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Objective: To report the treatment of complex wounds by the division of Plastic Surgery, “Hospital das Clinicas, Faculty of Medicine, University of Sao Paulo (HC-FMUSP). Method: Over a period of 4 years (2006-2009), it was performed a retrospective analysis of patients with complex wounds treated by Plastic Surgery at HC-FMUSP, through requests for consultation. Results: 1,569 patients were treated, with a mean of 32.7 consultations per month. The mean age was 45.9 years, predominantly male (62%). From 1,569 consultations, 899 were requested by the surgical specialties (57%) and 670 for clinical specialties (43%). The distribution by type of wound was: 533 pressure sores (34%), 471 traumatic wounds (30%), 235 complicated surgical wounds (15%), 157 necrotizing wounds (10%), 63 venous ulcers (4%), 62 wounds by vasculitis (4%), 31 diabetic wounds (2%) and 17 post-radiation wounds (1%). There were surgical treatment in 1,145 patients (73%) and non-surgical management in 424 cases (27%). In operated patients, there were 2,263 surgeries: 759 debridements with vacuum therapy (34%), 679 debridements (30%), 293 skin grafts (13%), 213 skin grafts with vacuum therapy (9%), 186 pedicle flaps (8%), 80 digital replantation (4%) and 53 free flaps (2%). Conclusion: Plastic Surgery has an important role in the treatment of complex wounds, by adopting an earlier surgical treatment to cure definitively these cases, reducing the healing time and hospital stay

Tratamento cirúrgico das feridas complexas: experiência da cirurgia plástica no Hospital das Clínicas da FMUSP