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1.
Rev. bras. cir. plást ; 34(3): 378-383, jul.-sep. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047159

RESUMO

Realizamos uma análise de quais são os elementos responsáveis pelo sustento e formato abdominal, determinando assim, que é devido a uma excessiva flacidez musculoaponeurótica de origem primária, à qual promove uma incapacidade do suporte da parede abdominal e pode estar relacionada a fatores predisponentes. Para esses casos específicos, desenvolvemos um tratamento propondo a colocação da tela e apresentando nossa experiência. Apresentamos esta série de casos de experiência em 26 anos. Onde 15 pacientes foram tratados com abdominoplastia primária e secundária. O reforço da parede abdominal foi realizado através da colocação de tela de polipropileno no plano submuscular com pontos em U na fáscia transversalis, buscando-se fortalecer o músculo e a fáscia transversa. Os resultados foram satisfatórios a longo prazo. Obtendo resolução das protuberâncias abdominais e restaurando a harmonia dos músculos. Apenas duas complicações ocorreram, que foram a presença de dor crônica localizada no abdome tratada com infiltrações de esteroides e fístula umbilical precoce de resolução rápida espontânea, independente da proposta.


We investigated the causative factors of abdominal support and shape and found that excessive musculoskeletal flaccidity of primary origin causes an inability to support the abdominal wall and may be associated with the predisposing factors. For such cases, we developed a treatment consisting of the placement of a subcutaneous mesh. Here, we present our experience with this treatment. We present a case series of 15 patients in our 26 years of experience who were treated with primary and secondary abdominoplasties. The abdominal wall was reinforced by placing a polypropylene mesh in the submuscular plane with U-stitches in the transversalis fascia, aiming at strengthening the muscle and transverse fascia. The results were satisfactory in the long term. Abdominal bulges were repaired, and muscle harmony was restored. Only two complications occurred: chronic pain localized in the abdomen, which was treated with steroid infiltrations, and an early umbilical fistula with spontaneous and rapid resolution, regardless of the proposal.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , História do Século XXI , Atrofia Muscular , Tratamento Secundário , Procedimentos Cirúrgicos Reconstrutivos , Parede Abdominal , Tela Subcutânea , Abdome , Sistema Musculoaponeurótico Superficial , Diástase Muscular , Atrofia Muscular/cirurgia , Tratamento Secundário/análise , Tratamento Secundário/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Parede Abdominal/anatomia & histologia , Tela Subcutânea/cirurgia , Abdominoplastia/métodos , Sistema Musculoaponeurótico Superficial/cirurgia , Diástase Muscular/cirurgia , Abdome/cirurgia
2.
Int. j. morphol ; 37(3): 1033-1037, Sept. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1012392

RESUMO

La infección por Actinomices (actinomicosis), es una entidad poco frecuente y que puede crear dificultades diagnósticas y terapéuticas; principalmente cuando por su presentación se asemeja a neoplasias malignas. El objetivo de este estudio fue reportar un caso de actinomicosis de pared abdominal con infiltración hepática y revisar la evidencia existente. Se trata de una paciente sexo femenino, de 33 años de edad, sin antecedentes quirúrgicos ni de utilización de dispositivos intra-uterinos. Consultó por dolor abdominal y masa palpable a nivel epigástrico. Se estudió con imágenes, las que permitieron verificar una masa de pared abdominal con trayecto fistuloso al hígado. Se realizó una exéresis amplia de la lesión antes descrita. Una vez extirpado el espécimen, se fue a estudio histopatológico, que reveló gránulos de azufre consistentes con actinomices. La paciente evolució de forma satisfactoria, sin inconvenientes. Presentamos un caso poco común de actinomicosis de pared abdominal con infiltración hepática. Cuando se encuentra una gran masa intraperitoneal, la actinomicosis debe incluirse en el proceso de diagnóstico diferencial.


Actinomyces infection (actinomycosis) may create diagnostic conflicts and be confused with malignant neoplasms, especially in the abdomen. The objective of this study was to report a case of abdominal wall actinomycosis with hepatic infiltration, and review the existing evidence. Female patient, 33 years of age, with no surgical history or use of intra-uterine devices. She consulted for abdominal pain and palpable mass at the epigastrium. It was studied with images, which allowed verifying an abdominal wall mass with hepatic fistulae. A broad extirpation of the lesion was performed. The histological study revealed sulfur granules consistent with actinomyces. The patient has evolved satisfactorily, without problems; and is currently in treatment with amoxicillin. We present an unusual case of abdominal wall actinomycosis with hepatic infiltration that resulted in a difficult diagnosis. When a large intraperitoneal mass is found, actinomycosis needs to be included as a differential diagnoses.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Actinomicose/diagnóstico , Actinomicose/cirurgia , Actinomicose/patologia , Parede Abdominal/microbiologia , Diagnóstico Diferencial , Abscesso Hepático/etiologia , Neoplasias Abdominais/diagnóstico
3.
Arq. bras. med. vet. zootec. (Online) ; 71(4): 1198-1206, jul.-ago. 2019. tab, graf, ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1038616

RESUMO

The aim of this study was to characterize the tissue reactions triggered by the polypropylene mesh coated with chitosan and polyethylene glycol film, and if it's able to prevent the formation of peritoneal adhesions. Defects in the abdominal wall of rats were induced and polypropylene meshes coated with chitosan/polyethylene glycol (CPEG group, n= 12) and uncoated (PP control group, n= 12) were implanted. On the fourth and forty-fifth postoperative day the formation of adhesion and the tissue reaction to the biomaterial was evaluated through histological and histochemical analysis. The area (P= 0.01) and severity (P= 0.002) of the adhesion was significatively less in the CPEG group. On the fourth day the foreign body reaction was less intense in CPEG group (P= 0.018) and the production of collagen fibers was more intense in this group (P= 0.041). The tissue reactions caused by the biomaterials were similar on the 45th day, with the exception of the high organization of collagen fibers in the CPEG group. The CPEG meshes did not fully prevent the formation of adhesions, but minimized the severity of the process. The foreign body reaction promoted by polypropylene meshes coated with CPEG is less intense than that triggered by uncoated polypropylene meshes.(AU)


O objetivo deste estudo foi caracterizar as reações tissulares desencadeadas pela tela de polipropileno revestida com o filme de quitosana e polietilenoglicol e verificar se ela é capaz de prevenir a formação de aderências peritoneais. Um defeito na parede abdominal dos ratos foi realizado, e as telas de polipropileno revestidas com quitosana/polietilenoglicol (grupo CPEG, n= 12) e sem revestimento (grupo controle PP, n= 12) foram implantadas. No quarto e no 45º dia pós-operatório, avaliou-se a formação de aderências e a reação tecidual ao biomaterial por análise histológica e histoquímica. A área (P= 0,01) e a severidade (P= 0,002) da aderência peritoneal foram significativamente menores no grupo CPEG no 45º dia. No quarto dia, observou-se que a reação do corpo estranho foi menor no grupo CPEG (P= 0,018), e a produção de fibras de colágeno mais intensa (P= 0,041). As reações tissulares causadas pelos biomateriais implantados foram semelhantes no 45º dia, com exceção da melhor organização das fibras colágenas no grupo CPEG. As telas CPEG não impediram completamente a formação de aderências, porém minimizaram a gravidade do processo. A reação de corpo estranho promovida por telas de polipropileno revestidas com CPEG é menos intensa do que a desencadeada por telas de polipropileno não revestidas.(AU)


Assuntos
Animais , Ratos , Polietilenoglicóis , Polipropilenos , Telas Cirúrgicas/veterinária , Reação a Corpo Estranho/veterinária , Parede Abdominal/cirurgia , Quitosana , Aderências Teciduais/veterinária
4.
Rev. bras. cir. plást ; 34(1): 23-40, jan.-mar. 2019. ilus, tab, graf
Artigo em Português | LILACS | ID: biblio-994538

RESUMO

Introdução: A necessidade de oferecer resultados com maior definição nas abdominoplastias nos compele a evoluir tecnicamente. O objetivo deste trabalho é apresentar a técnica de plicatura em Crossbow com suas três variantes, reforçando o conceito de aproximação vertical e horizontal da aponeurose dos músculos retos e oblíquos abdominais ao mesmo tempo, promovendo dois vetores diferentes de tração, culminando em uma maior definição da parede abdominal, principalmente na região do hipogastro e fossas ilíacas. Métodos: No período entre janeiro de 2016 e fevereiro de 2018, foram realizadas 22 cirurgias exclusivamente com a técnica Crossbow em seus tipos l, ll e lll, tanto em pacientes estéticos como pós-bariátricos. Resultados: Os resultados foram favoráveis tanto do ponto de vista estético, com maior definição do hipogastro, como do ponto de vista clínico, uma vez que nenhum paciente apresentou sinais ou sintomas diferentes de técnicas convencionais. Conclusão: A técnica Crossbow é simples e reprodutível, sendo mais um agregante na armamentária para melhorar a estética abdominal. Apesar de promover o reforço da região hipogástrica, tanto para tratamento primário como secundário desta região, só o aumento da casuística poderá demonstrar as possíveis vantagens do método.


Introduction: Owing to the need to deliver results with greater definition in abdominoplasties, techniques must evolve. The objective of this study was to introduce the crossbow technique for plication along with its three variants that reinforces the concept of vertical and horizontal alignments of the aponeurosis of the rectus and oblique abdominis muscles at the same time, promotes 2 different traction vectors, and culminates in a greater definition of the abdominal wall, mainly in the hypogastrium and iliac fossa regions. Methods: From January 2016 to February 2018, 22 surgeries were performed exclusively with the types l, ll, or lll crossbow technique, both in esthetic surgery cases and post-bariatric patients. Results: The results were favorable both from the esthetic point of view, with greater definition of the hypogastrium, and from a clinical point of view, as none of the patients showed signs or symptoms different from those of the conventional techniques. Conclusion: The crossbow technique is a simple and reproducible tool in the medical armamentarium to improve abdominal esthetics. Although it promotes the strengthening of the hypogastric region, both for primary and secondary treatments of this region, only a sample size increase can demonstrate the possible advantages of the method.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Músculos Abdominais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Parede Abdominal/anormalidades , Parede Abdominal/cirurgia , Aponeurose/anormalidades , Aponeurose/cirurgia
5.
Acta cir. bras ; 34(6): e201900603, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019263

RESUMO

Abstract Purpose To Compare the extent and intensity of adhesions formed between the intra-abdominal organs and the intraperitoneal implants of polypropylene mesh versus polypropylene/polyglecaprone versus polyester/porcine collagen used for correction of abdominal wall defect in rats. Methods After the defect in the abdominal wall, thirty Wistar rats were placed in three groups (ten animals each) for intraperitoneal mesh implant: polypropylene group, polypropylene/polyglecaprone group, and polyester/porcine collagen group. The macroscopic evaluation of the extent and intensity of adhesions was performed 21 days after the implant. Results The polypropylene group had a higher statistically significant impairment due to visceral adhesions (p value = 0.002) and a higher degree of intense adherence in relation to polypropylene/polyglecaprone and polyester/porcine collagen groups (p value<0.001). The polyester/porcine collagen group showed more intense adhesions than the polypropylene/polyglecaprone group (p value=0.035). Conclusions The intraperitoneal implantation of polypropylene meshes to correct defects of the abdominal wall caused the appearance of extensive and firm adhesions to intra-abdominal structures. The use of polypropylene/polyglecaprone or polyester/porcine collagen tissue-separating meshes reduces the number and degree of adhesions formed.


Assuntos
Animais , Masculino , Ratos , Doenças Peritoneais/etiologia , Poliésteres/administração & dosagem , Polipropilenos/administração & dosagem , Telas Cirúrgicas/efeitos adversos , Aderências Teciduais/etiologia , Colágeno/administração & dosagem , Dioxanos/administração & dosagem , Poliésteres/efeitos adversos , Polipropilenos/efeitos adversos , Teste de Materiais , Colágeno/efeitos adversos , Ratos Wistar , Parede Abdominal/patologia , Dioxanos/efeitos adversos
6.
Acta cir. bras ; 34(6): e201900608, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019267

RESUMO

Abstract Purpose To analyze the resistance to medial traction of abdominal wall muscles, before and after performing relaxing incisions. Methods Seventeen live pigs were used. After a median laparotomy, the handles were made in the rectus abdominis muscles (RAM) to fit the dynamometer. Step 1 (control phase): tensile strength measured without performing relaxant incisions. Step 2: A curvilinear relaxant incision was made on the anterior blade of the right RAM sheath and then the tensile strength was measured by the edge of the wound. The same procedure was adopted after incision of the left posterior blade. Step 3: Relaxing incisions were made in the right posterior and left anterior blade, so that both sides were left with a relaxing incision on both blades. Measurements of resistance were performed. Results There was no statistically significant difference between the sides. On the right and left side, all treatments reduced the tensile strength when compared to each other and to the control. There was a reduction of 12% and 9.8% after incision of the anterior and posterior blade, respectively. Conclusion Relaxing incisions reduced tensile strength in the ventral abdominal wall.


Assuntos
Animais , Resistência à Tração/fisiologia , Músculos Abdominais/cirurgia , Parede Abdominal/cirurgia , Laparotomia/métodos , Suínos , Cicatrização/fisiologia , Técnicas de Sutura , Músculos Abdominais/fisiologia
7.
Acta cir. bras ; 34(7): e201900703, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1038114

RESUMO

Abstract Purpose: To compare four types of mesh regarding visceral adhesions, inflammatory response and incorporation. Methods: Sixty Wistar rats were divided into four groups, with different meshes implanted intraperitoneally: polytetrafluoroethylene (ePTFE group); polypropylene with polydioxanone and oxidized cellulose (PCD); polypropylene (PM) and polypropylene with silicone (PMS). The variables analyzed were: area covered by adhesions, incorporation of the mesh and inflammatory reaction (evaluated histologically and by COX2 immunochemistry). Results: The PMS group had the lowest adhesion area (63.1%) and grade 1 adhesions. The ePTFE and PM groups presented almost the total area of their surface covered by adherences (99.8% and 97.7% respectively) The group ePTFE had the highest percentage of area without incorporation (42%; p <0.001) with no difference between the other meshes. The PMS group had the best incorporation rate. And the histological analysis revealed that the inflammation scores were significantly different. Conclusions: The PM mesh had higher density of adherences, larger area of adherences, adherences to organs and percentage of incorporation. ePTFE had the higher area of adherences and lower incorporation. The PMS mesh performed best in the inflammation score, had a higher incorporation and lower area of adherences, and it was considered the best type of mesh.


Assuntos
Animais , Masculino , Ratos , Próteses e Implantes/efeitos adversos , Telas Cirúrgicas/normas , Aderências Teciduais/patologia , Hérnia Incisional/cirurgia , Inflamação/patologia , Polipropilenos/efeitos adversos , Politetrafluoretileno/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Silicones/efeitos adversos , Telas Cirúrgicas/efeitos adversos , Teste de Materiais , Vísceras/fisiologia , Celulose Oxidada/efeitos adversos , Aderências Teciduais/prevenção & controle , Ratos Wistar , Estatísticas não Paramétricas , Parede Abdominal
8.
Rev. Col. Bras. Cir ; 46(6): e20192322, 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1057185

RESUMO

RESUMO Objetivo: avaliar os efeitos da arginina na cicatrização da parede abdominal de ratos Wistar. Métodos: vinte ratos Wistar foram submetidos à laparotomia e separados em dois grupos (arginina e controle), que receberam tratamento diário por via intraperitoneal com arginina (300mg/kg/dia) e solução tampão fosfato em dose equivalente ao peso, respectivamente, durante cinco dias. No sétimo dia pós-operatório, coletaram-se amostras de sangue e da cicatriz da parede abdominal de ambos os grupos. Avaliaram-se o nível sérico de nitratos e nitritos, a evolução cicatricial pelas dosagens de hidroxiprolina tecidual, formação de tecido de granulação, determinação da porcentagem de colágeno maduro e imaturo, densidade de miofibroblastos e angiogênese. Empregaram-se os testes de ANOVA e t de Student com p=0,05 para as comparações entre os grupos. Resultados: não ocorreram diferenças significantes entre os grupos estudados para dosagens de nitratos e nitritos (p=0,9903), hidroxiprolina tecidual (p=0,1315) e densidade de miofibroblastos (p=0,0511). O grupo arginina apresentou maior densidade microvascular (p=0,0008), maior porcentagem de colágeno tipo I (p=0,0064) e melhora na formação do tecido de granulação, com melhores índices de proliferação angiofibroblástica (p=0,0007) e re-epitelização das bordas (p=0,0074). Conclusão: na avaliação cicatricial da parede abdominal de ratos Wistar sob tratamento com arginina, não houve alteração do nível sérico de nitratos e nitritos, da deposição de colágeno total e da densidade de miofibroblastos. Verificaram-se aumento da maturação de colágeno do tipo I, da densidade microvascular e melhora na formação do tecido de granulação cicatricial pelas melhores re-epitelização de bordas e proliferação angiofibroblástica.


ABSTRACT Objective: to evaluate the effects of arginine on abdominal wall healing in rats. Methods: we submitted 20 Wistar rats to laparotomy and divided them into two groups, arginine and control, which then received, respectively, daily intraperitoneal treatment with arginine (300mg/kg/day) and weight-equivalent phosphate buffered solution, during five days. On the seventh postoperative day, we collected blood and scar wall samples from both groups. We evaluated serum nitrate and nitrite levels, wound evolution by tissue hydroxyproline dosages, granulation tissue formation, percentage of mature and immature collagen, myofibroblast density and angiogenesis. We used the ANOVA and the Student's t tests with p=0.05 for comparisons between groups. Results: there were no significant differences between the groups studied for nitrate and nitrite (p=0.9903), tissue hydroxyproline (p=0.1315) and myofibroblast density (p=0.0511). The arginine group presented higher microvascular density (p=0.0008), higher percentage of type I collagen (p=0.0064) and improved granulation tissue formation, with better angiofibroblastic proliferation rates (p=0.0007) and wound edge reepithelization (p=0.0074). Conclusion: in the abdominal wall healing evaluation of Wistar rats under arginine treatment, there was no change in serum nitrate and nitrite levels, total collagen deposition and myofibroblast density. There was an increase in type I collagen maturation, microvascular density and improvement in scar granulation tissue formation by better edge reepithelization and angiofibroblastic proliferation.


Assuntos
Animais , Ratos , Arginina/farmacologia , Cicatrização/efeitos dos fármacos , Colágeno/efeitos dos fármacos , Parede Abdominal/cirurgia , Colágeno/metabolismo , Ratos Wistar , Modelos Animais , Parede Abdominal/patologia , Miofibroblastos/efeitos dos fármacos , Traumatismos Abdominais/tratamento farmacológico
9.
Rev. colomb. cir ; 34(4): 338-345, 20190000. tab, fig
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1049182

RESUMO

Introducción. La endometriosis de la pared abdominal se define como la presencia de tejido endometrial en cualquiera de las capas que componen la pared abdominal. Su incidencia es baja y se caracteriza por un diagnóstico tardío. Materiales y métodos. Se trata de un estudio descriptivo y retrospectivo entre 2010 y 2014 en pacientes con endometriosis de la pared abdominal, cuyo análisis patológico fue realizado en un centro de ayudas diagnósticas de Medellín. Se identificaron las variables histopatológicas del reporte, y la información clínica mediante una entrevista telefónica suministrada por la paciente. Se analizaron los datos con medidas descriptivas de resumen. Resultados. Participaron 21 de 65 pacientes con diagnóstico de endometriosis de la pared abdominal. La media de edad al momento del diagnóstico fue de 35,3 años (desviación estándar, DE=8), el 71,4 % tenía el antecedente de cesárea y, el 38,1 %, el de endometriosis pélvica. El 95,2 % de las pacientes manifestaron dolor, de las cuales el 50 % lo percibió como constante con agudización cíclica y, el 40 %, como cíclico; además, el 90,5 % manifestó sensación de masa. La mediana del tiempo desde la aparición de la lesión hasta el diagnóstico, fue de 24 meses (RIQ=6-60). Solo en cuatro pacientes se hizo el diagnóstico prequirúrgico. El tratamiento fue quirúrgico en todas las pacientes y ocho (38,1 %) presentaron recidiva.Conclusiones. La endometriosis de la pared abdominal usualmente se manifiesta como masas dolorosas aso-ciadas con cicatrices quirúrgicas previas, generalmente de origen ginecológico y los síntomas empeoran con la menstruación. Es usual que su diagnóstico sea tardío y pocas veces se hace antes del estudio histopatológico. El tratamiento de elección es la resección quirúrgica, aunque no es despreciable el porcentaje de recidivas (AU)


Introduction: Abdominal wall endometriosis is defined by the presence of endometrial tissue in any of the layers that compose the abdominal wall. It has a low incidence and is characterized by a late diagnosis. Materials and Methods: A descriptive, ambispective study that included patients with abdominal wall endometriosis whose pathological analysis was performed in a diagnostic center in Medellín between 2010 and 2014. Histopathological variables of the report were identified, and clinical information was provided by the patient by a phone interview. They were analyzed with descriptive summary measures.Results: 21 patients with abdominal wall endometriosis of 65 identified participated. The mean age at diagnosis was 35.3 years ± 8, 71.4% had a prior caesarean section and 38.1% had pelvic endometriosis. 95.2% manifested pain, among them, 50% was perceived as constant with cyclical exacerbation, 40% cyclical; 90.5% manifested mass sensation. The median from the onset of the lesion to the diagnosis was 24 months (IQR 6-60). Only four patients had pre-surgical. The treatment was surgical in all patients and eight (38.1%) had recurrence.Conclusions: Abdominal wall endometriosis usually manifests through painful masses associated with previous surgical scars usually of gynecological origin and whose symptoms worsen with menstruation. Its diagnosis is usually late and it is rarely reached before the histopathological study. Management of choice is surgical resection, however, its percentage of recurrence is not negligible (AU)


Assuntos
Humanos , Endometriose , Procedimentos Cirúrgicos Operatórios , Umbigo , Parede Abdominal
10.
An. bras. dermatol ; 93(6): 884-886, Nov.-Dec. 2018. graf
Artigo em Inglês | LILACS | ID: biblio-973617

RESUMO

Abstract: Cutaneous metastases from internal malignant neoplasms are a rare event and a late clinical finding that is associated with disseminated disease and a poor prognosis. Skin metastases from colon tumors occur in only 4% of cases of metastatic colorectal cancer. They are most often located on the abdominal skin. We report a case of 54-year-old male patient with a cutaneous metastatic focus on the lower abdomen as the initial presenting symptom of an underlying colon cancer.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/secundário , Adenocarcinoma/secundário , Neoplasias do Colo/patologia , Biópsia , Imuno-Histoquímica , Evolução Fatal , Parede Abdominal
11.
Acta cir. bras ; 33(9): 792-798, Sept. 2018. graf
Artigo em Inglês | LILACS | ID: biblio-973505

RESUMO

Abstract Purpose: To evaluate the fibrosis induced by four different meshes: Marlex®, Parietex Composite®, Vicryl® and Ultrapro®. Methods: Histological cutouts of abdominal wall were analyzed with polarized light 28 days after the meshes implants and colorized by picrosirius to identify the intensity of collagen types I and III, and their maturation index. Results: When the four groups were compared, the total collagen area analyzed was bigger in groups A and D, with no difference between them. The collagen type I density was bigger in group A, with an average of 9.62 ± 1.0, and smaller in group C, with an average of 3.86 ± 0.59. The collagen type III density was similar in groups A, B and C, and bigger in group D. The collagen maturation index was different in each of the four groups, bigger in group A with 0.87, group B with 0.66, group D with 0.57 and group C with 0.33 (p = 0.0000). Conclusion: The most prominent fibrosis promotion in the given meshes was found on Marlex® (polypropylene mesh) and the Parietex Composite® (non-biodegradable polyester); the collagen maturation index was higher in the Marlex® mesh, followed by Ultrapro®, Parietex Composite® and Vicryl® meshes.


Assuntos
Animais , Poliésteres/efeitos adversos , Poliglactina 910/efeitos adversos , Polipropilenos/efeitos adversos , Telas Cirúrgicas/efeitos adversos , Colágeno/efeitos adversos , Parede Abdominal/patologia , Poliésteres/administração & dosagem , Poliglactina 910/administração & dosagem , Polipropilenos/administração & dosagem , Fatores de Tempo , Fibrose/etiologia , Fibrose/patologia , Teste de Materiais , Aderências Teciduais/etiologia , Aderências Teciduais/patologia , Colágeno/administração & dosagem , Modelos Animais , Parede Abdominal/cirurgia
12.
Acta cir. bras ; 33(9): 762-774, Sept. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-973507

RESUMO

Abstract Purpose: To compare wound healing performed with cold blade (CSB) and ultrasonic harmonic scalpel (UHS) in the abdominal aponeurosis of rats. Methods: Eighty Wistar rats divided into two groups and underwent midline incision in the linea alba with cold blade and harmonic ultrasonic scalpel. Analysis were performed in subgroups of 10 animals after 3, 7, 14 and 21 days. Macroscopically was observed the presence of hematoma, infection, wound dehiscence, fistula and adherences. Microscopically were used collagen and immunohistochemical staining methods. Results: Macroscopic, complications showed no statistical difference. Immunohistochemical analysis for MMP-9 was more intense in UHS group (p<0.05). TGF β presented its lower expression in UHS group at 14 and 21 days, with no statistical difference at 3 and 7 days (p<0.05). α-AML expression appeared higher in UHS group after 14 days and remained similar in others (p<0.05). Collagen deposition had no change in type I, and increased in type III in UHS; at 7th day the deposition was higher in CSB group; at 14th was similar in both groups (p<0.001). Conclusion: UHS compared to the CSB has higher lesion area at the time of the incision; as well as it led to the delay of regeneration and scar maturation process.


Assuntos
Animais , Masculino , Ratos , Cicatrização/fisiologia , Colágeno/fisiologia , Parede Abdominal/cirurgia , Ferida Cirúrgica/patologia , Instrumentos Cirúrgicos , Imuno-Histoquímica , Ratos Wistar , Modelos Animais , Parede Abdominal/patologia , Análise Serial de Tecidos , Procedimentos Cirúrgicos Ultrassônicos , Ferida Cirúrgica/fisiopatologia
13.
Acta cir. bras ; 33(5): 454-461, May 2018. graf
Artigo em Inglês | LILACS | ID: biblio-949348

RESUMO

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.


Assuntos
Animais , Masculino , Ratos , Próteses e Implantes , Telas Cirúrgicas , Cicatrização/fisiologia , Parede Abdominal/cirurgia , Herniorrafia/efeitos adversos , Hérnia Ventral/cirurgia , Materiais Biocompatíveis , Aderências Teciduais/fisiopatologia , Músculos Abdominais/transplante
14.
Rev. cuba. cir ; 57(1): 72-77, ene.-mar. 2018. ilus
Artigo em Espanhol | LILACS | ID: biblio-960349

RESUMO

Los defectos de pared abdominal son un desafío para los cirujanos plásticos. El sarcoma de partes blandas es muy recidivante y hay que hacer amplias exéresis con margen oncológico y como consecuencia quedan amplias zonas por reconstruir. El colgajo transverso de recto abdominal es una opción reconstructiva de esta región con buenos resultados estéticos y funcionales. El objetivo del trabajo es mostrar los resultados de la reconstrucción inmediata de la pared abdominal luego de una amplia exéresis oncológica. Se presenta una paciente femenina, mestiza, de 60 años, con diagnóstico de sarcoma de partes blandas, que abarcaba todo el hemiabdomen ínfero izquierdo hasta límites del reborde costal izquierdo, comprometía aponeurosis, el músculo recto izquierdo, y pequeña parte del peritoneo que se reparó. Se decidió una amplia exéresis y se planificó la reconstrucción con un colgajo miocutáneo transverso de recto del abdomen. Se utilizaron mallas de polipropileno. Se logró la reconstrucción inmediata del defecto oncológico con buenos resultados estéticos y funcionales(AU)


Abdominal wall defects are a challenge for plastic surgeons. Soft-tissue sarcoma is very recurrent and it is necessary to make extensive exeresis with oncological margin and, as a result, there are large areas to be reconstructed. The transverse rectus abdominis flap is a reconstructive option for this region and with good aesthetic and functional results. The objective of the work is to show the results of the immediate reconstruction of the abdominal wall after an extensive oncological exeresis. We present the case of a female patient, mestiza, aged 60 years, with a diagnosis of soft-tissue sarcoma, which encompassed all the left inferior hemiabdomen to the left costal margin limits, compromised the aponeurosis, the left rectus muscle, and a small part of the peritoneum that was repaired. A wide exeresis was decided and the reconstruction was planned with a transverse rectus abdominis myocutaneous flap. Polypropylene meshes were used. The immediate reconstruction of the oncological defect was achieved with good aesthetic and functional results(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias de Tecidos Moles/diagnóstico , Telas Cirúrgicas/estatística & dados numéricos , Parede Abdominal/cirurgia , Retalho Miocutâneo/efeitos adversos
15.
Rev. cuba. invest. bioméd ; 37(1): 32-46, ene.-mar. 2018. tab
Artigo em Espanhol | LILACS | ID: biblio-991089

RESUMO

Fundamento: el cáncer gástrico constituye la segunda causa de muerte por cáncer en el mundo. Objetivo: validar el ultrasonido hidrogástrico en el diagnóstico del cáncer gástrico avanzado. Métodos: el ultrasonido hidrogástrico fue realizado por dos observadores independientes a 100 pacientes, 30 con cáncer gástrico avanzado, confirmados por endoscopia y biopsia; y 70 pacientes sin cáncer gástrico. Resultados: por regresión logística se determinó que el engrosamiento de la pared gástrica fue el único signo con valor como predictor de la presencia de CG. La sensibilidad, especificidad, certeza, valor predictivo positivo y valor predictivo negativo del ultrasonido hidrogástrico fueron de 83,3 por ciento; 90, por ciento; 88,0 por ciento; 78,1 por ciento y 92,6 por ciento respectivamente. Conclusiones: el ultrasonido hidrogástrico es una modalidad diagnostica útil en el diagnóstico del cáncer gástrico avanzado(AU)


Background: gastric cancer still remains one of the most common malignancies worldwide. Objective: to validate the Conventional hydrogastric ultrasound in the diagnosis of the advanced gastric cancer. Methods: the hydrogastric ultrasound was carried out by two independent observers 30 with cancer patients with advanced gastric cancer, confirmed by endoscopy and biopsy; and 70 patients without gastric cancer. Results: for logistical regression it was determined that the thickening of the gastric wall was the only sign with value like predictor of the presence of advancedgastric cancer. The sensibility, specificity, certainty, value positive predictive and value negative predictive of the hydrogastric ultrasound in the diagnosis of gastric cancer were of 83,3 percent; 90;0 percent; 88,0 percent; 78,1 percent y 92,6 percent respectively. Conclusions: the Hydrogastric ultrasound is a diagnostic modality useful in the diagnosis of the advanced gastric cancer(AU)


Assuntos
Humanos , Masculino , Feminino , Neoplasias Gástricas/diagnóstico por imagem , Ultrassom/métodos , Parede Abdominal/diagnóstico por imagem , Estudo de Validação
16.
Rev. bras. cir. plást ; 33(1): 56-63, jan.-mar. 2018. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-883638

RESUMO

Introdução: Os pacientes com defeitos de parede abdominal chegam ao consultório do cirurgião plástico em situações muitas vezes complexas, necessitando de abordagem cirúrgica avançada. Métodos: Estudo primário, retrospectivo e descritivo de pacientes submetidos a procedimentos cirúrgicos de reconstrução de parede abdominal pelo Serviço de Cirurgia Plástica do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE). Resultados: Foram revisados e incluídos os prontuários de 18 pacientes, 15 (83,3%) do sexo feminino e 3 (16,7%) do masculino, com idade variando de 16 a 79 anos (média de 41 anos). Dezessete pacientes possuíam histórico de cirurgia prévia (94,4%), sendo a cesárea presente em 8 dos casos (44,4%), seguida de cirurgia oncológica com 6 (33,3%), cirurgia do trauma com 2 (11,1%) e bariátrica com 2 (11,1%). Em relação à etiologia do defeito, 8 (44,4%) eram decorrentes de fasciite necrosante, 4 (22,2%) de hérnia incisional, 2 (11,1%) por trauma, 2 (11,1%) por infecção de ferida operatória e 2 (11,1%) por neoplasia de parede abdominal, sendo somente um (5,5%) paciente com defeito de espessura total. A técnica cirúrgica de separação dos componentes foi realizada em 7 dos casos (38,9%), seguida de retalho de avanço simples em 6 (33,3%), fechamento com tela associado à abdominoplastia em 3 (16,7%), e expansor tecidual em 2 (11,1%). Quanto às complicações, houve 4 casos (22,2%). Conclusões: Defeitos de parede abdominal são casos desafiadores para o cirurgião plástico, seu tratamento se mostra árduo, porém com resultados satisfatórios mesmo nos casos mais severos.


Introduction: Patients with abdominal wall defects present challenging complications that require the use of advanced surgical approaches. Methods: This primary, retrospective, and descriptive study evaluated patients who underwent abdominal wall reconstruction at the Plastic Surgery Service of the Clinics Hospital of the Federal University of Pernambuco. Results: The medical records of 18 patients were reviewed, including 15 women (83.3%) and 3 men (16.7%), with a mean age of 41 years (range, 16-79 years). Seventeen patients (94.4%) had a history of previous surgery. The causes of abdominal injury were cesarean section in eight cases (44.4%), oncologic surgery in six (33.3%), trauma surgery in two (11.1%), and bariatric surgery in two (11.1%). The etiology of the defect was necrotizing fasciitis in eight cases (44.4%), incisional hernia in four (22.2%), trauma in two (11.1%), surgical wound dehiscence in two (11.1%), abdominal wall neoplasia in two (11.1%), and total thickness defect in one (5.5%). The surgical interventions included the component separation technique in seven cases (38.9%), simple VY advancement flap in six (33.3%), closure with abdominoplasty in three (16.7%), and tissue expander in two (11.1%). Four patients (22.2%) presented complications. Conclusions: Abdominal wall defects are challenging cases for plastic surgeons, as their treatment is difficult, but the results are satisfactory even in the most severe cases.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , História do Século XXI , Procedimentos Cirúrgicos Menores , Registros Médicos , Estudos Retrospectivos , Fasciite Necrosante , Procedimentos Cirúrgicos Reconstrutivos , Parede Abdominal , Hérnia Abdominal , Abdome , Fáscia , Hérnia Ventral , Procedimentos Cirúrgicos Menores/efeitos adversos , Procedimentos Cirúrgicos Menores/métodos , Registros Médicos/estatística & dados numéricos , Fasciite Necrosante/cirurgia , Fasciite Necrosante/complicações , Procedimentos Cirúrgicos Reconstrutivos/instrumentação , Procedimentos Cirúrgicos Reconstrutivos/métodos , Parede Abdominal/anormalidades , Parede Abdominal/cirurgia , Hérnia Abdominal/cirurgia , Hérnia Abdominal/complicações , Fáscia/lesões , Abdome/cirurgia , Hérnia Ventral/cirurgia , Hérnia Ventral/complicações
17.
An. bras. dermatol ; 93(1): 111-113, Jan.-Feb. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-887138

RESUMO

Abstract: Primary cutaneous amyloidosis is limited to the skin without involving any other tissue. Nodular amyloidosis is rare, and atrophic nodular cutaneous amyloidosis is even rarer. We describe the fourth case of atrophic nodular cutaneous amyloidosis by searching PubMed databases. A 52-year-old female presented to our hospital with a 2-year history of orange papules and nodules without subjective symptom on her right abdomen. Review of systems was negative. Atrophic nodular amyloidosis may progress to primary systemic disease in up to 7% of cases. Because our patient had no systemic involvement, she was diagnosed with atrophic nodular cutaneous amyloidosis based on characteristic symptoms and histopathologic examination. Routine follow-up for this patient is necessary to detect any potential disease progression.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Dermatopatias/patologia , Amiloidose/patologia , Atrofia/patologia , Dermatopatias/diagnóstico , Parede Abdominal/patologia , Amiloidose/diagnóstico
18.
Artigo em Espanhol | LILACS | ID: biblio-1000254

RESUMO

Los defectos de la pared abdominal son un grupo de malformaciones congénitas poco comunes que presentan alteraciones heterogéneas y comparten una característica en común, que es la herniación o evisceración de uno o más órganos de la cavidad abdominal, debido a un defecto en la formación de la pared abdominal. Existen diversas patologías entre las que se encuentran extrofia de vejiga y extrofia de cloaca y la Pentalogía de Cantrell, sin embargo, las más frecuentes son la gastrosquisis y el onfalocele; en esta revisión se discutirá el manejo y el protocolo de seguimiento de estas dos patologías.


Abdominal wall defects are a group of rare congenital malformations, which represent heterogeneous alterations and share an uncommon characteristic, which is the herniation or evisceration of one or more organs of the abdominal cavity, due to a defect in the formation of the abdominal wall. There are several pathologies among which are bladder exstrophy and cloacal exstrophy and the Pentalogy of Cantrell, however, the most frequent are gastroschisis and omphalocele. In this article we will review and discuss the management and follow-up protocol of these two pathologies


Assuntos
Humanos , Diagnóstico Pré-Natal , Anormalidades Congênitas , Gastrosquise , Parede Abdominal , Hérnia Umbilical
19.
Rev. chil. cir ; 70(2): 104-111, 2018. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-959357

RESUMO

Resumen Objetivo: El objetivo de este estudio fue evaluar el papel de los mastocitos en la respuesta inflamatoria posoperatoria tras el implante de mallas protésicas para la reparación de defectos de la pared abdominal en biomodelos rata Wistar. Materiales y Métodos: Se fabricó una malla de fibroma entretejiendo sus hilos. Se utilizaron 25 ratas Wistar macho adultas, a las cuales se les creó un defecto quirúrgico de 30 × 20 mm en la pared abdominal anterior. Este defecto anatómico fue posteriormente reparado con uno de los dos tipos de mallas previamente esterilizadas, las cuales fueron la malla de fibroína, y la malla comercial ultrapo monocryl prolene composite (Johnson & Johnson-Ethicon). A los 28 días después del procedimiento quirúrgico se sacrificaron los biomodelos y se extrajeron las muestras que posteriormente fueron tratadas con técnicas histoquímicas para su análisis histológico. Resultados: El estudio reportó adherencia a omento en los dos tipos de malla utilizadas, sin embargo, la malla comercial mostró adherencias de amplio espesor a colon, intestino delgado e hígado, incluyendo también al omento menor. Se encontró que la malla comercial presentaba mayor cantidad de mastocitos en las regiones estudiadas (dermis, perimisio, y la serosa visceral). Discusión: Estudios refieren que los mastocitos y sus productos como la histamina, la serotonina, entre otras juegan un papel clave en el control de la inflamación local, la cicatrización de heridas, adherencias y las reacciones a cuerpos extraños in vivo. Conclusión: Con base en la literatura consultada se puede concluir que el presente estudio es vanguardista en lo que respecta al posible papel que juegan los mastocitos en el proceso de reparación de defectos anatómicos de la pared abdominal.


Objective: The objective of this study was to evalúate the role of mast cells in the postoperative inflammatory response after implantation of prosthetic mesh to repair abdominal wall defects in Wistar rat. Materials and Methods: An abdominal wall defect (30 × 20 mm) was created in the anterior abdominal wall of 25 adult male Wistar rats. The anatomical defect was then repaired with one of the two type's meshes. Fibroin and monocryl ultrapo prolene meshes. Fibroin meshes were manufactured by weaving its threads, the polypropylene mesh was bought to Johnson & Johnson-Ethicon. After 28 days of implantation Wistar rats were sacrificed and the mesh with abdominal tissue was extracted. Subsequently the samples were treated with histochemical techniques for histological analysis. Results: The study reported adherence to omentum in both types of meshes used, however, the polypropylene mesh showed widely adhesions to colon, slight to intestine and liver, also in a very lower amount, adhesions to omentum. It was found that mast cells were presented in all the studied regions for the polypropylene mesh (dermis, perimysium, and visceral serosa). Discussion: Studies indicate that mast cells and their products such as histamine, seroto- nin, and others play a key role in controlling local inflammation, wound healing, adhesions, and reactions to foreign bodies in vivo. Conclusion: We can conclude that this study is a good step to show the possible role of mast cells in the abdominal wall repair process.


Assuntos
Animais , Masculino , Ratos , Telas Cirúrgicas , Parede Abdominal/cirurgia , Mastócitos/metabolismo , Histamina/metabolismo , Serotonina/metabolismo , Ratos Wistar , Modelos Animais , Inflamação
20.
Rev. méd. hondur ; 85(3/4): 99-102, jul.-dic. 2017. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-970085

RESUMO

Introducción: Gastrosquisis es una malformación congénita caracterizada por una herniación visceral a través de un defecto de la pared abdominal. Comúnmente se localiza a la derecha del cordón umbilical con protrusión visceral principalmente de íleon distal, estómago e hígado; y no se encuentra cubierto por una membrana protectora. La prevalencia de gastrosquisis es de 0.5-7 por cada 10,000 recién nacidos vivos, con un promedio de 1/2700 nacimientos a nivel mundial. La mayor prevalencia de casos con gastrosquisis ocurre en madres jóvenes <20 años y un mal estado nutricional. Descripción del caso: Madre de 18 años, primigesta, con antecedentes gineco-obstétricos de pobre cuidado prenatal. Se realizó dos ultrasonidos en hospital público durante el embarazo, los cuales no reportaron alteraciones. A las 38 semanas un día nace por cesárea, producto con diagnóstico de gastrosquisis. Tres horas después, se recibe en Hospital Escuela Universitario donde se le colocó un Silo plástico e ingresó a la unidad de cuidados inter-medios. A los 23 días de vida se hizo el cierre de la pared abdominal. Actualmente, se encuentra estable, con motilidad gastrointestinal reducida, drenaje de 50-60 mL diarios por sonda orogástrica, en ayuno y nutrición parenteral. Discusión: El reconocimiento temprano de esta patología es esencial para prevenir complicaciones mortales. Permite considerar diferentes abordajes terapéutico-quirúrgicos para alcanzar un mayor porcentaje de sobrevida, especialmente en zonas donde la incidencia es alta como en nuestro medio con una media de 17 casos anuales y una sobrevida de apenas 47%


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Anormalidades Congênitas , Gastrosquise/diagnóstico , Parede Abdominal/anormalidades
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