A realistic model for vasectomy reversal training using swine testicles

Purpose: To evaluate the viability of the porcine vas deferens as a realistic microsurgical training model for vasectomy reversal Methods: The model uses swine testicles (vas deferent), which are usually discarded in large street markets since they are not part of Brazilian cuisine. The spermatic cord was carefully dissected, and the vas deferens were isolated, measuring 10 cm in length. A paper quadrilateral with 5 cm2 was built to delimit the surgical training field. The objective of the model is to simulate only the microsurgical step when the vas deferens are already isolated. The parameters analyzed were: feasibility for reproducing the technique, patency before and after performing the vasovasostomy, cost of the model, ease of acquisition, ease of handling, execution time, and model reproducibility. Results: The simulator presented low cost. All models made were viable with a texture similar to human, with positive patency obtained in 100% of the procedures. The internal and external diameters of the vas deferens varied between 0.2-0.4 mm and 2-3 mm, respectively, with a mean length of 9 ± 1.2 cm. The total procedure time was 43.28 ± 3.22 minutes. Conclusions: The realistic model presented proved to be viable for carrying out vasectomy reversal training, due to its low cost, easy acquisition, and easy handling, and providing similar tissue characteristics to humans.

Carcinoma de células escamosas corneal em um cão - uso da Mitomicina C 0, 02% como adjuvante no tratamento / Corneal squamous cell carcinoma in a dog - use of Mitomycin C 0. 02% as an adjuvant therapy

Background: Although Squamous Cell Carcinoma (SCC) is most commonly seen in the epidermis, this malignant neoplasm can manifest in various other tissues. A wide range of factors may be related to the development of SCC in the cornea, with continuous exposure to ultraviolet radiation and chronic friction to the ocular surface being the most accepted theories. In addition to surgical procedures, the use of mitomycin C in the topical treatment of corneal SCC has shown good results in therapeutic management. Thus, the objective of the current work is to report the satisfactory response observed in the use of mitomycin C in a case of SCC in the cornea of a dog. Case: A 9-year-old male Pug dog was attended by the Veterinary Ophthalmology and Microsurgery Sector (SOMVET) of the University Veterinary Hospital (HVU) of the Federal University of Santa Maria (UFSM) with Squamous Cell Carcinoma (SCC) in the cornea of the left eye, which had recurred after a previous surgical intervention. Secretion and discomfort in the left eye were noted during clinical examination. In addition, both eyes presented pigmentary keratitis in the medial corner. Surgical excision of the neoplasm was performed using the surgical technique of anterior lamellar keratectomy. In the immediate postoperative period, topical therapy was started with eye drops based on mitomycin C at 0.02%, for a period of 28 consecutive days. The use of this chemotherapy drug in the topical form was intended to minimize the chances of recurrence of the clinical condition, since the patient is predisposed to this alteration. In addition, supportive therapy was implemented to improve patient comfort, consisting of the use of tobramycin-based eye drops (6 times a day, for 14 days), atropine 1% eye drops (BID, for 3 days), lubricating eye drops based on sodium hyaluronate (3 times a day, for continuous use), and immunomodulatory eye drops based on tacrolimus 0.02% (twice a day, for continuous use). The patient was evaluated 7, 14, 21, and 28 days after surgery, when good results were observed. One year after treatment, the dog was still showing no signs of recurrence of the treated clinical condition. Discussion: It is known that chronic friction on the surface of the cornea predisposes to the diagnosis of corneal SCC. Accordingly, in the clinical examination of the patient in this report, the presence of bilateral pigmentary keratitis was observed, an alteration that leads to a framework of chronic aggression to the cornea. Surgical treatment is recommended to remove the tumor mass in the ocular region. However, in cases of corneal SCC, the literature highlights that recurrence after surgical excision is a common factor. As the patient in this study arrived at the clinic with a history of recurrence, topical therapy with mitomycin C associated with surgical treatment was instituted. This chemotherapy drug has shown encouraging results in the treatment of some neoplasms, especially SCC. Its use in this case supported previous findings, pointing to a satisfactory result in which the patient had no recurrences after one year of follow-up. In addition, the concentration and frequency used of the active ingredient did not lead to adverse effects in the short or medium term.

Microsurgical arterial anastomosis in young and adult rats: an evolutive and comparative study

Purpose: To evaluate the caliber of an arterial micro-anastomosis in the young growing animal using a continuous suture technique. Additionally, late morphological changes and blood flows distal to the anastomosis were evaluated. Methods: Seventy-four Wistar rats were submitted to laparotomy to access the aorta for blood flow measurement. The aorta was sectioned using microsurgery technique and an end-to-end anastomosis with continuous suture. After a period of six months to one year, the anastomosis was checked. Results: Regarding the size of the aortas, comparing the pre- and postoperative values, there was an increase of 13.33% in adult animals and 25% in young animals, without any difference in the blood flows. Conclusions: The arteries of young rats show signs of growth at the site of the anastomosis performed with continuous suture.

Comparison of three different strategies to treat sciatic nerve regeneration: an experimental study

Purpose: To compare the effect of vein conduit filled with adipose tissue stem cells (ASC) on peripheral nerve injury regeneration. Methods: We analyzed 30 male Wistar rats surgically submitted to a 5-mm gap on the sciatic nerve. Then, the animals were divided into three groups: nerve autografting (AG, n=10), autogenous inverted glycerol-conserved vein (VG, n=10), and autogenous inverted glycerol-conserved vein + ASC (VASCG, n=10). The study endpoints were neuromotor functional analysis, gastrocnemius muscle weight, and sciatic nerve graft histomorphometry analysis. In the histologic analysis, we added a control group (naïve nerve). Results: Regarding functional analysis (Walking tract- score), the findings at week 3 showed a difference between the AG and the VG (-96.6 vs. -59.6, p=0.01, respectively) and between the VG and the inverted vein + VASCG (-59.9 vs. -88.92, p=0.02). At week 12, this study showed a difference between the AG and the VG (-64.8 vs. -47.3, p=0.004, respectively), and also a difference between the VG and the VASCG (-47.3 vs. -57.4, p=0.02, respectively). There was no difference in the histomorphometry analysis (nerve diameter, Schwann cells counting). The gastrocnemius muscles on the intervention side were more atrophic when compared to the gastrocnemius muscles on the control side. Conclusions: Our results suggested better functional recovery in the inverted vein group when compared to control group, and inverted vein + ASC group.

Anatomical description of the extratemporal facial nerve under high-definition system: a microsurgical study in rats

Purpose: To describe the microsurgical anatomical aspects of the extratemporal facial nerve of Wistar rats under a high-definition video system. Methods: Ten male Wistar rats (12­15 weeks old), without veterinary diseases, weighing 220­280 g, were used in this study. All animals in this study were submitted to the same protocol and by the same surgeon. A 10-mm incision was made below the bony prominence of the right or left ear, and extended towards the angle of the mandible. The dissection was performed and the main branches of the facial nerve were dissected. Results: The main trunk of the facial nerve has a length of 0.88 ± 0.10 mm and a length of 3.81 ± 1.03 mm, measured from its emergence from the stylomastoid foramen to its bifurcation. Seven branches originating from the facial nerve were identified: posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic. Conclusions: The anatomy of the facial nerve is comparable to that of humans, with some variations. The most observed anatomical division was the distribution in posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic branches. There is no statistical difference between the thickness and distance of the structures compared to the contralateral side.

Microsurgery versus embolization: different risk factors for short- and long- term outcomes of patients with ruptured aneurysms

Purpose: To evaluate the risk factors for poor outcomes after surgical and endovascular treatment of aneurysmal subarachnoid hemorrhage (aSAH). Methods: Patients with ≥ 18-years of age and aSAH were included, while patients who died within 12 h of admission or lost follow-up were excluded. All participants underwent standardized clinical and radiological assessment on admission and were reassessed at discharge and at 6-months follow-up using the Glasgow Outcome Scale (GOS). Results: Death at discharge was associated with female gender, anterior communication artery (ACoA) aneurysm location and presence of atherosclerotic plaque in the surgical group, and with age in the endovascular group. Both groups had clinical condition on follow-up associated with mFisher score on admission and hypertension. GOS on follow-up was also associated with presence of atherosclerotic plaque and multiple aneurysms in surgical group, and with age in endovascular group. Conclusions: Subjects treated surgically are prone to unfavorable outcomes if atherosclerotic plaques and multiple aneurysms are present. In patients with endovascular treatment, age was the main predictor of clinical outcome.

Could outcomes of intracranial aneurysms be better predict using serum creatinine and glomerular filtration rate?

Purpose: To analyze the role of serum creatinine levels as a biomarker of intracranial aneurysm outcomes. Methods: This is a prospective analysis of outcomes of patients with intracranial aneurysm. One hundred forty-seven patients with serum creatinine at admission and 6 months follow up were included. Linear and logistic regressions were used to analyze the data. Modified Rankin scale (mRS) was used to assess outcome. Results: Creatinine level was not directly related to aneurysm outcome nor aneurysm rupture (p > 0.05). However, patients with a glomerular filtration rate (GFR) lower than 72.50 mL·min­1 had an odds ratio (OR) of 3.049 (p = 0.006) for worse outcome. Similarly, aneurysm rupture had an OR of 2.957 (p = 0.014) for worse outcomes. Stepwise selection model selected 4 variables for outcomes prediction: serum creatinine, sex, hypertension and treatment. Hypertensive patients had, on average, an increase in 0.588 in mRS (p = 0.022), while treatment with microsurgery had a decrease in 0.555 (p = 0.038). Conclusions: Patients with higher GFR had better outcomes after 6 months. Patients with higher GFR had better outcomes after 6 months. Creatinine presented an indirect role in GFR values and should be included in models for outcome prediction.

Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery

ABSTRACT Purpose: To evaluate the impact of submersion of the microsurgical anastomosis suture area using saline (0.9% NaCl) in an experimental laboratory during the training of medical students and resident physicians. Methods: Wistar rats (n = 10) were selected to have the two femoral arteries sectioned and anastomosed end-to-end under optical magnification. They were randomly divided, so that on one side suturing was performed under submersion with saline, and the contralateral side was kept dry during the procedure. The surgical times, as well as the patency within 30 min and 72 h of the procedure, were evaluated. Results: Six male Wistar rats survived the surgical anesthetic procedure, with the average initial weight of 243.3 g and the average artery diameter of 0.86 mm, with average time of 15.67 min for the submerged technique and 20.50 min for the dry technique (p = 0.03). The failure rates were 17 and 50% for the submerged group and the dry one, respectively (p = 0.62). Conclusions: Submerged microvascular suture does not compromise the patency of the vessel or increase the time of anastomosis. Therefore, it is a strategy that can be applied by the surgeon according to his/her technical preferences.

A new anesthetic protocol to medullary nerve roots access in rats

ABSTRACT Purpose: To describe a new anesthetic protocol medullary and nerve roots access and in Rattus norvegicus. Methods: Seventy female Wistar rats (n=70) were used. The animals were randomly divided into two laminectomy groups: cervical (n=40) and thoracic (n=30). In cervical group, a right posterior hemilaminectomy was performed to access the nerve roots. In thoracic group, a laminectomy of the eighth thoracic vertebra was accomplished. Thirty-five rats (20 cervical and 15 thoracic) were submitted to old anesthetic protocol (ketamine 70 mg/kg plus xylazine 10 mg/kg); and the 35 other animals (20 cervical and 15 thoracic) were submitted to a new anesthetic protocol (ketamine 60 mg/kg,xylazine 8 mg/kg and fentanyl 0.03 mg/kg). Results: The time to complete induction was 4.15 ±1.20 minin ketamine, xylazine and fentanyl group, and it was 4.09 ±1.47 min in the ketamine and xylazine group. There was no correlation in the time required to perform the cervical laminectomy in the old anesthetic protocol. In all groups, the animals submitted to the old anesthetic protocol had a higher level of pain on the first and third postoperative days than the animals submitted to the new anesthetic protocol. Conclusions: The new anesthetic protocol reduces the surgical time, allows better maintenance of the anesthetic plan, and brings more satisfactory postoperative recovery.

Techniques of fragile renal organoids transplantation in mice

Purpose: This study aimed to develop a microsurgical technique to transplant extremely fragile renal organoids in vivo, created by in-vitro reaggregation of metanephros from fetal mice. These organoids in reaggregation and development were examined histologically after transplantation under the renal capsule. Methods: Initially, metanephros from fetal mice were enzymatically treated to form single cells, and spheroids were generated in vitro. Under a microscope, the renal capsule was detached to avoid bleeding, and the outer cylinder of the indwelling needle was inserted to detach the renal parenchyma from the renal capsule using water pressure. The reaggregated spheroid was aspirated from the culture plate using a syringe with an indwelling needle outer cylinder and carefully extruded under the capsule. Pathological analysis was performed to evaluate changes in reaggregated spheroids over time and the effects of co-culture of spinal cord and subcapsular implantation on maturation. Results: In vitro, the formation of luminal structures became clearer on day 5. These fragile organoids were successfully implanted without tissue crapes under the renal capsule and formed glomerular. The effect of spinal cord co-transplant was not obvious histrionically. Conclusions: A simple and easy method to transplant fragile spheroids and renal under the renal capsule without damage was developed.

Modified eye evisceration in a tropical screech owl (Megascops choliba)

Background: An adult owl was presented with an injury to the right eye that rendered it blind in that eye. The left eye was normal. Removal of the right eye was recommended and a modified eye evisceration was performed. No complications were observed during or after surgery. The objective of this paper is to describe the modified eye evisceration technique that was successfully used in a tropical screech owl (Megascops choliba). Case: An adult owl was presented with an injury to the right eye that rendered it blind in that eye. Two previous surgical treatments have been carried out but have not been successful. Using a portable slit-lamp (Kowa SL-15®), both eyes were examined. The left eye was normal. Upon ophthalmic examination of the right eye, the owl demonstrated blepharospasm and large central corneal ulcer. Removal of the right eye was recommended. The bird received midazolam hydrochloride [Dormire® - 1 mg/kg, IM] and ketamine hydrochloride [Ketamina® - 5 mg/kg IM] as pre-anesthetic medications. Subsequently, the bird was anesthetized with isoflurane (Isoforine®) by facemask for induction, and then maintained with isoflurane vaporized in 100% oxygen through an endotracheal tube. With the aid of a surgical microscope and microsurgery materials, a modified eye evisceration was performed. Post-operatively, the owl received meloxicam [Maxicam® - 0.5 mg/kg, IM] and tramadol hydrochloride [Cronidor® - 15 mg/kg, orally for 4 days]. The day after surgery, the owl was comfortable and its usual appetite was regained. The patient remained hospitalized for 3 weeks and was evaluated daily. The skin sutures were removed 10 days after the surgical procedure and the surgical wound had healed normally. The patient was reintroduced into the wild after 2 months. During the 6 months post-release, the bird was evaluated once a month, and no complications were observed. Discussion: Severe eye trauma and complicated corneal ulcers are common causes of eyeball removal in birds. In birds, there is a high risk of complications during enucleation. The fragility of the orbital bones makes them susceptible to trauma during the surgery. Evisceration involves the removal of the inner contents of the eye while leaving the cornea and the sclera intact. In the current case, evisceration was chosen because the eye was blind, and maintaining a blind eye would be a source of pain and infection. In the modified evisceration technique, the risk of complications is minimal compared to enucleation, mainly because surgical manipulation is minimal. In our case, the total surgery time was 20 min. Another complication reported after enucleation in birds is the possibility of disfiguring the bird because the removal of the globe disturbs the natural head balance. To avoid these complications, the use of an intraocular prosthesis after evisceration in birds has been performed. However, owls have a tubular-shaped globe with scleral ossicles. These factors could hinder or even prevent the accommodation of a cylindrical silicone prosthesis. In the present case, an intraocular prosthesis implant was never considered due to the unavailability of the prosthesis and to avoid the risk of postoperative complications that have been reported from the literature in dogs. In this case, the owl recovered well from anesthesia without complications, and no postoperative hemorrhage was observed. No signs of pain were observed during the postoperative period and the owl had already shown an appetite and fed on the first postoperative day. The previously published reports using the modified evisceration technique also demonstrated an absence of pain signs during the postoperative period.(AU)

A microsurgical technique for catheter insertion in the rat femoral artery

Purpose: To modify a surgical catheterization method using the bent needle introducer in small animals. Methods: Eight-week-old male Lewis rats were used in the study. A needle introducer was created by bending a 21G injection needle at 45°. The bent needle introducer was used for catheter insertion into the left femoral artery of the rats under anesthesia. As a control, a catheter was directly inserted into the blood vessel without the introducer. The insertion time of each method was measured. Blood pressure and heart rate were measured 24 h after catheter insertion using the telemetry system. Results: Using the introducer, the catheter was successfully inserted within a short time in all rats. Without the introducer, a longer duration was required for catheter insertion. The frequency of the insertion with no catheter-based errors with the introducer tended to be higher than that without the introducer. The mean arterial pressure and heart rate 24 h after catheter insertion in each group were almost the same. Conclusions: We developed a surgical catheterization method using the introducer in small animals. This could potentially reduce the frequency of the insertion with catheter-based errors and insertion time.(AU)

Stem cells in end-to-side neurorrhaphy: experimental study in rats

Purpose: To evaluate the influence of mesenchymal stem cells from adipose tissue in the end-to-side neurorrhaphy, focusing in the nerve regeneration and the muscle reinnervation in acute trauma. Methods: 140 animals were randomly divided in seven groups: control, denervated, end-to-side neurorrhaphy between distal stump of common peroneal nerve and tibial nerve (ESN), ESN wrapped in fascia, ESN wrapped in fascia and platelet gel, ESN wrapped in platelet gel, ESN wrapped in fascia and platelet gel within stem cells (without culture) removed from the adipose tissue. Mass measurements of the animal and of cranial tibial muscles, electromyography, walking track analysis tests and histological examinations of the nerves and muscles after 180 days was performed. Results: In the groups where the ESN was performed, the results were always better when compared to the denervated group, showing reinnervation in all ESN groups. The most sensitive methods were walking track and histological analysis. Only the group with stem cells showed values similar to the control group, as well as the functional indices of peroneal nerve and the number of nerve fibers in the peroneal nerve. Conclusions: Stem cells were effective in ESN according with the functional index of the peroneal nerve, evaluated by walking track analysis and the number of nerve fibers in the peroneal nerve.(AU)

New trends in translational microsurgery

Technological advances such as optical instruments and surgical tools have enabled the considerable contributions of microsurgery to surgical therapies. Accordingly, surgical therapeutics has provided the latest information across a wide range of medical specialties, including immunology and pharmacology, despite specialization according to organs and organ systems. The International Society for Experimental Microsurgery, an academic organization, has utilized experimental microsurgery technology in the identification of curative concepts for diseases that remain difficult to treat. For this publication to mark the 32nd anniversary of the Brazilian Surgical Society, I introduced the following types of technology related to the further development of microsurgical technological innovations in the future: high-resolution three-dimensional (3D) video and touch-sensitive microsurgery robots.(AU)

Experiences with basic microsurgical training programs and skill assessment methods at the University of Debrecen, Hungary

During the past decades microsurgical training programs together with skill assessment methods had been developing intensively worldwide. Concerning the teaching of basic techniques at various levels, we aimed to summarize the education program types and experiences at our department, in order to define the way of continuity. All in the hope that this summary might contain useful information for other educators as well. About 50 years ago, in the late 1960s, microsurgical basic education had been established in Debrecen. Since the 1990s multilevel education programs have been developed, starting in undergraduate years up to the postgraduate training, residency and continuous medical education programs. In the last three decades about 2,300 participants completed courses, including over 470 residents. The ones who already succeeded microsurgical course as medical students, during residency program could reach better results and skill development. Concluding thoughts, the traditional methods and special experiences are highly important in microsurgical education. The necessary duration and individual training approach are emphasized. Standardization (self and international), comparability, accessibility, providing milestones of microsurgical skills are key factors. Proper feedback and skill assessment (experiences, internationally recognized scores, or combinations) are indispensable, but have to be fitted to the characteristic elements of the course.(AU)

Impacto do grau de uveíte em diferentes tipos de úlceras de córneas em cães submetidos ao enxerto pediculado de conjuntiva bulbar - 34 casos / Impact of uveitis score on different types of corneal ulcers in dogs subjected to the bulbar conjunctival pedicle graft - 34 cases

O presente trabalho objetivou avaliar os resultados de 34 olhos submetidos ao enxerto conjuntival pediculado (ECP) em ceratites ulcerativas profundas (n=5), em ceratites ulcerativas com colagenólise (n=2), descemetocele (n=7), perfuração corneal (n=15) e prolapso de íris (n=5). Os impactos do grau de uveíte e da integridade da córnea foram correlacionados com presença e ausência de visão por tabelas de contingência. Raças braquicefálicas foram acometidas em 91,11% dos casos. O número de córneas consideradas perfuradas [20/34 (58,82%)] foi maior que o de córneas íntegras [14/34 (41,17%)]. Ao 50º dia de pós-operatório, o número de olhos visuais que apresentavam córneas íntegras previamente às cirurgias (n=13) não diferiu significativamente dos olhos com córneas perfuradas (n=12) (P=0,05). Avaliações relativas ao grau de uveíte, revelaram que a metade dos casos foi considerada severa [17/34 (50%)] e na outra metade as uveítes foram consideradas discretas. Dos 17 casos que apresentaram uveíte severa, oito recuperaram a visão. Já nos 17 olhos onde a uveíte foi considerada leve, 15 mantiveram a visão ao final do período de avaliação. Apesar de a integridade da córnea não se correlacionar com a severidade da uveíte (P=0,48), constatou-se que o número de olhos visuais com uveíte discreta foi significativamente maior que os olhos com uveíte severa (P=0,006). Neste estudo, a taxa geral de sucesso visual após ECP foi de 73,52% e a integridade da córnea não exerceu impacto significativo sobre a manutenção da visão. Todavia, olhos acometidos por uveítes severas apresentaram menor chance de recuperar a visão.(AU)

The present study aimed to evaluate the results of 34 eyes of dogs presenting deep corneal ulcer (n=5), colagenolytic corneal ulcer (n=2), descemetocele (n=7), corneal perforation (n=15), and iris prolapse (n=5) that were corrected by the bulbar conjuntival pedicle graft (CPG). The uveitis score and the corneal integrity were correlated with the presence or absence of vision by contingency tables. Brachycephalic breeds accounted for 91.11% of all cases. The number of perforated corneas [20/34 (58.82%)] were higher than the non-perforated ones [14/34 (41.17%)]. At post-operative day 50, the number of visual eyes with non-perforated corneas before surgery (n=13) did not differ significantly from the eyes with perforated corneas (n=12) (P = 0.05). In half of the cases, uveitis score was considered severe [17/34 (50%)], and in the other half, mild. Eight out of 17 eyes classified with severe uveitis regained vision. In 17 eyes where uveitis score was considered mild, 16 regained vision at the end of the study. Although corneal integrity was non-correlated with the uveitis score (P = 0.48), the number of visual eyes scored with mild uveitis were significantly larger than the eyes with severe uveitis (P = 0.006). In this study, the overall success visual rate after CPG was 73,52% % and the corneal integrity did not play an important role regarding maintenance of vision. However, eyes presenting severe uveitis score had less chance to regain vision.(AU)

Impacto do grau de uveíte em diferentes tipos de úlceras de córneas em cães submetidos ao enxerto pediculado de conjuntiva bulbar - 34 casos / Impact of uveitis score on different types of corneal ulcers in dogs subjected to the bulbar conjunctival pedicle graft - 34 cases

O presente trabalho objetivou avaliar os resultados de 34 olhos submetidos ao enxerto conjuntival pediculado (ECP) em ceratites ulcerativas profundas (n=5), em ceratites ulcerativas com colagenólise (n=2), descemetocele (n=7), perfuração corneal (n=15) e prolapso de íris (n=5). Os impactos do grau de uveíte e da integridade da córnea foram correlacionados com presença e ausência de visão por tabelas de contingência. Raças braquicefálicas foram acometidas em 91,11% dos casos. O número de córneas consideradas perfuradas [20/34 (58,82%)] foi maior que o de córneas íntegras [14/34 (41,17%)]. Ao 50º dia de pós-operatório, o número de olhos visuais que apresentavam córneas íntegras previamente às cirurgias (n=13) não diferiu significativamente dos olhos com córneas perfuradas (n=12) (P=0,05). Avaliações relativas ao grau de uveíte, revelaram que a metade dos casos foi considerada severa [17/34 (50%)] e na outra metade as uveítes foram consideradas discretas. Dos 17 casos que apresentaram uveíte severa, oito recuperaram a visão. Já nos 17 olhos onde a uveíte foi considerada leve, 15 mantiveram a visão ao final do período de avaliação. Apesar de a integridade da córnea não se correlacionar com a severidade da uveíte (P=0,48), constatou-se que o número de olhos visuais com uveíte discreta foi significativamente maior que os olhos com uveíte severa (P=0,006). Neste estudo, a taxa geral de sucesso visual após ECP foi de 73,52% e a integridade da córnea não exerceu impacto significativo sobre a manutenção da visão. Todavia, olhos acometidos por uveítes severas apresentaram menor chance de recuperar a visão.(AU)

The present study aimed to evaluate the results of 34 eyes of dogs presenting deep corneal ulcer (n=5), colagenolytic corneal ulcer (n=2), descemetocele (n=7), corneal perforation (n=15), and iris prolapse (n=5) that were corrected by the bulbar conjuntival pedicle graft (CPG). The uveitis score and the corneal integrity were correlated with the presence or absence of vision by contingency tables. Brachycephalic breeds accounted for 91.11% of all cases. The number of perforated corneas [20/34 (58.82%)] were higher than the non-perforated ones [14/34 (41.17%)]. At post-operative day 50, the number of visual eyes with non-perforated corneas before surgery (n=13) did not differ significantly from the eyes with perforated corneas (n=12) (P = 0.05). In half of the cases, uveitis score was considered severe [17/34 (50%)], and in the other half, mild. Eight out of 17 eyes classified with severe uveitis regained vision. In 17 eyes where uveitis score was considered mild, 16 regained vision at the end of the study. Although corneal integrity was non-correlated with the uveitis score (P = 0.48), the number of visual eyes scored with mild uveitis were significantly larger than the eyes with severe uveitis (P = 0.006). In this study, the overall success visual rate after CPG was 73,52% % and the corneal integrity did not play an important role regarding maintenance of vision. However, eyes presenting severe uveitis score had less chance to regain vision.(AU)

Continuous versus interrupted suture technique in microvascular anastomosis in rats

Purpose: To compare the continuous and interrupted suture technique on femoral artery on rats after vessel repair and 14 days after. Methods: Twenty rats were operated randomly divided into two group matched according to the suture technique used: interrupted or continuous. We performed a femoral anastomosis on the right femoral artery. We analyzed weight, arterial caliber, anastomosis time and patency after vessel repair and 14 days after. Results: There was no significant difference between groups in the weight (p=0.64), diameter of the femoral artery (p=0.95) and patency (p=1.00). The time spent in the anastomosis was 451 seconds in the continuous group and 718 seconds in the interrupted group, presenting significant difference (p 0.01). Conclusion: The continuous suture technique shows a similar patency rates than interrupted technique, however with a shorter time to perform the anastomosis.(AU)

A non-living, effective model for microvascular training

Purpose: To introduce a nonliving microvascular training model based on vessels diameter and feasibility. Methods: We dissected ten oxen tongues, and divided the pedicles into three-thirds: proximal, middle and distal. We measured the external vessels diameter in all regions. We performed a descriptive statistical analysis. Three students (two beginner level and one intermediate level) performed this training. We evaluated the confidence, according Likert scale. Results: We dissected all oxen tongues, each tongue showed two parallel pedicles. Each pedicle was located at 1.5 - 2.0 cm from the midline. Proximal median artery and vein diameter were 3.9 ± 0.7, and 5.04 ± 1.44mm, respectively. In the middle third, the mean artery diameter was 3.3 ± 0.4mm, and the vein diameter was 3.5 ± 0.9mm. The distal third showed a mean artery diameter of 2.0 ± 0.42mm, and a vein diameter of 2.4 ± 0.82mm. The students performed ten anastomoses. This study showed a higher confidence level (CL) (p=0.03) than the pre training CL assessment. Conclusion: This study suggested a feasible non-animal model for microsurgical training process for beginners and intermediate trainees.(AU)

End-to-side versus end-to-end neurorrhaphy at the peroneal nerve in rats

Purpose: To evaluate three different kinds of neurorrhaphy of the peroneal nerve. Methods: Eigthy rats were divided into 5 groups. Control: nerve had no intervention. End-to-end (EE): nerve was cut and elongated with a nerve graft with two end-to-end neurorrhaphies. End-to-side (ES): nerve was cut and sutured to the graft with at the lateral side of the nerve. Side-to-end (SE): the nerve was cut and sutured to the graft with end-to-end neurorrhaphy. Denervated: nerve was cut and both endings were buried into the muscle. The evaluation was done by walking track analysis, electrophysiology, body mass, cranial tibial muscle mass, nerve and muscle fibers morphometry. Results: The EE, ES and SE have the same potential of reinnervation. Conclusion: There is no functional or histological difference between these different types of neurorrhaphy.(AU)