1
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Diferimiento del sitio receptor en reconstrucción de defectos faciales. Reporte clínico e histopatológico Translated title: Deferral of the recipient site in the reconstruction of facial defects. Clinical and histopathological report

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Resumen Introducción y objetivo. La reconstrucción de tejidos blandos es un requerimiento frecuente en cirugía craneofacial por diferentes causas, congénitas y adquiridas. Debido a la complejidad de las alteraciones no existe un tratamiento uniforme. Aunque el uso de injertos dermograsos es una herramienta útil, el diferimiento del lecho receptor previo a su colocación es una técnica poco frecuente en la práctica clínica. El objetivo del presente estudio es evaluar clínica e histológicamente los beneficios del diferimiento del sitio receptor previo a la colocación del injerto dermograso en la reconstrucción facial de tejidos blandos. Material y método. Estudio realizado entre 2016 y 2019 sobre una serie de 10 pacientes con atrofa hemifacial, microsomia hemifacial y secuelas de cáncer, en el Hospital Universitario del Valle de Cali, Colombia. Primer tiempo quirúrgico para la colocación de material aloplástico y segundo tiempo para la colocación del injerto dermograso, tomando biopsias del sitio receptor durante cada intervención. Resultados. La cicatrización, simetría facial y satisfacción tuvo una puntuación promedio de 8.7 ± 1.5 (6-10), evaluado de 0 a 10. Uno de los pacientes (10%) se sintió insatisfecho después del procedimiento y requirió lipoinyeccion, sin complicaciones. El análisis histopatológico reveló aumento estadísticamente significativo en el segundo tiempo quirúrgico con respecto al primero en el número de capilares por campo (14.6 ± 4.0 frente a 8 ± 2.4) (P<0.05), tortuosidad de los capilares (1.8 ± 0.4 frente a 0.1 ± 0.3) (P<0.05) e infiltración leucocitaria (1.9 ± 0.3 frente a 0.5 ± 0.5) (P<0.05) respectivamente. Conclusiones. Esta técnica quirúrgica es un procedimiento rápido y efectivo para la reconstrucción facial de tejidos blandos. Histológicamente, favorece la infiltración leucocitaria, número de capilares y tortuosidad de los vasos, logrando menor reabsorción, mayor integración y supervivencia del injerto.

          Translated abstract

          Abstract Background and objective. The reconstruction of soft tissues is a frequent requirement in craniofacial surgery for diferent congenital and acquired causes. Due to the complexity of the alterations, there is no uniform treatment. However, the use of fat grafts is a useful tool; the recipient site deferral before its placement is a rare technique in clinical practice. Our objective is to clinically and histologically evaluate the benefts of deferral of the recipient site before placement of the dermal fat graft in facial soft tissue reconstruction. Methods. Descriptive observational study between 2016 and 2019, at the Hospital Universitario del Valle de Cali, Colombia, including 10 patients with hemifacial atrophy, hemifacial microsomia, and cancer sequelae: frst surgical time for the placement of alloplastic material and a second surgical time for the dermal fat graft placement. Also, we took biopsies from the recipient site during each intervention. Results. The scarring, facial symmetry and satisfaction had an average score of 8.7 ± 1.5 (6-10), evaluated from 0 to 10. One of the patients (10%) felt unsatisfed after the procedure and required lipoinjection without complications. Histopathological analysis revealed an increase in the number of capillaries per feld (14.6 ± 4.0 vs. 8 ± 2.4) (P <0.05), tortuosity of the capillaries (1.8 ± 0.4 vs. 0.1 ± 0.3) (P <0.05) and leukocyte infiltration (1.9 ± 0.3 vs. 0.5 ± 0.5) (P<0.05) in the second surgical time when compared to the frst. Conclusions. This surgical technique is a fast and efective procedure for facial soft tissue reconstruction. It favors the leukocyte infiltration, number of capillaries and tortuosity of the vessels, achieving less resorption, higher integration and graft survival.

          Related collections

          Most cited references19

          • Record: found
          • Abstract: not found
          • Article: not found

          The Wound Healing Process: An Overview of the Cellular and Molecular Mechanisms

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Technique for liposuction fat reimplantation and long-term volume evaluation by magnetic resonance imaging.

            Injection with one's own fat tissue remains controversial due to a lack of objective data pertaining to postoperative volume control. Facial defects in a total of 53 patients were repaired using autogenous fat tissue. The fatty tissue was obtained from the lower abdomen, buttocks, or inner portion of the upper thigh and then suspended before injection in a solution of 250 ml Ringer's solution, 50 ml distilled water, and 0.7 ml hyaluronidase. The fatty tissue was collected by a filter integrated within the suction system and subsequently prepared, as follows: (1) Cell detritus, blood constituents, and local anesthetic were flushed away by using a physiological Ringer's solution. (2) The defects were filled by using a finely calibrated, locked injection, whereby the desired amount of fatty tissue could be accurately instilled. (3) Injection was carefully performed directly under the cutis through a large lumen cannula and under close observation to avoid the injection of any fatty tissue intracutaneously. Before the procedure, the augmented areas had been evaluated by using magnetic resonance imaging (in T1-weighted images). Postoperatively, the sites were once again documented for volume at control intervals of 6 days, and 3, 6, 9, and 12 months. The volumes were computer-calculated integrally from the sum of the area of all the layers according to the following formula:v = (d + g).E(ai). Despite the use of hyaluronidase as well as an atraumatic liposuction technique, microscopic examination revealed 40% of the aspirated cells to have defective cell membranes. Without hyaluronidase, this figure rose to 50%. One-year follow-up in 10 patients showed that through the break-down of these damaged cells, a particularly high volume loss of 49% was documentable at 3 months after the procedure. Further follow-up at 6 months showed that average volume decline had risen to a total of 55%, whereas, at 9 months as well as 12 months, no further loss could be detected. Autogenous fat transplantation after liposuction is a procedure only suitable for the repair of small, soft-tissue defects, especially of the face. The individual deposits should not be any larger than 1 ml, whereby intact fat cells are guaranteed sufficient diffusion up to the point of neovascularization. It is essential that the fatty tissue injection be exactly administered subcutaneously. Together with basic clinical observation, magnetic resonance imaging provides an objective evaluation of volume loss with an average error of only 5%.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Current concepts in the physiology of adult wound healing

                Bookmark

                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                December 2021
                : 47
                : 4
                : 395-402
                Affiliations
                [2] Cali Valle del Cauca orgnameUniversidad del Valle orgdiv1Escuela de Medicina orgdiv2Departamento de Cirugía / Cirugía Plástica Colombia
                [1] Cali Valle del Cauca orgnameUniversidad del Valle orgdiv1Escuela de Medicina orgdiv2Departamento de Cirugía / Cirugía Plástica Colombia
                [3] Cali Valle del Cauca orgnameUniversidad del Valle orgdiv1Escuela de Medicina orgdiv2Departamento de Cirugía / Cirugía Plástica Colombia
                Article
                S0376-78922021000400395 S0376-7892(21)04700400395
                10.4321/s0376-78922021000400010
                37b7ec25-d4f7-4ef9-a522-b6c688257315

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 13 September 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 8
                Product

                SciELO Spain

                Categories
                Reconstructiva

                Dermal fat-graf,Deferral,Hemifacial atrophy,Hemifacial microsomy,Diferimiento,Injerto dermograso,Atrofa hemifacial,Microsomia hemifacial

                Comments

                Comment on this article