Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Ortopedia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000500772 |
Resumo: | Abstract Objective Advances in reconstructive microsurgery in orthopedic surgery provided better functional and aesthetic results and avoided many indications for amputation. In high-volume trauma and orthopedic hospitals, microsurgical reconstruction is essential to reduce costs and complications for these complex orthopedic defects. We describe a microsurgical approach to traumatic wounds, tumor resection, bone defects, and free muscle transfer, performed by an orthopedic microsurgery unit. The objective of the present study was to evaluate predictor factors for outcomes of microsurgical flaps for limb reconstruction, and to provide a descriptive analysis of microsurgical flaps for orthopedic indications. Methods Cross-sectional prospective study that included all consecutive cases of microsurgical flaps for orthopedic indications from 2014 to 2020. Data were collected from personal medical history, intraoperative microsurgical procedure, and laboratory blood tests. Complications and free-flap outcomes were studied in a descriptive and statistical analysis. Results We evaluated 171 flaps in 168 patients; the indications were traumatic in 66% of the patients. Type III complications of the Clavien-Dindo Classification were observed in 51 flaps. The overall success rate of the microsurgical flaps was 88.3%. In the multivariate analysis, the risk factors for complications were ischemia time ≥ 2 hours (p= 0.032) and obesity (p= 0.007). Partial flap loss was more common in patients with thrombocytosis in the preoperative platelet count (p= 0.001). Conclusion The independent risk factors for complications of microsurgical flaps for limb reconstruction are obesity and flap ischemia time ≥ 2 hours, and presence of thrombocytosis is a risk factor for partial flap loss. |
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Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adultsfree tissue flapstraumamicrosurgeryorthopedic procedurestissue transplantationAbstract Objective Advances in reconstructive microsurgery in orthopedic surgery provided better functional and aesthetic results and avoided many indications for amputation. In high-volume trauma and orthopedic hospitals, microsurgical reconstruction is essential to reduce costs and complications for these complex orthopedic defects. We describe a microsurgical approach to traumatic wounds, tumor resection, bone defects, and free muscle transfer, performed by an orthopedic microsurgery unit. The objective of the present study was to evaluate predictor factors for outcomes of microsurgical flaps for limb reconstruction, and to provide a descriptive analysis of microsurgical flaps for orthopedic indications. Methods Cross-sectional prospective study that included all consecutive cases of microsurgical flaps for orthopedic indications from 2014 to 2020. Data were collected from personal medical history, intraoperative microsurgical procedure, and laboratory blood tests. Complications and free-flap outcomes were studied in a descriptive and statistical analysis. Results We evaluated 171 flaps in 168 patients; the indications were traumatic in 66% of the patients. Type III complications of the Clavien-Dindo Classification were observed in 51 flaps. The overall success rate of the microsurgical flaps was 88.3%. In the multivariate analysis, the risk factors for complications were ischemia time ≥ 2 hours (p= 0.032) and obesity (p= 0.007). Partial flap loss was more common in patients with thrombocytosis in the preoperative platelet count (p= 0.001). Conclusion The independent risk factors for complications of microsurgical flaps for limb reconstruction are obesity and flap ischemia time ≥ 2 hours, and presence of thrombocytosis is a risk factor for partial flap loss.Sociedade Brasileira de Ortopedia e Traumatologia2022-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000500772Revista Brasileira de Ortopedia v.57 n.5 2022reponame:Revista Brasileira de Ortopedia (Online)instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)instacron:SBOT10.1055/s-0041-1735946info:eu-repo/semantics/openAccessIamaguchi,Raquel BernardelliMacedo,Lucas SousaCho,Alvaro BaikRezende,Marcelo Rosa deMattar Júnior,RamesWei,Teng Hsiangeng2022-11-18T00:00:00Zoai:scielo:S0102-36162022000500772Revistahttp://www.rbo.org.br/https://old.scielo.br/oai/scielo-oai.php||rbo@sbot.org.br1982-43780102-3616opendoar:2022-11-18T00:00Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)false |
dc.title.none.fl_str_mv |
Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults |
title |
Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults |
spellingShingle |
Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults Iamaguchi,Raquel Bernardelli free tissue flaps trauma microsurgery orthopedic procedures tissue transplantation |
title_short |
Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults |
title_full |
Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults |
title_fullStr |
Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults |
title_full_unstemmed |
Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults |
title_sort |
Microsurgical Reconstruction in an Orthopedic Hospital: Indications and Outcomes in Adults |
author |
Iamaguchi,Raquel Bernardelli |
author_facet |
Iamaguchi,Raquel Bernardelli Macedo,Lucas Sousa Cho,Alvaro Baik Rezende,Marcelo Rosa de Mattar Júnior,Rames Wei,Teng Hsiang |
author_role |
author |
author2 |
Macedo,Lucas Sousa Cho,Alvaro Baik Rezende,Marcelo Rosa de Mattar Júnior,Rames Wei,Teng Hsiang |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Iamaguchi,Raquel Bernardelli Macedo,Lucas Sousa Cho,Alvaro Baik Rezende,Marcelo Rosa de Mattar Júnior,Rames Wei,Teng Hsiang |
dc.subject.por.fl_str_mv |
free tissue flaps trauma microsurgery orthopedic procedures tissue transplantation |
topic |
free tissue flaps trauma microsurgery orthopedic procedures tissue transplantation |
description |
Abstract Objective Advances in reconstructive microsurgery in orthopedic surgery provided better functional and aesthetic results and avoided many indications for amputation. In high-volume trauma and orthopedic hospitals, microsurgical reconstruction is essential to reduce costs and complications for these complex orthopedic defects. We describe a microsurgical approach to traumatic wounds, tumor resection, bone defects, and free muscle transfer, performed by an orthopedic microsurgery unit. The objective of the present study was to evaluate predictor factors for outcomes of microsurgical flaps for limb reconstruction, and to provide a descriptive analysis of microsurgical flaps for orthopedic indications. Methods Cross-sectional prospective study that included all consecutive cases of microsurgical flaps for orthopedic indications from 2014 to 2020. Data were collected from personal medical history, intraoperative microsurgical procedure, and laboratory blood tests. Complications and free-flap outcomes were studied in a descriptive and statistical analysis. Results We evaluated 171 flaps in 168 patients; the indications were traumatic in 66% of the patients. Type III complications of the Clavien-Dindo Classification were observed in 51 flaps. The overall success rate of the microsurgical flaps was 88.3%. In the multivariate analysis, the risk factors for complications were ischemia time ≥ 2 hours (p= 0.032) and obesity (p= 0.007). Partial flap loss was more common in patients with thrombocytosis in the preoperative platelet count (p= 0.001). Conclusion The independent risk factors for complications of microsurgical flaps for limb reconstruction are obesity and flap ischemia time ≥ 2 hours, and presence of thrombocytosis is a risk factor for partial flap loss. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000500772 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000500772 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1055/s-0041-1735946 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Ortopedia e Traumatologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Ortopedia e Traumatologia |
dc.source.none.fl_str_mv |
Revista Brasileira de Ortopedia v.57 n.5 2022 reponame:Revista Brasileira de Ortopedia (Online) instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT) instacron:SBOT |
instname_str |
Sociedade Brasileira de Ortopedia e Traumatologia (SBOT) |
instacron_str |
SBOT |
institution |
SBOT |
reponame_str |
Revista Brasileira de Ortopedia (Online) |
collection |
Revista Brasileira de Ortopedia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT) |
repository.mail.fl_str_mv |
||rbo@sbot.org.br |
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1752122363624816640 |