Applications of platelet- and leukocyte-rich fibrin (L-PRF) in Oral and Maxillofacial Surgery

Introduction: Oral and maxillofacial surgery plays a crucial role in the reconstruction and restoration of facial structures, seeking to improve both aesthetics and function. The use of platelet-rich fibrin (L-PRF) represents a notable advance, accelerating healing and improving surgical outcomes. Materials and Methods: This review covers 710 studies from various electronic databases (PubMed, Scopus, Web of Science, Science Direct and Google Scholar). The aim is to thoroughly investigate the applications of platelet- and leukocyte-rich fibrin (L-PRF) in Oral and Maxillofacial Surgery and Traumatology. Results: The analysis reveals that L-PRF stands out as an effective autologous therapy in oral and maxillofacial surgery. Its application shows remarkable potential for accelerating the healing process, contributing significantly to the effectiveness of procedures. Discussion: L-PRF has emerged as an excellent choice in oral and maxillofacial surgery and traumatology, improving both the aesthetic and functional aspects of facial reconstructions. This highlights the relevance of this autologous therapy and its benefits in surgical practice. Conclusion: The applications of platelet and leukocyte-rich fibrin (L-PRF) in Oral and Maxillofacial Surgery and Traumatology are fundamental and promising. This advance represents not only a means of accelerating healing, but also a significant contribution to better aesthetic and functional results in surgical procedures in this area.Introduction: Oral and maxillofacial surgery plays a crucial role in the reconstruction and restoration of facial structures, seeking to improve both aesthetics and function. The use of platelet-rich fibrin (L-PRF) represents a notable advance, accelerating healing and improving surgical outcomes. Materials and Methods: This review covers 710 studies from various electronic databases (PubMed, Scopus, Web of Science, Science Direct and Google Scholar). The aim is to thoroughly investigate the applications of platelet- and leukocyte-rich fibrin (L-PRF) in Oral and Maxillofacial Surgery and Traumatology. Results: The analysis reveals that L-PRF stands out as an effective autologous therapy in oral and maxillofacial surgery. Its application shows remarkable potential for accelerating the healing process, contributing significantly to the effectiveness of procedures. Discussion: L-PRF has emerged as an excellent choice in oral and maxillofacial surgery and traumatology, improving both the aesthetic and functional aspects of facial reconstructions. This highlights the relevance of this autologous therapy and its benefits in surgical practice. Conclusion: The applications of platelet and leukocyte-rich fibrin (L-PRF) in Oral and Maxillofacial Surgery and Traumatology are fundamental and promising. This advance represents not only a means of accelerating healing, but also a significant contribution to better aesthetic and functional results in surgical procedures in this area

Lymphatic function in the early postoperative period of breast cancer has no short-term clinical impact

To evaluate by lymphoscintigraphy the lymphatic function in the preoperative period up to 2 months after surgery for breast cancer, and the relationship between the lymphatic function with clinical features and physical complications. Methods: One hundred and five women were studied before and 2 months after surgery to treat breast cancer. On each occasion, inspection and palpation of surgical wound, upper limb circumference, and lymphoscintigraphy were performed. Lymphatic function analysis consisted of velocity of axillary lymph node (LN) visualization; intensity of LN uptake; collateral circulation; dermal backflow; and hepatic uptake. Results: In the postoperative period, there was a significant worsening of the degree of LN uptake (p = 0.0003) and in the velocity of LN visualization (p = 0.01). No significant differences in dermal backflow (p = 0.4) and collateral circulation (p = 0,07) were observed. There was a significant increase in liver absorption (p = 0.0002). 37.1% of the patients developed seroma, 11.2% dehiscence, and 25.8% infection. No relationship was found between lymphoscintigraphy changes and postoperative complications or clinical characteristics. Conclusion: Lymphoscintigraphy, performed 60 days post surgery for breast cancer, can detect a worsening in lymphatic drainage and some sign of lymphatic changes. These changes are not related to clinical characteristics and physical complications14422022

Manual lymphatic drainage and active exercise effects on lymphatic function do not translate into morbidities in women who underwent breast cancer surgery

PURPOSE: To evaluate the effects of levobupivacaine on neuromuscular transmission and neuromuscular blockade produced by pancuronium in vitro. METHODS: Thirty rats were distributed into groups (n = 5) according to the drug used alone or in combination: Group I - levobupivacaine (5 µg.mL-1); Group II - pancuronium (2 µg.mL-1); Group III - pancuronium (2 µg.mL-1) + levobupivacaine (5µg.mL-1). The following parameters were evaluated: 1) amplitude of diaphragmatic response to indirect stimulation, before and 60 minutes after the addition of levobupivacaine and pancuronium alone, and after the addition of levobupivacaine combined with pancuronium; 2) membrane potentials (MP) and miniature endplate potentials (MEPP). RESULTS: Levobupivacaine alone did not alter the amplitude of muscle response and MP. In preparations previoulsy exposed to levobupivacaine, the block with pancuronium was significantly denser (90.2 ± 15.2%), showing a significant difference (p=0.031) in comparison to the block produced by pancuronium alone (48.9% ± 9.8%). There was a decrease in the frequency and amplitude of MEPPs. CONCLUSION: Levobupivacaine potentiated the neuromuscular blockade produced by pancuronium, confirming a presynaptic action by a decrease in miniature endplate potentials.To evaluate manual lymphatic drainage (MLD) and active exercise effects on lymphatic alterations of the upper limb (UL), range of motion (ROM) of shoulder, and scar complications after breast cancer surgery. Design: Clinical trial. Setting: Health care ce982256263FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO2009/14864-

Long term effects of manual lymphatic drainage and active exercises on physical morbidities, lymphoscintigraphy parameters and lymphedema formation in patients operated due to breast cancer: A clinical trial

<div><p>Purpose</p><p>evaluate whether manual lymphatic drainage (MLD) or active exercise (AE) is associated with shoulder range of motion (ROM), wound complication and changes in the lymphatic parameters after breast cancer (BC) surgery and whether these parameters have an association with lymphedema formation in the long run.</p><p>Methods</p><p>Clinical trial with 106 women undergoing radical BC surgery, in the Women’s Integrated Healthcare Center—University of Campinas. Women were matched for staging, age and body mass index and were allocated to performed AE or MLD, 2 weekly sessions during one month after surgery. The wound was evaluated 2 months after surgery. ROM, upper limb circumference measurement and upper limb lymphoscintigraphy were performed before surgery, and 2 and 30 months after surgery.</p><p>Results</p><p>The incidence of seroma, dehiscence and infection did not differ between groups. Both groups showed ROM deficit of flexion and abduction in the second month postoperative and partial recovery after 30 months. Cumulative incidence of lymphedema was 23.8% and did not differ between groups (p = 0.29). Concerning the lymphoscintigraphy parameters, there was a significant convergent trend between baseline degree uptake (p = 0.003) and velocity visualization of axillary lymph nodes (p = 0.001) with lymphedema formation. A reduced marker uptake before or after surgery predicted lymphedema formation in the long run (>2 years). None of the lymphoscintigraphy parameters were shown to be associated with the study group. Age ≤39 years was the factor with the greatest association with lymphedema (p = 0.009). In women with age ≤39 years, BMI >24Kg/m² was significantly associated with lymphedema (p = 0.017). In women over 39 years old, women treated with MLD were at a significantly higher risk of developing lymphedema (p = 0.011).</p><p>Conclusion</p><p>Lymphatic abnormalities precede lymphedema formation in BC patients. In younger women, obesity seems to be the major player in lymphedema development and, in older women, improving muscle strength through AE can prevent lymphedema. In essence, MLD is as safe and effective as AE in rehabilitation after breast cancer surgery.</p></div

Main clinical features of the women in the AE and MLD groups.

<p>Main clinical features of the women in the AE and MLD groups.</p

Clinical features, postoperative complications and adjuvant treatment as related to the development of lymphedema after 30 months of follow-up.

<p>Clinical features, postoperative complications and adjuvant treatment as related to the development of lymphedema after 30 months of follow-up.</p

Recursive partitioning showing the factors associated with the presence of lymphedema after 30 months of follow-up.

<p>Recursive partitioning showing the factors associated with the presence of lymphedema after 30 months of follow-up.</p

Visual classification of upper limb lymphoscintigraphy.

<p>Visual classification of upper limb lymphoscintigraphy.</p

Flowchart of study sample.

<p>Flowchart of study sample.</p