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Cirugía Plástica Ibero-Latinoamericana

versão On-line ISSN 1989-2055versão impressa ISSN 0376-7892


AREVALO VELASCO, J.M. et al. Rescue of a pedicled trapezious muscle flap with skin paddle in a patient with spinal cord injury who needded inmediate rehabilitation. Cir. plást. iberolatinoam. [online]. 2011, vol.37, suppl.1, pp.S25-S29. ISSN 1989-2055.

Negative pressure therapy (subatmospheric) is a noninvasive treatment modality included in the armamentarium of any Service of Plastic Surgery and also in General Surgery, Vascular Surgery and Traumatology Services. It can be applied in the treatment of both chronic and acute wounds to decrease the time and number of priests and also to reduce surgeries with high morbidity for the patient. We present a patient with depressive syndrome secondary to an unfortunate postoperative course of a vertebroplasty that produced an spinal cord injury, classified as ASIA C, level D4. The patient suffered a high dorsal ulcer with 6 months of complicated evolution which finally was covered with a pedicled trapezious flap with skin paddle and, again iatrogenicaly, suffered a partial loss of the paddle and a significant seroma at the donor site. In our opinion, this case is interesting because the use of negative pressure therapy with VAC® system allows: 1) Minimize the loss of flap tissue. 2) To decrease the number of cures. 3) To decrease the time in each healing. 4) Allows the patient to move in his wheelchair with two portable VAC® systems to assist to the gym and follow his rehabilitation program. 5) With this unexpected and fast evolution, the patient had a significant clinical improvement of his depressive-anxious state and 6) The final placement of a latest generation VAC-VIA® systems on autografts allowed the patient to go on with his occupational therapy and physiotherapy for the upper extremities. We think that VAC-VIA® therapy is completely indicated to complex acute and chronic wounds because it can save time in terms of total hospital stance and avoid unnecessary surgeries with high risk morbidity for the patient.

Palavras-chave : Negative pressure therapy; Wounds; Flaps.

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