O. García Duque’s research while affiliated with University of Las Palmas de Gran Canaria and other places

Background: Fat grafting is a procedure commonly used in breast reconstruction nowadays. Nevertheless, its oncological safety remains controversial. The potential risk that progenitor cells included in fat graft tissue may contribute to disease progression in patients with breast cancer is still debatable. We have designed a matching-cohort study with 250 patients with history of breast cancer trying to elucidate an answer for this question. Methods: We selected 250 patients with a history of breast cancer in our hospital, between 2011 and 2019. A total of 125 patients (cases) had a history of breast cancer reconstructed with fat grafting. The additional 125 patients are matched controls. We analyzed the distribution of eight different variables within the cases and their matched controls: date of first oncological surgery, age, type of oncological surgery, histological subtype, Her-2 status, pN, smoking habit and diabetes mellitus. The objective of this study was to analyze the influence of fat grafting over breast cancer recurrence. Results: There are not statistically significant differences in breast cancer locoregional recurrences (P=0.183), distant metastases (P=0.200) or total recurrences (P=0.065) amongst the two groups (cancer cases and matched controls). Conclusions: Our study adds more information over the oncological safety of fat grafting. These findings should encourage long-term prospective trials to provide surgeons with accurate information regarding the role of lipofilling on breast neoplasms.

There is an increasing number of surgeons willing to help countries with fewer surgeons. Between heroic individual aid and the displacement of well-stocked multidisciplinary professional teams, numerous scenarios are possible. Our model of short and repeated visits to the same place conducted by a non-professional humanitarian aid group, is here shown as a way to provide surgical help to low-income countries. Local health workers implication in this effort is mandatory. Africa Plastica comes up with that intention and under this dynamics, in order to aid African countries, that represent for us, as Canarian, our natural hinterland.

The use of more radical surgery and adjuvant treatment for locally advanced anorectal cancers have increased complex vulvo-perineal wounds.These patients have some disturbing factors, such as, abdominal scars, perineal radiation, deficient nutritional status, that hinder the solution of these wounds, especially, if the posterior vaginal wall is envolved. We report a simple and reliable technique for posterior vaginal wall reconstruction using two ipsilateral fasciocutaneous gluteus maximus flap.

The aim of this study was to evaluate the results of sentinel lymph node biopsy (SLNB) in cutaneous melanoma at our institution. 128 patients with primary cutaneous melanoma who underwent SLNB between April, 2004, and August, 2010 were studied. Univariate and multivariate analysis was performed to explore the effect of variables on mortality and sentinel node status. Survival analysis was performed using the Kaplan-Meier approach. Positive SLNB were detected in 35 (27.3%) of 128 cases. Mean Breslow depths were 3.7 mm for SLNB positive patients and 1.99 mm for SLNB negative patients. False negative rate was 1%. The recurrence rate was 40% for positive patients and 6.5% for negative patients (odds ratio 9.7 [confidence interval 95 % 3.3-28.1]). 33 patients (29%) had an ulcerated melanoma, 12 (10.5%) in the positive group and 21 (18.5%) in the negative group. The disease recurred in a 48.5% of patients with ulcerated melanoma, but only in a 2.5% of patients with non-ulcerated melanoma. Upon multivariate analysis, only Breslow thickness (P = 0.005) demonstrate statistically significance for SLNB status. Multivariate analysis for clinicopathologic predictors of death demonstrate statistically significance for Breslow thickness (P = 0.020), ulceration (P = 0.030) and sentinel node status (P = 0.020). This study confirms that the status of the sentinel node is a strong independent prognostic factor with a higher risk of death and lower survival. Patients with ulcerated melanoma are more likely to develop recurrence, and also higher risk of death than patients with non-ulcerated melanoma.

Cutaneous metastasis of the digestive tract are infrequent lesions appearing in patients with advanced disease. Most of these patients have been already operated of their primary tumour. Lesions are variable in aspect, arising de novo and evolving with rapid growth. They usually lie in the trunk or lower extremities thus facilitating an early diagnosis and management with simple extirpation and direct closure. A case-report of a patient with advanced colonic cancer is here presented. At admission he presented a cutaneous matastasic lesion in the right cheek; it was a 6 cm ulcerated, bad -smelling lesion which needed daily dressings affecting patient's normal life. The lesion was removed using successfully a submental flap as coverage. The submental flap provides a very similar tissue to facial defects, leaving no donor area sequelae which is in addition well hidden, being consequently a good tool for midsize facial defects.

Cutaneous metastasis of the digestive tract are infrequent lesions appearing in patients with advanced disease. Most of these patients have been already operated of their primary tumour. Lesions are variable in aspect, arising de novo and evolving with rapid growth. They usually lie in the trunk or lower extremities thus facilitating an early diagnosis and management with simple extirpation and direct closure. A case-report of a patient with advanced colonic cancer is here presented. At admission he presented a cutaneous matastasic lesion in the right cheek; it was a 6 cm ulcerated, bad -smelling lesion which needed daily dressings affecting patient's normal life. The lesion was removed using successfully a submental flap as coverage. The submental flap provides a very similar tissue to facial defects, leaving no donor area sequelae which is in addition well hidden, being consequently a good tool for midsize facial defects.

After sustaining a clean-cut mid-carpal hand amputation on a tanker 120 miles north of Lanzarote, a 28- -year-old seafarer was evacuated by helicopter to a microsurgical unit in Gran Canaria. The amputated hand was cooled according to precise instructions. The 6-hour flight time included two refuelling stops and transfer time. The hand had been revascularized thirteen hours after the accident and was still well circulated at repatriation 3 weeks later.