Ossificação heterotópica em saco herniário incisional

Abstract

The heterotopic ossification (HO) on abdominal scars is a rare but very unconfortable finding. It causes pain, induration and discomfort in the scar, leading patients to undergo reoperation. This report aims to describe a case of HO, and especially to call attention of surgeons to fibroblast transforming potential, once its close relationship with HO is undeniable. Therefore the surgeon should endeavor all atempts on good surgical practice to avoid HO occurrence. He should also associate pure tissue repair techniques to prosthetic management of incisional hernias, in the hope that patient's fibroblast grow factors can be offered to the wound healing as a biologically reinforcement of the repair.

Tracking stem cells in the incisional hernial sac: a gaze beyond pure tissue repairs

“…Some incidental findings in the HS, such as smooth muscle cells 3 and heterotopic ossification 4 , can be a final stage of metaplasia from primitive cells. By a similar biological process, the "epithelial-to-mesenchymal" transition of these cells, and finally to fibroblasts, is the mechanism responsible for peritoneal fibrosis that occurs in some patients undergoing peritoneal dialysis, rendering this alternative route of renal clearance unfeasible 5 .…”

Treatment of heterotopic ossification of the hip with use of a plaster cast: case report

“…The etiology of HO is still uncertain. 2 It may be primary – rare and hereditary – known as progressive or secondary myositis ossificans, precipitated by musculoskeletal trauma or neurological disease. 3 In 60–75% of cases, it is a post-traumatic complication (traumatic brain injury, spinal cord injury, and surgical trauma), but it may also be associated with certain conditions, such as myelodysplasia, tabes dorsalis, large burn injuries, spinal tumors, tetanus, poliomyelitis, meningoencephalitis, and multiple sclerosis.…”