Validação de um novo protocolo de processamento de pele humana em um banco de tecidos
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Tipo
TCC
Data de publicação
2023-11-27
Periódico
Citações (Scopus)
Autores
Alves, Carolina inocêncio
Techy, Giovana Maier
Techy, Giovana Maier
Orientador
Nisihara, Renato Mitsunori
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Introdução: O glicerol é o principal agente antimicrobiano utilizado pelos bancos de tecidos, porém estudos anteriores mostraram altas taxas de descarte (30,9%) por contaminação bacteriana das peles doadas. Para tentar diminuir os descartes, foi criado um novo protocolo para conservação dessas peles, com a adição de antibióticos no meio de descontaminação. Objetivo: Avaliar se o novo protocolo é capaz de minimizar o crescimento bacteriano após o uso do meio de descontaminação. Métodos: Estudo descritivo realizado no Banco de Multitecidos Humanos do Hospital Universitário Evangélico Mackenzie entre janeiro e março de 2022. Foram utilizados fragmentos obtidos pela doação da pele de abdominoplastia, que foram cortados (2x2 cm) e divididos em grupos. Para simular a contaminação por bactérias gram positivas e gram negativas, foi efetuada a contaminação das amostras isolada e separadamente com Staphylococcus aureus e Escherichia coli. Os fragmentos foram divididos em 4 grupos: Grupo pele não contaminada (controle negativo), Grupo pele contaminada (controle positivo), Grupo protocolo antigo (pele descontaminada com glicerol 90%), e o Grupo protocolo atual (pele descontaminada com glicerol 90% mais antibióticos: gentamicina, vancomicina e meropenem). As etapas desse estudo simularam o processamento feito para peles doadas, desde a retirada da pele no centro cirúrgico, até a liberação para uso. Realizou-se três culturas nos três últimos grupos: a primeira cultura, efetuada para analisar se a pele está contaminada; a segunda, após a descontaminação, para avaliar se a solução foi eficiente; a terceira foi realizada após o empacotamento das peles, para avaliar a descontaminação previamente a liberação do tecido para doação. Resultados: Os controles positivos e negativos funcionaram adequadamente. Nos fragmentos contaminados com S.aureus com uso protocolo antigo, todas as culturas foram positivas. Nos fragmentos do grupo protocolo atual (com antibióticos), resultaram positivo apenas na primeira cultura, não ocorrendo crescimento na segunda e terceira cultura. Nos grupos contaminados por E. coli, tanto o protocolo antigo quanto o atual inibiram o crescimento desse grupo bacteriano na cultura final. Conclusão: O acréscimo de antibióticos na solução de descontaminação se mostrou eficiente para inibir o crescimento de bactérias gram positivas e gram negativas com igual eficiência. O uso desse meio de descontaminação poderá minimizar a taxa de descartes das peles doadas processadas pelo banco de pele, beneficiando, assim, um maior número de pacientes que necessitem do aloenxerto alógeno.
Introduction: Glycerol is the main antimicrobial agent used by tissue banks, but previous studies have shown high discard rates (30.9%) due to bacterial contamination of donated skins. In order to reduce discards, a new protocol for the preservation of donated skins was created, with the addition of antibiotics to the decontamination medium. Objective: To evaluate whether the new protocol is able to minimize bacterial growth after the use of the decontamination medium. Methodology: Descriptive study conducted at the Human Multitissue Bank of Mackenzie Evangelical University Hospital between January and March 2022. Fragments obtained from abdominoplasty skin donations were used, which were cut into 2x2 cm pieces and divided into groups. To simulate contamination by gram-positive and gram-negative bacteria, the samples were separately contaminated with Staphylococcus aureus and Escherichia coli. The fragments were divided into 4 groups: Non-contaminated skin group (negative control), Contaminated skin group (positive control), Old protocol group (skin decontaminated with 90% glycerol), and Current protocol group (skin decontaminated with 90% glycerol plus antibiotics: gentamicin, vancomycin, and meropenem). The steps of this study simulated the processing of donated skins, from the removal of the skin in the surgical center to its release for use. Three cultures were performed in the last three groups. The first culture was done to analyze whether the skin was contaminated. The second culture, performed after decontamination, aimed to assess the effectiveness of the solution. The third culture was carried out after the packaging of the skins to evaluate the pre-release decontamination of the tissue for donation. Results: The positive and negative controls worked properly. In the fragments contaminated with S. aureus using the old protocol all cultures were positive. In the fragments from the current protocol group (with antibiotics) only the first culture resulted positive, with no growth in the second and third cultures. In groups contaminated with E. coli, both the old and current protocols inhibited the growth of this bacterial group in the final culture. Conclusion: The addition of antibiotics to the decontamination solution was effective in inhibiting the growth of both gram-positive and gram-negative bacteria with equal efficiency. The use of this decontamination medium may minimize the discard rates of processed donated skins by the skin bank, benefiting a greater number of patients in need of allogeneic allografts.
Introduction: Glycerol is the main antimicrobial agent used by tissue banks, but previous studies have shown high discard rates (30.9%) due to bacterial contamination of donated skins. In order to reduce discards, a new protocol for the preservation of donated skins was created, with the addition of antibiotics to the decontamination medium. Objective: To evaluate whether the new protocol is able to minimize bacterial growth after the use of the decontamination medium. Methodology: Descriptive study conducted at the Human Multitissue Bank of Mackenzie Evangelical University Hospital between January and March 2022. Fragments obtained from abdominoplasty skin donations were used, which were cut into 2x2 cm pieces and divided into groups. To simulate contamination by gram-positive and gram-negative bacteria, the samples were separately contaminated with Staphylococcus aureus and Escherichia coli. The fragments were divided into 4 groups: Non-contaminated skin group (negative control), Contaminated skin group (positive control), Old protocol group (skin decontaminated with 90% glycerol), and Current protocol group (skin decontaminated with 90% glycerol plus antibiotics: gentamicin, vancomycin, and meropenem). The steps of this study simulated the processing of donated skins, from the removal of the skin in the surgical center to its release for use. Three cultures were performed in the last three groups. The first culture was done to analyze whether the skin was contaminated. The second culture, performed after decontamination, aimed to assess the effectiveness of the solution. The third culture was carried out after the packaging of the skins to evaluate the pre-release decontamination of the tissue for donation. Results: The positive and negative controls worked properly. In the fragments contaminated with S. aureus using the old protocol all cultures were positive. In the fragments from the current protocol group (with antibiotics) only the first culture resulted positive, with no growth in the second and third cultures. In groups contaminated with E. coli, both the old and current protocols inhibited the growth of this bacterial group in the final culture. Conclusion: The addition of antibiotics to the decontamination solution was effective in inhibiting the growth of both gram-positive and gram-negative bacteria with equal efficiency. The use of this decontamination medium may minimize the discard rates of processed donated skins by the skin bank, benefiting a greater number of patients in need of allogeneic allografts.
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Palavras-chave
queimaduras , aloenxertos , transplante de pele , burns , allografts , skin transplantation