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The microsurgical repair of sarcoma defects is a reliable option that, though not free of complications, is necessary in selected cases such as patients receiving neoadjuvant treatments and those with head and neck location and high-grade tumors. The procedure enables both adequate oncosurgical resection and function preservation. Our microsurgical sarcoma reconstruction data, based on an observation period of 12 years and presenting the results of 42 free tissue transfers in 41 patients, adds further evidence to the previously published smaller series.

Primary reconstructive surgery has a fundamental role in sarcoma treatment enabling radical surgical resection, avoiding amputations and facilitating adjuvant treatments.

La elefantiasis escrotal es una condición que ha sido historicamente descrita en áreas endémicas de filariasis, siendo menos frecuente su presentación idiopática o asociada a otras entidades. Presentamos un caso de elefantiasis escrotal gigante de causa adquirida al que se le practicó exéresis de estructura linfadematosa con reconstrucción con colgajo local y autoinjerto cutáneo. El caso clínico presentado es raro, ya sea por la baja frecuencia o por su etiología, así como por la importante magnitud del problema. Por esta razón hemos decidido presentarlo para dar a conocer posibilidades terapéuticas y realizar una revisión del tema.

The gastro-omental flap represents a useful method for reconstruction of the pharyngoesophageal segment in a surgical field compromised by previous multimodal therapy. Despite being useful, the complication rate is relevant.

Background: Maxillary reconstructive surgery with fibula free flaps (FFFs) is a challenging procedure for head and neck surgeons. However, virtual surgical planning (VSP) and three-dimensional (3D) printing technologies have contributed to improved functional and aesthetic outcomes. The objective of this report is to demonstrate VSP/3D application in reconstruction of maxillary defects using the FFF by describing the different configurations available. We reviewed a series of consecutive cases operated at our institution and considered the management strategy of in-house planning in VSP/3D application.Methods: In total, 11 cases were included from November 2016 to December 2021.Eight male and three female were included, with a mean age of 55.4 years old (range: 34-74 years old). Maxillary defects were classified according to Brown's Classification: two cases with IIB, one case with IIC, four cases with IID, three cases with III, and one case with IV. Preoperatively, facial computed tomography (CT) and lower extremity computed tomography angiogram (CTA) were performed in all patients.Osteocutaneous FFFs were planned, harvested, and customized according to the VSP/3D guide configuration. VSP and 3D printed cutting guides were performed by an external company in nine cases and were self-planned in three of them. Titanium 3D-printed fixation plates were used in four cases.Results: All flaps survived, and the main reconstructive goals were achieved in 9 cases out of 11. Mean FFF length before osteotomy was 20.0 cm (17.5-22.5 cm). None of the cases experienced flap ischemia or venous congestion. At least one complication occurred in four cases: Prefabricated titanium plate exposure (two cases), loss of donor site skin grafts (one case), and ectropion (one case). One patient underwent a second FFF reconstruction. Two titanium printed plates became exposed after radiotherapy and needed to be removed. Mean follow-up time was 23.5 months (range 6-63 months). Dental rehabilitation was completed in eight of the 11 cases. Regarding functional recovery, five cases underwent delayed osseo-integrated dental implants

No abstract

Cada vez más, con el fin de alcanzar un resultado final integral óptimo, las Unidades de tratamiento del cáncer de mama requieren las habilidades de un cirujano plástico reconstructor. En nuestra Unidad, desde hace más de 20 años, se entiende como calidad asistencial la suma de competencia oncológica y habilidad reconstructiva. Por ello se incorpora como miembro integral del equipo clínico la figura del cirujano plástico, aportando criterios estéticos a la cirugía oncológica aplicando las técnicas de cirugía oncoplástica. En este artículo analizamos la evolución de la cirugía oncoplástica en los últimos 20 años, demostrando la importancia del cirujano plástico como miembro integral de Unidad de Patología Mamaria.