ABSTRACT
INTRODUÇÃO: As reparações de defeitos extensos do terço médio da face, ao necessitarem de grandes quantidades de pele e subcutâneo, tornam-se complexas. Buscando reduzir morbidade e associar bom resultado estético-funcional, Ariyan & McGrath e, posteriormente, Behan et al. propuseram reconstruções a partir de retalhos transversos cervicais e cérvico-submandibulares, respectivamente. Tais retalhos dispõem de boas quantidades de tecidos e baixa morbidade da área doadora. Os autores propõem e descrevem uma variante do retalho de Behan para reconstruções de grandes defeitos no terço médio de face. MÉTODOS: Foi realizado um estudo retrospectivo de 8 casos de reconstrução do terço médio da face pelo retalho cérvico-submandibular transverso, no período de junho de 2011 a dezembro de 2013. Os parâmetros analisados foram: resultados possíveis e complicações precoces e tardias. RESULTADOS: Foram operados 8 pacientes, com média de idade de 73,5 anos. Todos os pacientes apresentaram resultados estético-funcionais satisfatórios. Dentre as complicações precoces, 3 pacientes apresentaram congestão vascular na primeira semana com resolução espontânea e 1 apresentou fistula salivar consequente à ressecção tumoral. Em relação às complicações tardias, a retração cicatricial foi a complicação observada, manifestada por ectrópio (2 pacientes) e retração labial (1 paciente). CONCLUSÃO: O retalho cérvico-submandibular transverso randomizado e com pedículos axiais é mais uma opção para reconstruções de defeitos do terço médio da face.
INTRODUCTION: The need for large amounts of skin and subcutaneous tissue makes it complex to repair extensive defects of the middle third of the face. Aiming to reduce morbidity and attain good aesthetic-functional outcomes, Ariyan and McGrath and, subsequently, Behan et al. proposed reconstruction techniques that use transverse and submandibular cervical flap, respectively. Such flaps have fair amounts of tissue and are associated with low morbidity in the donor area. The present authors propose and describe a variant of the Behan flap for use in the reconstruction of large defects of the middle third of the face. METHODS: We conducted a retrospective study of 8 cases of reconstruction with transverse submandibular cervical flaps for defects of the middle third of the face, conducted between June 2011 and December 2013. The following parameters were analyzed: possible results, and early and late complications. RESULTS: Eight patients with a mean age of 73.5 years were included. All of the patients presented aesthetic-functional satisfactory results. Among the early complications, vascular congestion occurred in 3 patients in the first week with spontaneous resolution, and salivary fistula occurred after tumor resection in 1 patient. With regard to late complications, scar retraction was observed, manifested by either by ectropion (2 patients) or labial retraction (1 patient). CONCLUSION: Randomized transverse submandibular cervical flaps with axial pedicles may be considered as another option for reconstruction of defects of the middle third of the face.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , History, 21st Century , Postoperative Complications , Surgical Flaps , Cross-Sectional Studies , Retrospective Studies , Plastic Surgery Procedures , Evaluation Study , Esthetics , Face , Facial Bones , Head , Head and Neck Neoplasms , Neck , Postoperative Complications/surgery , Surgical Flaps/surgery , Cross-Sectional Studies/methods , Plastic Surgery Procedures/methods , Face/abnormalities , Face/surgery , Facial Bones/surgery , Head/abnormalities , Head/surgery , Head and Neck Neoplasms/surgery , Neck/surgeryABSTRACT
PURPOSE: To propose an experimental burn model in NIH-3T3 cell line. METHODS: Induction of thermal injury in cultures of mouse fibroblast - NIH-3T3- cell line and determination of cell viability by MTT and imunofluorescence. RESULTS: The heating of the Petri dish increased proportionally to the temperature of the base and the time of exposure to microwave. In this in vitro burn model, using the cell line NIH-3T3 was observed drastic cellular injury with significant changes in cell viability and activity. It showed drastically modified cell morphology with altered membrane, cytoskeleton and nucleus, and low cellularity compared to the control group. CONCLUSION: The burn model in vitro using the cell line NIH-3T3 was reproductive and efficient. This burn model was possible to determine significant changes in cell activity and decreased viability, with drastic change in morphology, cell lysis and death. .