La reparación de lesiones de partes blandas del tercio distal del miembro inferior, constituye un desafío para la cirugía plástica reconstructiva. El objetivo del presente trabajo consiste en ilustrar una de las indicaciones del colgajo sural para la adecuada cobertura de una herida compleja en la región calcánea. Se describe el caso de un niño de 6 años de edad con antecedentes de accidente en motocicleta, que ocasionó una herida con pérdida de sustancia en la región calcánea derecha. Se realizó inicialmente curación e instalación de sistema aspirativo. Técnica quirúrgica: Diseño del colgajo, disección de la isla de piel incluyendo la fascia, identificación del paquete vasculonervioso proximal, ligadura y sección, disección fasciocutánea de proximal a distal. Movilización del colgajo y cobertura del defecto. Autoinjerto cutáneo parcial en zona donante. Evolución favorable. El colgajo sural permite una confiable cobertura cutánea del tercio distal del miembro inferior cuando no se cree factible el uso de injertos. Ventajas: no depende de microcirugía, un solo tiempo operatorio, sin déficit funcional importante, amplio rango de rotación y aceptable morbilidad del sitio donante. Desventaja: Sacrificio del nervio sural. Se concluye que el colgajo sural permite la reconstrucción de defectos en el tercio distal de la pierna.

Summary: Nasal reconstruction can be a difficult task to perform. It is a challenge when the defect to be reconstructed is extensive and involves the entire thickness of the nose. The difficulty is further increased when a recurrent tumor is removed, where other flaps were previously used to reconstruct the initial defect. A therapeutic option is microsurgical reconstruction; however, sometimes this cannot be performed. Furthermore, free flaps such as the anterolateral thigh or the antebrachialis radial tend to be very thick for the integuments of the face. Therefore, it is important to think of another reconstructive option to solve this problem. We present a case of nasal reconstruction with a prelaminated temporoparietal osteofascial flap, after full-thickness excision for recurrent carcinoma.

No abstract

El síndrome de Poland es una malformación congénita infrecuente, caracterizada por hipoplasia de la mama y el pezón, escasez de tejido subcutáneo y ausencia de la porción esternal del músculo pectoral mayor. Presentamos el caso de una paciente de 25 años en el que se realiza una reconstrucción con colgajo de dorsal ancho, expansor tisular, prótesis mamaria de silicona y lipofilling mamario más injerto de pezón y areola en varias etapas.

Pressure ulcers or sores are regions of localized damage to the skin and underlying tissues that generally develop from constant pressure on bones or body prominences. Pressure ulcers are associated with longer and more expensive hospital stays, with higher mortality rates. The present work is of a retrospective, observational, analytical, cross-sectional design, with a non-probabilistic sampling of consecutive cases. Data from 178 patients were analyzed. The predominant underlying pathology (24%) was cerebrovascular accident or stroke. The most frequent location was the sacral eschar (58%). There was a statistically significant relationship between diagnoses that implied chronic bedriddening and the appearance of deep grade IV ulcers, as well as progression to grade IV in both sacral locations and their appearance in multiple simultaneous locations. The treatment of choice in grade I (70%) was wound dressing, in Grade III (14%) it was scarectomy and in grade IV (46%) a surgical debridement. Pressure ulcers constitute a health problem with significant repercussions on the state of health and quality of life, with a great socio-economic impact and that is why the comprehensive evaluation of the patient allows their prevention by identifying the factors predisposing to develop them.