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1.
Rev. bras. cir. plást ; 36(3): 366-372, jul.-set. 2021.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1365554

ABSTRACT

RESUMO Introdução: A mamoplastia é uma das cirurgias mais realizadas pelos cirurgiões plásticos. Como todo procedimento, não é isenta de riscos ou complicações. Objetivos: Discutir questões controversas e intercorrências em cirurgia mamária e principais tratamentos. Métodos: Participaram da discussão quatro membros titulares da SBCP com ampla experiência em cirurgia plástica mamária, além do regente do capítulo de mamoplastias. Foram avaliados fatores que apresentavam maior controvérsia em mamoplastias: utilização de antibióticos; infiltração pré-operatória; associação da mamoplastia com implantes mamários; grandes ptoses mamárias; mamoplastia masculinizadora; retalhos para ascensão do complexo areolopapilar (CAP); utilização de drenos; curativos em mamoplastias e enxerto de gordura. Resultados: A literatura e discussão entre especialistas gerou as observações: há evidencias robustas da efetividade no uso de antibióticos perioperatório de mamoplastias redutoras, mas não há evidências de benefícios em se manter o uso por mais de 24 horas; a infiltração pré- operatória com soluções vasoconstritoras não reduz a incidência de hematoma; em mamoplastia associada a implantes não houve consenso sobre a melhor técnica, plano ou textura do implante; não houve consenso sobre a melhor técnica na ascensão do CAP em grandes ptoses, se enxertos ou retalhos; a mamoplastia masculinizadora não apresenta complicações diversas das encontradas na literatura; não existe protocolo específico para conduta quando há sofrimento do CAP; curativos podem ser removidos no primeiro dia de pós-operatório ou mantidos por mais tempo, e deve haver parcimônia no enxerto de gordura. Conclusão: O presente estudo concluiu que a mamoplastia é uma cirurgia segura, porém são necessários estudos continuados que possibilitem minimizar complicações.


ABSTRACT Introduction: Mammoplasty is one of the most performed surgeries by plastic surgeons. Like every procedure, it is not free of risks or complications. Objectives: Discuss controversial issues and complications in breast surgery and main treatments. Methods: Four full members of the SBCP with extensive experience in breast plastic surgery participated in the discussion, in addition to the regent of the mammoplasty chapter. Factors that presented the greatest controversy in mammoplasties were evaluated: use of antibiotics; preoperative infiltration; association of mammoplasty with breast implants; large mammary ptoses; masculinizing mammoplasty; flaps for the elevation of the nipple-areola complex (NAC); use of drains; dressings in mammoplasties and fat grafting. Results: The literature and discussion among specialists generated the observations: there is robust evidence of the effectiveness in the use of perioperative antibiotics of reducing mammoplasties, but there is no evidence of benefits in maintaining use for more than 24 hours; preoperative infiltration with vasoconstrictor solutions does not reduce the incidence of hematoma; in mammoplasty associated with implants there was no consensus on the best technique, plane or texture of the implant; there was no consensus on the best technique in the elevation of NAC in large ptoses, whether grafts or flaps; masculinizing mammoplasty does not present complications different from those found in the literature; there is no specific protocol for conduct when there is suffering from the NAC; dressings can be removed on the first postoperative day or kept longer, and there should be parsimony in the fat graft. Conclusion: The present study concluded that mammoplasty is safe surgery, but continued studies are needed to minimize complications.

2.
Rev. bras. cir. plást ; 36(3): 257-262, jul.-set. 2021. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1365564

ABSTRACT

RESUMO Introdução: O controle da absorção de proteínas é necessário para a definição das propriedades dos biomateriais e de seus usos específicos. O plasma sanguíneo contém diversas proteínas diferentes, dentre elas o fibrinogênio, que apresenta importante papel na adesão celular e nos resultados de biocompatibilidade em implantes. Os objetivos deste estudo foram avaliar laboratorialmente as ratas submetidas à colocação de mini-implantes de silicone nanotexturizados e revestidos por espuma de poliuretano a partir da aferição do fibrinogênio sérico e mensuração da proteína plasmática. Métodos: Foram utilizadas 60 ratas albinas, divididas em dois grupos de 30 animais para cada tipo de mini-implante de silicone (nanotexturizado e espuma de poliuretano) e subdivididas em 3 subgrupos, conforme o tempo de eutanásia dos animais (30, 60 e 90 dias). Os mini-implantes foram inseridos no dorso dos animais abaixo do Panniculus carnosus. No momento das eutanásias, amostras de sangue foram obtidas por punção cardíaca. Utilizou-se a técnica de precipitação térmica para determinação das proteínas plasmáticas total e sérica, e o valor do fibrinogênio foi obtido mediante a diferença entre estas duas últimas. Resultados: Quando comparados os grupos entre si, observou-se que o grupo nanotexturizado apresentou uma maior quantidade de fibrinogênio e da proteína plasmática no subgrupo de 90 dias, com significância estatística (p=0,004). Ao comparar os subgrupos entre si, em ambos os grupos, evidenciou-se uma diferença significativa (p<0,001). Conclusão: Os mini-implantes nanotexturizados mostraram uma menor absorção de proteínas em relação aos implantes revestidos pela espuma de poliuretano, no subgrupo de 90 dias.


ABSTRACT Introduction: The control of protein absorption is necessary to define biomaterials' properties and their specific uses. Blood plasma contains several different proteins, including fibrinogen, which plays an important role in cell adhesion and biocompatibility results in implants. This study's objectives were to evaluate in the laboratory rats subjected to the placement of nano-textured silicone mini-implants and polyurethane foam-coated mini-implants based on the measurement of serum fibrinogen and plasma proteins. Methods: Sixty albino rats were used, divided into two groups of 30 animals for each type of silicone mini-implant (nanotextured and polyurethane foam) and subdivided into three subgroups, according to the animals' euthanasia time (30, 60 and 90 days). The mini-implants were inserted in the animals' backs below the Panniculus carnosus. At the time of euthanasia, blood samples were obtained by cardiac puncture. The thermal precipitation technique was used to determine total and serum plasma proteins, and the difference between the latter two obtained the fibrinogen value. Results: When the groups were compared, it was observed that the nanotextured group presented a higher amount of fibrinogen and plasma protein in the 90-day subgroup, with statistical significance (p=0.004). When comparing the subgroups among themselves, a significant difference was evidenced (p<0.001). Conclusion: The nanotextured mini-implants showed a lower protein absorption concerning polyurethane foam-coated implants in the 90-day subgroup.

3.
Rev. bras. cir. plást ; 36(3): 249-256, jul.-set. 2021. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1365568

ABSTRACT

RESUMO Introdução: Nas últimas décadas houve uma grande evolução na superfície de revestimento dos implantes mamários, o que resultou na diminuição das complicações. No pós-operatório a inflamação é uma constante e pode ser avaliada pelo hemograma, pois é um exame rápido, barato e com alta disponibilidade. O presente estudo tem como objetivo avaliar os biomarcadores sanguíneos em ratas submetidas à colocação de mini-implantes de silicone nanotexturizados e revestidos por espuma de poliuretano. Métodos: Foram utilizadas 60 ratas Wistar divididas em dois grupos para utilização de mini-implantes nanotexturizados e revestidos com espuma de poliuretano, subdivididos em subgrupos de acordo com a eutanásia dos animais nos 30, 60 e 90 dias. No momento da eutanásia, as amostras de sangue foram obtidas por punção cardíaca e foi analisado o hemograma. Resultados: A hemoglobina, o hematócrito, a hemoglobina corpuscular média, os leucócitos, os neutrófilos, os linfócitos e as plaquetas tiveram os resultados muito semelhantes em todos os subgrupos avaliados (30, 60 e 90 dias). Entretanto, quando os diferentes subgrupos foram comparados entre si dentro de cada grupo, obteve-se resultados estatisticamente significantes na hemoglobina corpuscular média (nanotexturizado p=0,032 e poliuretano p=0,007) e nos leucócitos (nanotexturizado p=0,038 e poliuretano p=0,034). Sobre as alterações dos biomarcadores sanguíneos no pós-operatório encontrou-se anemia hipocrômica, contagem de leucócitos normais, neutrofilia, linfopenia e trombocitopenia. Conclusão: Após a colocação de mini-implantes de silicone, as ratas de ambos os grupos evoluíram com anemia hipocrômica, contagem de leucócitos normais às custas de neutrofilia e linfopenia, e trombocitopenia.


ABSTRACT Introduction: In recent decades, there has been a great evolution in breast implants' lining surface, which has resulted in decreased complications. In the postoperative period, the inflammation is constant and can be evaluated by the blood count, as it is a fast, inexpensive, and highly available examination. The present study evaluates blood biomarkers in rats submitted to the placement of nanotextured silicone implants and implants coated with polyurethane foam. Methods: 60 Wistar rats were used divided into two groups for nanotextured mini-implants and others mini-implants coated with polyurethane foam, subdivided into subgroups according to the animals' euthanasia in the 30, 60, and 90 days. At the time of euthanasia, blood samples were obtained by cardiac puncture and the blood count was analyzed. Results: Hemoglobin, hematocrit, mean corpuscular hemoglobin, leukocytes, neutrophils, lymphocytes, and platelets had very similar results in all subgroups evaluated (30, 60, and 90 days). However, when the different subgroups were compared within each group, statistically significant results were obtained in the mean corpuscular hemoglobin (nanotextured p=0.032 and polyurethane p=0.007) and leukocytes (nanotextured p=0.038 and polyurethane p=0.034). Changes in postoperative blood biomarkers were hypochromic anemia, normal leukocyte count, neutrophilia, lymphopenia, and thrombocytopenia. Conclusion: After the placement of mini-silicone implants, the rats of both groups evolved with hypochromic anemia, normal leukocyte count at the expense of neutrophilia and lymphopenia, and thrombocytopenia.

4.
Rev. bras. cir. plást ; 36(2): 236-241, abr.jun.2021. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1368065

ABSTRACT

Introdução: O câncer de pele é a neoplasia mais incidente em vários países, incluindo o Brasil, e a sua incidência continua subindo. A detecção precoce e a prevenção primária são as principais formas de diminuir a morbidade e mortalidade. Locais como cabeça, pescoço e dorso são de difícil visualização pela própria pessoa. Há um potencial nos profissionais de beleza em detecção precoce destas lesões e encaminhamento para avaliação e conduta médica. Objetivos: Desenvolver um projeto on-line com ferramentas para educação de profissionais de beleza sobre o câncer de pele. Métodos: Baseado na literatura atual, foram formulados vídeos e material ilustrado educativos, disponíveis em um website. Resultados: O "Projeto Pele Alerta" pode ser acessado em www.projetopelealerta.com; este conta atualmente com 4 tópicos, cada qual com um vídeo (YouTube) e material de apoio em PDF. Conclusão: O projeto em questão é viável, de fácil execução e permite grande alcance na educação em relação ao câncer de pele.


Introduction: Skin cancer is the most common neoplasm in several countries, including Brazil, and its incidence continues to rise. Early detection and primary prevention are the main ways to reduce morbidity and mortality. Places such as the head, neck and back are difficult to see by the person himself. There is a potential in beauty professionals for the early detection of these lesions and referral for evaluation and medical conduct. Objectives: Develop an online project with tools to educate beauty professionals about skin cancer. Methods: Based on current literature, videos and educational illustrated material were made available on a website. Results: The "Pele Alerta Project" can be accessed at www.projetopelealerta.com; this currently has four topics, each with a video (YouTube) and support material in PDF. Conclusion: The project in question is feasible, easy to execute and allows comprehensive education concerning skin cancer.

5.
Nursing (Säo Paulo) ; 24(276): 5670-5685, maio.2021.
Article in Portuguese, French | LILACS, BDENF | ID: biblio-1247608

ABSTRACT

Objetivo: Verificar e discutir as metodologias ativas de ensino adotadas na educação de enfermeiros em cursos à distância. Método: A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal de São Paulo. Realizou-se revisão integrativa da literatura em bases de dados utilizando os seguintes descritores e suas combinações: Educação a Distância, Enfermagem e Metodologias ativas. Resultados: Observou-se que 33,3% dos estudos promoviam aprendizagem por meio de ambiente virtual de aprendizagem, 30,3% usavam o formato e-learning e 12,1% utilizavam método híbrido. Considerações finais: As metodologias ativas de ensino têm sido empregadas em cursos de capacitação de profissionais de saúde, inclusive enfermagem, e têm contribuído positivamente na qualidade da assistência prestada aos pacientes. (AU)


Objective: To verify and discuss the active teaching methodologies adopted in the education of nurses in distance learning courses. Method: The research was approved by the Research Ethics Committee of the Federal University of São Paulo. An integrative literature review was carried out on databases using the following descriptors and their combinations: Distance Education, Nursing and Active Methodologies. Results: It was observed that 33,3% of the studies promoted learning through a virtual learning environment, 30,3% used the e-learning format and 12.1% used a hybrid method. Conclusion: Active teaching methodologies have been used in training courses for health professionals, including nursing, and have contributed positively to the quality of care provided to patients.(AU)


Objetivo: Verificar y discutir las metodologías activas de enseñanza utilizadas en los cursos de educación a distancia para la educación en enfermería. Métodos: El estudio fue aprobado por el Comité de Ética en Investigación de la Universidad Federal de São Paulo. Se realizó una revisión bibliográfica integradora utilizando los siguientes descriptores y sus combinaciones: educación a distancia, enfermería y metodologías activas. Resultados: Se observó que el 33,3% de los estudios promovió el aprendizaje a través del entorno de aprendizaje virtual, el 30,3% utilizó el formato de aprendizaje electrónico y el 12,1% utilizó el método híbrido. Consideraciones finales: Se han empleado metodologías de Aprendizaje Activo en cursos de capacitación para profesionales de la salud, incluida la enfermería, que han contribuido positivamente a la calidad de la atención brindada a los pacientes.(AU)


Subject(s)
Humans , Education, Distance , Education, Nursing, Continuing , Training Courses , Nurses , Quality of Health Care , Nursing Education Research , Problem-Based Learning , Education, Continuing/methods
6.
Rev. bras. cir. plást ; 36(1): 69-75, jan.-mar. 2021. ilus, tab
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1151656

ABSTRACT

Introdução: Embora o tratamento do câncer de cabeça e pescoço tenha evoluído nos últimos anos, ainda é um desafio preservar e restaurar a simetria facial após o mesmo, comprometendo significativamente a qualidade de vida dos pacientes. Em cirurgia reconstrutiva, o enxerto de gordura autóloga vem sendo usado para tratar defeitos de volume e de contorno. O objetivo é revisar os efeitos do enxerto de gordura em pacientes com radiodermite, devido ao tratamento radioterápico de câncer de cabeça e pescoço. Métodos: Revisão de literatura nas bases PubMed e SciELO, buscando estudos publicados nos últimos 20 anos nas línguas portuguesa, inglesa ou espanhola. Foram utilizados os descritores "adipose tissue", "transplantation", "neoplasms", "head and neck neoplasms" e "radiotherapy"; e os termos não descritores "fat grafting", "fat transplantation" e "fat graft". Resultados: De 212 artigos encontrados, apenas 7 estavam em conformidade aos critérios de elegibilidade. Conclusão: A revisão sugere que a lipoenxertia em reconstrução oncológica de cabeça e pescoço é um tratamento seguro e permite otimizar os resultados estéticos e funcionais. Faltam estudos prospectivos para melhor definição de técnicas e de resultados.


Introduction: Although treatment of head and neck cancer has evolved in recent years, it is still a challenge to preserve and restore facial symmetry afterward; this fact significantly compromises the quality of life of patients. In reconstructive surgery, autologous fat grafting has been used to treat volume and contour defects. The objective is to review the effects of fat grafting in patients with radiodermatitis due to head and neck cancer radiotherapy treatment. Methods: Literature review in PubMed and SciELO databases, looking for studies published in the last 20 years in Portuguese, English, or Spanish. The descriptors "adipose tissue", "transplantation", "neoplasms", "head and neck neoplasms" and "radiotherapy" and the non-descriptive terms "fat grafting", "fat transplantation" and "fat graft" were used. Results: Of 212 articles found, only seven complied with the eligibility criteria. Conclusion: The review suggests that fat grafting in head and neck cancer reconstruction is a safe treatment and optimizes aesthetic and functional results. Prospective studies are lacking for a better definition of techniques and results.

7.
Nursing (Säo Paulo) ; 24(272): 5115-5127, jan.2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1148449

ABSTRACT

Objetivo: Avaliar a qualidade de vida e autoestima de pacientes com úlcera venosa. Método: Estudo primário, exploratório, observacional, transversal e descritivo realizado com 75 pacientes atendidos na Atenção Primária de Conselheiro Lafaiete-MG no período de dezembro de 2018 a maio de 2019 com a aplicação da Escala de autoestima de Rosenberg e o questionário de qualidade de vida SF-36. Resultados: O gênero feminino foi mais prevalente (60%), idade média de 68,9 anos e predomínio de doenças crônico-degenerativas. O levantamento das médias da Escala de Autoestima de Rosenberg teve maiores pontuações foram relacionadas ao gênero feminino, raça branca, aposentados, tabagistas, etilistas, com HAS e DM. Conclusão: A presença de úlcera venosa interferiu negativamente na autoestima de ambos os gêneros, entretanto o gênero masculino apresenta melhores escores quando comparados ao gênero feminino.(AU)


To assess the quality of life and self-esteem of patients suffering from venous ulcer. Method: Cross-sectional study regarding 75 patients, seen in the family health units in the Conselheiro Lafaiete municipality-MG. The individual basic care registration form, Rosenberg's self-esteem scale and the SF-36 quality of life survey were utilized for the data gathering. Results: Attested female predominance(60%), with a median age of 68,9 years. The Rosenberg's self-esteem scale attested an average of 9,7, the greatest average of the SF-36 test was 57,7. The Overall Health Status variable indicated the highest score among those evaluated, correlating to improvement, while the Physical Aspect corresponded to worsening, especially when associated with the female sex and the presence of comorbid conditions. Conclusion: The presence of venous ulcers interfered the self-esteem of both genders.(AU)


Objetivo: Evaluar la calidad de vida y la autoestima de pacientes con úlceras venosas. Método: Estudio primario, exploratorio, observacional, transversal y descriptivo realizado con 75 pacientes atendidos en la Atención Primaria de Conselheiro Lafaiete-MG entre diciembre 2018 y mayo 2019 con la aplicación de la escala de autoestima de Rosenberg y el cuestionario de calidad de vida SF-36. Resultados: el sexo femenino tuvo mayor prevalencia (60%), con edad promedia de 68,9 años y predominio de enfermedades crónico-degenerativas. Los promedios de la escala de Rosenberg con mayor puntuación fueron los relacionados al género femenino, de raza blanca, jubilados, fumadores, usuarios de bebidas alcohólicas, con HSA y DM. Conclusión: la presencia de úlceras venosas interfirió negativamente en la autoestima de ambos sexos, sin embargo, el sexo masculino presenta mejores puntajes cuando comparados al sexo femenino.(AU)


Subject(s)
Humans , Quality of Life , Self Concept , Varicose Ulcer , Family Health , Wounds and Injuries/nursing , Family Nurse Practitioners
8.
Clinics ; 76: e2066, 2021. graf
Article in English | LILACS | ID: biblio-1153935

ABSTRACT

OBJECTIVES: To analyze the histology and histomorphometry of healing associated with acellular dermal matrix in skin wounds in rabbits. METHODS: Twelve male rabbits were divided into two groups: the control group (CG) and the matrix group (MG). Three skin wounds with a total area of 20 × 20 mm were created on the dorsal region of each animal. Photographic records of the lesions taken over a 21-day period and use of the ImageJ program allowed calculation of the wound contraction rate. The lesions were biopsied on days 3, 14 and 21 for histomorphometric analysis to define the thicknesses of the dermis and epidermis (hematoxylin-eosin) and calculate the densities of type I and type III collagen (picrosirius). RESULTS: No significant difference in the healing rate was found between the groups (p>0.05). The MG presented greater epidermal thickness on day 3 (p<0.05) and on days 14 and 21 (p<0.001). The MG presented greater dermal thickness throughout the study period (p<0.05). The type I collagen density was higher in the MG throughout the study period (p<0.05), and the type III collagen density was higher in the MG on days 3 and 14 (p<0.05) and on day 21 (p<0.001). CONCLUSION: The use of acellular dermal matrix increased the thickness of the dermal and epidermal layers and the amount of type I and III collagen during skin wound healing and did not alter the rate of wound contraction.


Subject(s)
Animals , Male , Rats , Acellular Dermis , Skin , Wound Healing , Skin Transplantation , Collagen Type I , Collagen Type III
9.
Rev. bras. cir. plást ; 35(4): 408-411, out.dez.2020. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1367917

ABSTRACT

Introdução: A transposição de veia cefálica é uma alternativa interessante como veia doadora na reconstrução oncológica de cabeça e pescoço em pacientes com história de radioterapia cervical. O objetivo do trabalho é avaliar as características anatômicas da veia cefálica em cadáveres. Métodos: Foram dissecadas seis veias cefálicas de três cadáveres. As veias foram seccionadas na parte medial do braço e transpostas até o pescoço por cima das clavículas. Resultados: As veias apresentaram média de comprimento de 18,75±1,84cm e número de tributárias com variação de 7-9. O diâmetro coincidiu em ambas as veias de cada cadáver. O parâmetro anatômico usado para identificálas (sulco deltopeitoral) se mostrou confiável, possibilitando uma dissecação previsível. Conclusão: A veia cefálica tem características constantes e fácil localização, sendo uma opção relevante ao arsenal terapêutico do cirurgião plástico reconstrutor.


Introduction: Cephalic vein transposition is an interesting alternative as a donor vein in head and neck cancer reconstruction in patients with a cervical radiotherapy history. This work aims to evaluate the cephalic vein anatomical characteristics in cadavers. Methods: Six cephalic veins from three cadavers were dissected. The veins were sectioned in the medial part of the arm and transposed to the neck over the clavicles. Results: The veins had an average length of 18.75 ± 1.84 cm and several tributaries with a variation of 7-9. The diameter coincided in both veins of each corpse. The anatomical parameter used to identify them (deltopectoral groove) proved reliable, allowing predictable dissection. Conclusion: The cephalic vein has constant characteristics and is easy to locate, being an option relevant to the reconstructive plastic surgeon's therapeutic arsenal.

10.
Rev. bras. cir. plást ; 35(3): 261-268, jul.-sep. 2020. ilus, tab
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1128029

ABSTRACT

Introdução: As medidas precisas dos seios femininos são difíceis de obter devido à topografia, volume e projeções presentes. Portanto, este estudo teve como objetivo comparar medidas da região mamária obtidas por antropometria direta (fita métrica) e indireta (fotogrametria computadorizada). Métodos: Este é um estudo transversal. Foram avaliadas 40 mulheres, com idades entre 18 e 60 anos, índice de massa corporal <29,2 kg / m², que tinham 12 marcas anatômicas na região das mamas e braços. A união desses pontos formou 7 segmentos lineares e 1 ângulo para cada hemicorpo, e 1 segmento comum a ambos os hemicorpos. As fotografias obtidas de forma padronizada foram mensuradas por fotogrametria computadorizada com o software Image Tool®. Os mesmos segmentos também foram medidos por antropometria direta, com fita métrica. O teste de Shapiro-Wilk foi usado para avaliar se cada variável tinha uma distribuição normal. O teste de correlação de Pearson foi aplicado para avaliar a correlação entre os diferentes métodos: antropometria direta (medição com fita) e indireta (fotogrametria por Image Tool®). O nível de significância adotado para os testes estatísticos foi de 5% (p <0,05). Resultados: Diferenças significativas foram encontradas nas comparações entre a fita métrica e a fotogrametria computadorizada para todos os segmentos analisados (p> 0,05). Conclusão: Existe correlação entre as medidas dos seios da face obtidas pela antropometria direta (medição com fita métrica) e indireta (fotogrametria pelo software Image Tool®), principalmente nas medidas da papila.


Introduction: Accurate female breast measurements are difficult due to the topography, volume, and projections present there. Therefore, this study aimed to compare breast region measurements obtained by direct (tape measurement) and indirect (computer-based photogrammetry) anthropometry. Methods: This is a transversal study. Forty women were evaluated, aged 18-60 years, body mass index of <29.2kg/m² that had 12 anatomical marks on the breast region and arms. These points' union formed 7 linear segments and 1 angle for each hemibody, and 1 segment common to both hemibodies. The photographs obtained in a standardized way were measured using computer-based photogrammetry with Image ToolTM software. The same segments were also measured by direct anthropometry, using a tape measure. The Shapiro-Wilk test was used to assess whether each variable was normally distributed. The Pearson correlation test was applied to evaluate the correlation between different methods: the direct (tape measurement) and indirect (photogrammetry by Image ToolTM) anthropometry. The significance level adopted for statistical tests was 5% (p<0,05). Results: Significant differences were found in the comparisons between the tape measurement and computer-based photogrammetry for all segments analyzed (p>0.05). Conclusion: There is a correlation between the breast measurements obtained by direct (tape measurement) and indirect (photogrammetry by Image ToolTM software) anthropometry, especially the papilla measures.

11.
Acta cir. bras ; 35(9): e202000907, 2020. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1130680

ABSTRACT

Abstract Purpose To assess the effect of antibiotic prophylaxis on surgical site infection (SSI) rates in women undergoing breast cancer surgery in two tertiary hospitals in Brazil. Methods This was a randomized, double-blind, placebo-controlled, parallel-group clinical trial. A total of 124 women without independent risk factors for SSI were randomly assigned to receive either cefazolin (antibiotic group, n = 62) or placebo (control group, n = 62) as preoperative prophylaxis. After surgery, all surgical wounds were examined once a week, for four weeks, according to the Centers for Disease Control and Prevention definitions and classifications for SSI. Results Baseline characteristics were homogeneous between the two groups. Only one patient in the antibiotic group developed SSI, which was classified as superficial incisional. The overall SSI rate was low, with no significant difference between groups. Conclusion Antibiotic prophylaxis had no significant effect on reducing SSI rates in women without independent risk factors for SSI undergoing breast cancer surgery.

12.
Acta cir. bras ; 35(10): e202001008, 2020. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1141931

ABSTRACT

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.

13.
Clinics ; 75: e1568, 2020. tab
Article in English | LILACS | ID: biblio-1133395

ABSTRACT

OBJECTIVES: This study aimed to culturally validate the FACE-Q - Satisfaction with Facial Appearance Overall Scale (Face-Q SFAOS) in a population of Brazilian rhytidoplasty patients. METHOD: Authorization for the translation and validation of the questionnaire was obtained from the FACE-Q SFAOS distribution rights holders. The FACE-Q SFAOS was translated and then back-translated. For cultural validation, a total of 57 women were selected 5 to 8 months after undergoing rhytidoplasty. Twenty of them participated in the cultural adaptation, 30 participated in the reproducibility analysis, and 57 participated in the construct validation. RESULTS: The analysis identified two factors (general appearance and face geometry) that exhibited excellent internal consistency. The total satisfaction score, which comprised nine items, also presented excellent internal consistency. Good reproducibility was found for Overall Appearance, Geometry and Total. There was a difference in the satisfaction means (total and factors) between procedure locations; patients undergoing frontal, upper eyelid and lower eyelid procedures were less satisfied than those who did not undergo such procedures. Satisfaction was higher with geometry than with overall face appearance. CONCLUSION: The FACE-Q SFAOS was adapted to the cultural context of Brazilian rhytidoplasty patients and was reproducible, and the scale exhibited face, content and construct validity.


Subject(s)
Humans , Female , Rhytidoplasty , Personal Satisfaction , Psychometrics , Brazil , Cross-Cultural Comparison , Surveys and Questionnaires , Reproducibility of Results , Patient Satisfaction
14.
Acta cir. bras ; 34(10): e201901007, Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054673

ABSTRACT

Abstract Purpose: To conduct a scope review of the experimental model described by Walker and Mason, by identifying and analyzing the details of the method. Methods: The authors searched Pubmed-Medline, Cochrane-Bireme and PEDro databases for articles published between January 2016 and December 2018, using the following search queries: burns, burn injuries, models animal, and animal experimentation. All articles whose authors used Walker and Mason's model - with or without changes to the method in Wistar rats - were included in this study. Results: The search identified 45 mentions of Walker and Mason's model; however, after reading each summary, 20 were excluded (of which 5 due to duplicity). The inconsistencies observed after the scope review were: water temperature, length of time of exposure of the experimental model's skin to water, extent of the burnt area, and the description of the thickness/depth of the injury. Conclusions: Reproducibility of a scientific method is the basis to prove the veracity of the observed results. Thus, it is necessary to have a greater number of publications that adopt a reproducible scientific method, for this review found inconsistencies in the description of Walker and Mason's model.


Subject(s)
Animals , Burns/etiology , Disease Models, Animal , Hot Temperature , Skin/injuries , Time Factors , Water , Reproducibility of Results
15.
Rev. bras. cir. plást ; 34(3): 384-390, jul.-sep. 2019. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1047160

ABSTRACT

Introdução: O tratamento de grandes e médias feridas é um desafio para os cirurgiões quando precisam fechálas e, normalmente, são utilizadas técnicas cirúrgicas de enxertias ou retalhos, que podem deixar sequelas e até mesmo mutilações. Ao longo do tempo desenvolveu-se a técnica de "sutura elástica" que promove a cicatrização em curto espaço de tempo com sequelas menores, entretanto o procedimento tem sido realizado com material improvisado. Objetivo: Desenvolver um fio de sutura elástico cirúrgico que possa ser esterilizado e confeccionado nos moldes dos produtos médicos cirúrgicos. Métodos: Revisão das patentes existentes por meio da busca de anterioridade e comparação com o dispositivo do estudo. Pesquisa de materiais com as características necessárias como elasticidade e tensão. Teste destas características em laboratórios especializados. Resultados: O produto desenvolvido é um fio elástico com duplo agulhamento para suturas, com matéria prima de silicone que apresenta elasticidade e resistência a tensão. Conclusão: O fio de sutura elástico, com duplo agulhamento, para feridas de médio e grande porte foi desenvolvido.


Introduction: Closing large and medium wounds is challenging for surgeons and often leads to the use of graft or flap surgical techniques. These procedures can leave sequelae and even mutilations. An "elastic suture" technique was developed to promote wound healing in a short time span with minor sequelae; however, improvised materials have been used in this procedure. Objective: To develop a surgical elastic suture thread that can be manufactured and sterilized following the standards of surgical medical products. Methods: We conducted a patent search, compared the findings with the study device, and researched materials with necessary characteristics such as elasticity and tension. Testing these characteristics in specialized laboratories. Results: The developed device is a double-needled elastic suture made of silicone that presents tensile strength. Conclusion: Here, we developed a double-needled elastic suture for medium and large wounds.


Subject(s)
Humans , History, 21st Century , Surgery, Plastic , Surgical Instruments , Sutures/standards , Wound Healing , Suture Techniques/instrumentation , Wound Closure Techniques , Surgery, Plastic/instrumentation , Surgery, Plastic/methods , Surgical Instruments/standards , Sutures , Wound Healing/ethics , Wounds and Injuries , Wound Closure Techniques/instrumentation
16.
Rev. bras. cir. plást ; 34(1): 86-93, jan.-mar. 2019. tab
Article in English, Portuguese | LILACS | ID: biblio-994552

ABSTRACT

Introdução: Em dois estudos prévios, avaliou-se a qualidade dos ensaios clínicos aleatórios (ECAs) com a participação de pelo menos um cirurgião plástico, em dois períodos: 1966 a 2003 e 2004 a 2008. O objetivo é avaliar a evolução da qualidade das publicações de ECAs por cirurgiões plásticos no período subsequente de cinco anos, de 2009 a 2013. Métodos: ECAs publicados de 2009 a 2013, em língua inglesa, com a participação de pelo menos um cirurgião plástico, foram identificados por busca eletrônica e classificados quanto ao sigilo de alocação, por dois avaliadores independentes. Os estudos com sigilo de alocação adequado tiveram a qualidade avaliada por dois avaliadores, utilizando-se a Lista de Delphi e a Escala de Qualidade de Jadad. Resultados: Dos 6.997 estudos identificados, 261 foram classificados quanto ao sigilo de alocação. Destes, 43 (16,47%) tinham sigilo de alocação adequado. Segundo a avaliação pela Lista de Delphi, houve melhora, em relação a 1966-2003, nos itens "características mais importantes do prognóstico" (p < 0,001), "uso de avaliador independente" (p = 0,0029) e "medidas de variabilidade e estimativa de pontos para a variável primária" (p = 0,0057); não houve diferença em relação a 2004-2008. Quanto à Escala de Qualidade de Jadad, houve um aumento dos escores em relação a 1996-2003 (p < 0,0004), mas também sem diferença significante em relação ao período 2004-2008. Conclusão: Não houve diferença na qualidade das publicações de ECAs por cirurgiões plásticos no período de 2009 a 2013, em relação aos cinco anos anteriores (2004 a 2008). Entretanto, ambos os períodos apresentaram maior qualidade quando comparados ao período de 1966 a 2003.


Introduction: In two previous studies, the quality of randomized clinical trials (RCTs) with the participation of at least one plastic surgeon was assessed in two periods: from 1966 to 2003 and from 2004 to 2008. The objective is to evaluate the evolution of the quality of RCTs published by plastic surgeons in the subsequent five-year period, from 2009 to 2013. Methods: RCTs published from 2009 to 2013, in English, with the participation of at least one plastic surgeon, were identified by an electronic search and classified according to allocation concealment by two independent evaluators. The quality of the studies with adequate allocation concealment was evaluated by two evaluators using the Delphi List and the Jadad Scale. Results: Of the 6,997 identified studies, 261 were classified according to allocation concealment. Of these, 43 (16.47%) had adequate allocation concealment. According to an assessment conducted using the Delphi List, there was an improvement in the items "most important characteristics of the prognosis" (p < 0.001), "use of an independent evaluator" (p = 0.0029), and "measures of variability and estimation of points for the primary variable" (p = 0.0057) compared to the 1966-2003 assessment ; there was no difference in the assessment of the same items from 2004-2008. Regarding the Jadad Scale, there was an increase in the scores from 2009 to 2013 compared to the 1996-2003 period (p < 0.0004); however, there was no significant difference in the 2004-2008 period. Conclusion: There was no difference in the quality of the RCTs published by plastic surgeons in the 2009-2013 period compared to the previous five-year period (2004 to 2008). However, both periods indicated higher quality compared to the 1966-2003 period.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Surgery, Plastic/adverse effects , Surgery, Plastic/methods , Randomized Controlled Trials as Topic/methods , Randomized Controlled Trials as Topic/statistics & numerical data , Randomized Controlled Trials as Topic/ethics , Statistical Analysis , Health Care Evaluation Mechanisms/statistics & numerical data
17.
Rev. bras. cir. plást ; 34(1): 120-126, jan.-mar. 2019.
Article in English, Portuguese | LILACS | ID: biblio-994565

ABSTRACT

Introdução: A cirurgia de mama, especialmente as associadas aos implantes de silicone, teve uma crescente popularização, tornando-se a cirurgia plástica mais realizada no mundo. Junto com esta proliferação, observa-se um aumento da preocupação com a segurança dos implantes mamários de silicone, pelas intercorrências relacionadas. Objetivo: Revisar métodos existentes para minimizar as complicações relacionadas com implante mamário de silicone, bem como as tecnologias existentes e tendências tecnológicas para implantes mamários de silicone. Métodos: Foi realizada revisão de artigos científicos relacionados com novas tecnologias e tendências para redução das complicações relacionadas com implantes mamários de silicone, bem como as patentes e fabricantes de implante de silicone mamário. Resultados: Identificamos inicialmente 78 referências, sendo reduzido para 40 para publicação, todos com linhas de pesquisas que buscam melhores resultados e redução das complicações relacionadas com implantes de silicone, seja esta cirurgia com objetivo estético ou reconstrutivo. Conclusão: A busca por um implante mamário que reduza as possíveis e frequentes complicações, principalmente a formação do biofilme, processos infecciosos e resposta imune, é o foco da maioria das pesquisas encontradas. Com o mesmo objetivo, porém surgindo mais recentemente como alternativas, existem as pesquisas para o uso de matriz dérmica acelular e a lipoenxertia, com boas expectativas.


Introduction: Breast surgery with silicone implants is gaining popularity and has become the most performed plastic surgery worldwide. However, there is increasing concern about the safety of silicone breast implants due to associated complications. Objective: To review existing technologies, technological trends, and existing methods to minimize complications related to silicone breast implants. Methods: We conducted a literature review of articles describing new technologies and trends to reduce complications related to silicone breast implants, along with information on patents and manufacturers of silicone breast implants. Results: We initially identified 78 articles, out of which 40 were shortlisted for publication . All articles had a common aim of obtaining better results and reducing complications related to silicone implants, either in aesthetic or reconstructive surgeries. Conclusion: The search for a breast implant that reduces possible and frequent complications, especially biofilm formation, infectious processes, and abnormal immune response, was the focus of most articles studied. Acellular dermal matrix and fat grafting have been reported in the literature as promising alternatives.


Subject(s)
Humans , Female , Middle Aged , Aged , Silicone Elastomers/adverse effects , Silicone Elastomers/standards , Breast Neoplasms/surgery , Mammaplasty/methods , Breast Implants/adverse effects , Breast Implants/standards , Reconstructive Surgical Procedures/methods , Reconstructive Surgical Procedures/trends
18.
Acta cir. bras ; 34(1): e20190010000008, 2019. graf
Article in English | LILACS | ID: biblio-983687

ABSTRACT

Abstract Purpose: To create a question and answer tool on patents on EMHO. Methods: Was used the Thinking Design methodology divided into four phases: Discovery, Definition, Development and Delivery. Discovery Phase: Desk research was carried out in: SciELO, Pubmed, LILACS, Google and Google Scholar. Once the target audience was selected, the interviews were conducted. Definition Phase: the interviewees' difficulties were mapped, on an Excel spreadsheet. Development Phase: a brainstorming was conducted with the public interviewed. Delivery Phase: the prototype, validation and final elaboration of the tool were made. Results: Discovery Phase: 10 inventors were identified and the interviews were carried out. Definition Phase: 80% of the interviewees determined lack of information as one of the problems. The main content was defined as: the patent process, from the beginning of the idea to the deposit (70%), search for precedence (40%) and informing partners (30%). Development Phase: with the brainstorming, the tool type was defined as an interactive site. Delivery Phase: a prototype with content framework and an interactive video was presented for validation. After approval, the interactive website was developed, which was made available to the public. Conclusion: A question and answer tool on patents in EMHO was developed.


Subject(s)
Humans , Patents as Topic , Dental Equipment/standards , Equipment and Supplies, Hospital/standards , Surveys and Questionnaires , Retrospective Studies , Qualitative Research , Inventors
19.
Acta cir. bras ; 34(9): e201900907, 2019. graf
Article in English | LILACS | ID: biblio-1054696

ABSTRACT

Abstract Purpose: To describe a case report of FG associated with NPWT in the treatment of complex wound on the distal third of the lower limb with bone exposure. Case Report: A 59-year-old patient with chronic left tibial osteomyelitis since childhood underwent extensive debridement of the distal tibial diaphysis (40% of bone thickness per 10 cm extension) and placement of bioactive glass S53P4. Distal necrosis occurred in the fasciocutaneous flap used as the primary bone coverage. After flap debridement, the case was resolved with FG, directly on the exposed bone and biomaterial, associated with NPWT. Three weeks after the first FG session over bony tissue, 100% granulation was achieved with NPWT. The closure was completed with thin laminated skin graft over the granulated wound area. Discussion: The association of FG and NPWT is not known in the clinical practice. Except for the only one experimental study described by Kao et al.4, the theme was not addressed in the medical literature before. In this clinical case, the result obtained regarding the granulation tissue formation drew attention and prevented the use of more complex flaps such as the microsurgical ones. Accelerated granulation tissue formation was observed, filling an extensive and deep bone defect, even with infected bone and biomaterial. Low morbidity and no complications were observed with the use of FG associated with NPWT. When the grafted fat was compacted with the NPWT, it seemed to behave as a true autologous biological matrix with large amount of cells. To date, scientific studies on fat grafting have focused on the cellular aspect (adipocytes and mesenchymal cells), growth factors and fat differentiation in different tissues. The property of aspirated adipose tissue as a biological matrix seemed to be revealed by the application of NPWT in association with FG. This new roll for the aspirated fat tissue may represent a new research field in plastic surgery.


Subject(s)
Humans , Male , Middle Aged , Osteomyelitis/surgery , Wound Healing , Adipose Tissue/transplantation , Negative-Pressure Wound Therapy/methods , Surgical Flaps , Glass
20.
Clinics ; 74: e883, 2019. tab
Article in English | LILACS | ID: biblio-1011917

ABSTRACT

OBJECTIVES: To evaluate the impact of breast reconstruction after mastectomy on sexual function, body image, and depression. METHODS: This cross-sectional, comparative, controlled study was conducted with 90 women between 18 and 65 years of age who had undergone either mastectomy alone (mastectomy group, n=30) or mastectomy combined with breast reconstruction (mastectomy-reconstruction group, n=30) at least one year prior to the study or who had no breast cancer (control group, n=30). Patients were assessed for sexual function, depression, and body image using the validated Brazilian-Portuguese versions of the Female Sexual Function Index, the Beck Depression Inventory, and the Body Dysmorphic Disorder Examination, respectively. RESULTS: The three groups were homogeneous for age, marital status, body mass index, and education level. The women in the mastectomy group reported significantly worse sexual function, greater depressive symptoms, and lower body image than those in the mastectomy-reconstruction and control groups. In the mastectomy group, the frequency of sexual dysfunction was significantly greater among patients without a marital partner and those with a higher level of education than among patients in the other two groups with the same characteristics. CONCLUSION: Patients who had undergone breast reconstruction after mastectomy reported better sexual function and body image and fewer depressive symptoms than patients who had undergone mastectomy alone. Sexual dysfunction was associated with the absence of a marital partner and a higher level of education and was more frequent in the mastectomy group.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Sexual Behavior/psychology , Body Image/psychology , Breast Neoplasms/psychology , Mammaplasty/psychology , Sexuality/psychology , Mastectomy/psychology , Socioeconomic Factors , Breast Neoplasms/surgery , Body Mass Index , Cross-Sectional Studies , Depression/psychology
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