Reconstrução microcirúrgica de deformidades cervicais pós queimadura com o retalho anterolateral da coxa / Microsurgical reconstruction of post burn neck deformities with free anterolateral thogh flap

RESUMO

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.

ABSTRACT

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).