Tratamiento quirúrgico de las lesiones con exposición ósea y uso de colgajo músculo cutáneo
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La reconstrucción de la extremidad inferior de un paciente que presenta pérdida de sustancia tanto de piel como de músculo y exposición ósea, necesita una buena cobertura de manera primaria y en forma conjunta con otro tipo de tratamiento, este colgajo que se utiliza para reconstrucción tomo como la primera opción el músculo sóleo, realizando una pequeña variante de una isla muscular dejando solamente el pedículo vascular dominante, el cual se complementa con injerto parcial de piel, los pacientes evolucionaron satisfactoriamente con una rápida reincorporación a la rehabilitación física y a su vida cotidiana. La ventaja de este colgajo es la factibilidad que se puede utilizar para la reconstrucción de pared abdominal en los casos de pérdida muscular, como en la fascitis necrotizante.
El inconveniente que se observó del colgajo sóleo en su descripción en los libros y tanto en la práctica era el grosor del colgajo músculo cutáneo exagerado y la consiguiente forma desagradable y anti estética que quedaba de la zona dadora, dicho colgajo cuando se lo realizó tuvo una retracción y atrofiamiento o adelgazamiento que no era muy satisfactoria estéticamente ni funcionalmente, es por eso que se realizó dicha variante con excelente resultado tanto estético como funcional, para el paciente y una pronta recuperación con su respectiva reincorporación al trabajo, el cual reduce el tiempo de hospitalización y lucro cesante del paciente.
El colgajo músculo cutáneo de sóleo es fácil de realizar, y muy flexible normalmente se lo suele utilizar para reconstrucción de miembro inferior, es un colgajo no muy divulgado entre los cirujanos pero es una buena opción debido a su gran pedículo vascular, sirve para reconstrucciones de otra parte del organismo como en la pared abdominal y efecto del mismo
The reconstruction of lower limb of a patient with loss of substance both skin and muscle and bone exposure good coverage of primary manner and in conjunction with other treatment is needed, this flap is used for reconstruction volume as first choice soleus muscle, making a small variant of a muscular island leaving only the dominant vascular pedicle, which is complemented by partial skin graft, which the patient evolved satisfactorily with a rapid return to physical rehabilitation and everyday life. The advantage of this flap is the feasibility which can be used for reconstruction of the abdominal wall in cases of muscular loss, and necrotizing fasciitis. The drawback we saw the soleus flap in its description in the books and both practice was the thickness of the muscle flap skin exaggerated and the subsequent unpleasant manner and to aesthetics that remained of the donor site, said flap despite eventually will have a retraction and atrophy or thinning was not satisfactory aesthetically and functionally, is why this variant was performed with excellent in both aesthetic result and functional, for the patient and a speedy recovery with their respective return to work, which reduces the time hospitalization and loss of earnings patient. The flap musculo cutaneous soleus is easy to perform is very flexible normally normally use for reconstruction of lower limb, is a flap which is not widely publicized among surgeons but it is a good choice due to its high vascular pedicle, which It serves to reconstructions of another p [art of the organism as in the abdominal wall and effect thereof.
The reconstruction of lower limb of a patient with loss of substance both skin and muscle and bone exposure good coverage of primary manner and in conjunction with other treatment is needed, this flap is used for reconstruction volume as first choice soleus muscle, making a small variant of a muscular island leaving only the dominant vascular pedicle, which is complemented by partial skin graft, which the patient evolved satisfactorily with a rapid return to physical rehabilitation and everyday life. The advantage of this flap is the feasibility which can be used for reconstruction of the abdominal wall in cases of muscular loss, and necrotizing fasciitis. The drawback we saw the soleus flap in its description in the books and both practice was the thickness of the muscle flap skin exaggerated and the subsequent unpleasant manner and to aesthetics that remained of the donor site, said flap despite eventually will have a retraction and atrophy or thinning was not satisfactory aesthetically and functionally, is why this variant was performed with excellent in both aesthetic result and functional, for the patient and a speedy recovery with their respective return to work, which reduces the time hospitalization and loss of earnings patient. The flap musculo cutaneous soleus is easy to perform is very flexible normally normally use for reconstruction of lower limb, is a flap which is not widely publicized among surgeons but it is a good choice due to its high vascular pedicle, which It serves to reconstructions of another p [art of the organism as in the abdominal wall and effect thereof.
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Colgajos quirúrgicos, Colgajo musculocutáneo, Heridas y traumatismos, Tratamiento quirúrgico, Extremidad inferior, Clínica Naranjo, Cantón MIlagro, Ecuador