RESUMO
PURPOSE: The aim of the study is to improve operative speed and precision of haemangiomas excision. CASE-REPORT: haemangioma is a common affection of the 8% of the population during the neonatal period. In complicated cases and involution sequelae surgical treatment is the first choice. The Authors propose a surgical refinement to prevent intraoperative bleeding. METHODS: several suture stitches were placed around the hemangioma. The edges of the lesion became more defined, thus allowing accurate excision. RESULTS AND CONCLUSIONS: Haemangiomas are characterized by rich blood supply. Surgery is often hindered by massive bleeding and Temporary placement of full-thickness sutures, surrounding the hemangioma, allowed a noticeable improvement in hemostasis precision and greater definition of the margins of the hemangioma.
Assuntos
Hemangioma/cirurgia , Hemostasia Cirúrgica , Neoplasias Cutâneas/cirurgia , Blefaroptose/etiologia , Criança , Pálpebras/patologia , Feminino , Hemangioma/complicações , Hemangioma/patologia , Hemorragia/etiologia , Hemorragia/cirurgia , Hemostasia Cirúrgica/métodos , Humanos , Imageamento por Ressonância Magnética/métodos , Procedimentos de Cirurgia Plástica , Medição de Risco , Índice de Gravidade de Doença , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/patologia , Técnicas de Sutura , Fatores de Tempo , Resultado do TratamentoRESUMO
Lower limb reconstruction with pedicled or free flaps can be commonly compromised by venous insufficiency. This complication often leads to partial/complete flap necrosis and increases the risk of superinfection. Negative-pressure wound therapy (NPWT) is known to increase local blood flow, decrease edema, promote tissue granulation, and reduce the likelihood of soft tissue infection. This study aims to evaluate the effectiveness of NPWT in the treatment of congested pedicled and free flaps of the lower limb after reconstructions in lower limb traumas. A retrospective analysis was performed on four congested (pedicled and free) flaps on the lower limbs. NPWT was applied in all cases after partial flap debridement. NPWT was able to improve and resolve tissue edema and venous insufficiency, avoid further flap necrosis, and promote granulation. On NPWT removal, a split-thickness skin graft was applied on the wound, achieving complete and uneventful healing. NPWT is a useful instrument in managing flaps affected by venous insufficiency in lower limb reconstruction, although larger studies are necessary to better define the effectiveness and indications of NPWT in this setting.
