Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Abdominal wall"

Navegando por Palavras-chave "Abdominal wall"

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Acesso aberto (Open Access)
Body Shape Questionnaire, Escala de Auto-Estima Rosenberg/UNIFESP-EPM e Short-Form 36 após abdominoplastia
(Universidade Federal de São Paulo (UNIFESP), 2007) Rocha, Maria José Azevedo de Brito [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
INTRODUÇÃO: A abdominoplastia visa a restaurar o contorno do abdome. O objetivo deste estudo é avaliar a imagem corporal, auto-estima e qualidade de vida em pacientes submetidas à abdominoplastia. MÉTODOS: Distribuiu-se 40 pacientes do gênero feminino, entre 25-60 anos de idade, IMC entre 19-30kg/m2, com deformidade abdominal tipos III e A pela classificação de NAHAS, em dois grupos: Grupo Estudo com 25 pacientes submetidas a abdominoplastia e Grupo Controle com 15 pacientes sem intervenção cirúrgica. Três questionários foram aplicados: BSQ, Escala de Auto Estima ROSENBERG/UNIFESP-EPM, SF-36 no pré e pós-operatório de um e seis meses no Grupo Estudo, no pré-operatório e após seis meses no Grupo Controle. RESULTADOS: Trinta e nove pacientes terminaram o estudo. No Grupo Estudo (24 pacientes), a abdominoplastia provocou impacto positivo no primeiro mês pósoperatório, mantendo-se no sexto mês. Houve diferença estatisticamente significante em valores totais e nas subescalas (BSQ), na auto-estima (ROSENBERG/ UNIFESPEPM) e no domínio saúde mental (SF-36). Nos domínios aspectos físicos, emocionais e vitalidade (SF-36), houve diferença estatisticamente significante apenas no pósoperatório de um mês. As demais dimensões não apresentaram diferença estatisticamente significante. No Grupo Controle, a diferença não foi estatisticamente significante em todos os domínios do BSQ, na auto-estima (ROSENBERG/UNIFESPEPM) e domínios do SF-36, com exceção do domínio vitalidade. Quando comparados os dois grupos aos seis meses, os valores não apresentaram diferença estatisticamente significante em nenhum dos domínios, com exceção da subescala percepção comparativa da imagem corporal (BSQ). CONCLUSÃO: A abdominoplastia promoveu melhora da imagem corporal, auto-estima e saúde mental.
Acesso aberto (Open Access)
Cadaver as an experimental model to study the effect of muscle advancement on the waistline
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2004-12-01) Nahas, Fabio Xerfan [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The use of cadaver as an experimental model to evaluate the waistline after correction of rectus diastasis and the advancement of the external oblique muscles in cadavers were described on this article. Two parameters were used: the measurement of the abdominal circumference and the overlap of the two skin flaps formed by a xypho-pubic incision. With a previously marked area of undermining of the aponeurotic layer, measurements of the overlapped flaps were made in the following stages of dissection: 1) with the myo-aponeurotic layer intact; 2) after the correction of rectus diastasis; and 3) after the advancement of the external oblique muscle. The experimental model described showed to be feasible to demonstrate the effects of the correction of rectus diastasis and of the advancement of external oblique muscles on the waistline.
Acesso aberto (Open Access)
Comparative study of the healing process of the aponeurosis of the anterior abdominal wall of rats after wound closure using 3-0 nylon suture and N-butil-2-cyanoacrylate tissue adhesive
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2008-08-01) Batista, Carlos Augusto Marques [UNIFESP]; Colleoni Neto, Ramiro [UNIFESP]; Lopes Filho, Gaspar de Jesus [UNIFESP]; School of Medicine of Valença; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To investigate the healing process of the aponeurosis of the anterior abdominal wall of rats, comparing two different materials for wound closure: 3-0 nylon suture and tissue adhesive N-butyl-2-cyanoacrylate. METHODS: Forty-four Wistar rats were randomly divided into four groups according to the type of material used (suture or adhesive) and the number of days until reoperation (seven or 14 days). After a 4 cm incision in the aponeurosis, 22 rats underwent wound closure using 3-0 nylon suture and the other 22, the tissue adhesive. After seven days, 11 rats from each group were weighed again, submitted to reoperation and then euthanized. The same procedure was carried out after 14 days with the remaining rats. The surgical wound was macroscopically examined, the tensile strength was measured and the tissue edges were histologically examined. The statistical analysis was performed using analysis of variance and Cox's proportional hazards model. Significance level was set at p < 0.05. RESULTS: The animals lost on average 20 g over the period between the two operations. Wound closure was faster using the tissue adhesive. Only one animal, from the tissue adhesive group, had a small abscess with wound dehiscence. With regard to tensile strength, the best results were obtained with the tissue adhesive 14 days after the first surgery. The results of the histological examination showed no significant difference between groups. CONCLUSIONS: Upon morphological evaluation, the two types of material analyzed in this study (3-0 nylon suture and N-butyl-2-cyanoacrylate, a tissue adhesive) were not significantly different with regard to the healing process of the aponeurosis of the anterior abdominal wall of rats. Wound closure using the tissue adhesive was faster. Higher tensile strength was observed in the tissue adhesive group 14 days after the first surgery.
Somente Metadadados
Concepts on Correction of the Musculoaponeurotic Layer in Abdominoplasty
(Elsevier B.V., 2010-07-01) Nahas, Fabio Xerfan [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The musculoaponeurotic layer of the abdominal wall should be corrected during abdominoplasty according to the specific deformity that the patient presents with in this article, the anatomic basis of deformities and defects of the abdominal wall is described. Different degrees of deformities secondary to pregnancy are described as well as congenital muscle malposition These conditions should be treated in specific ways so that the most efficient correction can be achieved and no recurrence will occur in cases of associated incisional hernias, the components separation technique can be considered for abdominal wall reconstruction and 2 alternative techniques of dissection of myoaponeurotic components are described for the correction of specific defects.
Acesso aberto (Open Access)
Experimental model for evaluation of the cutaneous sensitivity of the abdomen
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2004-12-01) Farah, Andréia Bufoni [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The purpose of this study is to report an experimental model to evaluate several modalities of sensibility and to map the areas of the abdominal wall with decreased sensibility after abdominoplasty. Patients were divided in two groups: in the control group, patients had no previous abdominal incisions and patients of the experimental group had been undergone abdominoplasty. The sensibility evaluation of patients from the experimental group was made from 12 to 60 months after the operation. The abdominal skin was divided into twelve areas; nine of them were above the abdominoplasty incision and three below it. Sensibility to superficial touch, superficial pain, hot and cold temperature, vibration was tested and recorded as positive if the patient mentioned that he felt the stimulation or negative. Sensibility to pressure was tested with the use of different weights; therefore, a value was obtained when the patient felt the pressure. A specific test was used to evaluate each modality of sensibility. The experimental model designed to test skin sensibility after abdominoplasty showed to be feasible in patients.
Somente Metadadados
Hematological Variables and Iron Status in Abdominoplasty After Bariatric Surgery
(Springer, 2013-01-01) Montano-Pedroso, Juan Carlos [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Omonte, Ivan René Viana [UNIFESP]; Rocha, Mario Guilherme Cesca [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Abdominoplasty, the treatment for abdominal wall deformity stemming from weight loss after bariatric surgery, can cause postoperative anemia. Moreover, bariatric surgery has been associated with iron deficiency, which by itself can compromise erythropoiesis. the objective of this research is to describe the development of anemia after postbariatric abdominoplasty.The study group consisted of 32 adult women who had received bariatric surgery. Treatment group included 20 patients who were undergoing postbariatric abdominoplasty. Control group included 12 patients waiting for abdominoplasty. Values of hemoglobin, reticulocytes, iron, ferritin, and the transferrin saturation were obtained on the evening before abdominoplasty and during the first, fourth, and eighth postoperative weeks. Hemoglobin was measured at 48 h.Mean hemoglobin levels for treatment group decreased from 12.98 to 10.8 g/dL after 48 h, increased on day 7 to 11.53 g/dL, but did not increase further after day 7. the reticulocyte number increased in the first week. Serum iron and transferrin saturation index fell during the first week and remained low. Ferritin levels increased non-significantly from 29.77 to 37.24 ng/mL at week 1, then fell until they were decreased (16.44 ng/mL) by day 56.As expected, hemoglobin fell after abdominoplasty. However, after a one-third recovery of hemoglobin concentrations by week 1 postoperative, they failed to return to preoperative levels by the eighth week. Additionally, by the eighth postoperative week, 45 % of abdominoplasty patients had developed an iron deficiency and hemoglobin deficit that was higher than that of patients who maintained normal iron stocks.
Somente Metadadados
Improving tension decrease in components separation technique
(Springer, 2014-02-01) Barbosa, Marcus Vinicius [UNIFESP]; Ayaviri, N. A. M. [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Juliano, Y. [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Univ Franca; Universidade Federal de São Paulo (UNIFESP)
The purpose of this study is to evaluate the tension at the aponeurotic edges after the undermining of the anterior rectus sheath associated with the classic components separation in cadavers.Twenty fresh adult cadavers were placed supine and an incision in the anterior rectus sheath was done, thus exposing the posterior sheath. the two levels to be studied were marked 3 cm above and 2 cm below the umbilicus. An analogical dynamometer was used to measure the traction values, consecutively during four stages as follows: initial stage, no aponeurotic undermining; Stage 1, separation of the anterior rectus sheaths; Stage 2, after Stage 1 the external oblique aponeurosis were incised along the semilunaris and the external oblique muscles were undermined; Stage 3, after Stage 2 rectus muscles were completely separated from their posterior sheaths. Statistical analysis was done by Friedman's analysis of variance (p < 0.05).There was a progressive and significant decrease in tension along the stages (Friedman's analysis of variance, p < 0.001). Traction indexes were higher in the initial stage and became gradually lower along the other stages.The undermining of the anterior rectus sheaths helps to decrease tension during the components separation technique.Level V, experimental study.
Somente Metadadados
Is it Possible to Repair Diastasis Recti and Shorten the Aponeurosis at the Same Time?
(Springer, 2014-04-01) Veríssimo, Pamella [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Barbosa, Marcus Vinicius [UNIFESP]; Carvalho Gomes, Heitor Francisco de [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Mandaqui Hosp Complex
Abdominal wall deformity secondary to pregnancy is multidirectional. Plication of the anterior rectus sheath is the most widely used technique for correction of this condition. However, it would be desirable to simultaneously perform the transverse and longitudinal repair of this deformity. the aim of this study was to assess changes in the length of the musculoaponeurotic layer after diastasis recti repair using triangular mattress sutures.Thirty-one women with Nahas' type III/A deformity were divided into two groups: the triangular mattress suture (TS) group and the continuous suture (CS) group. All patients underwent conventional abdominoplasty and diastasis recti repair with medial longitudinal plication performed between two metal clips. the two types of suture were used in both groups. in the TS group, after a CS was performed and removed, TSs were used and maintained in place. in the CS group, the order of suture placement was reversed. the distance between clips was measured before and immediately after suturing and at 3 weeks and 6 months postoperatively using plain abdominal radiographs. Statistical analysis was conducted using Friedman's analysis of variance and Wilcoxon's test.The use of TSs significantly reduced the length of the aponeurosis compared with both the intraoperative situation without suture (P < 0.001) and the use of CS (intraoperatively and 6 months after surgery; P < 0.001).The repair of diastasis recti using TSs resulted in vertical shortening of musculoaponeurotic layer immediately after the procedure and in the long term.This journal requires that authors assign a level of evidence to each article. for a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Acesso aberto (Open Access)
Plicatura da lâmina anterior da bainha dos músculos retos do abdome com a técnica de sutura triangular
(Universidade Federal de São Paulo (UNIFESP), 2013) Veríssimo, Pamella [UNIFESP]; Nahas, Fábio Xerfan; Gomes, Heitor Francisco de Carvalho [UNIFESP]; Barbosa, Marcus Vinícius Jardini [UNIFESP]; http://lattes.cnpq.br/2266460253828291; http://lattes.cnpq.br/3485738680161626; http://lattes.cnpq.br/3567288065904681; http://lattes.cnpq.br/2034024966821166; Universidade Federal de São Paulo (UNIFESP)
A deformidade musculo-aponeurotica da parede abdominal decorrente da gestacao e multidirecional. A tecnica mais utilizada para sua correcao e a plicatura da aponeurose anterior. Seria desejavel obter ao mesmo tempo uma correcao transversal e longitudinal. O objetivo deste estudo e avaliar o eixo vertical do plano musculo-aponeurotico apos o uso da sutura triangular na correcao da diastase de retos. Metodos: Foram selecionadas 31 pacientes com deformidade abdominal tipo III/A de Nahas, divididas em dois grupos (GST- grupo sutura triangular e GSC u grupo sutura continua). Estas foram submetidas a abdominoplastia e correcao da diastase dos musculos retos com plicatura longitudinal mediana, feita entre dois clipes metalicos implantados. Os dois tipos de sutura foram realizados em todas as pacientes. No GST, apos a realizacao da sutura continua, foi realizada e mantida a sutura triangular e o oposto ocorreu no GSC. Apos cada sutura a distancia entre os clipes foi medida. Foram realizadas radiografias de abdome tres semanas e seis meses apos a cirurgia quando foi medida a distancia entre os clipes. Os dados foram comparados utilizando-se Analise de Variancia de Friedman e teste de Wilcoxon. Resultados: A sutura triangular promoveu reducao significante do eixo vertical da aponeurose quando comparada a sutura continua e a situacao sem sutura no periodo intraoperatorio (Wilcoxon p<0,001). Esta diferenca manteve-se nas radiografias de seis meses (Wilcoxon p<0,001). Conclusao: A sutura triangular produziu encurtamento do eixo vertical do plano musculo-aponeurotico da parede abdominal em longo prazo
Somente Metadadados
Post-Bariatric Abdominoplasty: Skin Sensation Evaluation
(Springer, 2010-07-01) Bussolaro, Rodolpho Alberto [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Barbosa, Marcus Vinicius [UNIFESP]; Omonte, Ivan René Viana [UNIFESP]; Rodrigues Huijsmans, Juliana Perez [UNIFESP]; Bariani, Roberta Lopes [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The number of bariatric surgeries is progressively increasing in the USA and in Brazil. the number of post-bariatric plastic surgeries also increases as a response to this phenomenon. Abdominoplasties performed in former morbidly obese patients present a larger number of postoperative complications. Studies show that abdominoplasty caused postoperative skin hypesthesia. This study aims at evaluating skin sensibility/sensation in post-bariatric patients submitted to anchor-line abdominoplasty with clinical, qualitative, reliable and reproductive methods.Thirty-nine former morbidly obese women after open Roux-en-Y Gastric Bypass were evaluated for skin tactile pain, touch in movement, noxious and innocuous thermal sensibility and vibration. Fifteen patients composed the Control group (which did not undergo abdominoplasty) and 24 patients composed the Study group (which was submitted to anchor-line abdominoplasty without flap undermining). the sensations were evaluated before and after the abdominoplasty.The Control group which did not undergo abdominoplasty showed nearly 100% of positivity to all sensory modalities exception made to vibration which was 56.4-62.2-64.9%. Surprisingly, the Study group showed the same sensation maintenance after the abdominoplasty for nearly all modalities, vibration showed improvement (56.7-71.1-78.3%) without statistical value (p = 0.67).There was skin sensation maintenance after anchor-line post-bariatric abdominoplasty. Non-undermining of xipho-pubic flap is a possible reason for this discovery.
Acesso aberto (Open Access)
Postoperative intravenously administered iron sucrose versus postoperative orally administered iron to treat post-bariatric abdominoplasty anaemia (ISAPA): the study protocol for a randomised controlled trial
(Biomed Central Ltd, 2016) Montano-Pedroso, Juan Carlos [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Novo, Neil Ferreira [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]
Background: Anaemia and iron deficiency are common complications following post-bariatric abdominoplasty. Given the low oral absorbability of iron resulting from bariatric surgery, it has been hypothesised that postoperative intravenously administered iron supplementation could be used to treat anaemia and to prevent the development of iron deficiency in these patients. Methods/Design: In this multicentre open-label randomised clinical trial, 56 adult women undergoing post-bariatric anchor-line abdominoplasty will be allocated at a ratio of 1: 1 for postoperative supplementation with two intravenously administered applications of 200 mg of iron saccharate or postoperative supplementation with 100 mg of iron polymaltose complex administered orally, twice a day for 8 weeks. The primary outcome is the difference in mean haemoglobin levels between the two groups at eight postoperative weeks. Secondary outcomes evaluated at one, four and eight postoperative weeks include iron profile, reticulocyte count, overall quality of life measured using the Short-Form 36 Health Survey (SF-36) questionnaire, fatigue measured using the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F), adverse effects and postoperative complications. Discussion: This randomised clinical trial aims to evaluate the haematopoietic effectiveness of intravenously administered iron supplementation in patients undergoing post- bariatric abdominoplasty. A more effective recovery of haemoglobin levels could help improve the patients' quality of life and could provide an improved haematological status in preparation for the subsequent and frequent plastic surgeries these patients undergo.
Somente Metadadados
Rectus Diastasis Corrected with Absorbable Suture: A Long-Term Evaluation
(Springer, 2011-02-01) Nahas, Fabio Xerfan [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Ely, Pedro Bins [UNIFESP]; Ghelfond, Charles; Universidade Federal de São Paulo (UNIFESP); Hosp Jaragua
Correction of rectus diastasis (RD) is performed during most abdominoplasties. This study aimed to evaluate the long-term result of RD correction when the plication of the anterior rectus sheath is performed with an absorbable suture.Abdominoplasty was performed for 12 women who presented with Nahas' type A musculoaponeurotic deformity. the RD was measured preoperatively with two computed tomography (CT) scan slices at two levels: 3 cm above and 2 cm below the umbilicus. the bony levels at which the slices were taken served as a reference for the postoperative CT scans. During the operation, the RD was measured with a ruler at the same levels as the preoperative CT scan slices. the force necessary to bring the medial edge of the rectus muscle to the midline was measured on both levels with a dynamometer. Plication of the anterior rectus sheath was performed using a double-layer 0-PDS (polydioxanone) suture. Postoperative CT scans were performed 3 weeks after the operation. A long-term follow-up CT scan was performed 32-48 months postoperatively for every patient.The 3-week postoperative CT scan proved that the correction of RD was achieved by the procedure. Despite the fact that there were different abdominal wall resistances and that the average weight gain during this period was 4.5 kg, the long-term CT-scans showed no recurrence of RD for any patient of this series in either the superior or inferior abdomen.Plication of the anterior rectus sheath with PDS suture to correct RD seems to be a long-lasting procedure.
Acesso aberto (Open Access)
Resistência à tração dos componentes músculo-aponeuróticos na área doadora do retalho musculocutâneo transverso do reto do abdome
(Universidade Federal de São Paulo (UNIFESP), 2010-11-24) Vidal, Ronaldo [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Introduction: The defect on the abdominal wall in the transverse rectus abdominis myocutaneos flap -TRAM flap- donor site is extensive, complex and predisposes the emergence of hernia, bulging and abdominal weakness. The closure of the abdominal wall must be anatomic and functional, preferably with autologous tissues, resistance synthesis material and minimal tension suture. The selective musculoaponeurotic undermining of the abdominal provide a abdominal wall closure with autologous tissue and reduced tension. Despite many clinical studies, no experimental researches prove the real efficacy of selective musculoaponeurotic undermining in the TRAM flap donor site. Objective: The aim of this study is to evaluate the resistance to medial traction of the musculoaponeurotic components in the bipedicled TRAM flap donor site. Methods: In the period of May of 2006 until May of 2008, 20 patients, with ages from 29 to 58 years old, submitted to mammary reconstruction with bipedicled TRAM flap were studied. The resistance to medial traction of the musculoaponeurotic components in the bipedicled TRAM flap donor site was measured with a dynamometer that was fixed in the lateral edge of the defect, 3 cm below the umbilicus. The traction coefficients obtained were compared in three situation: Initial Stage - with no incision or additional underminig in the flap donor site; Stage 1 - incision above the lateral edge of the rectus sheath; Stage 2 - undermining of the external oblique muscle. To the statistical analyses it was used the Wilcoxon and the t test to paired data in the comparison of the right and left traction coefficients in Initial Stage, Stage 1 and Stage 2. The Friedman test and the post hoc of Dunn test was used to compare traction coefficients in initial Stage, stage 1 and Stage 2, in the right and left sides. Results: There was a significant reduction of traction resistance after each stage of the dissection. Conclusion: The incision on the internal lateral edge of the rectus sheath and the external oblique undermining reduce the medial traction resistance of the musculoaponeurotic components in the TRAM flap donor site.
Acesso aberto (Open Access)
Seroma em lipoabdominoplastia e abdominoplastia convencional: estudo comparativo
(Universidade Federal de São Paulo (UNIFESP), 2009-09-30) Di Martino, Marcello [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Introduction: Abdominoplasty is one of the most frequently performed cosmetic procedures and its combination with liposuction has become more common. Seroma is one of the most common complications in abdominoplasty.Objective: To compare the rate of seroma formation in patients who underwent either abdominoplasty without the use of quilting sutures, or lipoabdominoplasty. Methods: The sample consisted of 41 female patients, who were divided into two groups and underwent one of the following procedures: group A (n=21), abdominoplasty without quilting sutures and group B (n=20), lipoabdominoplasty. In order to investigate seroma formation, abdominal ultrasound was performed in 5 regions of the abdominal wall [epigastrium (EPI), umbilical (UMB), hypogastrium (HYPO), right iliac fossa (RIF) and left iliac fossa (LIF)], at two postoperative periods: (P1), between postoperative days 11 and 14, and (P2), between postoperative days 18 and 21. Results: The rate of seroma formation P1 was 38,1% in group A and 10,0% in group B. In P2 the rate of seroma formation was 33,3% in group A and 0,0% in group B. It was observed that, in group A at P1, the regions RIF and LIF developed larger fluid collections. In group B, there were significantly larger fluid collections in the HYPO region at P1, and in the UMB and HYPO regions at P2. Conclusion: Lipoabdominoplasty is a effective techniques for the prevention of seromas compared with conventional abdominoplasty.
Acesso aberto (Open Access)
Síntese da parede abdominal: avaliação de dois tipos de sutura contínua em ratos
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2003-06-01) Loureiro, Vanessa Medeiros [UNIFESP]; Fagundes, Djalma José [UNIFESP]; Taha, Murched Omar [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: To establish morphologic relationship between the continuous simple mass suture and the continuous far-near, near-far mass suture of longitudinal midline abdominal incision. METHODS: A total of 48 male Wistar rats underwent longitudinal standard laparotomy with equal distribution to one of two groups: GI- continuous simple mass suture, GII-continuous far-near, near-far suture, both with polypropylene. On postoperative day 7th or14th, 12 animals of each group were submitted to euthanasia and anterior abdominal wall was removed (without skin) for histologic and immune- histochemistry analysis. The samples of the abdominal wall were stained by hematoxylin-eosin in order to performed a qualitative healing tissue reaction. Others samples were stained by Picrosirius red F3BA in order to performed a quantitative analysis of macrophages and collagen. Statistical analysis was done by use the chi-square test, Fisher exact test and Mann-Whitney variance test ( p< 0,05). RESULTS: The findings of the macrophages cells and the collagen evaluation were statistical significantly on day 7th. CONCLUSION:The continuous far-near, near-far technique improved the abdominal wall healing on day 7th. On day 14th the findings were the same.
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Suction Drains, Quilting Sutures, and Fibrin Sealant in the Prevention of Seroma Formation in Abdominoplasty: Which is the Best Strategy?
(Springer, 2012-04-01) Bercial, Marcos Eduardo [UNIFESP]; Sabino Neto, Miguel [UNIFESP]; Calil, Jose Augusto; Rossetto, Luis Antonio [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hosp Servidor Publ Municipal São Paulo
Seroma is the most common complication in abdominoplasty and abdominal ultrasound is one of the best noninvasive methods for diagnosing seroma formation. the aim of this study was to compare the use of suction drains, quilting sutures, and fibrin sealant in abdominoplasty to determine the best strategy to prevent seroma formation.Forty-three female patients, aged 20-66 years, nonsmokers, with Nahas' type III deformities, and body mass index (BMI) ranging from 18.0 to 24.9 kg/m(2), underwent abdominoplasty between March and October 2008 in a public hospital setting. the patients were randomly allocated to one of three treatment groups: DN group (n = 15), abdominoplasty with suction drains alone; QS group (n = 13), abdominoplasty with quilting suture between the subcutaneous tissue of the flap and musculoaponeurotic layer of the anterior abdominal wall; and FS group (n = 15), abdominoplasty with fibrin sealant. All patients underwent ultrasound examination on postoperative days 15 and 30 for detection of abdominal fluid collections.The groups were homogeneous for age and BMI. There was a significant reduction in seroma formation between postoperative days 15 and 30 in the three groups (DN group, P = 0.0003; QS group, P = 0.0011; and FS group, P = 0.0003). Seroma formation was significantly higher in the FS group (H = 6.04, P < 0.05) compared with the DN and QS groups on postoperative day 15.Seroma formation was significantly lower in the DN and QS groups compared with the FS group on postoperative day 15.
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A variation in the component separation technique that preserves linea semilunaris: a study in cadavers and a clinical case
(Elsevier B.V., 2010-03-01) Barbosa, Marcus Vinicius [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Oliveira Filho, Renato Santos de [UNIFESP]; Montecinos Ayaviri, Natalia Alinda [UNIFESP]; Novo, Neil Ferreira [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
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. (C) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier B.V. All rights reserved.

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