RESUMO
El cráneo en trébol es una malformación rara asociada al cierre temprano de múltiples suturas; se presenta con alteraciones en el desarrollo neurológico y una alta mortalidad. El tratamiento quirúrgico tiene como objetivo restaurar la forma y función del cráneo, en lo posible con el menor número de procedimientos.Este trabajo tiene como objetivo la presentación del caso de un lactante con deformidad de cráneo en trébol, caracterizado con el uso de ayudas diagnósticas e intervenido en un único tiempo quirúrgico con distracción de fosa posterior y remodelación de la bóveda craneal. (AU)
Cloverleaf skull is a rare malformation associated with early closure of multiple sutures; it presents with alterations in neurological development and high mortality. Surgical treatment aims to restore the shape and function of the skull, if possible with the fewest number of procedures.This paper aims to present the case of an infant with a cloverleaf skull deformity, characterized with the use of diagnostic aids and operated on in a single surgical stage with distraction of the posterior fossa and remodeling of the cranial vault. (AU)
Assuntos
Humanos , Masculino , Lactente , Crânio/anormalidades , Cabeça/anormalidades , Craniossinostoses/cirurgiaRESUMO
BACKGROUND: TULUA, a transverse plication lipoabdominoplasty, which excludes elevation of the supraumbilical flap and includes a skin graft neoumbilicoplasty, claims greater safety and better results. An animal study was designed to compare it, with two current techniques. MATERIALS AND METHODS: Three matched groups of 12 rats had combined liposuction and abdominoplasty. Liposuction was extensive and unrestricted. Groups 1 and 2 had vertical plication and transposition umbilicoplasty, and group 3 had transverse plication and neoumbilicoplasty. Flap elevation in the epigastrium was wide to costal margins in group 1, limited to a tunnel in group 2, and no dissection in group 3. The animals were observed for 21 days and then euthanized. Intraoperative, postoperative, and postmortem variables and findings were measured and analyzed to find differences between groups. RESULTS: Transverse lipoabdominoplasty demonstrated a wider wall plication area, as well as a decrease in tension to close the wound, causing the horizontal scar to remain in a low position. In vertical plication lipoabdominoplasty groups, flap necrosis and seromas were more frequent, and the umbilical position descended due to secondary healing and scar contraction. The scar's scores were better in the transverse group and were confirmed when evaluated by external observers.In postmortem examination, horizontal plication presented less widening; perforator vessels were preserved when surgical undermining of the upper abdomen was not performed, and there were fewer seromas. CONCLUSION: In a rat model, TULUA demonstrates superior results and a decrease in complications when compared to lipoabdominoplasties with vertical plication and wide or tunneled dissection in the upper abdomen. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
