Avalia??o da integra??o de enxerto de gordura no dorso da m?o
Ano de defesa: | 2010 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Pontif?cia Universidade Cat?lica do Rio Grande do Sul
|
Programa de Pós-Graduação: |
Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de
|
Departamento: |
Faculdade de Medicina
|
País: |
BR
|
Palavras-chave em Português: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://tede2.pucrs.br/tede2/handle/tede/1590 |
Resumo: | Introduction: Autologous fat transplantation is a well-established method often used for soft-tissue augmentation, both in cosmetic and reconstructive procedures. Its most important disadvantages are the unpredictable rate of fat absorption and the difficulty to evaluate results objectively. This study describes quantitative methods to measure the rate of fat absorption. Methods: Nine patients seen in the Hand Surgery Service of Hospital S?o Lucas of Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS) from March 2008 to October 2009 underwent autologous fat grafting prepared using centrifugation or not in areas of hand atrophy due to ulnar nerve lesions. To evaluate graft integration, digital photos of the hands and diagnostic radiographs were obtained before and after the procedures. Results: The cases were analyzed quantitatively according to patients individual sequelae. Overall, the results of digital photos showed no significant changes in measures. The radiographic technique, although not adequate to measure depth and volume, was more efficient. This type of image provides information about the area of the whole hand or of a region of interest, and demonstrates the augmentation in graft recipient areas. Radiographic analyses may be used to evaluate grafting results. In the qualitative analysis, no observer found deterioration in the cases under study. Most observers did not see any change in the claw condition, but the other evaluations were positive. The statistic difference between methods was not significant, although the procedures that were prepared with centrifugation were rated improved by the observers at a greater percentage. Conclusion: a) The qualitative method described in the literature did not reveal any statistically significant difference between the two grafting methods under study. b) Two quantitative methods to evaluate the integration of fat graft were developed and tested. The comparison between evaluation methods revealed that radiographic images were more efficient than digital photos. c) Results suggest that, based on the radiographic images, computed tomography may be an alternative to measure volume and follow up fat absorption |
id |
P_RS_615b7c90d8e481a78322ef94d51e21b2 |
---|---|
oai_identifier_str |
oai:tede2.pucrs.br:tede/1590 |
network_acronym_str |
P_RS |
network_name_str |
Biblioteca Digital de Teses e Dissertações da PUC_RS |
repository_id_str |
|
spelling |
Silva, Jefferson Luis Braga daCPF:32077491000http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4707540D6CPF:66829811Rodr?guez Mart?nez, M?nica Adriana2015-04-14T13:35:01Z2012-11-302010-09-30http://tede2.pucrs.br/tede2/handle/tede/1590Introduction: Autologous fat transplantation is a well-established method often used for soft-tissue augmentation, both in cosmetic and reconstructive procedures. Its most important disadvantages are the unpredictable rate of fat absorption and the difficulty to evaluate results objectively. This study describes quantitative methods to measure the rate of fat absorption. Methods: Nine patients seen in the Hand Surgery Service of Hospital S?o Lucas of Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS) from March 2008 to October 2009 underwent autologous fat grafting prepared using centrifugation or not in areas of hand atrophy due to ulnar nerve lesions. To evaluate graft integration, digital photos of the hands and diagnostic radiographs were obtained before and after the procedures. Results: The cases were analyzed quantitatively according to patients individual sequelae. Overall, the results of digital photos showed no significant changes in measures. The radiographic technique, although not adequate to measure depth and volume, was more efficient. This type of image provides information about the area of the whole hand or of a region of interest, and demonstrates the augmentation in graft recipient areas. Radiographic analyses may be used to evaluate grafting results. In the qualitative analysis, no observer found deterioration in the cases under study. Most observers did not see any change in the claw condition, but the other evaluations were positive. The statistic difference between methods was not significant, although the procedures that were prepared with centrifugation were rated improved by the observers at a greater percentage. Conclusion: a) The qualitative method described in the literature did not reveal any statistically significant difference between the two grafting methods under study. b) Two quantitative methods to evaluate the integration of fat graft were developed and tested. The comparison between evaluation methods revealed that radiographic images were more efficient than digital photos. c) Results suggest that, based on the radiographic images, computed tomography may be an alternative to measure volume and follow up fat absorptionINTRODU??O: O transplante de gordura aut?loga se transformou em um m?todo bem estabelecido e frequentemente aplicado para o aumento de tecido adiposo, tanto em indica??es cosm?ticas como reconstrutivas. A desvantagem mais significativa sobre o enxerto de gordura aut?loga est? no seu ritmo de absor??o altamente imprevis?vel e nas formas de avaliar, de maneira objetiva, os resultados. Este trabalho define metodologias quantitativas que podem ser utilizadas para medir o grau de reabsor??o do enxerto. M?TODO: Avalia??o realizada em 9 pacientes atendidos no Servi?o de Cirurgia da M?o do Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS), no per?odo de mar?o de 2008 a outubro 2009. Realizou-se o procedimento de enxerto de gordura aut?loga, com ou sem centrifuga??o, em ?reas de atrofia da m?o devido a les?es do nervo ulnar. Para avaliar a integra??o do enxerto, foram utilizadas imagens digitais de fotografias com escala e de radiologia diagn?stica pr? e p?s-procedimento. RESULTADOS: Os casos foram analisados de forma quantitativa, respeitando a individualidade das sequelas observadas. O resultado referente ?s fotografias digitais, de forma global, mostra que n?o houve altera??es significativas nas dimens?es medidas. Cabe ressaltar que a t?cnica de imagenologia por raios X, mesmo apresentando as limita??es de estudo em profundidade de volumetria, mostrou-se mais eficiente. Esse tipo de imagem possibilita o estudo da ?rea total da m?o ou regi?o de interesse, evidenciando um aumento nas ?reas enxertadas. Ficou demonstrado que o uso de an?lises radiol?gicas quantitativas ? um m?todo que pode ser utilizado na avalia??o dos resultados. De forma geral, na avalia??o qualitativa, nenhum avaliador verificou piora para os casos estudados. A maior parte dos avaliadores n?o percebeu altera??o na condi??o de garra, sendo as demais avalia??es positivas. Na compara??o entre os m?todos, apesar do maior percentual para a resposta Melhorou nos procedimentos realizados com centrifuga??o da gordura enxertada, essa diferen?a n?o pode ser considerada estatisticamente significativa. CONCLUS?O: a) O m?todo qualitativo sugerido pela bibliografia n?o conseguiu definir diferen?a significativa entre os dois m?todos de enxerto comparados. b) Foram definidos e avaliados dois m?todos quantitativos para a avalia??o da integra??o da gordura do enxerto. A compara??o entre os m?todos de avalia??o utilizados mostrou que as imagens diagn?sticas geradas com raios X s?o ferramentas mais eficientes do que as fotografias digitais. c) Sugere-se, com base nos resultados obtidos com as imagens da radiologia diagn?stica, que imagens de tomografia computadorizada possam ser utilizadas para realiza??o de estudos volum?tricos e acompanhamento de autoabsor??o de gordura enxertada.Made available in DSpace on 2015-04-14T13:35:01Z (GMT). No. of bitstreams: 1 426504.pdf: 4328362 bytes, checksum: 74a78cee96d1cf6cc80c54d02c210b62 (MD5) Previous issue date: 2010-09-30application/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/8979/426504.pdf.jpgporPontif?cia Universidade Cat?lica do Rio Grande do SulPrograma de P?s-Gradua??o em Medicina e Ci?ncias da Sa?dePUCRSBRFaculdade de MedicinaMEDICINACIRURGIAM?OS - CIRURGIATRAUMATISMOS DA M?O - CIRURGIATRANSPLANTETECIDO ADIPOSOCNPQ::CIENCIAS DA SAUDE::MEDICINAAvalia??o da integra??o de enxerto de gordura no dorso da m?oinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis7620745074616285884500600 8624664729441623247info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAIL426504.pdf.jpg426504.pdf.jpgimage/jpeg3577http://tede2.pucrs.br/tede2/bitstream/tede/1590/3/426504.pdf.jpg628ee83cdcff3a530e2487413fd1ae4fMD53TEXT426504.pdf.txt426504.pdf.txttext/plain194714http://tede2.pucrs.br/tede2/bitstream/tede/1590/2/426504.pdf.txt06730d4294e920d6111ea5e891622586MD52ORIGINAL426504.pdfapplication/pdf4328362http://tede2.pucrs.br/tede2/bitstream/tede/1590/1/426504.pdf74a78cee96d1cf6cc80c54d02c210b62MD51tede/15902015-04-30 08:15:45.172oai:tede2.pucrs.br:tede/1590Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2015-04-30T11:15:45Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Avalia??o da integra??o de enxerto de gordura no dorso da m?o |
title |
Avalia??o da integra??o de enxerto de gordura no dorso da m?o |
spellingShingle |
Avalia??o da integra??o de enxerto de gordura no dorso da m?o Rodr?guez Mart?nez, M?nica Adriana MEDICINA CIRURGIA M?OS - CIRURGIA TRAUMATISMOS DA M?O - CIRURGIA TRANSPLANTE TECIDO ADIPOSO CNPQ::CIENCIAS DA SAUDE::MEDICINA |
title_short |
Avalia??o da integra??o de enxerto de gordura no dorso da m?o |
title_full |
Avalia??o da integra??o de enxerto de gordura no dorso da m?o |
title_fullStr |
Avalia??o da integra??o de enxerto de gordura no dorso da m?o |
title_full_unstemmed |
Avalia??o da integra??o de enxerto de gordura no dorso da m?o |
title_sort |
Avalia??o da integra??o de enxerto de gordura no dorso da m?o |
author |
Rodr?guez Mart?nez, M?nica Adriana |
author_facet |
Rodr?guez Mart?nez, M?nica Adriana |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Silva, Jefferson Luis Braga da |
dc.contributor.advisor1ID.fl_str_mv |
CPF:32077491000 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4707540D6 |
dc.contributor.authorID.fl_str_mv |
CPF:66829811 |
dc.contributor.author.fl_str_mv |
Rodr?guez Mart?nez, M?nica Adriana |
contributor_str_mv |
Silva, Jefferson Luis Braga da |
dc.subject.por.fl_str_mv |
MEDICINA CIRURGIA M?OS - CIRURGIA TRAUMATISMOS DA M?O - CIRURGIA TRANSPLANTE TECIDO ADIPOSO |
topic |
MEDICINA CIRURGIA M?OS - CIRURGIA TRAUMATISMOS DA M?O - CIRURGIA TRANSPLANTE TECIDO ADIPOSO CNPQ::CIENCIAS DA SAUDE::MEDICINA |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::MEDICINA |
description |
Introduction: Autologous fat transplantation is a well-established method often used for soft-tissue augmentation, both in cosmetic and reconstructive procedures. Its most important disadvantages are the unpredictable rate of fat absorption and the difficulty to evaluate results objectively. This study describes quantitative methods to measure the rate of fat absorption. Methods: Nine patients seen in the Hand Surgery Service of Hospital S?o Lucas of Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS) from March 2008 to October 2009 underwent autologous fat grafting prepared using centrifugation or not in areas of hand atrophy due to ulnar nerve lesions. To evaluate graft integration, digital photos of the hands and diagnostic radiographs were obtained before and after the procedures. Results: The cases were analyzed quantitatively according to patients individual sequelae. Overall, the results of digital photos showed no significant changes in measures. The radiographic technique, although not adequate to measure depth and volume, was more efficient. This type of image provides information about the area of the whole hand or of a region of interest, and demonstrates the augmentation in graft recipient areas. Radiographic analyses may be used to evaluate grafting results. In the qualitative analysis, no observer found deterioration in the cases under study. Most observers did not see any change in the claw condition, but the other evaluations were positive. The statistic difference between methods was not significant, although the procedures that were prepared with centrifugation were rated improved by the observers at a greater percentage. Conclusion: a) The qualitative method described in the literature did not reveal any statistically significant difference between the two grafting methods under study. b) Two quantitative methods to evaluate the integration of fat graft were developed and tested. The comparison between evaluation methods revealed that radiographic images were more efficient than digital photos. c) Results suggest that, based on the radiographic images, computed tomography may be an alternative to measure volume and follow up fat absorption |
publishDate |
2010 |
dc.date.issued.fl_str_mv |
2010-09-30 |
dc.date.available.fl_str_mv |
2012-11-30 |
dc.date.accessioned.fl_str_mv |
2015-04-14T13:35:01Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://tede2.pucrs.br/tede2/handle/tede/1590 |
url |
http://tede2.pucrs.br/tede2/handle/tede/1590 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.program.fl_str_mv |
7620745074616285884 |
dc.relation.confidence.fl_str_mv |
500 600 |
dc.relation.department.fl_str_mv |
8624664729441623247 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
dc.publisher.program.fl_str_mv |
Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de |
dc.publisher.initials.fl_str_mv |
PUCRS |
dc.publisher.country.fl_str_mv |
BR |
dc.publisher.department.fl_str_mv |
Faculdade de Medicina |
publisher.none.fl_str_mv |
Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) instacron:PUC_RS |
instname_str |
Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
instacron_str |
PUC_RS |
institution |
PUC_RS |
reponame_str |
Biblioteca Digital de Teses e Dissertações da PUC_RS |
collection |
Biblioteca Digital de Teses e Dissertações da PUC_RS |
bitstream.url.fl_str_mv |
http://tede2.pucrs.br/tede2/bitstream/tede/1590/3/426504.pdf.jpg http://tede2.pucrs.br/tede2/bitstream/tede/1590/2/426504.pdf.txt http://tede2.pucrs.br/tede2/bitstream/tede/1590/1/426504.pdf |
bitstream.checksum.fl_str_mv |
628ee83cdcff3a530e2487413fd1ae4f 06730d4294e920d6111ea5e891622586 74a78cee96d1cf6cc80c54d02c210b62 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
repository.mail.fl_str_mv |
biblioteca.central@pucrs.br|| |
_version_ |
1796793182138138624 |