No abstract

Os autores descrevem o trabalho realizado no laboratório de Microcirurgia Experimental do Serviço de Cirurgia Plástica ISCMPA-FFFCMPA, enfatizando alternativas no treinamento inicial de microcirurgia com investimento reduzido, mostrando o resultado experimental obtido
The authors describe their experience at the Experimental Microsurgery Lab of the Plastic Surgery Service of Irmandade Santa Casa de Misericórdia de Porto Alegre Hospital -- Fundação Faculdade Federal de Ciências Médicas de Porto Alegre Medical School, highlighting initial low cost microsurgery training alternatives. They present the experimental results obtained

The aim of this study was to verify the role of the venous drainage system in the pathogenesis of complications in microsurgical head and neck reconstruction. In a nonrandomized cohort study, 52 consecutive cases of complex head and neck microsurgical reconstruction were evaluated. The patients were divided in two groups based on the treatment: the deep (DVDG; n = 30) and superficial (SVDG; n = 22) venous drainage groups. The complications evaluated included vascular obstruction with partial or total loss of the microsurgical flap, inadequate healing (fistulas or suture dehiscence), and infections. The arterial anastomotic site, neoplastic recurrence, use of medications and neoadjuvant radiotherapy, flap selection, tumor histology, smoking/alcoholism, and systemic diseases had no effect on postoperative complications, while the venous component influenced the overall complication rate (chi-square test, P = 0.006). A protective effect was achieved in the DVDG when the overall complication rate was considered--relative risk (RR) 0.65, 95% confidence interval (CI) 0.45-0.94. The recipient vein should be the surgeon's main concern as it influenced the outcomes of patients undergoing complex microsurgical head and neck reconstruction. A protective effect was observed when the internal jugular vein drainage system was used for this purpose.

Breast reconstruction can reduce psychologic distress without interfering with adjuvant treatment. The study was conducted to determine how ptosis affects satisfaction after immediate partial breast reconstruction with local flaps and symmetrization of the contralateral breast. Twenty patients, with estimated breast volume between 300 and 600 mL and tumor size until T2 by TNM classification, were included in a retrospective cohort study based on a prospective database. The breast was reconstructed using local flaps based on the perforating vessels of the intercostal and pectoralis major muscles. The donor site was located at the intersection of the lower quadrants of the breast. Contralateral mammaplasty using the vertical technique was used to maintain balanced breast volume and shape. A satisfaction score on a scale of 0 to 10 was used, and its correlation with the degree of breast ptosis (1-3) was evaluated. Despite good overall satisfaction scores, significant differences between the ptosis groups 1 (<1 cm) and 3 (>3 cm) were observed (P = 0.010). Breast reconstruction using local flaps plus contralateral mammaplasty performed at the time of surgical resection produced satisfaction scores considered good (8/10). This combined technique seems to be of greatest benefit when the degree of breast ptosis is marked.