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Id: biblio-975764
Autor: Alarcón-Arratia, Ana; Muñoz-Repetto, Maximiliano; Moreno-Fluxá, Begoña.
Título: Injerto de Piel en Territorio Oral: Presentación de un Caso / Skin Graft in Oral Cavity. Case Report
Fonte: Int. j. odontostomatol. (Print);12(4):401-406, dic. 2018. tab, graf.
Idioma: es.
Resumo: RESUMEN: Los injertos de piel consisten en la toma de un segmento de epidermis y dermis logrando una separación completa del sitio dador y del aporte vascular, transfiriéndolos a un sitio receptor. Existen dos tipos de injertos de piel: de espesor parcial y de espesor total. En cavidad oral se utilizan en reconstrucción de lengua, piso de boca, mucosa bucal y defectos producto de maxilectomías. Se presenta el caso de un paciente sexo masculino 26 años que acudió por secuela de tejidos duros y blandos secundarios a trauma facial hace 7 años. Al examen se observó pérdida de fondo de vestíbulo en sector mandibular anteroinferior y pérdida de piezas anteroinferiores. Bajo anestesia general, se realizó vestibuloplastía más injerto de piel de espesor parcial abordando el antebrazo izquierdo de donde se tomó el injerto de piel con el dermatomo. Se llevó el injerto a boca posicionándolo con la dermis hacia la zona cruenta del sitio receptor, cubriendo la cara interna de labio denudada y fijándolo con sutura continua. Se instaló splint de acrílico en el área para mantener colgajos en posición fijándolo con 3 tornillos de 15 mm. Debemos considerar todos los requisitos funcionales de la cavidad oral al momento de planificar una reconstrucción. El injerto de piel de espesor parcial permite tener una buena resistencia, movilidad adecuada y menor contracción por cicatrización. El paciente evoluciona de manera satisfactoria con una clara mejoría en la función labial, en la morfología del vestíbulo oral y en su estética.

ABSTRACT: Skin grafts consist in taking a segment of dermis and epidermis, achieving a complete separation of the donor site and vascular supply, and transferring them to a receptor site. There are two types of skin grafts: split-thickness and full-thickness. In the oral cavity, they are used in tongue reconstruction, oral mucosa reconstruction, floor of mouth reconstruction and in defects product of maxillectomies. We present a case of a 26-year-old male patient who presented sequelae of hard and soft tissues secondary to facial trauma. Clinical examination showed a compromised vestibule and loss of anterior mandibular teeth. Under general anesthesia, soft tissue management consisting of vestibuloplasty and a split-thickness skin graft was performed. The skin graft was taken from the forearm with a dermatome. The graft was then taken to the mouth with the dermis towards the wounded area of the recipient site, covering the inner face of the denuded lip and fixing it with sutures. An acrylic splint was installed in the area to keep the flaps and skin graft in position, fixing it with three 15 mm screws. We must consider all functional requirements of the oral cavity when planning a reconstruction. The split-thickness skin graft allows for good resistance, adequate mobility and less contraction due to scars. The patient evolves with definite improvement in labial function, the morphology of the oral vestibule and in its aesthetic.
Descritores: Cicatrização/fisiologia
Transplante de Pele/métodos
-Vestibuloplastia/métodos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Limites: Humanos
Masculino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-957889
Autor: Brosut, Oscar; Wenger, Matas; Eticheverry, Mariano G; Bonsembiante, Nicolás; Pierini, Ángel L.
Título: Biopsia de ganglio centinela por melanoma en territorio de linfadenectomía previa / Sentinel node biopsy for melanoma in the territory of prior lymphadenectomy
Fonte: Rev. argent. cir;108(4):1-10, dic. 2016. ilus.
Idioma: es.
Descritores: Biópsia de Linfonodo Sentinela
Melanoma/cirurgia
-Neoplasias da Mama/cirurgia
Transplante de Pele
Excisão de Linfonodo/efeitos adversos
Metástase Linfática
Melanoma/diagnóstico
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Carta
Responsável: AR144.1 - CIBCHACO - Centro de Información Biomedica del Chaco


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Id: lil-480750
Autor: Caraballo, María Eva.
Título: Rol de enfermería en el cuidado de la zona dadora en el paciente quemado / Role of the nurse in the care of the donor skin zone of the burned patient
Fonte: Med. infant;14(1):75-79, mar. 2007. graf, ilus.
Idioma: es.
Resumo: La cobertura de una quemadura, con un injerto cutáneo de espesor parcial, constituye el tratamiento qurúrgico de eleción para las quemaduras de tipo AB, o B. Para ello es necesario tener una zona dadora o donante, que permita ir recuperando la piel dañada, con la mayor celeridad posible, debido a la inestabilidad del gran quemado. Una zona donante es el área intacta de piel de la que se ha extraído, con una cuchilla protegida (navaja) o con un dermátomo eléctrico, una lámina que se denomina auto injerto y puede ser de espesor total (epidermis y dermis completa). Los sitios donantes son heridas desarrolladas quirúrgicamente y pueden considerarse estériles. La cobertura de elección, es una lámina de piel porcina liofilizada e hidratada con solución fisiológica que se aplica en quirófano, protegida con gasa furacinada de 10 x 10, áposito espiriforme y venda.
Descritores: Queimaduras/cirurgia
Queimaduras/complicações
Queimaduras/enfermagem
Queimaduras/terapia
Papel do Profissional de Enfermagem
Transplante Autólogo/enfermagem
Transplante de Pele/enfermagem
Transplante de Pele/reabilitação
Limites: Lactente
Pré-Escolar
Criança
Adolescente
Responsável: AR94.1 - Centro de Información Pediatrica


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Id: biblio-1040041
Autor: Favorito, Luciano A; Conte, Paulo P; Sobrinho, Ulisses G; Martins, Rodrigo G; Accioly, Tomas.
Título: Double inlay plus ventral onlay buccal mucosa graft for simultaneous penile and bulbar urethral stricture
Fonte: Int. braz. j. urol;44(4):838-839, July-Aug. 2018.
Idioma: en.
Resumo: ABSTRACT Objectives: Buccal mucosa grafts and fascio-cutaneous flaps are frequently used in long anterior urethral strictures (1). The inlay and onlay buccal mucosa grafts are easier to perform, do not need urethral mobilization and generally have good long-term results (2-4). In the present video, we present a case where we used a double buccal mucosa graft technique in a simultaneous penile and bulbar urethral stricture. Materials and Methods: A 54 year-old male patient was submitted to appendectomy where a urethral catheter was used for two days in May 2015. Three months after surgery, the patient complained of acute urinary retention and a supra-pubic tube was indicated. Urethrocystography was performed two weeks later and showed strictures in penile and bulbar urethra with 3.5 cm and 3 cm in length respectively. Urethroplasty was proposed for the surgical treatment in this case. We used a perineal approach with a ventral sagittal urethrotomy in both strictures. Penile urethra stricture measuring 3.5 cm in length was observed and a free graft from the buccal mucosa was harvested and placed into the longitudinal incision in the dorsal urethra and fixed with interrupted suture as dorsal inlay. Bulbar urethra stricture measuring 3 cm was observed and a free graft from the buccal mucosa was harvested and placed into the longitudinal incision in the ventral urethra and fixed with interrupted suture as ventral onlay. The ventral urethrotomy was closed over a 16Fr Foley catheter and the skin incision was then closed in layers. Results: No intraoperative or postoperative complications occurred. The patient could achieve satisfactory voiding and no complication was seen during the six-month follow-up. Postoperative imaging demonstrated a widely patent urethra, and the mean peak flow was 12 mL/s. Conclusion: The BMG placement can be ventral, dorsal, lateral or combined dorsal and ventral BMG in the meeting of stricture but the first two are most common (5, 6). Ventral location provides the advantages of ease of exposure and good vascular supply by avoiding circumferential rotation of the urethra (7). Early success rates of dorsal and ventral onlay with BMG were 96 and 85%, respectively. However, long-term follow-up revealed essentially no difference in success rates (8-11). Anterior urethral stricture treatments are various, and comprehensive consideration should be given in selecting individualized treatment programs, which must be combined with the patient's stricture, length, complexity, and other factors. Traditionally, anastomotic procedures with transection and urethral excision are suggested for short bulbar strictures, while longer strictures are treated by patch graft urethroplasty preferably using the buccal mucosa as gold-standard material due to its histological characteristics. The current management for complex urethral strictures commonly uses open reconstruction with buccal mucosa urethroplasty. However, there are multiple situations whereby buccal mucosa is inadequate (pan-urethral stricture or prior buccal harvest) or inappropriate for utilization (heavy tobacco use or oral radiation). Multiple options exist for use as alternatives or adjuncts to buccal mucosa in complex urethral strictures (injectable antifibrotic agents, augmentation urethroplasty with skin flaps, lingual mucosa, colonic mucosa, and new developments in tissue engineering for urethral graft material). In the present case, our patient had two strictures and we chose to correct the first stricture with a dorsal graft and the bulbar stricture with a ventral graft because of our personal expertise. We can conclude that the double buccal mucosa graft is easier to perform and can be an option to repair multiple urethral strictures.
Descritores: Doenças do Pênis/cirurgia
Estreitamento Uretral/cirurgia
Transplante de Pele/métodos
Mucosa Bucal/transplante
-Procedimentos Cirúrgicos Urológicos Masculinos/métodos
Retalhos Cirúrgicos/transplante
Reprodutibilidade dos Testes
Resultado do Tratamento
Constrição Patológica/cirurgia
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: biblio-892955
Autor: Alsagheer, Gamal A; Fathi, Atef; Abdel-Kader, Mohamed Sayed; Hasan, Ahmed M; Mohamed, Omar; Mahmoud, Osama; Abolyosr, Ahmad.
Título: Management of long segment anterior urethral stricture (≥ 8cm) using buccal mucosal (BM) graft and penile skin (PS) flap: outcome and predictors of failure
Fonte: Int. braz. j. urol;44(1):163-171, Jan.-Feb. 2018. tab, graf.
Idioma: en.
Resumo: ABSTRACT Purpose To evaluate the surgical outcome and predictors of failure of substitution urethroplasty using either dorsal onlay buccal mucosal (BM) graft or ventral onlay penile skin flap (PS) for anterior urethral stricture ≥ 8cm. Patients and methods Between March 2010 and January 2016, 50 patients with anterior urethral stricture ≥ 8 cm were treated at our hospital. The surgical outcome and success rate were assessed. The predictors of failure were analyzed using multivariate analysis. Failure was considered when subsequent urethrotomy or urethroplasty were needed. Results Dorsal onlay BM graft was carried out in 24 patients, while PS urethroplasty in 26 patients. There was no significant difference between both groups regarding patients demographics, stricture characteristics or follow-up period. One case in the BM group was lost during follow-up. Stricture recurrence was detected in 7 (30.4%) patients out of BM group while in 6 (23.1%) patients out of PS group (p value= 0.5). No significant differences between both groups regarding overall early and late complications were observed. Occurrence of early complications and the stricture length were the only predictors of failure in univariate analysis, while in multivariate analysis the occurrence of early complications was only significant. Conclusion On short-term follow-up, both dorsal onlay BM graft and ventral onlay PS flap urethroplasty have similar success rates. However, BM graft has a potential advantage to reduce operative time and is also technically easier. The surgeon should avoid early local complications as they represent a higher risk for failure.
Descritores: Pênis
Procedimentos Cirúrgicos Urológicos Masculinos
Retalhos Cirúrgicos/transplante
Estreitamento Uretral/cirurgia
Transplante de Pele/métodos
Mucosa Bucal/transplante
-Estreitamento Uretral/patologia
Estudos Retrospectivos
Seguimentos
Resultado do Tratamento
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Adulto
Responsável: BR1.1 - BIREME


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Id: biblio-1040075
Autor: Favorito, Luciano A.
Título: Bulbar urethral stricture: penile skin flap may be a good option?
Fonte: Int. braz. j. urol;45(5):871-872, Sept.-Dec. 2019.
Idioma: en.
Descritores: Retalhos Cirúrgicos/transplante
Estreitamento Uretral/cirurgia
Transplante de Pele/métodos
-Pênis/cirurgia
Reprodutibilidade dos Testes
Limites: Humanos
Masculino
Tipo de Publ: Editorial
Responsável: BR1.1 - BIREME


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Id: biblio-1040063
Autor: Hmida, Wissem; Othmen, Mouna Ben; Bako, Amidou; Jaidane, Mehdi; Mosbah, Faouzi.
Título: Penile skin flap: a versatile substitute for anterior urethral stricture
Fonte: Int. braz. j. urol;45(5):1057-1063, Sept.-Dec. 2019. tab, graf.
Idioma: en.
Resumo: ABSTRACT Purpose Penile skin flap uretroplasty is a useful technique for a long urethral stricture due to the ample length and surgical handling characteristics. We investigated the surgical technique and initial results of uretroplasty for anterior urethral strictures using a dorsal penile skin flap. Patients and methods From January 2003 to January 2018, a total of 77 patients underwent substitution urethroplasty using dorsal penile skin flap for bulbar urethral strictures in our institution. All patients were assessed preoperatively, and followed postoperatively by physical examination, urinalysis, retrograde and voiding urethrography, uroflowmetry and post-void residual urine measurement. Success was defined as no requirement of additional urethral instrumentation. Results The mean age was 45 years (10-87). The mean stricture length was 5cm (3-10cm). The mean flap length was 6cm. Urinary fistula was the most common postoperative complication. The mean follow-up was 60 months (6-120). The overall success rate was 88%. Recurrent strictures were found in 4 patients (5%) at 1 year. At 3 year follow-up, 5 (7%) more patients had recurrences. All recurrences were managed by internal urethrotomy. Conclusions Substitution urethroplasty using penile skin flap appear to be a safe and efficient technique for the treatment of a long and complex anterior urethral stricture. It provides encouraging cosmetic and functional results.
Descritores: Pênis/cirurgia
Retalhos Cirúrgicos/transplante
Estreitamento Uretral/cirurgia
Transplante de Pele/métodos
-Complicações Pós-Operatórias
Recidiva
Reprodutibilidade dos Testes
Estudos Retrospectivos
Resultado do Tratamento
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Criança
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-1153935
Autor: Carvalho-Júnior, José da Conceição; Zanata, Fabiana; Aloise, Antônio Carlos; Ferreira, Lydia Masako.
Título: Acellular dermal matrix in skin wound healing in rabbits - histological and histomorphometric analyses
Fonte: Clinics;76:e2066, 2021. graf.
Idioma: en.
Resumo: OBJECTIVES: To analyze the histology and histomorphometry of healing associated with acellular dermal matrix in skin wounds in rabbits. METHODS: Twelve male rabbits were divided into two groups: the control group (CG) and the matrix group (MG). Three skin wounds with a total area of 20 × 20 mm were created on the dorsal region of each animal. Photographic records of the lesions taken over a 21-day period and use of the ImageJ program allowed calculation of the wound contraction rate. The lesions were biopsied on days 3, 14 and 21 for histomorphometric analysis to define the thicknesses of the dermis and epidermis (hematoxylin-eosin) and calculate the densities of type I and type III collagen (picrosirius). RESULTS: No significant difference in the healing rate was found between the groups (p>0.05). The MG presented greater epidermal thickness on day 3 (p<0.05) and on days 14 and 21 (p<0.001). The MG presented greater dermal thickness throughout the study period (p<0.05). The type I collagen density was higher in the MG throughout the study period (p<0.05), and the type III collagen density was higher in the MG on days 3 and 14 (p<0.05) and on day 21 (p<0.001). CONCLUSION: The use of acellular dermal matrix increased the thickness of the dermal and epidermal layers and the amount of type I and III collagen during skin wound healing and did not alter the rate of wound contraction.
Descritores: Derme Acelular
-Pele
Cicatrização
Transplante de Pele
Colágeno Tipo I
Colágeno Tipo III
Limites: Animais
Masculino
Ratos
Responsável: BR1.1 - BIREME


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Id: lil-768559
Autor: Costa, Mariana Takahashi Ferreira; Gomes, Aline da Silva; Santos, Poliana Brito dos; Martins, Renata Soares; Moura, Sara Ribeiro; Scota, Sayonara; Oliveira, Andreia Cristine Deneluz Schunck de; Gamba, Mônica Antar; Nadal, Sidney Roberto.
Título: Giant condyloma acuminatum: report of surgical treatment and evolution of healing / Condiloma acuminado gigante: relato de tratamento cirúrgico e evolução da cicatrização
Fonte: DST j. bras. doenças sex. transm;27(1-2):48-53, 2015.
Idioma: en.
Resumo: O condiloma acuminado gigante, variante rara do condiloma acuminado anogenital, apresenta crescimento rápido associado a estados de imunodeficiência.Relatamos os resultados com os cuidados com a ferida operatória. Trata-se de homem de etnia negra, 55 anos, portador do vírus da imunodeficiência humana com condiloma acuminado acometendo desde as regiões inguinais até o sulco interglúteo, que foi ressecado permanecendo a ferida aberta para posterior enxertia. Os cuidados com essa ferida incluíram solução de polihexametileno biguanida/betaína, solução de ácidos graxos essenciais, hidrofibra/prata e película. Evoluiu com infecção secundária sendo a hidrofibra substituída por espuma de poliuretano/prata/ibuprofeno. Houve melhora da infecção e da dor, contração das bordas e presença de tecido de granulação em toda a lesão. Naquelas condições, o enxerto de pele foi realizado no 41º dia. A despeito dos possíveis vieses de confusão, pode-se inferir que esses cuidados prepararam o leito da ferida para receber o enxerto de pele.

Giant condyloma acuminatum, a rare variant of anogenital condyloma, shows rapid growth associated with immunodeficiency. Wound care after resection andoutcomes were reported. NGS, black, 55 years, HIV positive, with giant condyloma acuminatum affecting from the groin to the intergluteal groove, which wasresected, remaining the wound opened for later skin graft. Topical care included polihexametilene biguanide/betaine solution, essencial fatty acids solution,hydrofiber/silver, and poliuretane film. The wound developed secondary infection, so hidrofiber was replaced by polyurethane foam/silver/ibuprofen. Therewas improvement in infection and pain, contraction of the edges and the presence of granulation tissue across the lesion. In those conditions the skin graft was performed after 41 days. Despite possible confusion bias, it can be inferred that the care adopted prepared the wound bed to receive the skin graft.
Descritores: Cicatrização
Infecção dos Ferimentos
Condiloma Acuminado
Transplante de Pele
Tumor de Buschke-Lowenstein
-Prata
Betaína
Ácidos Graxos Essenciais
Ibuprofeno
HIV
Dor Pélvica
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: biblio-1223459
Autor: Mackfarlane, Marcelo; Tamayo, Andrés; Caradonti, Matías; Pefaure, Joaquín.
Título: Genitoplastia feminizante en paciente transgénero / Feminizing genitoplasty in a transgender patient
Fonte: Rev. argent. cir. plást;27(1):15-20, jan.-mar. 2021. tab, fig, ilus.
Idioma: es.
Resumo: Introducción. La ausencia vaginal tiene un impacto devastador en paciente transgénero de hombre a mujer, por lo tanto, es primordial crear una neovagina de funcionamiento normal con satisfacción sexual, apariencia estética óptima y a su vez las características de micción femenina. Para tal objetivo existen diferentes procedimientos quirúrgicos. La genitoplastia feminizante con colgajo pene escrotal invertido cumple con las necesidades y expectativas del paciente.1-6 Método. En este caso se realizó un análisis descriptivo y retrospectivo de 28 pacientes, transgénero, en los cuales se realizó genitoplastia feminizante con colgajo pene escrotal invertido, con edades entre 18 y 46 años, en un período de 2,5 años desde febrero de 2018 a agosto de 2020. Resultados. La vitalidad del colgajo fue un 100% con una satisfacción sexual del 96,4%, con bajo porcentaje de complicaciones (3%) que incluyen hematoma, dehiscencia y estenosis. Estéticamente la satisfacción fue del 100%. Para muchas pacientes la genitoplastia feminizante es la etapa final de muchas mujeres transgénero en su proceso de confirmación de género.

Introduction. Vaginal absence has a devastating impact on a male to female transgender patient, therefore, it is essential to create a normally functioning neovagina with sexual satisfaction, optimal aesthetic appearance and in turn the characteristics of female urination. For this purpose there are different surgical procedures. Feminizing Genitoplasty with inverted scrotal penis flap meets the needs and expectations of the patient.1-6 Method. In this case, a descriptive and retrospective analysis of 28 transgender patients was performed, in which Feminizing Genitoplasty was performed with an inverted scrotal penis flap, aged between 18 and 46 years, over a period of 2.5 years from february 2018 to august 2020.For many patients, Feminizing Genitoplasty is the final stage for many transgender women in their gender confirmation process. Results. The vitality of the flap was 100% with a sexual satisfaction of 96.4%, with a low percentage of complications in 3% that include hematoma, dehiscence and stenosis, aesthetically we present 100% satisfaction
Descritores: Retalhos Cirúrgicos/transplante
Transexualidade/cirurgia
Vagina
Estudos Retrospectivos
Transplante de Pele
Procedimentos Cirúrgicos Reconstrutivos/métodos
Pessoas Transgênero
Limites: Humanos
Masculino
Adulto
Responsável: AR392.1 - Biblioteca



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