{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:37:10Z","timestamp":1740148630406,"version":"3.37.3"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ortop (Sao Paulo)"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Resumo<\/jats:title><jats:p>\n          Objetivo\u2003Os avan\u00e7os da microcirurgia reconstrutiva na cirurgia ortop\u00e9dica proporcionaram melhores resultados funcionais e est\u00e9ticos, evitando as muitas indica\u00e7\u00f5es de amputa\u00e7\u00e3o. Nos hospitais de ortopedia e traumatologia com um grande volume de atendimento, a reconstru\u00e7\u00e3o microcir\u00fargica \u00e9 essencial, a fim de reduzir os custos e as complica\u00e7\u00f5es destes complexos defeitos ortop\u00e9dicos. Descrevemos uma abordagem microcir\u00fargica para feridas traum\u00e1ticas, ressec\u00e7\u00e3o tumoral, defeitos \u00f3sseos e transfer\u00eancia muscular livre realizada por uma unidade ortop\u00e9dica especializada em microcirurgia. O objetivo do presente estudo \u00e9 avaliar os fatores preditivos de resultados dos retalhos microcir\u00fargicos na reconstru\u00e7\u00e3o dos membros, fornecendo uma an\u00e1lise descritiva dos retalhos microcir\u00fargicos para as indica\u00e7\u00f5es ortop\u00e9dicas.<\/jats:p><jats:p>\n          M\u00e9todos\u2003Estudo prospectivo transversal, que incluiu todos os casos consecutivos de retalhos microcir\u00fargicos com indica\u00e7\u00e3o ortop\u00e9dica de 2014 a 2020. Foram coletados os dados do hist\u00f3rico cl\u00ednico pessoal, procedimentos microcir\u00fargicos intraoperat\u00f3rios e exames laboratoriais. As complica\u00e7\u00f5es e os desfechos de retalho livre foram estudados mediante uma an\u00e1lise descritiva e estat\u00edstica.<\/jats:p><jats:p>\n          Resultados\u2003Avaliamos 171 retalhos em 168 pacientes. A indica\u00e7\u00e3o mais frequente para a realiza\u00e7\u00e3o de um retalho microcir\u00fargico foi a traum\u00e1tica, em 66% dos pacientes. Foram observadas complica\u00e7\u00f5es cir\u00fargicas em 51 retalhos, conforme a classifica\u00e7\u00e3o de Clavien-Dindo do tipo III. A taxa de \u00eaxito global dos retalhos microcir\u00fargicos foi de 88,3%. Na an\u00e1lise multivariada, foram identificados como fatores de risco para complica\u00e7\u00f5es tempo de isquemia \u2265 2 horas (p\u2009=\u20090,032) e obesidade (p\u2009=\u20090,007). A perda parcial do retalho foi mais comum em pacientes com trombocitose, com contagem de plaquetas pr\u00e9-operat\u00f3ria (p\u2009=\u20090,001).<\/jats:p><jats:p>\n          Conclus\u00e3o\u2003Os fatores de risco independentes para complica\u00e7\u00f5es de retalhos microcir\u00fargicos para a reconstru\u00e7\u00e3o de membro s\u00e3o obesidade e tempo de isquemia do retalho \u2265 2 horas, e a presen\u00e7a de trombocitose como fator de risco para perda parcial do retalho.<\/jats:p>","DOI":"10.1055\/s-0041-1735946","type":"journal-article","created":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T23:42:18Z","timestamp":1647042138000},"page":"772-780","source":"Crossref","is-referenced-by-count":1,"title":["Reconstru\u00e7\u00e3o microcir\u00fargica em um hospital ortop\u00e9dico: Indica\u00e7\u00f5es e desfechos em adultos"],"prefix":"10.1055","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8965-5147","authenticated-orcid":false,"given":"Raquel Bernardelli","family":"Iamaguchi","sequence":"additional","affiliation":[{"name":"Grupo de Cirurgia da M\u00e3o e Microcirurgia Reconstrutiva, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2585-6609","authenticated-orcid":false,"given":"Lucas Sousa","family":"Macedo","sequence":"additional","affiliation":[{"name":"Grupo de Cirurgia da M\u00e3o e Microcirurgia Reconstrutiva, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3099-4750","authenticated-orcid":false,"given":"Alvaro Baik","family":"Cho","sequence":"additional","affiliation":[{"name":"Grupo de Cirurgia da M\u00e3o e Microcirurgia Reconstrutiva, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3441-8117","authenticated-orcid":false,"given":"Marcelo Rosa de","family":"Rezende","sequence":"additional","affiliation":[{"name":"Grupo de Cirurgia da M\u00e3o e Microcirurgia Reconstrutiva, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4202-4652","authenticated-orcid":false,"suffix":"J\u00fanior","given":"Rames","family":"Mattar","sequence":"additional","affiliation":[{"name":"Grupo de Cirurgia da M\u00e3o e Microcirurgia Reconstrutiva, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculdade de Medicina, 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