FABIO DE FREITAS BUSNARDO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
36 resultados
Resultados de Busca
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bookPart Ultrassonografia de alta resolução na avaliação dos retalhos cirúrgicos(2021) MARCELINO, Antônio Sérgio Zafred; BUSNARDO, Fábio; JúNIOR, Frederico Teixeira; ZATTAR, Luciana- Chimerical anterolateral thigh flap for plantar reconstruction(2015) OLIVAN, Marcelo V.; BUSNARDO, Fabio F.; FARIA, Jose C.; COLTRO, Pedro S.; GRILLO, Victor A.; GEMPERLI, RolfObjectiveThe purpose of this study is to evaluate the results of reconstruction and rehabilitation of patients with plantar defects by using a chimerical flap of muscle and skin from anterolateral thigh. MethodsTwenty-five patients with plantar defects were reconstructed with a chimerical anterolateral thigh (ALT) flap, composed by a vastus lateralis muscle segment and a thinned skin island. Neurorrhaphy between lateral femoral cutaneous nerve and calcaneal nerve was performed in 7 patients. Evaluation of flap contour and stability and patient ambulation was performed 6 and 12 months after surgery. Evaluation of cutaneous sensiblity of ALT flap and contralateral thigh was performed 12 months after surgery using Pressure Specified Sensory Device (PSSD). ResultsFlap viability was complete in 23 patients and 2 patients had complications with partial flap loss of its cutaneous component. Six months postoperatively, flap contour, and stability was considered good in 19 and 21 patients respectively, and all 25 patients presented good ambulation. Twelve months postoperatively, all 25 patients presented good flap contour and stability, as well as good ambulation. All 7 flaps undergoing to reinnervation partially recovered cutaneous sensibility in comparison to donor site (contralateral thigh). Cutaneous tactile thresholds (g/mm(2)) of static one-point test and moving one-point test from the ALT flap and the contralateral thigh presented statistically significant differences, for both comparisons (P=0.009, P=0.002). ConclusionThis flap is suitable for reconstruction of plantar defects, with good flap contour and stability, proper patient ambulation and low complication rates. (c) 2015 Wiley Periodicals, Inc. Microsurgery 35:546-552, 2015.
- Tradução, adaptação e validação linguística do FACE-Q Câncer de Cabeça e Pescoço para o português do Brasil(2022) PAGOTTO, VITOR PENTEADO FIGUEIREDO; LOBATO, RODOLFO COSTA; BUSTILLO, ADRIANA MARGARITA BUELVAS; LOPES, CRISTIANE PEREIRA; TUTIHASHI, RAFAEL MAMORU CARNEIRO; BUSNARDO, FÁBIO DE FREITAS; GEMPERLI, ROLFABSTRACT Introduction: Head and neck neoplasms often affect fundamental functions, such as swallowing, speech, eating, and socializing. Evaluating their treatment should consider the physician’s opinion and the patient’s perspective. This difficulty in assessing the success of treatment led to the development of the FACE-Q Head and Neck Cancer Module, a questionnaire of patient-reported outcomes that measure the appearance, facial function, quality of life, and experience of care to head and neck neoplasms. The objective is to translation, cultural adaptation, and linguistic validation of the FACE-Q Head and Neck Cancer questionnaire for Brazilian Portuguese. Methods: The translation, cultural adaptation, and linguistic validation of the full questionnaire took place in four stages, using official guidelines from the World Health Organization and the International Society of Pharmacoeconomics and Outcomes Research. Results: A semantic, idiomatic, and conceptually equivalent Brazilian Portuguese version was achieved through a linguistically validated translation of the English FACE-Q Head and Neck Cancer module. Conclusion: The Brazilian Portuguese version presents a version equivalent to the original English instrument, which can be used as a critical patient-reported outcome assessment.
- Evaluation of nerve regeneration in diabetic rats(2013) SALLES JR., Guatacara Schenfelder; FARIA, Jose Carlos Marques de; BUSNARDO, Fabio Freitas; GEMPERLI, Rolf; FERREIRA, Marcus CastroPURPOSE: To compare sciatic nerve regeneration between non-diabetic (control) and streptozotocin-induced diabetic Wistar rats. METHODS: Four subgroups were evaluated. CN: Non-diabetic rats submitted to neurorrhaphy (n=9); DN: Diabetic rats submitted to neurorrhaphy (n=9); CG: Non-diabetic rats submitted to nerve grafting (n=10); DG: Diabetic rats submitted to nerve grafting (n=9). The nerve regeneration was evaluated by walking track analysis (sciatic functional index), electrophysiological test, histomorphometric analysis and triceps surae muscle weight. RESULTS: At 60 days post-surgery, functional recovery of DN was similar to that of the non-diabetic rats (CN, CG), but DG didn't achieve the same. Evoked potential amplitudes showed no statistically significant differences among subgroups. Triceps surae muscle was heavier in CN. No statistically significant differences were observed between the control and diabetes subgroups with respect to histomorphometric analysis. CONCLUSION: After 60 days, DN had a functionally similar recovery to that of the control animals, whereas nerve grafting in diabetic rats didn't allow the same. The muscle atrophy was lower in CN. In the rest of evaluations, as electrophysiological and histomorphometric, diabetic rats were not different from control ones.
- Outcomes of Immediate Internal Pudendal Artery Perforator Flap Reconstruction for Irradiated Abdominoperineal Resection Defects(2017) COLTRO, Pedro S.; BUSNARDO, Fabio F.; MONACO FILHO, Franklin C.; OLIVAN, Marcelo V.; MILLAN, Lincoln S.; GRILLO, Victor A.; MARQUES, Carlos F.; NAHAS, Caio S.; NAHAS, Sergio C.; RIBEIRO JR., Ulysses; GEMPERLI, RolfBACKGROUND: There are many previous reports for using the internal pudendal artery perforator flap in vulvovaginal reconstruction; however, reports of this flap for perineal reconstruction after abdominoperineal excision of the rectum are scarce. OBJECTIVE: The purpose of this study was to evaluate the outcomes of immediate internal pudendal artery perforator flap reconstruction for irradiated abdominoperineal resection defects. DESIGN: This was a prospective case series. SETTINGS: This flap could represent a step forward over other perineal flap approaches or primary closure. PATIENTS: A total of 73 consecutive patients with anorectal tumors were included. INTERVENTIONS: The study included immediate perineal reconstruction using 122 internal pudendal artery perforator flaps after abdominoperineal excision of the rectum. MAIN OUTCOME MEASURES: Dimensions of the perineal defect (in centimeters squared), hospital stay (days), healing time (days), and postoperative complications (Clavien-Dindo grades) were measured. RESULTS: The means of the perineal defect, hospital stay, and healing time were 51.62 cm(2), 15.94 days, and 38.52 days. The higher the patient BMI, the longer healing time (p = 0.02); Clavien-Dindo complications grades III to IV were greater in patients with perineal defect >= 60 cm(2) (p = 0.03; OR = 10.56); postoperative complications were higher both in patients with anal squamous cell carcinoma (p = 0.005; OR = 6.09) and in patients with comorbidities (p = 0.04; OR = 2.78); hospital stay (p = 0.001) and healing time (p < 0.001) were higher in patients who had postoperative complications. The complete perineal wound healing at 12 weeks was achieved by 95% of patients, and our 30-day mortality rate was 4%. LIMITATIONS: As a nonrandomized study, our results have to be interpreted with caution. CONCLUSIONS: Multiple previously described advantages associated with internal pudendal artery perforator flap were also observed here, reinforcing the idea that it is reliable, versatile, and a useful option for perineal reconstruction after abdominoperineal excision of the rectum. Therefore, we propose that this flap could be considered as the first choice for perineal reconstruction in selected patients with moderate and some large defects after abdominoperineal excision of the rectum. See Video Abstract at http://links.lww.com/DCR/A367.
- 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.
bookPart Tumores cutâneos(2015) COLTRO, Pedro Soler; BUSNARDO, Fábio de Freitas; GEMPERLI, Rolf- Supraclavicular flap as a salvage procedure in reconstruction of head and neck complex defects(2019) ALVES, Helio R. N.; FARIA, Jose Carlos Marques de; SANTOS, Rafael Varella dos; CERNEA, Claudio; BUSNARDO, Fabio; GEMPERLI, RolfThe supraclavicular island flap (SCIF) is an interesting therapeutic option in head and neck reconstruction. Since popularized by Pallua in the late 90s, several clinical series have been published showing its versatility and usefulness. However, only a few studies have focused on factors associated with complications from SCIF use. In this study, we analyzed the factors contributing to SCIF unreliability. We performed a retrospective review of the data of 87 patients undergoing SCIF reconstruction between 2008 and 2015. No significant differences in mean complication rates were observed when the SCIF was used for primary or salvage reconstruction (28% versus 25%, respectively, p = 0.816) or for cutaneous or intraoral reconstruction (27% versus 28%, respectively, p= 0.932). Flap folding, preoperative radiotherapy, and microsurgery were associated with significantly increased complication rates (p =0.002, p= 0.043, and p= 0.001, respectively), whereas smoking (p =0.431) had no impact with regard to this. In conclusion, the SCIF is a versatile flap and an important therapeutic tool for use in salvage surgeries, particularly in those performed in patients with poor clinical conditions and limited flap options.
- The Thoracodorsal Artery Perforator Flap in the Treatment of Axillary Hidradenitis Suppurativa: Effect on Preservation of Arm Abduction(2011) BUSNARDO, Fabio F.; COLTRO, Pedro S.; OLIVAN, Marcelo V.; BUSNARDO, Ana Paula V.; FERREIRA, Marcus C.Hidradenitis suppurativa is a chronic, recurrent inflammatory disease of the skin characterized by abscesses and scars. The axillary region is predominantly affected, leading to limited mobility of the arm due to scar retraction. This prospective study aimed to analyze the surgical treatment of severe lesions of axillary hidradenitis suppurativa by using the thoracodorsal artery perforator flap while focusing on the preservation of arm abduction. We enrolled 12 patients with severe axillary hidradenitis suppurativa who underwent bilateral surgical treatment of their lesions by radical excision, followed by immediate reconstruction with the thoracodorsal artery perforator flap. The amplitude of arm abduction was measured preoperatively and 6 months postoperatively by goniometry, and statistical analysis was performed using Student's t test. Preoperative and 6-month postoperative mean amplitude of arm abduction were 98.7 degrees and 152.7 degrees, respectively, with a significant mean increase of 54 degrees (p < 0.0001). The thoracodorsal artery perforator flap can be used as a good option for axillary reconstruction after radical excision of severe lesions of hidradenitis suppurativa, and its use would allow a significant increase in the amplitude of arm abduction. It has several other advantages when compared with other types of coverage, including its anatomical proximity to the axilla, similar thickness, and high-quality skin. (Plast. Reconstr. Surg. 128: 949, 2011.)
- The descending branch of the lateral femoral circumflex artery is a good option in CABG with arterial grafts(2013) GAIOTTO, Fabio Antonio; VIANNA, Caio B.; BUSNARDO, Fabio F.; PARGA, Jose R.; DALLAN, Luis Alberto de Oliveira; CESAR, Luis A. M.; STOLF, Noedir A. G.; JATENE, Fabio B.Introduction: The descending branch of the lateral femoral circumflex artery is an option for coronary artery bypass grafting. Objective: To evaluate the early patency and adaptation of lumen diameter using multidetector computed angiotomography. Methods: Thirty-two patients were selected to undergo coronary artery bypass grafting using the descending branch of the lateral circumflex artery, the internal thoracic artery, and other grafts. Evaluations were carried out through high resolution computed tomography performed on the 7th and 90th postoperative day. Diameters of the descending branch of the lateral circumflex artery and the left internal thoracic artery were measured 3 cm before the distal anastomosis, in the middle portion, and 3 cm after the proximal anastomosis. Diameters were compared using paired t-test (P<0.05). Results: Descending branch of the lateral femoral circumflex artery wDescending branch of the lateral femoral circumflex artery was used in 26 patients, as its use was not viable in six patients (18%). It was used as composite graft in all cases. The anterior descending branch was revascularized by the left internal thoracic artery in all cases. Patency rates of the descending branch of the lateral femoral circumflex artery were 96% and 92%, respectively. No occlusions were observed in the left internal thoracic artery (LITA) and no ischemic events were observed in the descending branch of the lateral circumflex. Descending branch of the lateral femoral circumflex artery increased the lumen diameter in the middle (P=0.001) and distal portions (P=0.006); the left internal thoracic artery (LITA) increased in the middle portion (P=0.001). Conclusion: Similar to the left internal thoracic artery, the descending branch of the lateral femoral circumflex artery showed high patency rate and positive luminal adaptation. This early evaluation confirms the descending branch of the lateral femoral circumflex artery as a potential alternative for grafting. Due to anatomical variations, preoperative femoral angiographic evaluation appears to be mandatory.