Pedro Coltro

To present the clinical-surgical three year-experience related to body contour surgery in the massive weight loss patient, performed by the Plastic Surgery team of the Sapopemba State Hospital. Retrospective study performed at the Sapopemba State Hospital, linked to the 'Hospital das Clínicas' of the University of São Paulo School of Medicine, from July 2005 to July 2008. A total of 98 patients was operated, whose morbid obesity had been treated by bariatric surgery, after success of the technique, or weight loss by non-surgical method. Exclusion criteria were smoking, gestational intent and weight instability. Stable weight for at least 6 months after satisfactory weight loss was required from patients. Of the 98 operated patients, 97% were female, with mean age of 40.5 years and the weight loss method was the surgery in 88% of cases. From 177 plastic surgeries performed, 46% were abdominoplasty, followed by mammaplasty (15%), thigh suspension (13%) and brachioplasty (12%)....

This study aims to compare the major anatomical aspects among anterolateral thigh, parascapular and lateral arm flaps. Sixty flaps were dissected in 20 human cadavers, comparing their vascular pedicle length, flap thickness and arterial/venous pedicle diameters. The vascular pedicle length (from the origin of the vascular pedicle to its entry into the skin flap) of anterolateral thigh flap (13.43 ± 3.92 cm, lateral circumflex femoral artery) was longer than parascapular (9.07 ± 1.20 cm, circumflex scapular artery) and lateral arm flap (8.90 ± 1.65 cm, posterior collateral radial artery) (P < 0.001). The thickness of lateral arm flap (6.32 ± 2.33 mm) was lesser than parascapular (8.59 ± 2.93 mm) and anterolateral thigh flap (9.30 ± 3.54 mm) (P < 0.001). The arterial/venous pedicle diameters of lateral arm flap (2.37 ± 0.69 mm / 2.61 ± 0.74 mm) were lesser than parascapular (3.46 ± 0.80 mm / 4.07 ± 0.87 mm) and anterolateral thigh flap (3.26 ± 0.74 mm / 3.87 ± 0.70 mm) (P < 0.001). The vascular pedicle length of anterolateral thigh flap was the longest and that lateral arm flap presented a pedicle with the smallest arterial and venous diameters, in addition to being the thinnest flap. © 2014 Wiley Periodicals, Inc. Microsurgery, 2014.

... Quanto ao estado civil, 60% dos pacientes eram casados e 30% solteiros. O método de tratamento de obesidade foi cirúrgico em 86 pacientes e não-cirúrgico em 12 deles. ... Hurwitz DJ,Agha-Mohammadi S. Postbariatric surgery breast reshaping: the spiral flap. Ann Plast Surg. ...

In oncological perineal reconstructions, the internal pudendal artery perforator (IPAP) flap is our flap of choice, supplied by perforator vessels from the internal pudendal artery and innervated by branches from the pudendal nerve and the posterior femoral cutaneous nerve. Data related to the evaluation of its cutaneous sensibility are scarce, discrepant, and subject to methodological criticism. The objective of this study was to evaluate the cutaneous sensibility of the IPAP flap 12 months after perineal reconstruction and compare it with the preoperative cutaneous sensibility of the gluteal fold (flap donor area). A prospective study of 25 patients undergoing abdominoperineal excision of rectum (APER) and reconstruction with bilateral VY advancement IPAP flap was conducted. The tactile, pain, thermal, and vibration sensibilities were analyzed in four areas of the gluteal fold preoperatively and in the four corresponding areas of the flap 12 months after surgery. Tactile sensibili...

Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP). MÉTODO: Em um período de 4 anos (2006 a 2009), foi realizada análise retrospectiva dos pacientes com feridas complexas atendidos pela Cirurgia Plástica no HC-FMUSP, pelas ...

PURPOSE: development of a new experimental model of endometriosis induction in rabbits evaluating its temporal evolution both macro-and microscopically. METHODS: thirty female rabbits were submitted to endometriosis induction through the fixation of a piece of the left ...

Hidradenitis suppurativa is a chronic, recurrent inflammatory disease of the skin characterized by abscesses and scars. The axillary region is predominantly affected, leading to limited mobility of the arm due to scar retraction. This prospective study aimed to analyze the surgical treatment of severe lesions of axillary hidradenitis suppurativa by using the thoracodorsal artery perforator flap while focusing on the preservation of arm abduction. We enrolled 12 patients with severe axillary hidradenitis suppurativa who underwent bilateral surgical treatment of their lesions by radical excision, followed by immediate reconstruction with the thoracodorsal artery perforator flap. The amplitude of arm abduction was measured preoperatively and 6 months postoperatively by goniometry, and statistical analysis was performed using Student's t test. Preoperative and 6-month postoperative mean amplitude of arm abduction were 98.7 degrees and 152.7 degrees, respectively, with a significant mean increase of 54 degrees (p<0.0001). The thoracodorsal artery perforator flap can be used as a good option for axillary reconstruction after radical excision of severe lesions of hidradenitis suppurativa, and its use would allow a significant increase in the amplitude of arm abduction. It has several other advantages when compared with other types of coverage, including its anatomical proximity to the axilla, similar thickness, and high-quality skin. Therapeutic, V.

This study aims to analyze the use of autogenic auricular cartilage grafts as weight for the upper eyelid in conjunction with lateral canthopexy for patients with mild paralytic lagophthalmos. This procedure was also accompanied by elevation of the lower eyelid using the cartilage graft for moderate cases. We conducted a retrospective study including case series of 30 patients with paralytic lagophthalmos from 1997 to 2010. For mild cases, cartilage from the auricular scapha was placed in pretarsal space of the upper eyelid and cartilage from the concha was inserted in preaponeurotic space and then sutured to the levator aponeurosis in conjunction with lateral canthopexy. For moderate cases, lower eyelid was also elevated by suturing cartilage graft to tarsum and resting it by the inferior orbital rim. All patients had some degree of keratopathy before the intervention. After treatment, they presented with evident clinical improvement, reduction of eye symptoms, and resolution of keratopathy. During the mean postoperative follow-up of 37.3 months, none of the patients presented with cartilage graft exposition, reabsorption, visibility, infection, or warping. Complete eye closure was achieved in 24 (80%) patients, whereas the remaining 6 (20%) patients had residual asymptomatic lagophthalmos. The intervention using autogenic auricular cartilage grafts explained in this study was only effective for the treatment of mild and moderate cases of paralytic lagophthalmos. This outpatient surgery is associated with low morbidity and achievement of functional and aesthetic improvement.

Changes in skin sensibility occur in various postoperative plastic surgeries, especially when they involve major skin and subcutaneous dissection. There were no studies so far that objectively compared changes of ear sensibility. This prospective study was conducted to compare ear sensibility before and after otoplasty. Patients with prominent ears (n = 15) underwent bilateral otoplasty. Ear tactile sensibility was tested preoperatively and 6 and 12 months after surgery by Pressure Specified Sensory Device, an apparatus that quantifies cutaneous pressure sensation (g/mm(2)). Comparison between preoperative and 6-months postoperative results indicated an increment on mean skin pressure thresholds; however, mean thresholds between pre- and 12 months postoperative period were similar. Vibratory and hot/cold sensibility did not present any difference during this period. This is the first comparative assessment of ear tactile sensibility using quantitative methods. After otoplasty, initially there was reduction in an ear tactile sensibility, followed by a return to levels similar to preoperative sensibility.