Free omental graft without vascular microanastomosis in the cutaneous wound healing of rabbits / [Enxerto omental livre sem microanastomose vascular na cicatrização de feridas cutâneas em coelhos]

This study aims to evaluate the influence of free omental graft without vascular microanastomosis (FOGWVA) on experimental skin healing in rabbits. Through celiotomy, a 9cm2 free omental fragment was collected in 36 rabbits, with subsequent production of a deep linear cutaneous wound in the dorsal midline measuring 3cm. In 18 animals from the omental group (OG), the omental fragment collected was fixed subcutaneously with six simple interrupted stitches using a 4-0 polyamide thread. In both treated and control (CG) groups, intradermal dermorrhaphy was performed with 4-0 polyamide thread. Experimental wounds were clinically evaluated every day. Each of the groups was divided into three subgroups of 6 animals each for histopathological evaluation on the 7th, 14th, and 28th days of postoperative. In the OG wounds, the increase in volume (omentum activation) stood out after the second postoperative day. Macroscopy showed an organic reaction to the graft on day 7, with a progressive reduction in addition to neovascularization towards the omental graft. The intense presence of mononuclear cells and collagen deposition on day 7 demonstrated an accelerated process of tissue remodeling and repair. The FOGWVA omental graft remained viable and positively influenced the cutaneous healing of the experimental wounds in rabbits.

Neste estudo, objetiva-se avaliar a influência do enxerto omental livre sem microanastomose vascular (FOGWVA) na cicatrização cutânea experimental em coelhos. Por meio de celiotomia, foi coletado fragmento omental livre de 9cm2 em 36 coelhos, com posterior produção de ferida cutânea profunda linear na linha média dorsal medindo 3cm. Apenas em 18 animais, do grupo omento (GO), o fragmento omental coletado foi fixado no subcutâneo com seis pontos simples interrompidos utilizando fio poliamida 4-0. Em ambos os grupos, tratado e controle (GC), efetuou-se dermorrafia intradérmica com fio poliamida 4-0. As feridas experimentais foram avaliadas clinicamente todos os dias. Cada um dos grupos foi dividido em três subgrupos, com seis animais cada, para avaliação anatomopatológica no sétimo, 14º e 28o dias de pós-operatório. Nas feridas do GO, destacou-se aumento de volume (ativação do omento) a partir do segundo dia pós-operatório. A macroscopia evidenciou reação orgânica ao enxerto no dia sete, com redução progressiva, além de neovascularização em direção ao enxerto omental. Intensa presença de células mononucleares e deposição de colágeno no dia sete demonstraram acelerado processo de remodelamento e reparo tecidual. O FOGWVA manteve-se viável e influenciou positivamente na cicatrização cutânea de feridas experimentais em coelhos.

Reconstrução prepucial com uso de enxerto combinado em cães / Preputial reconstruction combined with graft in dogs

Background: Preputial injuries are significant in the clinical routine. Traumas, conditions, and mass excision result in extensive and full-thickness defects that lead to chronic penile exposure and consequential injuries. Severe injuries may require preputial reconstructive surgery to restore function and aesthetics. The objective is to report the use of the preputial reconstruction technique using the caudal superficial epigastric axial standard flap associated with a single-stage, full-thickness oral mucosa graft in 3 dogs where the loss of the prepuce was significant. Cases: Three dogs were admitted to the Veterinary Teaching Hospital of UFMT with preputial lesions of different etiologies. All cases were referred for preventive reconstruction using a flap in the caudal axial epigastric pattern associated with a single-stage oral mucosa graft. In the 3 reported cases, changes that compromised surgical success, such as suture dehiscence, necrosis, or infection, were not observed during hospitalization. Cutaneous stitch dehiscence, however, was observed in all 3 cases. Dog 1. A small point of dehiscence and tissue necrosis was found and treated with chemical debridement and healed by second intention, which proved to be sufficient on the 30th day. Dog 2. A half-moon rotation flap was performed, which closed the defect. Dog 3. A new procedure using the reporting theme technique was necessary in order to cover the cranial portion of the foreskin. The dehiscence present in dogs 2 and 3 was significant. Flap retraction was observed in all 3 cases. In dogs 1 and 3, the retraction was slight, and the exposure of a small portion of the penile glans were observed, showing no changes that required intervention. In dog 2, retraction was important, leading to partial stenosis of the preputial ostium. A larger ostium was obtained by suturing the mucosa to the edge of the wedge. Considering the possibility of adhesion formation, "captons" were made in sterile silicone tubes, and sutures were placed in the dorsal and ventral aspects to prevent adherence of the oral mucosa graft located on the inside of the new foreskin. The captons were removed on the tenth post-operative day, revealing a good opening of the preputial orifice and adequate penile exposure. Discussion: The absence of a foreskin caused by trauma or surgical excision leads to chronic penile exposure, dryness, and ulcerations. The simple covering of the skin with an axial-type flap of the caudal superficial epigastric region tends to fail since only the graft edges are sutured into the abdominal skin. In these circumstances, the subcutaneous region on the penis is exposed and comes in direct contact with urine and the penile mucosa, causing the flap skin to grow to exacerbated retraction. The transplantation of a free-lip mucosa graft allows the subcutaneous region of the transposed skin flap to create adhesions in the fenestrated regions of the lip tissue through the formation of granulation tissue buds, which is performed in a single stage. The permanence of the penis protects the lower urinary system from the occurrence of infections relative to what is normally observed in cases where partial or total penile amputation is practiced in combination with adjunctive scrotal urethrostomy. Given the observations of the 3 cases described here, the technique of pre-facial reconstruction with an axial skin flap of the caudal superficial epigastric region, combined with free-labial mucosa graft, was found to be feasible for the single-stage foreskin technique, but that paraphimosis remanagement may be necessary when cutaneous portions of the penile skin caudal to the glans are removed.

Autologous platelet-rich plasma action on skin autografts in horses / Ação do plasma rico em plaquetas autólogo em autoenxertos de pele em equinos

This study evaluated the action of autologous platelet-rich plasma (PRP) on cutaneous wounds, containing skin autografts, in the gluteal region of horses. Seven healthy horses were used. Two 6 x 6cm cutaneous wounds were produced on each side of the gluteal region. Eight days after wound induction, grafts were performed with skin fragments harvested from the neck, as well as the application of PRP, prepared by double-centrifugation protocol. Wounds with autografts on the left side received PRP (group T), and those with autografts on the right side did not receive treatment (group C). Macroscopic and microscopic evaluations were performed, considering the integration of autografts and retraction of wound edges, as well as neovascularization, inflammatory infiltrate, young fibroblasts, collagenization, reepithelization and autografts integration. There was no difference between the groups (P > 0.05) in relation to most macroscopic and microscopic variables. However, neovascularization was significantly greater (p = 0.0191) in group T, on the 14th day after grafting. It is concluded that PRP favors the process of skin repair with autografts in horses, since it increases the neovascularization in the initial phase of wound healing. Furthermore, the PRP seems to positively influence the integration of the skin autografts and the retraction of the wound edges.

Este estudo avaliou a ação do plasma rico em plaquetas (PRP) autólogo em feridas cutâneas, contendo autoenxertos de pele em equinos. Foram utilizados sete equinos hígidos, nos quais foram produzidas duas feridas cutâneas de 6 x 6cm, em cada um dos lados da região glútea. Oito dias após a indução das feridas, foram realizados enxertos com fragmentos de pele colhidos do pescoço, assim como a aplicação do PRP, preparado através de protocolo de dupla centrifugação. As feridas com autoenxertos do lado esquerdo receberam PRP (grupo T), e as com autoenxertos do lado direito não receberam tratamento (grupo C). Foram realizadas avaliações macroscópica e microscópica, considerando as variáveis integração dos autoenxertos e retração das bordas da ferida, além de neovascularização, infiltrado inflamatório, fibroblastos jovens, colagenização, reepitelização e integração dos autoenxertos. Não houve diferença entre os grupos (p > 0,05) em relação à maioria das variáveis macroscópicas e microscópicas. Contudo, a neovascularização foi significativamente maior (P = 0,0191) no grupo T, no 14º dia após a realização da enxertia. Conclui-se que o PRP favorece o processo de reparo da pele com autoenxertos em equinos, já que aumenta a neovascularização na fase inicial da cicatrização da ferida. Ainda, o PRP parece influenciar positivamente a integração dos autoenxertos de pele e a retração das bordas da ferida.

Autologous platelet-rich plasma action on skin autografts in horses / Ação do plasma rico em plaquetas autólogo em autoenxertos de pele em equinos

This study evaluated the action of autologous platelet-rich plasma (PRP) on cutaneous wounds, containing skin autografts, in the gluteal region of horses. Seven healthy horses were used. Two 6 x 6cm cutaneous wounds were produced on each side of the gluteal region. Eight days after wound induction, grafts were performed with skin fragments harvested from the neck, as well as the application of PRP, prepared by double-centrifugation protocol. Wounds with autografts on the left side received PRP (group T), and those with autografts on the right side did not receive treatment (group C). Macroscopic and microscopic evaluations were performed, considering the integration of autografts and retraction of wound edges, as well as neovascularization, inflammatory infiltrate, young fibroblasts, collagenization, reepithelization and autografts integration. There was no difference between the groups (P > 0.05) in relation to most macroscopic and microscopic variables. However, neovascularization was significantly greater (p = 0.0191) in group T, on the 14th day after grafting. It is concluded that PRP favors the process of skin repair with autografts in horses, since it increases the neovascularization in the initial phase of wound healing. Furthermore, the PRP seems to positively influence the integration of the skin autografts and the retraction of the wound edges.(AU)

Este estudo avaliou a ação do plasma rico em plaquetas (PRP) autólogo em feridas cutâneas, contendo autoenxertos de pele em equinos. Foram utilizados sete equinos hígidos, nos quais foram produzidas duas feridas cutâneas de 6 x 6cm, em cada um dos lados da região glútea. Oito dias após a indução das feridas, foram realizados enxertos com fragmentos de pele colhidos do pescoço, assim como a aplicação do PRP, preparado através de protocolo de dupla centrifugação. As feridas com autoenxertos do lado esquerdo receberam PRP (grupo T), e as com autoenxertos do lado direito não receberam tratamento (grupo C). Foram realizadas avaliações macroscópica e microscópica, considerando as variáveis integração dos autoenxertos e retração das bordas da ferida, além de neovascularização, infiltrado inflamatório, fibroblastos jovens, colagenização, reepitelização e integração dos autoenxertos. Não houve diferença entre os grupos (p > 0,05) em relação à maioria das variáveis macroscópicas e microscópicas. Contudo, a neovascularização foi significativamente maior (P = 0,0191) no grupo T, no 14º dia após a realização da enxertia. Conclui-se que o PRP favorece o processo de reparo da pele com autoenxertos em equinos, já que aumenta a neovascularização na fase inicial da cicatrização da ferida. Ainda, o PRP parece influenciar positivamente a integração dos autoenxertos de pele e a retração das bordas da ferida.(AU)

Túnica vaginal autógena para herniorrafia perineal em cães / Autogenous tunica vaginalis for perineal herniorrhaphy in dogs

A túnica vaginal possui características ideais para enxertia e já foi empregada na reparação de diversos tecidos, inclusive do diafragma pélvico. Objetivou-se avaliar a aplicabilidade da túnica vaginal como enxerto autógeno livre, em dupla camada, para a reparação do diafragma pélvico em 14 cães portadores de hérnia perineal, das quais, nove eram unilaterais e cinco, bilaterais. Após a orquiectomia, as túnicas de ambos os testículos foram coletadas, sobrepostas e fixadas entre si por meio de quatro pontos de reparo. Foi realizada abordagem ao saco herniário, inspeção, redução do conteúdo herniário, desbridamento muscular e síntese primária mediante sutura. O enxerto foi fixado à musculatura remanescente por meio de pontos simples separados e, posteriormente, encoberto pela sutura intradérmica e por síntese cutânea. Observações transoperatórias e, posteriormente, avaliações clínicas e ultrassonográficas, por período de um ano, permitiram sugerir que a túnica vaginal possui atributos ideais para a reparação do diafragma pélvico. Conclui-se que o enxerto autógeno livre de túnica vaginal, em dupla camada, é exequível e aplicável para o reparo do diafragma pélvico no tratamento da hérnia perineal em cães.(AU)

The tunica vaginalis has ideal characteristics for grafting and has already been used to repair several tissues, including the pelvic diaphragm. The aim of this study was to evaluate the applicability of the tunica vaginalis as a free double-layer autogenous graft to repair the pelvic diaphragm in 14 dogs with perineal hernia, of which, nine were unilateral and five, bilateral. After orchiectomy, the tunics of both testicles were collected, overlapped and fixed to each other by four repair points. The hernial sac was approached, followed by inspection, reduction of the hernia content, muscle debridement and primary synthesis through suture. The graft was attached to the remaining musculature by simple interrupted stitches and later hidden by intradermal suture and cutaneous synthesis. Intraoperative observations and, later, clinical and sonographic evaluations over a one-year period, allow to suggest that the tunica vaginalis has ideal attributes for the pelvic diaphragm repair. It is concluded that the autogenous graft-free of tunica vaginalis in double layer is feasible and applicable in order to repair the pelvic diaphragm in the perineal hernia treatment in dogs.(AU)

Túnica vaginal autógena para herniorrafia perineal em cães / Autogenous tunica vaginalis for perineal herniorrhaphy in dogs

A túnica vaginal possui características ideais para enxertia e já foi empregada na reparação de diversos tecidos, inclusive do diafragma pélvico. Objetivou-se avaliar a aplicabilidade da túnica vaginal como enxerto autógeno livre, em dupla camada, para a reparação do diafragma pélvico em 14 cães portadores de hérnia perineal, das quais, nove eram unilaterais e cinco, bilaterais. Após a orquiectomia, as túnicas de ambos os testículos foram coletadas, sobrepostas e fixadas entre si por meio de quatro pontos de reparo. Foi realizada abordagem ao saco herniário, inspeção, redução do conteúdo herniário, desbridamento muscular e síntese primária mediante sutura. O enxerto foi fixado à musculatura remanescente por meio de pontos simples separados e, posteriormente, encoberto pela sutura intradérmica e por síntese cutânea. Observações transoperatórias e, posteriormente, avaliações clínicas e ultrassonográficas, por período de um ano, permitiram sugerir que a túnica vaginal possui atributos ideais para a reparação do diafragma pélvico. Conclui-se que o enxerto autógeno livre de túnica vaginal, em dupla camada, é exequível e aplicável para o reparo do diafragma pélvico no tratamento da hérnia perineal em cães.(AU)

The tunica vaginalis has ideal characteristics for grafting and has already been used to repair several tissues, including the pelvic diaphragm. The aim of this study was to evaluate the applicability of the tunica vaginalis as a free double-layer autogenous graft to repair the pelvic diaphragm in 14 dogs with perineal hernia, of which, nine were unilateral and five, bilateral. After orchiectomy, the tunics of both testicles were collected, overlapped and fixed to each other by four repair points. The hernial sac was approached, followed by inspection, reduction of the hernia content, muscle debridement and primary synthesis through suture. The graft was attached to the remaining musculature by simple interrupted stitches and later hidden by intradermal suture and cutaneous synthesis. Intraoperative observations and, later, clinical and sonographic evaluations over a one-year period, allow to suggest that the tunica vaginalis has ideal attributes for the pelvic diaphragm repair. It is concluded that the autogenous graft-free of tunica vaginalis in double layer is feasible and applicable in order to repair the pelvic diaphragm in the perineal hernia treatment in dogs.(AU)

Use of the angularis oris axial pattern buccal flap for the correction of facial defects in six dogs

Background: Reconstructive surgery is an important area of veterinary surgery because it allows the reconstruction of large cutaneous defects in areas where a primary approach is not possible. Axial patterns flaps are composed by one direct cutaneous artery and vein, leading to a better blood supply with a good survival outcome. The angularis oris axial pattern buccal flap was introduced for correction of facial defects, but its versatility is not really explored in the existing literature. This article reports the use and complications of the angularis oris axial pattern buccal flap in six dogs, to treat defects in mandibular, temporal or labial regions. Cases: Five mixed breed dogs and one Labrador, with age between 4 and 9-year-old were submitted for surgery and the angularis oris axial pattern buccal flap was used to close the different defects. Causes of defect included a lesion caused by myiasis in three of the dogs, and tumoral removal in the other three, where two were mast cell tumors and one a keratinizing basal cell carcinoma. The regions affected included rostral mandible with oral mucosa, intermandibular region, temporal region and upper lip. Before flap confection the tissue was cleaned, resected and prepared properly, according to each cause of lesion. The flap was made with two parallel incisions, which center was usually the labial commissure, with the dorsal limits at the ventral aspect of the zygomatic arch, and the ventral incision on the ventral aspect of the mandibular ramus. Caudal extension was based on the length needed for surgical closure, but stained between the vertical auditory canal or up to atlas wing. Suture size and pattern depend the region and patient size. Patients were observed closely for any complication in the surgical site. From the six dogs presented here, five got some complications in the surgical site, including: lymphedema (2), suture dehiscence (4) and hematoma (1); however...

Use of the angularis oris axial pattern buccal flap for the correction of facial defects in six dogs

Background: Reconstructive surgery is an important area of veterinary surgery because it allows the reconstruction of large cutaneous defects in areas where a primary approach is not possible. Axial patterns flaps are composed by one direct cutaneous artery and vein, leading to a better blood supply with a good survival outcome. The angularis oris axial pattern buccal flap was introduced for correction of facial defects, but its versatility is not really explored in the existing literature. This article reports the use and complications of the angularis oris axial pattern buccal flap in six dogs, to treat defects in mandibular, temporal or labial regions. Cases: Five mixed breed dogs and one Labrador, with age between 4 and 9-year-old were submitted for surgery and the angularis oris axial pattern buccal flap was used to close the different defects. Causes of defect included a lesion caused by myiasis in three of the dogs, and tumoral removal in the other three, where two were mast cell tumors and one a keratinizing basal cell carcinoma. The regions affected included rostral mandible with oral mucosa, intermandibular region, temporal region and upper lip. Before flap confection the tissue was cleaned, resected and prepared properly, according to each cause of lesion. The flap was made with two parallel incisions, which center was usually the labial commissure, with the dorsal limits at the ventral aspect of the zygomatic arch, and the ventral incision on the ventral aspect of the mandibular ramus. Caudal extension was based on the length needed for surgical closure, but stained between the vertical auditory canal or up to atlas wing. Suture size and pattern depend the region and patient size. Patients were observed closely for any complication in the surgical site. From the six dogs presented here, five got some complications in the surgical site, including: lymphedema (2), suture dehiscence (4) and hematoma (1); however...(AU)

Malformações faciais congênitas em cão: relato de caso / Congenital facial malformations in dog: case report

O estudo anatômico descreve os aspectos normais da conformação de determinada espécie, ou seja, as características que ocorrem com alta frequência nesta. Desta forma, quando um evento ocorre na maioria dos indivíduos de uma espécie, ele é considerado como normal. Embora também sejam observadas as variações anatômicas, caracterizadas pela alteração no padrão normal, em anatomia, define-se variação como um pequeno desvio do aspecto morfológico normal de um órgão ou ainda o desvio do plano geral de organização de um indivíduo, eventos que em animais e humanos é bastante estudado. No presente caso, a fissura craniofacial é considerada uma anomalia congênita rara de etiologia desconhecida. A localização é geralmente em determinadas linhas das pálpebras, sobrancelhas, narinas, lábios e maxilas, atingindo partes moles e ósseas. Na medicina veterinária é pouco estudada e sua classificação está baseada nas alterações observadas em humanos baseada nas relações anatômicas. As fissuras podem-se apresentar com as características de excesso de tecido ou agenesia dos mesmos. Em humanos, dependendo do caso, o tratamento é baseado em sutura dos tecidos moles, em três planos: cutâneo, muscular e mucoso; zetaplastias; tratamento ortodôntico; enxertos ósseos, quando necessário já em animais na bibliografia consultada não foram encontrados casos com tratamento. O presente relato descreve as alterações relacionadas com uma fissura craniofacial associado à palatosquise, queilosquise, macroglossia, ausência da órbita ocular e consequentemente o globo ocular em um neonato de cão.

The anatomical study describes the normal aspects of the conformation of a certain species, that is, the characteristics that occur with high frequency in this. In this way, when an event occurs in most individuals of a species, it is considered as normal. Although anatomical variations are also observed, characterized by the alteration in the normal pattern in anatomy, it is defined as a small deviation from the normal morphological aspect of an organ or the deviation from the general plane of organization of an individual, events that in animals and humans is well studied. In the present case, craniofacial fissure is considered a rare congenital anomaly of unknown etiology. The location is usually in certain lines of eyelids, eyebrows, nostrils, lips and jaws, reaching soft and bony parts. In veterinary medicine it is little studied and its classification is based on the changes observed in humans based on the anatomical relations. The cracks may present with the characteristics of excess tissue or agenesis of the same. In humans, depending on the case, the treatment is based on suture of the soft tissues, in three planes: cutaneous, muscular and mucous; zetaplasty; orthodontic treatment; bone grafts, when necessary already in animals in the consulted bibliography there were no cases with treatment. The present report describes the changes related to a craniofacial fissure associated to palatoschisis, cheiloschisis, macroglossia, absence of the ocular orbit and consequently the eyeball in a newborn of dog.

Malformações faciais congênitas em cão: relato de caso / Congenital facial malformations in dog: case report

O estudo anatômico descreve os aspectos normais da conformação de determinada espécie, ou seja, as características que ocorrem com alta frequência nesta. Desta forma, quando um evento ocorre na maioria dos indivíduos de uma espécie, ele é considerado como normal. Embora também sejam observadas as variações anatômicas, caracterizadas pela alteração no padrão normal, em anatomia, define-se variação como um pequeno desvio do aspecto morfológico normal de um órgão ou ainda o desvio do plano geral de organização de um indivíduo, eventos que em animais e humanos é bastante estudado. No presente caso, a fissura craniofacial é considerada uma anomalia congênita rara de etiologia desconhecida. A localização é geralmente em determinadas linhas das pálpebras, sobrancelhas, narinas, lábios e maxilas, atingindo partes moles e ósseas. Na medicina veterinária é pouco estudada e sua classificação está baseada nas alterações observadas em humanos baseada nas relações anatômicas. As fissuras podem-se apresentar com as características de excesso de tecido ou agenesia dos mesmos. Em humanos, dependendo do caso, o tratamento é baseado em sutura dos tecidos moles, em três planos: cutâneo, muscular e mucoso; zetaplastias; tratamento ortodôntico; enxertos ósseos, quando necessário já em animais na bibliografia consultada não foram encontrados casos com tratamento. O presente relato descreve as alterações relacionadas com uma fissura craniofacial associado à palatosquise, queilosquise, macroglossia, ausência da órbita ocular e consequentemente o globo ocular em um neonato de cão.(AU)

The anatomical study describes the normal aspects of the conformation of a certain species, that is, the characteristics that occur with high frequency in this. In this way, when an event occurs in most individuals of a species, it is considered as normal. Although anatomical variations are also observed, characterized by the alteration in the normal pattern in anatomy, it is defined as a small deviation from the normal morphological aspect of an organ or the deviation from the general plane of organization of an individual, events that in animals and humans is well studied. In the present case, craniofacial fissure is considered a rare congenital anomaly of unknown etiology. The location is usually in certain lines of eyelids, eyebrows, nostrils, lips and jaws, reaching soft and bony parts. In veterinary medicine it is little studied and its classification is based on the changes observed in humans based on the anatomical relations. The cracks may present with the characteristics of excess tissue or agenesis of the same. In humans, depending on the case, the treatment is based on suture of the soft tissues, in three planes: cutaneous, muscular and mucous; zetaplasty; orthodontic treatment; bone grafts, when necessary already in animals in the consulted bibliography there were no cases with treatment. The present report describes the changes related to a craniofacial fissure associated to palatoschisis, cheiloschisis, macroglossia, absence of the ocular orbit and consequently the eyeball in a newborn of dog.(AU)

Utilização de enxerto cutâneo no tratamento de ferida traumática grave associada à luxação metatarsofalangeana aberta: relato de caso / Use of cutaneous graft in the treatment of severe traumatic cutaneous wound associated with open metatarsal and falloid dislocation: case report in dogs

Na pele, quando a cicatrização por primeira intenção não é possível devido ao excesso de tensão tecidual, a melhor opção setorna a utilização de técnicas cirúrgicas reconstrutivas como retalhos e enxertos. A utilização de enxertos ou retalhos, reduzconsideravelmente o tempo de cicatrização das lesões, além de minimizar os riscos de possíveis infecções. Ademais, pela grandefrequência de lesões traumáticas múltiplas, cutâneas e ósseas que ocorrem nos pequenos animais após atropelamentos e suasinúmeras opções de tratamento, o que torna por vezes difícil a escolha da melhor conduta a estes pacientes, objetivou-se descrevero tratamento de uma ferida traumática, utilizando, açúcar, tala de Robert Jones modificada, seguido de enxerto cutâneo em malhade espessura total, em um cão que apresentava extensa ferida cutânea infectada e luxação aberta metatarsofalangeana, dandoênfase ao retorno funcional do membro. O paciente canino, foi submetido ao tratamento por segunda intenção da ferida, até amesma estar apta a receber a enxertia cutânea. Os resultados foram satisfatórios, ocorrendo cicatrização completa da ferida ereestabilização funcional do membro com 120 dias de tratamento. Conclui-se que a combinação de tratamentos, conservativoe cirúrgico, pode ser uma alternativa eficiente a amputação do membro no tratamento de ferida lacerada infectada associada aluxação articular completa(AU)

In the skin, when healing by first intention is not possible due to excess tissue tension, the best option becomes the use of reconstructive surgical techniques such as flaps and grafts. The use of grafts or flaps, greatly reduces the healing time of the lesions, in addition to minimizing the risks of possible infections. In addition, due to the great frequency of multiple traumatic, cutaneous and bone injuries that occur in small animals after running over and their innumerable treatment options, which makes it sometimes difficult to choose the best behavior for these patients, the objective was to describe the treatment of a traumatic wound, using modified Robert Jones sugar, followed by total thickness mesh cutaneous graft, in a dog that had an extensive infected cutaneous wound and open metatarsophalangeal luxation, emphasizing the functional return of the limb. The canine patient, was submitted to the second intention treatment of the wound until it was able to receive cutaneous grafting. The results were satisfactory, with complete wound healing and functional limb reestablishment with 120 days of treatment. It is concluded that the combination of conservative and surgical treatments can be an efficient alternative to limb amputation in the treatment of infected lacerated wound associated with complete joint dislocation, generating satisfactory functional and aesthetic results.(AU)

Graft of small patch of partial thickness in equine wound

Background: Cutaneous wounds in locomotor limbs represent one of the most frequent disorders in equine medicine. Wounds in equines are distinguished from those in other species by unique characteristics, including different healing rates among breeds, wound location and high propensity to formation of exuberant granulation tissue during the healing process. The wound healing process that cannot be sutured can be accelerated by the use of skin grafts, lowering the treatment cost. The objective of this report was to divulgate the success upon treatment of an extensive lacerated wound in the metatarsal region of a horse using autologous skin grafts.Case: A 3-year-old, female, American quarter horse weighting 450 kg was brought to veterinary hospital with lower limb injury. According to the owner’s report, the animal had one of its limbs stuck in a plain wire fence. A wound was observed in the metatarsal region during physical examination, the lesion caused an extensive skin laceration that showed the dorsal surface of the metatarsal bone and the digital extensor tendon. After injury assessment, wound debridement was carried out by surgery intervention followed by antisepsis and application of autologous plasma every two days as post-surgical care and wound preparation to receive the graft. Forty-five days after the first intervention, grafts were collected from the neck and implanted in the wound. The procedure achieved 70% of success. After approximately 75 days, transplantation was performed in other regions of the wound using the same technique. The duration of treatment at the Veterinary Hospital of the Universidade Paranaense (UNIPAR) was eight months, and then the animal returned home, where dressings were applied for two months to avoid the risk of contamination and until complete recovery.Discussion: The debridement of the wound and edges approximation were of great value in order to begin the process of wound granulation.[...]

Graft of small patch of partial thickness in equine wound

Background: Cutaneous wounds in locomotor limbs represent one of the most frequent disorders in equine medicine. Wounds in equines are distinguished from those in other species by unique characteristics, including different healing rates among breeds, wound location and high propensity to formation of exuberant granulation tissue during the healing process. The wound healing process that cannot be sutured can be accelerated by the use of skin grafts, lowering the treatment cost. The objective of this report was to divulgate the success upon treatment of an extensive lacerated wound in the metatarsal region of a horse using autologous skin grafts.Case: A 3-year-old, female, American quarter horse weighting 450 kg was brought to veterinary hospital with lower limb injury. According to the owners report, the animal had one of its limbs stuck in a plain wire fence. A wound was observed in the metatarsal region during physical examination, the lesion caused an extensive skin laceration that showed the dorsal surface of the metatarsal bone and the digital extensor tendon. After injury assessment, wound debridement was carried out by surgery intervention followed by antisepsis and application of autologous plasma every two days as post-surgical care and wound preparation to receive the graft. Forty-five days after the first intervention, grafts were collected from the neck and implanted in the wound. The procedure achieved 70% of success. After approximately 75 days, transplantation was performed in other regions of the wound using the same technique. The duration of treatment at the Veterinary Hospital of the Universidade Paranaense (UNIPAR) was eight months, and then the animal returned home, where dressings were applied for two months to avoid the risk of contamination and until complete recovery.Discussion: The debridement of the wound and edges approximation were of great value in order to begin the process of wound granulation.[...](AU)

Cranioplasty using autologous fasciae latae graft for nasal bone fracture repair in a dog

Background: In facial reconstruction, several kinds of grafts can be used, like bone grafting, cutaneous grafting, biological membranes, fasciae latae, biomaterials, and others. The advantage of using fasciae latae in the tissue reparation is the need of little blood supply, making it a viable option in the restoration of biological functions. The objective of this study was to describe the case of a female poodle, 12-year-old, and with subcutaneous emphysema due to fracture of the nasal bone, submitted to cranioplasty using fasciae latae. Case: It was attended a 12-year-old female poodle due to a traumatic brain injury. At physical examination, the animal had presented facial swelling and respiratory distress with inspiratory effort. Additionally, were verified subcutaneous emphysema and a depression in the nasal plane region with crepitus on palpation. Radiographic examinations revealed nasal bone and maxilla fractures. The animal was submitted to cranioplasty for nasal bone fracture repair. To access the nasal bone and frontal sinus was performed an incision in the dorsal midline from the level of medial orbital rim to the nasal plane. The subcutaneous tissue was divulsioned to allow the exposure of the nasal bone fracture, whose small fragments prevented the internal fixation. The bone defect was then repaired using free autologous fasciae latae of 2 cm wide x 3 cm long, sutured to the periosteum. Subcutaneous emphysema gradually decreased until its resolution at three days postoperatively. The surgical wound had complete healing at 10 days after surgery without concomitant complications. Discussion: The choice of the reconstructive technique is based on the operative planning and the surgeons experience. In the present case we opted for the autologous fasciae latae graft since its ready availability and lesser predisposition to immunogenic sensibilization and rejection.[…](AU)

Cranioplasty using autologous fasciae latae graft for nasal bone fracture repair in a dog

Background: In facial reconstruction, several kinds of grafts can be used, like bone grafting, cutaneous grafting, biological membranes, fasciae latae, biomaterials, and others. The advantage of using fasciae latae in the tissue reparation is the need of little blood supply, making it a viable option in the restoration of biological functions. The objective of this study was to describe the case of a female poodle, 12-year-old, and with subcutaneous emphysema due to fracture of the nasal bone, submitted to cranioplasty using fasciae latae. Case: It was attended a 12-year-old female poodle due to a traumatic brain injury. At physical examination, the animal had presented facial swelling and respiratory distress with inspiratory effort. Additionally, were verified subcutaneous emphysema and a depression in the nasal plane region with crepitus on palpation. Radiographic examinations revealed nasal bone and maxilla fractures. The animal was submitted to cranioplasty for nasal bone fracture repair. To access the nasal bone and frontal sinus was performed an incision in the dorsal midline from the level of medial orbital rim to the nasal plane. The subcutaneous tissue was divulsioned to allow the exposure of the nasal bone fracture, whose small fragments prevented the internal fixation. The bone defect was then repaired using free autologous fasciae latae of 2 cm wide x 3 cm long, sutured to the periosteum. Subcutaneous emphysema gradually decreased until its resolution at three days postoperatively. The surgical wound had complete healing at 10 days after surgery without concomitant complications. Discussion: The choice of the reconstructive technique is based on the operative planning and the surgeon’s experience. In the present case we opted for the autologous fasciae latae graft since its ready availability and lesser predisposition to immunogenic sensibilization and rejection.[…]

Utilização de derme canina para a bioengenharia de tecidos

A pele apresenta inúmeras funções entre elas, barreira contra produtos químicos e radiação, proteção contra traumas, entre outras. É composta por uma camada de epitélio estratificado externo (epiderme) e uma camada fibrosa (derme). A quebra ou perda da integridade anatômica, fisiológica e funcional da pele é denominada ferida cutânea. Essas aparecem em alta incidência na rotina clínico-cirúrgico veterinária, exigindo do cirurgião além do conhecimento anatômico, o domínio das diferentes técnicas reconstrutivas disponíveis para um planejamento cirúrgico adequado. Existem inúmeras técnicas cirúrgicas reconstrutivas voltadas ao propósito de acelerar o processo cicatricial, devolvendo à pele sua integridade, reestabelecendo suas funções e minimizando complicações. O tema vem sendo objeto de estudo de muitos pesquisadores, que se concentram na criação de um material sintético semelhante à matriz extracelular (MEC) da derme, combinada com a utilização de células-tronco. A engenharia biomédica tem possibilitado elaborar novas abordagens terapêuticas, para minimizar e tratar feridas de difícil cicatrização, constituindo deste modo avanços significativos nos últimos anos. Estes melhoraram a compreensão dos processos de cicatrização de feridas e de regeneração de tecidos. O estudo em pauta visa trazer uma contribuição ao tema valendo-se da utilização da Bioengenharia de Tecidos (scaffolds biológicos), como técnica reconstrutiva alternativa, no que se refere ao tratamento de feridas complexas, com grandes perdas teciduais e superfícies articulares, favorecendo o processo cicatricial e anulando as possíveis complicações em especial a rejeição. Para tanto, amostras de derme canina foram descelularizadas por processo químico/físico e recelularizadas com células tronco mesenquimais, onde após validação das técnicas, foram utilizados como tratamento nos pacientes dos Grupos 1 e 2 respectivamente, avaliando o processo cicatricial desses grupos em relação aos pacientes do Grupo controle, feridas tratadas por segunda intenção. Os resultados do presente trabalho comprovaram as propriedades biocompatíveis e biodegradáveis do scaffold descelularizado e recelularizado caracterizada pela integração, ausência de complicações cicatriciais, de rejeição, e/ou contaminação, demostraram segurança, facilidade de aplicação da técnica de enxertia, capacidade regenerativa pela presença de tecido cicatricial maturo e organizado (histopatológico), aspecto cosmético final da ferida desejável e observou-se que os três tratamentos se diferem entre si e que tanto o tipo de tratamento quanto o tamanho da ferida, afetam o tempo de cicatrização, constituindo-se uma ferramenta inovadora e funcionalmente promissora no tratamento de feridas cutâneas em modelos caninos.

The skin has numerous functions, including a barrier against chemicals and radiation, protection against trauma, among others. It consists of a layer of external stratified epithelium (epidermis) and a fibrous layer (dermis). The breakdown or loss of the anatomical, physiological and functional integrity of the skin is called a cutaneous wound. These appear in high incidence in the veterinary clinical-surgical routine, demanding from the surgeon in addition to anatomical knowledge, the mastery of the different reconstructive techniques available for an adequate surgical planning. There are numerous reconstructive surgical techniques aimed at accelerating the healing process, restoring integrity to the skin, restoring its functions and minimizing complications. The subject has been the subject of study by many researchers, who are concentrating on creating a synthetic material similar to the extracellular matrix (ECM) of the dermis, combined with the use of stem cells. Biomedical engineering has made it possible to develop new therapeutic approaches to minimize and treat wounds that are difficult to heal, thus constituting significant advances in recent years. These improved understanding of wound healing and tissue regeneration processes. The study in question aims to bring a contribution to the theme using the Bioengineering of Tissues (biological scaffolds), as an alternative reconstructive technique, with regard to the treatment of complex wounds, with great tissue losses and joint surfaces, favoring the process healing and canceling possible complications, especially rejection. For that, samples of canine dermis were decellularized by chemical / physical process and recellularized with mesenchymal stem cells, where after validation of the techniques, they were used as treatment in patients in Groups 1 and 2 respectively, evaluating the healing process of these groups in relation to patients control group, wounds treated by second intention. The results of the present study proved the biocompatible and biodegradable properties of the decellularized and recelularized scaffold characterized by integration, absence of scar complications, rejection, and / or contamination, demonstrated safety, ease of application of the grafting technique, regenerative capacity due to the presence of tissue mature and organized healing (histopathological), final cosmetic aspect of the desirable wound and it was observed that the three treatments differ from each other and that both the type of treatment and the size of the wound affect the healing time, constituting a tool innovative and functionally promising in the treatment of skin wounds in canine models.

EFEITO DE EXTRATOS DE PRÓPOLIS VERDE E GEOPRÓPOLIS DE ABELHA CANUDO (Scaptotrigona sp.) E JANDAÍRA (Melipona subnitida) NA RESPOSTA INFLAMATÓRIA E VIABILIDADE DE TRANSPLANTES CUTÂNEOS ALOGÊNICOS E AUTÓLOGOS

A própolis e a geoprópolis são produtos resinosos elaborados a partir de exsudatos, óleos e resinas colhidas de plantas pelas abelhas. Esses produtos são conhecidos por apresentarem efeitos biológicos e são utilizados por populares devido às propriedades medicinais, inclusive no tratamento de feridas. Objetivou-se avaliar o efeito do extrato hidroalcoólico de própolis verde (EHPv), geoprópolis de abelha canudo, Scaptotrigona sp., (EHG-Can) e geoprópolis de abelha jandaíra, Melipona subnitida, (EHG-Jan) sobre a inflamação aguda, inflamação crônica por corpo estranho, cicatrização e transplante cutâneo alogênico e autólogo em ratos wistar. Para tanto, foram utilizados 36 ratos adultos saudáveis, de ambos os sexos, distribuídos em cinco grupos: animais tratados com formulação contendo 20% de EHPv; tratados com 20% de EHG-Can; tratados com 20% de EHG-Jan; grupo controle positivo (GC+) com fármaco registrado, e; apenas veículo como controle negativo (GC-). Anteriormente as análises in vivo, foi feita uma análise físico-química das para caracterização preliminar dos extratos. A inflamação aguda foi induzida por carragenina a 1% (n = 36), a inflamação crônica foi realizada por corpo estranho (lâmina de vidro) (n = 16) e a cicatrização foi acompanhada a partir de ferida circular de 8 mm de diâmetro (n = 16). Os transplantes (n = 20) foram feitos com a incisão e realocação de dois enxertos cutâneos quadrados (1cm2), um para autoenxerto e outro para aloenxerto, respectivamente. Sobre o teor de flavonoides, amostra do grupo EHG-Jan apresentou a maior quantidade (p<0,05), EHPv quantidade intermediária e a do grupo EHG-Can apresentou a menor. Verificou-se um efeito positivo antiedematoso pronunciado do EHPv, moderado efeito nos grupos EHG-Can e EHG-Jan. Na inflamação crônica, o grupo EHG-Jan destacou-se por acelerar a formação do granuloma. Houve aceleração da cicatrização com reepitelização completa por efeito dos extratos EHPv e EHG-Can em 16 dias. Os extratos aumentaram a proteção das áreas lesionadas e induziram retardo na rejeição (necrose) dos enxertos autólogos. De modo similar, porém menos acentuado ocorreu com os transplantes alogênicos. Provavelmente as diversas classes químicas, com substâncias biologicamente ativas específicas, presentes na geoprópolis foram responsáveis pelo satisfatório desempenho nas análises. Além disso, é provável que o efeito protetor contra infecções oportunistas tenha colaborado com os bons resultados. Os extratos hidroalcoólicos de própolis e geoprópolis apresentaram efeitos positivos sobre os processos inflamatórios e reparo de ferida, assim como promoveram proteção do enxerto e retardo na rejeição.

Propolis and geopropolis are resinous products elaborated starting from exudates, oils and picked resins of plants by the bees. Those products are known for they present biological effects and they are used for popular due to the medicinal properties, besides in the treatment of wounds. The aim of this work was to evaluate the effect of the hydroalcoholic extract of green propolis (HEP), canudo bee geopropolis (Scaptotrigona sp.) (HEG-Can) And the geopropolis of bee jandaíra (Melipona subnitida) (HEG-Jan) on acute inflammation, chronic inflammation, cicatrization of wounds and autogenic and allogenic skin flaps. 36 healthy adult wistar rats, of both sexes, were distributed in five groups: treated animals with formulation containing 20% of; agreements with 20% of HEG-Can; agreements with 20% of HEG-Jan; group positive control (CG+) with pharmaceutical products registered as a positive control group (CG +); only vehicle as a negative control (CG-). Previously the analyses in vivo, was made a physical-chemical analysis for preliminary characterization of the extracts. The acute inflammation was induced by 1% carrageenan, chronic inflammation caused by a foreign body (circular sight glass) and wound healing was accompanied starting from wound circular of 8mm of diameter. Transplants were made with the incision and reallocation of two grafts cutaneous squares (1cm2), first to autograft and second to allograft, respectively. On the flavonoides content, the HEG-Jan group has a large amount (p<0.05), an intermediate amount of HEP and a lower amount of HEG-Can. HEP presented a pronounced effect on the acute inflammation (anti-edematous effect), moderate effect of the HEP-Can and HEG-Jan groups was registered. In chronic inflammation, the group HEG-Jan accelerated the process of formation of the granuloma when compared to the other extracts (HEP and HEP- Can). In healing wounds, there was acceleration of the cicatrization due to effect of the extracts of HEP and HEP-Can in 16 days. The extracts show the protection of the skin graft area and discreet retard in the graft rejection (necrosis) of the autografts. In a similar way, however fewer accentuated it happened with the allografts. The several chemical classes of the geopropolis were probably responsible for the satisfactory acting in the analyses. Possibly the effects are biologically related to the presence of substances specific active. Besides, it is probable that the protecting effect against infections opportunists has collaborated with the sastisfatory results. The hydroalcoholic extracts of propolis from geopropolis have positive effects on the inflammatory processes and I repair of wound, as well as they promoted protection of the graft and retard in the graft rejection.

INFLUÊNCIA DO ENXERTO OMENTAL LIVRE NA CICATRIZAÇÃO DE FERIDAS CUTÂNEAS EXPERIMENTAIS EM COELHOS

Cicatrização é a combinação de eventos físicos, químicos e celulares que tem início após o trauma e é constituída por uma cadeia contínua de fases que se sobrepõe para restabelecer a continuidade do tecido lesionado. Falhas ou atrasos nessas fases resultam em feridas crônicas, sendo um desafio na rotina clínica veterinária. Nesse sentido, tem-se buscado cada vez mais alternativas terapêuticas eficazes que auxiliem no processo cicatricial. Em virtude das suas propriedades angiogênicas, riqueza vascular e presença de fatores de crescimento, o omento vem sendo amplamente estudado e utilizado no auxílio à cicatrização, não sendo encontrados estudos da utilização dos enxertos omentais livres sem microanastomose vascular (LSMAV) como auxiliar no reparo cutâneo. Desta forma, nesse estudo objetiva-se avaliar a influência do enxerto omental LSMAV na cicatrização cutânea de feridas experimentalmente produzidas em coelhos. Utilizou-se 24 coelhos provenientes do Laboratório de Quimioterapia Experimental em Parasitologia Veterinária da Universidade Federal Rural do Rio de Janeiro divididos em Grupo Controle (GC) e Omento (GO), submetidos à celiotomia longitudinal mediana para coleta de fragmento omental de 9cm2 . Após a celiorrafia foi produzida em todos os animais ferida linear de 3cm na linha média dorsal à altura da borda caudal das escápulas. Aprofundou-se a incisão até a fáscia toracodorsal em ambos os grupos, porém nos animais do GO o fragmento omental coletado foi fixado no subcutâneo com seis pontos simples interrompidos, seguindo-se a dermorafia com padrão intradérmico em ambos os grupos. As feridas experimentais foram avaliadas diariamente no que diz respeito à coloração, presença de crosta, tecido desvitalizado, secreção, resistência e medidas do aumento de volume, caso houvesse. Obteve-se imagens termográficas das feridas experimentais nos dias 0 (pré-operatório), 3, 7 e 14 de pós-operatório. Ainda, cada um dos grupos foi dividido em dois subgrupos com 6 animais cada, dos quais obteve-se material para avaliação anatomopatológica (macroscópica e microscópica) no 7º e 14º dias de pós-operatório. Clinicamente destacou-se a ativação do omento, observada pelo aumento de volume de consistência firme a partir do segundo dia de pós-operatório, com diminuição do edema e manutenção na coloração rósea ao longo dos momentos de avaliação. A avaliação anatomopatológica macroscópica evidenciou intensa reação orgânica (congestão e hemorragia) próximo ao enxerto no dia 7, com posterior abrandamento das respostas metabólicas, e sobretudo neovascularização em direção ao enxerto omental, indicando sua viabilidade. A microscopia corroborou os dados da avaliação macroscópica, sendo possível observar maior neovascularização na derme profunda do GO já no sétimo dia de pós-operatório, e mais quantidade de células polimorfonucleares e mononucleares, bem como aumentada presença de colágeno (sem diferença estatística) na derme profunda e superficial, indicando acelerado processo de remodelamento e reparo tecidual. A termografia captou menor temperatura cutânea na ferida experimental já no sétimo dia de avaliação, que juntamente à maior produção de colágeno na microscopia, ainda que sem diferença estatística, pode estar relacionada a um processo de fibroplasia mais acelerado no GO. Conclui-se que o enxerto omental LSMAV influenciou positivamente a cicatrização cutânea de feridas experimentais em coelhos, mantendo-se viável e sem sinais deletérios à região implantada.

Healing is the combination of physical, chemical and cellular events that begins after the trauma and consists of a continuous chain of phases that overlap to restore the continuity of the injured tissue. Failures or delays in these phases result in chronic wounds, being a challenge in the veterinary clinical routine. In this sense, more and more effective therapeutic alternatives that assist in the healing process have been sought. Due to its angiogenic properties, vascular richness and the presence of growth factors, the omentum has been widely studied and used to aid healing, and studies on the use of free omental grafts without vascular microanastomosis (LSMAV) as an aid in skin repair have not been found. Thus, this study aims to evaluate the influence of the LSMAV omental graft on the skin healing of wounds experimentally produced in rabbits. Twenty-four rabbits from the Experimental Chemotherapy Laboratory in Veterinary Parasitology of the Federal Rural University of Rio de Janeiro were used, divided into a Treated Group (GT) and Omento (GO), submitted to median longitudinal celiotomy to collect a 9cm2 omental fragment. After celiorraphy, a linear wound of 3 cm was produced in all animals on the dorsal midline at the height of the caudal border of the scapulae. The incision was deepened to the thoracodorsal fascia in both groups, but in the animals of the GO, the collected omental fragment was fixed in the subcutaneous tissue with six simple interrupted points, followed by dermoraphy with an intradermal pattern in both groups. The experimental wounds were evaluated daily with respect to color, presence of crust, devitalized tissue, secretion, resistance and volume measurements, in case of an increase. Thermographic images of the experimental wounds were obtained on days 0 (preoperative), 3, 7 and 14 postoperatively. In addition, each group was divided into two subgroups with 6 animals each, from which material was obtained for anatomopathological evaluation (macroscopic and microscopic) on the 7th and 14th postoperative days. Clinically, the activation of the omentum stood out, observed by the increase in the volume of firm consistency from the second postoperative day, with a decrease in edema and maintenance of pink color throughout the evaluation moments. The macroscopic anatomopathological evaluation showed an intense organic reaction (congestion and hemorrhage) close to the graft on day 7, with subsequent slowdown in metabolic responses, and especially neovascularization towards the omental graft, indicating its viability. Microscopy corroborated the data from the macroscopic evaluation, and it was possible to observe greater neovascularization in the GO deep dermis on the seventh postoperative day, and more polymorphonuclear and mononuclear cells, as well as an increased presence of collagen (without statistical difference), in deep and superficial dermis, indicating an accelerated remodeling and tissue repair process. Thermography captured lower skin temperature in the experimental wound on the seventh day of evaluation, which together with the higher collagen production under microscopy, although without statistical difference, may be related to a more accelerated fibroplasia process in the GO. It was concluded that the LSMAV omental graft positively influenced the cutaneous healing of experimental wounds in rabbits, remaining viable and without deleterious signs to the implanted region.

COMPARAÇÃO ENTRE DIFERENTES ONDAS DE LASER E ÓLEO DE GIRASSOL OZONIZADO NA EPITELIZAÇÃO DE ENXERTOS CUTÂNEOS APLICADO EM FERIDAS RECÉM CRIADAS DE COELHOS (ORYCTOLAGUS CUNICULUS)

A enxertia cutânea é uma técnica cirúrgica simples e bastante útil para o reparo de feridas, principalmente nas quais existe dificuldade da aplicação do fechamento primário ou de outras técnicas reconstrutivas. Entretanto, para a sobrevivência do enxerto, é necessário que o leito da ferida esteja saudável e com a presença de um tecido de granulação saudável. Objetivou-se com este trabalho foi comparar diferentes ondas do laser de baixa intensidade e do óleo de girassol ozonizado como potenciais estimulantes da cicatrização em enxertos aplicados em feridas sem tecido de granulação em coelhos. Para isso, foram elaborados dois experimentos onde o primeiro comparou a laser de baixa intensidade (LBI) de onda contínua com a LBI pulsada (Capítulo 2), no qual 31 coelhos foram distribuídos em três grupos, grupo controle (GC), grupo laser onda contínua (GLC) e grupo laser onda pulsada (GLP). O segundo experimento comparou a LBI de onda contínua com a aplicação tópica de óleo de girassol ozonizado (OGO) (Capítulo 3) e 32 coelhos também foram distribuídos em três grupos, sendo grupo controle (GC), grupo laser (GL) e grupo ozônio (GO3). No primeiro experimento, os grupos GLC e GLP apresentaram evolução semelhante, com processo cicatricial satisfatório do enxerto em ambos, ao contrário do grupo GC. Tais resultados se mantiveram na avaliação microscópica, pois o GC apresentou correlação significativa com critérios ligadas à falha do enxerto. Já no segundo experimento, novamente ficou comprovado a ineficácia do leito doador sem tecido de granulação em proporcionar ambiente ideal para cicatrização dos enxertos. Os grupos GL e GO3 apresentaram evolução superior comparado ao GC, embora tenha ocorrido maceração nos enxertos dos animais do que receberam OGO, interferindo negativamente no processo de revascularização.

Cutaneous grafting is a simple and useful surgical technique for the repair of wounds, especially in which there is a difficulty in applying the primary closure, or other reconstructive technique. However, for graft survival, it is necessary a healthy granulation tissue in the wound bed. The aim of this study was to compare differents waves of low level laser therapy (LLLT) and ozonated sunflower oil as potential healing stimulators in grafts applied rabbits in fresh wounds. Two trials were carried out in which the first one compared LLLT continuous wave with LLLT pulsed (Chapter 2) in 31 rabbits divided into three groups: control group (CG), continuous wave laser group (GLC) and pulsed wave laser group (GLP). The second trial compared LLLT continuous with ozonized sunflower oil (OGO) (Chapter 3), and 32 rabbits were also divided into three groups, being control group (GC), laser group (GL) and ozone group (GO3). In the first trial, the GLC and GLP groups showed similar evolution, with a satisfactory healing process in both, unlike the CG group. These results were maintained in the microscopic evaluation since the GC showed a significant correlation with criteria related to graft failure. In the second trial, the ineffectiveness of the donor bed without granulation tissue to provide an ideal environment for healing of the grafts was again demonstrated. The GL and GO3 groups presented superior evolution compared to the CG, although maceration occurred in the grafts of the animals that received OGO, have a negative effect on the revascularization process.

Células-Tronco na cirurgia reconstrutiva: revisão de literatura / Stem cells in reconstructive surgery: review of literature / Las células madre en cirugía reconstructiva: revisión de la literatura

As células-tronco mesenquimais (MSCs) são excelente alternativa para estimular a cicatrização de feridas agudas e crônicas, mediante uma variedade de funções incluindo suporte trófico, anti-inflamatória,imunomoduladora, revascularização, atividade antiapoptótica, capacidade de diferenciação e quimiotaxia. Assim,as cirurgias reconstrutivas são utilizadas para corrigir defeitos extensos, promovendo melhor resultados estéticos e proporcionando que o paciente retorne com maior rapidez a rotina normal. Uma das modalidades da cirurgia reconstrutiva são os enxertos cutâneos, os quais consistem de um segmento de pele separado por completo da área doadora, além disso são desprovidos de pedículo vascular, implicando em complicações pós-cirúrgicas como isquemia e necrose. Sendo assim, o uso de substâncias que estimulam a angiogênese e favoreçam a cicatrização são alvo de muitos estudos, como no caso das células-troncos. Dessa forma, objetivou-se com esse estudo realizar uma revisão de literatura sobre as células-tronco associadas aos enxertos cutâneos, a fim de avaliar seus efeitos na cicatrização.(AU)

Mesenchymal stem cells (MSCs) are an excellent alternative to stimulate the healing of acute and chronic wounds, acting through a variety of functions including trophic support, anti-inflammatory,immunomodulatory, revascularization, antiapoptotic activity, differentiation capacity and chemotaxis. Like this,reconstructive surgeries are used to correct extensive defects, promoting better aesthetic results and allowing the patient to return to normal routine more quickly. One of the modalities of reconstructive surgery are the cutaneous grafts, which involve a segment of skin completely separated from the donor area, besides they lack of vascular pedicle, resulting in postoperative complications such as ischemia and necrosis. Therefore, the use of substances that stimulate angiogenesis and promote wound healing are the target of many studies, as in the case of stem cells. Thus, this study aimed to review the literature on stem cells associated with cutaneous grafts,in order to evaluate their effects on wound healing.(AU)

Las células madre mesenquimales (MSCs) constituyen una excelente alternativa para estimular la cicatrización de heridas agudas y crónicas, mediante vários tipos de funciones tales como soporte trófico,antiinflamatório, inmunomodulación, neovascularización, actividad antiapoptosis, capacidad de diferenciación y quimiotaxis. Mientras que, las cirugías reconstructivas son utilizadas para corregir defectos extensos,proporcionando mejores resultados estéticos y permitiendo que el paciente retorne más rápido a la rutina normal.Uno de los métodos de cirugía recosntructiva son los injertos de piel, consisten en un segmento de piel separada por completo de la zona donante y desprovistos de pedículo vascular, reultando en complicaciones posquirúrgicas tales como isquemia y necrosis. Por lo tanto, el uso de substancias que estimulan la angiogénesis y cicatrización de heridas, tales como las células madre, son objeto de numerosos estúdios. Por esta razón, el objetivo de este trabajo es realizar una revisión de literatura sobre las células madres e injertos cutâneos, con el propósito de evaluar los efectos en la cicatrización.(AU)