Reconstrucción de partes blandas de la planta del pie: retrospective analysis of 12 patients / Soft tissue reconstruction of the sole: retrospective analysis of 12 patients

Background: An adequate reconstruction of foot soft tissue, specially in the sole, is crucial to restore functional capacity. Aim: To report the experience with reconstruction of sole soft tissues. Material and Methods: Retrospective analysis of 12 patients aged 19 to 72 years (seven males), subjected to reconstruction of soft tissue defects in the sole. Results: The lesions were secondary to excisions of malignant melanomas in seven patients, old traumatisms in two patients, a burn lesion in one patient and a diabetic ulcer in one patient. The reconstruction techniques used were skin grafts in one patient, local flaps in eight and free flaps in three patients. Five patients experienced complications and one of these required a new reconstructive surgery. Functional recovery was adequate in 11 patients. Conclusions: Reconstructive surgery of the sole can achieve an adequate functional recovery in most operated patients.

Se presenta una casuística de 12 pacientes que requirieron reconstrucción de la planta del pie en el Hospital de la Universidad Católica entre los años 2005 y 2008. La etiología principal fueron lesiones tumorales en 7 casos; las técnicas de reconstrucción fueron: injerto de piel (1 paciente), colgajos locales (8 pacientes) y colgajos libres (3 pacientes). Hubo complicaciones en 5 pacientes, uno de los cuales requirió una nueva cirugía reconstructiva. La recuperación funcional fue adecuada en 11 de los 12 pacientes.

Salvataje de extremidad inferior en diabéticos: trasplante muscular microquirúrgico con y sin reconstrucción vascular previa / Salvage of low extremity in diabetics: microsurgical muscular transplantation with and without previous vascular reconstruction

Soft tissue wounds with or without bony involvement are a common problem and a cause of limb loss in diabetics. Usually local care, antibiotics, minor debridement and skin grafting are enough for successful handling of these lesions. When there proximal bony involvement and tendom exposure, the incidence of primary amputation rises, frequently being considered the only alternative. Two cases of diabetic patients with indication of primary amputation of a lower limb for large infected ulcers are reported. A microvascularized muscle transplant wa sused to cover large defects of soft tissue, tendoms and infected bone. One patient presented also critical ischaemia of the limb, requiring iliac angioplasty and a femoro-distal by-pass with in situ greater saphenous vein previous to the muscle graft. Both patients had no postoperative complications, being able to walk two months after the operation with their useful limb. Microvascularized muscle transplant with or without revascularization is a very useful alternative to amputation in the management of complex wounds of selected diabetic patients

Reconstrucción de defectos complejos del párpado inferior y zonas adyacentes mediante colgajo de rotación de la mejilla / Reconstruction of complex inferior eyelid defects and adjacent zones by cheek rotation graft

Los defectos totales o parciales del párpado inferior plantean una problemática compleja debido a las características especiales del defecto. Se usa colgajo de rotación de la mejilla en 32 casos clínicos, en defectos causados por neoplasia o trauma. Se discute la técnica quirúrgica y complicaciones. Se concluye que el colgajo de rotación de la mejilla es una excelente alternativa para cubrir estos defectos