transposição do músculo reto do abdome para correção de defeito iatrogênico no diafragma em cães rectos abdominis muscle flap for repair of iatrogenic diaphragmatic defects in dogs

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Abstract
Neste experimento, foram utilizados 6 cães, com o objetivo de avaliar a viabilidade do músculo reto do abdome pediculado para correção de defeito no diafragma. O músculo foi dissecado até próximo sua inserção e deslizado para a cavidade abdominal através de uma incisão paracostal. Após a formação de um defeito no diafragma de aproximadamente 4 x l0cm, o músculo reto do abdome foi fixado com pontos de Wolff com fio de seda 2-0. Os animais foram observados por um período de tempo determinado de 15, 30 e 60 dias, quando foram operados novamente para observação macroscópica e microscópica. Tecido conetivo e áreas de hemorragia entre o retalho e diafragma, com tecido de granulação de maturidade média, foram observados no material das biópsias aos 15 dias. Aos 30 dias, foi notado pouco tecido de granulação que, aos 60 dias, era maduro. Na região do implante, foi verificada integração tecidual entre o músculo reto do abdome e diafragma com total oclusão do defeito diafragmático, formação de tecido de granulação, onde foram observadas aderências do fígado, lobo pulmonar caudal, estômago e omento. O músculo reto do abdome pediculado pode ser indicado para correção de defeitos no músculo diafragma, havendo uma completa integração tecidual na região do implante.
With the objective of analyzing the use Rectus abdominis muscle flaps for repair of large diaphagmatic defects, when direct suture is impossible, six dogs underwent surgery. The Rectus ahdominis muscle was dissected up to its insertion and was introduced into the abdominal cavity through a paracostal incision. A defect of 4 x l0cm was created in the diaphragmatic muscle and the flap was sutured to the edges of the defect with horizontal mattres suture with 2-0 silk. Animais were clinically evaluated every day at the post-operative period. Biopsies and macroscopic observation were done at the 15th, 30th and 60th day. Connective tissue and hemorrhagic areas among the flap and the diaphragm, and granulation tissue with median maturity were observed in the biopsy material at the 15th day. At the 30th day, few granulation tissue among the muscles were observed. At the 60th day, there was mature granulation tissue. Adherence ocurred in the region of the implant with the liver, caudal pulmonar lobe, stomach and omentun. The Rectus abdominis muscle can be used to correct defects in the diaphragm with a complete tissue integration in the implanted region.
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Authors ;Renato Xavier Faria;Ney luís Pippi;Luciana Oliveira de Oliveira;Luciana Dambrósio Guimarães;Alexandre Mazzanti;Alonso Gabriel Pereira Guedes
Journal Trials
Year 2000
DOI
10.1590/S0103-84782000000400014
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-84782000000400014
Keywords
dog diaphragm graft

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