Vaginal reconstruction with two lower abdominal skin flaps in rabbits: histological and macroscopic evaluation

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2012-02-01
Autores
Souza, Jesus Pires de [UNIFESP]
Rosito, Tiago Elias [UNIFESP]
Delcelo, Rosana [UNIFESP]
Ortiz, Valdemar [UNIFESP]
Macedo, Antonio [UNIFESP]
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Objective: To evaluate the use of two skin flaps of the lower abdominal wall in the creation of a cylindrical conduit in vaginal reconstruction surgery in rabbits, through macroscopic and histological analysis.Study design: An experimental study was performed in 16 female New Zealand rabbits, consisting of the use of two rectangular-shaped skin flaps of the lower abdominal wall measuring 1 cm longitudinally and 3 cm transversely anastomosed to each other through continuous suture of the edges of the two flaps to create a tube. Hysterectomy and excision of the vaginal vault were performed, and the skin tube was anastomosed to the remaining vaginal stump with separate points of polyglycolic acid 4.0. Animals were divided into 4 groups according to the euthanasia at 2, 4, 8 and 12 weeks, when after excision of the neovagina, macroscopic and histological evaluation with hematoxylin-eosin and Masson trichrome were performed.Results: of 16 operated rabbits, only 1 presented partial abdominal wall dehiscence, not compromising the flap viability. the macroscopic analysis of the vaginal conduit showed that it was kept open throughout the experimental steps, with a good patency and gauge, showing a slight retraction in the skin conduit length of no statistical significance. in the histopathological analysis, a local inflammatory process in the anastomosis was observed, which was larger in the early evaluation but decreased in late evaluations, as well as the local fibrosis process. Integration of the vaginal and skin epithelia was made with no alterations in their primary characteristics.Conclusion: the use of two skin flaps of the lower abdominal wall as a vaginal conduit presented good integration between skin and vaginal tissue with minimal length retraction, kept the patency during evaluations and did not show strictures, presenting good local healing and a low rate of complications. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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European Journal of Obstetrics & Gynecology and Reproductive Biology. Amsterdam: Elsevier B.V., v. 160, n. 2, p. 179-184, 2012.