ABSTRACT
ABSTRACT PURPOSE : To evaluate the effects of platelet rich plasma (PRP) on the healing of fascia wherein peritonitis has been created. METHODS: Twenty eight Wistar Albino rats were divided into four groups. Only a primary fascial repair following laparotomy was performed on Group 1, a primary fascial repair performed and PRP treatment applied following laparotomy on Group 2, and a fecal peritonitis created following laparotomy and a primary fascial repair carried out on Group 3. A fecal peritonitis was created following laparotomy and primary fascial repair and PRP treatment on the fascia was carried out on Group 4. RESULTS: TNF-α was found to be significantly lower in the control group (Group 1). It was detected at the highest level in the group in which fecal peritonitis was created and PRP applied (Group 4). TGF-β was determined as being significantly higher only in Group 4. Histopathologically, the differences between the groups in terms of cell infiltration and collagen deposition were not found to be significant. CONCLUSION: When platelet rich plasma was given histologically and biochemicaly as wound healing parameters cellular infiltration, collagen accumulation, and tissue hydroxyiproline levels were not increased but neovascularization, fibroblast activation and TNF Alfa levels were increased and PRP accelerated wound healing.
Subject(s)
Animals , Peritonitis/complications , Wound Healing , Platelet-Rich Plasma , Fascia/physiology , Peritonitis/metabolism , Serine Endopeptidases/metabolism , Random Allocation , Transforming Growth Factor beta/analysis , Transforming Growth Factor beta/metabolism , Collagen/drug effects , Collagen/metabolism , Tumor Necrosis Factor-alpha/analysis , Tumor Necrosis Factor-alpha/metabolism , Rats, Wistar , Gelatinases/metabolism , Neovascularization, Physiologic , Models, Animal , Fascia/blood supply , Hydroxyproline/analysis , Hydroxyproline/metabolism , Membrane Proteins/metabolismABSTRACT
The surgical anatomy of the Scarpa's fascia and its blood supply was studied by dissecting fifteen adult cadavers. Six cadavers were injected with red latex through common iliac artery to demonstrate the arterial supply of the fascia. The results of the present dissection revealed that: the Scarpa's fascia is a well defined single membranous sheet within subcutaneous tissue layer at the lower part of the anterior abdominal wall. It is thick and well developed inferiorly and thinned out superiorly. Histological study revealed that: the Scarpa's fascia is composed of multiple connective tissue vascularized sheets, loosely adherent to one another and it contains abundant elastic tissue. Cadaveric dissections revealed that the arterial supply of the fascia comes from the principle arterial vascular pedicle through the superficial epigastric artery which arises from femoral artery, pierces the Scarpa's fascia and ramifies on the superficial surface of the fascia. This artery has a wide caliber suitable for microvascular free transfer. Additional blood supply to the fascia were found in form of fine perforating blood vessels from the anterior wall of the rectus sheath. Depending on the present results, the Scarpa's fascia is a thin elastic vascular membrane and provides a reliable donor site for free and pedicled flap transfer in plastic surgery
Subject(s)
Humans , Fascia/anatomy & histology , Fascia/blood supply , Cadaver , Fascia/transplantation , Surgery, PlasticABSTRACT
A cobertura cutânea da regiäo do tornozelo e pé vem sendo um problema de difícil soluçäo. Os retalhos de fluxo reverso podem cobrir área grande sem os inconvenientes dos retalhos microcirúrgicos. Os autores realizaram um estudo anatômico do retalho fasciocutâneo da fíbula, tendo sido dado especial enfoque aos vasos que constituem esse retalho. Dez cadáveres foram submetidos a injeçäo da artéria fibular por soluçäo contrastante. Os calibres da artéria fibular e poplítea, o número de veias comitantes da artéria fibular, o número de perfurantes que väo nutrir o tecido cutâneo do retalho, a distância da emergência dessas perfurantes e a distância da emergência da artéria tibial anterior e da artéria fibular foram devidamente catalogados. A constância dos valores obtidos permitiu-nos concluir que esse retalho é bastante seguro. Com vista aos valores numéricos obtidos foi possível inferir regras práticas aplicáveis no planejamento desse retalho, o que vem ao encontro da idéia de tornar a utilizaçäo desse retalho ainda mais segura.
Subject(s)
Humans , Adult , Middle Aged , Fascia/anatomy & histology , Fascia/blood supply , Perna/anatomy & histology , Perna/blood supply , Surgical Flaps , CadaverABSTRACT
A reparaçäo de perdas extensas na perna e no pé ainda apresenta dificuldades para o cirurgiäo plástico. Entre os muitos métodos que podem ser utilizados nessas situaçöes, os retalhos musculares e musculocutâneos säo freqüentemente muito volumosos e os retalhos microcirúrgicos, embora convenientes, näo podem ser aplicados em qualquer centro. Os retalhos fasciocutâneos parecem ser boa opçäo. Eles foram usados para cobertura de perda substancial na perna e pé em 19 pacientes. Os resultados foram satisfatórios, pois o retalho proporcionou cobertura estável para fraturas de tíbia ou de perdas no pé. As desvantagens foram a necessidade de procedimento em dois tempos e uma área doadora com seqüela aquém da ideal