The aim of this study was to review all cases of pseudoaneurysm in the literature, in predominantly arthroscopic procedures on the knee, and to report on a case of pseudoaneurysm that we treated. A bibliographic search was conducted for scientific articles published in Brazilian and foreign periodicals over the last 23 years. Forty-seven cases were found, in 40 articles. In addition to these 47 cases, there was the case that we treated, which was also included in the data. Among the operations that progressed with formation of a pseudoaneurysm, 60% were cases of meniscal injuries and 23%, anterior cruciate ligament injuries. In 46% of the cases, the artery affected with the popliteal, and in 21%, the inferomedial genicular artery. The commonest clinical symptom was pain (37%), followed by pulsating tumor (31%), edema of the calf (12%) and hemarthrosis (11%). The median time taken to make the diagnosis was 11 days, but it ranged from one day to 10 weeks after the procedure. Although rare, pseudoaneurysms are a risk that is inherent to arthroscopic surgery. All patients should be made aware of the vascular risks, even in small-scale procedures.
PURPOSE: To verify the effect of highly concentrated platelet-rich plasma (hPRP) in the pathways of bone repair using non-critical defects in the calvaria of rabbits. METHODS: The hPRP was produced from collected venous blood of 21 rabbits. Four non-critical defects of 8 mm in diameter were created on the calvaria of each animal. The defects were all treated differently: autogenous particled bone (APB, group 1), autogenous particled bone associated with hPRP (APB + hPRP, group 2), isolated hPRP (group 3), and blood clot (control, group 4). Animals were submitted to euthanasia on the 2nd, 4th and 6th week postoperatively. Histological and histomorphometric analysis were carried through. RESULTS: After two weeks, groups 1 and 2 were in more advanced stage of repair than 3 and 4. At this period, comparing the groups 1 and 2, no significant differences were found between both, which also happened between the groups 3 and 4. However, after four and six weeks, the group 1 showed a more advanced stage of repair among all the other studied groups, while group 2 was in more advanced signs of bone repair than groups 3 and 4. Comparing groups 3 and 4, after four and six weeks, the least advanced stage of bone repair was found to be within group 3. CONCLUSION: The use of a highly concentrated PRP was considered prejudicial to the repair of non-critical defects in the calvaria of rabbits, either in the association of autogenous particled bone, when compared to autogenous particled bone alone, or in its isolated form, when compared to blood clot (control).
Purpose:To evaluate the influence of hypothyroidism in tracheal wound healing process. Methods: A controlled study was designed with 48 male Wistar rats, divided into two groups: study and control groups. In the first one hypothyroidism was surgically induced and 10 weeks after, a tracheal opening followed by suture was performed in both groups, subdivided into 7, 14, and 21 days in accordance with the date of animals death. A laboratorial evaluation was performed to prove the decreased in thyroid function in the study group. Also a macroscopic evaluation through a stablished protocol and a microscopic analysis with Hematoxylin-eosin and Sirius-Red staining methods were done. Results: The laboratorial evaluation certified suppressed thyroid function in the study group. The macroscopic evaluation showed the presence of suture blockade in the study group in all the evaluated days. Microscopic analysis showed a prolongated inflammatory process and less collagen with delay in organization in the study group comparing to control group. All these data were statistic significant. Conclusion: Hypothyroidism had an influence in tracheal wound healing process, promoting delay in the inflammatory and organization processes and diminished tissue collagen quantity. Key words: Wound Healing. Hypothyroidism. Trachea. Rats. RESUMOObjetivo: Investigar a influência que o hipotireoidismo exerce no processo cicatricial da traquéia. Métodos: Estudo controlado, com 48 ratos Wistar machos, divididos em dois grupos, denominados: grupo estudo e grupo controle. No primeiro induziu-se hipotireoidismo cirurgicamente e após 10 semanas, realizou-se nos dois grupos o procedimento de abertura traqueal seguida de sutura. Houve subdivisão destes grupos em 7, 14 e 21 dias, de acordo com a data de morte dos animais. Foi realizada avaliação laboratorial para comprovar o hipotireoidismo no grupo estudo, avaliação macroscópica e microscópica através das colorações de hematoxilina-eosina e Sirius Red. Resultados: A avaliação laboratorial atestou que o grupo estudo encontrava-se em estado de hipotireoidismo. A avaliação macroscópica demonstrou predomínio de bloqueio da sutura no grupo estudo em todos os momentos avaliados. A microscopia comprovou prolongamento da fase inflamatória e diminuição da quantidade total de colágeno bem como atraso na sua organização no grupo estudo em relação ao grupo controle. Todos estes dados apresentaram significância estatística. Conclusão: O hipotireoidismo influencia no processo de cicatrização traqueal prolongando a fase inflamatória, diminuindo a quantidade de colágeno e atrasando sua maturação e organização. Descritores: Cicatrização de Feridas. Hipotireoidismo. Traquéia. Ratos.
Objective: to validate a lumbar spine endoscopic flavectomy simulator using the construct method and to assess the acceptability of the simulator in medical education. Methods: thirty medical students and ten video-assisted surgery experienced orthopedists performed an endoscopic flavectomy procedure in the simulator. Time, look-downs, lost instruments, respect for the stipulated edge of the ligamentum flavum, regularity of the incision, GOALS checklist (Global Operative Assessment of Laparoscopic Skills), and responses to the Likert Scale adapted for this study were analyzed. Results: all variables differed between groups. Procedure time was shorter in the physician group (p < 0.001). Look-downs and instrument losses were seven times greater among students than physicians. Half of the students respected the designated incision limits, compared to 80% of the physicians. In the student group, about 30% of the incisions were regular, compared to 100% in the physician group (p < 0.001). The physicians performed better in all GOALS checklist domains. All the physicians and more than 96% of the students considered the activity enjoyable, and approximately 90% believed that the model was realistic and could contribute to medical education. Conclusions: the simulator could differentiate the groups’ experience level, indicating construct validity, and both groups reported high acceptability.
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