ABSTRACT
The loss of continuity of the nerve structure interrupts the transmission of nerve impulses and leads to the disorganization of functional activities. Many methods, as the use of neurogenic factors, aid in the process of neural regeneration by accelerating or improving peripheral nerves neoformation. The adipose tissue is abundant in the human body, and it has presented promising results in the regeneration of peripheral nerves. We carried out a randomized controlled study in 9 months, using 45 male Wistar rats, 80 days old, and the sciatic nerve was chosen for analysis. The control animals were divided into three groups - Initial group (IG), Final group (FG), and denervated group (DG) - with seven animals each. The experimental groups, with twelve animals each, were polyethylene tube filled with fat (EGF) and polyethylene tube without filling (EGwf). All groups, except IG, were submitted to 10 sessions of hyperbaric oxygen treatment of 1h 45 min in alternating days. Functional evaluation by walking-track was assessed using the Catwalk XT® software and tissues were harvested and stained with 1% toluidine blue for histological analysis. Quantitative data were first analyzed with the Kolmogorov Smirnov normality test. Comparison between the four groups was analyzed by ANOVA followed by Tukey Test. We concluded that hyperbaric oxygen therapy had positive results on morphometric and functional parameters. However, no significant differences were found regarding the use of autologous fat graft.
Subject(s)
Hyperbaric Oxygenation , Adipose Tissue , Animals , Male , Nerve Regeneration , Oxygen , Rats , Rats, Wistar , Sciatic NerveABSTRACT
RESUMO: Objetivo: Avaliar os resultados obtidos da oxigenoterapia hiperbárica (OHB) como tratamento adjuvante na Gangrena de Fournier (GF). Casuística e Método: Estudo transversal, retrospectivo e descritivo baseado na análise de prontuários físicos de pacientes portadores de GF submetidos a oxigenoterapia hiperbárica, através da câmara hiperbárica no período de fevereiro de 2008 a maio de 2018, atendidos em uma clínica de oxigenoterapia hiperbárica na cidade de Bauru, SP. Os dados coletados foram: idade, sexo, etiologia, comorbidades, localização e extensão da lesão, número total de sessão e mortalidade. Resultado: Trinta e oito pacientes foram analisados, sendo 76% do sexo masculino, com média de idade de 55,6 anos. Entre os pacientes, 17 (44,7%) obtiveram alta médica, 18 (47,4%) interromperam o tratamento antes do término e ocorreram três (8,21%) óbitos. A principal etiologia foi o abcesso e os principais comorbidades predisponentes foram a diabetes mellitus e a hipertensão arterial. A localização e extensão com áreas mais afetadas foram na região escrotal, seguida pela região perineal. Conclusão: Os resultados deste estudo demostraram que o efeito da OHB como tratamento adjuvante oferece vantagem no tratamento da GF, resultando em considerável alta médica dos pacientes e baixa mortalidade. (AU)
ABSTRACT: Objective: Evaluating the results obtained from hyperbaric oxygen therapy (HBOT) as an adjuvant treatment in Fournier's Gangrene (GF). Casuistic and Method: Cross-sectional, retrospective, and descriptive study based on the analysis of physical records of patients with GF submitted to hyperbaric oxygen therapy through the hyperbaric chamber from February 2008 to May 2018, assisted at the hyperbaric oxygen therapy clinic, in Bauru, SP. The data collected were age, gender, etiology, comorbidities, lesion location and extension, total session number, and mortality. Result: It totaled 38 patients, 76% male, with a mean age of 55.6 years. Among the patients, 17 (44.7%) were discharged, 18 (47.4%) discontinued treatment before termination, and three (8.21%) deaths occurred. The main etiology was an abscess and the main predisposing comorbidities were diabetes mellitus and hypertension. The location and extension lesion with the most affected areas were in the scrotal region, followed by the perineal region. Conclusion: The results of this study demonstrated that the effect of HBOT as an adjuvant treatment has an advantage in the treatment of GF resulting in considerable patient medical discharge and low mortality. (AU)
