Fixação de enxerto cutâneo em malha de espessura total com sutura ou cola de fibrina
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Data
2004-06-01
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Universidade Federal de Minas Gerais (UFMG), Escola de Veterinária
Resumo
Avaliou-se a influência da cola de fibrina, derivada do veneno de serpente, na fixação e integração de enxerto de pele. Foram utilizados nove cães, sem raça definida, com peso médio de 15kg. Foi induzida ferida de 4×4cm de área, na face crânio-proximal dos antebraços direito e esquerdo. Um enxerto de espessura total foi colhido da região torácica e expandido por meio de expansor de pele. No membro direito o enxerto foi estabilizado no leito receptor por meio de pontos isolados simples; no esquerdo foi fixado pela aplicação de cola de fibrina e oito pontos de sutura. O sítio doador foi fechado empregando-se retalho cutâneo bipediculado. As bandagens do leito receptor foram oclusivas e não aderentes e aplicou-se pomada de neomicina com bacitracina. A troca de bandagens ocorreu diariamente até o sétimo dia de pós-operatório e, posteriormente, a cada três dias. A área de sobrevivência do enxerto foi obtida pela subtração das áreas não viáveis e total medidas com fotomicroscópio Nikon conectado a um sistema de análise de imagem KS-300 aos três, sete, 15 e 30 dias de pós-operatório. Para a avaliação microscópica, a área do enxerto foi colhida em três animais aos sete, 15 e 30 dias de pós-operatório. Não houve diferença entre momentos de avaliação e técnicas de fixação quanto à área de enxerto viável. Os enxertos fixados com cola apresentaram estágio de reparação mais avançado em todos os momentos. Concluiu-se que a cola de fibrina derivada do veneno de serpente tem moderado poder adesivo e, pela análise microscópica, favorece a integração do enxerto cutâneo em malha de espessura total.
The purpose of this study was to evaluate the efficiency of fibrin glue, derived from snake venom, on fixation and integration of skin graft. Nine crossbred dogs, with average weight of 15kg were used. Wounds measuring 4×4 cm were induced at the cranioproximal aspect of the right and left forelimb. Full-thickness skin grafts were harvested from thoracic area, and meshed with a commercial mesh dermatome. The graft was secured to the recipient bed using several simple interrupted sutures on the right forelimb. on the left forelimb fibrin glue and eight simple interrupted sutures were used. The bed was closed using bipedicle advancement flap. The non-adherent occlusive bandage and neomycin-bacitracin ointment were used on receptor bed. The bandage was changed every day until the seventh day postoperative and every three days afterwards. The graft survival area was obtained by subtraction of total and nonviable areas measured with a Nikon Photomicroscope connected to a KS-300 image analysis system at 3, 7, 15 and 30 days postsurgically. For microscopic evaluation, the skin graft, recipient bed and adjacent surrounding skin were collected at 7, 15 and 30 days postsurgery. No statistical difference was detected for the viable graft area, in each evaluation moment and between fixation methods. However, based on microscopic evaluation, fibrin glue enhanced the tissue repair process in all evaluation moments. It was possible to conclude that fibrin glue derived from snake venom has moderate adhesive capacity, and, based on microscopic examination, improves the integration of full-thickness mesh skin grafts.
The purpose of this study was to evaluate the efficiency of fibrin glue, derived from snake venom, on fixation and integration of skin graft. Nine crossbred dogs, with average weight of 15kg were used. Wounds measuring 4×4 cm were induced at the cranioproximal aspect of the right and left forelimb. Full-thickness skin grafts were harvested from thoracic area, and meshed with a commercial mesh dermatome. The graft was secured to the recipient bed using several simple interrupted sutures on the right forelimb. on the left forelimb fibrin glue and eight simple interrupted sutures were used. The bed was closed using bipedicle advancement flap. The non-adherent occlusive bandage and neomycin-bacitracin ointment were used on receptor bed. The bandage was changed every day until the seventh day postoperative and every three days afterwards. The graft survival area was obtained by subtraction of total and nonviable areas measured with a Nikon Photomicroscope connected to a KS-300 image analysis system at 3, 7, 15 and 30 days postsurgically. For microscopic evaluation, the skin graft, recipient bed and adjacent surrounding skin were collected at 7, 15 and 30 days postsurgery. No statistical difference was detected for the viable graft area, in each evaluation moment and between fixation methods. However, based on microscopic evaluation, fibrin glue enhanced the tissue repair process in all evaluation moments. It was possible to conclude that fibrin glue derived from snake venom has moderate adhesive capacity, and, based on microscopic examination, improves the integration of full-thickness mesh skin grafts.
Descrição
Palavras-chave
cola de fibrina, enxerto cutâneo, sutura, serpente, fibrin glue, skin graft, suture, snake
Como citar
Arquivo Brasileiro de Medicina Veterinária e Zootecnia. Universidade Federal de Minas Gerais, Escola de Veterinária, v. 56, n. 3, p. 312-319, 2004.