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
4 resultados
Resultados de Busca
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- Supraclavicular flap for head and neck oncological reconstruction: A series of 62 cases(2023) TAKAHASHI, G. G.; RIBEIRO, R. D. A.; PAGOTTO, V. P. F.; FERNANDES, T. R. R.; ALVES, H. R. N.; BUSNARDO, F. D. F.; GEMPERLI, R.Introduction: The oncological reconstruction of extensive defects in the head and neck requires the plastic surgeon to make a difficult decision between the use of free flaps and pedicled flaps. The supraclavicular flap is one of the main examples of a pedicled flap, being versatile, with a thin thickness and similar color to the region to be reconstructed. Method: A retrospective study was carried out by collecting data from medical records of patients admitted to the Cancer Institute of the State of São Paulo between December 2010 and March 2020. Results: Among the 62 patients reconstructed with a supraclavicular flap, 37 were male and 25 female. Fifty-eight patients (93.5%) had some associated comorbidity. In total, 27 complications related to the flap (43.5%) were recorded, 5 of which were total necrosis (8%). Conclusion: The supraclavicular flap plays an important role in head and neck oncological reconstructions and should be considered as an option in patients who are poor candidates for microsurgical flaps.
- A versatilidade e confiabilidade do retalho Keystone em reconstruções oncológicas(2022) RIBEIRO, RENAN DIEGO AMÉRICO; PAGOTTO, VITOR PENTEADO FIGUEIREDO; CLIVATTI, GUSTAVO MOREIRA; TAKAHASHI, GIULIA GODOY; BUSNARDO, FÁBIO DE FREITAS; GEMPERLI, ROLFABSTRACT Introduction: The Keystone flap is an island flap with reliable vascularization and simple dissection, first described in 2003. Despite its distinct advantages, there are few scientific publications on this matter, and it is not a common option in the clinical practice of reconstructive surgery. This article aims to report the experience of a cancer referral center with Keystone flaps in oncological reconstructions. Methods: A retrospective study was carried out data from medical records of patients who performed oncological plastic reconstruction with keystone flaps, operated by the Surgery team of the Cancer Institute of the State of São Paulo, in addition to the analysis of pre, intra and postoperative photographic records. Results: Nine patients were identified, all with comorbidities and a mean age of 52.7. Skin defects followed after oncological resections: five in the lower extremities, three in the trunk and one in the face. The mean of the skin resected area was 52.6cm2. The reconstructions were performed under shortened surgical time. There were no postoperative complications or flap losses. The average hospital stay was 2.2 days. Conclusion: The Keystone flap is technically simple and a reproducible option for covering wounds of different sizes and locations. Due to its reliability, simple and quick dissection, shortened hospital stay and low morbidity in the donor area, it should be considered for reconstructing cancer wounds from different locations in patients of all ages.
- Paramedian forehead flap in the treatment of nasal, non-melanoma skin cancer: a cross-sectional study(2022) RIBEIRO, RENAN DIEGO AMÉRICO; PAGOTTO, VITOR PENTEADO FIGUEIREDO; TAKAHASHI, GIULIA GODOY; TUTIHASHI, RAFAEL MAMORU CARNEIRO; CAMARGO, CRISTINA PIRES; BUSNARDO, FABIO DE FREITAS; GEMPERLI, ROLFABSTRACT Introduction: nose is the central point of the face and vulnerable to the occurence of non-melanoma skin cancer (NMSC), impacting on appearance. The paramedian forehead flap (PMFF) is considered the best option to treat extensive nasal defects. The objective of this study is to present the experience on PMFF for nasal reconstruction in the treatment of NMSC of a cancer referral center. Methods: retrospective study was carried out through data from medical records of patients who underwent nasal reconstruction with PMFF due to NMSC at the Cancer Institute of the State of São Paulo (ICESP). Results: 111 patients were identified, mostly ederly, with comorbidities and on initial tumors (T1 and T2). Basal cell carcinoma (BCC) was the predominant histological type. Dorsum and tip were the most affected subunitis. In addition to skin coverage, reconstruction of the lining and structural framework was also performed in half of the cases. Second intention healing was the technique of choice in closing the donor area. Pedicle division ocurred predominantly in the second operation and the median time to complete reconstruction was 6 months. There were low complication rates. Conclusions: the PMFF is safe and effective to treat nose NMSC, even in cases of high complexity. Since the treatment time can be prolonged and impact on quality of life, it is essential to emphasize and discuss this aspect with the patients before surgery.
- Application of FACE-Q and NOSE in Nasal Reconstruction with Paramedian Frontal Flap after Skin Cancer Resection(2021) PAGOTTO, Vitor Penteado Figueiredo; TUTIHASHI, Rafael Mamoru Carneiro; RIBEIRO, Renan Diego Americo; TAKAHASHI, Giulia Godoy; CAMARGO, Cristina Pires; BUSNARDO, Fabio de Freitas; GEMPERLI, RolfIntroduction: Nonmelanoma skin cancer (NMSC) is responsible for high morbidity and mortality, resulting in a high cost to the health system. The nose is the leading region affected by this type of tumor and may need reconstruction by tissue transfer. The paramedian forehead flap (PFF) is one of the main options used, and the factors that influence the result should be studied. The FACE-Q questionnaire allows the assessment of appearance, quality of life, and side effects related to the procedure, whereas the Nasal Obstruction Symptom Evaluation questionnaire enables the nose function evaluation. Methods: This study evaluates nasal reconstruction with a PFF after resection of NMSC with the FACE-Q questionnaire and Nasal Obstruction Symptom Evaluation. Spearman Rank correlation coefficient tests between the questionnaire results and patients' characteristics were performed. Results: The questionnaires were completely answered by 49 patients who underwent this reconstruction between 2011 and 2019 in a cancer center. The patients' evaluations demonstrate high satisfaction with appearance, quality of life, side effects, and function. Completing reconstruction under 6 months was associated with a higher quality of life among patients (P = 0.002). Reconstruction of lining or scaffold, moment of flap division, complications, and number of operations did not show an association. Conclusion: This study suggests that the PFF is a reliable option for nasal reconstruction. Identifying the total reconstruction time as an impact factor on patients' quality of life should be considered when planning treatment.