Navegando por Palavras-chave "Abdominal Wall"
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- ItemSomente MetadadadosAvaliação da resistência à tração medial dos componentes músculoaponeuróticos da parede abdominal após cada um dos descolamentos musculares da técnica de separação de componentes.(Universidade Federal de São Paulo (UNIFESP), 2019-07-31) Dias, Leandro Dario Faustino [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The component separation technique (CST) aims to reconstruct complex defects of the abdominal wall. The undermining of the rectus abdominis muscle (RAM) and external oblique muscle (EOM) decreases the tension in the abdominal midline, but also promotes several changes in the physiology of the abdominal wall. Identifying which muscle detachment promotes the highest decrease on midline tension may improve this technique by reducing postoperative complications and avoiding unnecessary undermining. Objective: the objective of this study is to identify which muscular undermining produces the most powerful tension decrease in the midline. Methods: Twenty fresh cadavers were dissected and tension forces in the abdominal midline were measured in the anterior and posterior aponeurosis in 3 phases: 1) before any undermining; 2) after undermining the RAM from its posterior aponeurosis on one side and the EOM on the opposite side of the abdomen; 3) after detachment of the remaining RAM on one side and the remaining EOM on the contralateral hemi-abdomen. The values obtained in each hemi-abdomen were analyzed using the Friedman variance test and Wilcoxon test. The level of significance adopted was 0.05. Results: After undermining the EOM and the RAM, there was a mean reduction in abdominal midline tension of 56% (p <0.05). After the undermining of only the RAM, there was a mean reduction in the abdominal midline tension of 35% (p <0.05), whereas a 42% tension reduction was obtained after the undermining of the EOM only (p <0.05). Conclusion: In the Components Separation Technique, the undermining of the External Oblique Muscle produces a greater reduction in the abdominal midline tension as compared to the undermining of the Rectus Abdominus Muscle.
- ItemAcesso aberto (Open Access)Ultrasonography for measuring rectus abdominis muscles diastasis(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2007-06-01) Mendes, Denise de Almeida [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Veiga, Daniela Francescato; Mendes, Fernando Vilela; Figueiras, Ricardo Góes; Gomes, Heitor Carvalho [UNIFESP]; Ely, Pedro Bins; Novo, Neil Ferreira [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UNIVAS; UNIVAS Surgery Department Plastic Surgery Division; Minas Center of Mastology and Imaging; UNIVAS Surgery Department Plastic Division; Santa Casa Plastic Surgery UnitPURPOSE: 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 Wilcoxon's 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.
- ItemAcesso aberto (Open Access)Variáveis hematológicas e perfil do ferro na abdominoplastia após a cirurgia bariátrica(Universidade Federal de São Paulo (UNIFESP), 2011-05-25) Pedroso, Juan Carlos Montano [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: The treatment of the abdominal wall deformity resulted from weight loss after bariatric surgery is a mixed type of abdominoplasty, which can induce post-operative anemia. In addition, bariatric surgery itself promotes a tendency to iron deficiency which could compromise erythropoiesis. To our knowledge, there is no study evaluating the degree of anemia and its recovery after post-bariatric abdominoplasty. Methods: The values of hemoglobin, reticulocytes, iron, ferritin and transferrin saturation index were measured the day prior to abdominoplasty and the first, fourth and eighth weeks after surgery. Hemoglobin was measured within 48h after surgery. Twenty adult women underwent surgery and had their data compared with 12 controls. Results: Hemoglobin levels dropped significantly from 12,98g/dL to 10,8g/dL within 48h. Hemoglobin increased significantly to 11,5g/dL by day seven, with correction of one third of the deficit, without significant increases thereafter. There was an increase in reticulocytes in the first week. Serum iron and transferrin saturation index fell in the first week and remained low. Ferritin levels showed no significant increase in the first week and subsequently fell. None of the patients received blood transfusion. Conclusion: Hemoglobin levels fell from 12,98 g/dL to 10,8 g/dL after abdominoplasty and showed an increase in the first week after surgery, with correction of one third of the deficit, but did not completely recover in the eighth week. At the end of the follow-up, 45% of the patients developed an iron deficiency and had a hemoglobin deficit higher than the patients that maintained normal iron stores.