ROLF GEMPERLI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina - Líder
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
- Radical resection and local coverage of hidradenitis suppurativa - acne inversa: analysis of results(2018) MENDES, ROGÉRIO RAFAEL DA SILVA; ZATZ, RAFAEL FERREIRA; MODOLIN, MIGUEL LUIZ ANTONIO; BUSNARDO, FÁBIO DE FREITAS; GEMPERLI, ROLFABSTRACT Objective: to evaluate the primary outcome of local complications and late recurrence in patients with hidradenitis suppurativa undergoing radical resection and specific reconstruction. Methods: we conducted a retrospective analysis of the medical records of patients attended by the Plastic Surgery Service of the Clinics Hospital, Medical School, USP, between 2010 and 2016. We included patients who underwent radical resection of hidradenitis suppurativa in advanced stage and reconstruction through primary closure, grafts or flaps. Results: we analyzed 34 lesions in 19 patients, of which 64.5% had local complications, though with 73.5% efficient healing after 12 weeks postoperatively. We observed late recurrence in 47%, but in isolation, 22.2% of the reconstructions with locoregional flaps had recurrence after one year. Conclusion: extensive and radical resection of the disease associated with locoregional flap coverage (pedicled or perforating) has been shown to be the best management in terms of late results.
- Endothelial Function in Skin Microcirculation(2018) CAMARGO, C. P.; GEMPERLI, R.Cutaneous microcirculation is responsible for thermoregulatory exchange, excretion of several substances such as water and minerals and protection against external stressors such as heat and cold. Thus skin microcirculation plays a significant role in human body homeostasis as well as in several diseases that may affect the whole organism, including cancer, allergic reaction, dermatosis and dermatites. Two vascular plexuses compose the skin microvasculature: subdermal and dermic. Therefore this anatomical configuration allows endothelial function assessment by laser Doppler flowmetry. This chapter evaluates some skin conditions such as aging, collagen immune disease, and external noxious elements that can interfere with endothelial evaluation. © 2018 Elsevier Inc. All rights reserved.
- Contralateral Botulinum Toxin Improved Functional Recovery after Tibial Nerve Repair in Rats(2018) LIMA, Washington; SALLES, Alessandra Grassi; FARIA, Jose Carlos Marques; NEPOMUCENO, Andre Coelho; SALOMONE, Raquel; KRUNN, Patricia; GEMPERLI, RolfBackground: There is clinical and experimental evidence that botulinum toxin applied to the healthy side of patients with facial paralysis positively affects functional recovery of the paralyzed side. The authors created an experimental model to study the effects of botulinum toxin injection in the gastrocnemius muscle contralateral to the side of tibial nerve lesion/repair in rats. Methods: Fifty rats were allocated into five groups: group I, control; group II, tibial nerve section; group III, tibial nerve section and immediate neurorrhaphy; group IV, tibial nerve section, immediate neurorrhaphy, and botulinum toxin injected into the contralateral gastrocnemius muscle; and group V, botulinum toxin injected into the gastrocnemius muscle and no surgery. Assessment tools included a walking track, electromyography, gastrocnemius muscle weight measurement, and histologic analysis of the nerve. Results: Paralysis in group V was transient, with function returning to normal at 8 weeks. At 12 weeks, group V had lower latency levels. At week 12, group IV showed higher functional outcomes and amplitude levels than group III, and lower muscle atrophy on the side injected with botulinum toxin compared with group V. Conclusion: Transient paralysis of the contralateral gastrocnemius muscle by botulinum toxin type A improved functional recovery in rats that underwent section and repair of the tibial nerve.
- Opções de tratamento cirúrgico em lesões cutâneas por extravasamento acidental de drogas: experiência do Hospital das Clínicas da Faculdade de Medicina da USP.(2018) MILCHESKI, Dimas André; MOTA, Wellington Menezes; LOBATO, Rodolfo Costa; MONTEIRO JÚNIOR, Araldo Ayres; GEMPERLI, RolfABSTRACT Objective: to report the experience of the Division of Plastic Surgery of the Hospital das Clínicas of the Medical School of the University of São Paulo in the treatment of cutaneous lesions due to accidental extravasation of drugs. Methods: we included patients with lesions due to extravasation of drugs over a period of 18 months. We retrospectively evaluated the following parameters: age, diagnoses during hospitalization and comorbidities, serum levels of albumin and hemoglobin, place of hospitalization, drug involved, anatomic segment affected, therapeutic management and death during hospitalization. Results: we followed-up 14 patients. The main drug involved was noradrenaline (21%). All patients underwent debridement of tissue necrosis. Three patients were submitted to flaps after preparation of the wound bed with negative pressure therapy, with good results. Seven patients had no definitive treatment of their lesions due to lack of clinical conditions. Conclusion: in patients with favorable clinical conditions, the definitive treatment with flaps was adequate for cases of wounds due to extravasation of drugs in the subcutaneous tissue when there was exposure of noble structures.
- POSTOPERATIVE RETROSPECTIVE ANALYSIS OF THE TREATMENT OF DUPLICATED THUMB(2018) NAKAMOTO, Hugo Alberto; RAMOS, Frederico Faleiro; GONCALVES, Reinaldo Borges; GOLDENBERG, Dov Charles; GEMPERLI, RolfObjective: To evaluate postoperative epidemiological and functional factors in patients operated to treat duplicate thumb. Methods: This retrospective case series evaluated 20 patients (23 thumbs) treated from January 2012 to December 2016 at our service. Epidemiological and clinical factors were studied, including Tada score. Results: Of the 34 children who were treated surgically, only 20 appeared for the functional evaluation and were included in the study. Of the operated cases, 60% were Wassel type 4. All evaluated cases had good functional results (Tada score >= 5, mean score: 6.65). The most frequently used surgical technique was resection of the radial thumb with reconstruction of the radial collateral ligament (47.8% of cases). Conclusion: Surgical correction of duplicated thumb yields good results, as long as attention is paid to abnormalities in bones, ligaments, and tendons.
- Fractional Carbon Dioxide Laser in Patients with Skin Phototypes III to VI and Facial Burn Sequelae: 1-Year Follow-Up(2018) SALLES, Alessandra Grassi; LUITGARDS, Bruno Ferreira; MORAES, Luciana Borsoi; REMIGIO, Adelina Fatima do Nascimento; ZAMPIERI, Ligia Araujo; GEMPERLI, RolfBackground: Fractional carbon dioxide laser treatment in postburn scars is safe and effective, but high rates of hypochromia (35 percent) have been described in patients with skin phototypes V and VI after 2 months. The authors militated the efficacy and safety of fractional carbon dioxide laser treatment of burn scars in skin phototypes III to VI after 1 year, focusing on the incidence of hypochromia. Methods: A case series of 20 patients had skin phototypes III to VI with facial burn sequelae. They underwent three sessions of fractional laser. Laser fluence was increased in patients with no hypochromia and reepithelialization time of less than 15 days. Scars were evaluated after 2 months and 1 year by a five-item scale: color, hydration, surface irregularities, volume, and distensibility. Results: The mean time for reepithelialization was 13.3 days (range, 2 to 40 days). The average final score of the scale increased from 4.4 before treatment to 7.33 after 1 year for physicians, and from 5.35 to 7.5 for patients. There was also an increase in the subjective score, which patients used to assess their skin. Two months after treatment, 60 percent of patients presented with punctate hypochromia. After 1 year, only 15 percent of patients still had mild hypochromia; all of them had skin phototypes V and VI. Nevertheless, they were satisfied with overall bleaching of the skin. Conclusions: Fractional carbon dioxide laser improved skin quality. Late punctate hypopigmentation should be considered a possible complication in patients with skin phototypes V and VI.
- Statistical Basic Steps to Be Considered on Planning a Research(2018) CAMARGO, Cristina Pires; GEMPERLI, Rolf
- Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps(2018) MONTAG, Eduardo; UEDA, Thiago; OKADA, Alberto; ONISHI, Bruno; GEMPERLI, RolfBackground Flap coverage is the gold standard in treating pressure sores, and due to the high recurrence rate, the possibility of multiple surgical procedures should be considered during flap selection. The gluteal thigh (GT) flap has become a workhorse for ischiatic pressure sore treatment at our hospital. Follow-up revealed a group of patients presenting recurrence of the pressure sore that needed a second flap. The inferior gluteal artery perforator (IGAP) flap was chosen in this series. The positive experience with both flaps raised the question of which flap should be the first option for the treatment of ischiatic and perineal pressure sores. Methods IGAP and GT flaps were dissected in 21 fresh human cadavers to allow comparison of anatomical features. In a series of 60 patients, the authors used both the gluteal thigh and the IGAP flap to cover 76 ischiatic and perineal ulcers. Results The IGAP flap was found to be wider and thicker than the gluteal thigh, but presented a shorter pedicle. All flaps healed uneventfully. Recurrent ulcers were treated successfully with both flaps. Conclusions Both flaps are suitable for coverage ischiatic and perineal sores. Due to its anatomical features, the IGAP flap should be considered the first choice of treatment for ischiatic ulcers. The gluteal thigh flap should be used in the recurrent sores.
- Subdermal neo-umbilicoplasty in abdominoplasty(2018) POVEDANO, Alejandro; SANTOS, Gabriel Salum D'Alessandro Lauren Klas Iurk Leme dos; MUNHOZ, Alexandre Mendonca; GEMPERLI, Rolf; GOES, Joao Carlos SampaioBackground Umbilicoplasty is an important surgical procedure in abdominoplasty, regardless of the technique used. An unaesthetic umbilicus often irreversibly affects surgical outcomes. This study describes the experience of our team with the subdermal neo-umbilicoplasty technique and assesses patient satisfaction with the appearance of the new umbilicus. Methods Fifty-eight patients with abdominal deformity underwent abdominoplasty with subdermal neo-umbilicoplasty. Patients were followed up for at least 1 year with photographic documentation, assessment of patient satisfaction, and evaluation of eventual postoperative complications. Results Postoperative complications included one case of shallow umbilicus, four cases of superficial necrosis, and one case of midline deviation. No patient required surgical revision. There was a high level of patient satisfaction with the natural-looking umbilicus. Conclusions Subdermal neo-umbilicoplasty resulted in low postoperative complications and provided a new, natural-looking umbilicus without external scars.
- Meretoja Syndrome: General Considerations and Contributions of Plastic Surgery in Surgical Treatment(2018) FRIEDHOFER, Henri; VASSILIADIS, Aneta Hionia; SCARPA, Marcela Benetti; LUITGARDS, Bruno Ferreira; GEMPERLI, Rolf