DIMAS ANDRE MILCHESKI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
23 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 23
bookPart Reconstrução de membros inferiores(2015) MILCHESKI, Dimas André; NAKAMOTO, Hugo Alberto; MUNHOZ, Alexandre Mendonça- Extensive scalp ulcer secondary to delusional infestation treated with antipsychotics and scalp reconstruction(2020) PINCELLI, M. S.; GUIMARARES, A. L. M.; MILCHESKI, D. A.; DWAN, A. J.; NICO, M. M. S.
- Estudo prospectivo da sensibilidade tátil em mãos de uma população brasileira usando pressure-specified sensory device(2012) TUSTUMI, Francisco; NAKAMOTO, Hugo Alberto; TUMA JUNIOR, Paulo; MILCHESKI, Dimas André; FERREIRA, Marcus CastroOBJECTIVE: To evaluate the pressure perception thresholds on the pulp of two fingers (index and little fingers), among a Brazilian population with no nerve injury or neuropathy. METHODS: We used the Pressure-Specified Sensory Device (a computerized device) to derive static and dynamic normal pressure perception thresholds and two-point discrimination distances. RESULTS: We tested finger sensitivity on 30 volunteers. Significance analyses were performed using the Student t test. The mean values (g/mm²) for static one and two-point pressure thresholds (s1PD, s2PD) and dynamic one and two-point discrimination (m1PD, m2PD) in the dominant index finger were: s1PD = 0.4, m1PD = 0.4, s2PD = 0.48, m2PD = 0.51. CONCLUSION: There was no significant difference in sensitivity between the dominant and nondominant hands.
- Abdominoplastia vertical para tratamento do excesso de pele abdominal após perdas ponderais maciças(2012) TUMA JR., Paulo; BATISTA, Bernardo Pinheiro de Senna Nogueira; MILAN, Lincoln Saito; FARIA, Gladstone Eustáquio de Lima; MILCHESKI, Dimas André; FERREIRA, Marcus CastroBACKGROUND: Bariatric surgeries are becoming increasingly common in the treatment of morbidly obese patients. The enormous weight loss resulting from these procedures causes excessive skin and subcutaneous tissue throughout the body, especially in the abdominal region. The objective of this study was to present the technique of vertical abdominoplasty as an alternative for resection of excess skin in ex-obese patients. METHODS: We retrospectively evaluated the records of 40 patients who underwent vertical abdominoplasty between 2004 and 2009. The degree of patient satisfaction was assessed through a subjective scale, with scores ranging from 0 to 10. RESULTS: Twenty-five percent of the patients had minor complications (3 seromas, 3 minor dehiscences, and 5 hypertrophic scars), which were all treated on an outpatient basis. Sixty-seven percent of the patients reported high satisfaction and considered their results as good (grades 7 or 8) or excellent (grades 9 or 10). CONCLUSIONS: The vertical abdominoplasty technique appears to be a new option for the treatment of excess abdominal skin in ex-obese patients.
- Complicação grave do uso irregular de silicone industrial em paciente transexual: relato de caso(2020) MENDES, MONIQUE; MONTEIRO, GUSTAVO GOMES RIBEIRO; BASTOS, EMILLY FREIRE BARBOSA; MILCHESKI, DIMAS ANDRÉ; MONTEIRO JUNIOR, ARALDO AYRES; GEMPERLI, ROLFABSTRACT The use of industrial liquid silicone as a material for aesthetic modification of body contour is a practice that has been carried out clandestine for about 60 years. Currently, most reports come from countries in Asia and South America, and the victims are mainly women and transsexuals. Due to the large number of cases with complications, the use of industrial silicone for aesthetic purposes has never been approved. However, it continues to be applied alone or associated with other products, determining severe local and systemic complications. We report a case of death of a transsexual patient after injecting industrial silicone in the thighs and buttocks.
- 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.
- Sensory Testing in Patients With Hemodialysis-Associated Carpal Tunnel Syndrome Submitted to Surgical Decompression(2014) NAKAMOTO, Hugo Alberto; FERREIRA, Marcus Castro; TUSTUMI, Francisco; MILCHESKI, Dimas A.; TUMA, PauloBackground: Carpal tunnel syndrome (CTS) is the most common compression neuropathy of the upper limb. Close to 5% of patients with chronic renal failure who need hemodialysis present CTS. Clinical history and physical examination remain the most adequate tools for diagnosis, and there is still controversy regarding the most reliable test to complement it. Evaluation of sensory thresholds using Pressure-Specified Sensory Device (PSSD) has become an important instrumental test. Method: This study aimed to determine the values of pressure sensory thresholds using the PSSD before and after treatment of CTS in a special group of patients who underwent chronic hemodialysis. The PSSD incorporates a pressure transducer linked to a computer capable of measuring the cutaneous pressure thresholds referred by the patient. Two groups were compared as follows: group 1, patients with hemodialysis-related CTS; and group 2, CTS in nonYhemodialysis patients. The following measurements were assessed: static one point, moving one point, static two points, and moving two points. Results: There was improvement (lower thresholds) in the postoperative measurements in all parameters assessed in group 1, and improvements in all parameters except the moving one point test in group 2. Conclusions: Nerve decompression, as expected, can be considered a good treatment of CTS even in more severe cases as in those patients under hemodialysis. The PSSD tests were reliable to confirm the diagnosis and thus to indicate the decompression. It is even more beneficial to provide a comparison between preoperative and postoperative data and different causes of CTS.
- Terapia por pressão negativa na ferida traumática complexa do períneo(2013) MILCHESKI, Dimas André; ZAMPIERI, Felipe Muniz de Castro; NAKAMOTO, Hugo Alberto; TUMA JÚNIOR, Paulo; FERREIRA, Marcus CastroOBJECTIVE: To review the experience (2011 and 2012) of Wound Center of Plastic Surgery Service, Clinics Hospital, Faculty of Medicine, University of São Paulo, with treatment of complex traumatic wounds in the perineal region with the association of negative pressure wound therapy followed by a surgical skin coverage procedure. METHODS: This was retrospective analysis of ten patients with complex wound in the perineum resulting from trauma assisted by the Department of Plastic Surgery in HC-USP. Negative pressure was used as an alternative for improving local conditions, seeking definitive treatment with skin grafts or flaps. RESULTS: Negative pressure was used to prepare the wound bed. In patients, the mean time of use of negative pressure system was 25.9 days, with dressing changes every 4.6 days. After negative pressure therapy, 11 local flaps were performed in nine patients, with fasciocutaneous anterolateral thigh flap used in four of these. Mean hospital stay was 58.2 days and accompaniment in Plastic Surgery was 40.5 days. CONCLUSION: The use of negative pressure therapy led to improvement of local wound conditions faster than traditional dressings, without significant complications, proving to be the current best alternative as an adjunct for the treatment of this type of injury, always followed by surgical reconstruction with grafts and flaps.
- Avaliação do impacto no atendimento de pacientes com ferimentos descolantes durante a pandemia de COVID-19 em serviço especializado(2021) CLIVATTI, GUSTAVO MOREIRA; MILCHESKI, DIMAS ANDRé; BRIZA, DANIELLE NUNES; RIBEIRO, RENAN DIEGO AMéRICO; ABBAS, LAIELLY; MONTEIRO, GUSTAVO GOMES RIBEIRO; GEMPERLI, ROLF■ ABSTRACT Introduction: The COVID-19 pandemic was responsible for increasing social isolation rates, resulting in a reduction in traffic accidents. Trauma, in general, is among the most important public health problems worldwide. This study aims to evaluate the impact of social isolation in the city of São Paulo during the COVID-19 pandemic on the care of patients with detaching wounds. Methods: Observational, retrospective and descriptive study. All medical records of patients treated at the Emergency Room of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HCFMUSP), by the Complex Wounds Group of the Plastic Surgery Service, admitted for detaching wounds and undergoing surgical procedures, were reviewed, from April to June of the years 2019 and 2020. Results: Twenty patients with detaching injuries on the lower limbs were included. In 2019, 14 patients were seen, with a mean age of 47 years, 7 of which were victims of traffic accidents, 5 of being run over, 1 of crushing and 1 of falling from standing height. In 2020, 6 patients were treated with detaching wounds during the pandemic, with a mean age of 36.16 years, 5 of which were victims of motorcycle accidents and 1 of being run over. No patient had COVID-19. Conclusion: During social isolation, there was a numerical reduction in care for detaching trauma during the quarantine period.
- Surgical treatment of sacral pressure wounds in patients with COVID-19: A case series(2023) FERREIRA, Joao; NICOLAS, Gregory; VALENTE, Daniel; MILCHESKI, Dimas; SALIBA, Marita; GEMPERLI, Rolf
- «
- 1 (current)
- 2
- 3
- »