Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Fístula Cutânea/tratamento farmacológico , Fístula/tratamento farmacológico , Doenças Parotídeas/tratamento farmacológico , Glândula Parótida/patologia , Idoso , Biópsia/efeitos adversos , Fístula Cutânea/etiologia , Feminino , Fístula/etiologia , Humanos , Doenças Parotídeas/etiologia , Fotografação , Sialorreia/tratamento farmacológico , Sialorreia/etiologiaRESUMO
Delayed flaps include surgical techniques performed in order to diminish the blood supply of a flap before placing it at the definitive location. The purpose is to improve the irrigation of the distal region of the flap. Three cases of head and neck reconstructions with delayed deltopectoral flaps are reported. Literature about anatomic and physiologic phenomenon occurred during the delay period is reviewed, as well as the different surgical techniques described to delay a flap. We think that the deltopectoral flap remains an adequate technique, being indicated when the reconstruction is impossible with local flaps. That is the case of defects or irradiated regions. In our opinion, if the deltoid region of the flap is necessary to the reconstruction it is recommended to delay the flap, to increase the probability of complete survival at the distal region. In our cases the delay period has been one week, obtaining a complete survival of the flap in all of them.
Assuntos
Carcinoma/terapia , Neoplasias Labiais/terapia , Músculo Esquelético/transplante , Retalhos Cirúrgicos , Idoso , Braquiterapia/métodos , Carcinoma/cirurgia , Terapia Combinada , Humanos , Neoplasias Labiais/cirurgia , Masculino , Procedimentos de Cirurgia Plástica/métodos , Fatores de TempoRESUMO
Repeated treatments on the neck in head and neck oncological patients make more and more difficult to elaborate microvascularized flaps because sometimes it is necessary to sacrifice receptor veins. In this paper it is showed one way of solving this problem, by dissection of the cephalic vein towards the deltoid region, keeping the venous pedicle intact. In this fashion venous anastomosis is avoided, getting efficient blood drainage. Simplicity and efficiency of this technique make possible thinking about it even with existing receptors veins. The main inconvenience is the surgical scare on the anterior region of the arm.