{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T16:23:30Z","timestamp":1732033410017},"reference-count":16,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Col. Bras. Cir."],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:p>OBJETIVO: Apresenta\u00e7\u00e3o e avalia\u00e7\u00e3o de protocolo para atendimento de pacientes com ferimentos descolantes dos membros inferiores atrav\u00e9s da retirada de enxerto de pele do tecido avulsionado e cobertura do leito cruento na fase aguda do trauma. M\u00c9TODOS: Este estudo avaliou retrospectivamente os pacientes com ferimentos descolantes em membros inferiores, em que o tratamento realizado baseou-se em protocolo de atendimento para ferimentos descolantes utilizado em nosso servi\u00e7o,com pacientes atendidos na Unidade de Emerg\u00eancia. RESULTADOS: Foram avaliados 21 pacientes. A etiologia do trauma foi atropelamento em 11 pacientes (52,4%) e acidente de motocicleta em 10 (47,6%). Os pacientes foram tratados conforme o protocolo apresentado a seguir: Os pacientes s\u00e3o inicialmente separados em inst\u00e1veis e est\u00e1veis, conforme a condi\u00e7\u00e3o hemodin\u00e2mica. Nos pacientes considerados inst\u00e1veis (dois pacientes nesta casu\u00edstica) realiza-se a retirada da pele e acondicionamento em banco de tecidos para enxertia posterior. Nospacientes considerados est\u00e1veis (19 pacientes) avalia-se a viabilidade do retalho atrav\u00e9s de par\u00e2metros cl\u00ednicos e do uso da fluoresce\u00edna. Se considerado vi\u00e1vel, faz-se a sutura do retalho \u00e0 posi\u00e7\u00e3o original, e, se considerado invi\u00e1vel (todos os 19 pacientes), faz-se a ressec\u00e7\u00e3o e emagrecimento do tecido e realiza-se a enxertia da pele em malha com aplica\u00e7\u00e3o de curativo a v\u00e1cuo sobre o enxerto. CONCLUS\u00c3O: Os ferimentos descolantes devem ter seu atendimento padronizado a fim de se obter melhores resultados no tratamento e prevenir necrose da por\u00e7\u00e3o desenluvada e assim evitar nova \u00e1rea doadora para enxerto de pele.<\/jats:p>","DOI":"10.1590\/s0100-69912010000300007","type":"journal-article","created":{"date-parts":[[2010,8,4]],"date-time":"2010-08-04T20:59:47Z","timestamp":1280955587000},"page":"199-203","source":"Crossref","is-referenced-by-count":16,"title":["Tratamento cir\u00fargico de ferimentos descolantes nos membros inferiores: proposta de protocolo de atendimento"],"prefix":"10.1590","volume":"37","author":[{"given":"Dimas Andr\u00e9","family":"Milcheski","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus Castro","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o 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