Iana Silva Dias

Treinamento inicial em microcirurgia

The microsurgical technique witch until the 1980s was an exclusion procedure, only chosen in extreme cases, due to easily observed advances seen in innumerous current publications, has become in various procedures the first surgical option, practically compelling all doctors who practice in the field of Plastic Surgery to perform training in the referred technique. The current article presents an easy executed model of microsurgery basic training.

Impacto da radioterapia adjuvante no resultado cosmético da reconstrução mamária imediata com retalho TRAM

INTRODUCAO: O efeito da radioterapia adjuvante apos a reconstrucao mamaria com retalhos autologos e controverso. O objetivo deste estudo e analisar se a radioterapia pos-operatoria causa alteracoes volumetricas e cosmeticas apos a reconstrucao mamaria imediata com retalho do musculo reto abdominal (TRAM, do ingles transverse rectus abdominis myocutaneous). METODO: No total, foram avaliadas 25 pacientes submetidas a reconstrucao autologa com retalho TRAM pediculado pos-mastectomia por câncer de mama e radioterapia adjuvante. Os resultados esteticos tardios foram coletados apos o intervalo minimo de 6 meses posteriormente ao esquema completo da radioterapia. RESULTADOS: A media de idade das pacientes foi de 42,2 anos, variando de 30 anos a 53 anos. Duas (8%) perdas completas do retalho ocorreram por necrose gordurosa macica, duas (8%) pacientes evoluiram com contratura do retalho e perda volumetrica, e 52% das pacientes apresentaram alteracoes cutâneas. Entretanto, a maioria das pacientes (84%) nao evoluiu com perda significativa do volume inicial do retalho ou com distorcao do contorno e contracao do retalho. CONCLUSOES: O resultado cosmetico apos a reconstrucao mamaria imediata com retalho TRAM irradiado foi aceitavel, comparativamente aos dados descritos na literatura. Esses achados indicam que os retalhos podem sofrer distorcoes de contorno pela contracao, alem de perda volumetrica significativa em pacientes candidatas a reconstrucao com TRAM e necessidade de radioterapia adjuvante pos-mastectomia. Assim, as complicacoes tardias da irradiacao pos-operatoria devem ser consideradas nesse contexto.

Strategies for chest reconstruction following extensive resection of locally advanced breast tumors: an 11-case series

Introduction: Breast cancer is a major cause of mortality among women in Brazil. Locally advanced breast tumors are classified as stage III because they compromise the breast tissue in all or almost all of its extensions and regional lymph nodes, without distant metastases. Surgical treatment of these advanced tumors includes modified radical mastectomy, which involves axillary dissection and large skin resection, leading to major defects in the chest cavity that require complex reconstruction. Method: A retrospective clinical study including a series of 11 cases diagnosed with locally advanced breast tumors was performed from January 2006 to March 2014. Results: The chest cavity reconstruction methods performed after resection of advanced breast tumors included three fasciocutaneous flaps, two skin grafts, and six reconstructions with muscle flaps. These procedures resulted in effective coverage of extensive chest defects. Conclusion: Aggressive surgical treatment is feasible in these tumors; although numerous reconstruction options are available, individual case assessment is necessary to determine the optimal technique to reduce surgical trauma and lower morbidity in order to avoid delays in adjuvant treatment in these patients. The reconstructions were safe, with satisfactory results similar to those reported in the literature.

Surgical correction of constrictive bands in Vohwinkel syndrome

Vohwinkel syndrome, also known as hereditary mutilating keratoderma, is a rare palmoplantar keratoderma that manifests in childhood and becomes more evident in adolescence and adulthood. This preferential autosomal dominant disease affects more women and Caucasians. Its clinical features are diffuse palmoplantar keratoderma with the appearance of honeycomblike constricting rings in the fingers and toes known as pseudo-ainhum, and starfish-shaped keratotic plaques on the dorsal aspect of the hands and feet that can affect the elbows and knees. The present report describes a case report of a patient with Vohwinkel syndrome and surgical correction of the constrictive bands.

Program for theoretical and practical training insuture techniques for medical students in the field of plastic surgery at the Federal University of Ceará (UFC)

289 1 General Surgeon Resident in the Plastic Surgery and Reconstructive Microsurgery Service at University Hospital Walter Cantídio/Federal University of Ceará, Fortaleza, Brazil; Aspirant Member of the Brazilian Society of Plastic Surgery (SBCP). 2 Member of the Brazilian Society of Plastic Surgery Regent of the Plastic Surgery and Reconstructive Microsurgery Service at University Hospital Walter Cantídio/Federal University of Ceará, Fortaleza, Brazil. 3 Member of the Brazilian Society of Plastic Surgery (SBCP) Plastic Surgery Preceptor in the Plastic Surgery and Reconstructive Microsurgery Service at University Hospital Walter Cantídio/Federal University of Ceará, Fortaleza, Brazil. 4 Specialist Member of the Brazilian Society of Plastic Surgery (SBCP) Plastic Surgery Preceptor in the Plastic Surgery and Reconstructive Microsurgery Service at University Hospital Walter Cantídio/Federal University of Ceará, Fortaleza, Brazil. 5 Medical Student at the Federal University of Ceará, Fortaleza, Brazil Member of the League of Plastic Surgery and Reconstructive Microsurgery Dr. German Riquet. 6 Medical Student at the Federal University of Ceará, Fortaleza, Brazil. -Member of the League of Plastic Surgery and Reconstructive Microsurgery Dr. German Riquet. Program for theoretical and practical training in suture techniques for medical students in the field of plastic surgery at the Federal University of Ceará (UFC)

Technical standardization of the microsurgery training program of plastic surgery and reconstructive microsurgery service of the Walter Cantídio University Hospital of the Federal University of Ceará (HUWC/UFC)

283 1 General Surgeon – Resident Physician at the Plastic Surgery and Reconstructive Microsurgery Service of Walter Cantídio University Hospital of the Federal University of Ceará, Fortaleza, CE, Brazil; Aspirant Member of the Brazilian Society of Plastic Surgery (BSPS). 2 Member of the Brazilian Society of Plastic Surgery (BSPS) – Regent of the Plastic Surgery and Reconstructive Microsurgery Service of Walter Cantídio University Hospital of the Federal University of Ceará, Fortaleza, CE, Brazil. 3 Member of the Brazilian Society of Plastic Surgery (BSPS) – Plastic Surgeon and Preceptor of the Plastic Surgery and Reconstructive Microsurgery Service of Walter Cantídio University Hospital of the Federal University of Ceará, Fortaleza, CE, Brazil. 4 Specialist Member of the Brazilian Society of Plastic Surgery (BSPS) – Plastic Surgeon and Preceptor of the Plastic Surgery and Reconstructive Microsurgery Service of Walter Cantídio University Hospital of the Federal University of Ceará, Fortaleza, CE, Brazil. 5 Professor of Medicine at the Federal University of Ceará, Fortaleza, CE, Brazil – Member of the Plastic Surgery and Reconstructive Microsurgery League Dr. Germano Riquet. Technical standardization of the microsurgery training program of plastic surgery and reconstructive microsurgery service of the Walter Cantídio University Hospital of the Federal University of Ceará (HUWC/UFC)

Síndrome de Plummer-Vinson: relato de caso

We present a case of Plummer-Vinson syndrome, which is a rare condition nowadays. The diagnosis was made after years of the disease, many doctors having attended the patient. The treatment consisted of oral supplementation of iron and endoscopic dilatations. The patient is asymptomatic.

Design de novo instrumento cirúrgico para ritidoplastia: agulha para suspensão do SMAS

This article describes an alternative surgical instrument that can be used for suspension of the malar fat pad. The needle was created using Kirschner wire to ensure that both tips were blunt. The double tip allows for passage of the wire through the superficial muscular aponeurotic system, ensuring that the suture is sufficiently deep to avoid dermatography. The utility of the new instrument was tested in rhytidoplasties involving minimal dissection. The needle described herein was proven safe, and could easily migrate through the tissues, without creating vascular and nerve lesions, and facilitate the positioning of the fixation points at the intended sites. The use of this needle for rhytidoplasty was quick, simple, and cost-effective, without any resulting dissection or damage to the anatomical structures or tissues.

Abordagem cirúrgica de neurofibroma gigante

Neurofibromatosis is a disease of genetic origin with autosomal dominant inheritance that is classified into 3 types: neurofibromatosis type I (NF1), neurofibromatosis type 2 (NF2), and schwannomatosis. The main characteristics of NF1 are cafe-au-lait spots, dermal and plexiform neurofibromas, false dermal and plexiform neurofibromas, false axillary or inguinal ephelides, and Lisch nodules. This study describes the case of a 26-year-old man who presented with small cutaneous nodules, present since he was 3 years old, and cafe-au-lait spots of different sizes distributed diffusely. At the age of 13, the patient developed a mass in the back and abdomen that subsequently developed into a rapidly growing voluminous mass, which hindered walking and caused social isolation. The surgical treatment consisted of the excision of the tumor in 2 phases, with a 2-month interval between procedures. Although a cure for neurofibromatosis has not been discovered, surgical removal is indicated in cases of neurological involvement, pain, disfigurement, possible involvement of adjacent structures, and suspicion of malignancy. Partial resection is acceptable if total removal is not possible. In the present case, surgical treatment was an excellent choice because it enabled the complete excision of the lesion, with satisfactory wound healing and aesthetic results, as well as the improvement of the quality of life of the patient.

Técnica simples e segura para a reconstrução areolopapilar com tatuagem intradérmica

BACKGROUND: The final step in the creation of the neo-breast is reconstruction of the nipple-areolar complex (NAC), which is aimed toward bringing the appearance of the NAC closer to that of the contralateral breast following mastectomy. NAC restoration has historically been a stepwise procedure, in which reconstruction of the nipple by the use of grafts or local flaps was followed by reconstruction of the areola to achieve the correct color. Currently, the popularity of the areolar tattoo is increasing compared to traditional techniques. The aim of this study was to describe the technique and equipment used for intra-dermal tattooing in mastectomized patients at the Plastic Surgery and Reconstructive Microsurgery Service of the Walter Cantidio University Hospital (Fortaleza, CE, Brazil). METHODS: This study describes the steps of the repair procedure by using permanent areolar tattooing with conventional equipment from a professional tattoo artist. The procedure was used in 10 patients undergoing post-mastectomy breast reconstruction. RESULTS: The advantages of this method included the technical simplicity of the procedure, the ability to use this procedure in outpatients, and the lack of morbidity of the donor areas. CONCLUSIONS: Tattooing the NAC is a safe, fast procedure with low morbidity and good results of breast reconstruction.