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
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bookPart Abordagem de ferimentos descolantes(2019) MILCHESKI, Dimas; MENDES, Rogério; FREITAS, Fernando Ramos de; GEMPERLI, Rolf- Complicação grave do uso irregular do PMMA: relato de caso e a situação brasileira atual(2019) KURIMORI, KLEBER TETSUO; MENDES, MONIQUE; MILCHESKI, DIMAS ANDRÉ; MONTEIRO JUNIOR, ARALDO AYRES; GEMPERLI, ROLF▪ ABSTRACT Introduction: Use of permanent fillers can lead to significant complications. In Brazil, polymethylmethacrylate (PMMA)is a product approved by the Agência Nacional de VigilânciaSanitária (ANVISA), but its use exceeds its indications, leadingto serious complications. Recommendations for restricteduse have been in place for more than a decade, but caseswith serious consequences due to inappropriate use are stillseen. Objective: To report a serious complication due to inappropriate use of PMMA and discuss the current status of PMMA use in Brazil based on recommendations of medical societies and regulatory agencies. Methods: This report describes a case of extensive necrosis of the gluteal region after injection of PMMA by a non-qualified practitioner; the report also reviews the literature on the current status of PMMA use in Brazil. Discussion Despite the efforts of medical societies, acute and chronic complications are still reported in the Brazilian literature. In 2016, more than 17,000 PMMArelated complications were reported; nevertheless, reliable epidemiological data remain unavailable because the number of treatments, the quality of the product, and the training of practitioners remain unregulated. Conclusion A significant number of repair procedures are performed in Brazil to correct complications resulting from the use of PMMA. The severity of the reported case highlights the need to combat bad practice by untrained professionals, as well as the need for greater control of PMMA marketing by regulatory agencies.
- Retalho interósseo posterior reverso do antebraço para o tratamento cirúrgico do trauma elétrico da mão: relato de caso(2019) LOBATO, RODOLFO COSTA; MOTA, WELLINGTON MENEZES; TUMA JUNIOR, PAULO; MILCHESKI, DIMAS ANDRÉ; NAKAMOTO, HUGO ALBERTO; GEMPERLI, ROLF▪ ABSTRACT Introduction: Lesions affecting the hands with significant skin loss often require flaps for early coverage, as these permit faster healing. Among the various options, the reverse posterior interosseous flap of the forearm is most commonly used for defects involving the back of the hand and wrist due to low complication rates. Normally, this flap is not used for the reconstruction of defects in the palmar region since its distal reach is insufficient. Case report: We present the case of a male patient with third-degree electrical burns on his right palm, whose reconstruction was performed on the 14th day postinjury using the reverse posterior interosseous flap of the forearm after conservative debridement. The patient presented good postoperative evolution, without long-term complications or functional sequelae. Conclusion: The reverse posterior interosseous flap of the forearm permits adequate coverage of palm injuries, preserving its functionality.