RESUMO
Raynaud's phenomenon consists of excessive contraction of the blood vessels in response to various stimuli; although it usually affects the extremities, other locations are less frequently involved. This study focused on describing the characteristics of a series of women with Raynaud's phenomenon of the nipple. Through medical record review and direct communication with patients, data from 12 women diagnosed with Raynaud's phenomenon of the nipple between 2016 and 2023 were collected and analyzed. The following variables were assessed: age, symptoms, triggering factors, treatment, and duration of symptoms. In this case series, Raynaud's phenomenon of the nipple in breastfeeding women was more common among primiparous women around 10 days after delivery; pain was severe and, in most cases, improved with local and/or drug treatment, and did not limit the duration of breastfeeding.
El fenómeno de Raynaud consiste en la contracción excesiva de los vasos sanguíneos en respuesta a diversos estímulos y, si bien suele comprometer las extremidades, existen otras localizaciones menos frecuentemente afectadas. Este trabajo se enfoca en describir las características de una serie de mujeres con fenómeno de Raynaud en el pezón. Mediante revisión de historias clínicas y comunicación directa con las pacientes, se recopilaron y analizaron los datos de 12 mujeres con Raynaud del pezón entre 2016 y 2023. Se evaluaron variables como edad, síntomas, desencadenantes, tratamientos y duración de los síntomas. En esta serie de casos, el fenómeno de Raynaud del pezón en mujeres lactantes se manifestó con mayor frecuencia en primigestas alrededor del décimo día posparto; el dolor fue intenso, en la mayoría mejoró con tratamientos locales y/o farmacológicos, y no limitó la duración de la lactancia materna.
Assuntos
Aleitamento Materno , Mamilos , Doença de Raynaud , Humanos , Feminino , Doença de Raynaud/etiologia , Doença de Raynaud/diagnóstico , Mamilos/irrigação sanguínea , Adulto , Adulto Jovem , Estudos Retrospectivos , Fatores de TempoRESUMO
Implant exposure due to cutaneous necrosis is one of the most feared complications of mastectomy with immediate prosthetic reconstruction. A key issue is to ensure good blood supply to the skin and complete integrity of the submuscular pocket. The latter is created with the pectoralis major and supplemented with the serratus anterior, the rectus abdominis sheat, the obliquus mayor and the pectoralis minor. The main drawback is that those muscles, when sutured to create a complete pocket, only allow the setting of small-sized implants. The authors present the application of polyglycolic mesh in an original fashion, mimicking the anatomy of the muscles usually employed in pocket creation. The proposed technique has been denominated Ensured Subpectoral Pocket and has proved to be a valid strategy in immediate single stage prosthetic breast reconstruction. It allows the setting of bigger implants without previous tissue expansion while preventing implant displacement. In addition, it reduces emotional trauma on patients and lowers surgical costs.
Assuntos
Neoplasias da Mama/cirurgia , Mamoplastia/métodos , Telas Cirúrgicas , Adulto , Mama/patologia , Implante Mamário/métodos , Neoplasias da Mama/patologia , Neoplasias da Mama/psicologia , Feminino , Humanos , Mamoplastia/economia , Mamoplastia/psicologia , Pessoa de Meia-Idade , Necrose/patologia , Mamilos/irrigação sanguínea , Resultado do TratamentoRESUMO
The assessment of viability of a pedicled nipple-areola complex after reduction mammoplasty frequently may be frustrating due to equivocal clinical signs of adequate blood flow. Although conversion to a composite graft is always a safe option, the aesthetic result may be inferior. An objective monitor might be beneficial to maximize the surgical outcome while minimizing the risk of nipple necrosis. Laser Doppler flowmetry provides a safe, simple, and noninvasive objective monitor that allows continuous intra-operative or postoperative evaluation of nipple perfusion. An evaluation of 31 nipples in 16 patients undergoing breast reduction based solely on the surgeon's judgment would have resulted in 9 false positive or negative results as compared with 3 using the laser Doppler. Four nipples that may otherwise have been converted to free grafts were instead preserved. However, conclusions from this data limit the laser Doppler as a valuable supplement, but not a replacement, for experienced clinical acumen.
Assuntos
Fluxometria por Laser-Doppler , Mamoplastia , Mamilos/irrigação sanguínea , Feminino , Humanos , Monitorização Fisiológica , Mamilos/cirurgia , Prognóstico , Retalhos CirúrgicosRESUMO
Fazendo uma revisäo sobre técnicas de transposiçäo de mamilo e aréola, selecionams a técnica de Sileira Neto, porque permite maior suprimento sangüíneo, maior segurança e facilidade de manipulaçäo. Este método apresenta o melhor resultado em relaçäo ao contorno natural do corpo