Claudio Guerra - Academia.edu (original) (raw)
Papers by Claudio Guerra
Revista chilena de cirugía, 2015
complex renal artery aneurysm. ex vivo repair and reimplantation introduction: True incidence of ... more complex renal artery aneurysm. ex vivo repair and reimplantation introduction: True incidence of renal artery aneurysms is unknown but it has been estimated to be around 1%. They are usually asymptomatic and diagnosed through imaging studies done for other medical reasons. Those that are more than 2 cm in diameter or any aneurysm in pregnant women should be treated because of an elevated risk of rupture. We present a case of a man with a complex 2.5 cm renal artery aneurysm, successfully treated with ex vivo repair and reimplantation by a multidisciplinary team.
Plastic and Reconstructive Surgery, 2008
Aesthetic Plastic Surgery
Aesthetic Plastic Surgery
Simulation training has become an integral part of plastic surgery postgraduate curricula. It fac... more Simulation training has become an integral part of plastic surgery postgraduate curricula. It facilitates the acquisition of skills in a safe environment that can be later transferred to real-life settings. A variety of models have been described covering some aspects of the specialty better than others. The aim of this study was to identify and classify all the previously reported plastic surgery simulation models and the possible gaps having the Accreditation Council for Graduate Medical Education (ACGME) list of competencies as a guide. Through a Delphi process, the complete list of ACGME minimum requirements for certification was analyzed to identify domains amenable for simulation training. A systematic search was conducted in Pubmed looking for all previously reported simulation models in plastic surgery. Predefined inclusion and exclusion criteria and parallel blind review were used to identify eligible models. A total of 81 ACGME competencies were identified. Following a 3-round Delphi process, consensus was reached on 19 reconstructive and 15 aesthetic surgery domains suitable for simulation training. 1667 articles were initially retrieved from Pubmed, of which 66 articles were eligible for inclusion. Descriptive (65%), quasi-experimental (24%) and experimental studies (11%) were found. For the 34 identified ACGME competencies, there were simulation models described for 58.8% of these, mostly covering reconstructive surgery (84.2%) while for aesthetic surgery it was 13.3%. This scoping review has identified that there are still gaps in ACGME competencies that could benefit from new simulation training models, especially in those related to aesthetic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
European Journal of Plastic Surgery
The transition from a presentation in a scientific conference to publication in an academic journ... more The transition from a presentation in a scientific conference to publication in an academic journal should be the ideal journey for a research project. This phenomenon is summarized in a conversion rate, which has been previously reported in the literature. The aim of this study was to determine the characteristics and conversion rate of Chilean authors’ aesthetic and reconstructive research projects in a nationwide study. Conference abstracts from the two official Chilean plastic surgery meetings released between 2008 and 2018 were analyzed. A bibliographic search of all published articles involving each Chilean plastic surgeon followed. This information was cross-referenced to obtain the conversion rates and time to publication for transferred studies. Fisher's exact test and Mann-Whitney test were used to establish statistical associations. Four hundred sixty-eight abstracts were included, and 227 articles were found in our bibliographic search. Of these, 82 were considered to qualify as transferred studies. Aesthetic surgery publications had a higher proportion of prospective design than reconstructive articles (34.6% vs 20.1% (p = 0.02)). Median time to publication was 15 months, with a longer delay for reconstructive articles (19.5 vs 13 (p = 0.035)). The 2008–2016 conversion rate index was 19.2%, which was significantly higher for aesthetic surgery studies (36.4% vs 11.9% (p < 0.001)). Despite a smaller proportion of plastic surgery research being focused on aesthetic topics in our sample, they accounted for higher quality study design, shorter time to publication, and higher overall chances of publication following presentations in local meetings. Level of evidence: Not ratable.
Revista Chilena de Cirugía, 2016
Conclusión: Es factible la monitorización en microcirugía por medio de la evaluación de la microc... more Conclusión: Es factible la monitorización en microcirugía por medio de la evaluación de la microcirculación con Microscan ®. Este método permite realizar el diagnóstico de oclusión vascular más tempranamente que con NIRS y evaluación clínica.
Rev Chil Cir, Aug 1, 1999
Resumo: El manejo profiláctico de los linfonodos regionales en melanoma maligno es un tema contro... more Resumo: El manejo profiláctico de los linfonodos regionales en melanoma maligno es un tema controversial. En la actualidad, se reconoce la utilidad de la identificación del primer linfonodo de drenaje a la lesión (ganglio centinela) para definir la conducta respecto a la ...
Pediatric Dermatology, 2016
The current treatment of keloids includes surgery, intralesional steroids, and radiotherapy, amon... more The current treatment of keloids includes surgery, intralesional steroids, and radiotherapy, among others. Radiotherapy is not recommended in children due to its effects on growing tissues. Our aim was to study intralesional triamcinilone therapy of keloids in children and analyze the impact of body location, age of the lesion, and etiology of the keloid on clinical response. We conducted a prospective clinical trial with patients 1 to 14 years of age evaluated for keloid treatment. A soft tissue ultrasound was performed to measure the keloid volume, prior to intralesional infiltration with triamcinolone acetonide. A posttreatment ultrasound quantified the volume differences attributed to therapy. For the analysis, Mann-Whitney/Wilcoxon test for paired samples and a multiple regression analysis were performed. Twenty-one patients with a total of 25 keloids were enrolled, with a median age of 12 years (range 6-14 yrs). The initial lesional volume was 1.25 cc (range 0.2-6.3 cc) and the final volume was 0.2 cc (range 0.0-1.53 cc), corresponding to 82.7% of size reduction (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Regarding the relationships between response and body location, etiology and age of the lesion, the multiple regression analyses obtained p-values of 0.46, 0.16, and 0.87, respectively. One patient failed to improve. Average follow-up was 30 months. Triamcinolone acetonide is highly effective for the treatment of pediatric keloids. There is no relationship between clinical response and the factors evaluated, such as lesion location, etiology and age of the keloid.
Revista chilena de cirugía, 2015
Double DIEP flap for lower extremities reconstruction introduction: A soft tissue defect consider... more Double DIEP flap for lower extremities reconstruction introduction: A soft tissue defect considering the extent, location, depth and involved structures can be a complex task, leading to search for unusual reconstructive alternatives. case report: Puerperal woman, 21 years, previously healthy, admitted for septic shock and skin necrosis of both extremities secondary to purpura fulminans. Escharectomy was performed and the final defect was 27% of total body surface, corresponding to necrotic areas of both superior and lower extremities. Is remarkable the presence of musculocutaneous perforating vessels thrombosis and segmental muscular necrosis in legs and interosseous muscles necrosis in hands. In upper extremity coverage was performed with dermoepidermal grafts. To cover peroneal malleolus and feet dorsum, whereas there were no regional or local alternatives, we realize a double DIEP flap. Flap elevation of bilateral DIEP flap was performed simultaneously for two surgical teams. The patient had no complications and was discharged with complete soft tissue coverage.
Plastic and Reconstructive Surgery, 2009
Cirugía Plástica Ibero-Latinoamericana, 2009
Plastic and Reconstructive Surgery, 2007
Apseudoaneurysm is a deformation of the arterial wall secondary to disruption by blunt or penetra... more Apseudoaneurysm is a deformation of the arterial wall secondary to disruption by blunt or penetrating trauma. The rupture affects all three layers of the vascular wall, and over time, fibrous tissue develops that eventually resembles the arterial wall. 1 Pseudoaneurysms have many locations, but ...
La Revista Chilena …, 1999
Rev. Chilena de Cirugía. Vol. 51-Ns 6, Diciembre 1999; págs 607-610 TRABAJOS CIENTIFICOS Fractura... more Rev. Chilena de Cirugía. Vol. 51-Ns 6, Diciembre 1999; págs 607-610 TRABAJOS CIENTIFICOS Fractura de mandíbula tratada con osteosíntesis. Experiencia de la Novena Región DRS. ARMIN RUDOLPH G, GUILLERMO ARISTIDES F, RAÚL GUERRA F, ALVARO CABELLO V, ...
Plastic and …, 2007
Apseudoaneurysm is a deformation of the arterial wall secondary to disruption by blunt or penetra... more Apseudoaneurysm is a deformation of the arterial wall secondary to disruption by blunt or penetrating trauma. The rupture affects all three layers of the vascular wall, and over time, fibrous tissue develops that eventually resembles the arterial wall. 1 Pseudoaneurysms have many locations, but ...
Plastic and …, 2009
The purpose of this study was to evaluate the seroma reduction capabilities of progressive tensio... more The purpose of this study was to evaluate the seroma reduction capabilities of progressive tension sutures and compare them with the conventional use of drains. Sixty female patients were randomized into four groups: group 1 (control, no drains, and no progressive tension sutures), group 2 (progressive tension sutures alone), group 3 (drains alone), and group 4 (progressive tension sutures and drains). All patients underwent a classic abdominoplasty and drains were left for 7 days in the corresponding groups. Clinical and ultrasound assessments were performed 2 weeks after the operation by blinded evaluators. Punctures, volumes, nonseroma complications, and aesthetic outcome were also measured. Surgical time was 50 minutes longer in groups 2 and 4. Drain outputs were higher in group 3 than in group 4. The clinical and ultrasound seroma frequency was 35 percent and 90 percent respectively, without significant differences among the groups. The control group was interrupted at 10 patients because of considerably larger seromas and an increased amount of punctures needed for treatment. No differences were found in the other groups. There were no differences with respect to complication rates and aesthetic outcome after follow-up. Progressive tension sutures increase surgical time, reduce drain outputs, and have the same clinical and ultrasound seroma frequency as the use of drains alone. The combination of both methods simultaneously does not add any advantages. However, complications and interventions increase if at least one of them is not used. The mechanism of action of progressive tension sutures could be the compartmentalization of the fluid collection under the flap facilitating absorption.
Revista chilena de …, 2011
Frecuentemente el cirujano plástico se enfrenta a la necesidad de utilizar colgajos para lograr c... more Frecuentemente el cirujano plástico se enfrenta a la necesidad de utilizar colgajos para lograr cubrir una serie de defectos de cobertura cutánea. En 1981, Thatte describió una nueva técnica de colgajo, la que consistía en el levantamiento de un colgajo random desepitelizado, ...
Plastic and Reconstructive Surgery, 2009
Plastic and Reconstructive Surgery, 2008
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > June ...
Revista chilena de cirugía, 2015
complex renal artery aneurysm. ex vivo repair and reimplantation introduction: True incidence of ... more complex renal artery aneurysm. ex vivo repair and reimplantation introduction: True incidence of renal artery aneurysms is unknown but it has been estimated to be around 1%. They are usually asymptomatic and diagnosed through imaging studies done for other medical reasons. Those that are more than 2 cm in diameter or any aneurysm in pregnant women should be treated because of an elevated risk of rupture. We present a case of a man with a complex 2.5 cm renal artery aneurysm, successfully treated with ex vivo repair and reimplantation by a multidisciplinary team.
Plastic and Reconstructive Surgery, 2008
Aesthetic Plastic Surgery
Aesthetic Plastic Surgery
Simulation training has become an integral part of plastic surgery postgraduate curricula. It fac... more Simulation training has become an integral part of plastic surgery postgraduate curricula. It facilitates the acquisition of skills in a safe environment that can be later transferred to real-life settings. A variety of models have been described covering some aspects of the specialty better than others. The aim of this study was to identify and classify all the previously reported plastic surgery simulation models and the possible gaps having the Accreditation Council for Graduate Medical Education (ACGME) list of competencies as a guide. Through a Delphi process, the complete list of ACGME minimum requirements for certification was analyzed to identify domains amenable for simulation training. A systematic search was conducted in Pubmed looking for all previously reported simulation models in plastic surgery. Predefined inclusion and exclusion criteria and parallel blind review were used to identify eligible models. A total of 81 ACGME competencies were identified. Following a 3-round Delphi process, consensus was reached on 19 reconstructive and 15 aesthetic surgery domains suitable for simulation training. 1667 articles were initially retrieved from Pubmed, of which 66 articles were eligible for inclusion. Descriptive (65%), quasi-experimental (24%) and experimental studies (11%) were found. For the 34 identified ACGME competencies, there were simulation models described for 58.8% of these, mostly covering reconstructive surgery (84.2%) while for aesthetic surgery it was 13.3%. This scoping review has identified that there are still gaps in ACGME competencies that could benefit from new simulation training models, especially in those related to aesthetic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
European Journal of Plastic Surgery
The transition from a presentation in a scientific conference to publication in an academic journ... more The transition from a presentation in a scientific conference to publication in an academic journal should be the ideal journey for a research project. This phenomenon is summarized in a conversion rate, which has been previously reported in the literature. The aim of this study was to determine the characteristics and conversion rate of Chilean authors’ aesthetic and reconstructive research projects in a nationwide study. Conference abstracts from the two official Chilean plastic surgery meetings released between 2008 and 2018 were analyzed. A bibliographic search of all published articles involving each Chilean plastic surgeon followed. This information was cross-referenced to obtain the conversion rates and time to publication for transferred studies. Fisher's exact test and Mann-Whitney test were used to establish statistical associations. Four hundred sixty-eight abstracts were included, and 227 articles were found in our bibliographic search. Of these, 82 were considered to qualify as transferred studies. Aesthetic surgery publications had a higher proportion of prospective design than reconstructive articles (34.6% vs 20.1% (p = 0.02)). Median time to publication was 15 months, with a longer delay for reconstructive articles (19.5 vs 13 (p = 0.035)). The 2008–2016 conversion rate index was 19.2%, which was significantly higher for aesthetic surgery studies (36.4% vs 11.9% (p < 0.001)). Despite a smaller proportion of plastic surgery research being focused on aesthetic topics in our sample, they accounted for higher quality study design, shorter time to publication, and higher overall chances of publication following presentations in local meetings. Level of evidence: Not ratable.
Revista Chilena de Cirugía, 2016
Conclusión: Es factible la monitorización en microcirugía por medio de la evaluación de la microc... more Conclusión: Es factible la monitorización en microcirugía por medio de la evaluación de la microcirculación con Microscan ®. Este método permite realizar el diagnóstico de oclusión vascular más tempranamente que con NIRS y evaluación clínica.
Rev Chil Cir, Aug 1, 1999
Resumo: El manejo profiláctico de los linfonodos regionales en melanoma maligno es un tema contro... more Resumo: El manejo profiláctico de los linfonodos regionales en melanoma maligno es un tema controversial. En la actualidad, se reconoce la utilidad de la identificación del primer linfonodo de drenaje a la lesión (ganglio centinela) para definir la conducta respecto a la ...
Pediatric Dermatology, 2016
The current treatment of keloids includes surgery, intralesional steroids, and radiotherapy, amon... more The current treatment of keloids includes surgery, intralesional steroids, and radiotherapy, among others. Radiotherapy is not recommended in children due to its effects on growing tissues. Our aim was to study intralesional triamcinilone therapy of keloids in children and analyze the impact of body location, age of the lesion, and etiology of the keloid on clinical response. We conducted a prospective clinical trial with patients 1 to 14 years of age evaluated for keloid treatment. A soft tissue ultrasound was performed to measure the keloid volume, prior to intralesional infiltration with triamcinolone acetonide. A posttreatment ultrasound quantified the volume differences attributed to therapy. For the analysis, Mann-Whitney/Wilcoxon test for paired samples and a multiple regression analysis were performed. Twenty-one patients with a total of 25 keloids were enrolled, with a median age of 12 years (range 6-14 yrs). The initial lesional volume was 1.25 cc (range 0.2-6.3 cc) and the final volume was 0.2 cc (range 0.0-1.53 cc), corresponding to 82.7% of size reduction (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Regarding the relationships between response and body location, etiology and age of the lesion, the multiple regression analyses obtained p-values of 0.46, 0.16, and 0.87, respectively. One patient failed to improve. Average follow-up was 30 months. Triamcinolone acetonide is highly effective for the treatment of pediatric keloids. There is no relationship between clinical response and the factors evaluated, such as lesion location, etiology and age of the keloid.
Revista chilena de cirugía, 2015
Double DIEP flap for lower extremities reconstruction introduction: A soft tissue defect consider... more Double DIEP flap for lower extremities reconstruction introduction: A soft tissue defect considering the extent, location, depth and involved structures can be a complex task, leading to search for unusual reconstructive alternatives. case report: Puerperal woman, 21 years, previously healthy, admitted for septic shock and skin necrosis of both extremities secondary to purpura fulminans. Escharectomy was performed and the final defect was 27% of total body surface, corresponding to necrotic areas of both superior and lower extremities. Is remarkable the presence of musculocutaneous perforating vessels thrombosis and segmental muscular necrosis in legs and interosseous muscles necrosis in hands. In upper extremity coverage was performed with dermoepidermal grafts. To cover peroneal malleolus and feet dorsum, whereas there were no regional or local alternatives, we realize a double DIEP flap. Flap elevation of bilateral DIEP flap was performed simultaneously for two surgical teams. The patient had no complications and was discharged with complete soft tissue coverage.
Plastic and Reconstructive Surgery, 2009
Cirugía Plástica Ibero-Latinoamericana, 2009
Plastic and Reconstructive Surgery, 2007
Apseudoaneurysm is a deformation of the arterial wall secondary to disruption by blunt or penetra... more Apseudoaneurysm is a deformation of the arterial wall secondary to disruption by blunt or penetrating trauma. The rupture affects all three layers of the vascular wall, and over time, fibrous tissue develops that eventually resembles the arterial wall. 1 Pseudoaneurysms have many locations, but ...
La Revista Chilena …, 1999
Rev. Chilena de Cirugía. Vol. 51-Ns 6, Diciembre 1999; págs 607-610 TRABAJOS CIENTIFICOS Fractura... more Rev. Chilena de Cirugía. Vol. 51-Ns 6, Diciembre 1999; págs 607-610 TRABAJOS CIENTIFICOS Fractura de mandíbula tratada con osteosíntesis. Experiencia de la Novena Región DRS. ARMIN RUDOLPH G, GUILLERMO ARISTIDES F, RAÚL GUERRA F, ALVARO CABELLO V, ...
Plastic and …, 2007
Apseudoaneurysm is a deformation of the arterial wall secondary to disruption by blunt or penetra... more Apseudoaneurysm is a deformation of the arterial wall secondary to disruption by blunt or penetrating trauma. The rupture affects all three layers of the vascular wall, and over time, fibrous tissue develops that eventually resembles the arterial wall. 1 Pseudoaneurysms have many locations, but ...
Plastic and …, 2009
The purpose of this study was to evaluate the seroma reduction capabilities of progressive tensio... more The purpose of this study was to evaluate the seroma reduction capabilities of progressive tension sutures and compare them with the conventional use of drains. Sixty female patients were randomized into four groups: group 1 (control, no drains, and no progressive tension sutures), group 2 (progressive tension sutures alone), group 3 (drains alone), and group 4 (progressive tension sutures and drains). All patients underwent a classic abdominoplasty and drains were left for 7 days in the corresponding groups. Clinical and ultrasound assessments were performed 2 weeks after the operation by blinded evaluators. Punctures, volumes, nonseroma complications, and aesthetic outcome were also measured. Surgical time was 50 minutes longer in groups 2 and 4. Drain outputs were higher in group 3 than in group 4. The clinical and ultrasound seroma frequency was 35 percent and 90 percent respectively, without significant differences among the groups. The control group was interrupted at 10 patients because of considerably larger seromas and an increased amount of punctures needed for treatment. No differences were found in the other groups. There were no differences with respect to complication rates and aesthetic outcome after follow-up. Progressive tension sutures increase surgical time, reduce drain outputs, and have the same clinical and ultrasound seroma frequency as the use of drains alone. The combination of both methods simultaneously does not add any advantages. However, complications and interventions increase if at least one of them is not used. The mechanism of action of progressive tension sutures could be the compartmentalization of the fluid collection under the flap facilitating absorption.
Revista chilena de …, 2011
Frecuentemente el cirujano plástico se enfrenta a la necesidad de utilizar colgajos para lograr c... more Frecuentemente el cirujano plástico se enfrenta a la necesidad de utilizar colgajos para lograr cubrir una serie de defectos de cobertura cutánea. En 1981, Thatte describió una nueva técnica de colgajo, la que consistía en el levantamiento de un colgajo random desepitelizado, ...
Plastic and Reconstructive Surgery, 2009
Plastic and Reconstructive Surgery, 2008
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > June ...