Efeito da colocação de um ponto simples em tendão flexor de coelho em região vascularizada e avascularizada: análise da propriedades mecânicas e histopatológicas
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Data
2009-10-23
Autores
Salate, Ana Claudia Bonome [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Nas últimas três décadas muitas pesquisas têm sido realizadas com o objetivo de compreender o processo cicatrização dos tendões flexores e ainda hoje, a reabilitação envolve processos complexos e não compreendidos totalmente. As incertezas em colocar a sutura central na face dorsal vascularizada ou na face palmar avascularizada, persistem ainda na prática clínica e nos experimentos das técnicas de reparo dos tendões flexores dos dedos da mão na região da bainha digital. O objetivo deste estudo foi analisar as propriedades mecânicas e histopatológicas da colocação de um ponto de sutura simples no tendão flexor profundo dos dedos do pé de coelhos, verificando os efeitos na interface sutura-tendão e comparar a colocação deste ponto na região do tendão fibroso, vascularizada e na região do tendão fibrocartilaginoso avascular. Foram estudados 88 coelhos machos divididos em dois grupos de acordo com o local de colocação do ponto de sutura e em mais três subgrupos de acordo com o tempo de seguimento pós- operatório de sete, 14 e 21 dias. O procedimento cirúrgico consistiu na colocação de um único ponto na região de tendão fibroso (Grupo TF) e na região de tecido fibrocartilaginoso (Grupo TFC) no tendão flexor profundo dos dedos do pé do coelho. Em ambos os grupos, os tendões estavam íntegros, sem lesão e os animais permaneceram livres de imobilização. As propriedades mecânicas estudadas foram carga máxima, tensão na carga máxima, módulo de elasticidade, energia na carga máxima e energia por área. Três tendões de cada grupo foram submetidos à análise histológica descritiva por meio de microscopia óptica com ênfase no progresso das etapas da cicatrização tendinosa. A análise das propriedades mecânicas demonstrou comportamento semelhante em ambos...
In the last three decades many studies have been undertaken with the aim of understanding the process of flexor tendon healing and even now, the rehabilitation involves a complex and not fully understood process. The doubts concerning placing the core suture in the vascularized dorsal region than of the palmar avascularized region remain in clinical practice and in the experimental techniques in the repair of flexor tendons of the finger in the digital sheath. The aim of this study was to evaluate the mechanical and histopathologic properties of placing a single suture on the deep flexor tendon in rabbit toes, examining the effects on suture-tendon interface and compare the placement of this point at normal vascularized tendon as well as at the avascular fibrocartilagenous tendon. Eighty-eight male rabbits were studied and divided into two groups according to the local of the point of suture and in three subgroups according to the time of postoperative segment of seven, fourteen and twenty-one days. The surgical procedure was inserting a single point in the region of fibrous tendon (TF Group) and the region of fibrocartilagenous tissue (TFC Group) in deep flexor tendon in rabbit toes. In both groups, the tendons were intact without injury and the animals were allowed free movement. The mechanical properties were maximum load, stress at maximum load, elasticity modulus (Young modulus), energy at maximum load and energy per area. Three tendons from each group were subjected to descriptive histological analysis by an optical microscopy emphasizing the process of tendon healing stages. The analysis of mechanical properties showed similar trend in both groups, with increasing values in accordance with the periods of seven, fourteen and twenty-one days in most of the variables. The control group showed relative similarity than operated group except in TFC twenty one days group that operated... (Complete abstract click electronic access below)
In the last three decades many studies have been undertaken with the aim of understanding the process of flexor tendon healing and even now, the rehabilitation involves a complex and not fully understood process. The doubts concerning placing the core suture in the vascularized dorsal region than of the palmar avascularized region remain in clinical practice and in the experimental techniques in the repair of flexor tendons of the finger in the digital sheath. The aim of this study was to evaluate the mechanical and histopathologic properties of placing a single suture on the deep flexor tendon in rabbit toes, examining the effects on suture-tendon interface and compare the placement of this point at normal vascularized tendon as well as at the avascular fibrocartilagenous tendon. Eighty-eight male rabbits were studied and divided into two groups according to the local of the point of suture and in three subgroups according to the time of postoperative segment of seven, fourteen and twenty-one days. The surgical procedure was inserting a single point in the region of fibrous tendon (TF Group) and the region of fibrocartilagenous tissue (TFC Group) in deep flexor tendon in rabbit toes. In both groups, the tendons were intact without injury and the animals were allowed free movement. The mechanical properties were maximum load, stress at maximum load, elasticity modulus (Young modulus), energy at maximum load and energy per area. Three tendons from each group were subjected to descriptive histological analysis by an optical microscopy emphasizing the process of tendon healing stages. The analysis of mechanical properties showed similar trend in both groups, with increasing values in accordance with the periods of seven, fourteen and twenty-one days in most of the variables. The control group showed relative similarity than operated group except in TFC twenty one days group that operated... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Tendões - Cirugia - Estudos experimentais, Biomechanics, Rabbit, Flexor tendon, Histology, Suture, Vascularization
Como citar
SALATE, Ana Claudia Bonome. Efeito da colocação de um ponto simples em tendão flexor de coelho em região vascularizada e avascularizada: análise da propriedades mecânicas e histopatológicas. 2009. 89 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2009.