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Acta Cirúrgica Brasileira, Volume: 35, Número: 10, Publicado: 2020
  • Biomechanical and adhesion comparison of linea alba prophylactic reinforcement with coated and uncoated three-dimensional T-shaped mesh in rabbits Original Article

    Hernani, Bruno De Lucia; Barros, Paulo Henrique Fogaça de; Tastaldi, Luciano; Ladeira, Luiza Nascimento; Roll, Sergio; Ferreira, Fabio Gonçalves; Garcia, Diego Paim Carvalho

    Resumo em Inglês:

    Abstract Purpose: Incisional hernia (IH) is a frequent complication of median laparotomy. The use of prophylactic mesh to reduce IH incidence has gained increasing attention. We hypothesized that in an animal model, linea alba prophylactic reinforcement with a three-dimensional T-shaped polypropylene mesh results in greater abdominal wall resistance. Methods: Study was performed in 27 rabbits. After abdominal midline incision, animals were divided into three groups according to the laparotomy closure method used: (1)3D T-shaped coated mesh; (2)3D T-shaped uncoated mesh; and (3) closure without mesh. After 4 months, each animal’s abdominal wall was resected and tensiometric tests were applied. Results included IH occurrence, adhesions to the mesh, and wound complications. Results: There was no significant difference between the groups in maximum tensile strength (p=0.250) or abdominal wall elongation under maximum stress (p=0.839). One rabbit from the control group developed IH (p=1.00). Small intestine and colon adhesions occurred only in the uncoated mesh group (p<0.001) and the degree of adhesions was higher in this group compared to the coated mesh group (p<0.05). Conclusion: Use of the current 3D T-shaped prophylactic mesh model did not result in a significant difference in tensiometric measurements when compared with simple abdominal wall closure in rabbits.
  • Periplaneta americana extract promotes intestinal mucosa repair of ulcerative colitis in rat Original Article

    Xue, Nan-nan; He, Miao; Li, Yue; Wu, Jun-zhu; Du, Wen-wen; Wu, Xiu-mei; Yang, Zi-zhong; Zhang, Cheng-gui; Li, Qi-yan; Xiao, Huai

    Resumo em Inglês:

    Abstract Purpose: To investigate the mechanism of Periplaneta americana extract promoting intestinal mucosal repair of OXZ-induced colitis in rat. Methods: All experiments used an equal number of male and female SD rats (n=48). We injected OXZ into the colon to induce UC rat model. To determine the optimal concentration of P. Americana's extract (PA-40), it was classified into low (L), medium (M), and high (H) doses. After OXZ treatment, each drug was administered by enema for 7 consecutive days. Rats were divided into the following 6 groups: (1) Saline treatment group (NC), (2) OXZ treatment UC model group (MC), (3) OXZ + budesonide group (BUN), (4) OXZ + PA-40 L group, (5) OXZ + PA-40 M group, (6) OXZ + PA-40 H group. Disease activity index (DAI) scores, colon length, histopathological score, serum cytokine level (IL-4, IL-10, iNOS, tNOS), and amount of MPO, EGF, IL-13 in colonic mucosa were measured. Results: PA treatment had a significant healing effect on the OXZ-colitis model and significantly reduced the lesioned area, especially in the PA-40H groups. PA treatment did not alter the expression of IL-10 and MPO level, but increased EGF (epidermal growth factor) and decrease IL-13 in the colonic tissue. PA inhibited the rise of NOSs (nitric oxide synthase) and decreased the serum IL-4 level. Conclusions: The data suggest that Periplaneta americana extract may be a potential compound for the treatment of colonic lesions. The mechanism may be related to inhibiting the secretion of IL-13 and promoting the formation of EGF.
  • The influence of splenic tissue on the survival and TCD4 and TCD8 lymphocyte rates in rats subjected to fecal peritonitis induction Original Article

    Borjaili, Andréa Saade Daher; Nunes, Giseli Celestino; Silveira, Julia Belizário; Dall'Orto, Flávia Heiderich; Lorenzoni, Gabriel Souza; Borjaili, Matheus Eduardo Daher; Campagnaro, Bianca Prandi; Lima, Maressa Cristiane Malini de; Paulo, Marcela Souza Lima; Paulo, Danilo Nagib Salomão; Nunes, Tarcizo Afonso

    Resumo em Inglês:

    Abstract Purpose: Comparing survival rates of rats subjected to spleen procedures after fecal peritonitis induction. Assessing changes in TCD4 and CD8 lymphocyte rates before and after the procedures. Correlating animal survival with CD4 and CD8 lymphocytes. Methods: Thirty male Wistar rats were distributed into 3 groups of ten: spleen manipulation (SM); total splenectomy (TS); subtotal splenectomy with preservation of the inferior pole (IP). Rats were subjected to surgical procedure depending on the group. Seven days after surgery they underwent induction of peritonitis and survival time was recorded. All animals were subjected to two blood collections: before surgery and 70 days after it for TCD4/TCD8 lymphocyte counting. Results: Mean survival time was longer in the IP and SM groups and shorter in the TS group; there was significant difference between them. The comparison of the median number of CD4 did not present changes, whereas the comparison of the median number of CD8 decreased in the SM and IP groups. The correlation between the median number of TCD4 and TCD8 lymphocytes and the animals’ survival was not significant. Conclusion: The maintenance of splenic tissue contributed to increase the survival of rats and there was a change in the number of TCD8 lymphocytes.
  • A microsurgical technique for catheter insertion in the rat femoral artery Original Article

    Sugai, Kazuhisa; Hakamata, Yoji; Tamura, Tomoyoshi; Kataoka, Masaharu; Fujisawa, Masahiko; Sano, Motoaki; Kobayashi, Eiji

    Resumo em Inglês:

    Abstract Purpose: To modify a surgical catheterization method using the bent needle introducer in small animals. Methods: Eight-week-old male Lewis rats were used in the study. A needle introducer was created by bending a 21G injection needle at 45°. The bent needle introducer was used for catheter insertion into the left femoral artery of the rats under anesthesia. As a control, a catheter was directly inserted into the blood vessel without the introducer. The insertion time of each method was measured. Blood pressure and heart rate were measured 24 h after catheter insertion using the telemetry system. Results: Using the introducer, the catheter was successfully inserted within a short time in all rats. Without the introducer, a longer duration was required for catheter insertion. The frequency of the insertion with no catheter-based errors with the introducer tended to be higher than that without the introducer. The mean arterial pressure and heart rate 24 h after catheter insertion in each group were almost the same. Conclusions: We developed a surgical catheterization method using the introducer in small animals. This could potentially reduce the frequency of the insertion with catheter-based errors and insertion time.
  • Effects of homologous and heterologous rich platelets plasma, compared to poor platelets plasma, on cutaneous healing of rabbits Original Article

    Meira, Raquel de Oliveira; Braga, Daniel Nogueira Mendes; Pinheiro, Leni Safira Gonçalves; Amorim, Izabela Ferreira Gontijo; Vasconcellos, Leonardo de Souza; Alberti, Luiz Ronaldo

    Resumo em Inglês:

    Abstract Purpose: To evaluate and compare the effects of homologous and heterologous PRP (Platelet-Rich Plasma) on the quality and speed of skin wound healing, compared to Poor Platelet Plasma (PPP). Methods: Twenty-one male adult rabbits were used; two for preparing homologous PRP, with the rest of them separated randomly in three groups, according to the treatment received: PPP - control (n=5), homologous PRP (n=7), heterologous (n=7). Excisional skin wounds were made on the back of the animals, for the application of homologous and heterologous PPP and PRP. At the 14th post-operative day (POD), the animals were subjected to a new wound, and the treatments were inverted. The wounds were evaluated macroscopically and histologically. Results: A larger percentage of scar retraction was observed on the group treated with heterologous PRP, compared to homologous PRP, at the third POD, an increase of 25.03% (p=0.01). No other statistically significant differences among treatments were observed. Among every group, skin healing was efficient, without local adverse effects. Conclusions: Heterologous PRP contributed with more tissue retraction at the beginning of the wound healing process. After this, there were no differences on the wound healing skin process treated with PRP or PPP. However, our findings suggest the presence of others plasmatic factors, besides platelets, which could also contribute to the wound healing process, and thus, should be further investigated.
  • Evaluation of a collagen matrix in a mandible defect in rats submitted to the use of bisphosphonates Original Article

    Cunha, Vanessa Vasconcelos; Silva, Paulo Goberlânio de Barros; Lemos, José Vitor Mota; Martins, Joyce Ohana Lima; Freitas, Milena Oliveira; Avelar, Rafael Linard

    Resumo em Inglês:

    Abstract Purpose: To assess the effect of a collagen matrix (Mucograft®) on the inflammatory process in a semi-critical experimental defect model in rats treated with bisphosphonates. Methods: Eighteen Wistar rats were randomly divided into three groups: saline (CG), alendronate (ALD) 5mg/kg (AG) or zoledronic acid (ZA) 0.2mg/kg (ZG). ALD was administered orally for 10 weeks and ZA was administered intravascularly on days 0, 7 and 14 and 49. On day 42, a 2mm defect was created and filled with Mucograft® collagen matrix. The contralateral side was filled with a clot (control side). The animals were euthanized 70 days after the beginning of the experiment and the hemimandibles were radiographically and histologically (counting of empty osteocyte lacunae (%), apoptotic (%) and total osteoclasts, neutrophil and mononuclear inflammatory cells) analyzed. The variables were submitted to ANOVA/Bonferroni and t test (parametric data) (p <0.05, GraphPad Prism 5.0). Results: Significant bone repair occurred in the groups treated with Mucograft®. High number of total inflammatory cells and neutrophils cells were showed in AG (p=0.026 and p=0.035) and AZ groups (p=0.005, p=0.034) on the control sides associated with delayed bone repair and the presence of devitalized bone tissue in AG and ZG on the Mucograft® side. Conclusion: Mucograft® collagen matrix attenuated the inflammatory process in a mandible defect in rats submitted to the use of bisphosphonates (AG and ZG).
  • Is there something new regarding triceps brachii muscle insertion? Clinical Investigation

    Akamatsu, Flávia Emi; Negrão, José Renato; Rodrigues, Marcelo Bordalo; Itezerote, Ana Maria; Saleh, Samir Omar; Hojaij, Flávio; Andrade, Mauro; Jacomo, Alfredo Luiz

    Resumo em Inglês:

    Abstract Purpose: Previous studies have questioned whether the triceps brachii muscle tendon (TBMT) has a double or single insertion on the ulna. Aiming to provide an answer, we describe the anatomy of the TBMT and review a magnetic resonance imaging (MRI) series of the elbow. Methods: Forty-one elbows were dissected to assess the details of the triceps brachii insertion. Elbow plastination slices were analyzed to determine whether there was a space on the TBMT. Magnetic resonance imaging from the records of the authors were also obtained to demonstrate the appearance of the pre-tricipital space on MRI. Results: A virtual space on the medial aspect near the TBTM insertion site in the olecranon was consistently found on anatomic dissections. It was a distal pre-tricipital space. Magnetic resonance imaging demonstrated the appearance of the pre-tricipital space on MRI, and its extension was measured longitudinally either in elbow flexion or extension. There was no statistically significant difference between the measurements of this space in the right and left elbows or between flexion and extension (p > 0.05). The coefficient of variation was <10% for all measurements. Conclusion: Knowledge of this structure may be essential to avoid incorrect diagnosis and unnecessary therapeutic interventions.
  • JPEG and raw image files compared to direct measurement of the breast region Clinical Investigation

    Quieregatto, Paulo Rogerio; Sabino Neto, Miguel; Furtado, Fabianne; Quieregatto, Andrea do Amaral; Trigo Junior, Thales Waltenior; Ferreira, Lydia Masako

    Resumo em Inglês:

    Abstract Purpose: To compare JPEG and RAW image file extensions to direct measurement of the breast region. Methods: Points were marked on the breasts and arms of 40 female volunteers. The joining of these points in each hemibody formed seven linear segments, one angular segment and one median segment common to both hemibodies. Volunteers were photographed in a standardized fashion and evaluated by three raters using the software Adobe Photoshop CS6® and three image file extensions (RAW, high resolution JPEG and low resolution JPEG); values were compared to direct anthropometry. Results: All variables had interclass correlation coefficient higher than 0.8 (ICC>0.8). On average, all variables in all methods showed differences (p<0.05) when compared to direct measurement. A formula was created for each segment and each image file extension in comparison with the direct measurement. Conclusion: Measurements were similar among the correlated JPEG and RAW image file extensions but differed from the actual breast measurement obtained with a caliper.
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