RESUMEN
The recent COVID-19 (coronavirus) pandemic is causing an increase in the number of patients who, due to their pulmonary ventilatory status, may require orotracheal intubation. COVID-19 infection has demonstrated a high rate of transmissibility, especially via the respiratory tract and by droplet spread. The Spanish Society of Otolaryngology and Head and Neck Surgery, based on the article by Wei et al. of 2003 regarding tracheotomies performed due to severe acute respiratory syndrome (SARS), has made a series of recommendations for the safe performance of tracheotomies.
Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Traqueotomía/métodos , COVID-19 , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Urgencias Médicas , Humanos , Intubación Intratraqueal , Otolaringología , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , SARS-CoV-2 , Sociedades Médicas , España , Traqueotomía/normas , Precauciones Universales/métodosRESUMEN
INTRODUCTION: The radial forearm free flap (RFFF) is a widely used tool in head and neck reconstructive surgery. It stands out as a relatively simple flap to achieve; it is versatile and has features that enable the reconstruction of complex head and neck defects. The aim of the study was to present our results using the RFFF in the reconstruction of seated defects in the head and neck area. MATERIAL AND METHODS: A retrospective, observational and analytical study that included 58 cases of RFFF interventions, performed between January 2002 and July 2019. The data studied were the age and sex of the patients, location of the tumour, histological type, previous radiation therapy, number of venous anastomoses performed in the surgery and body temperature in the immediate postoperative period, at 24 and 48hours following surgery. RESULTS: The percentage of viable RFFF was 82.8%. None of the variables analysed appear to be a risk factor for flap failure. The most frequent cause of flap failure was venous thrombosis. CONCLUSIONS: Microvascularised flaps play an important role in reconstructive surgery, being the RFFF one of the most interesting for head and neck reconstruction. It is a very versatile tool that allows the reconstruction of many of the sites where the head and neck surgeon operates.
Asunto(s)
Carcinoma de Células Escamosas/cirugía , Colgajos Tisulares Libres/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Procedimientos de Cirugía Plástica/métodos , Adenocarcinoma/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Temperatura Corporal , Carcinoma de Células Escamosas/radioterapia , Terapia Combinada , Femenino , Colgajos Tisulares Libres/irrigación sanguínea , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Isquemia/diagnóstico , Isquemia/epidemiología , Isquemia/etiología , Masculino , Persona de Mediana Edad , Especificidad de Órganos , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Sarcoma/cirugía , Insuficiencia del Tratamiento , Vasoconstricción , Trombosis de la Vena/epidemiología , Trombosis de la Vena/etiologíaRESUMEN
The current COVID-19 pandemic has rendered up to 15% of patients under mechanical ventilation. Because the subsequent tracheotomy is a frequent procedure, the three societies mostly involved (SEMICYUC, SEDAR and SEORL-CCC) have setup a consensus paper that offers an overview about indications and contraindications of tracheotomy, be it by puncture or open, clarifying its respective advantages and enumerating the ideal conditions under which they should be performed, as well as the necessary steps. Regular and emergency situations are displayed together with the postoperative measures.