Enxerto em ilha para tratamento de lesão dermonecrótica em um cão atribuída a aracnidismo por Loxosceles / Island graft for the treatment of a dermonecrotic lesion in a dog attributed to loxosceles arachnidism

A picada da aranha do gênero Loxosceles, popularmente conhecidas como "aranha marrom", pode levar a uma extensa lesão dermonecrótica de difícil cicatrização e fechamento, sendo um desafio o seu tratamento. Os enxertos cutâneos são segmentos livres e independentes de pele e epiderme transferidos para um local receptor distante, normalmente utilizados para perda tecidual extensa de membros e grandes falhas dermatológicas no tronco. No presente trabalho relata-se o caso de um canino, sem raça definida, macho, 4 anos de idade, com 13,3 kg, apresentando uma lesão extensa de pele com evolução para necrose dérmica e perda substancial de tecido cutâneo, sendo associada a picada por Loxosceles spp, com base em dados da anamnese, sinais clínicos e evolução da lesão, além de ser descartado outras causas de dermonecrose como aplicação de medicamentos no subcutâneo, lesão térmica ou química. O diagnóstico de loxoscelismo raramente é baseado na identificação da aranha, tendo em vista que os tutores normalmente não observam o momento do acidente uma vez que a picada é indolor. Foi utilizado técnica de cirurgia reconstrutiva por meio de enxertos em ilha devido à extensa lesão tecidual sem possibilidade de fechamento primário com justaposição de bordas. A evolução clínica foi positiva e o animal apresentou recuperação completa após 66 dias de tratamento, sendo necessários dois procedimentos cirúrgicos de desbridamento de tecido necrótico e aproximação de bordas, associado a curativos frequentes utilizando membrana de alginato e hidrocoloide em momentos diferentes das fases de cicatrização, a fim de estimular a granulação do tecido e evitar a infecção do local. Esses cuidados foram tomados para assegurar que a região estivesse apta a receber a enxertia de pele como procedimento cirúrgico final e que a cicatrização ocorresse de forma mais rápida do que por segunda intenção, reconhecidamente lenta quando ocorre de forma espontânea, levando o paciente a maior tempo de desconforto, com alto risco de tração tecidual e contaminação local. No presente relato a cirurgia reconstrutiva se mostrou uma boa alternativa no tratamento de ferida extensa e com isso espera-se contribuir para a divulgação do uso das diversas técnicas reconstrutivas visando acelerar o processo de cicatrização e possibilitar um bom resultado final para os pacientes.

The bite of the spider of the genus Loxosceles, popularly known as the "brown spider", can lead to an extensive dermonecrotic lesion that is difficult to heal and close, making its treatment a challenge. Skin grafts are free, independent segments of skin and epidermis transferred to a distant recipient site, typically used for extensive tissue loss from limbs and large dermatological defects on the trunk. This paper reports the case of a canine, mixed breed, male, 4 years old, weighing 13.3 kg, presenting with an extensive skin lesion that progressed to dermal necrosis and substantial loss of skin tissue, associated with bite by Loxosceles spp, based on data from the anamnesis, clinical signs and evolution of the lesion, in addition to ruling out other causes of dermonecrosis such as application of subcutaneous drugs, thermal or chemical injury. The diagnosis of loxoscelism is rarely based on the identification of the spider, considering that owners usually do not observe the moment of the accident, since the bite is painless. A reconstructive surgery technique was used using island grafts due to extensive tissue damage without the possibility of primary closure with juxtaposition of edges. The clinical evolution was positive and the animal presented complete recovery after 66 days of treatment, requiring two surgical procedures for debridement of necrotic tissue and approximation of edges, associated with frequent dressings using alginate membrane and hydrocolloid at different times of the healing phases, in order to stimulate tissue granulation and avoid local infection to be able to receive skin grafting as a final surgical procedure, favoring faster healing of the lesion, since healing by second intention takes longer to occur than spontaneously, leading the patient to greater discomfort with a high risk of tissue traction and local contamination when care is not performed properly. In this case, reconstructive surgery proved to be a good alternative in the treatment of extensive wounds.

Autologous platelet-rich plasma action on skin autografts in horses / Ação do plasma rico em plaquetas autólogo em autoenxertos de pele em equinos

This study evaluated the action of autologous platelet-rich plasma (PRP) on cutaneous wounds, containing skin autografts, in the gluteal region of horses. Seven healthy horses were used. Two 6 x 6cm cutaneous wounds were produced on each side of the gluteal region. Eight days after wound induction, grafts were performed with skin fragments harvested from the neck, as well as the application of PRP, prepared by double-centrifugation protocol. Wounds with autografts on the left side received PRP (group T), and those with autografts on the right side did not receive treatment (group C). Macroscopic and microscopic evaluations were performed, considering the integration of autografts and retraction of wound edges, as well as neovascularization, inflammatory infiltrate, young fibroblasts, collagenization, reepithelization and autografts integration. There was no difference between the groups (P > 0.05) in relation to most macroscopic and microscopic variables. However, neovascularization was significantly greater (p = 0.0191) in group T, on the 14th day after grafting. It is concluded that PRP favors the process of skin repair with autografts in horses, since it increases the neovascularization in the initial phase of wound healing. Furthermore, the PRP seems to positively influence the integration of the skin autografts and the retraction of the wound edges.

Este estudo avaliou a ação do plasma rico em plaquetas (PRP) autólogo em feridas cutâneas, contendo autoenxertos de pele em equinos. Foram utilizados sete equinos hígidos, nos quais foram produzidas duas feridas cutâneas de 6 x 6cm, em cada um dos lados da região glútea. Oito dias após a indução das feridas, foram realizados enxertos com fragmentos de pele colhidos do pescoço, assim como a aplicação do PRP, preparado através de protocolo de dupla centrifugação. As feridas com autoenxertos do lado esquerdo receberam PRP (grupo T), e as com autoenxertos do lado direito não receberam tratamento (grupo C). Foram realizadas avaliações macroscópica e microscópica, considerando as variáveis integração dos autoenxertos e retração das bordas da ferida, além de neovascularização, infiltrado inflamatório, fibroblastos jovens, colagenização, reepitelização e integração dos autoenxertos. Não houve diferença entre os grupos (p > 0,05) em relação à maioria das variáveis macroscópicas e microscópicas. Contudo, a neovascularização foi significativamente maior (P = 0,0191) no grupo T, no 14º dia após a realização da enxertia. Conclui-se que o PRP favorece o processo de reparo da pele com autoenxertos em equinos, já que aumenta a neovascularização na fase inicial da cicatrização da ferida. Ainda, o PRP parece influenciar positivamente a integração dos autoenxertos de pele e a retração das bordas da ferida.

Autologous platelet-rich plasma action on skin autografts in horses / Ação do plasma rico em plaquetas autólogo em autoenxertos de pele em equinos

This study evaluated the action of autologous platelet-rich plasma (PRP) on cutaneous wounds, containing skin autografts, in the gluteal region of horses. Seven healthy horses were used. Two 6 x 6cm cutaneous wounds were produced on each side of the gluteal region. Eight days after wound induction, grafts were performed with skin fragments harvested from the neck, as well as the application of PRP, prepared by double-centrifugation protocol. Wounds with autografts on the left side received PRP (group T), and those with autografts on the right side did not receive treatment (group C). Macroscopic and microscopic evaluations were performed, considering the integration of autografts and retraction of wound edges, as well as neovascularization, inflammatory infiltrate, young fibroblasts, collagenization, reepithelization and autografts integration. There was no difference between the groups (P > 0.05) in relation to most macroscopic and microscopic variables. However, neovascularization was significantly greater (p = 0.0191) in group T, on the 14th day after grafting. It is concluded that PRP favors the process of skin repair with autografts in horses, since it increases the neovascularization in the initial phase of wound healing. Furthermore, the PRP seems to positively influence the integration of the skin autografts and the retraction of the wound edges.(AU)

Este estudo avaliou a ação do plasma rico em plaquetas (PRP) autólogo em feridas cutâneas, contendo autoenxertos de pele em equinos. Foram utilizados sete equinos hígidos, nos quais foram produzidas duas feridas cutâneas de 6 x 6cm, em cada um dos lados da região glútea. Oito dias após a indução das feridas, foram realizados enxertos com fragmentos de pele colhidos do pescoço, assim como a aplicação do PRP, preparado através de protocolo de dupla centrifugação. As feridas com autoenxertos do lado esquerdo receberam PRP (grupo T), e as com autoenxertos do lado direito não receberam tratamento (grupo C). Foram realizadas avaliações macroscópica e microscópica, considerando as variáveis integração dos autoenxertos e retração das bordas da ferida, além de neovascularização, infiltrado inflamatório, fibroblastos jovens, colagenização, reepitelização e integração dos autoenxertos. Não houve diferença entre os grupos (p > 0,05) em relação à maioria das variáveis macroscópicas e microscópicas. Contudo, a neovascularização foi significativamente maior (P = 0,0191) no grupo T, no 14º dia após a realização da enxertia. Conclui-se que o PRP favorece o processo de reparo da pele com autoenxertos em equinos, já que aumenta a neovascularização na fase inicial da cicatrização da ferida. Ainda, o PRP parece influenciar positivamente a integração dos autoenxertos de pele e a retração das bordas da ferida.(AU)

Use of the angularis oris axial pattern buccal flap for the correction of facial defects in six dogs

Background: Reconstructive surgery is an important area of veterinary surgery because it allows the reconstruction of large cutaneous defects in areas where a primary approach is not possible. Axial patterns flaps are composed by one direct cutaneous artery and vein, leading to a better blood supply with a good survival outcome. The angularis oris axial pattern buccal flap was introduced for correction of facial defects, but its versatility is not really explored in the existing literature. This article reports the use and complications of the angularis oris axial pattern buccal flap in six dogs, to treat defects in mandibular, temporal or labial regions. Cases: Five mixed breed dogs and one Labrador, with age between 4 and 9-year-old were submitted for surgery and the angularis oris axial pattern buccal flap was used to close the different defects. Causes of defect included a lesion caused by myiasis in three of the dogs, and tumoral removal in the other three, where two were mast cell tumors and one a keratinizing basal cell carcinoma. The regions affected included rostral mandible with oral mucosa, intermandibular region, temporal region and upper lip. Before flap confection the tissue was cleaned, resected and prepared properly, according to each cause of lesion. The flap was made with two parallel incisions, which center was usually the labial commissure, with the dorsal limits at the ventral aspect of the zygomatic arch, and the ventral incision on the ventral aspect of the mandibular ramus. Caudal extension was based on the length needed for surgical closure, but stained between the vertical auditory canal or up to atlas wing. Suture size and pattern depend the region and patient size. Patients were observed closely for any complication in the surgical site. From the six dogs presented here, five got some complications in the surgical site, including: lymphedema (2), suture dehiscence (4) and hematoma (1); however...(AU)

Evaluation of platelet-rich plasma gel as an angiogenesis-inducing agent in canine advancement skin flaps / Avaliação do gel de plasma rico em plaquetas como agente indutor da angiogênese em flapes cutâneos de avanço em cães

This work aimed to evaluate the effect of platelet-rich plasma (PRP) on advancement skin flaps in dogs regarding improvement of vascularization, with focus on increasing its viable area, since there are reports that it is a potential angiogenesis stimulator. The experimental group was composed of eight adult bitches, in which two advancement skin flaps were made in the ventral abdominal region. No product was applied in the control flap (CF), while PRP was used in the contralateral flap, called treated flap (TF). The areas were clinically evaluated every two days until the 7th postoperative day regarding skin color and presence of necrosis. At 10 days, both flaps were removed and submitted to histological examination and blood vessel morphometry. The vessels counted in each group were statistically analyzed by the F-test at 1% probability. Results showed no significant difference in macroscopic changes in the wound, or CF and TF vascularization, thus suggesting that PRP gel did not improve advancement skin flap angiogenesis in bitches under the experimental conditions in which this research was developed.(AU)

Objetivou-se com o presente artigo avaliar a ação angiogênica do gel de plasma rico em plaquetas (PRP) em flapes cutâneos de avanço em animais da espécie canina, visando aumentar a viabilidade da pele após o procedimento, uma vez que existem relatos de que o produto é um potente estimulador da angiogênese. O grupo experimental foi composto por oito cadelas adultas, onde foram confeccionados dois flapes de avanço (de padrão subdérmico) na região abdominal ventral. Em um dos flapes, considerado controle (FC) não foi aplicado nenhum produto, enquanto que no flape contralateral, denominado tratado (FT), foi usado o gel de PRP. As áreas foram macroscopicamente avaliadas a cada dois dias até o 7º dia de pós-operatório em relação à coloração da pele e presença de área de necrose, e com 10 dias ambos os flapes foram coletados por biópsia e submetidos ao exame histológico e morfometria dos vasos sanguíneos. Os vasos contados em cada grupo foram estatisticamente analisados pelo teste de F ao nível de 1% de probabilidades. Os resultados demonstraram que não houve diferença significativa nas alterações macroscópicas das feridas e na morfometria vascular dos FC e FT, sugerindo dessa maneira que dentro das condições experimentais nas quais a pesquisa foi executada, que o gel de PRP não incrementou a angiogênese de flapes de avanço em cadelas.(AU)

Utilização da pele de tilápia-do-Nilo (Oreochromis niloticus) como xenoenxerto em um equino com ferimento traumático / Treatment of a traumatic equine wound using Nile tilapia (Oreochromis niloticus) skin as a xenograft

Background: Wounds are disruptions of the normal continuity of anatomic structures, generally due to local trauma. Theyare extremely prevalent in animals, especially horses, and a common reason for seeking veterinary attention. Their management aims to restore the function and integrity of the affected area in the shortest possible time and cost, while providingsatisfactory cosmetic results. This task becomes challenging when working with horses, considering the contact betweenwounds and contaminated environment is common. Thus, the present study aims to report the case of a traumatic equinewound treated with Nile Tilapia Fish Skin (NTFS).Case: A male 27-year-old horse previously castrated, with no defined breed (NDB), and weighing 400 kg presented a 6.0 x5.5 cm superficial wound in the distal left anterior limb (LAL) due to skin laceration. The animal belonged to the cavalry ofthe Military Police of Ceará, a public institution in Fortaleza, Brazil. Although in excellent general health, with no previouscomorbidities or restriction of movement, the animal was removed from its role in equine-assisted therapy (EAT) until completewound healing, aiming adequate evaluation of the novel biomaterial via lower influence of external factors. After informedconsent from the owner was obtained, Nile Tilapia Fish Skin was applied to the lesion. The Ethics Committee on the use ofanimals of the Drug Research and Development Center of the Federal University of Ceará, Fortaleza, Brazil, approved the studyprotocol. Compliance with regulations on the ethical treatment of animals was performed. Nile Tilapia Fish Skin applicationfollowed a protocol similar to that established in human clinical studies. Initially, the horse was submitted to wound cleaningwith tap water and 2% chlorhexidine gluconate, with no requirement of pre-treatment surgical...(AU)

Evaluation of platelet-rich plasma gel as an angiogenesis-inducing agent in canine advancement skin flaps / Avaliação do gel de plasma rico em plaquetas como agente indutor da angiogênese em flapes cutâneos de avanço em cães

This work aimed to evaluate the effect of platelet-rich plasma (PRP) on advancement skin flaps in dogs regarding improvement of vascularization, with focus on increasing its viable area, since there are reports that it is a potential angiogenesis stimulator. The experimental group was composed of eight adult bitches, in which two advancement skin flaps were made in the ventral abdominal region. No product was applied in the control flap (CF), while PRP was used in the contralateral flap, called treated flap (TF). The areas were clinically evaluated every two days until the 7th postoperative day regarding skin color and presence of necrosis. At 10 days, both flaps were removed and submitted to histological examination and blood vessel morphometry. The vessels counted in each group were statistically analyzed by the F-test at 1% probability. Results showed no significant difference in macroscopic changes in the wound, or CF and TF vascularization, thus suggesting that PRP gel did not improve advancement skin flap angiogenesis in bitches under the experimental conditions in which this research was developed.(AU)

Objetivou-se com o presente artigo avaliar a ação angiogênica do gel de plasma rico em plaquetas (PRP) em flapes cutâneos de avanço em animais da espécie canina, visando aumentar a viabilidade da pele após o procedimento, uma vez que existem relatos de que o produto é um potente estimulador da angiogênese. O grupo experimental foi composto por oito cadelas adultas, onde foram confeccionados dois flapes de avanço (de padrão subdérmico) na região abdominal ventral. Em um dos flapes, considerado controle (FC) não foi aplicado nenhum produto, enquanto que no flape contralateral, denominado tratado (FT), foi usado o gel de PRP. As áreas foram macroscopicamente avaliadas a cada dois dias até o 7º dia de pós-operatório em relação à coloração da pele e presença de área de necrose, e com 10 dias ambos os flapes foram coletados por biópsia e submetidos ao exame histológico e morfometria dos vasos sanguíneos. Os vasos contados em cada grupo foram estatisticamente analisados pelo teste de F ao nível de 1% de probabilidades. Os resultados demonstraram que não houve diferença significativa nas alterações macroscópicas das feridas e na morfometria vascular dos FC e FT, sugerindo dessa maneira que dentro das condições experimentais nas quais a pesquisa foi executada, que o gel de PRP não incrementou a angiogênese de flapes de avanço em cadelas.(AU)

Male-to-Female Gender-Affirming Surgery Using Nile Tilapia Fish Skin as a Biocompatible Graft.

STUDY OBJECTIVE: Insufficient penile skin is common during vaginoplasty for male-to-female transition. This issue may be compensated by a scrotal skin flap, with the drawback of hair growth [1]. In recent studies, Nile tilapia skin was successfully used for the surgical management of Mayer-Rokitansky-Küster-Hauser syndrome [2,3] and vaginal stenosis [4,5]. This study aims to describe a novel technique for primary vaginoplasty in male-to-female gender-affirming surgery using Nile tilapia skin as a biocompatible graft to ensure adequate vaginal depth. DESIGN: Stepwise demonstration of the procedure with narrated video footage. SETTING: Transgender health clinic. INTERVENTIONS: A 29-year-old patient with gender dysphoria was referred to our office because of a desire for gender-affirming surgery. A physical examination revealed normal male genitalia with a 14-cm-long penis. Before surgery, approval from the institutional review board and written permission from the patient were obtained. After orchiectomy, penile disassembly, perineal dissection, and urethroplasty were performed, and a hollow Nile tilapia skin mold was prepared and sutured to the distal edge of the remaining penile skin. This structure was inverted, covering the newly created canal. The neocavity was then filled with a handmade inflatable vaginal mold, held in place by sutures in the labia majora. Finally, labiaplasty and clitoroplasty were conducted. After 7 days, the inflatable mold was removed, and the use of progressively larger dilators was initiated. After 3 weeks, a neovagina that was 16 cm long and able to accommodate the width of 2 fingers was detected. At that time, the Nile tilapia skin was completely reabsorbed into the neovaginal mucosa. There were no complications in the early postsurgical period. CONCLUSION: Nile tilapia skin, a safe, low-cost, and easy-to-use biocompatible material, may be an alternative option to scrotal skin grafts for neovaginal augmentation in primary vaginoplasty for male-to-female gender transition. However, further studies are needed to confirm this assertive.

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

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

Use of the angularis oris axial pattern buccal flap for the correction of facial defects in six dogs

Background: Reconstructive surgery is an important area of veterinary surgery because it allows the reconstruction of large cutaneous defects in areas where a primary approach is not possible. Axial patterns flaps are composed by one direct cutaneous artery and vein, leading to a better blood supply with a good survival outcome. The angularis oris axial pattern buccal flap was introduced for correction of facial defects, but its versatility is not really explored in the existing literature. This article reports the use and complications of the angularis oris axial pattern buccal flap in six dogs, to treat defects in mandibular, temporal or labial regions. Cases: Five mixed breed dogs and one Labrador, with age between 4 and 9-year-old were submitted for surgery and the angularis oris axial pattern buccal flap was used to close the different defects. Causes of defect included a lesion caused by myiasis in three of the dogs, and tumoral removal in the other three, where two were mast cell tumors and one a keratinizing basal cell carcinoma. The regions affected included rostral mandible with oral mucosa, intermandibular region, temporal region and upper lip. Before flap confection the tissue was cleaned, resected and prepared properly, according to each cause of lesion. The flap was made with two parallel incisions, which center was usually the labial commissure, with the dorsal limits at the ventral aspect of the zygomatic arch, and the ventral incision on the ventral aspect of the mandibular ramus. Caudal extension was based on the length needed for surgical closure, but stained between the vertical auditory canal or up to atlas wing. Suture size and pattern depend the region and patient size. Patients were observed closely for any complication in the surgical site. From the six dogs presented here, five got some complications in the surgical site, including: lymphedema (2), suture dehiscence (4) and hematoma (1); however...

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

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

Utilização da pele de tilápia-do-Nilo (Oreochromis niloticus) como xenoenxerto em um equino com ferimento traumático / Treatment of a traumatic equine wound using Nile tilapia (Oreochromis niloticus) skin as a xenograft

Background: Wounds are disruptions of the normal continuity of anatomic structures, generally due to local trauma. Theyare extremely prevalent in animals, especially horses, and a common reason for seeking veterinary attention. Their management aims to restore the function and integrity of the affected area in the shortest possible time and cost, while providingsatisfactory cosmetic results. This task becomes challenging when working with horses, considering the contact betweenwounds and contaminated environment is common. Thus, the present study aims to report the case of a traumatic equinewound treated with Nile Tilapia Fish Skin (NTFS).Case: A male 27-year-old horse previously castrated, with no defined breed (NDB), and weighing 400 kg presented a 6.0 x5.5 cm superficial wound in the distal left anterior limb (LAL) due to skin laceration. The animal belonged to the cavalry ofthe Military Police of Ceará, a public institution in Fortaleza, Brazil. Although in excellent general health, with no previouscomorbidities or restriction of movement, the animal was removed from its role in equine-assisted therapy (EAT) until completewound healing, aiming adequate evaluation of the novel biomaterial via lower influence of external factors. After informedconsent from the owner was obtained, Nile Tilapia Fish Skin was applied to the lesion. The Ethics Committee on the use ofanimals of the Drug Research and Development Center of the Federal University of Ceará, Fortaleza, Brazil, approved the studyprotocol. Compliance with regulations on the ethical treatment of animals was performed. Nile Tilapia Fish Skin applicationfollowed a protocol similar to that established in human clinical studies. Initially, the horse was submitted to wound cleaningwith tap water and 2% chlorhexidine gluconate, with no requirement of pre-treatment surgical...

Tilapia Skin for Neovaginoplasty after Sex Reassignment Surgery.

STUDY OBJECTIVE: To describe a new technique of neovaginoplasty after a female sex reassignment surgery using a tilapia skin as a graft. DESIGN: Stepwise demonstration of a new technique with narrated video of a single case report. The patient provided oral and written informed consent. Moreover, this video report is part of a multicenter, Investigational Review Board-approved study. SETTING: Women's university hospital in Campinas, Brazil. INTERVENTIONS: Neovaginoplasty technique using tilapia skin with the following key strategies: (1) corpus cavernosum removal, (2) vagina tunnel creation, (3) mold coating with tilapia skin, (4) mold fixation, and (5) postoperative care. The patient remained with the mold coated with tilapia skin for 5 days; after this time, the mold was removed, and the tissue graft was adhered and incorporated in the new vaginal canal. After 2 months, the tissue resembled a vaginal mucosa, and the vaginal length was 8 cm. The patient has not had intercourse yet. CONCLUSION: We introduce an alternative for low-morbidity neovaginoplasty based on the experience of plastic surgery in burned grafts. The procedure described offers an alternative option to develop an anatomic neovagina with tissue similar to mucosa tissue by a simple, low-morbidity minimally invasive procedure.

Graft of small patch of partial thickness in equine wound

Background: Cutaneous wounds in locomotor limbs represent one of the most frequent disorders in equine medicine. Wounds in equines are distinguished from those in other species by unique characteristics, including different healing rates among breeds, wound location and high propensity to formation of exuberant granulation tissue during the healing process. The wound healing process that cannot be sutured can be accelerated by the use of skin grafts, lowering the treatment cost. The objective of this report was to divulgate the success upon treatment of an extensive lacerated wound in the metatarsal region of a horse using autologous skin grafts.Case: A 3-year-old, female, American quarter horse weighting 450 kg was brought to veterinary hospital with lower limb injury. According to the owners report, the animal had one of its limbs stuck in a plain wire fence. A wound was observed in the metatarsal region during physical examination, the lesion caused an extensive skin laceration that showed the dorsal surface of the metatarsal bone and the digital extensor tendon. After injury assessment, wound debridement was carried out by surgery intervention followed by antisepsis and application of autologous plasma every two days as post-surgical care and wound preparation to receive the graft. Forty-five days after the first intervention, grafts were collected from the neck and implanted in the wound. The procedure achieved 70% of success. After approximately 75 days, transplantation was performed in other regions of the wound using the same technique. The duration of treatment at the Veterinary Hospital of the Universidade Paranaense (UNIPAR) was eight months, and then the animal returned home, where dressings were applied for two months to avoid the risk of contamination and until complete recovery.Discussion: The debridement of the wound and edges approximation were of great value in order to begin the process of wound granulation.[...](AU)

Graft of small patch of partial thickness in equine wound

Background: Cutaneous wounds in locomotor limbs represent one of the most frequent disorders in equine medicine. Wounds in equines are distinguished from those in other species by unique characteristics, including different healing rates among breeds, wound location and high propensity to formation of exuberant granulation tissue during the healing process. The wound healing process that cannot be sutured can be accelerated by the use of skin grafts, lowering the treatment cost. The objective of this report was to divulgate the success upon treatment of an extensive lacerated wound in the metatarsal region of a horse using autologous skin grafts.Case: A 3-year-old, female, American quarter horse weighting 450 kg was brought to veterinary hospital with lower limb injury. According to the owner’s report, the animal had one of its limbs stuck in a plain wire fence. A wound was observed in the metatarsal region during physical examination, the lesion caused an extensive skin laceration that showed the dorsal surface of the metatarsal bone and the digital extensor tendon. After injury assessment, wound debridement was carried out by surgery intervention followed by antisepsis and application of autologous plasma every two days as post-surgical care and wound preparation to receive the graft. Forty-five days after the first intervention, grafts were collected from the neck and implanted in the wound. The procedure achieved 70% of success. After approximately 75 days, transplantation was performed in other regions of the wound using the same technique. The duration of treatment at the Veterinary Hospital of the Universidade Paranaense (UNIPAR) was eight months, and then the animal returned home, where dressings were applied for two months to avoid the risk of contamination and until complete recovery.Discussion: The debridement of the wound and edges approximation were of great value in order to begin the process of wound granulation.[...]

Histochemical and immunohistochemical evaluation of angiogenesis in rabbits (Oryctolagus cuniculus) submitted to skin grafts associated with platelet-rich plasma / Histoquímica e imunohistoquíca na avaliação da angiogênese em coelhos submetidos ao emprego de enxertos cutâneos associado com plasma rico em plaquetas

Histochemical staining consists of a set of specific chemical reactions of structures or tissue-endogenous substances. Immunohistochemistry allows verification of proteins in tissues related to biological and pathological factors. The standardization of methods to assess angiogenesis resulting from formation of new blood vessels in procedures with stimulants is important to facilitate the implementation of research as well as to assist interpretation of data. In rabbits some markers of angiogenesis antibodies in the skin are not standardized because of cross-reactions that may occur because the antibodies are made from such animals.The aim of this study was to analyze the immunohistochemical methods through dyes and immunohistochemical markers angiogenesis in rabbits (Oryctolagus cuniculus) having undergone reconstructive surgery with skin grafts associated with plasma angiogenesis stimulator rich in platelets, in order to evaluate which method would be better to visualize the vessels, as well as to evaluate which antibody would promote better immunostaining, and find the differences between the methods and to standardize the methodology to be applied in experiments using rabbits. Sixteen rabbits were used, split into two groups of eight animals: Gprp (plasma rich in platelets) and Gc (control, saline solution, 9%).(AU)

Colorações histoquímicas consistem de um conjunto de reações químicas específicas das estruturas ou substâncias endógenas do tecido. Logo a Imunohistoquímica permite observar proteínas presentes nos tecidos relacionadas com fatores determinantes do comportamento biológico e patológico. A padronização dos métodos que avaliam a angiogênese decorrente de procedimentos que utilizam substâncias estimulantes à formação de novos vasos são importantes, a fim de facilitar a execução das pesquisas, bem como auxiliar na interpretação dos dados, visto que em coelhos alguns anticorpos marcadores de angiogênese na pele ainda não são padronizadas em virtude das reações cruzadas que podem ocorrer devido aos anticorpos serem confeccionados a partir de tais animais. Objetivou-se analisar os métodos histoquímicos por meio das colorações e imunohistoquímicas com marcadores de angiogênese em coelhos (Oryctolagus cuniculus) submetidos ao emprego de enxertos cutâneos associado com estimulador de angiogênese plasma rico em plaquetas, a fim de avaliar qual método seria melhor para visualização dos vasos, bem como avaliar qual anticorpo promoveria melhor imunomarcação, buscando-se assim encontrar a diferenças entre os métodos e padronizar a metodologia a ser aplicada em experimentos que utilizem coelhos.(AU)

Histochemical and immunohistochemical evaluation of angiogenesis in rabbits (Oryctolagus cuniculus) submitted to skin grafts associated with platelet-rich plasma / Histoquímica e imunohistoquíca na avaliação da angiogênese em coelhos submetidos ao emprego de enxertos cutâneos associado com plasma rico em plaquetas

Histochemical staining consists of a set of specific chemical reactions of structures or tissue-endogenous substances. Immunohistochemistry allows verification of proteins in tissues related to biological and pathological factors. The standardization of methods to assess angiogenesis resulting from formation of new blood vessels in procedures with stimulants is important to facilitate the implementation of research as well as to assist interpretation of data. In rabbits some markers of angiogenesis antibodies in the skin are not standardized because of cross-reactions that may occur because the antibodies are made from such animals.The aim of this study was to analyze the immunohistochemical methods through dyes and immunohistochemical markers angiogenesis in rabbits (Oryctolagus cuniculus) having undergone reconstructive surgery with skin grafts associated with plasma angiogenesis stimulator rich in platelets, in order to evaluate which method would be better to visualize the vessels, as well as to evaluate which antibody would promote better immunostaining, and find the differences between the methods and to standardize the methodology to be applied in experiments using rabbits. Sixteen rabbits were used, split into two groups of eight animals: Gprp (plasma rich in platelets) and Gc (control, saline solution, 9%). The same technique of reconstructive surgery using graft mesh was performed on each rabbit. The groups differed only in the application of platelet-rich plasma before the surgical wound synthesis. Samples for evaluation of angiogenesis were collected 15 days after the surgical procedure. The dyes Hematoxylin & Eosin and Masson's Trichrome were used in the histochemical study to evaluate vascular proliferation. Markers CD31, CD34 and Caveolin-1 was used for the immunohistochemical study. The evaluation between the groups (Gprp and Gc) in regard to the categorical variable (vascular proliferation intensity) used the Kruskal-Wallis test with p values equal to or less than 0.05 being considered significant. The immunohistochemistry was subjected to analysis of variance for a completely randomized design, with two groups and five repetitions (medium) and 5% significance level. Multiple comparison of groups resulted in the Tukey test (p=0.05) used. The amount of vascular proliferation assessed by histochemical method HE and Masson's Trichrome was found to be a significant variable in Gprp when compared with group Gc. When evaluating the methods used, there was no significant difference. There was no difference in the three markers which were used for correlating microvessels; however, there was more intense staining of vessels when Caveolin-1 Antibody was used. This caused intense marking of the capillaries and small vessels, as well as of larger vessels. When using CD31 and CD34, the same was observed, but it was not as intense as with Caveolin-1; though some cases showed sincere and discreet marking. The results of this study demonstrated that the histochemical methods performed are effective for semi-quantitative assessment of angiogenesis. The immunohistochemical comparison of Caveolin-1, CD31, and CD34 as markers of angiogenesis in rabbits showed that both antibodies could immunostain the newly formed vessels; but the Caveolin-1 showed better immunostaining in small and medium-sized vessels, as well as a minor presence in the background. Although not specific markers for angiogenesis, they can be used as immunohistochemical markers of vascular endothelium in rabbits.(AU)

Colorações histoquímicas consistem de um conjunto de reações químicas específicas das estruturas ou substâncias endógenas do tecido. Logo a Imunohistoquímica permite observar proteínas presentes nos tecidos relacionadas com fatores determinantes do comportamento biológico e patológico. A padronização dos métodos que avaliam a angiogênese decorrente de procedimentos que utilizam substâncias estimulantes à formação de novos vasos são importantes, a fim de facilitar a execução das pesquisas, bem como auxiliar na interpretação dos dados, visto que em coelhos alguns anticorpos marcadores de angiogênese na pele ainda não são padronizadas em virtude das reações cruzadas que podem ocorrer devido aos anticorpos serem confeccionados a partir de tais animais. Objetivou-se analisar os métodos histoquímicos por meio das colorações e imunohistoquímicas com marcadores de angiogênese em coelhos (Oryctolagus cuniculus) submetidos ao emprego de enxertos cutâneos associado com estimulador de angiogênese plasma rico em plaquetas, a fim de avaliar qual método seria melhor para visualização dos vasos, bem como avaliar qual anticorpo promoveria melhor imunomarcação, buscando-se assim encontrar a diferenças entre os métodos e padronizar a metodologia a ser aplicada em experimentos que utilizem coelhos. Utilizou-se 16 coelhos, separados em dois grupos com oito animais, compreendendo os grupos Gprp (plasma rico em plaquetas) e Gc (controle, solução fisiológica 0,9%). Em todos os animais foi realizada a mesma técnica de cirurgia reconstrutiva de enxertia do tipo malha, os grupos diferiram apenas a aplicação do plasma rico em plaquetas antes da síntese da ferida cirúrgica. As amostras para avaliação da angiogênese foram coletadas após 15 dias do procedimento cirúrgico. Utilizou-se no estudo histoquímico as colorações Hematoxilina & Eosina e Tricrômico de Masson para avaliação da proliferação vascular, e os anticorpos CD31 e CD34 e Caveolina - 1 para avaliação imunohistoquímica. A comparação entre os grupos (Gprp e Gc) em relação à variável categórica (intensidade de proliferação vascular) foi utilizado o teste de Kruskal-Wallis, com valores de p iguais ou inferiores a 0,05 foram considerados significativos. Os dados imuno-histoquímico foram submetidos à análise de variância para um delineamento inteiramente ao acaso, com 2 grupos e 5 repetições (médias) e nível de significância de 5%. Nas comparações múltiplas das médias dos grupos, utilizou-se o teste de Tukey (α = 0,05). A intensidade de proliferação vascular avaliada pelo método histoquímico HE e Tricômico de Masson encontrou-se que tal variável foi significativa no Gprp, quando comparado com o Gc. Avaliando os métodos utilizados não houve diferença significativa. A contagem microvascular (MVC) realizada com os diferentes marcadores (Caveolina-1, CD31 e CD34) foi significativa no Gprp. Correlacionando a contagem microvascular dos três marcadores utilizados não houve diferença significativa, no entanto observou-se marcação mais intensa dos vasos utilizando o anticorpo Caveolina-1, sendo intensa a marcação dos capilares, vasos de pequeno calibre, bem como em vasos maiores. Nas avaliações de CD31 e CD34 observou que houve imunomarcação dos vasos, porém não foi intensa como a Caveolina-1, alguns casos apresentaram fundo, bem como marcação discreta. Os resultados encontrados neste estudo evidenciaram os métodos histoquímicos são eficazes para avaliação semiquantitativa da angiogênese. A comparação imunohistoquímicas da Caveolina-1, CD31 e CD34 como marcadores de angiogênese em coelhos evidenciaram que ambos os anticorpos são capazes de imunomarcar os vasos neoformados, porém a Caveolina-1 apresentou melhor imunomarcação de vasos de pequeno e médio calibre, bem como menor presença de fundo, embora não seja um marcador específico para angiogênese pode ser utilizada como marcador imunohistoquímico de endotélio vascular em coelhos.(AU)

Efeito do gel de plasma rico em plaquetas na cicatrização de enxertos cutâneos em equinos / Effect of platelet-rich plasma gel on graft skin healing in equines

O gel de plasma rico em plaquetas (PRP) é uma concentração autóloga de plaquetas em um pequeno volume de plasma com potencial de melhorar a integração dos enxertos. Foram utilizados oito equinos adultos, realizando-se enxertos de pele com largura de 2,5 x 2,5 centímetros em cada lado do pescoço, sendo um lado o tratamento, com o uso do gel de PRP e do outro lado o controle. Os animais foram avaliados nos dias 0, 7, 14, 21 e 28 após a cirurgia por meio de avaliação clínica, histológica, morfométrica e cultura bacteriana dos enxertos. As avaliações clínicas, morfométricas e bacteriológicas dos tecidos enxertados não revelaram diferenças significativas entre o grupo controle e o grupo tratamento com PRP. A avaliação histológica revelou um aumento da inflamação aguda no momento 7 e de concentração de colágeno no momento 14 no grupo tratamento, decorrente da liberação de fatores de crescimento pelas plaquetas presentes no gel, que não diferiu nos demais momentos. De acordo com as condições experimentais utilizadas neste estudo, pode-se concluir que não houve diferenças significativas entre o lado tratado com PRP e o lado controle em enxertos cutâneos em equinos.

The platelet-rich plasma (PRP) gel is an autologous platelet concentration in a small plasma volume with the potential to improve the integration of the grafts. Eight adult equines were used, performing skin grafts, with 2.5x2.5 centimeters, on both sides of the neck, in which one was the treatment side, using the PRP gel, and the other side was the control. The animals were assessed after the surgery on days 0, 7, 14, 21, and 28, by clinical, histological, morphometric, and culture analysis of the grafts. The clinical, morphological, and biological analysis of tissue grafts revealed no significant differences between the control group and the treatment group with PRP. Histologic evaluation revealed an increase in acute inflammation on day 7 and collagen concentration on day 14, resulting from the release of growth factors by the platelets present in the gel, which did not differ in further moments. According to the experimental conditions used in this study, we concluded there were no significant differences between the side treated with PRP and the control side in skin grafts in horses.

Efeito do gel de plasma rico em plaquetas na cicatrização de enxertos cutâneos em equinos / Effect of platelet-rich plasma gel on graft skin healing in equines

O gel de plasma rico em plaquetas (PRP) é uma concentração autóloga de plaquetas em um pequeno volume de plasma com potencial de melhorar a integração dos enxertos. Foram utilizados oito equinos adultos, realizando-se enxertos de pele com largura de 2,5 x 2,5 centímetros em cada lado do pescoço, sendo um lado o tratamento, com o uso do gel de PRP e do outro lado o controle. Os animais foram avaliados nos dias 0, 7, 14, 21 e 28 após a cirurgia por meio de avaliação clínica, histológica, morfométrica e cultura bacteriana dos enxertos. As avaliações clínicas, morfométricas e bacteriológicas dos tecidos enxertados não revelaram diferenças significativas entre o grupo controle e o grupo tratamento com PRP. A avaliação histológica revelou um aumento da inflamação aguda no momento 7 e de concentração de colágeno no momento 14 no grupo tratamento, decorrente da liberação de fatores de crescimento pelas plaquetas presentes no gel, que não diferiu nos demais momentos. De acordo com as condições experimentais utilizadas neste estudo, pode-se concluir que não houve diferenças significativas entre o lado tratado com PRP e o lado controle em enxertos cutâneos em equinos.(AU)

The platelet-rich plasma (PRP) gel is an autologous platelet concentration in a small plasma volume with the potential to improve the integration of the grafts. Eight adult equines were used, performing skin grafts, with 2.5x2.5 centimeters, on both sides of the neck, in which one was the treatment side, using the PRP gel, and the other side was the control. The animals were assessed after the surgery on days 0, 7, 14, 21, and 28, by clinical, histological, morphometric, and culture analysis of the grafts. The clinical, morphological, and biological analysis of tissue grafts revealed no significant differences between the control group and the treatment group with PRP. Histologic evaluation revealed an increase in acute inflammation on day 7 and collagen concentration on day 14, resulting from the release of growth factors by the platelets present in the gel, which did not differ in further moments. According to the experimental conditions used in this study, we concluded there were no significant differences between the side treated with PRP and the control side in skin grafts in horses.(AU)

Laserterapia de baixa intensidade (LTBI) associada à técnica de autoenxerto cutâneo em malha para o tratamento de ferida em membro torácico de cão: relato de caso

Um cão macho, sem raça definida, de seis meses de idade foi atendido noHospital Veterinário “Governador Laudo Natel” (Unesp-FCAV) de Jaboticabal-SP comferida cutânea grave em região distal de rádio até a região falangeana de membro torácicoesquerdo, causada por trauma. Optou-se inicialmente pelo tratamento clínico da ferida atémelhora de suas características, tento como resultado a formação de tecido de granulação Em seguida o paciente foi submetido à cirurgia onde foi realizado um enxerto em malhade espessura total para recobrir o leito da ferida. No pós-operatório, foram realizadassessões de Laserterapia de Baixa Intensidade (LTBI) a cada três dias, totalizando 6aplicações, com o intuito de estimular e acelerar a cicatrização. O paciente apresentou boarecuperação sem sinais de necrose e deiscência de pontos em nenhuma porção do enxerto.A LTBI associada ao correto manejo da ferida auxiliou na evolução pós-operatória datécnica do autoenxerto cutâneo, acelerando o processo de reparação tecidual.PALAVRAS-CHAVE: Reparação tecidual, cirurgia reconstrutiva, ferida, laser.

A male dog, mongrel, one-year-old was the Veterinary Hospital "GovernadorReport Natel" (Unesp-FCAV) Jaboticabal-SP with severe skin wound in the left forelimb,caused by trauma. It was decided initially by medical treatment of the wound to improveits characteristics, try results in the formation of granulation tissue. Then the patientunderwent surgery which was performed in a graft mesh overall thickness to cover thewound bed. Postoperatively, meetings were held laser therapy of low intensity (LTBI) inorder to stimulate and accelerate healing. The patient recovered with no signs of necrosisand dehiscence points in any portion of the graft. The LTBI associated with the propermanagement of wound assisted in the postoperative evolution of the free graft technique,accelerating the process of tissue repair