Use of the amniotic membrane to cover the peritoneal cavity in the reconstruction of the abdominal wall with polypropylene mesh in rats / Uso da membrana amniótica como cobertura da cavidade abdominal na reconstrução da parede com tela de polipropileno em ratos

OBJECTIVE: To evaluate the efficacy of the amniotic membrane used with polypropylene mesh against the formation of adhesions and its influence on healing. METHODS: twenty five female Wistar rats were anesthetized for creating a parietal defect in the anterior abdominal wall. Its correction was made with polypropylene mesh alone and associated with amniotic membrane. In the control group (n=11), the screen was inserted alone. In group A (n=7) we interposed the amniotic membrane between the screen and the abdominal wall. In group B, the amniotic membrane was placed on the mesh, covering it. After seven days, the animals were euthanized for macroscopic and microscopic evaluation of healing. RESULTS: adhesions were observed in all animals except one in the control group. Severe inflammation was observed in all animals in groups A and B and in three of the control group, with significant difference between them (A and B with p=0.01). Pronounced angiogenic activity was noted in one animal in the control group, six in group A and four in group B, with a significant difference between the control group and group A (p=0.002) and group B (p=0.05). The scar collagen was predominantly mature, except in five animals of the control group, with significant difference between the control group and group A (p=0.05) and group B (p=0.05). CONCLUSION: The amniotic membrane did not alter the formation of adhesions in the first postoperative week. There were also pronounced inflammation, high angiogenic activity and predominance of mature collagen fibers, regardless of the anatomical plane that it was inserted in.

OBJETIVO: Avaliar a eficácia da membrana amniótica usada com tela de polipropileno contra a formação de aderências e sua influência na cicatrização. MÉTODOS: vinte e cinco ratas Wistar foram anestesiadas para criação de um defeito parietal na parede abdominal anterior. Sua correção foi feita com tela de polipropileno isolada e associada à membrana amniótica. No grupo Controle (n=11), a tela foi inserida isoladamente intra abdominal. No grupo A (n=7), interpôs-se a membrana amniótica entre a tela e a parede abdominal. No grupo B, a membrana amniótica foi colocada sobre a tela, recobrindo-a. Após sete dias, os animais foram eutanasiados para avaliação macroscópica e microscópica da cicatrização. RESULTADOS: aderências foram observadas em todos os animais, exceto em um do grupo Controle. Inflamação acentuada foi observada em todos os animais dos grupos A e B e em três do grupo Controle, com diferença significativa entre eles (A e B com p=0,01). Acentuada atividade angiogênica foi notada em um animal do grupo Controle, seis do grupo A e quatro do grupo B, com diferença significativa entre o grupo Controle e os grupos A (p=0,002) e B (p=0,05). O colágeno cicatricial foi predominantemente maduro, exceto em cinco animais do grupo Controle, com diferença significativa entre o grupo Controle e os grupos A (p=0,05) e B (p=0,05). CONCLUSÃO: a presença da membrana amniótica não alterou a formação de aderências na primeira semana de pós-operatório. Associou-se à inflamação acentuada, elevada atividade angiogênica e predomínio de fibras colágenas maduras, independente do plano anatômico em que foi inserida.

Amniotic membrane as a biological dressing in infected wound healing in rabbits

PURPOSE: To investigate amniotic membrane as a biological dressing in infected wound healing in rabbits. METHODS: The use of preserved amniotic membranes (AMs) was examined using 15 rabbits with experimentally induced wound infections on their backs. Healing was histologically evaluated during different phases including inflammation, granulation, epithelialization, and fibroplasia. The animals were distributed into three groups for histological study at seven, 14, 21, and 28 days post-wound induction. Group A did not receive treatment: the wound was left exposed and dry; Group B received a daily exposure treatment with collagenase; and Group C received one AM, which also remained exposed. RESULTS: A marked reduction of the inflammatory phase was observed in Group C at 21 days, and the granulation phase of this healing increased at 14 days. Epithelialization was similar among the three groups, and fibroplasia was more pronounced in Group C at 14 days. Furthermore, gradual collagen organization also began for the animals in Group B at 14 days. CONCLUSION: The amniotic membrane did not significantly alter the inflammation, epithelialization, or fibroplasia phases but did increase angiogenesis up to Day 14 compared with the dry dressing and collagenase treatments. .

Paramentação cirúrgica: artigo de revisão / Surgical attire: a review article

Esta revisão objetivou a descrição da paramentação cirúrgica e suas reais necessidades. Procedimentos cirúrgicos e anestésicos tornam necessárias precauções para reduzir os riscos biológicos que ocorrem em pacientes e na equipe multiprofissional em contato com líquidos, tecidos orgânicos e agentes infecciosos em centro cirúrgico. Seu intuito é proteger pacientes e a equipe multiprofissional contra microrganismos presentes e liberados em centro cirúrgico. A paramentação cirúrgica é a troca das vestimentas rotineiras por outras adequadas, em áreas restritas ou semirrestritas do centro cirúrgico, proporcionando barreiras contra ainvasão de microrganismos. Utilizou-se a seleção de artigos publicados na MEDLINE, LILACS, PUBMED, COCHRANE LIBRARY e livros. Não existem normas de leis para o uso da paramentação cirúrgica, ficando sob a vigilância sanitária vigente em cada município e ainda às normas internas de funcionamento de cada centro cirúrgico. Constitui-se em medida eficaz na redução dos processos infecciosos pós-operatórios, mesmo com resultados contraditórios em vários estudos sobre o reconhecimento das reais fontes e formas de transmissão dos microrganismos em um centro cirúrgico.

This review focused on the description of surgical attire and its actual requisite use. Surgical and anesthetic procedures requite that precautions are taken to reduce biological risk to patients and to the multiprofessional team in contact with fluids, organic tissues and infectious agents in the surgical center. Its purpose is protecting patients and the multiprofessional team against microorganisms existing and released in the surgical center. Use of surgical attire includes the exchange of everyday clothing for more adequate pieces in restricted or semi-restricted areas in the operatingroom, thus providing barriers against the invasion of microorganisms. A selection of articles published in MEDLINE, LILACS, PUBMED, COCHRANE LIBRARY and books were used. There are no regulations in place for the use of surgical attire, and its use is controlled by each municipaltiy's health surveillance team as well as by internal rules of operation in every surgical center. It constitutes an effective measure to decrease postoperative infectious processes, even though several studies contradict with regards to the actual sources and modes of transmission of microorganisms in the operating room.

Lesões múltiplas de osteoma cutis na face: terapêutica minimamente invasiva em pacientes com sequela de acne - relato de casos / Multiple injuries of osteoma skin in the face: therapeutical least invasive in patients with acne sequela - case report

Osteoma cutis é a formação óssea no interior da pele, podendo ser primária ou secundária. Única ou múltipla, de tamanhos variados e acometendo ambos os sexos, é uma lesão cutânea rara, de etiopatogenia e classificação ainda discutidas. Nosso objetivo foi relatar o diagnóstico e a terapêutica minimamente invasiva de lesões múltiplas de osteoma cutis na face em pacientes com sequelas de acne. Fizemos a retirada dos osteomas com agulhas BD 0,70 x 25 22G1, sem anestésicos tópicos ou injetáveis no local. As pequenas incisões foram deixadas expostas, com pomada cicatrizante. Obteve-se um excelente resultado estético em 15 dias.

Osteoma cutis is a bone formation in the dermis can to be primary or secondary forms. Only, multiples, many forms, occurring on either sex, they are a rare cutaneous disease. The pathogenesis and classification remains unclear. Our objective was the diagnostic and small invasive surgery treatment of the osteoma cutis multiple of the face, in patients as a sequel of acne. To remove the osteoma we used needle BD 0,70x25 22G1, without anesthetic topic or inject able site. The small wounds were exposed with scarring balsam. We got an excellent esthetic result after 15 days.