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Liposuction is among the most performed plastic surgery procedures in Brazil. According to data from the International Society of Aesthetic Plastic Surgery (ISAPS), 231,604 liposuctions were performed, 15.5% of all aesthetic procedures in the country in 2019. Adopting liposuction as a single procedure or adjunct to other cosmetic procedures stimulated its technical evolution from simple fat aspiration to more sophisticated body shaping. Thus, this review aimed to systematically evaluate the published data regarding the complications found in liposuction. A review was conducted using PubMed, SciELO, LILACS, Cochrane Library, SCOPUS, Web of Science, and gray literature databases, published between 2016 and 2021, using the descriptors “Liposuction” and “Complications.” A total of 187 articles were found in the searched databases, of which 16 were selected according to the outcome “to assess safety through the prevalence of complications in liposuction as a single procedure and associated with other procedures such as abdominoplasty and fat grafting.” We found a mortality rate ranging from 0 to 0.06 among all procedures and a predominance of venous thromboembolism, hematoma, seroma, and hyperpigmentation concerning all complications, being more common when liposuction is associated with other procedures. Therefore, through this review, it was possible to verify that liposuction as a single procedure has lower complication rates when compared to liposuction combined with other procedures.

Introduction: The concept of female aesthetics has been changing, strongly influenced by cultural and regional patterns. Buttocks and breasts are the main regions emphasized, especially in Latin America. Then, gluteal fat grafting becomes increasingly important. In this article, we aim to study the results of this procedure and its complications, suggest a classification of the shape of the buttocks and standardize areas to be treated with fat grafting. Methods: This is a prospective study realized from January 2018 to February 2020, and there was a follow-up of the patients for 6 months of postoperative. The surgical technique was tumescent to get fat, and decantation was the method to prepare the graft, which was injected through the intergluteal and subgluteal folds. Results: Of 146 patients, nine were excluded, remaining 137, of which 132 were women, and four were men. The mean age of patients was 34.1 years, and the mean body mass index was 27.2Kg/m2. The predominant gluteal shape was the trapezoid (52.5%), and the average volume of fat injected into the buttocks was 510.8ml on the right side and 580.5ml on the left, with the central and lateral gluteal areas being the most grafted. As for complications, asymmetry occurred in 3.65% of patients, skin blister in 2.9% and chronic pain in 2.2% of them. Conclusion: It is a safe procedure with a low incidence of complication when the fat grafting respects the subcutaneous plane, and this procedure has high patient satisfaction.

Introduction: Body liposuction and abdominoplasty are surgeries often performed together to obtain superior results in body modeling. Since associated surgeries often increase spoliation, being aware of the evolution of hemoglobin (Hb) in the postoperative period and during the recovery of the patients undergoing these associated surgeries is important for their safety. This study aimed to analyze the decrease in Hb and the clinical and laboratory results throughout the recovery of patients undergoing body liposuction associated with lipoabdominoplasty. Methods: A prospective study was conducted with patients undergoing body liposuction and lipoabdominoplasty. CBCs were collected before anesthetic induction, at the end of the surgery, before hospital discharge, after the 1st, 2nd, and 4th postoperative weeks, and during their clinical follow-up period. Results: The average Hb values at the end of surgery and hospital discharge were 10.4 g/dL (standard deviation (SD) 0.76) and 8.92 g/dL (SD 0.86), respectively. The average values during the recovery of Hb after the 1st, 2nd, and 4th weeks were 2.4% (SD 18.07), 41.6% (SD 18.4), and 74% (SD 15.2), respectively. This is in relation to the reduction between the initial Hb and at hospital discharge. Complaints of weakness and lipothymia were frequent until the second day. Conclusion: Clinical improvement was observed until the second postoperative day (PO day). Hemoglobin required approximately 1 month to normalize in most patients. These patients were treated only with oral iron replacement and did not require blood transfusions.

Introduction: Trauma injuries are sudden aggravations to health that may lead to temporary disabilities and interfere with the victim's quality of life. The reconstructive plastic surgery (RPS) unit of the Urgency and Emergency Metropolitan Hospital (Hospital Metropolitano de Urgência e Emergência - HMUE) is a referral unit for the treatment of trauma patients in the state of Pará, Brazil. Methods: This was an observational, analytical, and cross-sectional prospective study. The study population was composed of 78 patients treated from December 2015 to December 2016. Results: The study population was predominantly male, autonomous, and aged between 21 and 30 years. Traffic accidents were the most frequent cause of trauma. The most affected area was the lower limbs, and the most common type of surgery performed was grafting. Viability was in the range of 90-100% in both patients undergoing graft and flap surgery. No significant association was found between the age range of patients and the degree of viability. However, there was a relationship between the number of days from the accident until the medical intervention and the degree of graft viability. Conclusion: Patients admitted to the hospital on the same day of the accident were six times more likely to present graft viability above 80%, and therefore, to have a favorable outcome.

Abstract Purpose: To evaluate the effects of this thymol-rich oil in the proliferation of human adipose tissue-derived stem cells. Methods: Stem cells were isolated from human adipose tissue by liposuction. After the first passage, cells were cultivated in triplicate for three days in control medium and medium supplemented with three oil samples (1.0 μg/mL, 5.0 μg/mL, and 25.0 μg/mL). Cells were analyzed by the MTT assay at passage 1 (P1), and cell proliferation of control and 1 μg/mL groups was determined with a hemocytometer at P2 and P3. Results: Viability of the essential oil-treated cells was significantly higher than the control group at P1 (p = 0.0008). The treatment with the oil, at a concentration of 1 µg/mL, led to increases of 24.8% at P1 and 43.0% at P3 in the rate of cell proliferation compared with control cells. Conclusion: Supplementing culture medium with essential oil of Lippia origanoides increased cell proliferation, especially at later passages.

INTRODUCTION: Despite complex multidisciplinary treatment, many burn patients die. This study aimed to determine epidemiologic profiles of burn patients, highlighting major complications. METHODS: This retrospective study analyzed the medical records of burn patients managed at the Metropolitan Hospital for Urgent and Emergent Care, Pará State, between January 2007 and December 2012. RESULTS: most patients were males (69.1%) aged 18 to 30 years (35.5%), referred from other hospitals (35.8%), and employed as construction workers (21.2%). The most frequent complications were respiratory (69.4%) and renal failure (57.1%), followed by sepsis (38.8%). CONCLUSIONS: The data obtained were similar to those reported in national and international literature, highlighting the need for burn prevention and inspection of construction sites, as well as implementation of treatment protocols to improve care for burn patients.

INTRODUÇÃO: O retalho sural de fluxo reverso tem se destacado como importante opção para reconstrução da região distal de pernas e pés. Alguns erros, porém, são comuns na fase de aprendizagem de emprego desse retalho. O objetivo deste estudo é analisar 10 anos de experiência com o emprego do retalho, comparando os primeiros 5 anos aos 5 anos subsequentes, buscando identificar se as alterações técnicas introduzidas contribuíram para obtenção de melhores resultados. Este estudo busca, ainda, alertar para os principais cuidados que os cirurgiões que estão em fase de aprendizagem da técnica devem tomar. MÉTODO: Foram estudados os resultados obtidos em 61 retalhos surais de fluxo reverso realizados no período de janeiro de 2002 a dezembro de 2011. Os pacientes foram alocados em dois grupos: grupo 1, constituído por pacientes operados de janeiro de 2002 a dezembro de 2006; e grupo 2, pacientes operados de janeiro de 2007 a dezembro de 2011. No grupo 2, foram realizadas alterações nos retalhos fasciocutâneos, como dissecção de uma borda fasciossubcutânea excedendo a porção cutânea do retalho e preservação de uma faixa de pele sobre o pedículo. RESULTADOS: No grupo 1, a incidência de necrose parcial foi de 18,5% e de necrose total, de 3,7%; no grupo 2, houve 8,8% de necrose parcial e nenhum caso de necrose total. CONCLUSÕES: O retalho sural de fluxo reverso é uma boa opção para o tratamento da região distal de pernas e pé. A experiência com a técnica e os cuidados implementados sugerem obtenção de melhores resultados.BACKGROUND: The reverse flow sural flap has been featured as a relevant option for reconstruction of the distal region of the legs and feet. However, some common mistakes are made while surgeons are learning how to employ this flap. The aim of this study was to analyze use of the flap by surgeons in with 10 years of experience by comparing the first 5 years to the last 5 years in order to identify technical alterations that contribute to better results. This study also aimed at alerting the surgeons in the learning phase regarding the most important details that should be addressed when using this technique. METHODS: We studied the results obtained for 61 reverse flow sural flaps used from January 2002 to December 2011. The patients were divided into 2 groups: group 1, patients that underwent surgery from January 2002 to December 2006 and group 2, patients that underwent surgery from January 2007 to December 2011. In group 2, we made changes to the fasciocutaneous flaps that included dissection of a fasciosubcutaneous margin exceeding the cutaneous portion of the flap and preservation of a lane of skin over the pedicle. RESULTS: In group 1, the incidences of partial necrosis and total necrosis were 18.5% and 3.7%, respectively, whereas group 2 had an 8.8% incidence of partial necrosis and no cases of total necrosis. CONCLUSIONS: The reverse flow sural flap is a good option for the treatment of the distal region of the legs and feet. Experience with this technique and the additional cautions described herein may contribute to even better results.

INTRODUÇÃO: A úlcera de pressão configura-se como uma das diversas complicações às quais pacientes hospitalizados estão suscetíveis, podendo levar à destruição parcial ou total de estruturas como tecidos cutâneo, subcutâneo e muscular, ossos e articulações. MÉTODO: Estudo do tipo observacional, longitudinal, prospectivo, desenvolvido no Hospital Metropolitano de Urgência e Emergência em Ananindeua, PA, Brasil. Foram coletados dados pertinentes às variáveis sexo, idade (maior ou menor que 60 anos), grau de acometimento e local de acometimento das úlceras de pressão, nos setores Unidade de Terapia Intensiva 1 (UTI 1), Clínica Cirúrgica 1 e Neuroclínica. RESULTADOS: Dentre os 474 pacientes estudados, 17 desenvolveram úlcera de pressão, com maior incidência no sexo masculino (88,2%), em estágio II (41,2%) e na localização sacral (40%). Pacientes com mais de 60 anos de idade apresentaram incidência de 58,8% de úlcera de pressão. CONCLUSÕES: Os dados obtidos neste estudo estão de acordo com os resultados apresentados na literatura. Ressalta-se a necessidade de criação de escalas de risco e medidas preventivas para diminuir a incidência de úlceras de pressão nos hospitais.BACKGROUND: Pressure ulcers are one of many complications to which hospitalized patients are susceptible. Such ulcers may lead to partial or total destruction of cutaneous, subcutaneous, and muscular tissues, as well as of bones and articulations. METHODS: An observational, longitudinal, and prospective study was carried out at Hospital Metropolitano de Urgência e Emergência em Ananindeua, PA, Brazil. Relevant data related to gender, age (younger or older than 60 years old), impairment degree, and region of pressure ulcer impairment were collected from Intensive Care Therapy 1 (UTI 1), Surgical Clinic 1, and the Neuro Clinic. RESULTS: Among 474 studied patients, 17 developed pressure ulcers, with greater incidence among male patients (88.2%), at stage II (41.2%) and in the sacral region (40%). Patients aged more than 60 years had an incidence rate of 58.8% for pressure ulcers. CONCLUSIONS: Data obtained in this study are in accordance with the results presented in the literature. It is important to highlight the need for creating risk scales and preventive measures for decreasing the incidence of pressure ulcers in hospitals.

INTRODUÇÃO: O plasma rico em plaquetas (PRP) é um produto que estimula a cicatrização e pode ajudar na integração de enxertos cutâneos em feridas crônicas. Neste estudo, objetivou-se avaliar os resultados da aplicação do PRP nas cirurgias de enxerto de pele em feridas crônicas. MÉTODO: Foi realizado um estudo prospectivo randomizado e cego, em relação ao avaliador, da utilização do PRP nas enxertias cutâneas em feridas crônicas. Alocaram-se os pacientes em dois grupos: grupo A (controle), que recebeu enxerto de pele, sem PRP, e grupo B, que recebeu enxerto de pele e em parte da ferida foi utilizado o PRP, enquanto a outra parte serviu de comparação. RESULTADOS: Houve melhor integração dos enxertos no lado que recebeu o PRP (88,99% no 14º DPO e 89,81% no 28º DPO) do que no lado da mesma ferida, mas sem o PRP (78,22% no 14º DPO e 76,83% no 28º DPO). No grupo A, a integração foi menor (77,85% no 14º DPO e 53,45% no 28º DPO). O lado que recebeu o PRP evoluiu de forma mais favorável que o grupo A (p-valor = 0,0004) e houve menos perda total do enxerto no grupo B em comparação ao grupo A (p-valor = 0,049). CONCLUSÕES: A aplicação do PRP nas feridas crônicas melhora a integração e a evolução dos enxertos de pele e diminui a incidência de perda total dos mesmos.BACKGROUND: The platelet-rich plasma (PRP) is a product that improves the healing and can help integrate the grafts in chronic wounds. This study aimed to evaluate the results of application of PRP in surgery for skin grafting in chronic wounds. METHOD: We conducted a prospective study, randomized and blinded, in relation to the appraiser, to the use of PRP in skin grafting in chronic wounds. Patients were divided into two groups: group A (control), who received a skin graft, without the use of PRP, and group B, who received a skin graft and the wound was partly used PRP, while the other part served for comparison. RESULTS: There was better graft integration on the side that used the PRP (88.99% in 14th POD and 89.81% at 28 th POD) than the same side of the wound, without PRP (integration was 78.22% in 14th POD and 76.83% at 28th POD). In group A, the integration was even lower (77.85% in 14th POD and 53.45% on the 28th POD). The side that used the PRP has evolved more favorably than group A (p-value = 0.0004) and there was less total loss of the graft in group B than in group A (p-value = 0.049). CONCLUSIONS: The application of PRP in chronic wounds at the time of surgery, improve the integration and evolution of skin grafts and reduces the incidence of total loss.

OBJETIVO: Mostrar a possibilidade da utilização do 1/3 proximal da perna como região doadora para o retalho fasciocutâneo sural de pedículo distal. MÉTODO: Estudo prospectivo de cinco casos operados para o tratamento de feridas de diversas etiologias na região distal da perna e pé, com utilização de retalho sural de pedículo distal abrangendo tecido da região superior da perna. Os tamanhos dos retalhos, e dos pedículos, e a incidência de perda parcial e total dos retalhos foram avaliados. RESULTADOS: Todos os casos tiveram uma evolução final satisfatória, com cicatrização da ferida e preservação anatômica e funcional do membro. Houve necrose parcial da área cutânea em dois retalhos. Não houve perda total de nenhum dos retalhos. Em dois casos necessitamos de mais de um tempo cirúrgico. CONCLUSÕES: A utilização de tecido fasciocutâneo da região superior da perna, correspondente ao trajeto subfascial do nervo, é possível e confere ao cirurgião a possibilidade de confeccionar retalhos mais amplos para tratar lesões mais extensas do tornozelo ou com pedículos mais longos para tratar as regiões do retropé e mediopé.

OBJETIVO: Estabelecer um método barato e eficiente de preparação do plasma rico em plaquetas e fatores de crescimento para utilização em cirurgia plástica. MÉTODO: Foram realizados 20 testes através de centrifugação de sangue, variando-se a força e o tempo de centrifugação, para determinarmos o melhor método que proporcione uma maior concentração plaquetária e mais 10 testes para comprovar a reprodutibilidade do método. RESULTADOS: A utilização de uma força de centrifugação de 300 g por 10 minutos na 1ª. centrifugação e de 640 g por 10 minutos na 2ª. centrifugação obtiveram as maiores concentrações plaquetárias, superiores a 4,5 vezes a concentração na amostra, e os testes foram reprodutíveis. CONCLUSÕES: Uma alta concentração plaquetária pode ser obtida por este protocolo de obtenção de plasma rico em plaquetas e fatores de crescimento e a formação do gel é possível através da utilização de trombina autóloga, também obtida pelo protocolo descrito, facilitando sua utilização em cirurgia plástica, onde vem mostrando bons resultados na cicatrização de feridas e na integração de enxertos ósseos e cutâneos.

INTRODUÇÃO: Nos serviços de urgências médicas, é crescente a incidência de lesões traumáticas de membros inferiores com perda de substância, que podem ocasionar deficiências e incapacitação física. O objetivo deste estudo foi avaliar o perfil epidemiológico das vítimas de trauma em membro inferior, atendidas pela equipe de cirurgia reparadora do Hospital Metropolitano de Urgência e Emergência. MÉTODO: Foi realizado um estudo de coorte prospectivo com pacientes que sofreram trauma de membro inferior e que se encontravam sob os cuidados da equipe de cirurgia reparadora. RESULTADOS: A amostra foi majoritariamente composta por homens jovens, vítimas de acidente de trânsito (principalmente por motocicletas), pardos, solteiros e com ensino fundamental incompleto. Noventa por cento dos pesquisados exerciam alguma atividade remunerada e apresentavam renda per capita mensal média de R$ 290,76. Sessenta e cinco por cento dos pesquisados eram etilistas, dos quais 35% eram tabagistas. A maioria dos pacientes era proveniente do interior do Pará. As lesões mais comuns eram as lacerocontusas, localizadas na perna e com exposição de estruturas nobres. O tempo decorrido entre o trauma e a cirurgia apresentou mediana de 32,5 dias. Os principais motivos de retardar a cirurgia foram atrasos na solicitação para que a equipe da cirurgia plástica avaliasse o paciente e espera para melhorar as condições da ferida. Retalhos foram utilizados em 65% dos casos, acompanhados ou não de enxertos, sendo o mais frequente o sural de fluxo reverso. Em 35% dos pacientes, realizou-se enxerto cutâneo isoladamente. CONCLUSÕES: Homens jovens, de baixa renda, com pouca escolaridade, pardos, etilistas, tabagistas e usuários de motocicletas são os mais envolvidos em acidentes que ocasionam lesões em membros inferiores que necessitam de reparo cirúrgico.