ABSTRACT
Numerous suture techniques and covering flaps have been described to minimize complications related to sutures in otoplasty. The split postauricular fascial flap is one of such techniques, and it has been used to pad otoplasty suture. The aim of this study was to evaluate complications related to nonabsorbable cartilage sutures in otoplasty, using a variation of the split postauricular fascial flap. In this retrospective case series, we analyzed otoplasty patients in whom simplified split postauricular fascial flap was utilized. A postauricular skin ellipse was de-epithelialized (preserving dermis) and a longitudinally split in half. Flaps were dissected, and they were positioned on the cartilage to promote additional soft tissue coverage to the sutures. The lateral flap covered conchoscaphal sutures while the medial flap covered the conchomastoid sutures. Both the flaps were not sutured to cartilage. Early and late postoperative complications were evaluated. A total of 142 patients were included. Twenty-four (16.9%) patients developed late complications: 13 (9.1%) patients had palpable and visible sutures, nine (6.3%) had suture extrusion and two (1.4%) had hypertrophic scars. In this case series, the simplified split postauricular flap did not prevent or reduce late complications related to suture extrusion in otoplasty. It is possible that suturing the entire length of the flaps may play a role in our results. So, anchoring the flap and possibly tightening it a little may be an important technical step to prevent extrusion of sutures whenever the postauricular flap is used.
Subject(s)
Ear Auricle/surgery , Otologic Surgical Procedures/methods , Postoperative Complications/prevention & control , Surgical Flaps , Suture Techniques , Adolescent , Adult , Child , Female , Humans , Male , Otologic Surgical Procedures/adverse effects , Plastic Surgery Procedures/adverse effects , Plastic Surgery Procedures/methods , Retrospective Studies , Young AdultABSTRACT
Os autores propõem alterações na técnica empregada nas dermolipectomias abdominais após cirurgia bariátrica, com o intuito de corrigir imperfeições nos resultados obtidos com a padronização clássica (i.e. ressecção de pele em bloco com manutenção da cicatriz umbilical). Método: Sessenta e sete pacientes ex-obesos foram submetidos à dermolipectomia abdominal em âncora com ressecção parcelada de pele (primeiro o fuso vertical e após o excesso horizontal), confecção de neoumbigo e dermolipectomia pubiana associada. Resultados: A nova padronização adotada permitiu reduzir as insatisfações previamente observadas, com melhor posicionamento da cicatriz horizontal e menor tensão na intersecção das cicatrizes. Conclusão: A nova sistematização facilitou a marcação pré-operatóriae permitiu refinar alguns aspectos que se mostravam insatisfatórios na experiência com estes casos.
The authors propose changes in the post-bariatric abdominoplasty technique to address some imperfections (tension on the T-junction, poor placement of the horizontal scar and unaesthetic umbilical scar) seen with the classic standardization (e.g. en-bloc skin resection and maintenance of the umbilicus). Methods: Assessment was realized on 67 patients who had previously been submitted to bariatric surgery and undergone modified vertical abdominoplasty with staged skin resection (first the vertical component and then the horizontal one), neo-onphaloplasty and dermolipectomy of the pubic area. Results: The new standardization led to reduction on the previous described down sides of the technique(better scar positioning and less tension). Conclusions: The new systematization provided an easier pre-operatory marking and improved aesthetic results.
Subject(s)
Humans , Adult , Abdomen/surgery , Bariatric Surgery , Gastroplasty , Intraoperative Complications , Lipectomy , Obesity, Morbid , Surgical Procedures, Operative , Diagnostic Techniques and Procedures , Methods , PatientsABSTRACT
Pacientes com graves sequelas de queimadura facial são um desafio à cirurgia plástica reparadora, principalmente porque as áreas doadoras estão frequentemente comprometidas e os resultados em sua maioria são limitados. O presente trabalho tem como objetivo apresentar o caso de um paciente submetido à reconstrução complexa nasal e cervical, com melhora significativa do contorno facial e da qualidade de vida do paciente.
Patients with severe facial burn sequelae are a challenge to reconstructive surgery mostly because donor areas are frequently compromised and results are often limited. This study presents a case of a patient that underwent a complex nasal and cervical reconstruction, with significant improvement of facial contour and quality of life of the patient
