Alternativas para onfaloplastia em cirurgia estética do abdome: Revisão da Revista Brasileira de Cirurgia Plástica e apresentação da experiência com técnica em H / Alternatives to omphaloplasty in aesthetic surgery of the abdomen: Review of the Revista Brasileira de Cirurgia Plástica and presentation of the experience with the technique in H

Introdução: A abdominoplastia está entre os procedimentos estéticos mais procurados na cirurgia plástica nos últimos anos. Dentro da perspectiva da imagem corporal, a confecção do neoumbigo é peça chave, e sua ausência, distorção ou má cicatrização comprometem o resultado cirúrgico. Diversas técnicas foram descritas, mas todas com suas limitações. O objetivo foi reunir um resumo das possibilidades cirúrgicas apresentadas na Revista Brasileira de Cirurgia Plástica (RBCP), além de reapresentar a técnica em H. Método: Foi realizada revisão qualitativa da literatura publicada na RBCP no período de 2000 a 2021. Foram incluídos artigos que descrevessem uma proposta de umbilicoplastia, referindo número de pacientes, idade, tempo de seguimento, avaliação da satisfação dos pacientes e complicações; sendo excluídas publicações sem fins estéticos ou pacientes pós grandes perdas ponderais. Resultados: Foram encontrados 38 artigos, sendo excluídos 7 pela análise dos títulos e resumos. Os demais artigos foram revisados por dois autores independentes, sendo realizada a exclusão de mais 20 artigos. No final, 11 artigos foram incluídos nesta revisão. Conclusão: A onfaloplastia em abdominoplastias pode ser realizada de várias formas, possibilitando uma gama variável de alternativas para os cirurgiões. A técnica em H é mais uma dessas ferramentas, podendo ser amplamente utilizada e trazendo resultados consistentes.

Introduction: Abdominoplasty has been among the most popular cosmetic procedures in plastic surgery in recent years. From the perspective of body image, making the new navel is a key part, and its absence, distortion, or poor healing compromises the surgical result. Several techniques have been described, but all with their limitations. The objective was to gather a summary of the surgical possibilities presented in the na Revista Brasileira de Cirurgia Plástica (RBCP), in addition to reintroducing the technique in H. Method: A qualitative review of the literature published in the RBCP in the period from 2000 to 2021 was carried out. Articles were included that described a proposal for umbilicoplasty, referring to the number of patients, age, follow-up time, assessment of patient satisfaction, and complications, excluding publications without aesthetic purposes or patients after major weight loss. Results: 38 articles were found, 7 of which were excluded by analyzing the titles and abstracts. Two independent authors reviewed the other articles, excluding another 20. In the end, 11 articles were included in this review. Conclusion: Omphaloplasty in abdominoplasties can be performed in several ways, providing surgeons with various alternatives. The H technique is one of these tools which can be widely used and bring consistent results.

Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery

ABSTRACT Purpose: To evaluate the impact of submersion of the microsurgical anastomosis suture area using saline (0.9% NaCl) in an experimental laboratory during the training of medical students and resident physicians. Methods: Wistar rats (n = 10) were selected to have the two femoral arteries sectioned and anastomosed end-to-end under optical magnification. They were randomly divided, so that on one side suturing was performed under submersion with saline, and the contralateral side was kept dry during the procedure. The surgical times, as well as the patency within 30 min and 72 h of the procedure, were evaluated. Results: Six male Wistar rats survived the surgical anesthetic procedure, with the average initial weight of 243.3 g and the average artery diameter of 0.86 mm, with average time of 15.67 min for the submerged technique and 20.50 min for the dry technique (p = 0.03). The failure rates were 17 and 50% for the submerged group and the dry one, respectively (p = 0.62). Conclusions: Submerged microvascular suture does not compromise the patency of the vessel or increase the time of anastomosis. Therefore, it is a strategy that can be applied by the surgeon according to his/her technical preferences.

Animal model of rapid crystalloid infusion in rats

PURPOSE: To describe an animal model of rapid intravenous infusion with different volumes of crystalloid and discuss the clinical findings. METHODS: Fifty six male Wistar rats were used, divided randomly in seven groups (n = 8). The rats of groups 1 to 6 received lactated Ringer´s solution intravenously, in the rate of 25 ml/min, with different volumes proportional to blood volume (BV). The rats of group 0 were submitted to the same procedure, but did not receive the fluid (control group). The data included respiratory rate, heart rate, saturation of peripheral oxygen (SpO2) in two times (before and after the infusion), and upshots (respiratory arrest and death). Dunnett´s test and ANOVA were used. RESULTS: The clinical signs significantly changed in the 2, 2.5 and 3 fold BV groups. The respiratory arrest was observed in the 1.5, 2, 2.5 and 3 fold BV groups, but death was present only in 2.5 and 3 fold BV groups. CONCLUSIONS: The infusion of crystalloid in the same volume of blood volume did not cause significant variation in respiratory and heart rate, saturation of peripheral oxygen and did not induce respiratory arrest. The infusion of a volume of 3 fold blood volume was lethal to all animals.

Modelo experimental do uso da neurorrafia términolateralem plexo braquial de ratos / Experimental model of use the end-to-side neurorrhaphy in rats brachial plexus

Introdução: Uma das sequelas dos acidentes de motocicleta tem sido a lesão do plexobraquial. Propomos um modelo experimental para tratamento de lesões parciais do plexobraquial com enxertos de nervo suturados com neurorrafia término-lateral entre os troncos.Método: Utilizamos 30 ratos Wistar, divididos em grupos Desnervado, Neurorrafia e Controle.Realizada a avulsão das raízes de C8 e T1. No Grupo Neurorrafia, dois segmentos doenxerto de nervo foram fixados entre o tronco superior e inferior avulsionado e entre troncomédio e inferior, sem janela epineural. No grupo desnervado, somente realizada avulsão dotronco inferior. O grupo controle não foi submetido a procedimento cirúrgico. Realizadoo “Grasping test” e estudo eletrofisiológico. Resultados: A análise microscópica após 16semanas confirmou a presença de axônios mielínicos nos enxertos e tronco inferior dosgrupos. No pós-operatório tardio, o “Grasping test” e a amplitude mostraram diferençasestatisticamente significantes entre os grupos. Na área da fibra nervosa e do axônio e naespessura da bainha de mielina, não houve significância. Na área da fibra muscular, houvediferença estatística. Conclusão: Concluiu-se que os troncos não lesados reinervaram otronco inferior no rato através das pontes de enxerto.

Introduction: One of the sequelae of motorcycle accidents has been the brachial plexusinjury. We propose an experimental model for treatment of partial injuries of the brachialplexus with nerve grafts sutured with end-to-side neurorrhaphy between the trunks. Method:We used 30 rats were divided into groups denervated (DG), neurorrhaphy (NG) andcontrol (CG). Held avulsion of the roots of C8 and T1. In neurorrhaphy group, two segmentsof nerve graft was fixed between the upper trunk and lower avulsed and between middleand lower trunk without epineural window. In the denervated group, only made avulsionof the lower trunk. The control group did not undergo surgery. Held the Grasping test,electrophysiological study and morphologicl study. Results: At microscopic analysis after16 weeks, confirmed the presence of myelinated axons in the grafts and lower trunk of thegroups. In the late postoperative period, the Grasping test and the scale showed statisticallysignificant differences between the groups. In the area of nerve fiber and the axon andthe thickness of the myelin sheath was not significant. In the area of muscle fiber was nostatistical difference. Conclusion: It was concluded that the trunks uninjured reinnervatedthe lower trunk in the rat through the bridge graft.