<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022017000200076</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Reconstrucción facial con colgajo libre lateral del brazo]]></article-title>
<article-title xml:lang="en"><![CDATA[Facial reconstruction with free lateral arm flap]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Centeno-Ramírez]]></surname>
<given-names><![CDATA[Carlos Alberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Centeno-Rodríguez]]></surname>
<given-names><![CDATA[Madelein]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital México Servicio de Cirugía Plástica, Reconstructiva y Microcirugía, ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital San Juan de Dios Servicio de Cirugía Plástica, Reconstructiva y Microcirugía ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2017</year>
</pub-date>
<volume>59</volume>
<numero>2</numero>
<fpage>76</fpage>
<lpage>78</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022017000200076&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022017000200076&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022017000200076&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Las lesiones faciales malignas complejas o muy extensas, tratadas mediante resección quirúrgica, a menudo constituyen un reto para el cirujano plástico, debido a la gran exposición social del sitio, así como la escasa oferta de tejido para la reconstrucción del defecto cutáneo residual. En estos casos es imperativa la obtención de márgenes libres de malignidad; en segundo lugar, intentar recuperar la funcionalidad del área quirúrgica, y por último, buscar resultados estéticos favorables. Cuando sea posible, la ausencia de cobertura cutánea debe ser restaurada con tejido de similar grosor, color y textura, para lo cual el cirujano debe evaluar cuidadosamente el tamaño del defecto, la localización, las capas de tejido involucradas, la relación con estructuras aledañas y la cantidad de tejido donador disponible, con el fin de conseguir el mejor resultado final. Para deformidades de gran extensión que involucran múltiples capas de tejido, el concepto del triángulo reconstructivo de Mathes y Nahai, puede brindar mejores resultados, dándole opción al cirujano de escoger entre transposición de colgajos locoregionales, colgajos libres o expansión tisular. Los colgajos libres pueden satisfacer mejor las necesidades de forma y función facial, y permiten una considerable oferta de tejido con adecuada vascularidad, similitud de color, textura y grosor. A continuación se presenta el caso clínico de un paciente masculino de 21 años con el diagnóstico de carcinoma basocelular de mejilla derecha recidivante, quien fue sometido a resección completa y reconstrucción del defecto mediante transferencia libre de un colgajo lateral del brazo derecho, con excelentes resultados anatómicos y funcionales.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Complex or very extensive malignant facial lesions that are treated by surgical resection are often challenging for the plastic surgeon because of the large social exposure of the site as well as for the limited supply of tissue for reconstruction of the residual skin defect. In these cases it is imperative to first obtain free margins from malignancy, secondly try to recover the functionality of the surgical area and finally seek for favorable aesthetic results. Whenever possible, the facial defect should be restored with tissue of similar thickness, color and texture, for which the surgeon should carefully evaluate the size of the defect, location, tissue layers involved, the relationship with surrounding structures and the available donor tissue, in order to obtain the best final result. For large deformities involving multiple layers of tissue, the Mathes and Nahai concept of the reconstructive triangle can provide better outcomes, giving the surgeon a choice among transposition of locoregional flaps, free flaps, or tissue expansion. Free flaps can better satisfy the need of facial contour and function, they allow a considerable supply of tissue with adequate vascularity, similarity of color, texture and thickness. The authors present a clinical case of a 21-year-old male patient with the diagnosis of recurrent basal cell carcinoma of the right cheek who underwent complete resection and reconstruction of the facial defect with a free right lateral arm flap with excellent anatomical and functional results.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Brazo]]></kwd>
<kwd lng="es"><![CDATA[colgajos tisulares libres]]></kwd>
<kwd lng="es"><![CDATA[microcirugía]]></kwd>
<kwd lng="es"><![CDATA[colgajos quirúrgicos]]></kwd>
<kwd lng="es"><![CDATA[neoplasias cutáneas]]></kwd>
<kwd lng="es"><![CDATA[carcinoma basocelular]]></kwd>
<kwd lng="es"><![CDATA[cara]]></kwd>
<kwd lng="es"><![CDATA[traumatismos faciales]]></kwd>
<kwd lng="en"><![CDATA[Arm]]></kwd>
<kwd lng="en"><![CDATA[free tissue flaps]]></kwd>
<kwd lng="en"><![CDATA[microsurgery]]></kwd>
<kwd lng="en"><![CDATA[surgical flaps]]></kwd>
<kwd lng="en"><![CDATA[skin neoplasms]]></kwd>
<kwd lng="en"><![CDATA[carcinoma basal cell]]></kwd>
<kwd lng="en"><![CDATA[face]]></kwd>
<kwd lng="en"><![CDATA[facial injuries]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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