Publications by authors named "Jesús Lago Oliver"

6 Publications

  • Page 1 of 1

The Effect of Hyperoxygenated Fatty Acids in Preventing Skin Lesions Caused by Surgical Pneumatic Tourniquets.

Adv Skin Wound Care 2018 May;31(5):214-217

In Madrid, Spain, Beatriz Castillo Martín is Associate Professor, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, and Nurse, Hospital Universitario Gregorio Marañón; Juan Ignacio Castillo Martín, MD, is Associate Professor, Faculty of Medicine, Universidad Complutense de Madrid, and Head of Physical Medicine and Rehabilitation, Hospital 12 de Octubre; Jesús Lago Oliver is Associate Professor, Department of Surgery, Universidad del Rey Juan Carlos de Madrid, and Specialist, General and Digestive Surgery, Hospital Universitario Gregorio Marañón; and Jorge Diz Gómez is Director, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid.

Objectives: To determine whether hyperoxygenated fatty acids (HOFAs) provide safe and effective protection against lesions caused by surgical pneumatic tourniquets (SPTs).

Methods: This was a nonrandomized, single-blind, 2-arm, prospective, comparative study. The study was approved by the Ethics and Clinical Research Commission of the Hospital Universitario Gregorio Marañón, in Madrid, Spain. Subjects in the intervention group were treated topically with HOFAs (Linovera; B. Braun Medical Inc, Bethlehem, Pennsylvania) at the site (upper and lower limbs) where an SPT was to be applied. An elastic bandage was then set in place and finally the SPT. Control subjects were treated in the same way, but no HOFAs were applied.

Participants: The study subjects were all patients of the Department of Orthopedic and Trauma Surgery at the Hospital Universitario Gregorio Marañón for whom the use of an SPT was indicated for 60 minutes or longer. In total, 174 patients completed the study, 83 in the HOFA-treatment arm and 91 in the control arm. All subjects gave their informed consent to be included.

Main Outcome: Assessment of the lesions induced by the SPT after its removal.

Main Results: Significant correlations were found between the risk of developing lesions and age 70 years or older (P = .021), a duration of ischemia of 70 minutes or longer (P = .006), and being a member of the control group (P < .001). Some 93.4% of the intervention group experienced only a grade 0 to 1 skin lesion compared with 55.4% of the control group. Moreover, 44.6% of the control arm subjects suffered a grade 2 to 4 lesion compared with only 6% of the HOFA-treated subjects. No subject in the treatment arm suffered any important skin lesion; in the control arm, however, 2 patients suffered edema, another suffered induration, and 2 experienced abrasions.

Conclusions: The use of topical HOFAs, in conjunction with the application of an elastic bandage before applying an SPT, is a safe and effective way of preventing SPT-induced skin lesions.
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http://dx.doi.org/10.1097/01.ASW.0000530065.52255.5dDOI Listing
May 2018

Succesful Management of Laparoscopic Sleeve Gastrectomy Leak with Negative Pressure Therapy.

Obes Surg 2017 09;27(9):2452-2453

Cirugía General y del Aparato Digestivo, H. General Universitario Gregorio Marañón, Madrid, Spain.

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http://dx.doi.org/10.1007/s11695-017-2752-0DOI Listing
September 2017

Delayed diagnosis of a traumatic intrapericardial diaphragmatic hernia.

Cir Esp 2014 Nov 16;92(9):e57. Epub 2014 Jun 16.

Servicio de Cirugía General y del Aparato Digestivo II, Hospital General Universitario Gregorio Marañón, Madrid, España.

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http://dx.doi.org/10.1016/j.ciresp.2014.03.009DOI Listing
November 2014

[Adjustable gastric band as surgical treatment for morbid obesity. Are worldwide results reproducibles in Spain?].

Cir Esp 2013 May 8;91(5):301-7. Epub 2013 Mar 8.

Hospital General Universitario Gregorio Marañón, Madrid, España.

Introduction: Adjustable gastric banding is a surgical technique used all over the world for the treatment of morbid obesity. In Spain, the number of patients treated with adjustable gastric banding is far lower than the average worldwide average. A number of reasons have been put forward to explain this difference.

Material And Methods: A program of bariatric surgery by means of implantation of an adjustable gastric banding was started in 2001, together with a dedicated follow-up protocol in order to prevent complications and improve results.

Results: A total of 132 patients were operated on between 2001 and 2011. The mean age of the 102 female and 30 male patients was 39 years, and the mean body mass index was 43. Follow-up was longer than 5 years in 61 patients, while the mean follow-up in the rest was 44.4 months. There was no mortality or severe morbidity. Eight patients (6.06%) underwent reoperation, 3 of them for complications related to the reservoir, 4 for slipping of the band, and one for erosion. One slipped band was removed, and a new one (of the Lap Band type) was inserted. Three slipping bands were converted to other techniques. The percentage excessive body weight loss was maintained in 54.8% of the patients followed-up for longer than 5 years.

Conclusions: The results of our series are comparable to those reported in the literature and show that, provided that a close follow-up, like that performed by most groups, is implemented, adjustable gastric banding can also be a safe and effective bariatric surgery technique in our country.
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http://dx.doi.org/10.1016/j.ciresp.2012.08.008DOI Listing
May 2013

[Use of fibrin based biological adhesives in the prevention of anastomotic leaks in the high risk digestive tract: preliminary results of the multicentre, prospective, randomised, controlled, and simple blind phase IV clinical trial: Protissucol001].

Cir Esp 2012 Dec 27;90(10):647-55. Epub 2012 Jun 27.

Hospital General Universitario Gregorio Marañón, Madrid, España.

Introduction: A multicentre, prospective, randomised, controlled, and simple blind clinical trial was started in January 2007, with the aim of demonstrating the efficacy of fibrin-based biological adhesives in the prevention of anastomotic leaks in the high risk digestive tract.

Material And Methods: A study on the prevention of anastomotic healing defects by applying biological adhesives along the suture line began in January 2007, and included the hospitals, Gregorio Marañón, Universitario de San Carlos, and Hospital del Sureste, in Madrid. The enrolled patients were randomised to one of 2 groups: the study group in which the adhesive was applied to the suture line, and a control group in which it was not applied. The primary outcome of the study was the presence or absence of leaks. The trial was approved by the corresponding Clinical Research Ethics Committees and the Spanish Medicines Agency (AEMPS) and registered www.clinicaltrials.gov (NCT01306851). The authors declared not to have any conflict of interests with the company, Baxter, which markets the product in Spain.

Results: A total of 104 patients were recruited between January 2007 and November 2010, of whom 52 were randomised to the study group, and 52 to the control group. A total of 22 anastomotic leaks were recorded, of which 7 (13.4%) were in the study group, and 15 (28.8%) in the control group (P=.046). The leak risk index was 0.384, which means that there was a 61% reduction in leaks in the patients who had the fibrin-based biological adhesive applied. There were 3 (5.7%) further surgeries in the study group, compared to 12 (23%) in the control group (P=.12). On analysing the mortality, it was observed that 3 patients in the study group and 4 patients in the control group died (5.7% vs. 7.7%, P=.5). No other significant differences were found as regards the type of suture, surgical time, or pre-surgical history, except that the use of drainages appeared to be a protective factor of anastomotic leak (P=.041), although the use or not of a drainage was not a controlled factor, but at the discretion of each surgeon.

Conclusions: Our study demonstrates, significantly, that in the 104 patients in the study that fibrin based biological adhesives are capable of preventing anastomotic leaks in the high risk digestive tract, reducing the risk of leaks by 61% and a further surgeries. This is the first clinical trial that shows these significant results. If our results are maintained at the end of the study, it will show that anastomotic leaks can be prevented with the application of these adhesives, thus their application may be recommended in all the anastomosis of the high risk digestive tract.
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http://dx.doi.org/10.1016/j.ciresp.2012.05.007DOI Listing
December 2012

[Severe pelvic fractures, associated injuries and hemodynamic instability: incidence, management and outcome in our center].

Cir Esp 2007 Jun;81(6):316-23

Sección de Cirugía de Urgencia, Departamento de Cirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.

Introduction: The aim of this study was to review the incidence, treatment and outcome of severe pelvic fractures, as well as associated injuries, in our center.

Patients And Method: We performed a retrospective study of patients included in our trauma registry between June 1993 and January 2005. Pelvic fractures were classified according to the system proposed by Tile. Clinical and demographic data such as age, gender, mechanism of injury, transfer time, hemodynamic status, and trauma scores were compared and analyzed statistically. Shock was defined as a systolic blood pressure of < or = 90 mmHg during the primary assessment. Mortality and associated risk factors were analyzed, with emphasis on patients in shock on admission.

Results: Of 1274 patients with severe trauma admitted during the study period, 192 (15%) had pelvic fracture. Only 6.7% were isolated fractures and 6% were open fractures. Twenty percent of the patients were in shock on admission. The mean Injury Severity Score of the series was 28.5 +/- 14 and that of patients in shock was 38 +/- 16. The most frequently associated injuries were thoracic (70%), abdominal (55%), long bone fractures (52%), and head injuries (40%). Twenty-three percent of the patients had retroperitoneal hematoma. Arteriograms were performed in 16 patients, with four embolizations. Eight patients underwent external orthopedic fixation, and none posterior orthopedic fixation. Five patients underwent pelvic packing and two patients underwent ligation of hypogastric arteries. Overall mortality was 30% and mortality in patients in shock was 61%. Predictors of mortality were shock on admission, a Glasgow Coma Scale score of < or = 8, ISS > 25 and age > 55 years.

Conclusions: Patients in shock with pelvic fractures have a poor prognosis in our center, frequently related to the severity of associated injuries, the relative rarity of these fractures, and the lack of a clearly defined management protocol. The main cause of death was massive hemorrhage.
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http://dx.doi.org/10.1016/s0009-739x(07)71330-1DOI Listing
June 2007
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