ABSTRACT
PURPOSE: To evaluate experimental cranial vault reconstructions, by combining bone morphogenetic protein type 2 (BMP-2) and different matrices. METHODS: Fourty-nine animals were initially included (seven per group). We designed an experimental, open, prospective and comparative study, divided in seven groups: 1 - BMP-2+calcium phosphate (BT); 2 - BMP-2+acellular dermal matrix (BM); 3 - BMP-2+calcium alginate (BA); 4 - TCP; 5 - MDM; 6 - ALG; 7 - Bone autograft (BAG). A bone failure was created in left parietal bone of adult male mice. At the same procedure reconstruction was performed. After five weeks, animals were sacrificed, and reconstruction area was removed to histological analysis. After exclusion due to death or infection, thirty-eight animals were evaluated (BT=5; BM=6; BA=6; TCP=7; MDM=3; ALG=6; BAG=5). RESULTS: A higher incidence of infection has occurred in MDM group (57%, P=0.037). In cortical fusion, groups BAG, TCP, and BMP-2+TCP (BT) obtained the best scores, comparing to the others (P=0.00846). In new bone formation, groups BT, BAG, and TCP have presented the best scores (P=0.00835). When neovascularization was considered, best groups were BMP-2+MDM (BM), BMP-2+ALG (BA), TCP, and MDM (P=0.001695). BAG group was the best in bone marrow formation, followed by groups BT and TCP (P=0.008317). CONCLUSIONS: Bone morphogenetic protein type 2 increased bone regeneration in experimental skull reconstruction, especially when combined to calcium phosphate. Such association was even comparable to bone autograft, the gold-standard treatment, in some histological criteria. .
Subject(s)
Animals , Male , Acellular Dermis , Alginates/therapeutic use , /therapeutic use , Bone Regeneration/drug effects , Calcium Phosphates/therapeutic use , Skull/surgery , Biocompatible Materials/therapeutic use , Bone Regeneration/physiology , Bone Substitutes/therapeutic use , Bone Transplantation/methods , Disease Models, Animal , Glucuronic Acid/therapeutic use , Hexuronic Acids/therapeutic use , Neovascularization, Physiologic/drug effects , Neovascularization, Physiologic/physiology , Reference Values , Reproducibility of Results , Skull/pathology , Time Factors , Treatment OutcomeABSTRACT
Hidrocolóide e alginato de cálcio são utilizados no tratamento de lesões cutâneas e muitos profissionais da saúde desconhecem as evidências que sustentam sua indicação na cicatrização. Objetivou-se nesse estudo identificar evidências da ação da placa de hidrocolóide e alginato de cálcio no tratamento de lesão cutânea. Utilizou-se o método de revisão integrativa da literatura. Fizeram parte da amostra 12 estudos com nível de evidências I, II, III e IV, formados por pacientes com lesão cutânea tratada durante qualquer período de tempo com hidrocolóide placa ou alginato de cálcio. Os desfechos avaliados foram redução da área, cicatrização da lesão, taxa de cicatrização, tempo e infecção. Os resultados permitiram estabelecer três recomendações para o uso de hidrocolóide e nenhuma para uso de alginato de cálcio no tratamento de lesão crônica.
Hydrocolloid and calcium alginate are used to treat cutaneous injuries and many health professionals do not know about its cicatrization effects. This study had the objective to identify the evidences of the action of the hydrocolloid and calcium alginate dressing in the treatment of cutaneous injuries. The method of integrative review was used. 12 studies with evidence levels I, II, III and IV were part of the sample; they were composed by patients with cutaneous injuries treated in any period of time with hydrocolloid dressing or calcium alginate. The evaluated outcomes had been reduction of the area, cicatrization of the injury, rate of cicatrization, time and infection. The results had allowed establishing three recommendations for the use of hydrocolloid and none for use of alginate of calcium in the treatment of chronic injury.
El hidrocoloide y el alginato de calcio se utilizan en el tratamiento de lesiones en la piel y muchos profesionales de la salud desconocen sus efectos sobre la cicatrización de heridas. Este estudio pretende identificar evidencia de acción de placas de alginato de calcio y de hidrocoloide para el tratamiento de la lesión cutánea. Se utilizó el método de revisión integradora. Fueran incluidos en la muestra 12 estudios con nivel de evidencia I, II, III y IV, formado por pacientes con lesión cutánea tratado durante cualquier período de tiempo con hidrocoloide placa o con alginato de calcio. Los resultados evaluados fueran reducción del área, cicatrización de lesión, tasa de cicatrización, tiempo e infección. Los resultados han permitido establecer tres recomendaciones para el uso del hidrocoloide y ninguna para el uso del alginato de calcio en el tratamiento de heridas.