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Fat grafting associated with negative pressure wound therapy
Souza, Gustavo Moreira Costa de; Amorim, Camila Camargos Bizzotto; Vallejo, Cristian Esteban Astudillo; Sternick, Marcelo Back; Costa, Sergio Moreira da; Sobral, Christiane Steponavicius; Ferreira, Lydia Masako.
Afiliação
  • Souza, Gustavo Moreira Costa de; Universidade Federal de São Paulo. Department of Surgery. Division of Plastic Surgery. Brazil
  • Amorim, Camila Camargos Bizzotto; Hospital Felício Rocho. Plastic Surgery and Burn Clinic. Belo Horizonte. Brazil
  • Vallejo, Cristian Esteban Astudillo; Hospital Felício Rocho. Plastic Surgery and Burn Clinic. Belo Horizonte. Brazil
  • Sternick, Marcelo Back; Hospital Felício Rocho. Orthopaedic Surgery Division. Belo Horizonte. Brazil
  • Costa, Sergio Moreira da; Hospital Felício Rocho. Division of Plastic Surgery. Belo Horizonte. Brazil
  • Sobral, Christiane Steponavicius; Hospital dos Defeitos da Face-Cruz Vermelha Brasileira. Division of Plastic Surgery. São Paulo. Brazil
  • Ferreira, Lydia Masako; Universidade Federal de São Paulo. Division of Plastic Surgery. São Paulo. Brazil
Acta cir. bras. ; 34(9): e201900907, Nov. 2019. ilus
Article em En | VETINDEX | ID: vti-24035
Biblioteca responsável: BR68.1
Localização: BR68.1
ABSTRACT

Purpose:

To describe a case report of FG associated with NPWT in the treatment of complex wound on the distal third of the lower limb with bone exposure.Case ReportA 59-year-old patient with chronic left tibial osteomyelitis since childhood underwent extensive debridement of the distal tibial diaphysis (40% of bone thickness per 10 cm extension) and placement of bioactive glass S53P4. Distal necrosis occurred in the fasciocutaneous flap used as the primary bone coverage. After flap debridement, the case was resolved with FG, directly on the exposed bone and biomaterial, associated with NPWT. Three weeks after the first FG session over bony tissue, 100% granulation was achieved with NPWT. The closure was completed with thin laminated skin graft over the granulated wound area.

Discussion:

The association of FG and NPWT is not known in the clinical practice. Except for the only one experimental study described by Kao et al.4, the theme was not addressed in the medical literature before. In this clinical case, the result obtained regarding the granulation tissue formation drew attention and prevented the use of more complex flaps such as the microsurgical ones. Accelerated granulation tissue formation was observed, filling an extensive and deep bone defect, even with infected bone and biomaterial. Low morbidity and no complications were observed with the use of FG associated with NPWT. When the grafted fat was compacted with the NPWT, it seemed to behave as a true autologous biological matrix with large amount of cells. To date, scientific studies on fat grafting have focused on the cellular aspect (adipocytes and mesenchymal cells), growth factors and fat differentiation in different tissues. The property of aspirated adipose tissue as a biological matrix seemed to be revealed by the application of NPWT in association with FG. This new roll for the aspirated fat tissue may represent a new research field in plastic surgery.(AU)
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Texto completo: 1 Base de dados: VETINDEX Assunto principal: Tíbia / Cicatrização / Transplante de Tecidos / Diáfises / Tratamento de Ferimentos com Pressão Negativa Limite: Humans Idioma: En Revista: Acta cir. bras. Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: VETINDEX Assunto principal: Tíbia / Cicatrização / Transplante de Tecidos / Diáfises / Tratamento de Ferimentos com Pressão Negativa Limite: Humans Idioma: En Revista: Acta cir. bras. Ano de publicação: 2019 Tipo de documento: Article