ABSTRACT
La utilización de lisado plaquetario alogénico abre otra posibilidad terapéutica en ortopedia. Se presenta su uso en una paciente femenina de 40 años de edad, con antecedentes de asma bronquial y tratamiento con esteroides, que como consecuencia de una caída sufrió herida avulsiva extensa en el tercio inferior de la pierna derecha con desgarro de piel de aproximadamente 11 cm con vértice distal y base proximal estrecha, que solamente tomó piel; y otra herida similar, aledaña a esta lesión, de aproximadamente 6 cm de diámetro. Se le realizó toilette y necreptomía de los bordes que tenían signos de necrosis, fundamentalmente los vértices. Se le realizaron puntos de afrontamiento donde se observó extrema fragilidad de la piel, se inició tratamiento con antibióticoterapia. A las 48 horas se observó necrosis de dos tercios del colgajo de piel, el cual se decidió mantener hasta pasados 10 días. Cuando se le retiró se comenzó a usar lisado plaquetario local en curaciones en días alternos. Se observó mejoría de la granulación, no así de la piel aledaña a la lesión. Posteriormente se le realizó infiltración perilesional con lisado plaquetario alogénico, con cuyo proceder mejoró el aspecto de la lesión y la cicatrización en un período de solo 7 días...
The use of allogenic platelet lysate opens another therapeutic possibility in orthopedics. Its use is presented in a 40 year-old patient with previous history of bronchial asthma and treated with steroids who, as a result a fall, suffered an extensive avulsive wound in her right foot of approximately 11 cm with skin laceration and necrosis of the torn piece, with vertex distal and proximal base that only took skin, with another torn piece of similar bodering and a diameter of approximatety 6 cm. A toilette and necrectomy of the cyanotic edge was made, mainly in the vertexes. Confrontation stitches were taken and an extreme fragility of the skin was observed when carrying this procedure. Treatment with antibiotics was started and after 48 hours necrosis of two third of the skin of the torn piece was observed which was not removed for ten days. After removal local therapy with alogenic platelet lysate was applied on alternate days. Improving of granulation was observed, but not in the surrounding skin lesion. Then, a perilessional infiltration with allogenic platelet lysate was made which improved the lesion appearance and its healing in a period of only 7 days...
Subject(s)
Humans , Adult , Female , Free Tissue Flaps/pathology , Platelet-Derived Growth Factor/therapeutic use , Necrosis/therapy , Transplantation, HomologousABSTRACT
Introdução: Retalho anterolateral da coxa (ALT) foi descrito em 1984, baseado nos vasos perfurantes da artéria circunflexa femoral lateral. Trata-se de um retalho cutâneo, localizado no terço médio da coxa anterior, e lateral aos músculos reto femoral e vasto lateral. A baixa morbidade, relacionada à área doadora, e a possibilidade de utiliza-lo com diversas dimensões o tornam um retalho muito versátil. Objetivo: Apresentar sua versatilidade no serviço de Cirurgia Plástica Reconstrutora e Microcirurgia, do Hospital Erasto Gaertner, através do relato de três casos. Casos: Foram descritos dois casos com utilização do retalho ALT para reconstrução de cabeça e pescoço, e um caso com reconstrução do hemitórax direito.
Introduction: The anterolateral thigh (ALT) flap first described in 1984 is based on perforator vessels of the lateral femoral circumflex artery. It is a cutaneous flap located in the middle third of the anterior thigh and lateral to the rectus femoris and vastus lateralis. The low morbidity related to the donor site and its usefulness for different dimensions make it a versatile flap. Objective: This study aimed to present the versatility of the ALT flap in plastic and reconstructive surgeries at the Erasto Gaertner Hospital through a report of three cases. Cases: We describe three cases in which the ALT flap was used for the head and neck, and right hemithorax reconstructions.