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.

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.

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.

Use of omentum flap for induction of free skin graft healing / [Utilização de flap de omento para indução da cicatrização de enxertos cutâneos]

The objective of this study was to assess healing induction of free skin grafts following transposition of omental flap through a subcutaneous tunnel to the recipient bed. Macroscopic and microscopic evaluations were performed. Nineteen piglets were used. Two surgical wounds were created of each subject. The graft removed from the left side (LS) was placed on the right side (RS) without the omental flap in the graft-bed (control group-CG). On the LS, an omental flap was placed between the graft removed from the RS and the recipient bed (omentum group-OG). Macroscopic evaluations showed edema, which gradually decreased on both groups. Suture dehiscence was highest at day 10 compared to other days in both groups. The CG had a higher incidence of unvitalized tissue compared to OG, although no difference was found among days of postoperative evaluation. The presence of unvitalized tissue was seen on 32% on OG and 53% on CG. Microscopic evaluations revealed higher collagenization, reepithelization, keratinization and less swelling in the OG compared to CG. In conclusion, mesh skin grafts evolved satisfactorily in swine even in newly created bedding without granulation tissue, but with appropriate vascularization. The omentum flap provided better macroscopic and microscopic outcomes regarding graft integration.

O objetivo deste estudo foi verificar a indução da cicatrização de enxertos cutâneos em malha após a utilização de flap de omento transposto através de túnel no subcutâneo até o leito receptor. Avaliações macroscópica e microscópica foram realizadas. Foram utilizados 19 suínos. Duas feridas cirúrgicas foram criadas em cada animal. O enxerto removido do lado esquerdo (LE) foi fixado do lado direito (LD), sem a presença do flap de omento entre o enxerto e o leito receptor (grupo controle - GC). No LE, foi fixado um flap de omento entre o enxerto cutâneo removido do LD e o leito receptor (grupo omento - GO). As avaliações macroscópicas mostraram que o edema diminuiu gradativamente em ambos os grupos. A deiscência foi maior no dia 10 em comparação aos demais dias, em ambos os grupos, entre os diferentes dias de avaliação. Foi verificada a presença de tecido desvitalizado em 32% do GO e em 53% no GC. Foi observada, na avaliação microscópica, maior colagenização, reepitelização, queratinização e menor edema no GO, quando comparado ao GC. Concluiu-se, com este estudo, que enxertos cutâneos em malha evoluíram satisfatoriamente em suínos, mesmo em leito receptor recém-criado e sem presença de tecido de granulação, desde que vascularizado, e que o flap de omento propiciou melhores resultados macro e microscópicos relativos à integração do enxerto.

Necrose tissular em equino associada ao uso de fenilbutazona / Tissue necrosis in equine associated with use of phenylbutazone

Background: Wounds that occur with tissue necrosis and that result from the application of medications through the most diverse accesses are described as drug skin medical embolism or Nicholas syndrome in human medicine, with wide description. In veterinary medicine, this subject has not yet been described extensively and specifically in veterinary medicine, especially regarding to wounds that occurred after the application of non-intravenous medications in horses, even though these lesions are recurrent in the clinical routine. This report aims to describe a case of skin necrosis in a horse, due to phenylbutazone infection. Case: A 7 year-old Mangalarga Marchador horse, weighing 400 kg, was admitted to the Veterinary Hospital for Large Animals of the Universiade Federal Rural do Rio de Janeiro (UFRRJ), with a history of phenylbutazone injection to the left side of the neck. The animal had an extensive wound on the neck and face on the left side and was characterized by the presence of cold and devitalized skin, with a hardened and parched appearance and that easily detached. During the anamnesis, a single administration of 10 mL of a non-steroidal anti-inflammatory drug based on phenylbutazone was reported intramuscularly for about 10 days to control the pain resulting from the claudication present for 14 days. The medication was administered in the region of the lateral border of the neck, on the left side. After drug administration, the animal presented an increase in volume at the application site. After 24 h, the lesion spread from the inoculation region, extending to the head and chest of the animal. During debridement, it was found that the lesion did not reach the underlying muscle tissue. In addition to the wound, the animal had upper eyelid palsy, lower lip, and auricular ptosis. Treatment with surgical debridement of devitalized tissue, topical application of ozonated sunflower oil, ketanserin, and a free skin graft was instituted. During hospitalization, the animal had a corneal ulcer in the left eye with an unfavorable prognosis due to paralysis of the upper eyelid, with enucleation of the affected eyeball. The animal was under veterinary care for 180 days and was discharged when his wound was already in an advanced stage of healing. Discussion: The history of the application of phenylbutazone intramuscularly and the location and characteristics of the lesion presented by the patient in the present report suggest that this animal presented aseptic tissue necrosis resulting from the administration of non-steroidal anti-inflammatory drugs, phenylbutazone. Although aseptic tissue necrosis, better known as Nicolau's syndrome or drug embolism cutis, is widely characterized and described in this species, there are studies in the literature that reproduce the syndrome in pigs and rabbits. Phenylbutazone was able to cause arterial damage, mainly in the tunica intima of the artery in which the medication was administered, with perivascular inflammatory infiltrate and subsequent skin necrosis at the site of administration. In addition to the skin lesion, the animal started to show signs compatible with the left facial nerve lesion, evidenced by the immobility of the upper eyelid and labial and ear ptosis. This resulted in corneal ulceration and subsequent enucleation. The animal also developed chewing difficulty in the first months of hospitalization. This dysfunction may be due to a lesion of the mandibular nerve, responsible for innervating the masticatory muscles and the oral mucosa. However, the animal showed improvement in this aspect, no longer showing this condition after 90 days of hospitalization. The treatment used was successful in healing the wound.

Skin graft associated with platelet-rich plasma in correcting extensive injuries resulting from the resection of skin cancer chemically induced in rats

ABSTRACT Purpose: To evaluate whether using platelet-rich plasma (PRP) in the graft recipient bed after the resection of a neoplasia can influence its recurrence because this product stimulates angiogenesis, mitogenesis and chemotaxis. Methods: A study with 30 rats Wistar (Rattus norvegicus albinus), which were separated into group A (induction of carcinogenesis, PRP in the postoperative period) and group B (induction of carcinogenesis, absence of PRP in the postoperative period), with 15 animals in each. Carcinogenesis was induced on the skin of the animals' chest by the topical application of 0.5% dimethylbenzantracene (DMBA) diluted in acetone. After surgical resection of the induced neoplasia, PRP was used to stimulate angiogenesis before surgical wound synthesis. Data on the control and experimental groups and macroscopic and microscopic variables were evaluated using analysis of variance and the Tukey's test (5%). Results: It was possible to determine that the use of PRP is good in reconstructive surgeries, but it is contraindicated in patients during tumor resection, as it can cause changes in the surgical bed, in addition to stimulating recurrences and metastases. Conclusions: PRP may interact with tumour cells that were in the recipient site of the surgical wound during the resection of a neoplasia, and a local recurrence process can be triggered by applying this product.

Enxerto cutâneo em semeadura associado à malha não aderente em membro pélvico de um cão / Island skin graft associated with non-adherent mesh in a dog's pelvic limb

Background: Large skin defects are caused by tumor excision, making appropriate reconstruction and complete healingof the lesion a challenge for surgeons. There are some difficulties in reaching these goals, especially in cases of surgicalwound in the limbs, due to the scarce amount of skin and its reduced elasticity, which limit the possibility of flaps whencompared to the head, neck, and trunk. This study reports a case of wound closure on the lateral skin in the femoral regionof a dog’s pelvic limb via island skin graft associated with the implantation of a non-adherent cellulose acetate mesh andintensive postoperative care.Case: An 8-year-old Rottweiler female dog was attended at Pontifical Catholic University of Paraná’s Veterinary Clinic(CVE) in Curitiba, Paraná, presenting a tumor located laterocaudally to the right stifle joint. After preoperative examinations the patient underwent tumor surgery; however, two more surgical procedures were required due to suture dehiscence in the region, which resulted in increased wound size. At first, the wound was treated for granulation tissue to beformed. Subsequently, the island skin grafting technique was chosen to close the wound, associated with the implantationof a non-adherent cellulose acetate mesh imbibed with petrolatum emulsion to keep the grafted fragments in place. Themesh was fixed in a simple interrupted suture pattern using 2-0 nylon thread. The lateral regions of the chest and abdomen were chosen as donor skin beds due to their large dimensions, skin elasticity, and ease in defect reconstruction. Thefragments were obtained using a 10-mm biopsy punch and scalpel, and the defects were sutured in a simple interruptedpattern using 2-0 nylon thread. The patient remained hospitalized for movement restriction and postoperative monitoringfor 72 h, and the bandage remained untouched during this time interval. Thereafter, the patient...

Enxerto cutâneo em semeadura associado à malha não aderente em membro pélvico de um cão / Island skin graft associated with non-adherent mesh in a dog's pelvic limb

Background: Large skin defects are caused by tumor excision, making appropriate reconstruction and complete healingof the lesion a challenge for surgeons. There are some difficulties in reaching these goals, especially in cases of surgicalwound in the limbs, due to the scarce amount of skin and its reduced elasticity, which limit the possibility of flaps whencompared to the head, neck, and trunk. This study reports a case of wound closure on the lateral skin in the femoral regionof a dogs pelvic limb via island skin graft associated with the implantation of a non-adherent cellulose acetate mesh andintensive postoperative care.Case: An 8-year-old Rottweiler female dog was attended at Pontifical Catholic University of Paranás Veterinary Clinic(CVE) in Curitiba, Paraná, presenting a tumor located laterocaudally to the right stifle joint. After preoperative examinations the patient underwent tumor surgery; however, two more surgical procedures were required due to suture dehiscence in the region, which resulted in increased wound size. At first, the wound was treated for granulation tissue to beformed. Subsequently, the island skin grafting technique was chosen to close the wound, associated with the implantationof a non-adherent cellulose acetate mesh imbibed with petrolatum emulsion to keep the grafted fragments in place. Themesh was fixed in a simple interrupted suture pattern using 2-0 nylon thread. The lateral regions of the chest and abdomen were chosen as donor skin beds due to their large dimensions, skin elasticity, and ease in defect reconstruction. Thefragments were obtained using a 10-mm biopsy punch and scalpel, and the defects were sutured in a simple interruptedpattern using 2-0 nylon thread. The patient remained hospitalized for movement restriction and postoperative monitoringfor 72 h, and the bandage remained untouched during this time interval. Thereafter, the patient...(AU)

Diminuição do índice de necrose em enxertos cutâneos em coelhos mediante a aplicação de células tronco mesenquimais xenógenas / Reducing of the necrosis index in skin grafts in rabbits through application of xenogenous mesenchymal stem cells

O presente estudo teve como objetivo avaliar a inflamação em auto-enxertos cutâneos obtidos no terceiro, sétimo e décimo quarto dia de pós-operatório, além disso, buscou-se determinar diferenças no processo de cicatrização no grupo tratado com células tronco mesenquimais xenógenas em relação ao grupo controle utilizando a avaliação microscópica e imuno-histoquímico. A avaliação microscópica foi realizada utilizando cortes histológicos corados pela técnica de histoquímica com hematoxilina-eosina (HE), e a imuno-histoquímica, com cortes submetidos a anticorpos específicos. As variáveis analisadas foram quantidade de vasos, células inflamatórias, COX-2, Macrófagos e presença de necrose. Os dados foram analisados estatisticamente pelo software R. A quantidade de vasos foi maior (p<0,0001) no grupo tratamento (GT) durante o dia 3, enquanto no grupo controle (GC) foi maior no dia 7. No dia 3 houve menor porcentagem de necrose no grupo tratamento (GT) (p = 0,038). Nos demais dias avaliados não houve diferença entre a porcentagem de necrose observada nos dois tratamentos (p = 0,98), sendo de 53% para o grupo controle (GC) e 47% para o grupo tratamento (GT). Em relação ao número de macrófagos não houve diferença entre os grupos (p = 0,5637). Entretanto, entre os dias houve diferença significativa (p = 0,0223), sendo menor número de macrófagos no terceiro dia. A imunomarcação de COX-2 foi similar entre os grupos (p = 0,5637) e entre os dias (p = 0,9843). Portanto, o emprego das células tronco mesenquimais xenógenas em enxertos cutâneos promoveu menor ocorrência de necrose, favorecendo sua cicatrização, e não induziu o processo inflamatório, sendo assim factível seu uso em cirurgias reconstrutivas.

The present study aimed to assess inflammation in skin autografts obtained on the third, seventh and fourteenth postoperative day, in addition, it sought to determine differences in the healing process in the group treated with xenogenous mesenchymal stem cells in relation to to the control group using microscopic and immunohistochemical evaluation. Microscopic evaluation was performed using histological sections, stained by the hematoxylin-eosin (HE) histochemistry technique, and immunohistochemistry with sections were subjected to specific antibodies. The variables analyzed were the number of vessels, inflammatory cells (COX-2 and Macrophages) and the presence of necrosis. The data were analyzed statistically by software R. The number of vessels was higher (p< 0.0001) ) in the treatment group (GT) during day 3, while in the control group (CG) it was higher on day 7. On day 3 there was a lower percentage of necrosis in the treatment group (GT) (p = 0.038). On the other evaluated days, there was no difference between the percentage of necrosis observed in the two treatments (p = 0.98), being 53% for the control group (CG) and 47% for the treatment group (GT). Regarding the number of macrophages, there was no difference between groups (p = 0.5637). However, between days there was a significant difference (p = 0.0223), with a lower number of macrophages on the third day. The immunostaining of COX-2 was similar between groups (p = 0.5637) and between days (p = 0.9843). Therefore, the use of xenogenous mesenchymal stem cells in skin grafts promoted a lower occurrence of necrosis, favoring its healing, and did not induce the inflammatory process, thus making its use in reconstructive surgery feasible.

Diminuição do índice de necrose em enxertos cutâneos em coelhos mediante a aplicação de células tronco mesenquimais xenógenas / Reducing of the necrosis index in skin grafts in rabbits through application of xenogenous mesenchymal stem cells

O presente estudo teve como objetivo avaliar a inflamação em auto-enxertos cutâneos obtidos no terceiro, sétimo e décimo quarto dia de pós-operatório, além disso, buscou-se determinar diferenças no processo de cicatrização no grupo tratado com células tronco mesenquimais xenógenas em relação ao grupo controle utilizando a avaliação microscópica e imuno-histoquímico. A avaliação microscópica foi realizada utilizando cortes histológicos corados pela técnica de histoquímica com hematoxilina-eosina (HE), e a imuno-histoquímica, com cortes submetidos a anticorpos específicos. As variáveis analisadas foram quantidade de vasos, células inflamatórias, COX-2, Macrófagos e presença de necrose. Os dados foram analisados estatisticamente pelo software R. A quantidade de vasos foi maior (p<0,0001) no grupo tratamento (GT) durante o dia 3, enquanto no grupo controle (GC) foi maior no dia 7. No dia 3 houve menor porcentagem de necrose no grupo tratamento (GT) (p = 0,038). Nos demais dias avaliados não houve diferença entre a porcentagem de necrose observada nos dois tratamentos (p = 0,98), sendo de 53% para o grupo controle (GC) e 47% para o grupo tratamento (GT). Em relação ao número de macrófagos não houve diferença entre os grupos (p = 0,5637). Entretanto, entre os dias houve diferença significativa (p = 0,0223), sendo menor número de macrófagos no terceiro dia. A imunomarcação de COX-2 foi similar entre os grupos (p = 0,5637) e entre os dias (p = 0,9843). Portanto, o emprego das células tronco mesenquimais xenógenas em enxertos cutâneos promoveu menor ocorrência de necrose, favorecendo sua cicatrização, e não induziu o processo inflamatório, sendo assim factível seu uso em cirurgias reconstrutivas.(AU)

The present study aimed to assess inflammation in skin autografts obtained on the third, seventh and fourteenth postoperative day, in addition, it sought to determine differences in the healing process in the group treated with xenogenous mesenchymal stem cells in relation to to the control group using microscopic and immunohistochemical evaluation. Microscopic evaluation was performed using histological sections, stained by the hematoxylin-eosin (HE) histochemistry technique, and immunohistochemistry with sections were subjected to specific antibodies. The variables analyzed were the number of vessels, inflammatory cells (COX-2 and Macrophages) and the presence of necrosis. The data were analyzed statistically by software R. The number of vessels was higher (p< 0.0001) ) in the treatment group (GT) during day 3, while in the control group (CG) it was higher on day 7. On day 3 there was a lower percentage of necrosis in the treatment group (GT) (p = 0.038). On the other evaluated days, there was no difference between the percentage of necrosis observed in the two treatments (p = 0.98), being 53% for the control group (CG) and 47% for the treatment group (GT). Regarding the number of macrophages, there was no difference between groups (p = 0.5637). However, between days there was a significant difference (p = 0.0223), with a lower number of macrophages on the third day. The immunostaining of COX-2 was similar between groups (p = 0.5637) and between days (p = 0.9843). Therefore, the use of xenogenous mesenchymal stem cells in skin grafts promoted a lower occurrence of necrosis, favoring its healing, and did not induce the inflammatory process, thus making its use in reconstructive surgery feasible.(AU)

Behavior of free omental grafts without vascular anastomosis implanted in cats experimental wounds / Comportamento do enxerto omental livre sem anastomose vascular implantado em feridas experimentais de gatos

It is known that skin healing in cats is slower and has a higher complication rate than in dogs, what leads to search for new resources to enhance this process. Omentum properties in the aid of tissue repair are known and, among the forms of extraperitoneal omentalization, the use of free omental grafts without vascular anastomosis is advantageous, but little studied; there is no knowledge about its effect on skin healing, nor if its still viable when implanted in the subcutaneous space. Thus, the present study aimed to describe possible alterations produced by free omental graft without anastomosis inserted in the subcutaneous space, by means of macroscopic clinical analysis of the implantation region in cats. Twenty intact female cats were divided into two groups (Group 1: treated animals; Group 2: controls) of similar size. All animals were subjected to ovariosalpingohysterectomy (OSH) prior to the induction of an experimental wound for the implantation of the omental graft. Wounds were evaluated on days 1, 2, 4, 8, and 15 postsurgery and then weekly until no lesions were noted. Data regarding color, consistency, presence or absence of crusts, wound resistance, and volume measurements were recorded. There was activation of the omentum on the 4th day of evaluation with reduction of hemorrhage and an increase in the resistance to traction of the experimental wound. We concluded that the omentum without vascular anastomosis is capable of maintaining its viability and exert positive influence on the repair process without showing deleterious signs on the implantation site.(AU)

Sabe-se que a cicatrização de pele em gatos é mais lenta e apresenta índice maior de complicações que nos cães, dai a importância da busca de novos recursos para estimular o processo cicatricial. São conhecidas as propriedades do omento no auxílio ao reparo tecidual e, dentre as formas de omentalização extraperitoneal, o uso do omento livre sem anastomose vascular é vantajoso, porém pouco estudado; não há conhecimento sobre seu efeito na cicatrização cutânea, tampouco se permanece viável quando implantado no espaço subcutâneo. Sendo assim, o presente trabalho tem como objetivo avaliar possíveis alterações produzidas pelo enxerto omental livre sem anastomose inserido no espaço subcutâneo, por meio da avaliação clínica macroscópica da região de implantação em gatos. Foram utilizadas 20 gatas, de idade entre um e sete anos, sem alterações em exame de sangue, FIV/FELV negativas. Os animais foram divididos em dois grupos (Tratado e Controle) de igual tamanho, diferindo quanto à utilização do enxerto de omento livre. Foi realizada cirurgia de ovariossalpingohisterectomia (OSH) em todos os animais, previamente à criação da ferida experimental para implantação ou não do enxerto omental. As feridas foram avaliadas nos dias 1, 2, 4, 8 e 15 do pós-operatório e a partir de então semanalmente, até nenhuma alteração ser observada. Foram anotados dados referentes à coloração, consistência, presença de crosta, resistência da ferida e medidas do volume. Nos resultados destacou-se a ativação do omento no quarto dia de avaliação, observada pelo aumento de volume, com redução de hemorragia e aumento na resistência da ferida experimental à tração. Conclui-se que o omento em sua forma livre sem anastomose é capaz de manter sua viabilidade e exercer influência positiva sobre o processo de reparo, sem demonstrar sinais deletérios sobre a região implantada.(AU)

Application of a meshed skin graft in the surgical bed immediately after resection of neurofibrosarcoma in the distal limb region of a dog

Background: Malignant peripheral nerve sheath tumors are neurogenic neoplasms that originate from cells that surroundthe axons of peripheral nerves. Surgery is the treatment of choice for peripheral nerve sheath tumors. They have a betterprognosis when the lesion is in the extremity of a limb and the surgeon leaves wide peripheral margins after resection.However, this procedure makes local treatment a challenge due to difficult wound healing in this region. This report describes a successful case involving the use of a meshed skin graft immediately after resection of a neurofibrosarcoma inthe distal region of the radius bone of a dog.Case: A 6-year-old Boxer bitch weighing 40 kg was admitted with a history of a round, firm, non-ulcerated skin noduleattached to the lateral side of the distal region of the right radius bone, which had been present for about 40 days. Fineneedle aspiration cytology of the lesion showed the presence of mesenchymal cells, suggesting a sarcoma. Thus, the decision was made for an incisional biopsy to confirm the diagnosis and for the preparation of a subdermal pattern tubular flapfor subsequent rotation and transposition to close the wound that would be formed after the complete removal of the lesion.After the 7th postoperative day, the diagnosis of low-grade neurofibrosarcoma was confirmed and due to the presence ofnecrotic onset in the middle portion of the tubular flap, further surgical intervention was scheduled for the resection of thetube flap, en bloc removal of the neoplastic lesion with peripheral margins of 2 cm, and wound closure with a free skingraft. A mesh skin graft was made with a portion of the right flank skin. The mesh graft was carefully implanted on therecipient bed using simple interrupted sutures with a 3-0 non-absorbable monofilament suture material. A dressing madewith water-based sterile lubricating solution and...

Application of a meshed skin graft in the surgical bed immediately after resection of neurofibrosarcoma in the distal limb region of a dog

Background: Malignant peripheral nerve sheath tumors are neurogenic neoplasms that originate from cells that surroundthe axons of peripheral nerves. Surgery is the treatment of choice for peripheral nerve sheath tumors. They have a betterprognosis when the lesion is in the extremity of a limb and the surgeon leaves wide peripheral margins after resection.However, this procedure makes local treatment a challenge due to difficult wound healing in this region. This report describes a successful case involving the use of a meshed skin graft immediately after resection of a neurofibrosarcoma inthe distal region of the radius bone of a dog.Case: A 6-year-old Boxer bitch weighing 40 kg was admitted with a history of a round, firm, non-ulcerated skin noduleattached to the lateral side of the distal region of the right radius bone, which had been present for about 40 days. Fineneedle aspiration cytology of the lesion showed the presence of mesenchymal cells, suggesting a sarcoma. Thus, the decision was made for an incisional biopsy to confirm the diagnosis and for the preparation of a subdermal pattern tubular flapfor subsequent rotation and transposition to close the wound that would be formed after the complete removal of the lesion.After the 7th postoperative day, the diagnosis of low-grade neurofibrosarcoma was confirmed and due to the presence ofnecrotic onset in the middle portion of the tubular flap, further surgical intervention was scheduled for the resection of thetube flap, en bloc removal of the neoplastic lesion with peripheral margins of 2 cm, and wound closure with a free skingraft. A mesh skin graft was made with a portion of the right flank skin. The mesh graft was carefully implanted on therecipient bed using simple interrupted sutures with a 3-0 non-absorbable monofilament suture material. A dressing madewith water-based sterile lubricating solution and...(AU)

Effects of canine adipose-derived mesenchymal stem cells on the epithelialization of rabbits' skin autograft (Oryctolagus cuniculus) / Efeitos das células-tronco mesenquimais derivadas do tecido adiposo de cães na epitelização de autoenxertos de pele em coelhos (Oryctolagus cuniculus)

The present study aimed to evaluate the effects of mesenchymal stem cells derived from canine adipose tissue in the healing process of full-thickness mesh skin grafts in rabbits. The stem cells were collected from young dogs; and, after characterization, remained in cryopreservation, in independent doses containing 2 x 106 cells. The mesh distal limb graft technique was performed in 60 rabbits, divided into three groups, CG (Control Group), GT1 (Intralesional Stem Cell Treated Group), and GT2 (Intravenous Stem Cell Treated Group), containing 20 animals each. After grafting, each group was randomly divided into four subgroups according to euthanasia time 3, 7, 14, and 30 days, containing five animals in each group. Animals of GT1_14, GT1_30, and GT2_14, GT2_30 subgroups received a second dose of xenogeneic cells on the seventh day. Meanwhile, animals from GT1_30 and GT2_30 received the third dose of xenogeneic cells on day 14. The groups treated with xenogeneic stem cells positively affected type III collagen re-epithelialization and deposition, and possibly GT1 had a controlled inflammatory response. However, no effect on angiogenesis. Thus, it was possible to demonstrate tolerance and therapeutic action of mesenchymal stem cells from canine adipose tissue in skin grafts in rabbits.(AU)

O presente estudo teve como principal objetivo avaliar os efeitos das células-tronco mesenquimais derivadas do tecido adiposo de cães no processo de cicatrização de autoenxertos de pele de espessura total em malha em coelhos. As células-tronco foram coletadas de cães jovens, após a caracterização estas permaneceram em criopreservação, em doses individuais contendo 2 x 106 células. A técnica de enxerto em malha na região distal do membro foi realizada em 60 coelhos, divididos em três grupos, GC (Grupo Controle), GT1 (Grupo tratado com células-tronco intralesional) e GT2 (Grupo tratado com células-tronco via endovenosa), contendo 20 animais cada. Imediatamente após a enxertia, cada grupo foi dividido aleatoriamente em quatro subgrupos, de acordo com o tempo de eutanásia 3, 7, 14 e 30 dias contendo cinco animais cada. Animais dos subgrupos GT1_14, GT1_30 e GT2_14, GT2_30 receberam uma segunda dose de células xenógenas no sétimo dia. Ademais, animais do GT1_30 e do GT2_30 receberam a terceira dose de células xenógenas no dia 14. Os grupos tratados com células-tronco xenógenas tiveram um efeito positivo na reepitelização e deposição de colágeno tipo III, e possivelmente, o GT1 teve uma resposta inflamatória controlada, entretanto o efeito na angiogênese não foi observado. Dessa forma, foi possível demonstrar que houve tolerância e ação terapêutica das células-tronco mesenquimais derivadas do tecido adiposo de cães em enxertos de pele em coelhos.(AU)

Effects of canine adipose-derived mesenchymal stem cells on the epithelialization of rabbits' skin autograft (Oryctolagus cuniculus) / Efeitos das células-tronco mesenquimais derivadas do tecido adiposo de cães na epitelização de autoenxertos de pele em coelhos (Oryctolagus cuniculus)

The present study aimed to evaluate the effects of mesenchymal stem cells derived from canine adipose tissue in the healing process of full-thickness mesh skin grafts in rabbits. The stem cells were collected from young dogs; and, after characterization, remained in cryopreservation, in independent doses containing 2 x 106 cells. The mesh distal limb graft technique was performed in 60 rabbits, divided into three groups, CG (Control Group), GT1 (Intralesional Stem Cell Treated Group), and GT2 (Intravenous Stem Cell Treated Group), containing 20 animals each. After grafting, each group was randomly divided into four subgroups according to euthanasia time 3, 7, 14, and 30 days, containing five animals in each group. Animals of GT1_14, GT1_30, and GT2_14, GT2_30 subgroups received a second dose of xenogeneic cells on the seventh day. Meanwhile, animals from GT1_30 and GT2_30 received the third dose of xenogeneic cells on day 14. The groups treated with xenogeneic stem cells positively affected type III collagen re-epithelialization and deposition, and possibly GT1 had a controlled inflammatory response. However, no effect on angiogenesis. Thus, it was possible to demonstrate tolerance and therapeutic action of mesenchymal stem cells from canine adipose tissue in skin grafts in rabbits.(AU)

O presente estudo teve como principal objetivo avaliar os efeitos das células-tronco mesenquimais derivadas do tecido adiposo de cães no processo de cicatrização de autoenxertos de pele de espessura total em malha em coelhos. As células-tronco foram coletadas de cães jovens, após a caracterização estas permaneceram em criopreservação, em doses individuais contendo 2 x 106 células. A técnica de enxerto em malha na região distal do membro foi realizada em 60 coelhos, divididos em três grupos, GC (Grupo Controle), GT1 (Grupo tratado com células-tronco intralesional) e GT2 (Grupo tratado com células-tronco via endovenosa), contendo 20 animais cada. Imediatamente após a enxertia, cada grupo foi dividido aleatoriamente em quatro subgrupos, de acordo com o tempo de eutanásia 3, 7, 14 e 30 dias contendo cinco animais cada. Animais dos subgrupos GT1_14, GT1_30 e GT2_14, GT2_30 receberam uma segunda dose de células xenógenas no sétimo dia. Ademais, animais do GT1_30 e do GT2_30 receberam a terceira dose de células xenógenas no dia 14. Os grupos tratados com células-tronco xenógenas tiveram um efeito positivo na reepitelização e deposição de colágeno tipo III, e possivelmente, o GT1 teve uma resposta inflamatória controlada, entretanto o efeito na angiogênese não foi observado. Dessa forma, foi possível demonstrar que houve tolerância e ação terapêutica das células-tronco mesenquimais derivadas do tecido adiposo de cães em enxertos de pele em coelhos.(AU)

Exérese de fibrossarcoma em membro torácico direito e reconstrução com enxerto autólogo de espessura completa em cão / Excision of a fibrosarcoma in the right forelimb and reconstruction with full-thickness autologous graft in a dog

Background: Fibrosarcomas are malignant neoplasms originating from fibroblasts that are normally located in the skin, subcutaneous tissue and adjacent to bones. The main treatment for fibrosarcoma is surgery. The removal of large neoplasms from dogs’ limbs usually leads to the formation of large skin defects, often preventing primary occlusion and thus requiring reconstructive surgery to close the wound. This paper reports on the surgical procedure and postoperative complications pursuant to the excision of a fibrosarcoma in the right forelimb and reconstruction with a full-thickness autologous graft in a dog. Case: A 12-year-old Brazilian mastiff presenting a nodule located in the distal segment of the right forelimb, which had grown over a 2-year period, was referred for clinical evaluation. Blood and imaging tests were performed, which showed no changes and excluded the possibility of metastasis. The cytological examination was suggestive of a mesenchymal neoplasm. The patient underwent tumor excision surgery followed by reconstructive surgery with a full-thickness autologous graft to close the defect. The neoplasm was excised by means of a circular geometric figure incision using a 3 cm margin. The defect resulting from removal of the tumor was kept constantly moistened and wrapped in surgical compresses until grafting was performed. The graft was harvested from the region of the right flank based on a surgical field mold taken from the recipient bed. After harvesting the graft, all the subcutaneous tissue was removed until the hair follicles were visible. Fenestrations were then made throughout the entire graft and it was placed in the recipient bed and...

Exérese de fibrossarcoma em membro torácico direito e reconstrução com enxerto autólogo de espessura completa em cão / Excision of a fibrosarcoma in the right forelimb and reconstruction with full-thickness autologous graft in a dog

Background: Fibrosarcomas are malignant neoplasms originating from fibroblasts that are normally located in the skin, subcutaneous tissue and adjacent to bones. The main treatment for fibrosarcoma is surgery. The removal of large neoplasms from dogs limbs usually leads to the formation of large skin defects, often preventing primary occlusion and thus requiring reconstructive surgery to close the wound. This paper reports on the surgical procedure and postoperative complications pursuant to the excision of a fibrosarcoma in the right forelimb and reconstruction with a full-thickness autologous graft in a dog. Case: A 12-year-old Brazilian mastiff presenting a nodule located in the distal segment of the right forelimb, which had grown over a 2-year period, was referred for clinical evaluation. Blood and imaging tests were performed, which showed no changes and excluded the possibility of metastasis. The cytological examination was suggestive of a mesenchymal neoplasm. The patient underwent tumor excision surgery followed by reconstructive surgery with a full-thickness autologous graft to close the defect. The neoplasm was excised by means of a circular geometric figure incision using a 3 cm margin. The defect resulting from removal of the tumor was kept constantly moistened and wrapped in surgical compresses until grafting was performed. The graft was harvested from the region of the right flank based on a surgical field mold taken from the recipient bed. After harvesting the graft, all the subcutaneous tissue was removed until the hair follicles were visible. Fenestrations were then made throughout the entire graft and it was placed in the recipient bed and...(AU)

Use of thermography in skin grafts after the application of therapeutic ultrasound in Wistar rats

Purpose To analyze changes in the thermal pattern in the skin graft receptor bed, after the use of therapeutic ultrasound through the thermographic images. Methods Eighteen Rattus norvegicus albinus Wistar, separated into two groups: GST groups (without tumor and without treatment with ultrasound) and GT (with tumor and treatment with ultrasound). In the GT group, induction of carcinogenesis was performed by single intradermal application of 0.05 ml DMBA at 0.5%, diluted in acetone. Subsequently, a technique of reconstructive grafting surgery of the mesh type was performed in both groups and treatment with therapeutic ultrasound was performed in the GT group the alternate day protocol at 3, 6, 10 and 15 days after the procedure. The thermographic evaluation occurred on days 3, 6, 10 and 15 after the grafting. Results There was a significant difference between the statistical evaluation of the temperature of the control group when compared to the treated group, on the different evaluation days (p <0.0001). Conclusion The thermographic analysis of the images was effective in evaluating the healing process, being the use of thermography feasible to evaluate changes in the thermal standard in the surgical bed, besides the beneficial effects of the US.(AU)

Transposição de coxim digital associada à órtese articulada caseira como alternativa à amputação de membro pélvico em cão - relato de caso

Os coxins podem ser definidos como a porção mais resistente da pele de cães e gatos, e possuem as funções de sustentação do peso do animal, e a proteção contra as forças de tração e de atrito. As cirurgias que objetivam a reconstrução dos coxins são alternativas viáveis à amputação do membro em diversas situações clínicas. Dentre as opções cirúrgicas, destaca-se a transposição dos coxins. Entretanto, quando se faz necessária a amputação dos dígitos, o encurtamento do membro pode comprometer a deambulação. Uma alternativa neste sentido é a associação à órteses. O objetivo do presente trabalho foi descrever o caso de um cão da raça pitbull, fêmea, com quatro anos de idade e histórico de gangrena úmida da extremidade do membro pélvico esquerdo, submetida à amputação dos dígitos e transposição dos coxins. Durante o período pós-operatório foi desenvolvida uma órtese articulada caseira a fim de facilitar a sustentação do peso e auxiliar na deambulação do animal. A paciente se adaptou ao dispositivo ortopédico e foi acompanhado até a completa reepitelização do membro residual aos 30 dias de pós-operatório. Desta forma, conclui-se que a transposição dos coxins associada à órtese articulada pode ser uma opção viável à amputação do membro pélvico em cães de grande porte.(AU)

The digital pad can be defined as the most resistant area of the skin of the dogs and cats, which functions includes animal weight support and protection against to tractive and frictional forces. The reconstructive surgeries of the digital pad are viable alternatives to the limb amputation in many clinical situations. Among the surgical options, the transposition of the digital pad is highlighted. However, when amputation of the digits is necessary, shortening of the limb can compromise ambulation. An alternative to this, it is the use of orthoses. The aim of this report was to describe the case of a four-years-old female pit bull with clinical history of wet gangrene of left pelvic limb, submitted to transposition of digital pad, obtained from the contralateral hindlimb. An articulate orthosis was projected at postoperative period in order to facilitate weight support and assist the patient ambulation. The patient has adapted itself to the new orthopedic device, and was constantly monitored until complete reepithelialization of the residual limb at 30 days of postoperative. Thus, it can be concluded that the transposition of digital pad associated to the articulate orthosis can be a viable option to the limb amputation in large breed dogs.(AU)

Transposição de coxim digital associada à órtese articulada caseira como alternativa à amputação de membro pélvico em cão - relato de caso

Os coxins podem ser definidos como a porção mais resistente da pele de cães e gatos, e possuem as funções de sustentação do peso do animal, e a proteção contra as forças de tração e de atrito. As cirurgias que objetivam a reconstrução dos coxins são alternativas viáveis à amputação do membro em diversas situações clínicas. Dentre as opções cirúrgicas, destaca-se a transposição dos coxins. Entretanto, quando se faz necessária a amputação dos dígitos, o encurtamento do membro pode comprometer a deambulação. Uma alternativa neste sentido é a associação à órteses. O objetivo do presente trabalho foi descrever o caso de um cão da raça pitbull, fêmea, com quatro anos de idade e histórico de gangrena úmida da extremidade do membro pélvico esquerdo, submetida à amputação dos dígitos e transposição dos coxins. Durante o período pós-operatório foi desenvolvida uma órtese articulada caseira a fim de facilitar a sustentação do peso e auxiliar na deambulação do animal. A paciente se adaptou ao dispositivo ortopédico e foi acompanhado até a completa reepitelização do membro residual aos 30 dias de pós-operatório. Desta forma, conclui-se que a transposição dos coxins associada à órtese articulada pode ser uma opção viável à amputação do membro pélvico em cães de grande porte.

The digital pad can be defined as the most resistant area of the skin of the dogs and cats, which functions includes animal weight support and protection against to tractive and frictional forces. The reconstructive surgeries of the digital pad are viable alternatives to the limb amputation in many clinical situations. Among the surgical options, the transposition of the digital pad is highlighted. However, when amputation of the digits is necessary, shortening of the limb can compromise ambulation. An alternative to this, it is the use of orthoses. The aim of this report was to describe the case of a four-years-old female pit bull with clinical history of wet gangrene of left pelvic limb, submitted to transposition of digital pad, obtained from the contralateral hindlimb. An articulate orthosis was projected at postoperative period in order to facilitate weight support and assist the patient ambulation. The patient has adapted itself to the new orthopedic device, and was constantly monitored until complete reepithelialization of the residual limb at 30 days of postoperative. Thus, it can be concluded that the transposition of digital pad associated to the articulate orthosis can be a viable option to the limb amputation in large breed dogs.