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      Versatilidade do retalho musculocutâneo do tensor da fáscia lata Translated title: Versatility of the fascia lata tensor musculocutaneous flap

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          Abstract

          OBJETIVO: Relatar a experiência com a utilização do retalho musculocutâneo do tensor da fáscia lata (TFL em diferentes situações clínicas, evidenciando suas diversas aplicações, analisando e discutindo as indicações, resultados e complicações. MÉTODO: Entre janeiro de 2003 e dezembro de 2005 dezessete retalhos miocutâneos do TFL foram realizados para cobertura cutânea em uma variedade de defeitos em quinze pacientes.Durante o ato operatório a equipe optou pelo posicionamento do paciente em decúbito lateral em oposição ao lado da lesão a ser reparada. RESULTADOS: Houve sucesso com cobertura cutânea adequada em todos os casos. Em quatro destes ocorreu necessidade de enxerto de pele parcial na área doadora. Em dois casos houve isquemia distal do retalho e em um aconteceu pequena deiscência de sutura em zona doadora. CONCLUSÃO: O retalho miocutâneo do tensor da fáscia lata, portanto, possibilita uma excelente cobertura cutânea para tratamento de defeitos em diversos segmentos anatômicos com pouca morbidade em área doadora.

          Translated abstract

          BACKGROUND: The fascia lata tensor (FLT) musculocutaneous flap holds a great versatility. It is used in countless situations. We present our experience with the use of this flap in several circumstances. We also analyze and discuss about indications, results and complications. METHODS: Between January 2003 and December 2005, 15 patients (10 man and 5 women) underwent 17 FLT flaps to treat many skin defects. Patients were between 18 and 65 years-old. Patients' position during surgery was lateral decubitus. Follow up has been obtained from 6 months to 3 years. RESULTS: We succeed with fit skin coverage in all cases. Partial skin graft was necessary in four cases. Distal flap ischemia occurred in two patients. Small dehiscence at the donor site was seen (and treated by simple suture) in one case. CONCLUSION: The FLT musculocutaneous flap is extremely reliable and versatile; it has easy and fast execution and relatively few complications. It can successfully be used in many clinical situations.

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          Most cited references10

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          An Algorithm for Abdominal Wall Reconstruction

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            Role of tensor fasciae latae in abdominal wall reconstruction.

            The role of the tensor fasciae latae as autogenous tissue in reconstruction of abdominal wall defects is well established. The use of various forms of the tensor fasciae latae (free graft versus pedicled flap versus free flap) is determined by the characteristics of the defect. A review of abdominal wall reconstructions using tensor fasciae latae was completed to determine efficacy and establish guidelines for its use. Abdominal wall reconstructions from 1991 to 1994 using tensor fasciae latae were reviewed. Demographics, wound characteristics, and complications were evaluated. Twenty-seven patients with a mean follow-up of 23.6 months underwent abdominal wall reconstruction with the tensor fasciae latae: free grafts, 12; pedicled flaps, 9; and free flaps, 6. An average defect size of 14.4 x 13.1 cm was seen. Fourteen (52 percent) of the reconstructions were completed in contaminated or infected wounds. One recurrent enteric fistula was seen. Twelve (44 percent) of the patients had flap complications of which 50 percent involved partial flap necrosis. Donor site complications were seen in five patients (18 percent) and included a hematoma, seroma, and two cases of skin graft dehiscence along the edge of the wound. Tensor fasciae latae free grafts are an option for repair of abdominal hernias if abdominal soft tissue is adequate. Pedicled flaps may be used for defects of soft tissue and fascia but are limited by the arc of rotation and size of the defect. Tensor fasciae latae free flaps are versatile in orientation and may be used for supraumbilical defects. Tip necrosis is significant in both types of vascularized flaps.
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              Abdominal wall reconstruction with the free tensor fascia lata musculofasciocutaneous flap using intraperitoneal gastroepiploic recipient vessels.

              The authors report their experience with a method for definitive abdominal wall reconstruction using the free tensor fascia lata musculofasciocutaneous flap anastomosed to the intraperitoneal gastroepiploic vessels. This is a single-stage reconstruction capable of reconstructing reliably a full-thickness defect involving any region of the abdominal wall. The fascial component of the flap reconstructs the abdominal wall with like tissue, and the cutaneous portion of the free tensor fascia lata provides a durable and aesthetically acceptable external cover. The intraperitoneal gastroepiploic artery and vein were the first-choice recipient vessels used in all three patients. These intraperitoneal recipient vessels allow uninterrupted fascial closure, restoring structural integrity to the abdominal wall, and allow the use of free flaps with short vascular pedicles. The authors present a series of three cases of full-thickness upper and lower abdominal wall reconstruction using this method, presenting its advantages compared with other methods.
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                Author and article information

                Journal
                rcbc
                Revista do Colégio Brasileiro de Cirurgiões
                Rev. Col. Bras. Cir.
                Colégio Brasileiro de Cirurgiões (Rio de Janeiro, RJ, Brazil )
                0100-6991
                1809-4546
                June 2008
                : 35
                : 3
                : 155-158
                Affiliations
                [01] orgnameUFBA orgdiv1FAMED
                [02] orgnameSociedade Brasileira de Cirurgia Plástica
                [03] orgnameUFBA orgdiv1FAMED
                [05] orgnameLiga Baiana de Cirurgia Plástica
                [06] orgnameLiga Baiana de Cirurgia Plástica
                [04] orgnameSociedade Brasileira de Cirurgia Plástica
                Article
                S0100-69912008000300003 S0100-6991(08)03500303
                10.1590/S0100-69912008000300003
                f320173f-6e97-44b4-9920-79bbe1a873db

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 21 January 2008
                : 21 November 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 4
                Product

                SciELO Brazil

                Categories
                Artigos Originais

                Retalhos Cirúrgicos,Músculos,Fáscia Lata,Surgical flaps,Muscles,Fascia Lata

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