ABSTRACT
Silicone breast implant is associated with complications inherent to the surgical procedure. Prosthesis coating with polyurethane, however, commonly reduces the incidence of such complications. In this paper, the authors evaluated the inflammatory histomorphometric profile and oxidative damage associated to the implant of polyester urethane sheets. Forty-eight Wistar rats were divided into Sham or polyester urethane groups (n = 8/group) and underwent a polyester urethane implant in the dorsal skinfold. Tissue samples were collected on days seven, 30, and 90 after surgery and subjected to histomorphometric analysis and biochemical tests. Results were analyzed by one-way ANOVA (p ≤ 0.05). Peri-implant tissue samples exhibited characteristic inflammatory response associated with the biomaterial, with increased vascularization on day seven and augmented levels of IL1-b and TNF-a after 30 days. Peri-implant fibrocystic population was small on day seven, but increased considerably after 90 days. A rise in the carbonyl group levels of skin samples in the polyester urethane group was observed on day seven. Findings suggest that polyester urethane sheets undergo biodegradation at an early stage after implantation, followed by increased vascularity and microencapsulation of biomaterial fragments, without persistent oxidative damage. Fiber arrangement inside the collagen matrix results in a fibrotic scar because of polyester urethane degradation.
Subject(s)
Absorbable Implants , Biocompatible Materials/administration & dosage , Oxidative Stress/drug effects , Polyurethanes/administration & dosage , Wound Healing/drug effects , Animals , Biocompatible Materials/pharmacokinetics , Female , Models, Animal , Polyurethanes/pharmacokinetics , Rats , Rats, WistarABSTRACT
Breast augmentation with silicone implants is one of the most common procedures performed by plastic surgeons around the world. Capsular contracture is a frequent complication in breast augmentation and reconstructive surgery, that requires invasive intervention. The inflammatory response to implanted mammary prostheses appears to be directly associated to capsular contracture. This review discusses the evidences from rat models studies, on the role of inflammation and fibrosis in capsular contraction and its relation to silicone breast implants surface.
Subject(s)
Breast Implants , Implant Capsular Contracture/etiology , Silicone Gels , Animals , Breast/pathology , Fibrosis/complications , Inflammation/complications , Models, Animal , RatsABSTRACT
Objective. To evaluate the possible migration of polymethylmethacrylate after injections in various corporal compartments of Wistar rats. Methods. The experimental work consisted in the injection of PMMA in corporal compartments for later histopathological analysis of the locations of implants and of distant filtering organs. The dose applied in each implant was of 0.2 mL. The animals were divided into groups according to the location of the implant realized: group GB had intradermic injections in the glabella. Group SD had subdermal injections in dorsal subcutaneous tissue cells. Group IP had intraperitoneal injections in the abdomen. Group PD had intramuscular injections in the right rear leg. The rats were sacrificed 30 days after realization of the implants and tissue samples from the lung, liver, spleen, and kidney, and locations of implantation were removed for histopathological analysis. Results. Characteristic microspheres that were compatible with the presence of PMMA in any of the histological slides analyzed were not observed. One animal had an amorphous exogenous substance, with a histiocytic reaction. Twelve of the 16 lungs analyzed had locations of intraalveolar hemorrhaging. Two animals had nonspecific spleen alterations. Conclusion. The histopathological analysis of this study found no PMMA microspheres in any of the tissues analyzed.
ABSTRACT
A hidradenite supurativa é definida como doença crônica, supurativa, bacteriana, que compromete as glândulas sudoríparas. Em sua grande maioria esta presente no períneo, região glútea e escrotal. Este trabalho vem relatar um caso de hidradenite supurativa com tratamento cirúrgico proposto de excisão em monobloco, e tem por objetivo nortear uma possível conduta atualizada para pacientes com esta afecção.
The hidradenitis suppurativa is defined as chronic, suppurative bacterial infection, which affects the sweat glands. The vast majority is present in the perineum, buttocks and scrotum. This work has been reporting a caseof hidradenitis suppurativa with surgical treatment of en bloc excision, and aims to guide conduct a possible date for patients with this disease.
ABSTRACT
PURPOSE: Evaluating histologically the silicone peri-implant coated by polyurethane inflammation associated to the use of anti-microbial and bacterial contamination. METHODS: It was used 35 Wistar rats. The animals were divided in seven groups: I - Control; II - implant cavity contamination with 10 bacteria/ml; III - implant cavity contamination with 10 bacteria/ml; IV - implant cavity contamination with 10 bacteria/ml; V - identical contamination to group II and implant immersions in anti-microbial solution; VI - identical contamination in group III and implant immersions in the anti-microbial solution; VII - identical contamination of group IV and implant immersions in anti-microbial solution. It was evaluated morphometrically the peri-implant capsules after 30 days of introduction. RESULTS: The factors with more discriminating power were the giants cells of a strange body and the mononuclear. There was no correlation between the bacterial concentrations and the histological alterations. CONCLUSION: 1) The histological standard of the inflammatory reaction around the silicone implant coated with polyurethan is chronic granulomatosis type of a strange body; 2) There isn't correlation between concentration of Staphylococcus epidermidis and histological changes; 3) The use of anti-microbial solution decreased the mononuclear cell reactions, with the increase of giant cells in a strange body.
Subject(s)
Breast Implants/adverse effects , Foreign-Body Reaction/pathology , Implants, Experimental , Polyurethanes , Silicone Gels/adverse effects , Animals , Biocompatible Materials , Drug Evaluation, Preclinical , Female , Foreign-Body Reaction/microbiology , Rats , Rats, Wistar , Staphylococcal Infections/microbiology , Staphylococcal Infections/pathology , Staphylococcus epidermidis/isolation & purificationABSTRACT
PURPOSE: Evaluating histologically the silicone peri-implant coated by polyurethane inflammation associated to the use of anti-microbial and bacterial contamination. METHODS: It was used 35 Wistar rats. The animals were divided in seven groups: I - Control; II - implant cavity contamination with10 bacteria/ml; III - implant cavity contamination with 10 bacteria/ml; IV - implant cavity contamination with 10 bacteria/ml; V - identical contamination to group II and implant immersions in anti-microbial solution; VI - identical contamination in group III and implant immersions in the anti-microbial solution; VII - identical contamination of group IV and implant immersions in anti-microbial solution. It was evaluated morphometrically the peri-implant capsules after 30 days of introduction. RESULTS: The factors with more discriminating power were the giants cells of a strange body and the mononuclear. There was no correlation between the bacterial concentrations and the histological alterations. CONCLUSION: 1) The histological standard of the inflammatory reaction around the silicone implant coated with polyurethan is chronic granulomatosis type of a strange body; 2) There isn´t correlation between concentration of Staphylococcus epidermidis and histological changes; 3) The use of anti-microbial solution decreased the mononuclear cell reactions, with the increase of giant cells in a strange body.
OBJETIVO: Avaliar, histologicamente, a reação inflamatória aos implantes de silicone revestidos por poliuretano, com contaminação bacteriana, associada ou não ao uso de antimicrobianos. MÉTODOS: Utilizou-se 35 ratos Wistar. Os animais foram divididos em 7 grupos: I- Controle, II- contaminação da cavidade do implante com 10¹ bactérias/ml, III- contaminação da cavidade do implante com 10³ bactérias/ml, IV- contaminação da cavidade do implante com 10(5) bactérias/ml, V- contaminação idêntica ao grupo II e imersão dos implantes em solução antimicrobiana, VI- contaminação idêntica do grupo III e imersão dos implantes em solução antimicrobiana, VII- contaminação idêntica do grupo IV e imersão dos implantes em solução antimicrobiana. Avaliou-se morfometricamente as cápsulas peri-implantes após 30 dias da introdução. RESULTADOS: Os fatores com maior poder discriminante foram as células gigantes de corpo estranho e os mononucleares. Não houve correlação entre as concentrações bacterianas e as alterações histológicas. CONCLUSÕES: 1) O padrão histológico da reação inflamatória ao redor dos implantes de silicone revestidos com poliuretano é do tipo crônica granulomatosa de corpo estranho; 2) Não há correlação entre a concentração de bactérias Staphylococcus epidermidis e as alterações morfométricas; 3) O uso de solução antimicrobiana diminui a reação de células mononucleares, com aumento de células gigantes de corpo estranho.
Subject(s)
Animals , Female , Rats , Breast Implants/adverse effects , Foreign-Body Reaction/pathology , Implants, Experimental , Polyurethanes , Silicone Gels/adverse effects , Biocompatible Materials , Drug Evaluation, Preclinical , Foreign-Body Reaction/microbiology , Rats, Wistar , Staphylococcal Infections/microbiology , Staphylococcal Infections/pathology , Staphylococcus epidermidis/isolation & purificationABSTRACT
Gigantomastia é uma patologia benigna, onde uma ou ambas as mamas sofrem um crescimento excessivo em suas dimensões. Os autores apresentam um relato de dois casosde gigantomastia idiopática, discutindo suas possíveis etiologias e os resultados da terapia cirúrgica. Conclui-se que, a gigantomastia pode ser satisfatoriamente tratada, com mamaplastia redutora, utilizando enxerto de complexo-aréolo-mamilar.
Gigantomastia is a benign disorder of the breast in which one or both of the breasts undergo a massive increase in their proportions. The authors present a report of two cases of idiopatic gigantomastia, discussing its possible etiologies, and the results of surgical therapy. Is concluded that gigantomatia may be satisfactorily treated with reduction mammaplasty using nipple-areolar graft.
Subject(s)
Humans , Female , Adult , Middle Aged , Mammaplasty , Surgery, Plastic , Surgery, Plastic/methods , Mammaplasty/methodsABSTRACT
Os autores descrevem os resultados dos trinta e oito retalhos livres microcirúrgicos, realizados entre março de 1995 e outubro de 1998. Os retalhos foram usados para corrigir perdas de substância secundária a trauma, seqüelas de tumores, queimadura, radionecrose e infecção. A principal complicação foi a perda total do retalho, que ocorreu em 7,9% dos casos. Apesar da dificuldade inerente, a realização do transplante microcirúrgico de tecidos à distância se mostrou útil na reparação de perdas de tecidos complexas...
Subject(s)
Humans , Microsurgery , Surgery, Plastic , Surgical Flaps , Medical RecordsABSTRACT
O insucesso de retalhos devido a necrose total ou parcial näo é um fato isolado. O edema pode ser um fator importante na perda do retalho. A hialuronidase degrada o ácido hialurônico presente no tecido conjuntivo que está envolvido na homeostase da água na matriz extracelular, e pode ser importante na melhora da sobrevida de retalhos. O objetivo do presente estudo foi avaliar a efetividade da hialuronidase na melhora da sobrevida de retalhos cutâneos em ratas. Quarenta e duas ratas Wistar distribuídas em quatro grupos foram incluídas na pesquisa. Praticou-se um retalho randomizado de 7 x 2 cm no dorso do animal. Três grupos receberam tratamento pós-operatório durante quatro dias. O grupo A (n=11) recebeu 100 UI/dia de hialuronidase, o grupo B (n=11) 50 UI/dia de hialuronidase e o grupo C (n=10) água destilada. O grupo D (n=10) näo recebeu tratamento. Foi avaliada a área de necrose e submetido a análise estatística. As taxas de necrose no dia 7 foram: no grupo A 38,69 por cento (ñ 9,26), grupo B 38,20 por cento (ñ 15,05), grupo C 51,97 por cento (ñ 8,37) e grupo D 45,90 por cento (ñ 12,57). Houve diferença estatisticamente significante (p<0,05) entre os grupos A e B quando comparados com o grupo C. Näo houve diferença estatisticamente significante dos grupos A e B em comparaçäo com o grupo D. A hialuronidase mostrou-se efetiva quando o fator infiltraçäo estava envolvido, o que sugere um efeito de dissoluçäo do edema como provável mecanismo de melhora da sobrevida em retalhos cutâneos em ratas.
Subject(s)
Animals , Female , Rats , Effectiveness , Hyaluronoglucosaminidase , Surgical Flaps , Edema , Necrosis , Rats, WistarSubject(s)
Humans , Female , Child , Ichthyosis , Skin Abnormalities , Xeroderma Pigmentosum , Wounds and Injuries/surgeryABSTRACT
Apresentamos tres casos de hidrosadenite supurativa cronica com comprometimento da regiao perianal. Nos tres casos, o tratamento foi cirurgico. Em dois deles, realizamos resseccao ampla com enxerto cutaneo imediato sem colostomia. Relacionamos ainda os achados clinicos e cirurgicos com a literatura.
Subject(s)
Humans , Male , Adult , Middle Aged , Hidradenitis/diagnosis , Hidradenitis/pathology , Hidradenitis/surgery , Hidradenitis/therapy , Buttocks/surgery , Buttocks/pathologyABSTRACT
Este estudo foi desenvolvido na University of California at San Francisco sob a supervisäo do Dr Stephen J. Mathes. O TAPA (Thermografic Assessment of Perfurating Arteries) é um método que permite a identificaçäo das artérias perfurantes, que fazem a comunicaçäo do sistema arterial profundo com o sistema arterial cutâneo. Este método pré-operatório permite o mapeamento e o mensuramento das artérias perfurantes envolvidas no planejamento dos retalhos fáscio-cutâneos e músculo-cutâneos. Sendo um método näo invasivo, descreve com segurança as artérias perfurantes do tronco e das extremidades, ocasionando um mínimo deconforto para o paciente e auxilia a preparaçäo de uma cirurgia segura
Subject(s)
Humans , Arteries/diagnosis , Thermography/methods , Arteries/anatomy & histology , Arteries/surgery , Infrared Rays , Surgical FlapsABSTRACT
Faz-se um breve histórico das principais técnicas usadas no presente momento, que visam a diminuiçäo da cicatriz horizontal da mama com o traçado final em "L" "J". Descrevem detalhes técnicos, acentuando a maneira de marcaçäo, que consiste numa modificaçäo da técnica clássica de Pitanguy, tendo como grande vantagem a supressäo do ramo interno do "T" invertido
