TENG HSIANG WEI
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
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- A REINFORCEMENT OF THE SUTURED MICROVASCULAR ANASTOMOSIS WITH FIBRIN GLUE APPLICATION: A RETROSPECTIVE COMPARATIVE STUDY WITH THE STANDARD CONVENTIONAL TECHNIQUE(2017) CHO, Alvaro Baik; PAULOS, Renata Gregorio; BERSANI, Gustavo; IAMAGUCHI, Raquel Bernardelli; TORRES, Luciano Ruiz; WEI, Teng Hsiang; RESENDE, Marcelo Rosa De; MATTAR JUNIOR, RamesPurpose: Although a reasonable number of studies report satisfactory results with fibrin glue application in microvascular anastomosis since 1977, its utilization in the clinical setting has being scant in the literature. The aim of this study was to report the cumulated experience with the fibrin glue in free flaps over a period of 10 years, comparing the survival rate with the standard sutured anastomosis. Patients and methods: From August 2001 through November 2014, 83 consecutive free flaps were performed by a team of surgeons from two hospitals. About 56 flaps were performed in 56 patients using the fibrin glue augmented microvascular anastomosis and 27 flaps were performed in 27 patients using the conventional anastomosis technique. The decision on whether or not the fibrin glue should be used at the anastomoses was based on its availability and whose surgeon was performing the anastomoses. About approximately 60% of sutures stitches were used that would be used in a conventional anastomosis, when fibrin glue application was anticipated (ranging from 5 to 7 sutures in the arteries and 5 to 8 in the veins). Results: The overall survival rate of the flaps performed with fibrin glue application was 92.85%. In one case, a revision of the venous anastomosis was required due to early flap congestion. Four cases (7.14%) had failure of the first free flap and two of them were submitted to another free flap without fibrin glue application. In the flaps performed with the conventional anastomosis technique the survival rate was 92.59%. This difference was not statistically significant (P=0.97). Conclusion: The application of fibrin glue in microvascular anastomoses did not increase the rate of flap loss and had a potential to reduce the number of sutures required to complete an anastomosis by its sealing effect. (C) 2016 Wiley Periodicals, Inc.
- Diabetic limb salvage procedure with bone allograft and free flap transfer: A case report(2017) GODOY-SANTOS, A. L.; AMODIO, D. T.; PIRES, A.; LIMA, A. L. M.; WEI, T. H.; CESAR-NETTO, C. D.; ARMSTRONG, D. G.The aim of this case report was to describe a successful diabetic limb salvage procedure in the treatment of an infected diabetic foot ulcer through a multidisciplinary team approach and complex surgical reconstruction involving a femoral head bone allograft and musculocutaneous latissimus dorsi free flap. The decision to proceed with aggressive staged efforts at diabetic limb salvage should be made only after careful consultation with the patient, his or her family, and the rest of the multidisciplinary healthcare team. © 2017 The Author(s).
- Reconstrução tardia na mão traumatizada com perda de múltiplos dedos(2017) TAKEMURA, RENAN LYUJI; NAKAMOTO, HUGO ALBERTO; IWASE, FERNANDA DO CARMO; NAKAMOTO, JOÃO CARLOS; VERONESI, BRUNO AZEVEDO; WEI, TENG HSIANGABSTRACT Mutilating hand injuries are a challenge to both the hand surgeon and the patient. The surgeon must make decisions ranging from the initial debridement to which fingers and joints will be preserved and the appropriate use of the parts to be removed. Late reconstruction constitutes the second part of this difficult task. The difficulty attributed to the characteristics of each lesion, the large number of treatment possibilities, and the different levels of complexity must be adapted to the personal needs and motivation of each patient. This case report describes a late hand reconstruction with index and middle finger loss, using metacarpophalangeal joint transplantation of the index finger to gain the proximal interphalangeal function of the middle finger.
- Experimental study of histological changes in vascular loops according to the duration of the postoperative period: Application in reconstructive microsurgery(2017) PAULOS, Renata Gregorio; RUDELLI, Bruno Alves; FILIPPE, Renee Zon; SANTOS, Gustavo Bispo dos; HERRERA, Ana Abarca; RIBEIRO, Andre Araujo; REZENDE, Marcelo Rosa de; HSIANG-WEI, Teng; MATTAR- JR., RamesOBJECTIVES: To analyze the histological changes observed in venous grafts subjected to arterial blood flow as a function of the duration of the postoperative period to optimize their use in free flap reconstructions. METHOD: Twenty-five rats (7 females and 18 males) underwent surgery. Surgeries were performed on one animal per week. Five weeks after the first surgery, the same five animals were subjected to an additional surgery to assess the presence or absence of blood flow through the vascular loop, and samples were collected for histological analysis. This cycle was performed five times. RESULTS: Of the rats euthanized four to five weeks after the first surgery, no blood flow was observed through the graft in 80% of the cases. In the group euthanized three weeks after the first surgery, no blood flow was observed in 20% of the cases. In the groups euthanized one to two weeks after the first surgery, blood flow through the vascular loop was observed in all animals. Moreover, intimal proliferation tended to increase with the duration of the postoperative period. Two weeks after surgery, intimal proliferation increased slightly, whereas strong intimal proliferation was observed in all rats evaluated five weeks after surgery. CONCLUSION: Intimal proliferation was the most significant change noted in venous grafts as a function of the duration of the postoperative period and was directly correlated with graft occlusion. In cases in which vascular loops are required during free flap reconstruction, both procedures should preferably be performed during the same surgery.