Lesão traumática facial em cão - reconstrução cirúrgica com retalho de transposição rotacional / Facial traumatic injury in a dog - surgical reconstruction with rotational transposition flap

Background: Bite injuries are commonly found in small animal clinics, especially in male dogs, due to their habits of fighting and territorial disputes. In general, the lesions are treated with the use of compresses and bandages, however, it is extremely important to carefully evaluate the site, in order to carry out the appropriate treatment. In cases of tissue loss, an increasingly used practice is reconstructive surgery, which launches alternatives for treatment through flaps and skin grafts, promoting healing and satisfactory aesthetic repair. This report describes the case of a dog with a facial bite, treated with reconstructive surgery. Case: A 5-year-old male mixed-breed dog, with a body mass of 5 kg, was treated and submitted to a physical examination, due to the owner's complaint that he had been attacked by another dog, causing a bite on the face. On physical examination, the animal showed normal vital parameters, except for mild hyperthermia due to rectal temperature (39.5°C). On the face, it was possible to observe a lacerative lesion in the temporomandibular and masseteric regions, with loss of skin and muscle, in addition to having an aspect of infection and necrosis. To describe the hematological profile, a blood count was performed, showing no changes. In the biochemical tests, the present alteration was a slight increase in Alkaline Phosphatase (393.8 IU/L). Surgical treatment was indicated through facial reconstruction with a skin graft. After performing the antisepsis, the lesion was debrided, the edges were regularized and the injured tissue was curetted. For reconstruction of the defect, we used a flap obtained through a perpendicular incision at the base of the ear, in a caudal direction, and this flap was pulled and transposed over the wound. Flap synthesis was performed with 3-0 nylon thread. After surgery, a compressive bandage was performed, which was removed after 24 h. It was indicated to avoid exertion in the area and to return in 10 days for the evaluation of the surgery and removal of the stitches. Discussion: Traumatic injuries in animals are being increasingly reported, with male and non-neutered dogs being the most prevalent patients. This report is in line with other studies, with the patient's profile being a male dog, with an average age, in line with the literature. In general, in certain types of wounds, the affected animals can develop sepsis and even progress to death, however, in this case the patient did not show changes in vital parameters and in hematological tests. Reconstructive surgeries are performed with the aim of correcting skin defects and knowledge of the available techniques is important. It is also necessary to carry out a good planning, in order to avoid complications in the trans and postoperative period. In the present case, we chose to use a flap obtained through an incision perpendicular to the base of the ear, transposing it over the wound, in addition to relieving tissue tension through skin divulsion, increasing its elastic potential. The use of bandages is considered extremely important for the success of the surgical procedure, as it provides an efficient barrier against infections, trauma and adhesions. However, we emphasize the need to use ointments, gauzes and bandages concomitantly, in order to have the desired success in the postoperative period. In addition to proper surgical techniques, pain management and infection control are important for patient recovery. It is important to use non-steroidal anti-inflammatory drugs and opioids to obtain analgesia, in addition to antibiotic therapy before and after surgery. The reported case demonstrated that lesions in dogs with skin loss can be reconstructed using skin flaps, with an excellent recovery and good prognosis, as was the case with the patient in this report.

Descrição anatômica dos músculos do membro torácico da preguiça-comum (Bradypus variegatus) / Anatomical description of the forelimb muscles of the brown-throated sloth (Bradypus variegatus)

Background: Brown-throated sloths are mammals of the order Xenarthra, suborder Pilosa, family Bradypodidae. These folivorous and arboreal animals, which possess a peculiar type of arboreal quadrupedalism, move through the forest canopy by means of suspensory locomotion. On the ground, their extremely slow movements make them easy targets for road accidents, often leading to serious injury or even death. This paper describes the forelimb muscles of the brown-throated sloth (Bradypus variegatus), updating the literature on the subject to help veterinarians in clinical and surgical interventions on this species, and to provide data for comparative animal anatomy.Materials, Methods & Results: Five brown-throated sloths (Bradypus variegatus Schinz, 1825), two adults and three babies were dissected. The animals were donated by the Arruda Câmara Zoo and Botanical Park in João Pessoa, state of Paraíba, Brazil, where they were thawed and fixed in 10% formalin. The sloths’ forelimbs were dissected by lifting and folding over a skin flap to expose, identify and describe the underlying musculature. The dissection revealed the following muscles: supraspinatus, infraspinatus, deltoideus, teres major, subscapularis, coracobrachialis, brachialis, biceps brachii, triceps brachii, anconeus epitrochlearis, dorsoepitrochlearis, brachioradialis, supinator, pronator teres, pronator quadratus, extensor carpi radialis, extensor carpi ulnaris, extensor carpi obliquus, flexor carpi radialis, flexor carpi ulnaris, extensor digitorum communis, extensor digitorum lateralis, palmaris longus, flexor digitorum superficialis, flexor digitorum profundus, extensor indicis longus second finger, extensor indicis brevis second finger, extensor digitorum third finger, abductor digitorum second finger, abductor digitorum third finger, palmaris brevis, and interosseous muscles.[...]

Descrição anatômica dos músculos do membro torácico da preguiça-comum (Bradypus variegatus) / Anatomical description of the forelimb muscles of the brown-throated sloth (Bradypus variegatus)

Background: Brown-throated sloths are mammals of the order Xenarthra, suborder Pilosa, family Bradypodidae. These folivorous and arboreal animals, which possess a peculiar type of arboreal quadrupedalism, move through the forest canopy by means of suspensory locomotion. On the ground, their extremely slow movements make them easy targets for road accidents, often leading to serious injury or even death. This paper describes the forelimb muscles of the brown-throated sloth (Bradypus variegatus), updating the literature on the subject to help veterinarians in clinical and surgical interventions on this species, and to provide data for comparative animal anatomy.Materials, Methods & Results: Five brown-throated sloths (Bradypus variegatus Schinz, 1825), two adults and three babies were dissected. The animals were donated by the Arruda Câmara Zoo and Botanical Park in João Pessoa, state of Paraíba, Brazil, where they were thawed and fixed in 10% formalin. The sloths forelimbs were dissected by lifting and folding over a skin flap to expose, identify and describe the underlying musculature. The dissection revealed the following muscles: supraspinatus, infraspinatus, deltoideus, teres major, subscapularis, coracobrachialis, brachialis, biceps brachii, triceps brachii, anconeus epitrochlearis, dorsoepitrochlearis, brachioradialis, supinator, pronator teres, pronator quadratus, extensor carpi radialis, extensor carpi ulnaris, extensor carpi obliquus, flexor carpi radialis, flexor carpi ulnaris, extensor digitorum communis, extensor digitorum lateralis, palmaris longus, flexor digitorum superficialis, flexor digitorum profundus, extensor indicis longus second finger, extensor indicis brevis second finger, extensor digitorum third finger, abductor digitorum second finger, abductor digitorum third finger, palmaris brevis, and interosseous muscles.[...](AU)

Uso de enxerto autógeno de fáscia lata no tratamento de defeito segmentar crônico do tendão calcâneo comum em felino doméstico / Use of autogenous fascia lata graft in the treatment of chronic segmental defect of the common calcaneus tendon in domestic feline

Background: The common calcaneus tendon is formed by the common tendon of the femoral biceps muscle, tendon of the superficial digital flexor muscle and gastrocnemius muscle tendon, and its rupture is related to acute traumas in small animals. Among some applications described, surgical repair can be adopted in the correction of tendon ruptures and the use of grafts may be indicated in some severe lesions, where it is not possible to perform tenorrhaphy. This study aims to report the case of a feline with rupture of the common calcaneus tendon in which the tenorrafia associated with the autogenous fascia lata graft was performed as adjuvant to the cicatrization of the same.Case: A 24-month-old, undefined male feline with approximately 3 kg was treated at the FCAV Veterinary Hospital, UNESP Jaboticabal, State of São Paulo, Brazil, with a history of falling, for approximately two weeks, and has since plantigrade posture. Upon physical examination, it was possible to identify a discontinuity of the common calcaneus tendon. The radiographs were performed, which did not show any bone changes. A hemogram and biochemical profile were performed, which were within normal limits. The patient underwent surgery, and a complete lesion of the common calcaneus tendon was identified, with a chronic aspect. Approximation of the stumps was impossible, so a flap of fascia lata, about two centimeters long and one centimeter wide, was removed, which was used as a bed and tendon support for tendon growth. After removal all of the present fibrosis, the tendon stumps were approximated by means of modified Kessler suture with mononylon thread, and fascia lata flap of the ipsilateral limb was sutured with separate single points in both tendon ends and in their lateral and medial portion. In the tibiotarsic joint, the external skeletal fixator type II was used for immobilization, during a period of 30 days.[...]

Uso de enxerto autógeno de fáscia lata no tratamento de defeito segmentar crônico do tendão calcâneo comum em felino doméstico / Use of autogenous fascia lata graft in the treatment of chronic segmental defect of the common calcaneus tendon in domestic feline

Background: The common calcaneus tendon is formed by the common tendon of the femoral biceps muscle, tendon of the superficial digital flexor muscle and gastrocnemius muscle tendon, and its rupture is related to acute traumas in small animals. Among some applications described, surgical repair can be adopted in the correction of tendon ruptures and the use of grafts may be indicated in some severe lesions, where it is not possible to perform tenorrhaphy. This study aims to report the case of a feline with rupture of the common calcaneus tendon in which the tenorrafia associated with the autogenous fascia lata graft was performed as adjuvant to the cicatrization of the same.Case: A 24-month-old, undefined male feline with approximately 3 kg was treated at the FCAV Veterinary Hospital, UNESP Jaboticabal, State of São Paulo, Brazil, with a history of falling, for approximately two weeks, and has since plantigrade posture. Upon physical examination, it was possible to identify a discontinuity of the common calcaneus tendon. The radiographs were performed, which did not show any bone changes. A hemogram and biochemical profile were performed, which were within normal limits. The patient underwent surgery, and a complete lesion of the common calcaneus tendon was identified, with a chronic aspect. Approximation of the stumps was impossible, so a flap of fascia lata, about two centimeters long and one centimeter wide, was removed, which was used as a bed and tendon support for tendon growth. After removal all of the present fibrosis, the tendon stumps were approximated by means of modified Kessler suture with mononylon thread, and fascia lata flap of the ipsilateral limb was sutured with separate single points in both tendon ends and in their lateral and medial portion. In the tibiotarsic joint, the external skeletal fixator type II was used for immobilization, during a period of 30 days.[...](AU)

Reparo de lesão penetrante em parede torácica de cão, ocasionada por javali (Sus scrofa scrofa), com flape unipediculado de músculo reto abdominal / Unipediculated flap of muscle rectos abdominales to repair a penetrating injury caused by javali (Sus scrofa scrofa) on the thoracic wall of a dog

Lesões penetrantes no tórax causadas por interação animal são frequentes em cães e caracterizam-se por dano extenso e desvitalização dos tecidos moles adjacentes. Quando a musculatura local é insuficiente para a reconstrução, retalhos musculares podem ser mobilizados para reparar o defeito torácico. O presente relato tem como objetivo demonstrar uma alternativa para o reparo de defeito da parede torácica em um cão, ocasionada por interação com javali (Sus scrofa scrofa), utilizando flape unipediculado de músculo reto abdominal. Com base na literatura consultada, essa técnica reconstrutiva ainda não foi descrita. O flape de músculo reto abdominal mostrou-se uma alternativa viável no reparo de lesão extensa e infectada na parede torácica em cães.(AU)

Penetrating thoracic wounds caused by animal bites are common in dogs and are characterized by extensive trauma and adjacent soft tissue devitalization. When the local musculature is insufficient for the reconstruction, muscle flaps can be taken to repair the thoracic defect. The aim of the present report is to demonstrate an alternative to the thoracic wall defect repair in a dog which was attacked by javali (Sus scrofa scrofa), using unipediculated flap of the rectus abdominis muscle. Based on the literature, this reconstructive technique has not yet been described. The rectus abdominis muscle flap proves to be a useful alternative for the repair of extensive and infected thoracic wall lesion in dogs.(AU)

Reparo de lesão penetrante em parede torácica de cão, ocasionada por javali (Sus scrofa scrofa), com flape unipediculado de músculo reto abdominal / Unipediculated flap of muscle rectos abdominales to repair a penetrating injury caused by javali (Sus scrofa scrofa) on the thoracic wall of a dog

Lesões penetrantes no tórax causadas por interação animal são frequentes em cães e caracterizam-se por dano extenso e desvitalização dos tecidos moles adjacentes. Quando a musculatura local é insuficiente para a reconstrução, retalhos musculares podem ser mobilizados para reparar o defeito torácico. O presente relato tem como objetivo demonstrar uma alternativa para o reparo de defeito da parede torácica em um cão, ocasionada por interação com javali (Sus scrofa scrofa), utilizando flape unipediculado de músculo reto abdominal. Com base na literatura consultada, essa técnica reconstrutiva ainda não foi descrita. O flape de músculo reto abdominal mostrou-se uma alternativa viável no reparo de lesão extensa e infectada na parede torácica em cães.(AU)

Penetrating thoracic wounds caused by animal bites are common in dogs and are characterized by extensive trauma and adjacent soft tissue devitalization. When the local musculature is insufficient for the reconstruction, muscle flaps can be taken to repair the thoracic defect. The aim of the present report is to demonstrate an alternative to the thoracic wall defect repair in a dog which was attacked by javali (Sus scrofa scrofa), using unipediculated flap of the rectus abdominis muscle. Based on the literature, this reconstructive technique has not yet been described. The rectus abdominis muscle flap proves to be a useful alternative for the repair of extensive and infected thoracic wall lesion in dogs.(AU)

Intra and postoperative evaluations of microcirculation and micro-rheological parameters in a rat model of musculocutaneous flap ischemia-reperfusion

To examine how the ischemia-reperfusion injury of latissimus dorsi-cutaneous maximus (LDCM) musculocutaneous flap affects the microcirculatory (flap's skin surface) and hemorheological parameters, and whether an intraoperative deterioration would predictively suggest flap failure in the postoperative period. Ten healthy male rats were subjected to the study. In Group I the left flap was sutured back after 2-hour, while the contralateral side was right after its elevation. In Group II the same technique was applied, but the pedicle of the left flap was atraumatically clamped for 2-hour. The contralateral side was left intact. On the flap skin surface laser Doppler tissue flowmetry measurements were done before and after and during the protocols applied in the groups. Microcirculatory and hemorheological examinations were done postoperatively. The microcirculatory parameters significantly decreased during immobilization and ischemia. Afterwards, all the regions showed normalization. In the retrospective analysis there was a prominent difference between the microcirculatory parameters of necrotic and survived flap during the early postoperative days (1-3) in Group II. Erythrocyte aggregation and deformability showed only slight differences.CONCLUSIONS: Two-hour ischemia and reperfusion caused deterioration in latissimus dorsi-cutaneous maximus flap microcirculation. Predicting the possible postoperative complication, the intraoperative laser Doppler measurement can be informative.(AU)

Analysis of effect isoxsuprine hydrochloride and nicotine in the Transverse Rectus Abdominis Myocutaneous flap (TRAM) in rats

PURPOSE: To evaluate the effects of isoxsuprine and nicotine on TRAM. METHODS: Forty eight 48 Wistar rats distributed into four Groups (n=12). All rats received medication managed daily for 20 days: saline solution (SA), nicotine solution (NI), isoxsuprine solution (IS) and nicotine solution (NI) + isoxsuprine solution (IS). On day 21st the rats were submitted to the caudally based, right unipedicled TRAM flap and after 48 hours, made the macroscopic evaluation of the surface of the flap, photographic documentation and collection of material for histology. Data from macroscopic evaluation were analyzed by ANOVA and microscopic evaluation by Kruskal-Wallis test, with significance level of 5%. RESULTS: In the macroscopic evaluation of isoxsuprine Group retail presented absolute numbers: final area (p=0.001*) and viable area (p=0.006*) with the highest values; necrosis (p=0.001*) had the lowest value. Microscopic examination revealed no significant findings in the study of TRAM under the action of isoxsuprine and nicotine to the percentage of necrosis in the left and right cranial and caudal regions. CONCLUSIONS: There was significant improvement in viability of TRAM using the isoxsuprine solution alone. No influence using nicotine alone and in association with isoxsuprine.(AU)

Botulinum toxin type A on cutaneous flap viability in diabetic and tobacco-exposed rats

To investigate the effect of Botulinum toxin A (BoNTA) on skin flap viability in healthy, tobacco-exposed and diabetic rats. Ninety male Wistar rats (250-300g) were randomly divided into six groups: control+saline (C1), control+BoNTA (C2), tobacco-exposed+saline (T1), tobacco-exposed+BoNTA (T2) diabetes+saline (D1) and diabetes+BoNTA (D2). A dorsal cutaneous flap (3×10cm) was performed. Survival area and total area of the flaps were measured. Lumen diameter, external arterial diameter and lumen/wall thickness ratio were recorded. Survival area increased in control group with BoNTA injection compared with control animals injected with saline (C2 x C1; 0.9±0.1 vs0.67±0.15, p= 0.001). A similar result was found in diabetes group injected with BontA (D2 x D1; 0.97±0.2 vs0.61±0.24, p=0.018). No difference was observed in skin flap viability in tobacco-exposed groups (T2 x T1; 0.74±0.24 vs 0.64±0.21, p=0.871). Lumen diameter (p= 0.004), external arterial diameter (p = 0.0046,) and lumen/wall thickness ratio (p= 0.003) were increased in diabetes+BoNTA-treated animals. This effect was not observed in control or in tobacco-exposed groups. Botulinum toxin A increased skin flap viability in control and diabetic rats on the seventh post-operative day. Increased lumen diameter, external arterial diameter, and lumen/wall thickness ratio were observed in the diabetes+BoNTA group. BoNTA had no effect in the tobacco-exposed group on the seventh postoperative day.(AU)

A gastrocnemius heterotopical transplant model with end-to-side neurorraphy

To present an animal model to assess the effects of end-to-side innervation in the heterotopically transplanted model with reduced chances of neural contamination. The medial portion of the gastrocnemius muscle in wistar male rats was isolated and its pedicle dissected and performed a flap in the abdominal portion. To prevent neural contamination in the abdominal region, the muscle was wrapped with a Goretex(r) sheet. The specimens were divided into 2 groups (G). In G1 was performed an end-to-end suture between tibial nerve of the gastrocnemius and femoral motor nerve and between the saphenous sensory nerve and the motor nerve. In G2 was performed a end-to-side suture between the tibial nerve and the motor femoral and between the tibial nerve and saphenous motor nerve. The specimens were evaluated 60 days later to check the structure of the neurorraphy. Sections were obtained proximal and distal to the coaptation site. The medial gastrocnemius muscle had the advantage of maintaining visible mass after 60 days. No disruption of the coaptation site was found. No major injury to the donor nerve was seen in group 2. The proposed model is simple, reproduciple and prevent the neural contamination in the flap in end-to-side suture.(AU)

TRANSPOSIÇÃO IPSILATERAL DO MÚSCULO SEMITENDINOSO PARA HERNIORRAFIA PERINEAL EM CÃES

Diversas técnicas cirúrgicas têm sido relatadas para o tratamento da hérnia perineal em cães, com destaque das transposições musculares na reparação diafragma pélvico. A técnica de transposição do músculo semitendinoso é descrita em casos onde houve recidiva da doença ou nos casos de hérnia perineal ventral e o flap muscular é deslocado do lado contralateral para o processo herniário. Nos casos de hérnia perineal bilateral não é possível executar a técnica e torna-se necessário a associação de outra técnica para reconstruir os dois lados acometidos. Desta forma, objetivou-se avaliar a eficácia terapêutica da técnica de transposição ipsilateral do músculo semitendinoso como única forma de tratamento em casos de hérnia perineal, unilateral ou bilateral e descrever sua aplicabilidade na reconstrução do diafragma pélvico em cães. Onze animais foram submetidos à herniorrafia com transposição ispsilateral do músculo semitendinoso para reparação do defeito herniário. Realizou-se abordagem do processo herniário, inspeção e redução do conteúdo, em seguida ampliação da incisão na face caudal da coxa até o linfonodo poplíteo, para posterior dissecação e deslocamento ipsilateral do segmento muscular para reconstrução do diafragma pélvico. A avaliação pós-cirúrgica, deu-se durante 180 dias, quanto à resistência, função motora e complicações pós-operatórias. Pôde-se concluir que a técnica de transposição do músculo semitendinoso, proporcionou resistência na região perineal, demonstrou ser de fácil aplicabilidade e boa cicatrização tecidual sem demais complicações.

Several surgical techniques have been reported for the treatment of perineal hernia in dogs, with emphasis on the muscular transpositions in the pelvic diaphragm repair. The technique of transposition of the semitendinosus muscle is described in cases where there was recurrence of the disease or in the cases of ventral perineal hernia and the muscular flap is displaced from the contralateral side to the hernial process. In cases of bilateral perineal hernia, it is not possible to perform the technique and it is necessary to associate another technique to reconstruct the two affected sides. The aim of this study was to evaluate the therapeutic efficacy of the technique of ipsilateral transposition of the semitendinosus muscle as the only form of treatment in cases of perineal, unilateral or bilateral hernia and to describe its applicability in the reconstruction of the pelvic diaphragm in dogs. Eleven animals were submitted to herniorrhaphy with ispsilateral transposition of the semitendinosus muscle to repair the hernia defect. The hernial process was approached, inspection and content reduction, then enlargement of the incision in the caudal aspect of the thigh to the popliteal lymph node, for posterior dissection and ipsilateral displacement of the muscle segment for reconstruction of the pelvic diaphragm. Postoperative evaluation occurred for 180 days regarding resistance, motor function and postoperative complications. It was concluded that the technique of transposition of the semitendinosus muscle, provided resistance in the perineal region, has been shown to be easy to apply and good tissue healing without other complications.

Effects of carbon dioxide therapy on the healing of acute skin wounds induced on the back of rats

PURPOSE: To evaluate the healing effect of carbon dioxide therapy on skin wounds induced on the back of rats. METHODS: Sixteen rats underwent excision of a round dermal-epidermal dorsal skin flap of 2.5 cm in diameter. The animals were divided into two groups, as follows: carbon dioxide group - subcutaneous injections of carbon dioxide on the day of operation and at three, six and nine days postoperatively; control group - no postoperative wound treatment. Wounds were photographed on the day of operation and at six and 14 days postoperatively for analysis of wound area and major diameter. All animals were euthanized on day 14 after surgery. The dorsal skin and the underlying muscle layer containing the wound were resected for histopathological analysis. RESULTS: There was no statistically significant difference between groups in the percentage of wound closure, in histopathological findings, or in the reduction of wound area and major diameter at 14 days postoperatively. CONCLUSION: Under the experimental conditions in which this study was conducted, carbon dioxide therapy had no effects on the healing of acute skin wounds in rats.(AU)

Histology of the rectus abdominis muscle in rats subjected to cranial and caudal devascularization / Histologia do músculo reto do abdome de ratos submetidos à desvascularização cranial e caudal

PURPOSE: To investigate the microscopic changes in the rectus abdominis muscle in rats subjected to five delay procedure. METHODS: 30 male holtzmann rats, weighting between 250 and 350 grams, were used. The animals were divided into five groups (n=6): A - cranial section of the right muscle; B - caudal section of the right muscle; C - craniocaudal section of the right muscle; D - cranial section reflecting the right muscle in the craniocaudal direction; E - caudal section reflecting the right muscle in the caudocranial direction. On the seventh day after surgery, a resection of the cranial and caudal fragments of the right and left muscles, respectively, was performed for microscopic analysis. Histological alterations were quantified and the right and left (control) muscle fragments compared. Fisher's exact test was used for statistical purposes with a significance level of 5 percent. RESULTS: The comparison between right and left muscles showed statistically significant differences in group A - inflammatory infiltrate in the cranial fragment (p=0.015); in group C - inflammatory infiltrate (p=0.000) and necrosis (p=0.015) in the caudal fragment; and in group E - edema in the caudal fragment (p=0.000). No significant alterations were noted in groups B and D. CONCLUSIONS: Irrigation exclusively through the perforating muscle vessels is inappropriate; irrigation exclusively through the cranial pedicle causes milder, insignificant histological alterations, when compared with irrigation exclusively through the caudal pedicle; irrigation exclusively through the caudal pedicle causes more pronounced, but still insignificant, histological alterations when compared with other forms of devascularization.(AU)

OBJETIVO: Investigar as alterações microscópicas no músculo reto do abdome de ratos submetidos a cinco técnicas de autonomização. MÉTODOS: Utilizaram-se 30 ratos machos Holtzmann, pesando entre 250 e 350 gramas. Os animais foram distribuídos em cinco grupos (n=6): A - secção cranial do músculo direito; B - secção caudal do músculo direito; C - secção cranial e caudal do músculo direito; D - secção cranial rebatendo o músculo direito no sentido cranial-caudal; E - secção caudal rebatendo o músculo direito no sentido caudal-cranial. No sétimo dia pós-operatório, ressecou-se um fragmento cranial e caudal dos músculos direito e esquerdo, respectivamente, para estudo microscópico. As alterações histológicas foram quantificadas e comparados os fragmentos dos músculos direito aos do esquerdo (controle). Utilizou-se, para fins estatísticos, o teste exato de Fisher, com nível de significância de 5 por cento. RESULTADOS: A comparação entre os músculos direito e esquerdo demonstrou significância estatística no grupo A - infiltrado inflamatório no fragmento cranial (p=0,015); no grupo C - infiltrado inflamatório (p=0,000) e necrose (p=0,015) no fragmento caudal; e no grupo E - edema no fragmento caudal (p=0,000). Não foram observadas alterações significativas nos grupos B e D. CONCLUSÕES: A irrigação exclusiva pelos vasos musculares perfurantes é inadequada; a irrigação exclusiva pelo pedículo cranial causa alterações histológicas menos acentuadas, não-significantes, em comparação à irrigação exclusiva pelo pedículo caudal; a irrigação exclusiva pelo pedículo caudal causa alterações histológicas mais acentuadas, não-significantes, em comparação com as demais formas de desvascularização.(AU)

Avaliação do tratamento cirúrgico da hérnia perineal em cães com o reforço de membrana de pericárdio equino preservado em glicerina a 98% / Evaluation of perineal hernia surgical treatment in dogs with the reinforcement of equine pericardium preserved in glycerine 98%

A utilização de membrana biológica constitui-se método alternativo na reparação de hérnia perineal, e avaliar suaeficiência como reforço após a herniorrafia pela técnica de elevação do músculo obturador interno consiste no objetivodeste trabalho. Para tanto, utilizaram-se dez cães atendidos no Serviço de Cirurgia de Pequenos Animais do HospitalVeterinário da FMVZ/USP. Os animais foram distribuídos em dois grupos, GI e GII, com cinco representantes em cadaum. A hérnia perineal foi corrigida pela técnica de elevação do músculo obturador interno em ambos os grupos, sendoque o grupo GII ganhou reforço no diafragma pélvico com enxerto de retalho de pericárdio equino Puro Sangue Inglês,conservado em glicerina a 98%. Os animais foram avaliados por até 90 dias de pós-operatório, mediante análises clínica,ultrassonográfica e radiográfica da região perineal. Os resultados obtidos demonstraram que houve reforço no local daherniorrafia ao se fixar o pericárdio de equino conservado em glicerina a 98%, diminuindo a ocorrência de deiscênciade pontos e ruptura do diafragma operado.(AU)

The use of biological membrane constitutes an alternative method to repair perineal hernia, and evaluate its performanceas a reinforcement after herniorrhaphy by of raising internal obturator muscle was the goal of this study. Ten dogsadmitted at the Department of Small Animal Surgery Veterinary Hospital of FMVZ / USP were included. Animalswere equally divided into two groups, GI and GII. Perineal hernia was corrected by the elevating the internal obturatormuscle in both groups, but in group GII won the strengthening of the pelvic diaphragm flap of equine pericardiumpure English Thoroughbred, preserved in glycerol to 98%. The animals were evaluated until 90 days post-operativelyby clinical examination, ultrasound and radiographic images of the perineal region. The results showed that therewere enhanced at the site of the hernia with equine pericardium preserved in glycerol 98%, reducing the occurrence ofdehiscence points and rupture of the diaphragm operated.(AU)

Retalho de omento maior para indução de vascularização e consolidação óssea em cão

This research reports the case of a whippet female dog, 10 years old, with delayed union of left tibia and fibula, exposure of the fracture focus with localized infection, and extensive loss of, muscle, bone and skin after instability caused by two surgical interventions accomplished previously. A flap was made of the greater omentum in a single layer. The fracture site was reached through the subcutaneous tunnel and the coating by mesh skin grafts. The objective of this study was to evaluate the ability of the larger omentum to induce angiogenesis to the fracture site and the subsequent bone healing, considering the strong role of angiogenesis. The left tibia and fibula were stabilized with external circular fixator. After 80 days there was bone healing of the tibia around the support member and removal of the implant. Postoperative complications included partial necrosis of the cutaneous (25%) flap and shortening of the tibia with consequent laxity ligament of the member.

Este trabalho relata o caso de uma cadela da raça whippet, de 10 anos, com união retardada de tíbia e fíbula esquerdas, exposta, cotaminada e com grande perda de massa muscular e óssea e de pele causada por instabilidade óssea decorrente de duas intervenções cirúrgicas realizadas anteriormente. Foi realizado retalho de omento maior em camada simples, alcance ao foco de fratura via túnel subcutâneo e recobrimento por enxerto cutâneo em malha. O objetivo do trabalho foi avaliar a capacidade de indução vascular do omento maior para foco de fratura e consequentemente consolidação óssea, tendo como hipótese a acentuada função de angiogênese do omento maior. A tíbia e fíbula esquerdas foram estabilizadas com fixador circular externo. Após 80 dias, houve consolidação óssea da tíbia, volta do apoio do membro e retirada do implante.

Retalho de omento maior para indução de vascularização e consolidação óssea em cão

This research reports the case of a whippet female dog, 10 years old, with delayed union of left tibia and fibula, exposure of the fracture focus with localized infection, and extensive loss of, muscle, bone and skin after instability caused by two surgical interventions accomplished previously. A flap was made of the greater omentum in a single layer. The fracture site was reached through the subcutaneous tunnel and the coating by mesh skin grafts. The objective of this study was to evaluate the ability of the larger omentum to induce angiogenesis to the fracture site and the subsequent bone healing, considering the strong role of angiogenesis. The left tibia and fibula were stabilized with external circular fixator. After 80 days there was bone healing of the tibia around the support member and removal of the implant. Postoperative complications included partial necrosis of the cutaneous (25%) flap and shortening of the tibia with consequent laxity ligament of the member.

Este trabalho relata o caso de uma cadela da raça whippet, de 10 anos, com união retardada de tíbia e fíbula esquerdas, exposta, cotaminada e com grande perda de massa muscular e óssea e de pele causada por instabilidade óssea decorrente de duas intervenções cirúrgicas realizadas anteriormente. Foi realizado retalho de omento maior em camada simples, alcance ao foco de fratura via túnel subcutâneo e recobrimento por enxerto cutâneo em malha. O objetivo do trabalho foi avaliar a capacidade de indução vascular do omento maior para foco de fratura e consequentemente consolidação óssea, tendo como hipótese a acentuada função de angiogênese do omento maior. A tíbia e fíbula esquerdas foram estabilizadas com fixador circular externo. Após 80 dias, houve consolidação óssea da tíbia, volta do apoio do membro e retirada do implante.

Characterization of pseudarthrosis with ultrasound backscattered signals in rats / Caracterização da pseudoartrose com sinais de retroespalhamentos de ultrassom em ratos

PURPOSE: To propose a novel model of pseudarthrosis in a small animal and to investigate the ability of backscatter parameters from ultrasound signals in differentiating normal bone from those ones with pseudarthorsis. METHODS: Twelve Rattus norvegicus albinus free from pathogenic species (SPF) were randomly divided in two groups, with six animals each. In the Control group a surgical approach to the femur was made, followed by the synthesis of the muscle and skin layers. The Experimental group was submitted to an osteotomy of the femur and a vascularized flap of the fascia lata was interposed in the line of the fractured bone. Then the alignment and bone stabilization were accomplished, by using nylon stitch in U shape introduced in holes made in the proximal and distal fractured bone. Bone samples were scanned with ultrasound and signals were collected for each one to analyze the parameter Apparent Integrated Backscatter - AIB. RESULTS: Radiological and anatomopathologic studies revealed the absence of bone consolidation with persistence of fiber-osteoid tissue. Values of the ultrasound parameter AIB from normal bones were statistically different from those with pseudarthrosis. CONCLUSION: The experimental model was suitable for pseudarthrosis development in rats and the ultrasound backscatter parameters were able to identify such a bone disease in vitro.(AU)

OBJETIVO: Propor um novo modelo de pseudoartrose em animais de pequeno porte e investigar o potencial de parâmetros de retroespalhamento de ultrassônico em diferenciar osso normal e com pseudoartrose. MÉTODOS: Doze Rattus norvegicus albinus (SPF) foram distribuídos aleatoriamente em dois grupos, tendo cada grupo seis animais. No grupo Controle realizou-se uma abordagem cirúrgica ao fêmur, seguida da síntese por planos do músculo e da pele. O grupo Experimental foi submetido à osteotomia do fêmur aduzida da confecção de um retalho pediculado de fascia lata para interposição entre os segmentos resultantes da fratura induzida cirurgicamente. Prosseguiu-se com o alinhamento e estabilização óssea, mediante a confecção de um nó com fio de náilon em formato de U, introduzido em orifícios efetuados nas extremidades proximal e distal à fratura. As amostras ósseas foram irradiadas pelo ultrassom e sinais foram coletados para cada uma no intuito de analisar o parâmetro Retroespalhamento Integrado Aparente - AIB. RESULTADOS: Estudos radiológicos e anatomopatológicos evidenciaram a ausência de consolidação óssea com persistência de tecido fibro-osteóide. Os valores de AIB para ossos normais foram estatisticamente diferentes em relação aos ossos com pseudoartrose. CONCLUSÃO: O modelo experimental apresentou-se adequado para a formação de pseudoartrose em ratos e o parâmetro de retroespalhamento de ultrassom foi capaz de detectar tal doença óssea, in vitro.(AU)

Nicotine on rat TRAM flap / Nicotina em retalho TRAM em ratos

PURPOSE: The transverse rectus abdominis myocutaneous (TRAM) flap is one of the preferential techniques used in breast reconstruction following mastectomy. Nicotine has a detrimental effect on cutaneous flap survival; although there are no experimental studies proving this effect on musculocutaneous flaps. The aim of this study is to verify the effect of nicotine on the rat TRAM flap. METHODS: 30 Wistar EPM-1 rats were randomly distributed in two groups: control and experimental. The animals of the control group received saline solution injected subcutaneously, in a volume of 0.2 ml, twice a day, during 28 days in the preoperative period. The animals of the experimental group were treated with nicotine, injected subcutaneously, in a dose of 2 mg/kg twice a day, during 28 days in the preoperative period. All the animals were submitted to the caudally based, right unipedicled TRAM flap. 48 hours after the procedure, a study of the viable area of the flap was done through photographic documentation. Statistical analysis was performed with nonparametric Mann-Whitney's test. RESULTS: The experimental group had significantly greater area of necrosis when compared with the control group (p<0.001). CONCLUSION: Nicotine increased the area of necrosis of the TRAM flap, in rats(AU)

OBJETIVOS: O retalho musculocutâneo transverso do músculo reto do abdome (TRAM) é uma das principais opções na reconstrução do relevo mamário pós-mastectomia. A nicotina tem efeito deletério na viabilidade de retalhos cutâneos; porém, não foram encontrados trabalhos experimentais comprovando este efeito em retalhos musculocutâneos. O objetivo deste trabalho é investigar o efeito da nicotina na viabilidade do retalho TRAM, em ratos. MÉTODOS: Foram utilizados 30 ratos da linhagem Wistar EPM-1. Os animais foram distribuídos aleatoriamente em dois grupos: controle e experimento. Os animais do grupo controle foram tratados com solução salina injetada no tecido celular subcutâneo num volume de 0,2 ml, duas vezes ao dia, durante 28 dias no período pré-operatório. Os animais do grupo experimento foram tratados com nicotina injetada no tecido celular subcutâneo em uma dose de 2mg/kg/2 vezes ao dia, durante 28 dias no período pré-operatório. Todos os animais foram submetidos ao procedimento do retalho TRAM de base caudal unilateral à direita (pedículo não dominante). 48 horas depois, foi feita a avaliação da área viável de superfície do retalho, por documentação fotográfica. Para análise dos resultados foram utilizados testes não paramétricos: Mann-Whitney. RESULTADOS: O grupo experimento apresentou uma área de necrose maior, quando comparado com o grupo controle (p<0,001). CONCLUSÃO: A nicotina aumentou a área de necrose do retalho TRAM, em ratos(AU)

The anatomy of superficial inferior epigastric artery flap / Anatomia do retalho com a artéria epigástrica superficial

PURPOSE: To describe the anatomical variations of superficial inferior epigastric artery (SIEA) flap as a muscle-sparing flap. METHODS: A series of 40 dissections were performed on 20 preserved or fresh male cadavers. The site origin and drainage of vessels, caliber, length, and correlation between diameter and length of pedicle were identified. RESULTS: The SIEA and SIEV were identified at inguinal ligament level in 38 (95 percent) and 40 (100 percent) dissections, respectively. The SIEA originated directly from a common femoral artery 22 (57.9 percent) or a common trunk with other arteries. The SIEA was found within 1 cm of the midpoint of the inguinal ligament in 33 of 38 cases. The meanSD length of SIEA was 3.041.73 (0.5-7) cm. The meanSD caliber of SIEA was 1.450.35 (0.7-2.1) mm. The length of SIEV ranged from 2.2 to 12 cm with a meanSD of 5.452.08 cm. The caliber of SIEV ranged from 1.6 to 4 mm with a meanSD of 2.140.45 mm. The length of SIEA correlated with caliber of arterial pedicle (p<0.001 and correlation coefficient = 0.517). CONCLUSION: The inferior epigastric artery flap can be applied to microsurgical flap transfer, potentially in breast reconstruction, hemifacial atrophy, phalloplasty, or when extremely large amounts of skin coverage are required.(AU)

OBJETIVO: Descrever as variações anatômicas do retalho muscular com artéria epigástrica superficial. MÉTODOS: Foram realizadas uma série de 40 dissecções em cadáveres do gênero masculino, preservados ou recentes, Foram identificados o local de origem e drenagem dos vasos: calibre, comprimento e correlação entre diâmetro e comprimento do pedículo. RESULTADOS: As artérias e veias epigástricas superficiais foram identificadas no nível do ligamento inguinal respectivamente em 38 (95 por cento) e 40 (100 por cento) das dissecções. A artéria epigástrica superficial originava diretamente da artéria femoral em 22 (57,9 por cento) ou de um tronco comum com outras artérias. A artéria foi encontrada em um cm do ponto médio do ligamento inguinal em 33 de 38 casos. A média do comprimento da artéria epigástrica superficial foi de 3.04 1.73 (0,5-7) cm. A média do calibre da artéria foi 1.45 0.35 (0.7-2.1). O comprimento da veia epigástrica superficial foi de 2.2 a 12 cm com média de 5.452.08 cm. O calibre da veia era de 1.6 a 4 mm com média de 2.140.45 mm. O comprimento da artéria epigástrica superficial foi correlacionado com o calibre do pedículo arterial. CONCLUSÃO: O retalho com a artéria epigástrica superficial pode ser aplicado em microcirurgia de retalhos, potencialmente em reconstrução mamária, atrofia hemifacial, faloplastia ou quando se faz necessário aplicar em perdas acentuadas de pele.(AU)