RESUMO
The purpose of this study is to evaluate and compare the effect of the incision of the external oblique aponeurosis along the semilunaris in amount of tension present after the undermining of the anterior rectus sheaths. Forty fresh adult cadavers were studied and divided into two groups: group A (n=20) and group B (n=20). Traction indexes were compared in three situations: (1) before any aponeurotic undermining (similar on both groups); (2) after incision and undermining of the anterior rectus sheaths (similar on both groups) and (3) group A: after undermining of the external oblique muscles with the incision of their aponeurosis along the semilunaris and group B: undermining of a continuous layer of the anterior rectus sheaths and the external oblique aponeurosis, after release of the lateral aspect of the rectus sheaths. Significance of differences was assessed using non-parametric tests. There was a significant tension reduction after each stage of dissection in both supra- and infra-umbilical levels and on both groups. Comparisons between groups A and B did not show statistically significant differences in all sites and stages of the dissections. Therefore, both techniques showed similar aponeurotic tension reduction after each stage of the dissections in cadavers.
Assuntos
Músculos Abdominais/fisiologia , Músculos Abdominais/cirurgia , Hérnia Abdominal/cirurgia , Adulto , Fenômenos Biomecânicos , Cadáver , Colectomia/efeitos adversos , Doença de Crohn/cirurgia , Dissecação , Feminino , Hérnia Abdominal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Dinamômetro de Força MuscularRESUMO
Our aim was to evaluate the amount of tension present after incision and undermining of the anterior rectus sheaths and the external oblique muscles in 20 fresh adult cadavers. Resistance to traction of the anterior and posterior rectus sheaths towards the midline was measured at three stages of dissection: before any aponeurotic undermining; after incision and undermining of the anterior rectus sheaths; and after incision and undermining of the external oblique muscles associated with the previous dissection. Significance of differences was assessed using non-parametric tests. There was a significant reduction in tension in the anterior and posterior sheaths on both levels after each stage of dissection. The incision and undermining of the anterior rectus sheaths and the external oblique muscles promoted a progressive reduction in tension at the aponeurotic edges of the abdominal wall.
Assuntos
Traumatismos Abdominais/cirurgia , Parede Abdominal/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reto do Abdome/cirurgiaRESUMO
Osteoma cutis is a rare disease in which there is formation of bony tissue in the skin that causes deformities. The etiology remains unknown and its treatment is controversial. A rare case of primary osteoma cutis in the face and scalp, which was not associated with any syndrome, is described. The patient was treated with surgery and topical retinoic acid. The retinoic acid treatment resulted in an improvement of the frontal area, and stabilized the disease over a two-year follow-up period. Surgical resection was a simple treatment with a quick recovery, minimal scarring and no local recurrence. The patient was followed for two years and presented a satisfactory result.The treatment of osteoma cutis is quite variable, and surgery is the most frequently reported treatment. However, a combination of clinical and surgical treatments seems to be an efficient way to manage these patients.
RESUMO
BACKGROUND: Incidental needlestick injury with exposure of blood pathogens has a high incidence among health care workers. Because plastic surgeons make up an important risk group for this type of accident, this study sought to evaluate the incidence of glove perforation during minor and major plastic surgery procedures. METHODS: Evidence of glove perforation was evaluated for 390 gloves after 100 consecutive minor surgical procedures and for 710 gloves after 100 consecutive major surgeries using Maffuli's test. An index based on the number of first assistant's glove perforation and the surgical time was created to compare these accidents associated with both types of procedures. RESULTS: Glove perforations were found in four gloves (1.02%) after minor surgery and 76 gloves (21.40%) after major surgery. During minor surgeries, the assistant was more likely to have exposure than the surgeon. During major surgery, the surgeon experienced more glove perforations (59.21%) than the assistant (40.79%). The most common location of perforations was the palmar face of the left hand in both groups. The surgeons did not notice these perforations at any time. The duration of the minor procedures varied from 10 to 30 min (average, 17.55 min), whereas the time of major procedures ranged from 1 to 6 h (average, 186 min). There was no statistical significant difference in the perforation's index between minor and major procedures. CONCLUSIONS: The risk of perforation to the surgeon's glove during minor surgery is minimal. The frequency of perforation to the first assistant's glove is similar between minor and major plastic surgery procedures.
Assuntos
Luvas Cirúrgicas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Ferimentos Penetrantes Produzidos por Agulha , Exposição Ocupacional/prevenção & controle , Médicos/estatística & dados numéricos , Procedimentos de Cirurgia Plástica , Brasil , Luvas Cirúrgicas/normas , Humanos , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Doenças Profissionais/prevenção & controle , Assistentes Médicos/estatística & dados numéricos , Estudos Prospectivos , Procedimentos de Cirurgia Plástica/efeitos adversos , Procedimentos de Cirurgia Plástica/normas , Medição de RiscoRESUMO
O trauma de nervos perifericos constitui uma situacao comum, porem com apresentacao clinica extremamente variavel. Quando associado a grandes contusoes, em particular no trauma fechado de membros, pode levar a alteracoes sensitivas e motoras no territorio do nervo comprometido sem que haja necessariamente seccao nervosa. A opcao pela conduta expectante ou pela abordagem cirurgica descompressiva frente a essa situacao e muito pouco estudada. Diante disso, desenvolveu-se um...