puntos de Kelly. Método: Evaluación prospectiva de 74 pacientes con incontinencia urinaria de esfuerzo sometidas a alguna de las técnicas señaladas entre Octubre de 2003 y Mayo de 2005 en el Hospital Parroquial de San Bernardo. Se realizó TOT en 52, Burch en 9, Marion en 9 y Kelly en 4 pacientes. Las pacientes fueron evaluadas en el seguimiento post operatorio por un médico diferente al que realizó la cirugía. Resultados: El seguimiento promedio para el TOT fue 10,6, Burch 14,8, Marion 11,3 y Kelly 8,6 meses. La continencia total o parcial fue para TOT 88%, Burch 77%, Marion 62% y Kelly 75%. La continencia a 18 meses para el TOT fue de 80%, Burch 71% y Marion 40%. Las pacientes que se sometieron sólo a TOT mantienen la continencia urinaria en un 100%, significativamente mejor al 81,9% de las que se sometieron a otro procedimiento quirúrgico asociado. La urgencia miccional desapareció en el TOT en 82%, Burch 66%, Marion 71% y Kelly en el 100% de las pacientes. La urgencia de novo apareció con TOT en 12%, Burch 33% y en ninguna paciente del grupo de Marion o Kelly. Conclusiones: La técnica de TOT tiene excelentes resultados sobre la continencia a mediano plazo y esta se logra con más frecuencia cuando se realizó como procedimiento único. Los síntomas irritativos vesicales ceden en un porcentaje importante de pacientes, independiente de la técnica utilizada. PALABRAS CLAVE: Incontinencia urinaria de esfuerzo, TOT, síntomas vesicales, urgencia miccional SUMMARYObjectives: Medium term evaluation of urinary incontinence in patients treated with transobturator tape (TOT) compared to Burch, Marion and Kelly technique. Method: Prospective evaluation of 74 patients with stress urinary incontinence, treated with the mentioned techniques between October 2003 and May 2005 at Hospital Parroquial of San Bernardo. There were 52 TOT, 9 Burch, 9 Marion and 4 Kelly surgeries performed. Patients were all evaluated by other physician different from the one who made the procedure. Results: The patients were followed up for an average of 10.6 months for TOT, 14,8 months for Burch, 11.3 for Marion, and 8,6 for Kelly. Total or partial continence was achieved in 88% of TOT, 77% of Burch, 62% of Marion and 75% of Kelly. Continence within 18 months was obtained in 80% of TOT, 71% of Burch and 40% of Marion submitted patients. Patients who underwent TOT only, had 100% continence rates, significantly higher than those who underwent another associated surgical procedure. Micturition urgency disappeared in 82% of TOT, 66% of Burch, 71% of Marion and 100% of Kelly surgery. De novo urgency appeared in 12% for TOT, 33% for Burch and in none of either Marion or Kelly group. Conclusions: The TOT surgical technique has excellent
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