Cicatrização de feridas realizadas na mucosa jugal de ratos com bisturi com lâmina fria e com bisturi harmônico ultra-sônico




Introduction: New techniques of incision and haemostasis have been used with different devices in the different operations with the intention of carrying them out in the shortest time and with the best results in healing. Objective: To evaluate the macroscopic and microscopic evolution of the healing process of incisions carried out with the ultrasonic harmonic scalpel in the oral mucosa of the rats and compare it that done with cold blade scalpel. Method: Thirty Wistar rats were used which had undergone incisions on the right side jugal mucosa with the ultrasonic harmonic scalpel and on the left side with the cold blade scalpel. The macroscopic and microscopic evaluation was carried out on the 3rd, 7th and 14th days after the collection of fusiforme material from each side of the rats. For the morphologic microscopic analysis, Haematoxilin and Eosin coloration techniques were used to evaluate the inflammatory process and the Sirius red technique was used to evaluated the type I and III collagens. Treatment with anti-CD3 antibodies and anti-factor VIII permited an evaluation of T linphocytes and angiogenesis. Results: The ultrasonic harmonic scalpel madeincisions without bleeding. However, it resulted in greater cellular damage shown by wider and more depressed wounds with consequent delayed regeneration. Microscopy showed that there was more intense inflamatory reaction with micro abscesses (p=0,313). In the resulting wounds of the ultrasonic harmonic scalpel there was the damage of the deposition of collagen, With lower density of collagen I (p=0,005) and collagen III (p=0,037) on the 7th day. Delayed maturation of the scars was witnessed by lower concentration of collagen I (p=0,008) and higher of collagen III (p=0,038) on the 14th day. Angiogenesis was more intense with the ultrasonic harmonic scalpel, as much on the 7th day (p=0,005) as on the 14th day (p=0,005). Conclusion: The analysis of the results of this study allows to conclude that the use of the ultrasonic harmonic scalpel compared to the cold blade scalpel in incisions made in the jugal mucosa of rats results in efficient haemostasis; leads to a larger area of injury at the time of incision; delays the regeneration process; results in an increased inflammatory process; prolongs the inflammatory phase; develops greater angiogenic activity; delays fibroplasia and the maturation of scars.


rato como animal de laboratório utra-son em cirurgia cirurgia instrumentos e aparelhos cirúrgicos cicatrização de feridas

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