ABSTRACT
The aim of this study was to characterize the tissue reactions triggered by the polypropylene mesh coated with chitosan and polyethylene glycol film, and if it's able to prevent the formation of peritoneal adhesions. Defects in the abdominal wall of rats were induced and polypropylene meshes coated with chitosan/polyethylene glycol (CPEG group, n= 12) and uncoated (PP control group, n= 12) were implanted. On the fourth and forty-fifth postoperative day the formation of adhesion and the tissue reaction to the biomaterial was evaluated through histological and histochemical analysis. The area (P= 0.01) and severity (P= 0.002) of the adhesion was significatively less in the CPEG group. On the fourth day the foreign body reaction was less intense in CPEG group (P= 0.018) and the production of collagen fibers was more intense in this group (P= 0.041). The tissue reactions caused by the biomaterials were similar on the 45th day, with the exception of the high organization of collagen fibers in the CPEG group. The CPEG meshes did not fully prevent the formation of adhesions, but minimized the severity of the process. The foreign body reaction promoted by polypropylene meshes coated with CPEG is less intense than that triggered by uncoated polypropylene meshes.(AU)
O objetivo deste estudo foi caracterizar as reações tissulares desencadeadas pela tela de polipropileno revestida com o filme de quitosana e polietilenoglicol e verificar se ela é capaz de prevenir a formação de aderências peritoneais. Um defeito na parede abdominal dos ratos foi realizado, e as telas de polipropileno revestidas com quitosana/polietilenoglicol (grupo CPEG, n= 12) e sem revestimento (grupo controle PP, n= 12) foram implantadas. No quarto e no 45º dia pós-operatório, avaliou-se a formação de aderências e a reação tecidual ao biomaterial por análise histológica e histoquímica. A área (P= 0,01) e a severidade (P= 0,002) da aderência peritoneal foram significativamente menores no grupo CPEG no 45º dia. No quarto dia, observou-se que a reação do corpo estranho foi menor no grupo CPEG (P= 0,018), e a produção de fibras de colágeno mais intensa (P= 0,041). As reações tissulares causadas pelos biomateriais implantados foram semelhantes no 45º dia, com exceção da melhor organização das fibras colágenas no grupo CPEG. As telas CPEG não impediram completamente a formação de aderências, porém minimizaram a gravidade do processo. A reação de corpo estranho promovida por telas de polipropileno revestidas com CPEG é menos intensa do que a desencadeada por telas de polipropileno não revestidas.(AU)
Subject(s)
Animals , Rats , Polyethylene Glycols , Polypropylenes , Surgical Mesh/veterinary , Foreign-Body Reaction/veterinary , Abdominal Wall/surgery , Chitosan , Tissue Adhesions/veterinaryABSTRACT
Aderências intra-abdominais são complicações de cirurgias de equinos que podem resultar em processos obstrutivos e comprometer a sobrevida dos animais. O presente estudo utilizou dez equinos hígidos, machos, sem raça definida (SRD), com quatro a 15 anos de idade e peso vivo situado entre 300 e 400 quilogramas (kg). Os animais foram submetidos à laparotomia esquerda em estação com o objetivo de serem induzidas aderências, testar a utilização intestinal de membrana biológica de pericárdio como prevenção e avaliar as diferentes alterações sistêmicas e do líquido abdominal. Após sedação e analgesia local, foi utilizado o acesso cirúrgico em grade, na flexura pélvica foi criada uma área de abrasão que, no Grupo 1, foi coberta por pericárdio homólogo e no Grupo 2, lavada com solução fisiológica. Após reposicionamento foi realizada a sutura muscular, de subcutâneo e pele. O pós-operatório constou de avaliações clínicas, citologia do líquido abdominal, hematologia e bioquímica sérica nos momentos M0- pré-operatório e M7, M14, M21 e M28 dias de pós-operatório. Nova laparotomia foi realizada aos 30 dias para verificar aderências, aspecto e biópsia intestinal. A técnica cirúrgica possibilitou menor trauma e campo operatório restrito. A evolução clínica foi satisfatória e cicatriz fibrosa foi identificada entre os planos musculares. Aderências não foram observadas. As avaliações laboratoriais demonstraram aumento de bilirrubinas, hematócrito, monócito, ureia sanguíneos e de proteína, densidade e leucócitos segmentados no líquido peritoneal. Conclui-se que a abrasão foi insuficiente para promover aderências fibrosas. O implante, sem comprovada eficácia, é viável e possível, por não resultar em diferenças laboratoriais significativas ou alterações deletérias.
Intra-abdominal adhesions are equine surgery complications, which can result in obstructive processes and jeopardize the survival of these animals. The present study used 10 healthy, male mongrel horses (SRD), with four and 15 years of age and weighing between 300 and 400 kilograms (kg), who underwent laparotomy left station with the aim of inducing adhesions, test intestinal membrane using pericardium as prevention and evaluating the different systemic changes and the abdominal fluid. After sedation and local anesthesia, the surgical approach was used in grade; pelvic flexure was created in an area of abrasion that in Group 1 was covered by homologous pericardium and in Group 2, washed with saline. After repositioning muscle, the skin and subcutaneous tissue were sutured. Postoperative care consisted of clinical evaluation, abdominal fluid cytology, hematology and serum biochemistry in moments M0- preoperative, and M7, M14, M21 and M28 days postoperatively. New laparotomy was performed at 30 days from the surgery to verify adhesion, appearance and intestinal biopsy. The surgical technique allowed less trauma and restricted operative field. The clinical course was satisfactory, and fibrous scar was identified between the muscle planes. Adhesions were not observed. Laboratory evaluations showed increased bilirubin, hematocrit, monocyte, blood urea and protein density and segmented leukocyte peritoneal fluid. The present study concluded that the abrasion was insufficient to promote fibrous adhesions. The implant without proven efficacy is feasible and possible, and does not result in significant differences laboratory or deleterious changes.
Subject(s)
Animals , Male , Abdomen/surgery , Tissue Adhesions/veterinary , Bioprosthesis/veterinary , Horses/surgery , Laparotomy/veterinary , Blood Chemical Analysis/veterinary , Outcome Assessment, Health CareABSTRACT
To study the repair of pericranium-cutaneous flaps fixed with suture anchored in a skull bone tunnel or N-butyl-2-cyanoacrylate adhesive in Wistar rats with emphasis on the cellular inflammatory response and the production of types I and III collagen. The operated region in the cephalic region of Wistar rats was removed minutes before euthanasia, fixed in formalin, and subjected to histological preparation. Slides were stained with hematoxylin-eosin and Picrosirius. Standardized counts of polymorphonuclear and mononuclear cells, fibroblasts, and macrophages were performed, and the percentages of types I and III collagen were determined. Data collection occurred on days 3, 7, 14, 21, and 45 postoperatively. A value of p<0.05 was considered statistically significant. Quantitative analysis of the data showed more fibroblasts in the surgical adhesive group than in the nylon monofilament thread groups (p=0.0211). Qualitative analysis showed higher reactivity in the adhesive group, with a predominance of polymorphonuclear cells from days 3-45 and macrophages from days 3-7. The amount of type I collagen exceeded 80% in the treated and control groups at the end of the experiment. CONCLUSIONS: Subperiosteal detachment triggers a cellular inflammatory response that is amplified using soft tissue fixation methods. The adhesive n-butyl-2-cyanoacrylate was more reactive than the nylon monofilament thread anchored in the skull bone tunnel.
Subject(s)
Animals , Rats , Tissue Adhesions/veterinary , Sinus Pericranii , Rats/classificationABSTRACT
No presente relato descreve-se a remoção de urólitos vesicais, bem como o tratamento de um cisto renal por cirurgia laparoscópica em um cão com aderências intraperitoneais. Para o acesso foram utilizados três portais, dois de 10mm e um de 5mm, dispostos na linha média ventral e nas paredes abdominal direita e esquerda. Após a remoção das litíases, realizou-se sutura intracorpórea da parede vesical em duas camadas. O cisto renal direito foi drenado e sua cápsula extirpada. Ocorreu a perda temporária de um urólito na cavidade abdominal e sua posterior recuperação pela cirurgia laparoscópica. O paciente não apresentou recidiva da doença pelo período mínimo de 14 meses. A cirurgia laparoscópica mostrou-se eficaz na terapêutica de ambas as patologias, sem a necessidade de alteração do posicionamento dos portais.
This study reports the laparoscopic treatment of urolithys and renal cist in a dog with adherences after laparotomy. Three portals (two with 10mm and one with 5mm) were used in the middle ventral line or lateral flanks. The calculi were removed, and two intracorporeal sutures were made in the vesicle tissue. The right cystic tissue was drained and its capsule was extirpated. One calculus was lost in the peritoneal cavity, but later recovered by laparoscopy. The patient did not show urinary vesicle disease during at least 14 months. The laparoscopic cistotomy appears to be adequate to remove urolithys and to treat renal cystic disease in dogs.