Revista brasileira de cirurgia最新文献

{"title":"Comparison of surgical techniques for prominent ear correction: Mustardé versus\u0000 Converse","authors":"M. F. M. B. Lima, Pablo Maricevich, K. Kawamura, Priscila da Silva Lopes, A. Freire, Rafael Anlicoara","doi":"10.5935/2177-1235.2020rbcp0027","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0027","url":null,"abstract":"Introduction: prominent ears, popularly called “flappy ears,” represent the most common congenital deformity of the external ear, affecting approximately 5% of the population. Methods: Primary, prospective and intervention study comparing the results of patients undergoing the surgical procedure to correct prominent ears using the Converse and the Mustardé techniques, performed at the Plastic Surgery Service of the Hospital das Clínicas, Federal University of Pernambuco (HC) -UFPE). Results: Twenty patients were evaluated, 10 with the Converse technique, and 10 with the Mustardé technique, from June 2016 to December 2017. Both groups showed a decrease in auricular mastoid distances at the end of the observation period, ranging from 6.67 to 14.6 mm, depending on the surgical technique and the evaluation point, but without statistical significance. Regarding the average auricular mastoid distances at the end of the observation period, a difference of a maximum of 6.3 mm was observed between the evaluated groups, but without statistical significance. Regarding the symmetry of the ears within the same group, the maximum mean level of asymmetry in the Mustardé and Converse groups was 0.9 mm and 0.5 mm, respectively. However, the percentage of loss of correction of the measures obtained surgically during the observation period in both groups ranged between 15 and 19%, without statistical significance. Regarding complications, there was 1 (10%) case of hematoma in the Mustardé group. Conclusion: Converse and Mustardé techniques did not show statistical differences in the results. ■ ABSTRACT","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"35 1","pages":"154-160"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71174302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microneedling: a review","authors":"Adriana Da Silva Ferreira, D. Aita, Meire Aparecida Muneratto","doi":"10.5935/2177-1235.2020rbcp0037","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0037","url":null,"abstract":"1 Universidade de Ribeirão Preto, Pós-Graduação Fisioterapia Dermatofuncional, Ribeirão Preto, SP, Brazil. Conflicts of interest: none. Introduction: Microneedling, also called percutaneous collagen induction therapy (PCIT), is a technique applied with an equipment called roller. It is suitable for rejuvenation, alopecia, all types of scars, acne, photo rejuvenation, stretch marks, skin flaccidity, melasma, expression wrinkles, and improvement of the general aspect of the skin. Objective: Perform a literature review to identify the major clinical applications of microneedling. Methods: The research was done from 2009 to 2018, in electronic databases PubMed and Scielo. The studies recovered were described and analyzed. Results: We selected 12 articles and two books for their relevant content. Conclusion: Microneedling is a simple technique, an innovative treatment that has been used for different dermatological pathologies. This method acts by naturally stimulating collagen by responding to the inflammatory process and also by activating the transdermal ingredient access system (TIAS), known as Drug Delivery. ■ ABSTRACT","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71174381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trochanteric dermolipectomy in a patient after bariatric surgery: case\u0000 report","authors":"M. Fernandes, O. Saldanha, Renato Giannini, C. Montoya, Beatriz Yaedu, Rodrigo Inácio Fernandes, V. Moretto","doi":"10.5935/2177-1235.2020rbcp0041","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0041","url":null,"abstract":"","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"35 1","pages":"249-253"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71174937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper Pedicle Breast Flap","authors":"A. R. Bozola, Alexandre Caroni Bozola","doi":"10.5935/2177-1235.2020rbcp0014","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0014","url":null,"abstract":"Introduction: Here we propose a tactic to fill the upper poles of breasts that are emptied by ptosis in primary and secondary cases to obtain anatomically beautiful breasts with sufficient breast volume. Objective: To describe breast tissue flaps used to fill the upper breast pole when there is adequate or surplus volume. Methods: In primary or secondary cases, if the measurement from point A to the submammary fold is long and that to the upper glandular ridge is short, one obtains from the difference between them a flap with an upper pedicle, termed a “book leaf,” and sutured at the upper mammary pole. Glandular detachment preserves the skin’s thickness with subcutaneous tissue in all maneuvers similar to the adjacent thorax according to the mammary gland’s vascular anatomy, which is irrigated and innervated from the subcutaneous tissue to the gland. Results: The six patients presented no complications related to flap irrigation. Adequate mammary shape and volume were achieved by inverting measurements between the lower and upper poles. Discussion: Here we proposed an innovative manner to fill the upper pole of the breast with a breast upper pedicle flap. A larger number of cases should be analyzed in the long term. Conclusion: The flap is used to fill the upper pole of the breast when the largest volume is in the lower pole. ■ ABSTRACT","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"35 1","pages":"88-93"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71174326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstructive surgery in the context of Covid-19: complications in the treatment of an inguinal complex wound","authors":"Da Silveira, Vinícius Gomes, Coltro, P. Soler, Gonçalves, H. Coraspe, Hohl, Diogo Hummel, Silva, Gabriel Maziero Alves, Farina-Junior, Jayme Adriano","doi":"10.5935/2177-1235.2020rbcp0044","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0044","url":null,"abstract":"Introducao: No final de 2019, o mundo viu surgir uma nova sindrome respiratoria denominada Covid-19, causada por um novo tipo de coronavirus, o Sars-CoV-2 Classificada como uma pandemia, ela tem causado impactos de magnitude ainda imensuraveis Relato de caso: Homem de 57 anos desenvolveu ferida inguinal direita, apos exploracao cirurgica por infeccao de protese usada em bypass femoro-popliteo A equipe de cirurgia plastica optou pelo tratamento com desbridamento cirurgico, associado com terapia por pressao negativa para preparo do leito da ferida No pos-operatorio, apresentou sindrome respiratoria aguda grave e suspeita de Covid-19, com necessidade de intubacao e de cuidados intensivos Foi colhido amostra para RT-PCR do Sars-CoV-2 e associado ao tratamento as medicacoes cloroquina e azitromicina Apesar do tratamento intensivo, o paciente foi a obito O resultado do exame RT-PCR para o novo coronavirus foi positivo, sendo liberado dois dias apos a morte Discussao: A analise deste relato permite supor que o paciente provavelmente contraiu o novo coronavirus dentro do proprio hospital, pois o mesmo encontrava-se internado pelo periodo dos 35 dias anteriores a evolucao para insuficiencia respiratoria Esse fato, juntamente com sua evolucao desfavoravel, corrobora a orientacao de minimizar ao maximo as internacoes e os procedimentos cirurgicos a fim de promover maior seguranca ao paciente e a equipe de saude Conclusao: Pacientes internados estao susceptiveis a infeccao pelo novo coronavirus e podem configurar grupo de maior de risco, uma vez que muitos deles ja se encontram debilitados Introduction: At the end of 2019, the world saw the emergence of a new respiratory syndrome called Covid-19, caused by a new type of coronavirus, Sars-CoV-2 Classified as a pandemic, it has caused impacts of considerable magnitude Case Report: A 57-year-old man developed a right inguinal wound after surgical exploration for infection of a prosthesis used in a femur-popliteal bypass The Plastic Surgery team opted for treatment with surgical debridement associated with negative pressure therapy to prepare the wound bed In the postoperative period, he had severe acute respiratory syndrome and suspected Covid-19, requiring intubation and intensive care A sample for RT-PCR of Sars-CoV-2 was collected, and the medications chloroquine and azithromycin were associated with the treatment Despite intensive treatment, the patient died The result of the RT-PCR test for the new coronavirus was positive, being released two days after death Discussion: The analysis of this report allows us to suppose that the patient probably contracted the new coronavirus at the hospital, as he was hospitalized for 35 days before the evolution of respiratory failure This fact, together with its unfavorable evolution, corroborates the orientation of minimizing hospitalizations and surgical procedures as much as possible to promote more safety for the patient and the health team Conclusion: Inpatients are","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"35 1","pages":"353-357"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71174806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of nasal defects using the Rieger flap","authors":"Filipe Lopes Decusati, A. Rinaldi","doi":"10.5935/2177-1235.2020rbcp0026","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0026","url":null,"abstract":"Introduction: the reconstruction of skin defects in the distal part of the nose is always a challenge. The dorsal nasal flap, initially described by Gillies, was unveiled when Rieger, in 1967, described the use of a modified rotation flap that used the redundant skin of the glabella to repair full-thickness defects of the lower half of the nose of equal or greater size of 2 cm, allowing reconstruction in a single surgical time. Methods: A retrospective study was carried out, selecting patients who had basal cell carcinoma, in the middle and/or lower third of the nose, who were treated at the Plastic Surgery outpatient clinic of the Plastic Surgery Service Prof. Dr. Oswaldo de Castro, in the period from 2017 to 2019. Results: The total number of patients was six, with ages ranging from 64 to 95 years, with an average of 80.67 years. Five of these patients were male, with only one female. There were no complications during or after the procedures. Also, there were no cases of infection, bleeding, hematoma, dehiscence, or necrosis of the flap. Conclusion: the Rieger flap is a good option for cases of reconstruction of defects located in the lower half of the nose; it is performed in a single moment, is easy to perform, and has a high level of patient satisfaction. It provides an adequate result aesthetics of the reconstructed area, in texture and color, through the use of specific tissues for the nasal covering. ■ ABSTRACT","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"35 1","pages":"149-153"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71174011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of trichloroacetic acid for closure of lesion by extensors in lobules of\u0000 ears","authors":"Juliana Gulelmo Staut, Diego Ovalle Torres, J. R. Pereira, André Coewlho Nepomuceno, Carina Padua, Fernando Giovanetti Morano, R. Gimenez","doi":"10.5935/2177-1235.2020rbcp0034","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0034","url":null,"abstract":"Introdução: O uso de alargadores de lóbulos de orelhas provoca um defeito circular cujo fechamento se torna um desafio para o cirurgião plástico. Existem múltiplas técnicas com mobilização de retalhos locais na tentativa de promover o fechamento e devolver o formato natural do lóbulo. Nossa proposta é apresentar o ácido tricloroacético (ATA) como alternativa para a correção dessas lesões. Métodos: Foram selecionados um total de 5 pacientes com lesões por alargadores nos lóbulos das orelhas e utilizado ATA 90% para o fechamento dos defeitos. Resultados: Após a aplicação do produto, observouse uma hiperemia ao redor da área onde foi aplicado o ácido nos primeiros dias, a área de frosting foi substituída por uma crosta, que foi se soltando com o passar dos dias, concomitante a redução do diâmetro da lesão com fechamento progressivo do defeito. Conclusão: Apesar de mais estudos serem necessários, a utilização de ATA 90% se mostrou uma opção simples e eficaz para o fechamento de lóbulos de orelhas alargados. ■ RESUMO","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"35 1","pages":"203-205"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71174365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peculiarities of cutaneous angiosarcoma","authors":"Sinval Soares Cruvinel, Victor Parreira Bizinoto, Nádia Cristine Nunes Côrtes, Alexandre Macedo, D. Pereira, Antônio Ricardo Duarte","doi":"10.5935/2177-1235.2020rbcp0021","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0021","url":null,"abstract":"Cutaneous angiosarcoma is a rare soft tissue sarcoma with a poor prognosis and an incidence of approximately 2.0%. This entity manifests as bruises, violaceous nodules and plaques, and diffuse hemorrhagic lesions with infiltrative growth. Here we report a case of an 80-year-old Caucasian man who presented with a nodular, hard, and dark lesion present in the upper third of the right ear for more than 1 year. The treatment of cutaneous angiosarcoma is multidisciplinary, including surgery alone or combined with radiotherapy for early lesions and chemotherapy for disseminated lesions. Cutaneous sarcomas are rare, and their appropriate treatment and follow-up are critical. ■ ABSTRACT","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"35 1","pages":"129-132"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71174394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fistula after primary palatoplasty: consensus among plastic surgery and\u0000 Speech-Language Pathology","authors":"Mahyara Francini Jacob, Gabriela Aparecida Prearo, Telma Vidotto de Sousa Brosco, H. L. D. Silva, J. Dutka","doi":"10.5935/2177-1235.2020rbcp0025","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0025","url":null,"abstract":"Introduction: The identification of complications of primary palatoplasty may vary among professionals from different areas of health due to the lack of standardization of the fistula classification. This study aimed to verify the consensus among professionals of plastic surgery (PC) and Speech-Language Pathology (SLP), regarding the occurrence of fistula, according to what was reported in the same craniofacial service. Methods: Analysis of the chart’s records of the areas of the PC and SLP of 466 patients with cleft lip and palate was performed about the presence and location of fistula about the presence and location of fistulas, as reported in 466 medical records of patients with a history of unilateral cleft lip and palate. To compare the findings between both areas, a gold standard classification for the occurrence of fistula (GSF) was established by an experienced plastic surgeon. Results: The PC area reported that 25% of the 466 patients had a fistula compared to the 37% reported by the SLP, while the GSF indicated fistula in 35% of the cases. The Kappa statistic reveals regular agreement between GSF and PC (r = 0.32) and substantial agreement between GSF and SLP (r = 0.63). Conclusion: There was a discrepancy between the areas of Speech-Language Pathology and plastic surgery regarding the occurrence and location of the fistula after primary palatoplasty in the same craniofacial center. The data indicates the need to create and implement a standardized fistula classification system. In this way, craniofacial teams can use it effectively, taking advantage of the scientific evidence that emerges from the results of cleft lip and palate treatment. ■ ABSTRACT","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"35 1","pages":"142-148"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71173996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified reduction mammoplasty for optimization of oncological approach: initial\u0000 results and literature review","authors":"G. D’Alessandro, Alejandro Povedano, F. Takeuchi, Natalia Lima e Silva Crema, J. Góes","doi":"10.5935/2177-1235.2020rbcp0029","DOIUrl":"https://doi.org/10.5935/2177-1235.2020rbcp0029","url":null,"abstract":"Introduction: Breast cancer is the second most common cancer among women. Constant scientific evolution has allowed increasingly less invasive surgical approaches, reducing treatment-related morbidity without cancer damage. The objective of this article is to show the surgical results and the versatility of reduction mammoplasty with the modified Pitanguy technique to optimize the immediate reconstruction associated with cancer surgery. Methods: We present the cases of three patients who underwent the proposed technique. Marking of the breast diagnosed with cancer is planned following the principles of reduction mammoplasty described by Pitanguy. However, the inferolateral resection triangle is transposed into the supratumoral area. It can be placed from the junction of the lateral quadrants (JLQ) to the superolateral quadrant (SLQ) of the oncological breast. Results: the three patients underwent the described technique associated with contralateral symmetrization mammoplasty with the Pitanguy technique. All were submitted to adjuvant radiation therapy, associated or not with chemotherapy. Two patients progressed without incident and one had a small necrosis of 1x1 cm at the flaps lower junction in the breast with cancer, which was treated conservatively without delaying the adjuvant treatment. All were satisfied with the aesthetic result. Conclusion: The described technique proved to be a good alternative for tumors located between the JLQ and the SLQ of the oncological breast. It provides broader resections and thus expands the indication for conservative surgery and reduces the need for radical surgery, with better aesthetic results without impairment of the cancer outcome ■ ABSTRACT","PeriodicalId":79099,"journal":{"name":"Revista brasileira de cirurgia","volume":"2623 1","pages":"168-174"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71174350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}