RODOLFO COSTA LOBATO
Projetos de Pesquisa
Unidades Organizacionais
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
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- 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.
- The impact of COVID-19 on the plastic surgery activity in a high-complexity university hospital in Brazil: the importance of reconstructive plastic surgery during the pandemic(2020) PAGOTTO, Vitor Penteado Figueiredo; ABBAS, Laielly; GOLDENBERG, Dov Charles; LOBATO, Rodolfo Costa; NASCIMENTO, Bruno Baptista do; MONTEIRO, Gustavo Gomes Ribeiro; CAMARGO, Cristina Pires; BUSNARDO, Fabio de Freitas; GEMPERLI, RolfBackground The Hospital das Clinicas - University of Sao Paulo Medical School (HCFMUSP) is the largest university hospital complex in Brazil. HCFMUSP has been converted into a reference center for coronavirus disease 2019. The Division of Plastic Surgery postponed non-essential surgeries and outpatient consultations, accomplishing new guidelines (ANG) of national and international organizations. Even with these challenges arising from the pandemic, alternatives were considered to maintain institutional characteristics. This study aims to analyze this new scenario and the impact on patients' assistance and Plastic Surgery residents training. Methods Total number of surgeries, type of procedures, and outpatient consultations in 2020, before (pre-ANG) and after (post-ANG) ANG, were compared with the same period in 2019 (2019-pre and 2020-post). Results A marked reduction in the total number of surgeries and outpatient consultations was observed in the post-ANG period. In the post-ANG period, 267 operations were performed (26.7 +/- 20.3/week), while in the 2019-post period, 1036 surgeries were performed (103.6 +/- 9.7/week) (p = 0.0002). Similarly, 1571 consultations were conducted in the post-ANG period (157.1 +/- 93.6/week), while in the 2019-post period, 3907 were performed (390.7 +/- 43.1/week) (p = 0.0003). However, in the post-ANG period, an increase in the proportion of reconstructive compared with aesthetic surgery was observed. The maintenance of highly complex procedures such as microsurgical transplants was also identified. Conclusions The predominant profile of reconstructive surgeries at the Division of Plastic Surgery allowed the continuity of procedures at all technical complexity levels, patient care maintenance, and Plastic Surgery residents training. Level of evidence: not ratable
- Translation, Cross-Cultural Adaptation and Linguistic Validation of the FACE-Q Questionnaire for Brazilian Portuguese(2019) BUSTILLO, Adriana Margarita Buelvas; LOBATO, Rodolfo Costa; LUITGARDS, Bruno Ferreira; CAMARGO, Cristina Pires; GEMPERLI, Rolf; ISHIDA, Luiz CarlosBackgroundPatient-reported outcomes measurement instruments (PRO) are a good way to measure results after aesthetic procedures. FACE-Q is a systematized and standardized PRO tool and was not available in Portuguese. MethodsThis cross-sectional study included four stages: translation of FACE-Q, backtranslation, testing in patients who underwent facial aesthetic procedures and review of the questionnaires between September and December, 2018. Guidelines merging WHO and ISPOR's rules were followed. ResultsTranslation was conducted by two translators, resulting in two versions, translation A and translation B, which were reconciled to generate the first Portuguese version. Reconciliation showed inconsistencies between TA and TB in 63% (n=222) of the 353 questions, which were solved by maintaining TA in 25% of cases (n=87), TB in 27% and a new version in 11% (n=40) of the questions. Backtranslation showed written differences with the original FACE-Q in 64 (22.7%) of the 353 question, but only one case of semantic difference, which was corrected resulting in production of the second Portuguese version. Seven patients with a mean age of 35.8years were interviewed to assess the difficulty in understanding the questionnaires. Four patients had no or minor difficulties understanding the questionnaire, and the other three had difficulties and suggested changes that led to a third Portuguese version. The third version was reviewed for grammar and spelling resulting in the final Portuguese version.ConclusionA Brazilian Portuguese version of the FACE-Q questionnaire was obtained maintaining equivalency with the source instrument. This will allow cross-cultural research and comparison of results between different studies.Level of Evidence VThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
- Surgical treatment of a penoscrotal massive localized lymphedema: Case report(2019) LOBATO, Rodolfo Costa; ZATZ, Rafael Ferreira; CINTRA JUNIOR, Wilson; MODOLIN, Miguel Luiz Antonio; CHI, Alex; ALMEIDA, Yanessa Katiana Van Dunem Filipe de; GEMPERLI, RolfINTRODUCTION: Massive localized lymphedema is an aggressive type of lymphedema that causes great functional impairment for the patient, depriving from one's basic life activities. The treatment of this type of lesion is eminently surgical, requiring ablative surgery (complete surgical resection of the lesion), but the possible techniques not always provide a good functional result. PRESENTATION OF CASE: We reported a case of a penoscrotal massive lymphedema treated by our Body Contour Group/Plastic surgery department of our institute. We performed the resection of the giant penoscrotal lesion, used a posterior scrotal flap for defect's reconstruction and a split-thickness skin graft for penis' body reconstruction, closed with Z-plasty. DISCUSSION: Contrary to what the literature says, we prefer to use the split-thickness skin graft to reconstruct the penis' body in these cases, against local flaps. According to our experience with some similar cases, this technique provides a better functional result once it allows the penis to a better expansion during erection. The key maneuver to avoid contracture of the graft and retraction of the penis is to perform a broken line suture (Z-plasty) in the topography of the median raphe. CONCLUSION: In cases of penoscrotal massive lymphedema, the treatment's option with better results is the surgical one. The use of a scrotal flap associated with split-thickness skin graft for penis provides good aesthetic and functional outcomes. (C) 2019 The Authors.