Clamp vascular de fio de mononylon em microcirurgia experimental / Vascular clamp of mononylon thread in experimental microsurgery

Introdução: A microcirurgia reparadora é ramo hoje indissociável e imprescindível na cirurgia plástica. O treinamento é longo, custo financeiro relativamente alto e exige muito dos proponentes. Para melhorar essa equação a favor da formação de novos microcirurgiões no Brasil, é fundamental facilitar o acesso ao treinamento experimental, utilizando materiais simples. Huaraca descreveu uma técnica utilizando um simples fio mononylon 5-0 para substituir o clamp vascular, que é instrumento indispensável da anastomose microcirúrgica e geralmente de alto custo. O objetivo é comparar a técnica de Huaraca com fio de mononylon e o clamp metálico tradicional durante anastomose microcirúrgica vascular. Métodos: Seis ratos da raça Wistar cujas duas artérias femorais foram aleatoriamente selecionadas para sutura término-terminal após secção completa, sendo um dos lados realizado com clamp vascular habitual e o contralateral com técnica de Huaraca, no mesmo tempo cirúrgico e pelo mesmo cirurgião. Resultados: Em ambas as situações, a taxa de patência foi de 67% após 72 horas, sendo que o tempo médio foi de 26 minutos com a técnica de Huaraca e de 18 minutos com o clamp tradicional (p=0,001). Conclusão: Apesar do tempo de execução mais longo, a técnica de Huaraca é medida simples e de baixo custo que pode substituir o clamp vascular tradicional.

Introduction: Reconstructive microsurgery is now an inseparable and essential branch of plastic surgery. The training is long, has a relatively high financial cost and requires a lot of the proponents. To improve this equation in favor of the formation of new microsurgeons in Brazil, it is essential to facilitate access to experimental training, using simple materials. Huaraca described a technique using a simple 5-0 mononylon thread to replace the vascular clamp, which is an indispensable instrument for microsurgical anastomosis and is generally expensive. The objective is to compare the Huaraca technique with mononylon thread and the traditional metal clamp during vascular microsurgical anastomosis. Methods: Six Wistar rats whose both femoral arteries were randomly selected for end-to-end suture after complete section, with one side performed with usual vascular clamp and the contralateral with Huaraca technique, at the same surgical time and by the same surgeon. Results: In both situations, the patency rate was 67% after 72 hours, with an average time of 26 minutes with the Huaraca technique and 18 minutes with the traditional clamp (p=0.001). Conclusion: Despite the longer execution time, the Huaraca technique is a simple and low-cost measure that can replace the traditional vascular clamp.

Surface alterations following instrumentation with a nylon or metal brush evaluated with confocal microscopy

PURPOSE: Surface alterations of titanium discs following instrumentation with either a nylon brush or a metal brush were evaluated. METHODS: A total of 27 titanium discs with 3 surface types (9 discs for each type), including machined (M) surfaces, sandblasted and acid-etched (SA) surfaces, and surfaces treated by resorbable blast media (RBM), were used. Three discs were instrumented with a nylon brush, another 3 discs were instrumented with a metal brush, and the remaining 3 discs were used as controls for each surface type. Surface properties including the arithmetic mean value of a linear profile (Ra), maximum height of a linear profile (Rz), skewness of the assessed linear profile (Rsk), arithmetic mean height of a surface (Sa), maximum height of a surface (Sz), developed interfacial area ratio (Sdr), skewness of a surface profile (Ssk), and kurtosis of a surface profile (Sku) were measured using confocal microscopy. RESULTS: Instrumentation with the nylon brush increased the Ra, Sa, and Sdr of the M surfaces. On the SA surfaces, Ra, Sa and Sdr decreased after nylon brush use. Meanwhile, the roughness of the RBM surface was not affected by the nylon brush. The use of the metal brush also increased the Ra, Sa, and Sdr of the M surface; however, the increase in Sdr was not statistically significant (P=0.119). The decreases in the Rz, Sz, Ra, Sa, and Sdr of the SA surfaces were remarkable. On the RBM surfaces, the use of the metal brush did not cause changes in Ra and Sa, whereas Rz, Sz, and Sdr were reduced. CONCLUSIONS: Titanium surfaces were altered when instrumented either with a nylon brush or a metal brush. Hence, it is recommended that nylon or metal brushes be used with caution in order to avoid damaging the implant fixture/abutment surface.

Evaluation of polyamide surgical mesh as an abdominal ventral implant in rabbits

Abstract Purpose: To evaluate abdominal ventral wound healing by using a specific biomaterial, a handmade polyamide surgical mesh. Methods: A surgical incisional defect was made in ten rabbits to simulate a hernia in the ventral abdominal musculature. A polyamide surgical mesh was used in hernioplasty. They were monitored for surgical wound healing, and macroscopically and histologically evaluated at the end of the experiment. The polyamide surgical mesh did not cause foreign body reaction, pain, edema, or infection in the surgical site. The manure production was not affected by intestinal tissue adherences to the mesh, consistent with the ultrasonography result where adherences were not observed and organized scarring tissue formed in the incisional defect. The polyamide mesh was fixed over the abdominal wall, and its external and internal sides were surrounded by a vascularized connective tissue. Results: None of the experimental animals developed adherences from internal organs to the polyamide mesh, except two rabbits where the omentum formed adherence to the internal scarring tissue without present herniation or compromise of the rabbit's health. Conclusion: Polyamide surgical mesh for hernioplasty presents, in rabbits, excellent biocompatibility, with minimal body adverse reactions and low cost.

Influence of dye and nylon fibers on microwave-cured acrylic resin properties / Influência de corante e fibras de nylon nas propriedades de uma resina acrílica polimerizada por micro-ondas

ABSTRACT Objective: The aim of this study is to analyze if both color and nylon fibers have an influence on microwave-cured acrylic resin properties. Methods: Rectangular and disk-shaped specimens were prepared using acrylic resins; medium pink with and without nylon fibers and colorless without nylon fibers. To obtain the rectangular specimens, a stainless steel die was used with the following dimensions: 64 X 10 x 3 mm (± 0.5mm). To obtain disk-shaped specimens, a die 50mm (±0.5mm) in diameter and 0.5mm (±0.05mm) thick was employed. They were randomized to form groups: control (colorless acrylic) and experimental (medium pink, with and without nylon fibers), with each group consisting of ten (10) specimens rectangular in shape and five (5) disk-shaped. They were analyzed in six (6) assays (izod impact strength, n=10; Knoop hardness, n=10; glass transition temperature, n=3; water sorption and solubility, n=5; degree of monomer/polymer conversion, n=1; flexural strength and flexural modulus, n=10). All variables were subjected to the analysis of variance test followed by Tukey's multiple comparison test, at a 5% level of significance. Results: The analysis of the monomer/polymer degree of conversion did not reveal any difference between the three groups of resins (medium pink, with and without nylon fibers and colorless resin); it was approximately 88%. The results did not show significant differences between the groups for each variable (p>0.05). Conclusion: The results showed that color and presence of nylon fibers in acrylic resins did not affect the properties analyzed in this study.

RESUMO Objetivo: Analisar se corantes e fibras de nylon influenciam nas propriedades de uma resina acrílica ativada por energia de micro-ondas. Métodos: Espécimes retangulares e em forma de disco foram confeccionados em resina acrílica rosa médio com e sem fibras de nylon e incolor sem fibras. Para obter os espécimes retangulares, foi utilizada uma matriz de aço inoxidável com as seguintes dimensões: 64 X 10 X 3 (± 0,5mm) e para obter os espécimes em forma de disco, foi utilizada uma matriz com 50mm (± 0,5mm) de diâmetro e 0,5mm (±0,05mm) de espessura. Os mesmos foram randomizados para formar os grupos controle (acrílico incolor sem fibras) e experimentais (rosa médio com e sem fibras), sendo cada grupo composto por dez (10) espécimes retangulares e cinco (5) em forma de disco. Foram os mesmos então submetidos a seis (6) ensaios (resistência ao impacto izod, n=10; dureza knoop, n=10; temperatura de transição vítrea, n=3; sorção e solubilidade, n=5; grau de conversão, n=1; resistência à flexão e módulo de flexão, n=10). Todas as variáveis foram submetidas à análise de variância seguida pelo teste de comparações múltiplas de Tukey, com nível de significância de 5%. Resultados: O grau de conversão foi de 88% para os 3 grupos de resinas e os resultados não mostraram diferença estatisticamente significativa entre os mesmos para cada variável (p>0,05). Conclusão: Os resultados mostraram que o corante e a presença de fibras de nylon em resina acrílica não afetaram as propriedades analisadas nesse estudo.

Preventive effect of endoclip and endoloop on post-polypectomy bleeding of large colorectal polyps and literature review / 中华消化内镜杂志

Objective To investigate the preventive effect of endoclips and endoloops on postpolypectomy bleeding of large colorectal polyps.Methods Data of patients,who underwent polypectomy during January 2013 to March 2016,were retrospectively collected.The diameters of all polyps were more than 10 mm.Cases were divided into 4 groups.Before large pedunculated (with thick stalks) polyps were resected,endoclips were used to ligate the pedicles of polyps in Group A,and endoloops were used in Group B.After large sessile and pedunculated (without thick stalks) polyps were resected,endoclips were used to close the incision of polypectomy in Group C,but not in Group D.The immediate and delayed postpolypectomy bleeding rate and clinicopathologic features were studied.Articles about endoclip or endoloop on preventing post-polypectomy bleeding in PubMed in last five years were searched and analyzed.Results A total of 2 006 polyps were included.The immediate bleeding rate was 3.4％ (5/147) and 3.8％ (5/132) of Group A and B,respectively.The delayed bleeding rate was 6.1％ (9/147) and 7.6％ (10/132) of Group A and B,respectively.The delayed bleeding rate of Group C and D was 3.2％ (28/888) and 1.9％ (16/839),respectively.None of the bleeding cases needed a surgical operation.And no perforation occurred.Six articles were included for analysis.Most of articles revealed that endoclip and endoloop were effective tools in prevention of post-polypectomy bleeding.Conclusion Endoclips and endoloops are useful to prevent bleeding after resection of large pedunculated (with thick stalks) polyps.For large sessile and pedunculated (without thick stalks) polyps (diameter＞ 10 mm),the effect of endoclips to prevent postpolypectomy bleeding still needs further discussion.

Comparação de resultado estético em cicatrizes com uso de fios cirúrgicos e Prineo® / Comparison between surgical sutures and Prineo® in terms of esthetic result and scar formation

Introdução: Cicatrização de ferida é um processo bem organizado que tem como finalidade a reparação tecidual completa. Colas e adesivos tópicos oferecem uma alternativa não invasiva, de retirada fácil e espontânea; boa força tênsil; menor tempo de aplicação, sendo o Prineo® uma cola adesiva associada a uma malha de poliéster aplicados sobre a ferida. Método: Trata-se de um estudo transversal retrospectivo com análise de 101 procedimentos cirúrgicos no período de 2012 a 2014, nos quais a síntese da ferida operatória ocorreu com fios cirúrgicos de náilon ou Prineo®, sendo aplicada análise estatística. Resultados: Neste estudo, seis pacientes apresentaram dermatite de contato ao uso do Prineo® com significância estatística (p = 0,042). O uso desse sistema diminuiu a taxa de alargamento cicatricial (p < 0,05). O presente trabalho não apresentou diferença estatística (p = 0,068) na qualidade da cicatriz entre os pacientes que utilizaram Prineo® em relação ao grupo controle, demonstrando que em ambos os grupos o resultado cicatricial foi de excelente (87%) a bom (27%) na sua maioria. Conclusão: Conclui-se no estudo que os pacientes que utilizaram o sistema de octil-2-cianocrilato associado a malha, Prineo®, apresentaram menores índices de alargamento cicatricial, dependentes de uma espessura de derme satisfatória, e maiores taxas de dermatites por contato em relação àqueles em que a ferida foi encerrada com fios cirúrgicos. Os dois grupos demonstraram qualidades cicatriciais excelentes a bons, sem diferença estatística em tais resultados estéticos cicatriciais.

Introduction: Wound healing is a well-organized, directed process of tissue repair. The process can be expedited using topical glues and adhesives, which offer a non-invasive, easily removable alternative to suturing. Furthermore, such products have good tensile strength and involve lower application time. In particular, the Prineo® adhesive is applied to a polyester mesh that covers the wound. Method: We carried out a retrospective, cross-sectional study, with subsequent statistical analysis , involving 101 surgical procedures in which wound closure was performed using either nylon sutures or Prineo®. All the procedures were performed between 2012 and 2014. Results: Six patients had contact dermatitis after Prineo® was used, with statistical significance (p = 0.042). Furthermore, Prineo® decreased the rate of scar enlargement (p < 0.05) . There was no statistical difference between the Prineo® and suture groups in terms of scar quality (p = 0.068); in both groups, the scar result was mostly excellent (87 %) to good (27%). Conclusion: Patients whose wounds were closed using Prineo® a system involving octyl-2-cyanoacrylate and an associated polyester mesh displayed lower rates of scar enlargement, which depended on whether the thickness of the dermis was satisfactory. However, the same patients had higher rates of contact dermatitis than those whose wounds were closed using surgical sutures. Both groups showed excellent to good scar quality, with no significant difference in terms of esthetic scar results.

Continuous absorbable suture versus interrupted permanent suture in the treatment of diastasis of the rectus abdominis muscle / Sutura contínua com fio absorvível versus interrompida com fio permanente no tratamento da diástase do músculo reto abdominal

Introduction: Plication of the rectus abdominis muscle is an important step in remodeling the abdomen in abdominoplasties. It can be performed using several types of threads with interrupted or continuous sutures, according to the surgeon's preferences. Few studies in the literature compared the different plication techniques in abdominoplasties. The present study aimed to compare continuous anchored suture with polydioxanone (PDS) with interrupted nylon suture regarding surgical time, relapse, and costs and discuss the advantages and disadvantages of each method. Methods: A randomized clinical trial in which 30 patients were enrolled for each of the two groups, 15 with continuous suture and 15 with interrupted suture, was conducted. The plication time was compared between the groups using the Student's t-test. Between 10 and 12 months postoperatively, all patients underwent ultrasonography for investigating diastasis recurrence. Results: Continuous suture decreased the plication time by almost 40% when compared to the interrupted suture (p < 0.001), without affecting the esthetic outcome. The PDS used in the continuous suture implied higher costs than those with the nylon threads used in the interrupted suture. No recurrence was found on the postoperative control ultrasonography results. Conclusion: Continuous suture reduced the plication time by almost 40% (p < 0.001) when compared to interrupted suture. Despite being associated with higher costs, PDS seems to be a good alternative to non-absorbable sutures, such as nylon threads, in plications of the rectus abdominis, since it is a more biocompatible material.

Introdução: A plicatura do músculo reto abdominal é um passo importante no remodelamento do abdômen nas abdominoplastias. Ela pode ser realizada com vários tipos de fios e com suturas interrompidas ou contínuas, de acordo com as preferências do cirurgião. Poucos estudos na literatura compararam diferentes técnicas de plicatura nas abdominoplastias. O objetivo do estudo é comparar a sutura contínua ancorada com polidioxanona (PDS) com a sutura interrompida com náilon quanto ao tempo cirúrgico, recidiva, custos e discutir vantagens de desvantagens de cada método. Métodos: Ensaio clínico randomizado no qual 30 pacientes foram arroladas para cada um dos grupos, 15 sutura contínua e 15 sutura interrompida. O tempo de plicatura foi comparado entre os grupos utilizando-se o teste t de Student. Entre 10 a 12 meses de pós-operatório, todas as pacientes foram submetidas à ecografia em busca de recidivas da diástase. Resultados: A sutura contínua diminuiu em quase 40% o tempo de plicatura quando comparada à sutura interrompida (p < 0,001), sem prejuízo no resultado estético. O PDS utilizado na sutura contínua implicou maiores custos que os fios de náilon utilizados na sutura interrompida. Nenhuma recidiva foi encontrada na ecografia de controle no pós-operatório. Conclusão: A sutura contínua quando comparada à sutura interrompida foi capaz de reduzir o tempo de plicatura em quase 40% (p < 0,001). A utilização do PDS, apesar dos maiores custos, parece ser uma boa alternativa às suturas com fios não absorvíveis como o náilon nas plicaturas do músculo reto abdominal, uma vez que se trata de um fio de maior biocompatibilidade.

Flexible resins: an esthetic option for partially edentulous patients / Resinas flexíveis: uma opção estética para desdentados parciais

Flexible thermoplastic resins have been used as an alternative to partially edentulous patients for decades in the USA. However, they are neither popular nor widespread in Brazil. This material represents an excellent treatment option to solve clinical problems such as compromised esthetics caused by visible metal clasps, and fall fracture of dentures made of conventional resins. Additionally, there is little researching and no controlled clinical studies about the use of flexible resins in prosthodontics. For these reasons, this study presents a case report of a dissatisfied patient treated with a conventional removable partial denture, which was replaced by a modified metal framework without metal clasps in combination with flexible resin, and a literature review about this material focusing on the dental practitioner. The study also reports how these polymers can be used, their indications, and their clinical and laboratory considerations.

As resinas termoplásticas flexíveis têm sido uma alternativa para tratamento de pacientes parcialmente desdentados disponível há décadas nos EUA. No Brasil, no entanto, ainda são pouco utilizadas e conhecidas. Este material pode representar uma excelente opção de tratamento reabilitador, para solucionar problemas tais como o aparecimento de grampos metálicos com comprometimento da estética e fratura de próteses confeccionadas com resinas convencionais devido a quedas. Além disso, pesquisas acerca desse material são escassas e não há estudos clínicos de sua utilização na área de prótese dentária na literatura. Por essas razões, este estudo apresenta um caso clínico de uma paciente insatisfeita tratada com prótese removível convencional, a qual foi substituída por uma estrutura metálica modificada sem grampos em combinação com resina, e uma revisão da literatura, com o objetivo de elaborar um apanhado de informações para o clínico sobre estes materiais, além de apresentar como estes polímeros podem ser utilizados, as suas indicações em prótese parcial removível, suas considerações clínicas e laboratoriais.

Nano-hydroxyapatite/polyamide 66 composite for repair of early femoral head necrosis / 中国组织工程研究

BACKGROUND:Nano-hydroxyapatite/polyamide 66 composite has good material-cel interface and three-dimensional porous network structure, and it can also be gradualy degraded over time after implantation in the human body. OBJECTIVE:To explore the effect of nano-hydroxyapatite/polyamide 66 in early repair of femoral head necrosis. METHODS:A retrospective analysis was performed on clinical data of 62 cases of early osteonecrosis of the femoral head, including 32 males and 30 females, aged 34-51 years. These patients were divided into control group (31 cases) and observation group (31 cases) according to treatment methods. Core decompression with nano-hydroxyapatite/polyamide 66 implantation and core decompression with bone graft were respectively performed in the observation and control groups. Incidence of pain in the two groups was compared at 1 day after treatmen; and during the 12-month folow-up, the Harris score of the hip function in the two groups was compared. RESULTS AND CONCLUSION:There was no significant difference in the visual analog scale scores between two groups at 1 day after treatment. The Harris scores in the observation group were significantly higher than those in the control group at 3 and 12 months after treatment (P < 0.05). There was no adverse reaction in the two groups. These findings indicate that nano-hydroxyapatite/polyamide 66 material for repair of early femoral head necrosis has good biocompatibility, and can obtain good effects on limb function recovery.

Application of nano-artificial bone in anterior cervical fusion / 中国组织工程研究

BACKGROUND:Nano-hydroxyapatite/polyamide artificial bone has good biocompatibility and strong tissue binding force, which exerts a significant role in the recovery of neurological function. OBJECTIVE: To investigate the clinical effect of nano-hydroxyapatite/polyamide artificial bone in anterior cervical fusion. METHODS: Ninety patients with cervical spondylosis and traumatic dislocation of the cervical spine were randomized into observation group and control group. Patients in the two groups underwent nano-hydroxyapatite/polyamide artificial bone and autologous iliac bone implantation, respectively. Surgical condition, Japanese Orthopaedic Association score, vertebral height loss and bone fusion rate were compared and analyzed at different time after implantation. RESULTS AND CONCLUSION:There were no significant differences in surgical time, out of bed time, postoperative hospitalization time between the two groups (P > 0.05), but the intraoperative blood loss was significantly lower in the observation group than the control group (P 0.05). The vertebral height loss and bone fusion rate had no difference between the two groups at 6 months after operation and at the last folow-up (P > 0.05). No adverse effects occurred in the two groups. These findings indicate that nano-hydroxyapatite/polyamide artificial bone has good clinical effects in anterior cervical fusion, and the treatment effect is equivalent to autologous iliac bone graft.

Comparative study of tissue reactivity to n-butyl-2-cyanoacrylate and nylon monofilament thread on pericranium-cutaneous flaps in rats

To study the repair of pericranium-cutaneous flaps fixed with suture anchored in a skull bone tunnel or N-butyl-2-cyanoacrylate adhesive in Wistar rats with emphasis on the cellular inflammatory response and the production of types I and III collagen. The operated region in the cephalic region of Wistar rats was removed minutes before euthanasia, fixed in formalin, and subjected to histological preparation. Slides were stained with hematoxylin-eosin and Picrosirius. Standardized counts of polymorphonuclear and mononuclear cells, fibroblasts, and macrophages were performed, and the percentages of types I and III collagen were determined. Data collection occurred on days 3, 7, 14, 21, and 45 postoperatively. A value of p<0.05 was considered statistically significant. Quantitative analysis of the data showed more fibroblasts in the surgical adhesive group than in the nylon monofilament thread groups (p=0.0211). Qualitative analysis showed higher reactivity in the adhesive group, with a predominance of polymorphonuclear cells from days 3-45 and macrophages from days 3-7. The amount of type I collagen exceeded 80% in the treated and control groups at the end of the experiment. CONCLUSIONS: Subperiosteal detachment triggers a cellular inflammatory response that is amplified using soft tissue fixation methods. The adhesive n-butyl-2-cyanoacrylate was more reactive than the nylon monofilament thread anchored in the skull bone tunnel.

Evaluation of the abdominal wall cicatrization of rabbits exposed to nicotine and undergone abdominoplasty using nylon thread or cyanoacrylate / Avaliação da cicatrização da parede abdominal de coelhos expostos à nicotina e submetidos à abdominoplastia, utilizando-se nylon ou cianocrilato

PURPOSE: To compare the wound healing of the abdominal wall of rabbits exposed to nicotine and submitted to abdominoplasty using 2-octyl cyanoacrylate or nylon thread for the surgery suture. METHODS: Thirty two rabbits were used. They were divided in subgroups: A1, A2, B1 e B2. Group A received saline 0.9%; group B received nicotine, both groups for 14 days before surgery. We performed an abdominoplasty with a nylon suture into the A1 and B1 subgroups; as for A2 and B2 groups the suture was performed with cyanoacrylate. The euthanasia happened in the 14th post-operative day. After, we evaluated: swollen process, fibroblast proliferation, collagen, neovascularization, and macroscope and microscope epithelization of the scars. RESULTS: We observed the presence of eosinophils in all scars exposed to the cyanoacrylate, and a significant increase of neovascularization in the subgroup B2 comparing to the A2 one (p=0.037). The other variables haven't showed any statistical difference. CONCLUSIONS: Nicotine hasn't influenced the swollen process, the fibroblast proliferation, the presence of collagen, neither the epithelialization. The neovascularization showed cicatricial immaturity when comparing group A2 to group B2. The eosinophils in the scars repaired with glue showed that the substance has acted as an allergen.

OBJETIVO: Comparar a cicatrização da parede abdominal de coelhos expostos à nicotina e submetidos à abdominoplastia utilizando 2-octil cianoacrilato ou nylon na síntese cirúrgica. MÉTODOS: Utilizou-se 32 coelhos. Estes foram distribuídos em subgrupos: A1, A2, B1 e B2. O grupo A recebeu solução de NaCl 0,9%; o B recebeu nicotina, ambos durante 14 dias do pré-operatório. Nos subgrupos A1 e B1 foi realizada abdominoplastia e sutura com "nylon"; enquanto A2 e B2 a síntese ocorreu com cianoacrilato. A eutanásia ocorreu no 14º dia do pós-operatório. Na pesquisa avaliou-se: processo inflamatório, proliferação fibroblástica, colágeno, neovascularização, epitelização macro e microscópica das cicatrizes. RESULTADOS: Observou-se presença de eosinofilia em todas as cicatrizes expostas ao cianoacrilato, e aumento significativo da neovascularização no subgrupo B2 em comparação com o A2 (p=0,037). Demais variáveis não apresentaram diferença estatística. CONCLUSÕES: A nicotina não influenciou o processo inflamatório, a proliferação fibroblástica, a presença de colágeno e a epitelização. A neovascularização indicou imaturidade cicatricial na comparação dos grupos A2 e B2. A eosinofilia nas cicatrizes reparadas com cola indica que a substância atuou como alergeno.

Adjustable loop-based purse-string technique in NOTES gastrotomy closure / 中华消化内镜杂志

Objective To assess the feasibility and safety of adjustable loop-based purse-string technique in gastrotomy closure of natural orifice translumenal endoscopic surgery (NOTES).Methods Ten healthy female dogs were used in this study.Transgastric NOTES peritoneal exploration was performed in 5 groups (2 dogs in each) via various sites of the stomach ( greater curvature of the antrum; greater and lesser curvature of the body; anterior and posterior wall of the body).The gastric incision was then closed by using loop-based purse-string technique.Healing of the incision and intra-peritoneal infection were checked by endoscopy,necropsy,bacterial culture and histological examination 2 weeks later.Results The performance of NOTES peritoneal exploration and closure with purse-string technique was successful in ten dogs without significant complications.The mean operation time of closure was 7.3 ± 1.8 min.Minor bleeding occurred in 2 dogs (20％) during the incision of greater curvature of the antrum and body,which was controlled by electrocoagulation.Culture of the ascitic fluid and necropsy revealed no sign of abdominal infection or other complications except for adhesion in 1 dog ( 10％ ).The intact incision was confirmed by endoscopic,postmortem and histological examination,which suggested complete healing of the incision.Conclusion It is easy and safe to use loop-based purse-string technique for closure of multi-regional NOTES gastrotomy.This technology may be used for the repair of gastric ulcer perforation theoretically.

The safety of endoscopic ligation of gastric and colic full-thickness wall with detachable nylon loops / 中华消化内镜杂志

Objective To evaluate the safety of endoscopic ligation of gastric and colic full-thickness wall with nylon loops.Methods Endoscopic ligation of full gastric and colic wall with detachable nylon loops, assisted by laparotomy, were performed in 4 dogs.Ligation healing was assessed on 3, 7, 10and 17 days after the procedure.Results All animals recovered after the procedure, without any clinical signs of infection or hemorrhage.Postoperative examination did not reveal gastric or colonic perforation, or local abscess.Loop ligature showed ulcer-like lesion.Histopathology revealed muscularis propria disruption, granulation tissue bridging the site of ligation and formation of scar tissue.Regenerative mucosa coyered the surface of the ligature completely 17 days after the operation.Conclusion Endoscopic ligation of gastric and colic full-thickness wall with detachable nylon loops is safe.Its application can be extended to other fields.

Estudo experimental comparando o uso do 2-octil cianoAcrilato ao nylon 4-0 na sutura da pele / Experimental study comparing 2-octyl cyanoacrylate to nylon for skin closure

OBJETIVO: Comparar o 2-octil cianoacrilato com o fio de "nylon" no fechamento da pele em ratos. MÉTODOS: Vinte e cinco ratos da linhagem Wistar, foram submetidos à incisão de 3 cm de cada lado do abdome. A síntese foi feita utilizando em um dos lados o "nylon" 4.0, pontos intradérmicos, e do outro o 2-octil cianoacrilato. Após sete dias, o fio foi removido e as incisões, analisadas quanto às complicações. Após 40 dias, o resultado da cicatriz foi avaliado. Os ratos foram sacrificados, as cicatrizes foram ressecadas, fixadas e enviadas ao patologista, sem informação sobre qual o método utilizado. RESULTADOS: Houve dois óbitos durante a anestesia e um tardio. O tempo de operação foi de 136 segundos com a cola e 176 segundos, com o "nylon" (P=0,003). Dentre as 50 operações realizadas, as complicações foram: um hematoma com cada método (P=0,80), quinze deiscências da cola contra 11 do "nylon" (P=0,20), sete cicatrizes de aspecto ruim ou razoável da cola contra quatro do "nylon" (P=0,30), três infecções na cola contra duas (P=0,40). Ao exame patológico, a mediana da largura da cicatriz foi de 1.119 micra com a cola e 1.800 com o "nylon" (P=0,40). A espessura foi de 1.795 contra 1.705 micra (P=0,40). CONCLUSÃO: O 2-octil cianoacrilato apresentou o mesmo aspecto cicatricial, a mesma resistência e as mesmas complicações que a sutura com o "nylon" 4.0, porém permitindo redução no tempo cirúrgico.

BACKGROUND: Tissue adhesive 2-octyl cyanoacrylate was developed to have more strength, less inflammatory reaction, and less histotoxicity than its shorter-chain derivates. METHODS: To evaluate the use of 2-octil cyanoacrylate in comparison with "nylon" suture in skin closure of rats. Methods: Twenty-five female Wistar rats were submitted to a 3cm surgical incision in each side of the abdomen. The wound was closed with intradermic suture using "nylon" 4-0 in one side, and 2-octil cyanoacrylate on the other side. After 7 days the thread was removed and the wound was checked for complications. After 40 days the wound aspect was clinically evaluated. The rats were sacrificed; the scars were resected, and sent to the pathologist without the information of which closing method was used. RESULTS: There were 2 deaths during anesthesia or few days after surgery. The mean surgical time was 136 seconds with the adhesive and 176 with "nylon" (P=0.003). The complications were: one hematoma in each method (P=0.8), fifteen wound dehiscence with the adhesive and 11 with "nylon" (P=0.2), seven scars with a bad or fair aspect with adhesive and 4 with "nylon" (P=0.3), three infections with adhesive and 2 with "nylon" 2 (P=0.4). Histological examination showed median scar width of 1.119 micron with the adhesive and 1.800 with "nylon" (P=0.7). The mean thickness was 1.795 in the adhesive group versus 1.705 micron (P=0.7). CONCLUSION: Surgical adhesive showed the same aesthetical results, the same strength, and the same complications as for "nylon" 4.0 sutures, but the adhesive decreased the surgical time.