ABSTRACT
Câncer em cabeça e pescoço é entidade muito comum nos países em desenvolvimento. Nos defeitos pe- quenos ou não complexos, podemos utilizar da várias opções para reconstrução, como retalhos locais ou pedículadosadistância,masquandonosdeparamoscom defeitos grandes ou complexos, microcirurgia torna-se necessária.
Introduction: head and neck cancer are very common entities of developing countries. In small or non complex defects we have a lot of options for reconstruction, like local or pedicle flaps, but when we consider big or complex defects microsurgery is necessary. Methods: in our casuistic, we have used radial forearm free flap for oral cavity, tongue and faryngeal defects, free anterolateral thigh flap with vastus lateralis muscle for maxilla defects and free fibula flap for mandible defects, between 20 patients. All flaps were done in the same institution and by the same surgical team. Results: the most common complications observed in microsurgical flaps like venous thrombosis and hematoma were not observed in this casuistic of 20 cases. Conclusion: microsurgical flaps for head and neck reconstruction represent an excellent alternative for big and complex defects, with low complication rates.
Subject(s)
Humans , Head and Neck Neoplasms , Microsurgery , Microsurgery/mortality , Microsurgery/rehabilitation , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/pathologyABSTRACT
Deformidades cervicais pós queimadura apresentam problemas funcionais e estéticos que desafiam Cirurgiões Plásticos. Quando essas deformidades envolvem pequenas áreas nós podemos realizar z-plastias, retalhos locais e enxertos cutâneos, mas em áreas ex- tensas nós temos que considerar os retalhos microcirúrgicos. O retalho ânterolateral da coxa tem sido utilizado em casos severos de contratura cervical, com bons resultados estéticos e funcionais.
Introduction: post burn neck contractures present with function alanda esthetic problems thatare achallenge for Plastic Surgeons. When theses deformities involve small areas we can perform Z-plasties, local flaps and skin graft, but in extensive areas we have to consider free flaps transfer. Free anterolateral thigh flap has been used in severe cases of neck contractures, with good aesthetic and functional results. Materials and Methods: 8 patients with extensive anterior neck contractures underwent free flap reconstruction with anterolateral thigh flap. There were 3 women and 5 men with mean age of 24,4 years (range 10 to 51). All cases resulted from flame burns. We have included in these series, patients that underwent to another procedure before, functional deficit (limited extension and rotation) and aesthetic consideration. After 60 days of surgery, 7 patients have been submitted to deffating procedure (liposuction) of the flap. Results: in all patients, release of contractures was excellent. All flaps survived well. One case presented with marginal necrosis of 3 x 1 cm of the flap, and another case with a marginal necrosis of burned area (receptor site).
Subject(s)
Humans , Male , Female , Adult , Contracture , Microsurgery , Tissue Transplantation , Contracture/surgery , Contracture/history , Microsurgery/methods , Tissue Transplantation/methodsABSTRACT
Fraturas expostas com grandes perdas cutâneas e osteomielite crônica de membros inferiores são problemas de difícil resolução para os cirurgiões plásticos, especialmente se localizados no terço inferior da perna ou no pé. Microcirurgia é uma técnica que fornece boa cobertura e aumento do aporte vascular para a região do trauma.
Introduction: open fractures and chronicosteomyelites in lower limb are really difficult problems for reconstructive surgeons, especially if it's localized on the lower third of the leg or in the foot. Microsurgery is a technique that can provide good soft tissue covering and increasing of blood flow for the trauma area. Method: we have studied 18 patients that were submitted to microsurgical flaps of latissimus dorsi and gracilis, depending of the size of defect, with open fractures IIIB and 5 cases with chronic osteomyelites. Results: between 18 cases, we had one total necrosis of the flap resulting from venous thrombosis. All of flaps have survived well. Conclusion: we have used microsurgical muscle flaps (latissimus dorsi and gracilis muscle) because they can provide good soft tissue covering, improvement of blood flow and they are easier to harvest if compared with perforator flaps. So, muscle flaps represents good alternatives for lower limb reconstruction.