ABSTRACT
ABSTRACT Purpose: To assess the effects of adipocyte-derived stem cell (ASC)-injection on the survival of surgical flaps under ischemia in diabetic rats. Methods: Diabetes was induced in 30 male Wistar rats using streptozotocin (55 mg/kg). After eight weeks, epigastric flap (EF) surgery was performed. The animals were divided into control (CG), medium-solution (MG), and ASC groups. The outcomes were: the survival area (SA), the survival/total area rate (S/TR), and expression levels (EL) of genes: C5ar1, Icam1, Nos2, Vegf-a. Results: In the ASC group, compared to CG, we observed improved flap SA (CG-420 mm2 vs. ASC-720 mm2; p=0.003) was observed. The S/TR analysis was larger in the ASC group (78%) than the CG (45%). This study showed an increase in the Vegf-a EL in the ASC group (2.3) vs. CG (0.93, p=0.0008). The Nos2 EL increased four-fold in the ASC group compared to CG, and C5ar1 EL decreased almost two-fold in the ASC group vs. the CG (p=0.02). There was no difference among the groups regarding Icam1 EL. Compared to the MG, the ASC group had a bigger flap SA (720 mm2 vs. 301 mm2, respectively), a bigger S/TR (78% vs. 32%, p=0.06, respectively) and increased EL of Vegf-a (2.3 vs. 1.3, respectively). No difference between ASC-group and MG was seen regarding Nos2 (p=0.08) and C5ar1 (p=0.05). Conclusions: This study suggests that ASCs increase the survival of EF under IR in diabetic rats.
Subject(s)
Diabetes Mellitus, Experimental , Stem Cells , Surgical Flaps , Adipose Tissue , Rats, Wistar , Adipocytes , IschemiaABSTRACT
Abstract Purpose: To evaluate the hyaluronic acid (HA) inflammatory reaction, fibroblasts, fibrosis and duration of effect in the dorsal region of tobacco-exposed rats. Methods: Ten Wistar rats were divided into two groups: tobacco-exposed-group (TEG;n=5) and air-control-group (CG;n=5). The TEG animals were tobacco-exposed twice a day, 30-minutes/session, during 60 days. After this period, all animals received 0.1 mL HA subcutaneous injection in the dorsal area. The volume of HA was measured immediately after HA injection and weekly using a hand-caliper in nine weeks. After this period, all the animals were euthanized, and a specimen of was collected to evaluate inflammatory cells, fibroblasts, and fibrosis by HE. Results: This study showed a higher inflammatory reaction in TEG than CG: inflammatory cell-count (CG: 1.07±0.9; TEG: 8.61±0.36, p<0.001); fibroblast count (CG: 2.92±0.17; TEG: 19.14±0.62, p<0.001), and fibrosis quantification (CG: 2.0; TEG: 3.75, p<0.001). The analysis of the HA volume in nine weeks in the dorsal region did not show a difference between groups (p=0.39). Conclusions: This study suggested that the HA injection in the TEG caused an increase in inflammatory cell count, fibroblast, and fibrosis quantification when compared to the CG. There was no difference in the duration of effect of HA between the groups.
Subject(s)
Animals , Male , Rats , Nicotiana/adverse effects , Inhalation Exposure/adverse effects , Viscosupplements/adverse effects , Fibroblasts/drug effects , Hyaluronic Acid/adverse effects , Inflammation/pathology , Time Factors , Fibrosis , Rats, Wistar , Disease Models, Animal , Epidural Space/drug effects , Epidural Space/pathology , Fibroblasts/pathology , Inflammation/chemically inducedABSTRACT
Abstract 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.
Subject(s)
Animals , Cattle , Vascular Surgical Procedures/education , Anastomosis, Surgical/education , Microsurgery/education , Vascular Surgical Procedures/methods , Anastomosis, Surgical/methods , Feasibility Studies , Suture Techniques/education , Animal Experimentation/ethics , Models, AnatomicABSTRACT
As conventional options for bone repair are not satisfactory, a new flap category was developed, the prefabricated flap (RPF). 42 metatarsic-I bone were obtained from 21 Wistar rats, and divided in two groups: group I (n=21) the bones were freeze- dryed and decalcified and group II (n=21) was frozen to - 70º C. After 3 weeks the bones were grafted in 21 rats, onto the left na right inferior epigastric vessels wrapped in silicon sheet. Groups I and II were subdivided in 3 groups each, following the period of permanence (1,2 or 4 weeks). In macroscopic histologic study, group I revealed loss of bone architecture and group II manteined its concistency and shape. In quantitative analysis, alterations were observed in group I, mainly inthe 2 weeks group. There is a histologic difference in prefabricated bone flaps betwenn groups I and II. Gradual bone reabsorption suggests that the flap should be rotated early. This study shows the applicability of homogenous bone for flap prefabrication.
As opções convencionais de tratamento de perdas ósseas, como enxertos e retalhos não são satisfatórias. Com isso uma nova categoria de retalhos, o retalho pré-fabricado (RPF), passou a ser estudada. Foram retirados 42 ossos metatársicos-I das patas traseiras de 21 ratos Wistar. O grupo I (n=21) foi descalcificado e liofilizado e o grupo II (n=21) foi não descalcificado e congelado a -70°C. Após 3 semanas os ossos foram enxertados em 21 animais sobre os vasos epigástricos inferiores nas regiões inguinal direita e esquerda, individualizados por uma lâmina de silicone. Os grupos I e II foram divididos em três subgrupos cada, de acordo com o tempo de permanência (1, 2 e 4 semanas) após a pré-fabricação do retalho. No estudo histológico macroscópico os grupos apresentaram diferenças em morfologia e consistência: o grupo I mostrou perda da arquitetura óssea e da rigidez e grupo II mantiveram sua forma, rigidez e consistência. Na análise qualitativa alterações foram observadas nos fragmentos do grupo desmineralizado e liofilizado, especialmente no subgrupo de 2 semanas. O grupo II não apresentou alteração no aspecto do tecido ósseo mineralizado entre os diversos subgrupos. É nítida a diferença histológica entre os RPF com osso descalcificado e liofilizado quando comparado ao não descalcificado e congelado. A reabsorção óssea gradual sugere que a rotação do retalho deve ocorrer precocemente. Este estudo demonstra a aplicabilidade do osso homógeno para pré-fabricação de retalhos.
ABSTRACT
De 1981 a 1988, 10 pacientes portadores de extensas lesöes tumorais em Cabeça e Pescoço foram submetidos a ressecçöes craniofaciais oncológicas, seguidos de reconstruçäo com retalhos transplantados com microcirurgia vascular. Foram executados 11 retalhos microcirúrgicos: cinco do músculo grande dorsal, três do músculo reto abdominal, um do omento maior e um paraescapular. Bons resultados foram obtidos em nove pacientes (90%) e nove retalhos (82%). Num mesmo doente, houve perda total dos dois retalhos microcirúrgicos empregados (um grande dorsal e um omento maior), provavelmente devido a uma somatória de fatores desfavoráveis. Após a apresentaçäo detalhada de um caso representativo e da análise crítica, algumas conclusöes säo delineadas em relaçäo a estas técnicas reconstrutivas
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Microsurgery , Head and Neck Neoplasms/surgery , Surgical FlapsABSTRACT
Relata-se experiência com migraçäo de 66 retalhos livres para tratamento de perdas de substância do pé. Foram transferidos 37 retalhos, musculares ou musculocutâneos do grande dorsal, 23 paraescapulares, 5 inguinocrurais e 1 retalho de sulco glúteo. Em 9 doentes, a superfície de apoio dos pés foi restaurada. A transferência de retalhos livres para a cobertura de lesöes extensas nos pés é método confiável, seguro e propicia resultado funcional satisfatório
Subject(s)
Humans , Foot/surgery , Microsurgery , Surgical FlapsABSTRACT
Os autores fazem um estudo anátomo-radiológico onde se procura estabelecer as características anatômicas da artéria circunflexa ilíaca profunda, visando uma melhor padronizaçäo da dissecçäo do retalho oesteocutâneo da crista ilíaca. Este retalho tem grande potencial para utilizaçäo clínica nas transferências microcirúrgicas para reparaçäo de perdas ósseas e cutâneas. Foram estudadas 46 arteriografias da regiäo ilíaca. Em 10 cadáveres frescos foi dissecada a ACIP e foram feitas injeçöes de corante pela artéria para determinar a área de pele irrigada pela ACIP. Em conclusäo, ACIP apresenta poucas variaçöes sendo bastante constante quanto à sua origem e diâmetro. A ACIP emerge 1 a 2 cm acima do ligamento inguinal e apresenta um diâmetro de 2,1 + ou - 0,4 mm. A área cutânea corada por injeçäo na acip variou de 8 a 14 cm a 22 x 15 cm