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
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- 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.
- 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.)
- 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.
- Face transplantation in rats. Reproducibility of the experimental model in Brazil(2014) BUSNARDO, Fábio de Freitas; COLTRO, Pedro Soler; OLIVAN, Marcelo Vitoriano; BARREIRO, Guilherme Cardinali; BAPTISTA, Rachel Rossine; FERREIRA, Marcus Castro; GEMPERLI, RolfPURPOSE: To investigate the reproducibility of the experimental model of face allotransplantation in rats in Brazil. METHODS: Eighteen rats were operated, nine-nine donors recipients. Animals underwent transplantation of the left hemiface, with periorbital and scalp. Transplants were made from donor Wistar rats to recipients Lewis rats. Flaps were based on the common carotid artery and the external jugular vein of the donor animal and the anastomosis in the recipient area was performed in common carotid artery (end-to-side) and in external jugular vein (end-to-end). RESULTS: Of the nine recipient animals operated, six survived and three progressed to death in the first days after surgery (survival rate = 67%). The mean time of the procedure was 252 minutes and the mean time of flap ischemia was 95 minutes. The five surviving animals were sacrificed at 14 days, in good general condition and without signs of tissue rejection. CONCLUSIONS: The experimental model of face allotransplantation in rats is reproducible in our midst. Duration of surgery, time of flap ischemia, animal survival rate and complications observed were similar to those described in the literature.
- Anatomical comparison among the anterolateral thigh, the parascapular, and the lateral arm flaps(2015) BUSNARDO, Fabio F.; COLTRO, Pedro S.; OLIVAN, Marcelo V.; FAES, Jose C.; LAVOR, Elizeu; FERREIRA, Marcus C.; RODRIGUES, Aldo J.; GEMPERLI, RolfObjectiveThis study aims to compare the major anatomical aspects among anterolateral thigh, parascapular and lateral arm flaps. MethodsSixty flaps were dissected in 20 human cadavers, comparing their vascular pedicle length, flap thickness and arterial/venous pedicle diameters. ResultsThe vascular pedicle length (from the origin of the vascular pedicle to its entry into the skin flap) of anterolateral thigh flap (13.433.92 cm, lateral circumflex femoral artery) was longer than parascapular (9.07 +/- 1.20 cm, circumflex scapular artery) and lateral arm flap (8.90 +/- 1.65 cm, posterior collateral radial artery) (P<0.001). The thickness of lateral arm flap (6.32 +/- 2.33 mm) was lesser than parascapular (8.59 +/- 2.93 mm) and anterolateral thigh flap (9.30 +/- 3.54 mm) (P<0.001). The arterial/venous pedicle diameters of lateral arm flap (2.37 +/- 0.69 mm / 2.61 +/- 0.74 mm) were lesser than parascapular (3.46 +/- 0.80 mm / 4.07 +/- 0.87 mm) and anterolateral thigh flap (3.26 +/- 0.74 mm / 3.87 +/- 0.70 mm) (P<0.001). ConclusionsThe vascular pedicle length of anterolateral thigh flap was the longest and that lateral arm flap presented a pedicle with the smallest arterial and venous diameters, in addition to being the thinnest flap. (c) 2014 Wiley Periodicals, Inc. Microsurgery 35:387-392, 2015.