<?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>2184-0628</journal-id>
<journal-title><![CDATA[Gazeta Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Gaz Med]]></abbrev-journal-title>
<issn>2184-0628</issn>
<publisher>
<publisher-name><![CDATA[Círculo Médico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-06282020000300304</article-id>
<article-id pub-id-type="doi">10.29315/gm.v7i3.324</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Defeitos Cirúrgicos Nasais: Reconstrução com Retalho de PENG Modificado]]></article-title>
<article-title xml:lang="en"><![CDATA[Nasal Surgical Defects: Reconstruction with Modified PENG Flap]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tavares]]></surname>
<given-names><![CDATA[Ermelindo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Maio]]></surname>
<given-names><![CDATA[Paula]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Vila Franca de Xira Serviço Dermatologia e Venereologia ]]></institution>
<addr-line><![CDATA[Vila Franca de Xira ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>09</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>09</month>
<year>2020</year>
</pub-date>
<volume>7</volume>
<numero>3</numero>
<fpage>304</fpage>
<lpage>312</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-06282020000300304&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-06282020000300304&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-06282020000300304&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  O retalho de Peng consiste numa modificação &#8220;em pinça&#8221; do retalho de Rintala e tem como finalidade o encerramento de defeitos cirúrgicos da ponta e do terço distal do dorso do nariz. Foi descrito inicialmente por Peng (retalho de Peng clássico) e revisto, posteriormente, por Rowe e Ahern (retalho de Peng modificado). O nosso objetivo foi fazer uma revisão teórica sobre o retalho de Peng (clássico e modificado) e relato dos resultados obtidos com a técnica de Ahern.  Material e métodos:  Três doentes foram submetidos à exérese de cancro cutâneo do nariz. A reconstrução foi feita com retalho de Peng modificado (técnica de Ahern). As cirurgias foram executadas num tempo operatório e sob anestesia local.  Resultados:  Foram obtidos bons resultados funcionais e estéticos. Não se registaram complicações.  Discussão:  O retalho de Peng é um procedimento com grande utilidade na reconstrução da ponta e dorso distal do nariz. A técnica de Ahern é a que apresenta maior dinamismo (mobilização da pele nasal e malar), versatilidade (encerramento de defeitos laterais e medianos) e capacidade de preservação da anatomia e estética nasal (incisões na junção das subunidades nasais e unidades faciais). Os procedimentos são exequíveis num único tempo operatório e sob anestesia local. O comprometimento parcial ou total do retalho raramente acontece, em particular com modificações introduzidas por Ahern.  Conclusão:  O retalho de Peng modificado (técnica de Ahern) demonstrou ser eficaz, seguro e boa alternativa às modalidades clássicas usadas na reconstrução da ponta do nariz, nos três casos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  The Peng flap is a pinch modification of linear advancement flap (Rintala flap). Its purpose is to close surgical defects in the tip and distal dorsum of the nose. It was initially described by Peng (classic Peng flap) and revised, later, by Rowe and Ahern (modified Peng flap). Our objective was to describe classic and modified Peng flap (Rowe&#8217;s and Ahern&#8217;s techniques), and we report the results achieved according to Ahern&#8217;s technique.  Material and methods:  Three cases of reconstruction of skin defects in the nose were performed using the modified Peng flap (Ahern&#8217;s technique). All the patients had skin cancer. The surgery was executed in single operative time under local anaesthesia.  Results:  Good functional and aesthetic results were achieved. There were no complications.  Discussion:  Ahern&#8217;s technique is the one that shows greater dynamism (mobilization of the nasal and malar skin), versatility (closure of lateral and median defects) and capacity to preserve the nasal anatomy and aesthetic (incisions at the junction of the nasal subunits and facial units). In general, the procedures are feasible in a single operative time under local anaesthesia. Partial and total flap failure is uncommon, particularly with Ryan&#8217;s technique.  Conclusion:  The Peng modified flap (Ahern&#8217;s technique) revealed to be effective, safe and a good alternative to the classic modalities performed in the reconstruction of the nasal tip.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Neoplasias da Pele]]></kwd>
<kwd lng="pt"><![CDATA[Neoplasias do Nariz]]></kwd>
<kwd lng="pt"><![CDATA[Retalhos Cirúrgicos]]></kwd>
<kwd lng="pt"><![CDATA[Rinoplastia]]></kwd>
<kwd lng="pt"><![CDATA[Transplante de Pele]]></kwd>
<kwd lng="en"><![CDATA[Nose Neoplasms]]></kwd>
<kwd lng="en"><![CDATA[Rhinoplasty]]></kwd>
<kwd lng="en"><![CDATA[Skin Neoplasms]]></kwd>
<kwd lng="en"><![CDATA[Skin Transplantation]]></kwd>
<kwd lng="en"><![CDATA[Surgical Flaps]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<collab>World Cancer Research Found</collab>
<source><![CDATA[Skin cancer - How diet, nutrition and physical activity affect skin cancer risk]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Choi]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[YJ]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Nam]]></surname>
<given-names><![CDATA[SH]]></given-names>
</name>
<name>
<surname><![CDATA[Choi]]></surname>
<given-names><![CDATA[YW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Distribution of Basal Cell Carcinoma and Squamous Cell Carcinoma by Facial Esthetic Unit]]></article-title>
<source><![CDATA[Arch Plast Surg]]></source>
<year>2013</year>
<volume>40</volume>
<page-range>387-91</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oda]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Kato]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Watanabe]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Morita]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Facial site distribution of basal cell carcinoma in Japanese]]></article-title>
<source><![CDATA[Exp Dermatol]]></source>
<year>2019</year>
<volume>28</volume>
<numero>^sSuppl 1</numero>
<issue>^sSuppl 1</issue>
<supplement>Suppl 1</supplement>
<page-range>69-71</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Burget]]></surname>
<given-names><![CDATA[GC]]></given-names>
</name>
<name>
<surname><![CDATA[Menick]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nasal reconstruction: seeking a fourth dimension]]></article-title>
<source><![CDATA[Plast Reconstr Surg]]></source>
<year>1986</year>
<volume>78</volume>
<page-range>145-57</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Burget]]></surname>
<given-names><![CDATA[GC]]></given-names>
</name>
<name>
<surname><![CDATA[Menick]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The subunit principle in nasal reconstruction]]></article-title>
<source><![CDATA[Plast Reconstr Surg]]></source>
<year>1985</year>
<volume>76</volume>
<page-range>239-47</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Onishi]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Okada]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Hirata]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Rintala flap: a versatile procedure for nasal reconstruction]]></article-title>
<source><![CDATA[Am J Otolaryngol]]></source>
<year>2014</year>
<volume>35</volume>
<page-range>577-81</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Peng]]></surname>
<given-names><![CDATA[VT]]></given-names>
</name>
<name>
<surname><![CDATA[Sturm]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Marsh]]></surname>
<given-names><![CDATA[TW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[&#8220;Pinch Modification&#8221; of the Linear Advancement FlapJ]]></article-title>
<source><![CDATA[Dermatol Surg Oncol]]></source>
<year>1987</year>
<volume>13</volume>
<page-range>251-3</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rowe]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Warshawski]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Carruthers]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Peng flap. The flap of choice for the convex curve of the central nasal tip]]></article-title>
<source><![CDATA[Dermatol Surg]]></source>
<year>1995</year>
<volume>21</volume>
<page-range>149-52</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ahern]]></surname>
<given-names><![CDATA[RW]]></given-names>
</name>
<name>
<surname><![CDATA[Lawrence]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Peng flap: reviewed and refined]]></article-title>
<source><![CDATA[Dermatol Surg]]></source>
<year>2008</year>
<volume>34</volume>
<page-range>232-7</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hwang]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Son]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Ryu]]></surname>
<given-names><![CDATA[WK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Smoking and flap survival]]></article-title>
<source><![CDATA[Plast Surg]]></source>
<year>2018</year>
<volume>26</volume>
<page-range>280-5</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[César]]></surname>
<given-names><![CDATA[AJF]]></given-names>
</name>
<name>
<surname><![CDATA[Barros]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[PH]]></given-names>
</name>
<name>
<surname><![CDATA[Azevedo]]></surname>
<given-names><![CDATA[FM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reconstructing surgical defects of the nasal tip in a single-stage procedure]]></article-title>
<source><![CDATA[Surg Cosmet Dermatol]]></source>
<year>2016</year>
<volume>8</volume>
<page-range>357-60</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Deluca]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Tappeiner]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Pichler]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Eisendle]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Using the Peng flap for a wide dorsal nasal defect]]></article-title>
<source><![CDATA[J Dtsch Dermatol Ges]]></source>
<year>2014</year>
<volume>12</volume>
<page-range>1060-2</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Paver]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Stanford]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Storey]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nasal dorsum]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Paver]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Storey]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Stanford]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<source><![CDATA[Dermatologic surgery a manual of defect repair options]]></source>
<year>2001</year>
<page-range>56-69</page-range><publisher-loc><![CDATA[Adelaide ]]></publisher-loc>
<publisher-name><![CDATA[McGraw-Hill Medical]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tissiani]]></surname>
<given-names><![CDATA[LAL]]></given-names>
</name>
<name>
<surname><![CDATA[Alonso]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Carneiro]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Bazzi]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Rocco]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Versatility of the bilobed flap]]></article-title>
<source><![CDATA[Rev Bras Cir Plást]]></source>
<year>2011</year>
<volume>26</volume>
<page-range>411-7</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oliveira Jr]]></surname>
<given-names><![CDATA[FC]]></given-names>
</name>
<name>
<surname><![CDATA[Figueiredo]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Piva]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Techniques of cutaneuos nasal reconstruction in the aesthetical nasal subunits]]></article-title>
<source><![CDATA[Rev Bras Cir Craniomaxilofac]]></source>
<year>2009</year>
<volume>12</volume>
<page-range>105-8</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brodland]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Paramedian forehead flap reconstruction for nasal defects]]></article-title>
<source><![CDATA[Dermatol Surg]]></source>
<year>2005</year>
<volume>31</volume>
<page-range>1046-52</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Segundo]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Ribeiro]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Filho]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Retalho médio-frontal tunelizado para reconstrução nasal e em canto de olho em único tempo: uma série de casos]]></article-title>
<source><![CDATA[Rev Med UFC]]></source>
<year>2018</year>
<volume>58</volume>
<page-range>75-9</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Matos]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Goulão]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Retalho nasogeniano de transposição com pedículo superior - princípios e aplicação fundamentais]]></article-title>
<source><![CDATA[Rev Soc Port Dermatol Venereol]]></source>
<year>2014</year>
<volume>72</volume>
<page-range>513-23</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tavares]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[J]]></surname>
<given-names><![CDATA[Rosa]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reconstrução de defeito cirúrgico do nariz com enxerto de pele total colhido na região pré-auricular]]></article-title>
<source><![CDATA[Rev Soc Port Dermatol Venereol]]></source>
<year>2012</year>
<volume>70</volume>
<page-range>495-8</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[YO]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[BY]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[WJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aesthetic reconstruction of the nasal tip using a folded composite graft from the ear]]></article-title>
<source><![CDATA[Br J Plast Surg]]></source>
<year>2004</year>
<volume>57</volume>
<page-range>238-44</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
