@javeriana.edu.co
Professor Medicine Faculty of Pontificia Universidad Javeriana
Pontificia Universidad Javeriana
Extensive experience in Plastic Surgery and Aesthetic Surgery, specializations in High Complexity Reconstructive Microsurgery, Brachial Plexus Injuries in adults and children, Congenital or acquired Facial Palsy, Peripheral Nerve Surgery and Hand Surgery. Research in Healing and Nervous Regeneration
Plastic Surgeon, Microsurgery, Hand Surgeon, Master Degree Neurosciences
Peripheral Nerve Regeneration
Nerve Injuries
Microsurgery
Hand surgery
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Diana Millán, Ronald A. Jiménez, Luis E. Nieto, Ivan Y. Poveda, Maria A. Torres, Ana S. Silva, Luis F. Ospina, João F. Mano, and Marta R. Fontanilla
Elsevier BV
Shortness of donor nerves has led to the development of nerve conduits that connect sectioned peripheral nerve stumps and help to prevent the formation of neuromas. Often, the standard diameters of these devices cannot be adapted at the time of surgery to the diameter of the nerve injured. In this work, scaffolds were developed to form filled nerve conduits with an inner matrix with unidirectional channels covered by a multidirectional pore zone. Collagen type I dispersions (5 mg/g and 8 mg/g) were sequentially frozen using different methods to obtain six laminar scaffolds (P1 to P5) formed by a unidirectional (U) pore/channel zone adjacent to a multidirectional (M) pore zone. The physicochemical and microstructural properties of the scaffolds were determined and compared, as well as their biodegradability, residual glutaraldehyde and cytocompatibility. Also, the Young's modulus of the conduits made by rolling up the bizonal scaffolds from the unidirectional to the multidirectional zone was determined. Based on these comparisons, the proliferation and differentiation of hASC were assessed only in the P3 scaffolds. The cells adhered, aligned in the same direction as the unidirectional porous fibers, proliferated, and differentiated into Schwann-like cells. Adjustable conduits made with the P3 scaffold were implanted in rats 10 mm sciatic nerve lesions to compare their performance with that of autologous sciatic nerve grafted lesions. The in vivo results demonstrated that the tested conduit can be adapted to the diameter of the nerve stumps to guide their growth and promote their regeneration.
Luis Eduardo Nieto Ramírez and Clara Italia Pedraza Borrero
SciELO Agencia Nacional de Investigacion y Desarrollo (ANID)
Los tumores malignos de lengua son una patologia frecuente con alto grado de morbilidad y mortalidad. Su tratamiento requiere manejo quirurgico y sistemico oncologico, con la respectiva reconstruccion, para lograr asi una adecuada calidad de vida, debido a la funcion primordial de la lengua durante la alimentacion, la comunicacion, la interaccion social y laboral. Es por esto que la eleccion de los tejidos donantes para ello depende en gran medida de sus caracteristicas y del tipo de defecto, aspecto fundamental para obtener resultados favorables en los pacientes. Se realiza una revision de la clasificacion de los defectos resultantes despues de la reseccion de tumores de lengua, un algoritmo de manejo y los colgajos libres microvasculares mas utilizados en este tipo de reconstruccion.
D. Millán, R. A. Jiménez, L. E. Nieto, I. Linero, M. Laverde, and M. R. Fontanilla
Springer Science and Business Media LLC
Previously, we have developed collagen type I scaffolds including microparticles of gelatin-collagen type I (SGC) that are able to control the release of a hydroglycolic extract of the Calendula officinalis flower. The main goal of the present work was to carry out the preclinical evaluation of SGC alone or loaded with the C. officinalis extract (SGC-E) in a lagomorph model of full-thickness skin wound. A total of 39 rabbits were distributed in three groups, of 13 animals each. The first group was used to compare wound healing by secondary intention (control) with wound healing observed when wounds were grafted with SGC alone. Comparison of control wounds with wounds grafted with SGC-E was performed in the second group, and comparison of wounds grafted with SGC with wounds grafted with SGC-E was performed in the third group. Clinical follow-ups were carried in all animals after surgery, and histological and histomorphometric analyses were performed on tissues taken from the healed area and healthy surrounding tissue. Histological and histomorphometric results indicate that grafting of SGC alone favors wound healing and brings a better clinical outcome than grafting SGC-E. In vitro collagenase digestion data suggested that the association of the C. officinalis extract to SGC increased the SGC-E cross-linking, making it difficult to degrade and affecting its biocompatibility.
Jose Rolando Prada Madrid, Luis Eduardo Nieto, Viviana Gomez, Pilar Echeverry, Maria Cristina Tavera, and Henry Oliveros
SAGE Publications
Objective The aim of this study is to compare patients treated with pharyngoplasty and those treated with palatoplasty for velopharyngeal insufficiency to establish what surgical procedure poses the highest risk for developing sleep apnea. The hypothesis tested in this study is that the incidence of obstructive sleep apnea syndrome associated with pharyngoplasty is greater than that associated with palatoplasty for velopharyngeal insufficiency. Subjects Twenty patients were taken from the Institution FISULAB. Design Observational cohort analytic study. Main Outcome Measures An overnight polysomnographic study was used to determine the incidence and severity of obstructive sleep apnea syndrome. Results The incidence of obstructive sleep apnea syndrome following pharyngoplasty was shown to be significantly higher than after palatoplasty. The apnea-hypopnea index, also called the respiratory disturbance index, was 12.7 in the pharyngoplasty group and 1.35 in the palatoplasty group (p < .001). When obstructive sleep apnea syndrome was stratified into different levels of severity according to the values of respiratory disturbance index, there were noticeable differences between these two groups. In the palatoplasty group, one patient had mild obstructive sleep apnea syndrome. In the pharyngoplasty group, two patients had mild obstructive sleep apnea syndrome, one patient had moderate obstructive sleep apnea syndrome, and two patients had severe obstructive sleep apnea syndrome. Conclusions When comparing the apnea-hypopnea index (i.e., respiratory disturbance index) of patients treated for velopharyngeal insufficiency with palatoplasty versus pharyngoplasty, we observed an important difference between the groups, with the highest indices in the pharyngoplasty group.
Luis Bermudez and Luis Nieto
Georg Thieme Verlag KG
When a viable proximal facial nerve is not accessible, facial nerve paralysis has been managed with hypoglossal facial anastomosis, which results in varying degrees of hemiglossal atrophy and its sequelae. These authors have used the masseteric nerve to neurotize the facial nerve in one patient.