| Popis: |
Resumen Históricamente la reconstrucción de tejidos blandos del tercio distal de la pierna ha constituido un gran desafío quirúrgico para el cirujano plástico, a pesar de los múltiples avances en materia de colgajos pediculados y libres. En la actualidad los colgajos perforantes en propela son una excelente opción reconstructiva muy utilizada para cubrir defectos de tejidos blandos a este nivel con o sin exposición ósea, tendinosa, vascular y/o nerviosa. Esta técnica reconstructiva tiene como ventajas que no requiere anastomosis microquirúrgicas lo cual reduce el tiempo operatorio y que la localización precisa de los vasos perforantes puede realizarse fácilmente con un doppler manual por parte de los cirujanos en sala de operaciones. Se presenta el caso clínico de un paciente masculino de 14 años de edad a quien se le realizó un colgajo perforante en propela de la Arteria Tibial Posterior para cubrir un defecto de tejidos blandos producido por la resección de una contractura cicatrizal a nivel del tercio distal de la pierna derecha y del dorso del pie derecho, que le afectaba funcional y estéticamente. Se pretende dar a conocer el procedimiento y sus resultados, con el fin de difundir otra opción reconstructiva de dicha zona anatómica, que no involucre técnicas microquirúrgicas. Abstract Historically soft tissue reconstruction of the distal third of the leg has been a significant surgical challenge for the plastic surgeon despite the many advances in pedicled and free flap subject. Among the various surgical alternatives to rebuild lower limb defects, reverse flow sural flap and the soleus flap may be mentioned and in many cases are viable options, taking into account the area to rebuild and the assessment by the surgeon. Nonetheless, at present, propeller perforator flaps are an excellent reconstructive option widely used in lower limbs to cover soft tissue defects with or without bone, tendon, vascular and/or nervous exposure. These techniques have the main advantage that they do not require performing vascular anastomosis, therefore, knowledge in microsurgery is not indispensable, it requires the precise location of the perforating arteries to use through a manual doppler, this represents less difficulty and operative time when performing the procedure The authors present a clinical case of a 14-year-old male patient, who underwent a propeller perforator flap from the Posterior Tibial Artery to cover a soft tissue defect produced by the excision of a scar contracture of the third distal of the right leg and dorsal right foot that affected him functionally and esthetically. The authors intend to create awareness of the procedure and its results, in order to disclose another reconstructive option for foot and distal leg that does not involve microsurgical techniques. |
