Estudo comparativo do fechamento da incisão mediana abdominal por planos e com o uso de pontos subtotais e tela de poliglactina 910, em ratos

Abstract

O objetivo deste trabalho foi comparar a resistência tênsil e a evolução da reação tecidual da parede abdominal de ratos, submetidos à incisão mediana e fechamento abdominal em três técnicas diferentes: fechamento por planos, fechamento por planos complementada com pontos subtotais e fechamento por planos complementada com tela de poliglactina 910, estudados no primeiro, no sétimo e no décimo quarto dia de pós-operatório. O teste de resistência, utilizado para aferir a resistência à ruptura, foi descrito por UDUPA & CHANSOURIA17, em 1969. Após a realização do teste, procedeu-se à ressecção de parte da ferida cirúrgica, sendo encaminhado o material para estudo microscópico ao Departamento de Patologia da USF. Os resultados obtidos no teste de resistência tênsil mostraram que as técnicas de fechamento abdominal complementadas com reforço conferem maior resistência à tração da parede abdominal nos primeiros dias do pós-operatório. A comparação dos testes de resistência, efetuados no décimo quarto dia, revelou que a resistência à tração da parede abdominal encontrava-se semelhante nos diferentes métodos utilizados. O estudo da reação tecidual, observada neste trabalho, mostrou um aumento da reação nos subgrupos de ratos em que se aplicaram as técnicas de reforço, sendo mais intensa quando do uso da tela de poliglactina 910. Conclui-se portanto que os métodos de fechamento de parede abdominal em ratos, quando da utilização de reforço, conferem à parede abdominal, nos primeiros dias de pós-operatório, maior resistência à tração. Em relação à reação tecidual, ela é maior quando se usa técnicas de reforço.<br>The purpose of this work was to compare the tensile resistance and the evolution of the tissue reaction of the rats&#146; abdominal wall, submitted to the mediana incision and abdominal wound closing by three different techniques: closing by plans, closing by plans completed with subtotal points and closing by plans completed with a poliglactina 910 mesh, studied in the first, the seventh and fourteenth post-operative days. 90 Wistar rats were studied, divided into three groups of 30 in each one in which the techniques described were conducted and afterwards subdivided into nine subgroups of 10 rats each, in which the test of tensile resistance was realized. The resistance test used for checking the resistance, the rupture was described by UDUPA & CHANSOURIA, in 1969. Afer the realization of the test a resection was made in a part of the surgical wound and fowarded for a microscopical study. The results obtained in the tensile resistance test showed the techniques of the abdominal wound closing, complemented with reinforcement give greater resistance to the traction of the abdominal wall in the first post-operativedays. The comparison of the tissue reaction observed in this work showed an increase of the reaction in the subgroups of rats in which the techniques of reinforcement were used , being more intense when using the poliglactina 910 mesh. I t was concluded therefore, that the methods of closing the abdominal ...

Effect of copaiba oil on correction of abdominal wall defect treated with the use of polypropylene/polyglecaprone mesh

“…Because of this, there are a variety of techniques and materials that can be used in the procedure, demonstrating surgeons' concern with regards to these complications 1,2 .…”

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

“…The closure of the abdominal wall is a common but important procedure, one of the first a surgeon is taught to perform. The surgeon has to choose a mechanical means of keeping the abdominal wall closed until the healing process is complete and strong enough to keep the surgical wound closed 2,3,4,5 .…”

“…It can certainly be said that the opening and closure of the abdominal wall are some of the most common procedures in the daily practice of surgery 2 .The wide variety of materials and techniques for the closure of the abdominal wall shows the concern of surgeons with the subject 2,3,5 . The sheer volume of surgical literature on the topic reveals the lack of consensus regarding the ideal suturing technique for the closure of the abdominal wall 3,5,6 .…”

“…Successful closure of the abdominal wall should restore its shape and function after a surgical intervention, and prevent possible complications. It should be comfortable for the patient and leave an esthetically acceptable scar 2,3,4,7,8 .…”

“…The results obtained so far are encouraging, especially because the procedure is quick and the cost is low 5,9,10,11,13 . Many comparative studies that investigate the best method of closing the abdominal wall are found in the literature 2,3,6,8 . Some studies have compared the use of sutures and adhesives, both in the skin 5,11,13 and in the aponeurosis, for the fixation of the Marlex® mesh in hernia repair 14 .…”