Immediate breast reconstruction using autologous skin graft associated with breast implant.

BACKGROUND: Immediate breast reconstruction with skin graft is still little mentioned in the literature. Follow-up studies regarding the technique aspects are particularly scarce. The objective was to detail immediate breast reconstruction using autologous skin graft. METHODS: Patients (n = 49) who underwent mastectomies and autologous immediate breast reconstruction with skin graft associated with a breast implant at A. C. Camargo Hospital (São Paulo, Brazil) between January 2007 and July 2010 were included. Information on clinical data, technique details and clinical outcome were prospectively collected. Following mastectomy, the autologous full-thickness skin graft was obtained through an inframammary fold incision along the contralateral breast in most patients. The skin graft was placed on the surface of the pectoralis major muscle after adjustments to conform to the mastectomy defect. A minimum of 10-month follow-up period was established. RESULTS: Patients' age ranged from 35 to 55 years and all received a silicone gel textured surface implant to obtain the necessary breast mound. The mean surgical time was 45 min, and the mean amount of skin resection was 4.5 cm in the largest diameter. Follow-up ranged from 10 to 35 months (median 23). All patients had silicone-gel textured surface implants to perform the breast mound reconstruction. No complications were observed in 87.8% of reconstructions. Forty-six patients (94%) had no complaints about the donor-site aesthetics. The result was a breast mound with a central ellipse of healed skin graft. Three (6%) poor results were observed. Thirty-six patients (67%) reported the results as good or very good. CONCLUSIONS: Our results lead us to conclude that autologous skin graft provided a reliable option in immediate breast reconstruction to skin-sparing mastectomy defects. The technique accomplished a single-stage implant breast reconstruction when there is inadequate skin coverage.

Viabilidade de embriões vitrificados oriundos da fertilização in vitro de oócitos de vacas suplementadas com canola / Viability of vitrified embryos obtained from the in vitro fertilization of oocytes from cows supplemented with canola

Avaliou-se a produção de oócitos e embriões de vacas Nelore in vitro e a resistência à vitrificação. Foram utilizadas 12 vacas Nelore, distribuídas aleatoriamente em dois tratamentos: T1-tratados com canola em grão (2,0kg/animal/dia) e T2-controle. Cada animal foi aspirado quatro vezes para obtenção de óocitos para fecundação in vitro. Os oócitos foram quantificados e classificados em viáveis ou inviáveis. Os zigotos foram cultivados in vitro e, sete dias após, os embriões foram avaliados quanto à qualidade e grau de desenvolvimento e vitrificados em hastes próprias. Na sequência, foram descongelados e cultivados em 6, 12 e 24 horas, observando-se a taxa de expansão e eclosão. Não houve diferenças (P>0,05) no número total de oócitos viáveis, T1=12,7% e T2=11,0%, na taxa de clivagem, T1=60,6% e T2=61,4%, e taxa de blastocistos, T1=23,7% e T2=27,0%, em função do tratamento. Também não houve influência na taxa de re-expansão, T1=70,5 e T2=59,6%, após a vitrificação e descongelamento. Todavia houve diferença (P<0,06) para a taxa de eclosão, T1=69,2 e T2=35,7. Conclui-se que a adição de canola na dieta de vacas não alterou a produção de embriões; entretanto, os embriões resultantes de oócitos coletados de vacas alimentadas com canola são mais resistentes à vitrificação.

It was evaluated the production of oocytes and embryos from Nellore cows in vitro, as well as its resistance to vitrification, when the animals were supplemented with canola grains. Twelve Nellore cows were randomly divided into two treatments: T1-treated with Canola grains (2.0kg/animal/day) and T2-control. Each animal was submitted to other four aspirations, to obtain oocytes for the in vitro fertilization. The oocytes were quantified and classified as viable or not viable. The embryos were cultivated in vitro, seven days after the quality and the level of development of embryos was evaluated and they were vitrified in vitrification straws. Then, the embryos were thawed and grown during 6, 12 and 24 hours, and the rate of expansion and hatching were recorded. There were no differences (P> 0.05) in the whole number of viable oocytes T1: 12.7±1.71 and T2: 11.0±1.77, cleavage rate T1= 60.6±4,72 and T2= 61.4±4.88 or blastocysts rate T1=23,7±5.12 and T2=27,0±5.30 due to the treatment. The treatments did not influence the rate of re-expansion T1= 70,5±6.99 and T2: 59.6±7.09 after vitrification and thawing. However, there was a significant difference (P <0.06) in the hatching rate (T1: 69.17±7.43; T2: 35.66±6.86). Thus, we conclude that supplementation with canola grains did not change embryos production, but the embryos yielded from oocytes of cows fed canola grains are more resistant to vitrification.