Abstract
To report the performance of plastic surgery in the treatment of complex wounds in a tertiary hospital, analyzing its characteristics, types of injuries and approaches adopted, with emphasis on surgical treatment. We conducted a etrospective analysis of patients with complex wounds treated by plastic surgery in a tertiary hospital in a period of five years (2006 to 2010). Data collection was obtained from visits made, serial assessments and records of the medical charts. There were 1927 patients treated (32 queries/month), mean age 46.3 years, predominantly male (62%). The surgical specialties requested 1076 consultations (56%), and the clinical, 851 (44%). The distribution by type of wound showed predominance of pressure ulcers (635/33%), traumatic wounds (570/30%), complicated surgical wounds (305/16%) and necrotizing wounds (196/10%), with the remainder represented by vasculitis (83/4%), venous ulcers (79/4%), diabetes (41/2%) and post-radiation (18/1%). The treatment was surgical in 1382 patients (72%) and non-operative in 545 cases (28%). There were 3029 operations, predominantly debridement (1988/65%) and skin grafting (619/21%) associated or not with negative pressure therapy (vacuum), followed by pedicle flaps (237/8 %), digital reimplantation (81/3%), microsurgical flaps (66/2%) and other (38/1%). The plastic surgeon played an important role in the treatment of complex wounds by adopting early surgical treatment, contributing to the effective resolution of cases.
Highlights
The treatment of wounds is probably one of the oldest areas of medicine
The objective of this study is to report the performance of plastic surgery in the treatment of complex wounds in a tertiary hospital, analyzing its characteristics, types of injuries and approaches adopted, with emphasis on surgical treatment
Was performed a retrospective analysis of patients with complex wounds treated by the Plastic Surgery HCFMUSP through consultations requested by all the clinics of this hospital and the emergency room in a five-year period, between January 2006 and December 2010
Summary
The treatment of wounds is probably one of the oldest areas of medicine. Archaeological evidence indicates that even in prehistoric times extracts of plants, fruits, mud, water and ice were applied to wounds. The ancient Egyptians used cloth strips to keep the borders of the lesion together, as they believed that a closed wound healed more quickly than an open one. In the IV b.C. Hippocrates advised the treatment of wounds, “Melt the fat an old pig and a mix it with resin and bitumen, spread on a piece of old clothing, heat it in the fire, apply it as a bandage”. In the nineteenth century, developed the concept of antisepsis of the skin and surgical supplies, contributing to the healing of wounds[1,2]
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