Pedro Bins Ely

Ultrasonography for measuring rectus abdominis muscles diastasis

PURPOSE Preoperative imaging evaluation may be useful for determining the position of recti abdominis muscles before their correction. The purpose of this study is to evaluate the accuracy of ultrasonography to measure the width of rectus abdominis muscle diastasis. METHODS Rectus diastasis was measured by ultrasonography preoperatively in 20 females. Rectus diastasis was measured in seven levels along the anterior rectus sheath by ultrasound after sustained deep inspiration and after expiration. Rectus diastasis, at the same levels, was also measured after its exposition during abdominoplasty by two independent observers, using a surgical compass. These values were compared using Wilcoxons statistical text, for non independent values. RESULTS There was no significant difference between the values obtained by ultrasound and those measured during surgery in the supra-umbilical levels and at the level of the umbilicus. However, below the umbilicus these values differed significantly, showing smaller values in the imaging evaluation. CONCLUSION Ultrasonography is an accurate method to measure rectus diastasis above the umbilicus and at the umbilical level.

Isolation of adipose-derived stem cells: a comparison among different methods.

Adipose-derived stromal cells (ASCs) are usually isolated by digestion with collagenase. We have compared alternative methods to isolate ASCs in a more economically viable protocol. Nine protocols using red blood cells lysis buffer solution, trypsin, collagenase and centrifugation were compared; the isolation rate, cell viability, expansion rate, immunophenotype and differentiation in adipogenic and osteogenic lineages were analyzed. ASCs were isolated and successfully maintained by digestion with trypsin. Cells presented similar immunophenotypes, adipogenic differentiation and in vitro proliferation but an osteogenic differentiation capacity up to seven times higher than ASCs isolated by collagenase. This alternative protocol is thus efficient and more cost-effective than the commonly-used methods and may represent a promising protocol for obtaining ASCs for bone tissue engineering.

Transverse rectus abdominis musculocutaneous flap (TRAM flap) - experimental model in rats

Este artigo relata e divulga um modelo experimental do retalho musculocutâneo abdominal transverso de musculo reto do abdome (TRAM flap), em ratos. Foram utilizados 30 ratos Wistar (Rattus norvegicus albinus, Rodentia, Mammalia) machos, adultos, com peso individual variando entre 180 e 220 gramas. Os animais foram submetidos ao procedimento operatorio do retalho musculocutâneo abdominal transverso de musculo reto do abdome (TRAM flap), de base caudal com pediculo do musculo reto do abdome unilateral a direita.

Tensile strength of the posterior and anterior layer of the rectus abdominis muscle sheath in cadavers

PURPOSE The aim of the present study was to assess, in cadavers, the resistance to medial traction of the posterior and anterior layer of the rectus abdominis muscle sheath. METHODS An anatomical, prospective, self-controlled study was carried out in 20 male cadavers. An evaluation of the tension of the posterior and anterior layers of the rectus abdominis muscle sheath was performed following anatomical dissection of these structures. The traction necessary to advance the tissue ten millimeters was assessed using an analogic dynamometer. RESULTS There was no significant statistical difference between the necessary traction at various levels of the anterior and posterior layers of the rectus sheath. However, medial advancement of the anterior layer of the rectus sheath required more traction strength than did advancement of the posterior layer to the midline. CONCLUSION There is no difference in the tensile strength in the various levels of the anterior and posterior layers of the rectus sheath; however, medial advancement of the the anterior layer required more traction strength.

Uso de quercetina a longo prazo em ratos cirróticos

PURPOSE: The long term use of quercetin flavonoid was evaluated in cirrhotic rats by common biliary duct bondage (LDB). METHODS: 32 male Wistar rats were submitted to LDB or simulation, and distributed in 4 groups: 1) control, 2) cirrhotic, 3) cirrhotic treated with quercetin the second day after the surgical procedure; and 4) cirrhotic treated with quercetin after the fourteenth day of the surgical procedure. The hepatic function was analyzed through biochemical tests (TB and DB) and enzymatic activity (ALT, AST, AP and GGT). In the anatomopatological analysis, Hematoxilin & Eosin (HE Group 2 = 46 days; Group 3 = 71 days; and the Group 4 = 90 days. In the animals with bondage of common biliary duct, there was an increase of the hepatic and anzymatic function tests, which was reduced with the treatment with quercetin. Cirrhosis, portal and centrolobular vascular congestion, were identified in the histopatological analysis with H&E and Picrosirius. CONCLUSION: The use of quercetin decreased significantly the biochemical alterations caused by cirrhosis, increasing the time of survival of the animals with secondary biliary cirrhosis due to LDB.

Nicotine on rat TRAM flap

PURPOSE The transverse rectus abdominis myocutaneous (TRAM) flap is one of the preferential techniques used in breast reconstruction following mastectomy. Nicotine has a detrimental effect on cutaneous flap survival; although there are no experimental studies proving this effect on musculocutaneous flaps. The aim of this study is to verify the effect of nicotine on the rat TRAM flap. METHODS 30 Wistar EPM-1 rats were randomly distributed in two groups: control and experimental. The animals of the control group received saline solution injected subcutaneously, in a volume of 0.2 ml, twice a day, during 28 days in the preoperative period. The animals of the experimental group were treated with nicotine, injected subcutaneously, in a dose of 2 mg/kg twice a day, during 28 days in the preoperative period. All the animals were submitted to the caudally based, right unipedicled TRAM flap. 48 hours after the procedure, a study of the viable area of the flap was done through photographic documentation. Statistical analysis was performed with nonparametric Mann-Whitneys test. RESULTS The experimental group had significantly greater area of necrosis when compared with the control group (p<0.001). CONCLUSION Nicotine increased the area of necrosis of the TRAM flap, in rats.

Treinamento em microcirurgia vascular: é economicamente viável?

The authors describe their experience at the Experimental Microsurgery Lab of the Plastic Surgery Service of Irmandade Santa Casa de Misericordia de Porto Alegre Hospital ¾ Fundacao Faculdade Federal de Ciencias Medicas de Porto Alegre Medical School, highlighting initial low cost microsurgery training alternatives. They present the experimental results obtained.

Quality of Life and Aesthetic Plastic Surgery: A Systematic Review and Meta-analysis

Background: Quality of life (QoL) is an important outcome in plastic surgery. However, authors use different scales to address this subject, making it difficult to compare the outcomes. To address this discrepancy, the aim of this study was to perform a systematic review and a random effect meta-analysis. Methods: The search was made in two electronic databases (LILACS and PUBMED) using Mesh and non-Mesh terms related to aesthetic plastic surgery and QoL. We performed qualitative and quantitative analyses of the gathered data. We calculated a random effect meta-analysis with Der Simonian and Laird as variance estimator to compare pre- and postoperative QoL standardized mean difference. To check if there is difference between aesthetic surgeries, we compared reduction mammoplasty to other aesthetic surgeries. Results: Of 1,715 identified, 20 studies were included in the qualitative analysis and 16 went through quantitative analysis. The random effect of all aesthetic surgeries shows that QoL improved after surgery. Reduction mammoplasty has improved QoL more than other procedures in social functioning and physical functioning domains. Conclusions: Aesthetic plastic surgery increases QoL. Reduction mammoplasty seems to have better improvement compared with other aesthetic surgeries.

Induction of Expression of CD271 and CD34 in Mesenchymal Stromal Cells Cultured as Spheroids

Cultured mesenchymal stromal cells (MSCs) are cells that can be used for tissue engineering or cell therapies owing to their multipotency and ability to secrete immunomodulatory and trophic molecules. Several studies suggest that MSCs can become pericytes when cocultured with endothelial cells (ECs) but failed to use pericyte markers not already expressed by MSCs. We hypothesized ECs could instruct MSCs to express the molecules CD271 or CD34, which are expressed by pericytes in situ but not by MSCs. CD271 is a marker of especial interest because it is associated with multipotency, a characteristic that wanes in MSCs as they are culture expanded. Consequently, surface expression of CD271 and CD34 was detected in roughly half of the MSCs cocultured with ECs as spheroids in the presence of insulin-like growth factor 1 (IGF-1). Conversely, expression of CD271 and CD34 was detected in a similar proportion of MSCs cultured under these conditions without ECs, and expression of these markers was low or absent when no IGF-1 was added. These findings indicate that specific culture conditions including IGF-1 can endow cultured MSCs with expression of CD271 and CD34, which may enhance the multipotency of these cells when they are used for therapeutic purposes.

Implante no plano subfascial: revisão da literatura

DOI: 10.5935/2177-1235.2018RBCP0085 Introdução: Atualmente, na literatura científica faltam evidências para comparação tanto do plano de inclusão quanto do local da incisão e do tipo de implante mamário. Sabemos que existem planos de inclusão para implante mamário, como o subglandular, submuscular, subfascial e também o duplo-plano. Objetivo: O objetivo deste trabalho foi analisar na literatura existente as evidências científicas que comparassem os planos subglandular e o plano subfascial para a analisar se há realmente diferença clínica e estatisticamente significativa entre eles. Métodos: Foi realizada uma revisão bibliográfica usando a base de dados PubMed com o objetivo de realizar uma revisão das evidências científicas disponíveis a respeito do plano de inclusão subfascial. Resultados: Analisamos os artigos disponíveis na literatura que eram compatíveis com os critérios de inclusão, foram selecionados 13 artigos que faziam menção ao plano subfascial e, desses, apenas três faziam comparação entre os planos de inclusão. Não encontramos evidências científicas que comprovem a superioridade do plano subfascial sobre os demais tanto em relação à taxa de complicações quanto ao grau de satisfação das pacientes nos artigos selecionados. Conclusão: No momento, não existe evidência científica que comprove a superioridade do plano subfascial em relação aos demais, tanto em relação à taxa de complicações quanto ao grau de satisfação das pacientes. Assim, novos estudos são necessários para adequada comparação dos planos. ■ RESUMO