Estudo experimental comparativo entre as telas de polipropileno microporoso, polipropileno/poliglecaprone e polipropileno macroporoso utilizadas na correção de defeito na parede abdominal de ratos
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Utrabo, Carlos Alberto Lima
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Introdução. O reparo de defeitos da parede abdominal é uma das cirurgias mais realizadas na atualidade. Com o aumento considerável de novas telas para utilização no tratamento das hérnias, existe uma incessante busca pela tela ideal. O uso de telas apresenta, em alguns casos, risco de infecção, seroma, fístula, dor crônica, e de retração da parede tratada. Esta pesquisa tem como objetivo avaliar o processo de cicatrização de defeito produzido em parede abdominal de ratos comparando-se o reparo com a utilização das telas polipropileno microporosa, polipropileno/poliglecaprone macroporosa e polipropileno macroporosa, avaliando-se a parede abdominal tratada no 30º, 60º e no 120º dia de pós-operatório visando: avaliação macroscópica, avaliação tensiométrica, e avaliação microscópica. Material e método: Foram utilizados 90 ratos da raça Wistar (Rattus norvergicus albinus), machos, adultos jovens, com três meses com peso variando de 280 a 300 gramas. Os animais foram distribuídos em três grupos de trinta ratos. Cada grupo foi dividido em três subgrupos de 10 ratos, que foram submetidos a procedimentos cirúrgicos semelhantes, com lesão da parede abdominal, mantendo a integridade do peritônio parietal e correção utilizando as telas estudadas. Realizou-se a eutanásia aos 30,60 e 120 dias de pós-operatório. Os segmentos parede abdominal dos animais foram submetidos à análise tensiométrica, histológica com utilização de hematoxilina/eosina e tricômio de Masson, imunoistoquímica, e avaliação do colágeno com o picrossírius Red. Resultados: O presente estudo demonstrou uma maior resistência dos tecidos reparados, nas telas macroporosas em relação às telas microporosas. O escore do processo inflamatório demonstrou prevalência significativa de processo subagudo no início e no final do estudo. Nas telas microporosas o encapsulamento é em bloco e nas telas macroporosas o encapsulamento é prevalentemente filamentar. O estudo imunoistoquímico com o marcador MMP9 teve redução constante durante todo o período de estudo no grupo G2 (polipropileno/poliglecaprone). Conclusão: As telas mais resistentes ao final do estudo foram as telas macroporosas. Nas telas microporosas o encapsulamento é em bloco e nas macroporosas prevalece o encapsulamento filamentar. Todas as telas estudadas mostraram resistência suficiente para a manutenção da correção do defeito de parede no período avaliado.
Introduction: Abdominal wall defect repair is one of the most commonly performed surgeries nowadays. Along with the considerable increase of new meshes for the use in the treatment of hernias, there is a constant search for the ideal mesh. The use of meshes presents, in some cases, risk of infection, seroma, fistula, chronic pain, and retraction of the treated wall. This research aims to assess the healing process of defects produced in the abdominal wall of rats by comparing the repair with the use of polypropylene microporous, polypropylene / polyglecaprone macroporous and polypropylene macroporous meshes, assessing the treated abdominal wall on the 30th, 60th and on the 120th postoperative day aiming at: macroscopic assessment, tensiometric assessment, and microscopic assessment. Material and method: 90 male young adult Wistar rats (Rattus norvergicus albinus) were used, weighing between 280 and 300 grams. The animals were divided into three sets of thirty rats. Each set was divided into three subsets of 10 rats, which underwent similar surgical procedures, with abdominal wall injury, maintaining the parietal peritoneum integrity and the correction using the studied meshes. Euthanasia was performed on the 30th, 60th and 120th days postoperatively. The abdominal wall segments of the animals went through tensiometric and histological analysis using hematoxylin / eosin and Masson's trichrome, immunohistochemistry, and collagen assessment with picrosirius Red. Results: The present study demonstrated a higher resistance of the repaired tissues in macroporous meshes compared to microporous meshes. The inflammatory process score showed a significant prevalence of subacute process at the beginning and at the end of the study. In microporous meshes the encapsulation occurs in blocks and in macroporous meshes the encapsulation is predominantly filamentary. The Immunohistochemical study with marker MMP9 had constant reduction throughout the study period in the G2 set (polypropylene / polyglecaprone). Conclusion: The most resistant meshes at the end of the study were macroporous meshes. In microporous meshes the encapsulation occurs in block and in the macroporous ones the filamentary encapsulation prevails. All the studied meshes presented sufficient resistance to maintain the correction of the wall defect in the assessed period.
Introduction: Abdominal wall defect repair is one of the most commonly performed surgeries nowadays. Along with the considerable increase of new meshes for the use in the treatment of hernias, there is a constant search for the ideal mesh. The use of meshes presents, in some cases, risk of infection, seroma, fistula, chronic pain, and retraction of the treated wall. This research aims to assess the healing process of defects produced in the abdominal wall of rats by comparing the repair with the use of polypropylene microporous, polypropylene / polyglecaprone macroporous and polypropylene macroporous meshes, assessing the treated abdominal wall on the 30th, 60th and on the 120th postoperative day aiming at: macroscopic assessment, tensiometric assessment, and microscopic assessment. Material and method: 90 male young adult Wistar rats (Rattus norvergicus albinus) were used, weighing between 280 and 300 grams. The animals were divided into three sets of thirty rats. Each set was divided into three subsets of 10 rats, which underwent similar surgical procedures, with abdominal wall injury, maintaining the parietal peritoneum integrity and the correction using the studied meshes. Euthanasia was performed on the 30th, 60th and 120th days postoperatively. The abdominal wall segments of the animals went through tensiometric and histological analysis using hematoxylin / eosin and Masson's trichrome, immunohistochemistry, and collagen assessment with picrosirius Red. Results: The present study demonstrated a higher resistance of the repaired tissues in macroporous meshes compared to microporous meshes. The inflammatory process score showed a significant prevalence of subacute process at the beginning and at the end of the study. In microporous meshes the encapsulation occurs in blocks and in macroporous meshes the encapsulation is predominantly filamentary. The Immunohistochemical study with marker MMP9 had constant reduction throughout the study period in the G2 set (polypropylene / polyglecaprone). Conclusion: The most resistant meshes at the end of the study were macroporous meshes. In microporous meshes the encapsulation occurs in block and in the macroporous ones the filamentary encapsulation prevails. All the studied meshes presented sufficient resistance to maintain the correction of the wall defect in the assessed period.
Palavras-chave
tela de polipropileno , hérnia abdominal , análise tensiométrica , imuno-histoquímica , CNPQ::CIENCIAS DA SAUDE