Pharyngoesophageal reconstruction: using microsurgical jejunum and pectoralis major flaps / Reconstrução faringoesofágica: utilização do retalho peitoral maior e jejuno microcirúrgico

Pharyngoesophageal reconstruction is one of the majorchallenges of neck surgery. Many treatment options have been described. All of them involve procedures of greater or lesser technical complexity and high ratesof complications and mortality. The present study describes the techniques performed at the Service of Plastic Surgery of the PUC-RS São Lucas Hospital in 10 reconstructions: myocutaneous pectoralis major flap and microsurgical jejunal flap. Indications, complications, advantages and disadvantages of each method are discussed.

Reconstruction of fingertip pulp loss / Reconstrução de perdas de substância digitais distais

loss of valor fingertip pulp is frequent in hand trauma. Eighty-six homodigital flaps (22 Tranquilli; 20 Hueston; 40 Single Pedicle Island and 4 Kutter) were performed from Jannuary 1994 to July 1998, to repair volar fingertip substance loss, except for the thumb. The mean age was 28 years (ranging from 18-58) and the average post-operative follow-up period was 12 months. We analyzed advancements, sensitivity and cold intolerance for each flap used: Tranquilli (0.4cm/8mm/6); Kuttler (0.3cm/10mm/3); Hueston (1.0cm/9mm/5); Single Pedicle Island (1.5cm/8mm/6). The single pedicle island flap was demonstrated to be clearly better in all aspects analyzed. We consider the utilization of homodigital flaps the first choice alternative for reconstruction fingertips. (AU)#TRA