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OBJECTIVE: To overview the literature to answer the following question: "What is the performance of different therapies on wound healing and postoperative discomfort after palatal ASTG removal?" METHODS: SRs that evaluated the wound healing (WH), postoperative pain, bleeding, and analgesic consumption of patients submitted to de-epithelialized/free gingival grafts (FGG) or subepithelial connective tissue grafts (SCTG) removed from the palate were included. The searches were conducted on six white and two gray databases up to December 2023. Methodological quality was evaluated through AMSTAR 2. The synthesis of results was described as a narrative analysis. RESULTS: Ten SRs (involving 25 randomized clinical trials) related to low-level laser therapy (LLLT) (3), platelet-rich fibrin (PRF) (4), cyanoacrylate tissue adhesives (CTA) (2), and ozone therapy (OT) (1) were included in this overview. All techniques demonstrated improvements in WH. LLT, PRF, and CTA reduced pain and analgesic consumption. PRF and CTA reduced bleeding. Regarding methodological quality, the SRs were classified as critically low (2), low (5), moderate (2), or high quality (1). CONCLUSIONS: In SRs related to LLLT, PRF, CTA, and OT, the use of different therapies after palatal ASTG removal improved WH and postoperative discomfort. Due to the studies' low methodological quality and high heterogeneity, data should be interpreted with caution. CLINICAL RELEVANCE: The present overview compiles the evidence of SRs related to different therapies for WH and patients' postoperative experience and reveals that different treatments can significantly improve the clinical outcomes of patients who require ASTG removal for periodontal or peri-implant surgeries. REGISTRATION: PROSPERO registration number: CRD42022301257.
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Dor Pós-Operatória , Fibrina Rica em Plaquetas , Cicatrização , Humanos , Palato/cirurgia , Gengiva/transplante , Terapia com Luz de Baixa Intensidade/métodos , Adesivos Teciduais/uso terapêutico , Tecido Conjuntivo/transplante , Revisões Sistemáticas como AssuntoRESUMO
Introduction: Asthma is a condition of airflow limitation, common throughout the world, with high mortality rates, especially as it still faces some obstacles in its management. As it constitutes a public health challenge, this study aimed to investigate the effect of copaiba oil (e.g., Copaifera langsdorffii), as a treatment resource, at doses of 50 and 100 mg/kg on certain mediators of acute lung inflammation (IL-33, GATA3, FOXP3, STAT3, and TBET) and early mechanisms of lung remodeling (degradation of elastic fiber tissues, collagen deposition, and goblet cell hyperplasia). Methods: Using an ovalbumin-induced acute allergic asthma model in BALB/c mice, we analyzed the inflammatory mediators through immunohistochemistry and the mechanisms of lung remodeling through histopathology, employing orcein, Masson's trichrome, and periodic acid-Schiff staining. Results: Copaiba oil treatment (CO) reduced IL-33 and increased FOXP3 by stimulating the FOXP3/GATA3 and FOXP3/STAT3 pathways. Additionally, it upregulated TBET, suggesting an additional role in controlling GATA3 activity. In the respiratory epithelium, CO decreased the fragmentation of elastic fibers while increasing the deposition of collagen fibers, favoring epithelial restructuring. Simultaneously, CO reduced goblet cell hyperplasia. Discussion: Although additional research is warranted, the demonstrated anti-inflammatory and re-epithelializing action makes CO a viable option in exploring new treatments for acute allergic asthma.
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Purpose: The extracellular polysaccharide (EPS) is produced by the bacterium Zoogloea sp. and plays a positive role in tissue repair. The purpose of this study was to clinically and histologically compare the effects of EPS in the healing of traumatic oral ulcers in rats with the effects of triamcinolone. Methods: Ulcers were induced in the oral mucous of 45 male Wistar rats, divided into three groups: control group, treated with triamcinolone, and treated with biopolymer gel. In the clinical evaluation, we considered the weight variation of the animals and the size of the lesion area, at baseline and on treatment days 1, 3 and 7. The histological parameters evaluated were the type and intensity of the inflammatory infiltration, the presence of necrosis and foreign body granuloma and the degree of re-epithelialization of the lesion. Results: The reduction of the lesion area was greater in the animals treated with EPS, with no difference in the intensity of the inflammatory infiltration between the groups on days 3 and 7 of treatment. Conclusions: The results suggest that topical application of EPS in traumatic oral ulcers of rats promotes faster repair than triamcinolone ointment, without increasing the intensity of inflammatory infiltration under the lesion.
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Animais , Ratos , Polissacarídeos , Zoogloea , Biopolímeros , Úlceras Orais , SaccharumRESUMO
The skin is essential to the integrity of the organism. The disruption of this organ promotes a wound, and the organism starts the healing to reconstruct the skin. Copaifera langsdorffii is a tree used in folk medicine to treat skin affections, with antioxidant and anti-inflammatory properties. In our study, the oleoresin of the plant was associated with nanostructured lipid carriers, aiming to evaluate the healing potential of this formulation and compare the treatment with reference drugs used in wound healing. Male Wistar rats were used to perform the excision wound model, with the macroscopic analysis of wound retraction. Skin samples were used in histological, immunohistochemical, and biochemical analyses. The results showed the wound retraction in the oleoresin-treated group, mediated by α-smooth muscle actin (α-SMA). Biochemical assays revealed the anti-inflammatory mechanism of the oleoresin-treated group, increasing interleukin-10 (IL-10) concentration and decreasing pro-inflammatory cytokines. Histopathological and immunohistochemical results showed the improvement of re-epithelialization and tissue remodeling in the Copaifera langsdorffii group, with an increase in laminin-γ2, a decrease in desmoglein-3 and an increase in collagen remodeling. These findings indicate the wound healing potential of nanostructured lipid carriers associated with Copaifera langsdorffii oleoresin in skin wounds, which can be helpful as a future alternative treatment for skin wounds.
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Fabaceae , Reepitelização , Ratos , Animais , Ratos Wistar , Pele/patologia , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Fabaceae/química , LipídeosRESUMO
OBJETIVO: Analisar a acurácia do método clínico no diagnóstico diferencial entre queimadura de espessura parcial e total, correlacionando o diagnóstico inicial das lesões com a confirmação do diagnóstico em até 21 dias. MÉTODO: Estudo prospectivo, descritivo e longitudinal, baseado na análise de parâmetros diagnósticos (sensibilidade, umidade, retorno de preenchimento capilar e coloração da área) em pacientes pediátricos, internados por queimaduras, no Hospital Joana de Gusmão em Florianópolis, SC. O diagnóstico inicial da profundidade da queimadura foi realizado no momento da internação hospitalar e comparado ao evolutivo em até 21 dias, sendo considerado diagnóstico final de espessura parcial a presença de reepitelização espontânea, e de espessura total na sua ausência, com necessidade de cirurgia para cobertura cutânea. RESULTADOS: Dos 81 diagnósticos avaliados, 55 (67,9%) corresponderam ao diagnóstico final de queimadura de espessura parcial e 26 (32,1%) ao diagnóstico final de queimadura de espessura total, sendo que a sensibilidade álgica e o retorno capilar foram as duas características mais presentes na queimadura parcial. A acurácia do exame médico baseado na presença ou ausência dos parâmetros na diferenciação entre as espessuras da queimadura foi de 80,24%. CONCLUSÕES: A presença de perfusão na área queimada foi a variável de maior acerto no diagnóstico de queimadura de espessura parcial, seguida pela presença de sensibilidade álgica. As duas variáveis também apresentaram alta sensibilidade diagnóstica na caracterização da queimadura de espessura parcial.
OBJECTIVE: To analyze the accuracy of the clinical method for differential diagnosis between partial and full-thickness burn, correlating the initial diagnosis of the injuries with its confirmation within 21 days. METHODS: A prospective longitudinal descriptive study, based on the analysis of diagnostic parameters (sensory sensitivity, humidity, return of hair growth and area coloration) in pediatric patients hospitalized for burn injury at Hospital Joana de Gusmão in Florianópolis, Santa Catarina state. The initial of the depth of the burn was done at the time of hospitalization and compared to the follow up in 21 days, in which the presence of spontaneous reepithelialization was considered final diagnosis of partial thickness burn and, its absence, of full-thickness burn, requiring surgery for skin coverage. RESULTS: Of the 81 diagnoses evaluated, 55 (67.9%) corresponded to the final diagnosis of partial-thickness burn while 26 (32.1%) to the final diagnosis of full-thickness burn and pain sensitivity as well as venous return were the two most common characteristics in partial-thickness burn. The accuracy of the medical examination based on the presence or absence of the parameters in order to differentiate burn thicknesses was 80.24%. CONCLUSIONS: The presence of venous return in the burned area was the most accurate variable in the diagnosis of partial thickness burn, followed by the presence of pain sensitivity. Both variables also showed high diagnostic sensitivity in the characterization of partial-thickness burn.
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Porphyromonas gingivalis inhibits the release of CXCL8 by gingival epithelial cells and reduces their proliferation. We previously reported that Bifidocaterium sp. and Lactobacillus sp. immunomodulate gingival epithelial cells response to this periodontal pathogen, but their effects on re-epithelialization properties are still unknown. Herein we explored these activities of potential probiotics on gingival epithelial cells and clarified their mechanisms. The immortalized OBA-9 lineage was used to perform in vitro scratches. Twelve clinical isolates and commercially available strains of Bifidobacterium sp. and Lactobacillus sp. were screened. L. casei 324 m and B. pseudolongum 1191A were selected to perform mechanistic assays with P. gingivalis W83 infection and the following parameters were measured: percentage of re-epithelialization by DAPI immunofluorescence area measurement; cell number by Trypan Blue exclusion assay; CXCL8 regulation by ELISA and RT-qPCR; and expression of CXCL8 cognate receptors-CXCR1 and CXCR2 by Flow Cytometry. Complementary mechanistic assays were performed with CXCL8, in the presence or absence of the CXCR1/CXCR2 inhibitor-reparixin. L. casei 324 m and B. pseudolongum 1191A enhanced re-epithelialization/cell proliferation as well as inhibited the harmful effects of P. gingivalis W83 on these activities through an increase in the expression and release of CXCL8 and in the number of cells positive for CXCR1/CXCR2. Further, we revealed that the beneficial effects of these potential probiotics were dependent on activation of the CXCL8-CXCR1/CXCR2 axis. The current findings indicate that these potential probiotics strains may improve wound healing in the context of the periodontal tissues by a CXCL8 dependent mechanism.
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Infecções por Bacteroidaceae/metabolismo , Infecções por Bacteroidaceae/microbiologia , Interações Hospedeiro-Patógeno , Interações Microbianas , Porphyromonas gingivalis , Probióticos/administração & dosagem , Reepitelização , Biomarcadores , Linhagem Celular , Regulação da Expressão Gênica , Humanos , Interleucina-8/genética , Interleucina-8/metabolismo , Receptores de Interleucina-8A/antagonistas & inibidores , Receptores de Interleucina-8A/genética , Receptores de Interleucina-8A/metabolismo , Receptores de Interleucina-8B/antagonistas & inibidores , Receptores de Interleucina-8B/genética , Receptores de Interleucina-8B/metabolismo , Transdução de Sinais , CicatrizaçãoRESUMO
A hydrogel containing exocellular (1 â 6)-ß-D-glucan (lasiodiplodan, LAS) was developed and its wound healing potential was evaluated. ß-Glucans have attracted much interest by the cosmetic industry sector because of their bioactive and functional properties and in promoting skin health. In the present work an ß-glucan was studied as a healing biomaterial that has not hitherto been reported in the scientific literature. LAS produced by the ascomycete Lasiodiplodia theobromae MMPI was used in the formulation of a healing hydrogel. Physicochemical and microbiological quality parameters, antioxidant potential and stability of the formulation was evaluated. FTIR, thermal analysis and SEM techniques were also employed in the characterization. Wistar rats were used as a biological model to investigate the wound healing potential. Histological analyses of cutaneous tissue from the dorsal region were conducted after 4, 7, 10 and 14 days of treatment, and evaluated re-epithelialization, cell proliferation and collagen production. Physicochemical stability, microbiological quality and antioxidant potential, especially in relation to its ability to scavenge hydroxyl radicals were found. The hydrogel stimulated cell re-epithelialization and proliferation during all days of the treatment, and stimulated an increase of collagen fibers. Lasiodiplodan showed immunomodulatory activity in wound healing and this biomacromolecule could be an alternative compound in wound care.
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Colágeno/química , Glucanos/química , Hidrogéis/química , Hidrogéis/farmacologia , Polissacarídeos/química , Cicatrização/efeitos dos fármacos , Animais , RatosRESUMO
BACKGROUND/OBJECTIVE: Electrical stimulation (ES) has been used to treat chronic wound and other clinical applications, showing favorable results in wound closure. It was hypothesized that ES can present a positive effect on oral mucosa healing. The aim of this study was to investigate the effects of ES during the palatal mucosa early healing process in Swiss mice. METHODS: Ninety animals were divided into two groups: Control (C; nâ¯=â¯45), which received Sham ES applications, and Test (ES; nâ¯=â¯45), which received ES (100⯵A; 9â¯kHz; 660 mVpp) once a day for 3 days. A full thickness wound was performed with a 1.5â¯mm diameter biopsy punch in the hard palate. Histologically, the following parameters were evaluated: palatal wound closure and epithelial and connective wound edge distance (EED and CED). Furthermore, IL-1ß, IL-6, IL-10 TNF-α, and VEGF cytokine levels were evaluated by multiplex assay. The percentage of collagen fibers was assessed using the polarization method and the Smad proteins using the immunofluorescence method. RESULTS: Palatal wound closure presented a significant reduction on day 5 in the ES group (pâ¯=â¯0.01). Additionally, both EED and CED were shorter for all time points in the ES group (pâ¯<â¯0.05), and the inflammatory markers IL-6, IL-10, TNF-α, and VEGF were reduced (pâ¯<â¯0.05). There were no differences in collagen fibers and phospho-Smad2 between the groups. CONCLUSION: ES had a positive effect on early palatal wound closure outcomes, as well as on inflammatory markers.
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Estimulação Elétrica , Mucosa Bucal/lesões , Palato/lesões , Cicatrização , Ferimentos e Lesões/terapia , Animais , Citocinas/metabolismo , CamundongosRESUMO
SUMMARY: The treatment of chronic wounds has become a public health issue in recent years mainly due to comorbidities associated with an older population and bacterial resistance. Honey has emerged as an alternative treatment for chronic wounds but lack of knowledge of its mechanism of actionin the treated tissue and low quality of evidence in clinical triads has distanced the medical community from honey as a possible treatment. One of the main processes that is altered in chronic wounds is re-epithelialization mediated by keratinocytes, where proliferation and migration processes are altered. Markers of proliferation, migration and activation of keratinocytes, such as adhesion molecules, growth factors, membrane receptors, signal translating proteins, transcription factors, microRNAs, among others are deregulated in this process. In general, honeys from different floral origins have a positive effect on markers of proliferation and migration in keratinocytes. In conclusion there are still few studies that focus on the molecular action of honey in keratinocytes and fail to report details on the honey used not allowing to achieve the same results.
RESUMEN: El tratamiento de heridas crónicas (HC) se ha vuelto un tema de salud pública en los últimos años, principalmente debido a comorbilidades asociadas a una población de mayor edad y a la resistencia bacteriana. La miel ha surgido como un tratamiento alternativo para HC pero la falta de conocimiento de su mecanismo de acción en el tejido tratado y de la baja calidad de la evidencia en triadas clínicas, ha distanciado a la comunidad médica de la miel como posible tratamiento. Uno de los principales procesos que se ve alterado en las HC es la re-epitelización mediada por queratinocitos, donde se ven alterados los procesos de proliferación y migración. Marcadores de proliferación, migración y activación de queratinocitos, como moléculas de adhesión, factores de crecimiento, receptores de membrana, proteínas traductores de señales, factores de transcripción, microARNs, entre otras, se ven desreguladas en éste proceso. De manera general las mieles de diferentes orígenes florales tienen un efecto positivo en marcadores de proliferación y migración en queratinocitos. En conclusión aún existen pocos estudios que se enfoquen en la acción molecular de la miel en queratinocitos y los pocos que existen fallan en la entrega de información en relación a la miel utilizada que pueda hacer reproducibles los resultados.
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Cicatrização/fisiologia , Queratinócitos/fisiologia , Reepitelização/fisiologia , Mel , Cicatrização/genética , MicroRNAs/fisiologia , MicroRNAs/genética , Reepitelização/genéticaRESUMO
BACKGROUND: Skin wounds continue to be a global health problem. Several cellular therapy protocols have been used to improve and accelerate skin wound healing. Here, we evaluated the effect of transplantation of mesenchymal stromal cells (MSC) on the wound re-epithelialization process and its possible relationship with the presence of epithelial progenitor cells (EPC) and the expression of growth factors. METHODS: An experimental wound model was developed in C57BL/6 mice. Human MSCs seeded on collagen membranes (CM) were implanted on wounds. As controls, animals with wounds without treatment or treated with CM were established. Histological and immunohistochemical (IH) studies were performed at day 3 post-treatment to detect early skin wound changes associated with the presence of EPC expressing Lgr6 and CD34 markers and the expression of keratinocyte growth factor (KGF) and basic fibroblast growth factor (bFGF). RESULTS: MSC transplantation enhanced skin wound re-epithelialization, as compared with controls. It was associated with an increase in Lgr6+ and CD34+ cells and the expression of KGF and bFGF in the wound bed. CONCLUSION: Our results show that cutaneous wound healing induced by MSC is associated with an increase in EPC and growth factors. These preclinical results support the possible clinical use of MSC to treat cutaneous wounds.
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Transplante de Células-Tronco Mesenquimais , Reepitelização/fisiologia , Pele/lesões , Células-Tronco Adultas/metabolismo , Animais , Antígenos CD34/metabolismo , Modelos Animais de Doenças , Células Epiteliais/metabolismo , Fator 2 de Crescimento de Fibroblastos/metabolismo , Fator 7 de Crescimento de Fibroblastos/metabolismo , Voluntários Saudáveis , Humanos , Masculino , Camundongos , Cultura Primária de Células , Receptores Acoplados a Proteínas G/metabolismo , Pele/citologia , Pele/metabolismoRESUMO
Objective: The objective of this study was to report the application of photobiomodulation therapy (PBMT) in the treatment of two patients diagnosed with acute cervical radiodermatitis (RD) induced by radiotherapy. Background data: An undesirable effect of radiotherapy, RD often poses a limitation to the continuity of treatment that can negatively affect the control and prognosis of the disease. RD is frequently associated with pain and aesthetic impairment and can significantly influence quality of life. Many agents used to prevent and treat RD do not have sufficient scientific evidence to support its use. Materials and methods: In both clinical cases, the patients presented RD degree 3 and were in drug treatment, with no satisfactory response, and PBMT was started. Two diode lasers were used, with a dose of 35.71 J/cm2, 10 sec/point, 100 mW of power, and a beam area of 0.028 cm2 and dose of 27.77 J/cm2, 25 sec/point, 40 mW, and 0.036 cm2 beam area. Both lasers were applied at the wavelength of red, daily, in contact and perpendicular to the skin, to deliver 1 J/point/1.5 cm, which covered the entire area affected with RD. Results: The PBMT made possible an expressive improvement in the healing process and reduction of painful symptoms associated with RD. Conclusions: Although PBMT facilitated healing and reduced pain experienced with RD, randomized controlled trials are needed to evaluate all of its possible benefits.
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Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Pescoço , Radiodermite/radioterapia , Adulto , Idoso , Humanos , Neoplasias Laríngeas/radioterapia , Masculino , Neoplasias da Língua/radioterapia , Cicatrização/efeitos da radiaçãoRESUMO
Introduction: Given the extensive use of plastic surgery and the search for better aesthetic and functional results, it is necessary to research ways to improve healing and scarring. The objective is to evaluate the effects of three radiofrequency (RF) sessions in healing the skin of mice. Methods: Forty-eight rats were divided into four groups by day of sacrifice and treatment (RF group: RG; control group: CG). Dissection of the excisional wound of 2 cm x 2 cm (4 cm²) was performed and a 6-mm punch was used to hold two excisional wounds 0.6 cm in diameter. After 24 h, radiofrequency was performed using Spectra® directly on the wound in the dorsal region for 7 minutes at 38°C. This was repeated three times on alternate days. For the control group, the radiofrequency protocol was performed with the device switched off. Results: A larger area of the square wound was measured on postoperative day three in RG (RG7: 3.3 cm² ± 0.7 cm² vs. CG7: 2.4 cm² ± 0.4 cm²; p = 0.009). On day 14, the square wound in RG was greater than in CG (RG14: 1.9 cm² ± 0.5 cm² vs. CG14: 1.0 cm² ± 0.3 cm²; p = 0.001). There was a 90% closure of wounds in CG14. In RG14, 60% of the wounds were re-epithelized while 40% remained ulcerated. In CG7, 70% of the remaining wounds were ulcerated and 30% were re-epithelized. In RG7, 8% were re-epithelized and 92% remained ulcerated. Conclusion: Radiofrequency has a negative influence on the healing process, as indicated by mice that received radiofrequency having a persistent ulcerated wound.
Introdução: Tendo em vista o número de cirurgias plásticas e a busca por melhores resultados estético-funcionais fazem-se necessárias pesquisas para encontrar meios para melhorar a cicatrização e as cicatrizes. O objetivo é avaliar os efeitos de três sessões de radiofrequência na cicatrização da pele de ratos. Métodos: Quarenta e oito ratos machos foram divididos em quatro grupos conforme ao grupo que pertenciam e o dia do sacrifício (grupo radiofrequência - GR - e grupo controle - GC). Realizada a dissecação da ferida excisional de 2 cm x 2 cm (4 cm²) e utilizou-se um punch de 6 mm para a realização de duas feridas excisionais de 0,6 cm de diâmetro. Após 24 h, foi realizada a radiofrequência com o equipamento Spectra® na região dorsal, diretamente sobre as feridas por 7 minutos, com temperatura de 38ºC. Repetida por três vezes, em dias alternados. No grupo controle foi realizada com o aparelho desligado. Resultados: Foi encontrada área maior na ferida quadrada, no 3º dia pós-operatório do GR (GR7 3,3 cm² ± 0,7 cm² vs. GC7 2,4 cm² ± 0,4 cm², p = 0,009). No 14º dia a ferida quadrada do GR foi maior do que no GC (GR14 1,9 cm² ± 0,5 cm² vs. GC14 1,0 cm² ± 0,3 cm², p = 0,001). Houve fechamento de 90% das feridas no GC14. No GR14, 60% das feridas foram reepitelizadas enquanto 40% permaneceram ulceradas. No GC7, 70% das feridas de permaneceram ulceradas e 30% foram reepitelizadas. Já no GR7, 8%, foram reepitelizadas e 92% permaneceram ulceradas. Conclusão: A radiofrequência tem influência negativa no processo cicatricial, mostrando que, nos ratos que receberam a radiofrequência, o quadrado permaneceu ulcerado.
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Animais , Ratos , História do Século XXI , Ondas de Rádio , Ratos , Cicatrização , Cicatriz , Fibroblastos , Reepitelização/efeitos da radiação , Ondas de Rádio/uso terapêutico , Ratos/lesões , Cicatrização/efeitos da radiação , Cicatriz/radioterapia , Fibroblastos/efeitos da radiação , ReepitelizaçãoRESUMO
The potential of tuber flour of Ipomoea batatas (L.) Lam. cv. Brazlândia Branca (white sweet potato) as wound healing and antiulcerogenic agent was investigated in vivo in animal model. Excision on the back of Wistar rats was performed to induce wounds that were topically treated with Beeler's base containing tuber flour of white sweet potato at 2.5%. Number of cells undergoing metaphase and the degree of tissue re-epithelialization were investigated 4, 7 and 10 days post-treatment. The protective effect of aqueous suspension of tuber flour (75 and 100 mg/kg animal weight) on gastric mucosa of Wistar rats was also studied by using the ethanol-induced ulceration model. Ointment based on white sweet potato at 2.5% effectively triggered the healing of cutaneous wound as attested by the increased number of cells undergoing metaphase and tissue re-epithelialization regardless the time of wound treatment. Tuber flour potentially prevented ethanol-induced gastric ulceration by suppressing edema formation and partly protecting gastric mucosa wrinkles. Crude extracts also exhibited potential as free radical scavengers. The results from animal model experiments indicate the potential of tuber flour of white sweet potato to heal wounds.
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Rhinophyma is a progressively growing benign tumor that has the ability to distort the nasal form. Even though, it is considered a rare subtype of rosacea, it is of great importance for the ability to create: psychic, aesthetic and functional disorders. This report describes a severe case of rhinophyma in a 52 years old male patient, the medical treatment and the surgical technique used for removal.
El Rinofima es un tumor benigno de crecimiento progresivo con la capacidad de provocar severas alteraciones en la morfología nasal. Es considerado un subtipo de rosácea poco frecuente, sin embargo, es de gran relevancia por su capacidad de crear trastornos tanto estéticos como funcionales y psicológicos en las personas afectadas. Este reporte describe un caso severo de rinofima, en un paciente de género masculino de 52 años, el tratamiento médico y la técnica quirúrgica que se utilizó para su remoción.
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Humanos , Masculino , Pessoa de Meia-Idade , Rinofima/cirurgia , Rosácea/cirurgia , Resultado do TratamentoRESUMO
The present study was aimed to evaluate the effects of topical 1% nalbuphine on corneal sensitivity and re-epithelialization, after lamellar keratectomy in rabbits. All protocols were approved by the Animal Care Comission of São Paulo State University (Protocol 028793-08) and were conducted in accordance with the Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO) statement for the use of animals in research. Surgeries were performed on the left eye (Nalbuphine Group) and on the right eye (Control Group). Two groups were formed (n=10) and corneas received either 30µl of 1% nalbuphine (NG) or 30µl of 0,9% saline (CG). Treatments occurred at 7, 11, 15 and 19 hours. After the surgery, the corneas were stained with fluorescein and photographed daily; corneal touch threshold (CTT) was assessed with Cochet-Bonnet aesthesiometer, at 7 and 19 hours, 20 minutes after treatments. Data were statistically compared with repeated measures ANOVA and Bonferroni post-hoc test, and T test (P<0.05). Average ±SD time for corneal re-epithelialization was 7.40±0.47 days (NG) and 8.90±0.31 days (CG) (P=0.11). The results showed that the diameter of the keratectomized area and CTT did not change significantly between both groups (P>0.05); however, a higher area under the curve for both parameters was observed in the NG (2771), in comparison to CG (2164). Topical 1% nalbuphine did not change significantly corneal sensitivity and re-epithelialization, after experimental lamellar keratectomy in rabbits.
Avaliaram-se os efeitos da nalbufina 1% sobre o limiar de sensibilidade corneal (LSC) e a epitelização corneal em coelhos submetidos à ceratectomia lamelar unilateral. Os procedimentos foram aprovados pela Comissão de Ética no Uso de Animais da Faculdade de Ciências Agrarias e Veterinárias da Universidade Estadual Paulista (Protocolo no 028793-08), de acordo com as normas do Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO). Conceberam-se dois grupos (n=10) e os olhos foram tratados com 30µl de Nalbufina 1% (Olho esquerdo - GN) ou com 30µl de solução salina (Olho direito - GC), às 7, 11, 15 e 19 horas das ceratectomias unilaterais, até sua reepitelização. O limiar de sensibilidade corneal (LSC) foi avaliado 20 minutos após cada tratamento, 48 horas antes e depois da ceratectomia a intervalos regulares de 12 horas (7 e 19 horas) com estesiômetro de Cochet-Bonnet. Após a realização da cirurgia, diariamente, as córneas foram coradas com fluoresceína e registradas em fotos digitais para mensuração em software Image-J. A normalidade dos dados foi avaliada ao teste de Kolmogorov-Smirnov. O limiar de sensibilidade e a área ulcerada foram comparados ao teste de Bonferroni, após ANOVA de medias repetidas (P<0,05). O teste t-Student foi aplicado na avaliação das médias quanto ao tempo de reepitelização. Não houve diferença significativa quanto ao limiar de sensibilidade entre os grupos, em qualquer dos períodos avaliados (P>0,05), todavia, constatou-se maior área sob a curva, relativamente ao LSC, no GN (2771), comparativamente ao GC (2164). O tempo médio±DP de reepitelização no GN foi de 7,40±0,47 dias e de 8,90±0,31 dias no GC, não havendo diferença significativa entre os grupos (P=0,11). Como conclusão, tem-se que o uso tópico de nalbufina 1% não alterou significativamente o limiar de sensibilidade e a reepitelização corneais em coelhos submetidos a ceratectomia lamelar experimental.
RESUMO
The present study was aimed to evaluate the effects of topical 1% nalbuphine on corneal sensitivity and re-epithelialization, after lamellar keratectomy in rabbits. All protocols were approved by the Animal Care Comission of São Paulo State University (Protocol 028793-08) and were conducted in accordance with the Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO) statement for the use of animals in research. Surgeries were performed on the left eye (Nalbuphine Group) and on the right eye (Control Group). Two groups were formed (n=10) and corneas received either 30µl of 1% nalbuphine (NG) or 30µl of 0,9% saline (CG). Treatments occurred at 7, 11, 15 and 19 hours. After the surgery, the corneas were stained with fluorescein and photographed daily; corneal touch threshold (CTT) was assessed with Cochet-Bonnet aesthesiometer, at 7 and 19 hours, 20 minutes after treatments. Data were statistically compared with repeated measures ANOVA and Bonferroni post-hoc test, and T test (P 0.05). Average ±SD time for corneal re-epithelialization was 7.40±0.47 days (NG) and 8.90±0.31 days (CG) (P=0.11). The results showed that the diameter of the keratectomized area and CTT did not change significantly between both groups (P>0.05); however, a higher area under the curve for both parameters was observed in the NG (2771), in comparison to CG (2164). Topical 1% nalbuphine did not change significantly corneal sensitivity and re-epithelialization, after experimental lamellar keratectomy in rabbits.
Avaliaram-se os efeitos da nalbufina 1% sobre o limiar de sensibilidade corneal (LSC) e a epitelização corneal em coelhos submetidos à ceratectomia lamelar unilateral. Os procedimentos foram aprovados pela Comissão de Ética no Uso de Animais da Faculdade de Ciências Agrarias e Veterinárias da Universidade Estadual Paulista (Protocolo no 028793-08), de acordo com as normas do Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO). Conceberam-se dois grupos (n=10) e os olhos foram tratados com 30µl de Nalbufina 1% (Olho esquerdo - GN) ou com 30µl de solução salina (Olho direito - GC), às 7, 11, 15 e 19 horas das ceratectomias unilaterais, até sua reepitelização. O limiar de sensibilidade corneal (LSC) foi avaliado 20 minutos após cada tratamento, 48 horas antes e depois da ceratectomia a intervalos regulares de 12 horas (7 e 19 horas) com estesiômetro de Cochet-Bonnet. Após a realização da cirurgia, diariamente, as córneas foram coradas com fluoresceína e registradas em fotos digitais para mensuração em software Image-J. A normalidade dos dados foi avaliada ao teste de Kolmogorov-Smirnov. O limiar de sensibilidade e a área ulcerada foram comparados ao teste de Bonferroni, após ANOVA de medias repetidas (P 0,05). O teste t-Student foi aplicado na avaliação das médias quanto ao tempo de reepitelização. Não houve diferença significativa quanto ao limiar de sensibilidade entre os grupos, em qualquer dos períodos avaliados (P>0,05), todavia, constatou-se maior área sob a curva, relativamente ao LSC, no GN (2771), comparativamente ao GC (2164). O tempo médio±DP de reepitelização no GN foi de 7,40±0,47 dias e de 8,90±0,31 dias no GC, não havendo diferença significativa entre os grupos (P=0,11). Como conclusão, tem-se que o uso tópico de nalbufina 1% não alterou significativamente o limiar de sensibilidade e a reepitelização corneais em coelhos submetidos a ceratectomia lamelar experimental.
RESUMO
The present study was aimed to evaluate the effects of topical 1% nalbuphine on corneal sensitivity and re-epithelialization, after lamellar keratectomy in rabbits. All protocols were approved by the Animal Care Comission of São Paulo State University (Protocol 028793-08) and were conducted in accordance with the Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO) statement for the use of animals in research. Surgeries were performed on the left eye (Nalbuphine Group) and on the right eye (Control Group). Two groups were formed (n=10) and corneas received either 30µl of 1% nalbuphine (NG) or 30µl of 0,9% saline (CG). Treatments occurred at 7, 11, 15 and 19 hours. After the surgery, the corneas were stained with fluorescein and photographed daily; corneal touch threshold (CTT) was assessed with Cochet-Bonnet aesthesiometer, at 7 and 19 hours, 20 minutes after treatments. Data were statistically compared with repeated measures ANOVA and Bonferroni post-hoc test, and T test (P 0.05). Average ±SD time for corneal re-epithelialization was 7.40±0.47 days (NG) and 8.90±0.31 days (CG) (P=0.11). The results showed that the diameter of the keratectomized area and CTT did not change significantly between both groups (P>0.05); however, a higher area under the curve for both parameters was observed in the NG (2771), in comparison to CG (2164). Topical 1% nalbuphine did not change significantly corneal sensitivity and re-epithelialization, after experimental lamellar keratectomy in rabbits.
Avaliaram-se os efeitos da nalbufina 1% sobre o limiar de sensibilidade corneal (LSC) e a epitelização corneal em coelhos submetidos à ceratectomia lamelar unilateral. Os procedimentos foram aprovados pela Comissão de Ética no Uso de Animais da Faculdade de Ciências Agrarias e Veterinárias da Universidade Estadual Paulista (Protocolo no 028793-08), de acordo com as normas do Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO). Conceberam-se dois grupos (n=10) e os olhos foram tratados com 30µl de Nalbufina 1% (Olho esquerdo - GN) ou com 30µl de solução salina (Olho direito - GC), às 7, 11, 15 e 19 horas das ceratectomias unilaterais, até sua reepitelização. O limiar de sensibilidade corneal (LSC) foi avaliado 20 minutos após cada tratamento, 48 horas antes e depois da ceratectomia a intervalos regulares de 12 horas (7 e 19 horas) com estesiômetro de Cochet-Bonnet. Após a realização da cirurgia, diariamente, as córneas foram coradas com fluoresceína e registradas em fotos digitais para mensuração em software Image-J. A normalidade dos dados foi avaliada ao teste de Kolmogorov-Smirnov. O limiar de sensibilidade e a área ulcerada foram comparados ao teste de Bonferroni, após ANOVA de medias repetidas (P 0,05). O teste t-Student foi aplicado na avaliação das médias quanto ao tempo de reepitelização. Não houve diferença significativa quanto ao limiar de sensibilidade entre os grupos, em qualquer dos períodos avaliados (P>0,05), todavia, constatou-se maior área sob a curva, relativamente ao LSC, no GN (2771), comparativamente ao GC (2164). O tempo médio±DP de reepitelização no GN foi de 7,40±0,47 dias e de 8,90±0,31 dias no GC, não havendo diferença significativa entre os grupos (P=0,11). Como conclusão, tem-se que o uso tópico de nalbufina 1% não alterou significativamente o limiar de sensibilidade e a reepitelização corneais em coelhos submetidos a ceratectomia lamelar experimental.