Uso do retalho axial Oris angularis em defeitos palpebrais, associado ou não a aplicação de terapia por ondas de choque extracorpóreas
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Data
2009-02-19
Autores
Sereno, Maria Guadalupe [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O comprometimento anatômico e funcional das pálpebras, por afecções congênitas ou adquiridas, pode repercutir na integridade do bulbo ocular. Entre as técnicas de cirurgia reconstrutivas disponíveis, os retalhos de padrão axial têm a vantagem de possuir o suprimento sanguíneo intrínseco, assegurando irrigação adequada. Quando há a possibilidade de complicações isquêmicas, a aplicação da terapia por ondas de choque extracorpóreas (TOCE) é descrita como técnica de salvamento de retalhos. Na literatura veterinária consultada não há relatos da utilização do retalho de padrão axial oris angularis para a reconstrução palpebral, assim como da aplicação da TOCE como técnica de salvamento do mesmo na região facial periorbitária. O presente trabalho tem como objetivos avaliar a utilização do retalho axial oris angularis, na reconstrução de defeitos experimentais da pálpebra inferior de cães e verificar a atuação da terapia por ondas de choque extracorpóreas (TOCE) nos retalhos, bem como comparar os resultados clínicos e oftalmológicos do retalho com e sem a aplicação da terapia por ondas de choque. Foram utilizados oito cães, os quais foram submetidos ao desenvolvimento experimental do retalho oris angularis para a correção do defeito palpebral; estes foram avaliados por meio de exame clínico e oftalmológico até o período final de 60 dias. A avaliação histológica e morfométrica de amostras de pele submetidas ou não à TOCE, obtidas da região distal do retalho axial, aos 10 dias do pós-operatório, também foi realizada. O retalho de padrão axial oris angularis apresentou resultados funcionais e cosméticos favoráveis em cães. A TOCE, nos parâmetros utilizados e na região periocular, não apresentou diferença de atuação significativa como técnica de salvamento quando comparada à confecção isolada do retalho oris angularis...
The functional and anatomical compromise of the eyelids by congenital or acquired affections, can affect the integrity of the eye bulb, making necessary reconstructive surgeries techniques. Among the available techniques, axial flaps patterns where describe to cover facial defects, being its vascularization intrinsic, considered an advantage to other techniques, ensuring the appropriate vascularization, and also preserving the facial esthetics. Considering isquemic complications extracorporeal shockwave therapy (ESWT) was described such rescue technique on compromised skin flaps. There are not any veterinary references to use of an oris angularis skin flap to eyelid reconstruction as well ESWT in facial areas. The present study was developed to evaluate the oris angularis axial flap clinical performance on dogs’ eyelids experimental defects reconstruction, and ESWT applicability over the distal end of the axial flap. The ophthalmologic exam was performed to determine possible prejudicial interactions between the treatments used and the eye. Eight dogs were ophthalmologic and clinically evaluated for sixty days. The skin samples treated or not with the shock wave therapy, obtained from flap’s distal border, where analyzed histological and with morfometry. The oris angularis axial skin flap presented good results, functional and esthetical, on the experimental repair of the dog’s eyelids. The ESWT with the protocol used in this study, did not demonstrate significant clinical outcomes as a rescue technique when applied over the oris angularis flap, however results showed no signals of collateral deleterious effects. The flap with or without ESWT did not show any histological sign of inflammatory or atrophic alterations. Both group treated showed similar morphometrical characteristics. The axial oris angularis skin flap was also used to repair large defects on the eyelids and nasal... (Complete abstract click electronic access below)
The functional and anatomical compromise of the eyelids by congenital or acquired affections, can affect the integrity of the eye bulb, making necessary reconstructive surgeries techniques. Among the available techniques, axial flaps patterns where describe to cover facial defects, being its vascularization intrinsic, considered an advantage to other techniques, ensuring the appropriate vascularization, and also preserving the facial esthetics. Considering isquemic complications extracorporeal shockwave therapy (ESWT) was described such rescue technique on compromised skin flaps. There are not any veterinary references to use of an oris angularis skin flap to eyelid reconstruction as well ESWT in facial areas. The present study was developed to evaluate the oris angularis axial flap clinical performance on dogs’ eyelids experimental defects reconstruction, and ESWT applicability over the distal end of the axial flap. The ophthalmologic exam was performed to determine possible prejudicial interactions between the treatments used and the eye. Eight dogs were ophthalmologic and clinically evaluated for sixty days. The skin samples treated or not with the shock wave therapy, obtained from flap’s distal border, where analyzed histological and with morfometry. The oris angularis axial skin flap presented good results, functional and esthetical, on the experimental repair of the dog’s eyelids. The ESWT with the protocol used in this study, did not demonstrate significant clinical outcomes as a rescue technique when applied over the oris angularis flap, however results showed no signals of collateral deleterious effects. The flap with or without ESWT did not show any histological sign of inflammatory or atrophic alterations. Both group treated showed similar morphometrical characteristics. The axial oris angularis skin flap was also used to repair large defects on the eyelids and nasal... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Oftalmologia veterinaria, Cão - Doenças, Pálpebra - Doenças, Eyelids, Oris angularis flap
Como citar
SERENO, Maria Guadalupe. Uso do retalho axial Oris angularis em defeitos palpebrais, associado ou não a aplicação de terapia por ondas de choque extracorpóreas. 2009. 126 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina Veterinária e Zootecnia de Botucatu, 2009.