A influência do CO2 intradérmico na sobrevivência de retalhos randomizados em hamsters

• Ano de defesa: 2016
• Autor(a) principal: Vieira, Christian de Araújo
• Orientador(a): Bouskela, Eliete
• Banca de defesa: Bottino, Daniel Alexandre , Aboudib Júnior, José Horácio Costa , Souza, ângela Maria Fausto
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade do Estado do Rio de Janeiro
• Programa de Pós-Graduação: Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental
• Departamento: Centro Biomédico::Faculdade de Ciências Médicas
• País: BR
• Palavras-chave em Português: CO2; Intradérmico; Pele do dorso; Hamster; Viabilidade do Retalho; Microcirculação; Pele Reparos e reconstrução; Dióxido de carbono; Retalhos cirúrgicos
• Palavras-chave em Inglês: CO2; Intradermal; Skin dorsum; Hamster; Flap survival
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::MEDICINA::CIRURGIA::CIRURGIA PLASTICA E RESTAURADORA
• Link de acesso: http://www.bdtd.uerj.br/handle/1/12712

Skin flaps are an important technique commonly used in Plastic Surgery, mainly for reparatory purposes. Lower tissue oxygen tension related to surgical trauma and associated to flap dimensions, can result in an unsatisfactory response for survival of distal extremities from the pedicle leading to ischemia, necrosis, dehiscence of suture lines and failure of the skin coverage intended to aimed reparation. This study was performed based on pre-surgical controlled infusion of CO2 to potentiate the regional microcirculation and increase the viability of randomized skin flaps in the hamster s dorsum. Fifteen Syrian golden hamsters were divided into three groups, with the finality to study the use of the Preheated medical gaseous transcutaneous CO2, mainly intradermal, and its infusion was performed, in a total of 10 sessions, on the topography of the future flap. We have investigated two infusion volumes of CO2 (80 and 150 ml/min; groups 2 and 3, respectively) and compared to the control group (not exposed previously to CO2; group 1). During 14 days, flaps viability was observed, followed by cutaneous fragment analysis with immunofluorescence (VEGF, Metalloproteinase II, Metalloproteinase IX, PCNA and Alpha-Actin) and real-time quantitative PCR (qRT-PCR) (TNF-α, Caspase-3, VEGF e HIF1-α). There was a 44.38 % average on flap survival (viability) in group 1 (control group); 93 .95% in group 2 (80 ml/min CO2) and 90.8% in group 3 (150 ml/min CO2). With expression of metalloproteinase II and IX by immunofluorescence and of TNF-α by qRT-PCR technique. Our results have shown an intense vascular remodeling, promoted by the inflammatory process without cellular apoptosis, directly related an improvement of viable flaps.