Purpose: This is a review with the aim of describing the physical and biological characteristics of the most used sutures in daily surgical practice, and their indications. Methods: We reviewed the medical literature by searching the Pubmed and SciElo databases. Results: Data on the ideal qualities of sutures, general classification, indications, uses criteria. The physical and biological characteristics of absorbable, nonabsorbable, monofilamentar and multifilamentar sutures were described. Conclusion: With this review it was possible to synthesize current knowledge about sutures, which will certainly be useful for medical students, residents and surgeons.

1 1-Experimental SurgeryActa Cir Bras. 2017;32(2):90-97 Abstract Purpose: To evaluate the effect of tadalafil in renal ischemia/reperfusion (I/R) injury in rats. Methods: Group I/R saline rats (n=6) were subjected to 45 minutes of left renal ischemia and treated with saline; the I/R tadalafil rats (n=6) received oral 10mg/kg tadalafil microemulsion one hour before ischemia. In both groups, 8 hours after ischemia, laboratory analysis were performed. Results: Better tissue perfusion was lower in ischemic left/kidney than in right/kidney in saline group, suggesting reduced kidney clearance. Fluorescence in left/kidneys of tadalafil treated rats was lower than in right/kidneys (difference not significant). The fluorescence signal intensity in kidneys of tadafil treated rats was higher than in saline rats. TNF-α levels were significantly lower in I/R tadalafil group rats compared to I/R saline group (154±10.3 vs 391.3±12.3), as well as IL-1β (163.4±13.2 vs 279±11.5pg/dL), and IL-6 (122.9±8.1 vs 173.7±6.3 respectively; p=0.0001). Urea, creatinine and C-reactive protein were significantly lower in tadafil treated rats then in saline group. Conclusion: Tadalafil therapy decreased the expression of circulating pro-inflammatory cytokines in a renal I/R rodent model, while improving kidney function proofs.

Purpose: Laparoscopic cholecystectomy (LC) is currently the most widely used surgical procedure for the treatment of gallstones. The aim of the study was to analyze and compare the postoperative results of patients undergoing laparoscopic cholecystectomy or open cholecystectomy (OC) with regard to complications, recovery time, hospital stay and cost. Method: This is a prospective study, which analyzed 1015 patients, 20-65 years old, diagnosed with gallstones undergoing LC or OC. We evaluated postoperative respiratory complications, surgical site infection, deep vein thrombosis, time to oral feeding and ambulation, use of antibiotics, duration of the postoperative period and the cost of surgery. Results: We analyzed 470 (46%) patients undergoing LC and 545 (54%) OC. Most patients were female (68,4%). Patients' comorbidities were hypertension (15.8%), diabetes mellitus (4.0%) and asthma (1.18%). LC resulted in lower prevalence of postoperative complications (2.9%) than OC (5.13%). Postoperative hospitalization for 18-24 hours was found in 71.68% of LC patients and in 13.4% in OC. The financial cost per surgery was US$ 495.00 in LC and US$ 435.00 in OC. Conclusion: Laparoscopic cholecystectomy showed higher benefits for patients with lower prevalence of postoperative complications, feeding earlier, shorter mean hospital stay and equivalent cost compared with open cholecystectomy. Laparoscopic versus open cholecystectomy: complications and cost Medeiros, AC, et al J Surg Cl Res -Vol. 3 (2) 2012:49-58 50 RESUMO Objetivo: A colecistectomia laparoscópica é atualmente o procedimento cirúrgico mais utilizado para o tratamento de litíase biliar. O objetivo do estudo foi analisar e comparar o pós-operatório imediato de grupos de pacientes submetidos a colecistectomia laparoscópica ou colecistectomia aberta no que diz respeito a complicações, tempo de recuperação, tempo de internação e custo das operações. Método: Estudo prospectivo, no qual foram analisados 1015 pacientes, entre 20 e 65 anos, com diagnóstico de litíase biliar submetidos a colecistectomia laparoscópica ou aberta. Para avaliação do pós-operatório imediato foram avaliadas as complicações respiratórias, infecção do sítio cirúrgico, trombose venosa profunda, tempo para início da alimentação oral e deambulação, o uso de antibióticos, duração do período pósoperatório e o custo do tratamento cirúrgico Resultados. Foram analisados 470 (46%) pacientes submetidos a colecistectomia laparoscópica e 545 (54%), por via aberta. A maioria dos pacientes era do sexo feminino (68,4%). As comorbidades apresentadas pelos pacientes foram hipertensão arterial (15,8%), diabetes mellitus (4,0%) e asma brônquica (1,18%). A colecistectomia laparoscópica resultou em menor prevalência de complicações operatórias (2,9%), maior número de pacientes com tempo de hospitalização pós-operatória abaixo de 18 horas (71,68%) e um custo financeiro de R$ 990,00 por procedimento cirúrgico. Comparada com a cirurgia aberta, os valores de complicações, tempo de hospitalização e custo foram respectivame...

PURPOSE:To test the hypothesis that liver regeneration after partial hepatectomy can be influenced by the ileum. METHODS:Eighteen Wistar rats were distributed into groups of six animals: 1 -ileum resection+ hepatectomy 2/3; 2 -hepatectomy 2/3, and 3 -sham. Anesthesia with ketamine and xylazine i.p., aseptic technique, analgesia with meperidine (10mg/kg s.c.). On day 6, serum ALT, AST, alkaline phosphatase (AP) and albumin were measured. Liver regeneration and hepatocyte mitosis were quantified.Statistical analysis with ANOVA and Tukey tests, with significance p<0.05. RESULTS:In group hepatectomy+ileal resection, ALT, AST and AP were 180.6±24.9, 58.6±3.1 and 254.6±46.6 respectively. They were significantly higher than in the hepatectomy group, whose values were 126.0±16.5, 44.1±3.9 and 163.5±8.6, respectively (p<0.001).Albumin levels were not significantly different among groups. Liver regeneration in hepatectomy group (94.17%) was statistically higher (p<0.001) than in ileal resection+hepatectomy group (55.96%). In the latter group the mitosis of hepatocytes were significantly less frequent than in the hepatectomy group. CONCLUSION:The data confirm that the ileum positively influence on liver regeneration in rats undergoing hepatectomy.

PURPOSE:To evaluate the heart and the Tc-99m-sestamibi biodistribution after statin pretreatment in a rat model of abdominal sepsis. METHODS:Twenty-four Wistar rats were randomly distributed into four groups (n=6 per group): 1) sepsis with simvastatin treatment, 2) sepsis with vehicle, 3) sham control with simvastatin and 4) sham control with vehicle. 24 hours after cecal ligation and puncture rats received 1.0MBq of Tc-99m-sestamibi i.v. 30min after, animals were euthanized for ex-vivo tissue counting and myocardium histological analysis. RESULTS:Myocardial histologic alterations were not detected 24 hours post-sepsis. There was significantly increased cardiac Tc-99m-sestamibi activity in the sepsis group with simvastatin treatment (1.9±0.3%ID/g, p<0.001) in comparison to the sepsis group+vehicle (1.0±0.2%ID/g), control sham group+ simvastatin (1.2±0.3%ID/g) and control sham group (1.3±0.2%ID/g). Significant Tc-99m-sestamibi activity in liver, kidney and lungs was also detected in the sepsis group treated with simvastatinin comparison to the other groups. CONCLUSIONS:Statin treatment altered the biodistribution of Tc-99m-sestamibi with increased cardiac and solid organ activity in rats with abdominal sepsis, while no impact on controls. Increased myocardial tracer activity may be a result of a possible protection effect due to increased tissue perfusion mediated by statins.Key words: Simvastatin. Sepsis. Inflammation. Heart. Technetium Tc 99m Sestamibi. Rats.Heart and systemic effects of statin pretreatment in a rat model of abdominal sepsis. Assessment by Tc 99m -sestamibi biodistribition Acta

Objective: To evaluate the effects of pentoxifylline in the treatment of abdominal sepsis in rats submitted to cecal ligation and puncture (CLP). Methods: We used 18 Wistar male rats three months old, randomly divided into control group C (n = 6); CLP (n = 6) for the rats submitted to CLP; Group CLP + PTX (n = 6) whose rats were treated with pentoxifylline and submitted to CLP. Pentoxifylline (40mg/Kg) was injected intraperitoneal 2 hours  before and 8 hours after the induction of peritonitis. Histopathology of the lung, liver and kidney as well as analysis of renal function, markers of liver injury and cytokines were studied. The results were compared through ANOVA, and post hoc by Bonferroni test, considering p <0.05 as significant. Results: The control group rats showed lower levels of all cytokines, compared to CLP group (p <0.05). The CLP+PTX rats showed significantly lower amounts of TNF-α and IL-1 β when compared to the CLP group, but similar to group C. The levels of IL-6 in Group CLP+PTX, were higher than that found in group C and lower than that found in Group CLP (p <0.05). Reduction of urea and creatinine occurred after administration of pentoxifylline. The values of AST and ALT were slightly lower in the experimental group, and no significant difference was observed comparing with the control group. The microscopic findings of kidney, liver and lung revealed less inflammatory reaction associated with the reduction of pathological changes in animals treated with pentoxifylline. Conclusion: The pentoxifylline attenuated the pathophysiological events of sepsis, reducing the expression of pro-inflammatory cytokines, preserving renal function and tissue injury in an experimental model of polymicrobial sepsis.

Background/ Purpose: This review aimed to discuss developments in care and surgical approaches to prevent, diagnose and treating surgical site infection, together with antimicrobial treatments, in order to significantly reduce the morbidity and mortality rates associated with this injury. Methods: Review of the pertinent English and Portuguese-language literature using electronic data bases. Results: Several resistant organisms have emerged as the maleficent cause of invasive infection in surgical patients. We discussed risk for surgical site infection as multifactorial and included a host of microbial, patient-related, and procedure-related factors. Prevention of surgical infection relies on optimization of patient factors and use of a variety of pharmacologic and non-pharmacologic measures were analysed. Surveillance and antibiotic prophylaxis has been shown to be effective at reducing risk of surgical site infection. Conclusion: It is important to recognize infection, and stablish measures for prevention of surgical site infection. This is an increasingly complex and nuanced problem. Strict infection control measures, and constant surveillance remain the principal adjuncts to control of invasive infections in surgical patients.

PURPOSE:To investigate the influence of partial colectomy associated with hepatectomy on the biodistribution of the 99m Tc-phytate, on metabolic parameters, as well as labeling and morphology of red blood cells. METHODS: Wistar rats were distributed into three groups (each with six), nominated as colectomy, colectomy+hepatectomy and sham. In the 30 th postoperative day all rats were injected with 99mTc-phytate 0.1mL i.v. (radioactivity 0.66 MBq). After 15 minutes, liver sample was harvested and weighed. Percentage radioactivity per gram of tissue (%ATI/g) was determined using an automatic gammacounter. Serum AST, ALT, alkaline phosphatase and red blood cells labeling were determined. RESULTS: The liver %ATI/g and red blood cells labeling were lower in colectomy and colectomy+hepatectomy rats than in sham rats (p <0.05), and no difference was detected comparing the colectomy and colectomy+hepatectomy groups. Red blood cells morphology did not differ among groups. Serum levels of AST, ALT and alkaline fosfatase were significantly higher in colectomy+hepatectomy than in colectomy rats (p<0.001). CONCLUSION: Hepatectomy associated with colectomy lowered the uptake of radiopharmaceutical in liver and in red blood cells in rats, coinciding with changes in liver enzymatic activity. Keywords: Colectomy. Hepatectomy. Metabolism. Biological Availability. Technetium. Rats. RESUMO OBJETIVO:Investigar a influência da colectomia associada à hepatectomia parcial, na biodistribuição do fitato99m TcO 4 , na marcação e morfologia de hemácias e em parâmetros metabólicos. MÉTODOS: Ratos Wistar foram distribuídos em três grupos (seis animais cada), denominados: colectomia, colectomia+hepatectomia e sham. No 30º dia pós-operatório, em todos eles foi feita injeção de 0,1 mL i.v. de fitato-