RESUMEN
BACKGROUND: The components separation technique (CS) is used for the reconstruction of complex abdominal wall defects. Release and undermining of the rectus abdominis muscle (RAM) and external oblique muscle (EOM) decrease tension on the abdominal midline, reducing recurrence of ventral hernia, but causes major changes in the physiology of abdominal wall. The purpose of the study was to determine which muscle release and undermining produces the lowest tension on the midline. METHODS: Twenty fresh cadavers were dissected and the anterior and posterior layers of the rectus sheath were isolated in the midline. The forces necessary to advance the layers of the rectus sheath to the mid abdomen were measured bilaterally at two points located 3 cm above and 2 cm below the umbilicus, and at 3 different stages: before any muscle release; after release and undermining of the right RAM and left EOM; and after release and undermining of the left RAM and right EOM. Comparisons of tensile forces were conducted separately for the different muscles involved, layers of the rectus sheath, measurement points, and stages of separation. RESULTS: Tension on the abdominal midline after the release and undermining of both the RAM and EOM was reduced by 56% (p <0.05), 42% after the release and undermining of the EOM alone (p <0.05), and 35% after release and undermining of the RAM alone (p <0.05). CONCLUSION: Release and undermining of the EOM by CS led to lower tension on the abdominal midline compared to that associated with the release of the RAM alone.
Asunto(s)
Pared Abdominal/anatomía & histología , Pared Abdominal/cirugía , Procedimientos de Cirugía Plástica/métodos , Recto del Abdomen/cirugía , Cadáver , Estudios Transversales , Disección , Hernia Ventral/prevención & control , Hernia Ventral/cirugía , Humanos , Recurrencia , Resistencia a la TracciónRESUMEN
Realizamos uma análise de quais são os elementos responsáveis pelo sustento e formato abdominal, determinando assim, que é devido a uma excessiva flacidez musculoaponeurótica de origem primária, à qual promove uma incapacidade do suporte da parede abdominal e pode estar relacionada a fatores predisponentes. Para esses casos específicos, desenvolvemos um tratamento propondo a colocação da tela e apresentando nossa experiência. Apresentamos esta série de casos de experiência em 26 anos. Onde 15 pacientes foram tratados com abdominoplastia primária e secundária. O reforço da parede abdominal foi realizado através da colocação de tela de polipropileno no plano submuscular com pontos em U na fáscia transversalis, buscando-se fortalecer o músculo e a fáscia transversa. Os resultados foram satisfatórios a longo prazo. Obtendo resolução das protuberâncias abdominais e restaurando a harmonia dos músculos. Apenas duas complicações ocorreram, que foram a presença de dor crônica localizada no abdome tratada com infiltrações de esteroides e fístula umbilical precoce de resolução rápida espontânea, independente da proposta.
We investigated the causative factors of abdominal support and shape and found that excessive musculoskeletal flaccidity of primary origin causes an inability to support the abdominal wall and may be associated with the predisposing factors. For such cases, we developed a treatment consisting of the placement of a subcutaneous mesh. Here, we present our experience with this treatment. We present a case series of 15 patients in our 26 years of experience who were treated with primary and secondary abdominoplasties. The abdominal wall was reinforced by placing a polypropylene mesh in the submuscular plane with U-stitches in the transversalis fascia, aiming at strengthening the muscle and transverse fascia. The results were satisfactory in the long term. Abdominal bulges were repaired, and muscle harmony was restored. Only two complications occurred: chronic pain localized in the abdomen, which was treated with steroid infiltrations, and an early umbilical fistula with spontaneous and rapid resolution, regardless of the proposal.
Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Historia del Siglo XXI , Atrofia Muscular , Tratamiento Secundario , Procedimientos de Cirugía Plástica , Pared Abdominal , Tejido Subcutáneo , Abdomen , Sistema Músculo-Aponeurótico Superficial , Diástasis Muscular , Atrofia Muscular/cirugía , Tratamiento Secundario/análisis , Tratamiento Secundario/métodos , Procedimientos de Cirugía Plástica/métodos , Pared Abdominal/anatomía & histología , Tejido Subcutáneo/cirugía , Abdominoplastia/métodos , Sistema Músculo-Aponeurótico Superficial/cirugía , Diástasis Muscular/cirugía , Abdomen/cirugíaRESUMEN
OBJECTIVE: The present quasi-experimental study aimed to assess the transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) thickness in healthy subjects with the proprioceptive Stabilizer™ training in abdominal wall muscles. METHODS: A sample of 41 healthy participants (age: 31.9 ± 4.5 y; height: 1.7 ± 0.1 m; weight: 68.3 ± 13.1 kg; body mass index, BMI: 22.9 ± 2.7 kg/m2) were recruited to participate in this study. Ultrasound images of the EO, IO, TrA, rectus anterior (RA) and interrecti distance (IRD) were measured and analyzed by the ImageJ software. Measurements were made at rest and during the abdominal drawing-maneuver (ADIM) developed by the patients with the Stabilizer™ located in the low back holding 40 mmHg for 10 seconds with a visual stimulus provided by a circular pressure marker. RESULTS: Ultrasound measurements for the abdominal wall muscles showed statistically significant differences (Π < .05) for a thickness decrease of the EO, IO and a thickness increase of TrA. A proprioceptive Stabilizer™ training produced a thickness increase in TrA muscle and a thickness decrease in EO and IO muscles in healthy subjects. CONCLUSIONS: These findings suggest that a proprioceptive Stabilizer™ training could be useful in individuals with low back pain and lumbopelvic pain.
Asunto(s)
Músculos Abdominales/diagnóstico por imagen , Pared Abdominal/diagnóstico por imagen , Modalidades de Fisioterapia/instrumentación , Músculos Abdominales/anatomía & histología , Músculos Abdominales/fisiología , Pared Abdominal/anatomía & histología , Pared Abdominal/fisiología , Adulto , Humanos , Contracción Muscular/fisiología , Fuerza Muscular/fisiología , UltrasonografíaRESUMEN
SUMMARY The present quasi-experimental study aimed to assess the transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) thickness in healthy subjects with the proprioceptive Stabilizer™ training in abdominal wall muscles. A sample of 41 healthy participants (age: 31.9 ± 4.5 y; height: 1.7 ± 0.1 m; weight: 68.3 ± 13.1 kg; body mass index, BMI: 22.9 ± 2.7 kg/m2) were recruited to participate in this study. Ultrasound images of the EO, IO, TrA, rectus anterior (RA) and interrecti distance (IRD) were measured and analyzed by the ImageJ software. Measurements were made at rest and during the abdominal drawing-maneuver (ADIM) developed by the patients with the Stabilizer™ located in the low back holding 40 mmHg for 10 seconds with a visual stimulus provided by a circular pressure marker. Ultrasound measurements for the abdominal wall muscles showed statistically significant differences (Π < .05) for a thickness decrease of the EO, IO and a thickness increase of TrA. A proprioceptive Stabilizer™ training produced a thickness increase in TrA muscle and a thickness decrease in EO and IO muscles in healthy subjects. These findings suggest that a proprioceptive Stabilizer™ training could be useful in individuals with low back pain and lumbopelvic pain.
RESUMO O objetivo do presente estudo foi avaliar o transverso abdominal (TrA), o oblíquo interno (OI) e a espessura oblíqua externa (EO) em indivíduos saudáveis com o treinamento proprioceptivo Stabilizer™ nos músculos da parede abdominal. Uma amostra de 41 participantes saudáveis (idade: 31,9±4,5 y, altura: 1,7±0,1 m; peso: 68,3±13,1 kg; índice de massa corporal, IMC: 22,9±2,7 kg / m2) foram recrutados para participar deste estudo. As imagens de ultrassom do EO, IO, TrA, reto anterior (RA) e distância interrecti (IRD) foram medidas e analisadas pelo software ImageJ. As medidas foram feitas em repouso e durante a manobra de desenho abdominal (Adim) desenvolvida pelos pacientes com o StabilizerTM localizado na parte inferior das costas segurando 40 mmHg por 10 segundos com um estímulo visual fornecido por um marcador de pressão circular. As medidas de ultrassom para os músculos da parede abdominal apresentaram diferenças estatisticamente significativas (P<0,05) para uma diminuição da espessura do EO, IO e um aumento de espessura do TrA. Um treinamento proprioceptivo Stabilizer™ produziu um aumento de espessura no músculo TrA e uma diminuição da espessura nos músculos EO e IO em indivíduos saudáveis. Esses achados sugerem que um treinamento de Stabilizer™ proprioceptivo poderia ser útil em indivíduos com dor lombar e dor lombo-pélvica.
Asunto(s)
Humanos , Adulto , Modalidades de Fisioterapia/instrumentación , Músculos Abdominales/diagnóstico por imagen , Pared Abdominal/diagnóstico por imagen , Ultrasonografía , Músculos Abdominales/anatomía & histología , Músculos Abdominales/fisiopatología , Pared Abdominal/anatomía & histología , Pared Abdominal/fisiología , Fuerza Muscular/fisiología , Contracción Muscular/fisiologíaRESUMEN
A abdominoplastia está entre os procedimentos cirúrgicos mais realizados na cirurgia plástica, de forma que muitas variações técnicas têm sido criadas com o objetivo de se reduzirem as complicações e para se obter melhores resultados no contorno abdominal. Nesse contexto, a anatomia da parede abdominal ganha papel de destaque, uma vez que as justificavas em defesa de técnicas, como a abdominoplastia clássica e lipoabdominoplastia, estão atreladas a princípios anatômicos. Isso evidencia a necessidade do domínio da anatomia da região pelo cirurgião plástico, pois, além de entender os motivos de se adotar determinados procedimentos cirúrgicos, o torna mais capacitado de adaptá-los às características anatômicas de cada paciente, além de compreender as alterações morfofuncionais provocadas pela cirurgia. Diante disso, esse trabalho teve o objetivo de buscar na literatura estudos que enfocassem a descrição anatômica da abdominoplastia, tanto clássica quanto de outras variantes, como a lipoabdominoplastia, bem como as explicações anatomofisiopatológicas das principais complicações operatórias inerentes.
Abdominoplasty is a common surgical procedure in plastic surgery. Consequently, several technical variations have been created with the aim of reducing complications and obtaining better results in the abdominal contour. The anatomy of the abdominal region plays an important role in this procedure, since arguments in favor of techniques, such as classic abdominoplasty and lipoabdominoplasty are linked to anatomical principles. This highlights the plastic surgeon's need to have a good knowledge of the anatomy of this region. Not only will this knowledge enable plastic surgeons to understand the reasons for adopting certain surgical procedures, but it will also enable them adapt these procedures to the anatomical characteristics of each patient. In addition, this knowledge will help determine the morphological changes caused by surgery. Therefore, this study aimed to identify studies in the literature focusing on the anatomical description of both classical abdominoplasty and other variants, such as lipoabdominoplasty. It also aimed to discover the anatomical and physiopathological explanations for the major inherent surgical complications.
Asunto(s)
Humanos , Historia del Siglo XXI , Complicaciones Posoperatorias , Procedimientos Quirúrgicos Operativos , Literatura de Revisión como Asunto , Lipectomía , Pared Abdominal , Abdomen , Abdominoplastia , Complicaciones Posoperatorias/cirugía , Procedimientos Quirúrgicos Operativos/métodos , Lipectomía/métodos , Pared Abdominal/anatomía & histología , Pared Abdominal/cirugía , Abdominoplastia/métodos , Abdomen/anatomía & histología , Abdomen/cirugíaRESUMEN
Antecedentes: La reconstrucción de la pared abdominal tiene como fin restaurar el soporte estructural, otorgando una cobertura estable y optimizando la apariencia estética. La técnica de separación de componentes consiste en el avance medial de un componente muscular y fascial inervados, para reconstruir defectos en la línea media, logra un cierre sin tensión y ayuda a recrear la dinámica de la pared abdominal. Objetivo: El objetivo del siguiente trabajo es presentar la experiencia del Hospital de Carabineros en la reconstrucción de tales defectos utilizando esta técnica y evaluar la tasa de recidiva. Material y método: Estudio retrospectivo de pacientes operados en el Hospital entre 2010 y 2015. Se describe la técnica quirúrgica utilizada.Resultados: Se presenta una serie de 6 pacientes operados en dicho período. El tamaño promedio del defecto fue 272,8 cm². Se utilizó la técnica clásica de separación de componentes y en algunos casos modificaciones para preservar perforantes. La cirugía tuvo una duración de 185 min en promedio. No se han presentado recidivas a la fecha entre los pacientes operados (seguimiento promedio 16,8 meses). Conclusiones: La técnica de separación de componentes repara defectos extensos de manera anatómica, autógena y devolviendo la funcionalidad a la pared abdominal. Es un procedimiento que no está libre de complicaciones, sin embargo, en nuestra experiencia los resultados son estables en el tiempo sin evidenciar recidivas. Se recomienda una adecuada evaluación y selección de cada caso.
Background: The component separation technique is a type of rectus abdominis muscle advancement flap that allows reconstruction of such large ventral defects. The advantages of the component separation technique are that it restores functional and structural integrity of the abdominal wall, provides stable soft tissue coverage, and optimizes aesthetic appearance. Aim: To report our experience in abdominal reconstruction using this technique. Material and methods: Review of medical records of 6 patients subjected to an abdominal wall repair using the component separation technique. Results: The mean size of the abdominal wall defect was 272.8 cm². The classic technique or a modification to preserve perforator vessels were used. The mean surgical time was 185 minutes. After a follow up of 16.8 months, no relapses were observed. Conclusions: In this experience the component separation technique had good results and no relapse of the defect was observed.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Pared Abdominal/cirugía , Abdominoplastia/métodos , Hernia Incisional/cirugía , Complicaciones Posoperatorias , Estudios Retrospectivos , Estudios de Seguimiento , Resultado del Tratamiento , Procedimientos de Cirugía Plástica , Pared Abdominal/anatomía & histología , Tempo OperativoRESUMEN
A eventração é a ruptura da parede abdominal com saída de vísceras, ficando contida apenas pela pele.O trauma é a etiologia mais frequente na maioria dos casos e pode ocasionar estrangulação das porções acometidas.Após a lesão ocorre deposição de fibrina e construção de aglutinações fibrinosas, que serão degradadas em poucos dias ou transformadas em aderências fibrosas permanentes. O tratamento é cirúrgico e consiste na redução do conteúdo eventrado e reconstituição da parede abdominal. O propósito deste trabalho é reportar um caso de. eventração equina com aderência de ceco, atendido no setor de Clínica Médica e Terapêutica de Equídeos da Faculdade de Medicina Veterinária e Zootecnia (FAMEZ), Universidade Federal de Mato Grosso do Sul (UFMS). O animal foi submetido à laparotomia paramediana direita com cecostomia e redução da eventração. O equino recebeu alta após 30 dias da intervenção com a ferida cirúrgica cicatrizada e sem evidências de complicações pós-operatórias.
The eventration is the rupture of the abdominal wall with output viscera, being restrained only by theskin. Trauma is the most frequent cause in most cases and may lead to strangulation of affected portions. Alter theinjury, the fibrin deposition and clumps fibrinous construction may be degraded in few days or transformed intopermanent fibrous adhesion. The treatment is surgical and consists to reduce the gut content and reconstitute abdominal wall. The purpose of this study is to report an equine eventration with cecal adhesion, atlended at Large Animal Medical and Surgical Clinic, Department of Veterinary Medicine and Zootechny College (FAMEZ), Federal University of Mato Grosso do Sul (UFMS). The animal under went laparotomy with right paramedian cecostomy andreducing herniation. The horse was discharged after 30 days of intervention with the healed wound and no evidenceof post-operative complications.
A eventración es Ia ruptura de Ia pared abdominal con salida de Ias viseras, quedandó sostenida apenaspor lapiel. EI trauma es Ia etologia mas frecuente en Ia mayoria de los casos que puede ocasionar estrangulacion deIas porciones acometidas despues de Ia lesion ocurre deposição de fibrina y construccion de glutinaco es fibrinosasque seran degradads en pocos dias o transformadas en aderência fibrosas permanente. EI tratamento es cirúrgico que consiste en Ia reduccion dei contenido eventrada y Ia regeneracion de Ia pared abdominal. EI proposito de estetrabajo es reportar un caso de eventración equina com aderência de ceco atendido en el sector de clinica medica y terapêutica de equideos de Ia Facultad de Medicina Veterinária y Zootecnia (FAMEZ), Universidade Federal de MatoGrosso do Sul (UFMS). EI animal fue sometido a laparotomia paramediana derecha con cecostomia y reduccion deIa eventración. EI equino tuvo de alta aios 30 dias de intervencion con Ia herida cirúrgica cicatrisada y sin evidenciade complicacion pos-operatória.
Asunto(s)
Masculino , Animales , Caballos/anatomía & histología , Caballos/fisiología , Heridas y Lesiones/veterinaria , Pared Abdominal/anatomía & histología , Traumatismos Abdominales/veterinaria , Cecostomía/veterinaria , Fibrina/fisiología , Procedimientos Quirúrgicos Operativos/veterinaria , Vísceras/lesionesRESUMEN
A eventração é a ruptura da parede abdominal com saída de vísceras, ficando contida apenas pela pele.O trauma é a etiologia mais frequente na maioria dos casos e pode ocasionar estrangulação das porções acometidas.Após a lesão ocorre deposição de fibrina e construção de aglutinações fibrinosas, que serão degradadas em poucos dias ou transformadas em aderências fibrosas permanentes. O tratamento é cirúrgico e consiste na redução do conteúdo eventrado e reconstituição da parede abdominal. O propósito deste trabalho é reportar um caso de. eventração equina com aderência de ceco, atendido no setor de Clínica Médica e Terapêutica de Equídeos da Faculdade de Medicina Veterinária e Zootecnia (FAMEZ), Universidade Federal de Mato Grosso do Sul (UFMS). O animal foi submetido à laparotomia paramediana direita com cecostomia e redução da eventração. O equino recebeu alta após 30 dias da intervenção com a ferida cirúrgica cicatrizada e sem evidências de complicações pós-operatórias.(AU)
The eventration is the rupture of the abdominal wall with output viscera, being restrained only by theskin. Trauma is the most frequent cause in most cases and may lead to strangulation of affected portions. Alter theinjury, the fibrin deposition and clumps fibrinous construction may be degraded in few days or transformed intopermanent fibrous adhesion. The treatment is surgical and consists to reduce the gut content and reconstitute abdominal wall. The purpose of this study is to report an equine eventration with cecal adhesion, atlended at Large Animal Medical and Surgical Clinic, Department of Veterinary Medicine and Zootechny College (FAMEZ), Federal University of Mato Grosso do Sul (UFMS). The animal under went laparotomy with right paramedian cecostomy andreducing herniation. The horse was discharged after 30 days of intervention with the healed wound and no evidenceof post-operative complications.(AU)
A eventración es Ia ruptura de Ia pared abdominal con salida de Ias viseras, quedandó sostenida apenaspor lapiel. EI trauma es Ia etologia mas frecuente en Ia mayoria de los casos que puede ocasionar estrangulacion deIas porciones acometidas despues de Ia lesion ocurre deposição de fibrina y construccion de glutinaco es fibrinosasque seran degradads en pocos dias o transformadas en aderência fibrosas permanente. EI tratamento es cirúrgico que consiste en Ia reduccion dei contenido eventrada y Ia regeneracion de Ia pared abdominal. EI proposito de estetrabajo es reportar un caso de eventración equina com aderência de ceco atendido en el sector de clinica medica y terapêutica de equideos de Ia Facultad de Medicina Veterinária y Zootecnia (FAMEZ), Universidade Federal de MatoGrosso do Sul (UFMS). EI animal fue sometido a laparotomia paramediana derecha con cecostomia y reduccion deIa eventración. EI equino tuvo de alta aios 30 dias de intervencion con Ia herida cirúrgica cicatrisada y sin evidenciade complicacion pos-operatória.(AU)
Asunto(s)
Animales , Masculino , Caballos/anatomía & histología , Caballos/fisiología , Pared Abdominal/anatomía & histología , Heridas y Lesiones/veterinaria , Traumatismos Abdominales/veterinaria , Procedimientos Quirúrgicos Operativos/veterinaria , Cecostomía/veterinaria , Vísceras/lesiones , Fibrina/fisiologíaRESUMEN
INTRODUÇÃO: A abdominoplastia é o terceiro procedimento mais realizado em cirurgia plástica. Na intenção de evitar complicações cirúrgicas, foi feito o estudo da artéria ilíaca circunflexa superficial do abdome (AICS), investigando a importância da sua preservação nestas cirurgias, como um dos fatores de alta importância na prevenção das necroses. MÉTODOS: O presente estudo anatômico prospectivo foi realizado no Serviço de Cirurgia Plástica do Hospital Agamenon Magalhães. Trinta e três pacientes foram submetidos à dermolipectomia abdominal à Pitanguy, com os retalhos cirúrgicos ressecados sendo submetidos a estudos hemodinâmicos para análise do território anatômico irrigado pela AICS. RESULTADOS: Foram operados 82 pacientes, sendo selecionados 33 que preencheram os critérios de inclusão para este estudo, seis (18,9%) foram excluídos por motivos técnicos. O grupo de pacientes em estudo apresentou faixa etária entre 23 e 49 anos (36,6 ± 7,5). O Índice de Massa Corporal variou de 22,0 a 30,5 (24,9 ± 2,1). O peso das peças cirúrgicas ressecadas variou de 450 a 1010 gramas (623,1 ± 141,5), o teste de Pearson entre IMC e peso das peças demonstrou importante correlação r = 0,91 e r2 = 0,83. Trinta e dois eram femininos (97%) e um masculino (3%). Uma paciente era portadora de hipertensão arterial sistêmica (3%). Vinte e sete eram pardos (81,8%), dois brancos (6,1%), três negros (9,1%) e um da raça indígena (3,0%). Nos estudos hemodinâmicos, as imagens e filmes obtidos demonstraram que a injeção do contraste iodado na AICS foi considerada adequada, compatível com o objetivo do trabalho em 25 (92%) pacientes e inadequada em dois (8%) pacientes. CONCLUSÃO: Os resultados hemodinâmicos deste estudo levam à conclusão que a preservação da AICS do abdome nas miniabdominoplastias tem relevante importância na prevenção das necroses da parede abdominal.
complications, a study of the superficial circumflex iliac artery of the abdomen (SCIA) was carried out to investigate the importance of this artery preservation in abdominoplasties as one of the high importance factors to prevent necrosis. METHODS: This prospective study was carried out at the Plastic Surgery Service of the Agamenon Magalhaes Hospital. We included 33 patients who underwent abdominoplasty using Pitanguy's technique where the resected surgical flaps underwent hemodynamic studies to analyze the anatomical area irrigated by SCIA. RESULTS: A total of 82 patients underwent surgery, of them 33 met the study inclusion criteria, and 6 (18.9%) were excluded for technical reasons. Patients' age ranged from 23 and 49 years (36.6±7.5), their body mass index (BMI) ranged from 22.0 to 30.5 (24.9 ± 2.1), and weight of resected surgical specimens ranged from 450 to 1010 grams (623.1 ± 141.5). Pearson's test between BMI and weight of surgical specimens showed significant correlation r = 0.91 and r2 = 0,83. We included in the study 32 women (97%) and 1 man (3%). One patient had hypertension (3%). Of the sample, 27 patients were pardo (81.8%), 2 white (6.1%), 3 black (9.1%) and 1 native south American (3.0%). In hemodynamic studies, images and videos obtained showed that injection of iodinated contrast in SCIA were considered adequate, and consistent with the objective of this study in 25 (92%) patients and inadequate for 2 (8%) patients. CONCLUSION: Hemodynamic results of our study indicated that preservation of SCIA of the abdomen in mini-abdominoplasties is important to prevent necrosis of abdominal wall.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Historia del Siglo XXI , Cirugía Plástica , Colgajos Quirúrgicos , Estudios Prospectivos , Estudio de Evaluación , Pared Abdominal , Abdomen , Abdominoplastia , Hemodinámica , Arteria Ilíaca , Anatomía , Necrosis , Cirugía Plástica/métodos , Colgajos Quirúrgicos/cirugía , Pared Abdominal/anatomía & histología , Pared Abdominal/cirugía , Pared Abdominal/patología , Abdominoplastia/métodos , Abdomen/anatomía & histología , Abdomen/cirugía , Arteria Ilíaca/anatomía & histología , Arteria Ilíaca/cirugía , Arteria Ilíaca/patología , Anatomía/métodos , Necrosis/patología , Necrosis/prevención & controlRESUMEN
O consumo de carne de jacaré-do-Pantanal tornou-se uma tendência de mercado e uma cadeia produtiva em ascensão no Estado de Mato Grosso, sendo 28,40% da carne comercializada nos últimos quatro anos oriundos do tronco. Estudos evolutivos, morfofisiológicos, ontogenéticos e tecnológicos foram desenvolvidos, mas não há descrição da musculatura e bases ósseas dos cortes comerciais. Objetivou-se descrever os músculos e correspondentes bases ósseas dos cortes filé de lombo, filé mignon e aparas. Na descrição óssea, utilizaram-se seis carcaças desossadas de exemplares juvenis de jacaré-do-Pantanal, além de um exemplar adulto, obtido por doação após óbito, do Zoológico da UFMT. Os ossos foram macerados em água corrente, clareados e descritos. Para a descrição muscular, 24 exemplares juvenis foram abatidos e esfolados, conservados em freezer e descongelados quando utilizados, sem qualquer fixação. Após a evisceração, foram dissecados em ambos os antímeros. Os músculos semiespinhal, longuíssimo e iliocostal, fixados nas vértebras e costelas torácicas, lombares e sacrais, formam o filé de lombo. O corte aparas é constituído pelos músculos grande dorsal, serrátil, peitoral e abdominais (oblíquo externo, oblíquo interno, transverso e reto), cuja base óssea corresponde as costelas torácicas, lombares e sacrais, a gastrália, o esterno e o epipúbis. Por sua vez, o m. puboisquiofemoral interno cranial, localizado na região sublombar e o m. troncocaudal, da superfície ventral da pelve, compreendem o filé mignon...
Yacare Caiman meat consumption has become a marketing trend and a commodity on the rise in Mato Grosso state in Brazil. In the last four years, cuts from the trunk represented 28.40% of total meat sales. Although evolutionary studies, morphophysiological ontogenetic and technology research have been carried out, characterization of muscle and bone bases of cuts from the torso has not been previously reported. The aim of this research is to describe the muscles and corresponding bones related to sirloin, filet mignon and meat trims cuts. To describe the bones, we used six boned carcasses from juvenile Yacare Caiman, as well as an adult specimen, obtained by donation after death from the Federal University of Mato Grosso Zoo. The bones were macerated, bleached and their anatomical details recorded. In order to study the muscle, 24 juvenile specimens were obtained after slaughter and skinning and dissected on both sides. The sirloin cut consists of the semispinal, longissimus and iliocostalis muscles, which are inserted on thoracic vertebrae and ribs, as well as lumbar and sacral ribs. The meat trims cut is formed by latissimus dorsi, serratus, pectoral and abdominal (external oblique, internal oblique, transversus and rectus) muscles, based in various bones: bone ribs are the thoracic, lumbar, and sacral ribs, the gastralia, the sternum and epipúbis. The filet mignon cut is formed by the internal puboischiofemoralis cranial (sublumbar) muscle and by the troncocaudal (ventral surface of the pelvis) muscle...
Asunto(s)
Animales , Caimanes y Cocodrilos/anatomía & histología , Huesos/anatomía & histología , Región Lumbosacra/anatomía & histología , Pared Abdominal/anatomía & histología , Pared Torácica/anatomía & histologíaRESUMEN
BACKGROUND: Abdominal obesity is an important cardiovascular risk factor. Therefore, identifying the best method for measuring waist circumference (WC) is a priority. OBJECTIVE: To evaluate the eight methods of measuring WC in patients with acute coronary syndrome (ACS) as a predictor of cardiovascular complications during hospitalization. METHODS: Prospective study of patients with ACS. The measurement of WC was performed by eight known methods: midpoint between the last rib and the iliac crest (1), point of minimum circumference (2); immediately above the iliac crest (3), umbilicus (4), one inch above the umbilicus (5), one centimeter above the umbilicus (6), smallest rib and (7) the point of greatest circumference around the waist (8). Complications included: angina, arrhythmia, heart failure, cardiogenic shock, hypotension, pericarditis and death. Logistic regression tests were used for predictive factors. RESULTS: A total of 55 patients were evaluated. During the hospitalization period, which corresponded on average to seven days, 37 (67%) patients had complications, with the exception of death, which was not observed in any of the cases. Of these complications, the only one that was associated with WC was angina, and with every cm of WC increase, the risk for angina increased from 7.5 to 9.9%, depending on the measurement site. It is noteworthy the fact that there was no difference between the different methods of measuring WC as a predictor of angina. CONCLUSION: The eight methods of measuring WC are also predictors of recurrent angina after acute coronary syndromes.
Asunto(s)
Síndrome Coronario Agudo/complicaciones , Antropometría/métodos , Obesidad Abdominal/complicaciones , Circunferencia de la Cintura , Pared Abdominal/anatomía & histología , Anciano , Angina de Pecho/complicaciones , Femenino , Insuficiencia Cardíaca/complicaciones , Hospitalización , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de RiesgoRESUMEN
Background: Abdominal obesity is an important cardiovascular risk factor. Therefore, identifying the best method for measuring waist circumference (WC) is a priority. Objective: To evaluate the eight methods of measuring WC in patients with acute coronary syndrome (ACS) as a predictor of cardiovascular complications during hospitalization. Methods: Prospective study of patients with ACS. The measurement of WC was performed by eight known methods: midpoint between the last rib and the iliac crest (1), point of minimum circumference (2); immediately above the iliac crest (3), umbilicus (4), one inch above the umbilicus (5), one centimeter above the umbilicus (6), smallest rib and (7) the point of greatest circumference around the waist (8). Complications included: angina, arrhythmia, heart failure, cardiogenic shock, hypotension, pericarditis and death. Logistic regression tests were used for predictive factors. Results: A total of 55 patients were evaluated. During the hospitalization period, which corresponded on average to seven days, 37 (67%) patients had complications, with the exception of death, which was not observed in any of the cases. Of these complications, the only one that was associated with WC was angina, and with every cm of WC increase, the risk for angina increased from 7.5 to 9.9%, depending on the measurement site. It is noteworthy the fact that there was no difference between the different methods of measuring WC as a predictor of angina. Conclusion: The eight methods of measuring WC are also predictors of recurrent angina after acute coronary syndromes. .
Fundamento: A obesidade abdominal é relevante fator de risco cardiovascular. Portanto, a identificação do melhor método para medição da circunferência abdominal (CA) é prioritária. Objetivo: Avaliar os oito métodos de medição da CA, em pacientes com síndrome coronariana aguda, como preditor de complicações cardiovasculares durante o período de internação. Métodos: Estudo prospectivo com pacientes com síndrome coronariana aguda. A medição da CA foi realizada pelos oito métodos conhecidos: ponto médio entre a última costela e a crista ilíaca (1), ponto da circunferência mínima (2); imediatamente acima da crista ilíaca (3), cicatriz umbilical (4), uma polegada acima do umbigo (5), um centímetro acima do umbigo (6), menor costela (7), no ponto de maior circunferência em torno da cintura (8). As complicações observadas foram: angina, arritmia, insuficiência cardíaca, choque cardiogênico, hipotensão, pericardite e óbito. Para os fatores de predição foram utilizados os testes de regressão logística. Resultados: Foram avaliados 55 pacientes. Durante o período de internação, que correspondeu, em média, a sete dias, 37 (67%) pacientes apresentaram complicações, com exceção do óbito, que não foi verificado em nenhum dos casos. Destas complicações, a única que apresentou associação com a CA foi a angina, sendo que a cada centímetro de elevação da CA, o risco de apresentar angina aumentou de 7,5 a 9,9%, conforme o local de medição. É importante destacar que não houve diferença entre os diferentes métodos de medição da CA como preditor de angina. Conclusão: Os oito métodos de medição da ...
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome Coronario Agudo/complicaciones , Antropometría/métodos , Obesidad Abdominal/complicaciones , Circunferencia de la Cintura , Pared Abdominal/anatomía & histología , Angina de Pecho/complicaciones , Hospitalización , Insuficiencia Cardíaca/complicaciones , Modelos Logísticos , Estudios Prospectivos , Factores de RiesgoRESUMEN
To construct a new biomaterial-small intestinal submucosa coated with gelatin hydrogel incorporating basic fibroblast growth factor, and to evaluate the new biomaterials for the reconstruction of abdominal wall defects. Thirty six Sprague-Dawley rats were used in the animal experiments and randomly divided into three groups. The new biomaterial was constructed by combining small intestinal submucosa with gelatin hydrogel for basic fibroblast growth factor release. Abdominal wall defects were created in rats, and repaired using the new biomaterials (group B), compared with small intestinal submucosa (group S) and ULTRAPROTM mesh (group P). Six rats in each group were sacrificed at three and eight weeks postoperatively to examine the gross effects, inflammatory responses, collagen deposition and neovascularization. After implantation, mild adhesion was caused in groups B and S. Group B promoted more neovascularization than group S at three weeks after implantation, and induced significantly more amount of collagen deposition and better collagen organization than groups S and P at eight weeks after implantation. Small intestinal submucosa coated with gelatin hydrogel incorporating basic fibroblast growth factor could promote better regeneration and remodeling of host tissues for the reconstruction of abdominal wall defects.
Asunto(s)
Animales , Ratas , Fibroblastos , Hidrogeles , Mucosa Intestinal/anatomía & histología , Pared Abdominal/anatomía & histología , Ratas/clasificaciónRESUMEN
To construct a new biomaterial-small intestinal submucosa coated with gelatin hydrogel incorporating basic fibroblast growth factor, and to evaluate the new biomaterials for the reconstruction of abdominal wall defects. Thirty six Sprague-Dawley rats were used in the animal experiments and randomly divided into three groups. The new biomaterial was constructed by combining small intestinal submucosa with gelatin hydrogel for basic fibroblast growth factor release. Abdominal wall defects were created in rats, and repaired using the new biomaterials (group B), compared with small intestinal submucosa (group S) and ULTRAPROTM mesh (group P). Six rats in each group were sacrificed at three and eight weeks postoperatively to examine the gross effects, inflammatory responses, collagen deposition and neovascularization. After implantation, mild adhesion was caused in groups B and S. Group B promoted more neovascularization than group S at three weeks after implantation, and induced significantly more amount of collagen deposition and better collagen organization than groups S and P at eight weeks after implantation. Small intestinal submucosa coated with gelatin hydrogel incorporating basic fibroblast growth factor could promote better regeneration and remodeling of host tissues for the reconstruction of abdominal wall defects.(AU)
Asunto(s)
Animales , Ratas , Pared Abdominal/anatomía & histología , Mucosa Intestinal/anatomía & histología , Hidrogeles , Fibroblastos , Ratas/clasificaciónRESUMEN
PURPOSE: To investigate the effects of alloxan diabetes on the abdominal wall healing of rats undergoing laparotomy. METHODS: Ninety-six male Wistar rats weighing between 200 and 300 grams, divided into two groups: non-diabetic group (G1) and another with untreated diabetes (G2). Three months after diabetes induction, the animals underwent a 5cm-long- laparotomy and 5.0 nylon monofilament suture. After the surgery, 12 animals from each group were euthanized on days 4, 14, 21 and 30 corresponding to the moments M1, M2, M3 and M4. In each moment a fragment of the abdominal wall containing the scar was removed for tensile strength measurement, histological and morphometric study. Clinical and biochemical parameters were also analyzed. RESULTS: G2 animals showed parameters compatible with severe diabetes and decreased plasma levels of insulin. The tensile strength in G2 was significantly smaller in M2 and M4, with a tendency to fall in the other two. Through light microscope, diabetic animals showed more difficulty to increase collagen density and contraction. G2 animals showed high cellularity of fibroblasts in later healing moments, with collagen thinning in M2 and M4. CONCLUSION: The abdominal wound healing in untreated diabetic animals was altered and led to a higher incidence of dehiscence and infections.
Asunto(s)
Pared Abdominal/fisiopatología , Diabetes Mellitus Experimental/fisiopatología , Resistencia a la Tracción/fisiología , Cicatrización de Heridas/fisiología , Pared Abdominal/anatomía & histología , Pared Abdominal/cirugía , Aloxano , Animales , Glucemia/análisis , Cicatriz , Colágeno/análisis , Diabetes Mellitus Experimental/inducido químicamente , Modelos Animales de Enfermedad , Fibroblastos/fisiología , Insulina/sangre , Masculino , Ratas , Ratas Wistar , Factores de TiempoRESUMEN
To investigate the effects of alloxan diabetes on the abdominal wall healing of rats undergoing laparotomy. METHODS: Ninety-six male Wistar rats weighing between 200 and 300 grams, divided into two groups: non-diabetic group (G1) and another with untreated diabetes (G2). Three months after diabetes induction, the animals underwent a 5cm-long- laparotomy and 5.0 nylon monofilament suture. After the surgery, 12 animals from each group were euthanized on days 4, 14, 21 and 30 corresponding to the moments M1, M2, M3 and M4. In each moment a fragment of the abdominal wall containing the scar was removed for tensile strength measurement, histological and morphometric study. Clinical and biochemical parameters were also analyzed. RESULTS: G2 animals showed parameters compatible with severe diabetes and decreased plasma levels of insulin. The tensile strength in G2 was significantly smaller in M2 and M4, with a tendency to fall in the other two. Through light microscope, diabetic animals showed more difficulty to increase collagen density and contraction. G2 animals showed high cellularity of fibroblasts in later healing moments, with collagen thinning in M2 and M4. CONCLUSION: The abdominal wound healing in untreated diabetic animals was altered and led to a higher incidence of dehiscence and infections.
Asunto(s)
Animales , Ratas , Alloxanum/análisis , Complicaciones de la Diabetes/patología , Pared Abdominal/anatomía & histología , Resistencia a la Tracción , Laparotomía/veterinaria , Ratas/clasificaciónRESUMEN
To investigate the effects of alloxan diabetes on the abdominal wall healing of rats undergoing laparotomy. METHODS: Ninety-six male Wistar rats weighing between 200 and 300 grams, divided into two groups: non-diabetic group (G1) and another with untreated diabetes (G2). Three months after diabetes induction, the animals underwent a 5cm-long- laparotomy and 5.0 nylon monofilament suture. After the surgery, 12 animals from each group were euthanized on days 4, 14, 21 and 30 corresponding to the moments M1, M2, M3 and M4. In each moment a fragment of the abdominal wall containing the scar was removed for tensile strength measurement, histological and morphometric study. Clinical and biochemical parameters were also analyzed. RESULTS: G2 animals showed parameters compatible with severe diabetes and decreased plasma levels of insulin. The tensile strength in G2 was significantly smaller in M2 and M4, with a tendency to fall in the other two. Through light microscope, diabetic animals showed more difficulty to increase collagen density and contraction. G2 animals showed high cellularity of fibroblasts in later healing moments, with collagen thinning in M2 and M4. CONCLUSION: The abdominal wound healing in untreated diabetic animals was altered and led to a higher incidence of dehiscence and infections.(AU)
Asunto(s)
Animales , Ratas , Complicaciones de la Diabetes/patología , Pared Abdominal/anatomía & histología , Resistencia a la Tracción , Alloxanum/análisis , Ratas/clasificación , Laparotomía/veterinariaRESUMEN
Petrus Camper's contributions to modern anatomical science include descriptions of the foot, upper limb, axilla, and inguinal region. His explanation of the etiology of inguinal hernias revolutionized the surgical practice of their repair. Camper's description of abdominal anatomy was an invaluable contribution to the field of abdominal surgery. Current research reviewed in this article shows the importance of understanding the layers of the abdominal wall, notably Camper's fascia, the closure of which has been found to be vital to proper wound healing and patient recovery. This article begins with a biography of Petrus Camper and his research in the inguinal region. It continues with anatomical and histological descriptions of Camper's fascia and finishes with its clinical correlates in surgical practice.
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Anatomía/historia , Pared Abdominal/anatomía & histología , Pared Abdominal/cirugía , Fascia/anatomía & histología , Fasciotomía , Historia del Siglo XVIII , Humanos , Países BajosRESUMEN
PURPOSE: To compare the inflammatory reaction and the growing resistance of the abdominal wall with the use of poliglecaprone meshes and polypropylene meshes associated with poliglecaprone in the correction of abdominal defects. METHODS: Seventy-seven Wistar rats were divided into three groups: CG (non-operated animals: EG (polypropylene mesh) and UG (polypropylene and poliglecaprone mesh). A muscular and aponeurotic defect was formed and treated according to the group. Evaluations were made after 4, 7, 14, 28 and 56 days. The resistance and inflammatory pattern were studied. RESULTS: There was a gradual and significant gain in resistance, regularly in the EG and irregularly in the UG, which was lower on the 14th day (p=0.008). The inflammatory reaction was acute and more intense in the UG on the fourth day. At all other times, the inflammatory pattern was acute to chronic, similar in both groups, with minimum intensity on the 56th day. CONCLUSION: The greater resistance offered by the polypropylene mesh was regular and ascending, stabilizing on the 28th day, while that of the polypropylene/poliglecaprone was not even. In the end, the resistances were similar. The inflammatory response was greater in the UG on the fourth day and similar at all other times.(AU)