Breast reconstruction using abdominal free flaps has become the therapeutic choice at our center when a lot of tissue is needed, The completion of this reconstructive technique requires a variable number of ancillary procedures. Patients who underwent breast reconstruction with abdominal free flap at our center between January 2010 and December 2013 were reviewed. The inclusion criterion was completion to nipple reconstruction. The patients were stratified attending to microsurgical reconstruction related factors and adjuvant radiotherapy. Number and sort of procedures and surgeries, and total elapsed time to complete the reconstruction were analyzed. Sixty-eight patients underwent reconstruction using abdominal free flap; 31 (45.6%) completed breast reconstruction. The average of procedures, surgical steps and elapsed time was 3.2, 2.4 and 15.5 months respectively. Surgical time and bilateral procedures, treatment with radiotherapy and early flap complications were not related to statistically significant differences in secondary surgery rates. Abdominal free flaps often need secondary surgeries to improve the result and finish the reconstruction. We remark the necessity of planning the reconstruction since first surgical time to diminish the secondary surgeries and the elapsed time until completion of breast reconstruction.

La reconstrucción mamaria con colgajo libre abdominal se ha convertido en la opción terapéutica de elección en nuestro centro hospitalario cuando se necesita abundante cantidad de tejido. La culminación de este tipo de reconstrucción requiere un número variable de procedimientos auxiliares de retoque. Revisamos las historias de las pacientes sometidas en nuestro centro a reconstrucción mamaria con colgajo libre abdominal entre enero de 2010 y diciembre de 2013. El criterio de inclusión fue la reconstrucción del pezón como última cirugía. Las pacientes fueron estratificadas atendiendo a factores relacionados con la reconstrucción microquirúrgica y la existencia de radioterapia adyuvante. Analizamos el número y tipo de procedimientos y cirugías de retoque, así como el tiempo transcurrido hasta completar el proceso de reconstrucción. En total, recogimos 68 pacientes reconstruidas con colgajo libre abdominal. De ellas, 31 (45,6%) completaron la reconstrucción mamaria. La media de procedimientos fue de 3,2 por paciente, con una media de 2,4 tiempos quirúrgicos y un tiempo medio de 15,5 meses hasta la reconstrucción del pezón. El momento de la reconstrucción, la bilateralidad, el tratamiento con radioterapia y la presencia de complicaciones tempranas del colgajo no se relacionaron con diferencias estadísticamente significativas en la tasa de cirugía secundaria. Los colgajos libres abdominales necesitan frecuentemente cirugías secundarias para mejorar el resultado y terminar la reconstrucción. Remarcamos la necesidad de planificar la reconstrucción desde el primer tiempo quirúrgico para disminuir la necesidad de cirugías de retoque y el tiempo hasta completar la reconstrucción mamaria.

Estudos citoquímicos, ao nível do microscópio óptico, foram efetuados para determinar a natureza química de inclusões intranucleares, de aspecto fibroso, induzidas pelo vírus do mosaico amarelo do salsão na maioria de suas hospedeiras. Os testes citoquímicos foram conduzidos em material foliar fresco ou fixado (aldeído glutárico, Carnoy 3:1 ou Bouin), tendo sido feitas as seguintes reações: hematoxilina férrica (testemunha); Sudan IV e Azul do Nilo (lipídios); iodo-iodeto (amido); Feulgen, Azur B e verde-de-metila-pironina (ácidos nucleicos); ninidrina-Schiff e "Fast Green", este último em soluções ácida e alcalina (proteínas). Os testes com verde-de-metila-pironina, Azur B e ninidrina-Schiff foram combinados com digestão enzimática pela ribonuclease ou pepsina. Os dados obtidos sugerem que, dentro da sensibilidade dos testes realizados, a inclusão contenha proteína, mas não tenha amido, lipídios ou ácidos nucleicos. Isso permite supor, portanto, que essas inclusões não sejam formadas de partículas de vírus.

Cytochemical studies at optical microscopic level were made to determine the chemical nature of intranuclear inclusions with fibrous aspect which were induced by the celery yellow mosaic virus (CYMV) in most of its hosts. The cytochemical tests were carried on fresh as well on fixed foliar material, fixation being in glutaric aldeid, Carnoy 3:1 or Bouin. The following reactions were tried: ferric haematoxylin (control); Sudan IV and Nile blue (for lipids); iodine ioduret (for starch); Feulgen, azur B and methyl green-pyronin (for nucleic acids); ninhydrin-Schiff and fast-green, the latter in acid and in alcaline solution (for protein). The tests with methyl green-pyronin, azur B and ninhydrin-Schiff were combined with enzimatic digestion with RNase or pepsin. The results suggest that, within the sensibility of the tests, the inclusion contains protein but does not contain starch, lipids or nucleic acids. This permit to suppose, therefore, such inclusions not to be formed of virus particles.