Aplicações do retalho romboide em reparações cutâneas

Abstract

Background:The plastic surgeon frequently performs reconstructions of diverse types of cutaneous defects; thus, it is essential to be versatile and have knowledge of appropriate techniques for each case. The rhomboid transposition flap, proposed by Alexander Limberg, is an extremely useful flap for a wide range of reconstructive procedures. This study aims to demonstrate the versatility, safety, and applicability of Limberg's flap for reconstruction of cutaneous losses located in a wide variety of body segments. Methods: A retrospective analysis of 50 patients with different cutaneous defects that had been reconstructed with the rhomboid flap was performed. A description of the surgical technique and a critical analysis of the results are presented. Results: The average age of the patients was 59.6 years. Neo plastic lesions accounted for most of the cases (84%). The face was the most frequently affected area, accounting for 36 (72%) cases; it was followed by the lumbosacral region (8%) and by the dorsal and inguinoscrotal regions (6%). Complications were observed in 4 (8%) patients. Conclusions: The rhomboid flap provides safe and predictable outcomes, and is the method of choice for most of the defects found.Keywords: Surgical flaps. Reconstructive surgical procedures/methods. Surgery, plastic/ methods. RESUMO Introdução:O cirurgião plástico frequentemente defrontase com a reparação dos mais diversos tipos de defeitos cutâneos; logo, é imprescindível que possua o conhecimento de técnicas versáteis e apropriadas para cada caso. O retalho romboide de transposição, proposto por Alexander Limberg, é um retalho extremamente útil para os mais diversos tipos de reconstrução. O objetivo deste trabalho é demonstrar a versatilidade, a segurança e a aplicabilidade do retalho de Limberg para reconstrução de perdas cutâneas localizadas nos mais diversos segmentos corporais. Método: Foi realizada análise retrospectiva de 50 pacientes apresentando defeitos cutâneos, dos mais variados tipos, reconstruídos com o retalho romboide. A descrição da técnica cirúrgica e uma análise crítica dos resultados são apresentadas. Resultados: A média de idade dos pacientes foi de 59,6 anos. As lesões neoplásicas foram responsáveis pela maioria dos casos (84%). A face foi a área mais envol vida nas reconstruções, totalizando 36 (72%) casos, seguida da região lombossacral (8%), e do dorso e da região inguinoscrotal (6%). Complicações foram observadas em 4 (8%) pacientes. Conclusões: O retalho romboide propicia resultados seguros e previsíveis, sendo a alternativa para a maioria dos defeitos encontrados.Descritores: Retalhos cirúrgicos. Procedimentos cirúrgicos reconstrutivos/métodos. Cirur gia plástica/métodos.

Rhomboid Flap: An Option to Many Anatomical Regions

“…The rhomboid flap has been considered the best technique for the treatment of the sacrococcygeal pilonidal disease [1,5]. It is a safe and versatile flap, as it can provide the transference of the adjacent tissue to the defect with the same skin color and texture, despite of generating increased tissue mobilization and scarring [1,4].…”

“…The rhomboid flap has been considered the best technique for the treatment of the sacrococcygeal pilonidal disease [1,5]. It is a safe and versatile flap, as it can provide the transference of the adjacent tissue to the defect with the same skin color and texture, despite of generating increased tissue mobilization and scarring [1,4]. This procedure can be easily executed and also has a low rate of complications as epitheliolysis with the partial necrosis of the flap, hematoma and bacterial infection.…”

“…In most cases, these complications can satisfactorily respond to conservative treatments, and can be minimized through a correct surgical marking and a meticulous intraoperative hemostasis [1,4].…”

“…In order to create a parallelogram, the skin excess resection might seem unnecessary, as it increases the bloody area. However, considering that the great majority of the lesions come from tumor excisions, such resection provides larger safety margins without compromising the final functional-aesthetic result [1,7].…”

“…The rhomboid transposition flap described by Alexander Limberg, in 1946, can be used at any region on the body surface, and is widely used on facial and breast reconstruction, neurosurgery, ophthalmology and proctology [1][2][3]. When used for surgical procedures for correcting facial defects, the Limberg's flap produces good functional and aesthetic results, particularly when scars are positioned at the junction of the aesthetic units of the face [4].…”