Science & Art Plastic Surgery Journal

Bilateral SCIP flaps to large scrotoperineal defect reconstruction

Francisco Sebastián Carvajal Flechas — 2022-05-27

Background: Scrotoperineal defects reconstruction can be related to multiple etiologies, being Fournier’s gangrene one of the most important etiologies due to its rapidly progressive nature and high mortality rates. Therefore, new reconstruction techniques have been developed and analyzed over the past few years to achieve good functional and esthetic results, among these techniques are the perforator flaps.

Objective: Presenting this case, we want to prove that using bilateral SCIP (superficial circumflex iliac artery perforator), flaps can be a satisfactory option for reconstruction of scrotoperineal defects, without major postoperative complications and adequate functional and esthetic results.

Design: This article describes the use of the bilateral SCIP flaps as a reconstructive alternative in scrotum and perineum large defects.

Results: SCIP flaps can achieve good results in the reconstruction of large scrotoperineal defects at the functional and esthetic levels, with minimum morbidity in the donor site.

Discussion: Multiple alternatives for perineoscrotal defects reconstruction have been described in the literature. The proposed surgical treatment algorithms depend on various factors such as the location and extension of the compromised areas.

Conclusions: The discussed SCIP flap proves a very good alternative in the analyzed cases and can be used in a unilateral or bilateral way depending on the extension of the defect to be reconstructed.

Use of tranexamic acid as a blood-saving method in patients of liposuction and other aesthetic surgeries: a retrospective study

Octavio de Jesus Carrascal-Navarro — 2022-06-28

Introduction: Liposuction is among the most grueling procedures in esthetic plastic surgery. Despite the existing evidence of tranexamic acid (ATX) as a blood-saving method in surgeries of different surgical specialties, its use in plastic-esthetic surgery is scarce, especially in liposuction.

Goal: To determine the impact of ATX on blood loss in patients who have undergone liposuction surgical procedures.

Methods: A total of 102 patients met the inclusion requirement criteria. All of them received balanced general anesthesia. 10–15 mg/kg IV of ATX (1 g on average) was administered 20 min before surgery, and so it continued for the first 24 h of postoperatory with 500 mg/IV every 8 h. Blood count samples were taken 12–20 h postoperatory.

Results: The hematocrit showed a median of 42.6% presurgical and 33.5% postsurgical. On the other hand, the presurgical hemoglobin median was 14.2 g/Dl (Interquartile ranges [RIC]) 13.4–15) and postsurgical of 11.4 (RIC: 10.6–12.1); giving a median difference of presurgical and postsurgical hemoglobin of −2.8 (RIC: −3.6 to −2.1), the difference percentage of hemoglobin concerning the base was −19.5% (RIC: –25.0 to −14.9).

Conclusion: The use of ATX in liposuction seems to grant the same benefits in terms of bleeding reduction, hemoglobin stabilization, hematocrit, and necessity of transfusions compared with operations of other surgical specialties. The dose used in this study is adequate and safe in order to achieve these goals and is consistent with the literature. More analytic studies in the field are necessary to reinforce these hypotheses.

Rib removal in body contouring surgery and its influence on the waist

Juan Pedro Verdugo — 2022-05-24

Objective: While modern cosmetic surgery allows patients to be offered less invasive and bloody procedures than before, there are cases where these are not sufficient to give the results that meet patients’ expectations, especially in the case of the upper region of the abdomen. The purpose of this study is to describe the 11th and 12th rib removal technique as body contouring surgery in patients for whom traditional surgery would not have reached the desired results.

Materials and methods: A case series study is presented, describing the surgical records of patients who underwent 11th and 12th rib removal for aesthetic purposes, with or without other elective cosmetic surgeries.

Results: A total of 104 women who underwent costal resection surgeries during a period of 8 years were identified. Only 10 of these patients underwent rib removal exclusively, being the most common combination of procedures liposuction and rib removal. The average age was 29, 39 at the time of surgery, and two pneumothorax were the only transoperative complications presented.

Conclusions: The 11th and 12th rib removal is a not-gory technique with a low complication rate.