Decellularized Wharton's Jelly and Amniotic Membrane Demonstrate Potential Therapeutic Implants in Tracheal Defects in Rabbits.

BACKGROUND: Tracheal grafts have been investigated for over a century, aiming to replace various lesions. However, tracheal reconstruction surgery remains a challenge, primarily due to anatomical considerations, intraoperative airway management, the technical complexity of reconstruction, and the potential postoperative morbidity and mortality. Due to research development, the amniotic membrane (AM) and Wharton's Jelly (WJ) arise as alternatives within the new set of therapeutic alternatives. These structures hold significant therapeutic potential for tracheal defects. This study analyzed the capacity of tracheal tissue regeneration after 60 days of decellularized WJ and AM implantation in rabbits submitted to conventional tracheostomy. METHODS: An in vivo experimental study was carried out using thirty rabbits separated into three groups (Control, AM, and WJ) (n = 10). The analyses were performed 60 days after surgery through immunohistochemistry. RESULTS: Different immunomarkers related to scar regeneration, such as aggrecan, TGF-ß1, and α-SMA, were analyzed. However, they highlighted no significant difference between the groups. Collagen type I, III, and Aggrecan also showed no significant difference between the groups. CONCLUSIONS: Both scaffolds appeared to be excellent frameworks for tissue engineering, presenting biocompatibility and a desirable microenvironment for cell survival; however, they did not display histopathological benefits in trachea tissue regeneration.

Acellular Biomaterials Associated with Autologous Bone Marrow-Derived Mononuclear Stem Cells Improve Wound Healing through Paracrine Effects.

Wound healing is a complex process of repair that involves the interaction between different cell types and involves coordinated interactions between intracellular and extracellular signaling. Bone Marrow Mesenchymal Stem Cells (BMSCs) based and acellular amniotic membrane (AM) therapeutic strategies with the potential for treatment and regeneration of tissue. We aimed to evaluate the involvement of paracrine effects in tissue repair after the flap skin lesion rat model. In the full-thickness flap skin experiment of forty Wistar rats: A total of 40 male Wistar rats were randomized into four groups: group I: control (C; n = 10), with full-thickness lesions on the back, without (BMSCs) or AM (n = 10); group II: injected (BMSCs; n = 10); group III: covered by AM; group IV-injected (AM + BMSCs; n = 10). Cytokine levels, IL-1, and IL-10 assay kits, superoxide dismutase (SOD), glutathione reductase (GRs) and carbonyl activity levels were measured by ELISA 28th day, and TGF-ß was evaluated by immunohistochemical, the expression collagen expression was evaluated by Picrosirius staining. Our results showed that the IL-1 interleukin was higher in the control group, and the IL-10 presented a higher mean when compared to the control group. The groups with BMSCs and AM showed the lowest expression levels of TGF-ß. SOD, GRs, and carbonyl activity analysis showed a predominance in groups that received treatment from 80%. The collagen fiber type I was predominant in all groups; however, the AM + BMSCs group obtained a higher average when compared to the control group. Our findings suggest that the AM+ BMSCs promote skin wound healing, probably owing to their paracrine effect attributed to the promotion of new collagen for tissue repair.

DEVELOPMENT OF ORTHOPEDIC SIMULATOR TO PRACTICE CLOSED REDUCTION OF PEDIATRIC FRACTURES OF THE MIDDLE THIRD OF FOREARM.

In the current scenario of medical education, a trend of using models and simulators to train operational skills, especially in the practice of basic orthopedic techniques, is growing. This form of teaching allows academics to maximize learning opportunities and contributes to improving the quality of care for their future patients. However, the realistic simulation has high costs as a major limitation. Objective: To develop a low-cost orthopedic simulator for practicing pediatric forearm reduction skills in the preclinical setting. Methods: A model of an arm and forearm with a fracture in the middle third was developed. Orthopedists, residents, and medical students evaluated the simulator's ability to reproduce fracture reduction. Results: The simulator had a significantly lower cost than the others in the literature. The participants agreed that the model had a good performance, and that the manipulation was consistent with the reality of reducing closed pediatric forearm fracture. Conclusion: The results suggest that this model can be used to teach orthopedic residents and medical students the skill of closed reduction of fractures in the middle third of the forearm. Level of Evidence III, Case Control Study.

No cenário atual de ensino médico existe uma tendência crescente do uso de modelos e simuladores para o treino de habilidades operacionais, principalmente na prática de técnicas ortopédicas básicas, que permite aos acadêmicos maximizarem as oportunidades de aprendizado e contribui para melhorar a qualidade de atendimento dos futuros pacientes atendidos. A simulação realística, no entanto, tem como grande limitação os altos custos. Objetivo: Desenvolver um simulador ortopédico de baixo custo para a prática de habilidades de redução incruenta do antebraço pediátrico no cenário pré-clínico. Métodos: Desenvolveu-se um modelo de braço e antebraço com fratura no terço médio, que foi avaliado por médicos ortopedistas, residentes e acadêmicos de medicina quanto à capacidade do simulador de reproduzir a redução da fratura. Resultados: O simulador desenvolvido teve custo significativamente inferior aos existentes na literatura. Os participantes concordaram que o modelo teve um bom desempenho e que a manipulação foi condizente com a realidade de redução de fratura incruenta do antebraço pediátrico. Conclusão: Os resultados levam a crer que esse modelo pode ser usado para ensinar a redução incruenta de fratura no terço médio do antebraço para residentes de ortopedia e acadêmicos de medicina. Nível de Evidência III, Estudo de Caso-Controle.

Development of orthopedic simulator to practice closed reduction of pediatric fractures of the middle third of forearm / Desenvolvimento de um simulador ortopédico para prática de redução incruenta de fraturas pediátricas do terço médio do antebraço

ABSTRACT In the current scenario of medical education, a trend of using models and simulators to train operational skills, especially in the practice of basic orthopedic techniques, is growing. This form of teaching allows academics to maximize learning opportunities and contributes to improving the quality of care for their future patients. However, the realistic simulation has high costs as a major limitation. Objective: To develop a low-cost orthopedic simulator for practicing pediatric forearm reduction skills in the preclinical setting. Methods: A model of an arm and forearm with a fracture in the middle third was developed. Orthopedists, residents, and medical students evaluated the simulator's ability to reproduce fracture reduction. Results: The simulator had a significantly lower cost than the others in the literature. The participants agreed that the model had a good performance, and that the manipulation was consistent with the reality of reducing closed pediatric forearm fracture. Conclusion: The results suggest that this model can be used to teach orthopedic residents and medical students the skill of closed reduction of fractures in the middle third of the forearm. Level of Evidence III, Case Control Study.

RESUMO No cenário atual de ensino médico existe uma tendência crescente do uso de modelos e simuladores para o treino de habilidades operacionais, principalmente na prática de técnicas ortopédicas básicas, que permite aos acadêmicos maximizarem as oportunidades de aprendizado e contribui para melhorar a qualidade de atendimento dos futuros pacientes atendidos. A simulação realística, no entanto, tem como grande limitação os altos custos. Objetivo: Desenvolver um simulador ortopédico de baixo custo para a prática de habilidades de redução incruenta do antebraço pediátrico no cenário pré-clínico. Métodos: Desenvolveu-se um modelo de braço e antebraço com fratura no terço médio, que foi avaliado por médicos ortopedistas, residentes e acadêmicos de medicina quanto à capacidade do simulador de reproduzir a redução da fratura. Resultados: O simulador desenvolvido teve custo significativamente inferior aos existentes na literatura. Os participantes concordaram que o modelo teve um bom desempenho e que a manipulação foi condizente com a realidade de redução de fratura incruenta do antebraço pediátrico. Conclusão: Os resultados levam a crer que esse modelo pode ser usado para ensinar a redução incruenta de fratura no terço médio do antebraço para residentes de ortopedia e acadêmicos de medicina. Nível de Evidência III, Estudo de Caso-Controle.