PEDRO SOLER COLTRO
Projetos de Pesquisa
Unidades Organizacionais
RCA, FMRP - Docente
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- 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.
- Obesity Modifies the Effect of Fitness on Heart Rate Indices during Exercise Stress Testing in Asymptomatic Individuals(2015) ANENI, Ehimen C.; ONI, Ebenezer T.; OSONDU, Chukwuemeka U.; MARTIN, Seth S.; BLAHA, Michael J.; VELEDAR, Emir; AGATSTON, Arthur S.; FELDMAN, Theodore; CARVALHO, Jose A. M.; CONCEICAO, Raquel D.; SANTOS, Raul D.; NASIR, KhurramObjective: To assess the impact of aerobic fitness on exercise heart rate (HR) indices in an asymptomatic cohort across different body mass index (BMI) categories. Methods: We performed a cross-sectional analysis of 506 working-class Brazilian subjects, free of known clinical cardiovascular disease (e.g. ischemic heart disease and stroke) who underwent an exercise stress test. Results: There was a significant trend towards decreased HR at peak exercise, HR recovery and chronotropic index (CI) measures as BMI increased, but resting HR increased significantly across BMI categories. In multivariate analysis, the change in CI per unit change in metabolic equivalents of task was greater among the obese subjects than the normal-weight (2.7 vs. -0.07; p interaction = 0.029) and overweight (2.7 vs. 0.7; p interaction = 0.044) subjects. A similar pattern was seen with peak HR and HR recovery, although the formal tests of interaction did not achieve statistical significance. Conclusion: Our findings strongly suggest that fitness is associated with a favorable HR profile and is modified by BMI. Intervention programs should place emphasis on fitness and not only on weight loss. (C) 2015 S. Karger AG, Basel
bookPart Tumores cutâneos(2015) COLTRO, Pedro Soler; BUSNARDO, Fábio de Freitas; GEMPERLI, Rolf- 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.)
- Alternative Surgical Treatment of Paralytic Lagophthalmos Using Autogenic Cartilage Grafts and Canthopexy(2013) FRIEDHOFER, Henri; COLTRO, Pedro Soler; VASSILIADIS, Aneta Hionia; NIGRO, Marcelus Vinicius; SAITO, Fabio Lopes; MOURA, Tatiana; FARIA, Jose Carlos; FERREIRA, Marcus CastroPurpose: This study aims to analyze the use of autogenic auricular cartilage grafts as weight for the upper eyelid in conjunction with lateral canthopexy for patients with mild paralytic lagophthalmos. This procedure was also accompanied by elevation of the lower eyelid using the cartilage graft for moderate cases. Methods: We conducted a retrospective study including case series of 30 patients with paralytic lagophthalmos from 1997 to 2010. For mild cases, cartilage from the auricular scapha was placed in pretarsal space of the upper eyelid and cartilage from the concha was inserted in preaponeurotic space and then sutured to the levator aponeurosis in conjunction with lateral canthopexy. For moderate cases, lower eyelid was also elevated by suturing cartilage graft to tarsum and resting it by the inferior orbital rim. Results: All patients had some degree of keratopathy before the intervention. After treatment, they presented with evident clinical improvement, reduction of eye symptoms, and resolution of keratopathy. During the mean postoperative follow-up of 37.3 months, none of the patients presented with cartilage graft exposition, reabsorption, visibility, infection, or warping. Complete eye closure was achieved in 24 (80%) patients, whereas the remaining 6 (20%) patients had residual asymptomatic lagophthalmos. Conclusions: The intervention using autogenic auricular cartilage grafts explained in this study was only effective for the treatment of mild and moderate cases of paralytic lagophthalmos. This outpatient surgery is associated with low morbidity and achievement of functional and aesthetic improvement.
bookPart A graduação médica, a cirurgia plástica e as ligas acadêmicas(2015) MUNHOZ, Alexandre Mendonça; COLTRO, Pedro Soler; DANILA, Arthur Hirschfeld; GEMPERLI, Rolf- Sensibility of the Ear After Otoplasty(2012) COLTRO, Pedro S.; ALVES, Helio R. N.; GALLAFRIO, Samuel T.; BUSNARDO, Fabio F.; FERREIRA, Marcus C.Changes in skin sensibility occur in various postoperative plastic surgeries, especially when they involve major skin and subcutaneous dissection. There were no studies so far that objectively compared changes of ear sensibility. This prospective study was conducted to compare ear sensibility before and after otoplasty. Patients with prominent ears (n = 15) underwent bilateral otoplasty. Ear tactile sensibility was tested preoperatively and 6 and 12 months after surgery by Pressure Specified Sensory Device, an apparatus that quantifies cutaneous pressure sensation (g/mm(2)). Comparison between preoperative and 6-months postoperative results indicated an increment on mean skin pressure thresholds; however, mean thresholds between pre- and 12 months postoperative period were similar. Vibratory and hot/cold sensibility did not present any difference during this period. This is the first comparative assessment of ear tactile sensibility using quantitative methods. After otoplasty, initially there was reduction in an ear tactile sensibility, followed by a return to levels similar to preoperative sensibility.
- Curativo da área doadora de enxerto de pele parcial com curativo de colágeno e alginato (Fibracol®): uma experiência de 35 pacientes(2015) MILLAN, LINCOLN SAITO; SILVA, DIEGO BARÃO DA; COLTRO, PEDRO SOLER; ALMEIDA, PAULO CEZAR CAVALCANTE DE; MATTAR, CARLOS ALBERTO; FAIWICHOW, LEÃOABSTRACT Introduction: The objective of this study was to report our findings with a collagen and alginate dressing (Fibracol®) used to cover donor areas of partial-thickness skin grafts. Method: We retrospectively evaluated the medical records of 35 patients in whom Fibracol® was used on donor areas. The routine used to manage the donor area is as follows: The area is covered with one or more units of Fibracol®, followed by application of a waterproof film. After three or four days, the dressing is removed and the area cleaned gently with saline and gauze; the area is dressed again if necessary. The mean patient age was 25.52 years (range, 1-65 years). Results: The thigh was used as the donor area in 29 patients, the arm in 2, the leg in 4, and the trunk in 3. Two patients had more than one donor area. The mean time needed for epithelization was 4.51 days (range, 3-8 days). The Pearson correlation coefficient value correlating age and time of epithelization was -0.0755; p = 0.6685. None of the patients experienced an infection in the donor area. The ideal dressing for the donor area of split-thickness skin grafts would have multiple characteristics including low price, good patient comfort, low infection rate, and a short epithelization period. Conclusion: The authors report a positive experience with the use of Fibracol® in 35 patients over a period of 22 months. The mean epithelization period was 4.51 days, shorter than that in the majority of published studies, and had no correlation with the age of the patient.
- Sensibility of the ear after otoplasty(2013) COLTRO, P. S.; FERREIRA, M. C.Assessment of cutaneous tactile sensibility may be carried out by some neurosensory tests, based on the knowledge of skin innervation Dellon (Ann Plast Surg 51(1):6–9, 2003). The group A-beta nerve fibers are responsible for conducting touch stimuli including both those from slow- and fast-adaptation sensory receptors. The slow-adaptative fibers conduct pressure perception, constant touch, and texture, and their skin receptors are the Merkel and Ruffini cells. The fast-adaptative fibers provide motion and vibration perception, and their cutaneous receptors are the Meissner and Pacini cells. The authors report the results of their study of the sensibility of the ear preoperatively and postoperatively. © Springer-Verlag Berlin Heidelberg 2013.
- Evaluation of cutaneous sensibility of the internal pudendal artery perforator (IPAP) flap after perineal reconstructions(2015) COLTRO, Pedro S.; FERREIRA, Marcus C.; BUSNARDO, Fabio F.; OLIVAN, Marcelo V.; UEDA, Thiago; GRILLO, Victor A.; MARQUES, Carlos F.; NAHAS, Caio S.; NAHAS, Sergio C.; GEMPERLI, RolfBackground: In oncological perineal reconstructions, the internal pudendal artery perforator (IPAP) flap is our flap of choice, supplied by perforator vessels from the internal pudendal artery and innervated by branches from the pudendal nerve and the posterior femoral cutaneous nerve. Data related to the evaluation of its cutaneous sensibility are scarce, discrepant, and subject to methodological criticism. Objective: The objective of this study was to evaluate the cutaneous sensibility of the IPAP flap 12 months after perineal reconstruction and compare it with the preoperative cutaneous sensibility of the gluteal fold (flap donor area). Methods: A prospective study of 25 patients undergoing abdominoperineal excision of rectum (APER) and reconstruction with bilateral VY advancement IPAP flap was conducted. The tactile, pain, thermal, and vibration sensibilities were analyzed in four areas of the gluteal fold preoperatively and in the four corresponding areas of the flap 12 months after surgery. Tactile sensibility was assessed using the Pressure Specified Sensory Device (TM) (PSSD (TM)), which measures the pressure applied to the skin. The other types of sensibility were analyzed using a needle for pain, hot/cold contact for thermal, and a tuning fork for vibration sensibility. Results: A comparison between tactile sensibility thresholds on the gluteal fold preoperatively and on the flap 12 months after surgery showed no statistically significant difference, with p values >0.05 in all four areas evaluated. All patients had preserved pain, thermal, and vibration sensibility in all four areas, postoperatively. Conclusion: In oncological perineal reconstructions after APER, it is expected that the cutaneous sensibility on the IPAP flap be maintained.