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Branchial Cyst 鳃裂囊肿
Pub Date : 2020-02-07 DOI: 10.32388/uoaltm
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引用次数: 0
The risks of rapid publications during the Covid-19 pandemic Covid-19大流行期间快速出版的风险
Pub Date : 2020-01-01 DOI: 10.5935/2177-1235.2020rbcp0024
D. Goldenberg
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引用次数: 0
Four-year epidemiological characterization of large burn patients at Celia Sánchez Manduley Surgical Hospital, 2015-2018 2015-2018年Celia Sánchez Manduley外科医院大面积烧伤患者的四年流行病学特征
Pub Date : 2020-01-01 DOI: 10.5935/2177-1235.2020rbcp0012
C. Hernández, V. Núñez, Roberto Frías Banqueris, S. Gil, F. Suárez, Mileydys Saborit García
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引用次数: 0
Treatment of deep second-degree burns on the abdomen, thighs, and genitalia: use of tilapia skin as a xenograft 腹部、大腿和生殖器深二度烧伤的治疗:罗非鱼皮异种移植
Pub Date : 2020-01-01 DOI: 10.5935/2177-1235.2020rbcp0040
E. Lima, M. Moraes, B. A. Costa, Alex Marques do Nascimento Uchôa, C. B. Martins, M. E. A. D. Moraes, Marina Becker Sales Rocha, F. V. Fechine
Tilapia skin has a non-infectious microbiota and a morphological structure similar to human skin. Phase II clinical studies, not yet published, have shown promising results in their use for the treatment of burns. In the protocols of these studies, patients with lesions in areas of skin folds, such as genitals and inguinal regions, were excluded, as it was thought that the biomaterial would not adhere properly, resulting in a lower degree of healing. Case report of a female patient, 18 years old, without comorbidities, with deep second-degree burns in the abdomen, inguinal region, part of the genitalia and upper half of both thighs, involving 13.5% of the total body surface area. Tilapia skin was applied to the lesions leading to a complete re-epithelialization with 16 days of treatment. No side effects were observed. Tilapia skin, therefore, brings the promise of an innovative product, easy to apply, and highly available, which can become the first animal skin nationally studied and registered by the Agência Nacional de Vigilância Sanitária, for use in the treatment of burns. This case report contributes to reduce the limitations concerning the anatomical areas appropriate for the application of tilapia skin, since, even with the need for skin replacement, good results were obtained with application to the genitalia and inguinal region. ■ ABSTRACT
罗非鱼皮肤具有非传染性微生物群和与人类皮肤相似的形态结构。尚未发表的II期临床研究已经显示出它们用于治疗烧伤的有希望的结果。在这些研究的方案中,排除了皮肤褶皱区域病变的患者,如生殖器和腹股沟区域,因为人们认为生物材料不能正确粘附,导致愈合程度较低。1例女性患者,18岁,无合并症,腹部、腹股沟区、部分生殖器及双大腿上半部深二度烧伤,烧伤面积占体表总面积的13.5%。罗非鱼皮应用于病变导致完全的再上皮化与16天的治疗。未观察到任何副作用。因此,罗非鱼皮带来了一种创新产品的希望,它易于应用,并且易于获得,可以成为Agência国家警戒局(ncia Sanitária)在全国研究和注册的第一种用于治疗烧伤的动物皮。本病例报告有助于减少罗非鱼皮适用解剖区域的局限性,因为即使需要更换皮肤,在生殖器和腹股沟区域应用罗非鱼皮也能获得良好的效果。■文摘
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引用次数: 11
Breast implant-associated anaplastic large cell lymphoma: a diagnostic challenge 乳房植入物相关间变性大细胞淋巴瘤:一个诊断挑战
Pub Date : 2020-01-01 DOI: 10.5935/2177-1235.2020rbcp0019
Ana Paula De-Azambuja, A. Groth, J. Jung, F. Gevert, S. Nabhan
O linfoma anaplásico de grandes células associado a implantes mamários (BI-ALCL) é uma entidade provisória com características morfológicas e imunofenotípicas indistinguíveis do linfoma anaplásico de grandes células ALK-negativo (ALCL), porém surge principalmente em associação com um implante mamário. A confirmação do diagnóstico pode ser difícil, e a associação da presença das células típicas na morfologia e anatomia patológica com exames de citometria de fluxo e imunohistoquímica pode auxiliar no diagnóstico. O objetivo deste estudo é descrever um caso de BI-ALCL em que a citologia e a análise da imunofenotipagem por citometria de fluxo sugeriram a presença de células grandes positivas para CD30 no fluido de efusão. ■ RESUMO
乳房植入物相关的大细胞间变性淋巴瘤(BI-ALCL)是一种暂时性的实体,具有形态学和免疫表型特征,与大细胞间变性ALK阴性淋巴瘤(ALCL)难以区分,但主要发生在乳房植入物相关。诊断的确认可能是困难的,将形态学和病理解剖中典型细胞的存在与流式细胞术和免疫组化检查相关联可能有助于诊断。本研究的目的是描述一个双alcl病例,其中细胞学和流式细胞术免疫表型分析表明在输液中存在CD30阳性的大细胞。■总结
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引用次数: 1
Histological comparison between irradiated and non-irradiated breasts in breast reconstruction 乳房再造术中放疗与未放疗乳房的组织学比较
Pub Date : 2020-01-01 DOI: 10.5935/2177-1235.2020rbcp0008
A. Benedik, Ronan Caputi Silva Dias, A. C. Campos, Carolina Castro, Marcela Caetano Cammarota, J. Daher
1 Hospital Daher Lago Sul, Brasília, DF, Brazil. Conflicts of interest: none. Introduction: The treatment of breast cancer includes not only curative therapies but also breast reconstruction. Radiotherapy, an adjuvant strategy, provides favorable outcomes by reducing the rate of recurrence of the disease. This study aimed to compare histological differences between irradiated and non-irradiated breasts in the same patient. Methods: This is a prospective cohort study of patients undergoing breast reconstruction with prosthesis or expander under pectoralis major muscle flap that compared histological skin patterns, subcutaneous cell tissue, pectoralis major muscle, and implant capsule of irradiated and non-irradiated breasts in paired samples of the same patient. All patients included in this study were irradiated in only one breast. The results of the anatomopathological analysis were compared to clinical findings and intraoperative macroscopic aspects. Results: The study included a total of 7 patients with a mean age of 52.15 years. The main histological findings in the skin and subcutaneous cellular tissue of the irradiated breast were as follows: epidermal hyperplasia, flattening of the papillary layer, atrophy of the skin appendages, vascular congestion in fatty tissue, high density of skin collagen fibers, hyalinization, and reduction of elastic fibers in the deep dermis and unidirectional alignment of collagen fibers. The main histological findings for the capsule and pectoralis major muscle in the irradiated breast were as follows: lower density of elastic fibrosis, perivascular fibrosis, synovial metaplasia, skeletal muscle sequestration at the interface with the capsule, capsular hyalinization, and capsular fribrosclerosis. Conclusion: We found common histological changes in irradiated breasts in most patients. These findings are compatible with the clinical and macroscopic changes observed. This study presents itself as a pilot for the development of further studies investigating the physiopathological mechanisms of the described histological changes. ■ ABSTRACT
1巴西南达赫尔拉戈医院,Brasília, DF。利益冲突:没有。乳腺癌的治疗不仅包括根治性治疗,还包括乳房重建。放疗是一种辅助治疗策略,通过降低疾病复发率提供了良好的结果。本研究的目的是比较同一患者接受过放疗和未接受过放疗的乳房之间的组织学差异。方法:这是一项前瞻性队列研究,研究对象是在胸大肌瓣下使用假体或扩张器进行乳房重建的患者,比较了同一患者的成对样本中辐照和未辐照乳房的组织学皮肤模式、皮下细胞组织、胸大肌和植入胶囊。本研究中所有患者仅在一个乳房进行放疗。将解剖病理分析结果与临床表现及术中肉眼观察结果进行比较。结果:共纳入7例患者,平均年龄52.15岁。辐照乳腺皮肤及皮下细胞组织的主要组织学表现为表皮增生,乳头层变平,皮肤附着物萎缩,脂肪组织血管充血,皮肤胶原纤维高密度,透明化,真皮深层弹性纤维减少,胶原纤维单向排列。在放疗后的乳房中,囊和胸大肌的主要组织学表现如下:弹性纤维化密度较低、血管周围纤维化、滑膜化生、与囊交界处骨骼肌隔离、囊透明化和囊纤维化硬化。结论:我们发现大多数患者在放疗后乳房有共同的组织学改变。这些发现与临床和肉眼观察到的变化一致。本研究为进一步研究所描述的组织学变化的生理病理机制的发展提供了一个试点。■文摘
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引用次数: 0
Use of VaserTM plus liposuction in body contouring surgery VaserTM加吸脂术在塑形手术中的应用
Pub Date : 2020-01-01 DOI: 10.5935/2177-1235.2020rbcp0028
W. Seidel, Caio Pundek Garcia
Introduction: Body contouring surgery is among the most requested surgical procedures in cosmetic surgery. Mentz was the first to perform superficial liposuction to define the abdominal muscles in male patients. However, Scuderi first popularized the use of continuous ultrasound to produce fat fragmentation in lipoplasty. Ultrasound, when applied internally to adipose tissue using a probe or metal cannula, breaks cells through three mechanisms: cavitation, thermal effect, and direct mechanical effect. Methods: Since November 2018, 50 patients with an indication for body liposuction performed the procedure with the help of the third-generation ultrasound equipment (VASER). Results: During the period between November 2018 and March 2019, 50 patients with a surgical indication underwent body contour liposuction using third-generation VASER technology. Of this universe of patients, 96% were women (47), with patients with an average age of 35 years (21-54). Conclusion: The association of VASER with liposuction is a safe and reproducible technique that has the advantage of improving the result of liposculpture. Good aesthetic results were achieved, with an athletic and more natural contour. ■ ABSTRACT
简介:人体塑形手术是整容手术中要求最多的手术之一。Mentz是第一个对男性患者进行浅表吸脂来确定腹部肌肉的医生。然而,Scuderi首先推广了连续超声在脂肪成形术中产生脂肪碎片的使用。超声,当使用探针或金属套管内部应用于脂肪组织时,通过三种机制破坏细胞:空化,热效应和直接机械效应。方法:自2018年11月起,50例有身体吸脂指征的患者在第三代超声设备(VASER)的帮助下进行了吸脂手术。结果:在2018年11月至2019年3月期间,50名有手术指征的患者使用第三代VASER技术进行了身体轮廓吸脂术。在所有患者中,96%为女性(47例),患者平均年龄为35岁(21-54岁)。结论:VASER联合吸脂术是一种安全、可重复的技术,具有提高吸脂效果的优点。达到了良好的审美效果,具有运动和更自然的轮廓。■文摘
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引用次数: 0
What is the role of plastic surgery in the health of post-bariatric patients? 整形手术对减肥后患者的健康有什么作用?
Pub Date : 2020-01-01 DOI: 10.5935/2177-1235.2020rbcp0023
J. Macedo, S. C. Rosa
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引用次数: 0
Breast reconstruction with implant: creating a pocket with a reverse serratus anterior muscle flap 假体乳房重建:用前锯肌皮瓣制造一个口袋
Pub Date : 2020-01-01 DOI: 10.5935/2177-1235.2020rbcp0009
Augusto C. Almeida, Aloisio Ferreira da Silva, Ronaldo Sapi Rossignoli, Nárlei Amarantes Pereira, Rebeca Paohwa Liu Da Fonseca, E. H. Portugal, Renato Santos de Oliveira, J. Alves
Introduction: Immediate breast reconstruction plays an important role in the treatment of breast cancer and relatively promotes patients’ emotional and physical recovery. It may be difficult to cover the entire prosthesis with a muscle flap in single-stage breast reconstructions based on a permanent implant. This study aimed to present a muscle pocket for the implant using a reverse anterior serratus muscle flap associated with submuscular dissection of the pectoralis major muscle. Methods: This was a prospective study comprising 61 patients undergoing mastectomy followed by immediate reconstruction (74 reconstructions) with implant and anterior serratus muscle reverse flap associated with submuscular pectoralis dissection between January 2017 and July 2018. In this study, age, adjuvant and neoadjuvant therapies, implant volume, length of hospital stay, follow-up, and complications, including functional deficit and reconstruction failure, were analyzed. Results: The technique described was used to operate 74 patients with a mean age of 49.2 years. The volume of the implant varied from 200 to 500 cc, and the mean follow-up time was 14.9 months. Complications such as hematoma, suture dehiscence, skin flap necrosis, and implant extrusion were observed in 14 patients (18.9%). Conclusion: In most cases, breast reconstruction with an anterior serratus muscle reverse flap associated with submuscular dissection of the pectoralis major muscle allows the complete muscle coverage of the implant, reduces the occurrence of major surgical complications, and has a good aesthetic result. ■ ABSTRACT
简介:乳房即刻重建在乳腺癌的治疗中起着重要的作用,相对促进了患者的情绪和身体的恢复。在基于永久假体的单阶段乳房重建中,用肌肉瓣覆盖整个假体可能是困难的。本研究旨在通过胸大肌肌下剥离的反向前锯肌皮瓣,为植入物提供一个肌肉袋。方法:这是一项前瞻性研究,包括61例2017年1月至2018年7月期间接受乳房切除术后立即重建(74例重建)的患者,其中植入物和前锯肌逆行皮瓣与胸肌下剥离相关。在这项研究中,我们分析了年龄、辅助和新辅助治疗、种植体体积、住院时间、随访和并发症,包括功能缺陷和重建失败。结果:应用该方法手术74例,平均年龄49.2岁。种植体体积200 ~ 500cc,平均随访14.9个月。14例(18.9%)出现血肿、缝合开裂、皮瓣坏死、种植体挤压等并发症。结论:在大多数情况下,胸大肌肌下剥离联合前锯肌逆行皮瓣重建乳房,可使植入物完全覆盖肌肉,减少主要手术并发症的发生,具有良好的美学效果。■文摘
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引用次数: 0
COVID-19: how to proceed with the practice of plastic surgery in Brazil. What do we know right now? 2019冠状病毒病:如何在巴西进行整形手术我们现在知道什么?
Pub Date : 2020-01-01 DOI: 10.5935/2177-1235.2020rbcp0046
Beatriz Lassance Brito, Cesár Isaac, Denise Piccioli Neves, P. Giavina-Bianchi
1 Hospital São Luiz Itaim, São Paulo, SP, Brazil. 2 Faculdade de Medicina do ABC, Plastic Surgery Department, São Paulo, SP, Brazil. 3 University of the São Paulo, Clinical Immunology and Allergy Division, São Paulo, SP, Brazil. Conflicts of interest: none. COVID-19 (coronavirus disease, described in 2019) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Most confirmed cases are mild or asymptomatic, but the most severe cases can progress to severe pneumonia with respiratory failure and death. In Brazil, there is a scenario of an exponential increase in cases, making it challenging to identify the source of contagion. We cannot yet specify when the peak of the COVID-19 outbreak will occur in our country or when the numbers of new contaminants and deaths will begin to decrease. So, the most important thing is protection against a virus for which all the details about contagion, transmission, and treatment are not known. The pandemic impacted and modified medical care, especially for surgical specialties, where face-to-face care is essential and cannot be replaced entirely by telemedicine. Thus, this review aimed to compile theoretical and practical aspects regarding the pandemic COVID-19 and its impact on plastic surgery activity routine. Protocols are proposed for resuming our routines, analyzing countries’ experience at an advanced stage of the pandemic. ■ ABSTRACT
1巴西圣保罗州路易斯伊塔姆医院。2巴西圣保罗州 ABC医学院整形外科。3巴西圣保罗州 大学临床免疫学与过敏科。利益冲突:没有。COVID-19(2019年描述的冠状病毒病)是由严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2)引起的传染病。大多数确诊病例为轻度或无症状,但最严重的病例可发展为严重肺炎,并伴有呼吸衰竭和死亡。在巴西,病例呈指数级增长,这使得确定传染源具有挑战性。我们还不能确定什么时候会出现COVID-19疫情的高峰,或者什么时候新的污染物和死亡人数会开始减少。所以,最重要的是预防一种关于感染、传播和治疗的所有细节都不知道的病毒。大流行影响并改变了医疗保健,特别是外科专科,在这些专科,面对面护理至关重要,不能完全被远程医疗所取代。因此,本综述旨在收集有关COVID-19大流行及其对整形手术活动常规影响的理论和实践方面的信息。提出了恢复我们日常工作的议定书,分析了各国在大流行晚期的经验。■文摘
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引用次数: 3
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Revista brasileira de cirurgia
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