HELIO RICARDO NOGUEIRA ALVES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Supraclavicular flap as a salvage procedure in reconstruction of head and neck complex defects(2019) ALVES, Helio R. N.; FARIA, Jose Carlos Marques de; SANTOS, Rafael Varella dos; CERNEA, Claudio; BUSNARDO, Fabio; GEMPERLI, RolfThe supraclavicular island flap (SCIF) is an interesting therapeutic option in head and neck reconstruction. Since popularized by Pallua in the late 90s, several clinical series have been published showing its versatility and usefulness. However, only a few studies have focused on factors associated with complications from SCIF use. In this study, we analyzed the factors contributing to SCIF unreliability. We performed a retrospective review of the data of 87 patients undergoing SCIF reconstruction between 2008 and 2015. No significant differences in mean complication rates were observed when the SCIF was used for primary or salvage reconstruction (28% versus 25%, respectively, p = 0.816) or for cutaneous or intraoral reconstruction (27% versus 28%, respectively, p= 0.932). Flap folding, preoperative radiotherapy, and microsurgery were associated with significantly increased complication rates (p =0.002, p= 0.043, and p= 0.001, respectively), whereas smoking (p =0.431) had no impact with regard to this. In conclusion, the SCIF is a versatile flap and an important therapeutic tool for use in salvage surgeries, particularly in those performed in patients with poor clinical conditions and limited flap options.
- A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients(2012) ALVES, Helio R. N.; ISHIDA, Luis C.; ISHIDA, Luis H.; BESTEIRO, Julio M.; GEMPERLI, Rolf; FARIA, Jose C. M.; FERREIRA, Marcus C.The supraclavicular island flap has been widely used in head and neck reconstruction, providing an alternative to the traditional techniques like regional or free flaps, mainly because of its thin skin island tissue and reliable vascularity. Head and neck patients who require large reconstructions usually present poor clinical and healing conditions. An early experience using this flap for late-stage head and neck tumour treatment is reported. Forty-seven supraclavicular artery flaps were used to treat head and neck oncologic defects after cutaneous, intraoral and pharyngeal tumour resections. Dissection time, complications, donor and reconstructed area outcomes were assessed. The mean time for harvesting the flaps was 50 min by the senior author. All donor sites were closed primarily. Three cases of laryngopharyngectomy reconstruction developed a small controlled (salivary) leak that was resolved with conservative measures. Small or no strictures were detected on radiologic swallowing examinations and all patients regained normal swallowing function. Five patients developed donor site dehiscence. These wounds were treated with regular dressing until healing was complete. There were four distal flap necroses in this series. These necroses were debrided and closed primarily. The supraclavicular flap is pliable for head and neck oncologic reconstruction in late-stage patients. High-risk patients and modified radical neck dissection are not contraindications for its use. The absence of the need to isolate the pedicle offers quick and reliable harvesting. The arc of rotation on the base of the neck provides adequate length for pharyngeal, oral lining and to reconstruct the middle and superior third of the face.
- Forehead reconstruction using supraclavicular flap with microsurgical technique: Free flap and a pedicle supercharged flap(2017) ALVES, H. R. N.; FARIA, J. C. M. de; BUSNARDO, F.; CERNEA, C.; RANGEL, T.; GEMPERLI, R.Large and deep defects in foreheads are best repaired with flaps. In these types of cases, reconstructions are made through the transfer of distant flaps, due to the small amount of available local tissue. The supraclavicular island flap (SCIF) has been extensive used for head and neck reconstructions during the last two decades. However, the flap extension is limited to the reconstruction of the superior third of the face, which may increase the risk of distal flap necrosis. The authors describe two cases of forehead reconstruction with the SCIF using a microsurgical technique. © 2017 The Author(s)