Wound healing in weaning, adult, and old rats with provoked incisional hernias. A comparative study

Background: Incisional hernias are more frequent in adults than in children. It is hypothesized that a more efficient healing process in pediatric patients could explain this difference in incidence. Certain elements of healing such as neovascularization, degree of inflammation, percentage of mature and immature collagen, the proliferation of fibroblasts, and expression of certain genes could explain why healing in children is more efficient when compared to the adult and elderly populations. Materials and methods: Seventy-one rats of 3 different age groups (weaning, adult, and old) underwent surgery with 3 different incisions (vertical, oblique, and horizontal). During the procedure, the skin and abdominal wall of the animal were sectioned and only the skin was sutured to mimic incisional hernia in the animals. Four weeks after surgery, the rats were euthanized, their skin was removed, and the extent of scar tissue formed in the muscle opening was measured. In addition, samples of the scar tissue were collected for histological, immunohistochemical, and molecular analyzes. Nine rats served as controls. Results: Shorter-length hernias were formed in weaning rats when compared to old ones when the surgical incision was horizontal (p = 0.03). There was a greater proliferation of fibroblasts in rats in the younger age groups, regardless of the type of incision. The Lox gene was more expressed in weaning rats with vertical and oblique incisions. Conclusions: These differences could explain the better healing and lower incidence of hernias in the pediatric population, although this aspect requires further studies

Vivência do familiar na qualidade de cuidador responsável pela diálise peritoneal domiciliar: baseado na teoria do autocuidado / Experience of the family member as the caregiver responsible for peritoneal dialysis at home: based on the theory of self-care

A Doença Renal Crônica (DRC) é uma das patologias que mais compromete o estilo de vida tanto físico, social, econômico, emocional de seus portadores, devido ao esgotamento gradual dos rins que, se não tratado, levará o paciente á óbito, as principais causas de perda da função renal no nosso meio são as doenças crônicas como hipertensão arterial (35% das causas), diabetes mellitus (28,5%) seguidas das glomerulonefrites (11,5%), objetivando conhecer o impacto da doença renal crônica na vida do familiar/ cuidador, do paciente em diálise peritoneal, a metodologia utilizada tratou-se de um estudo de abordagem exploratória, descritiva de cunho qualitativo, a pesquisa foi realizada após a aprovação do comitê de ética em pesquisa, no setor de hemodiálise do hospital de clínicas Gaspar Viana, durante o intervalo das consultas de seus entes cuidados, concluiu-se que o diagnóstico da doença renal crônica no âmbito familiar exigi um cuidador que faça a terapia dialítica e se responsabilize pelos cuidados no domicílio, de forma rigorosa. A maioria dos pacientes nessa atividade é realizada por apenas um familiar que geralmente é selecionado por afinidade ou por ser a única opção, sendo chamado de cuidador principal

Comparation between cicatrization in weaning, adult and old rats with provoked incisional hernia

Background: Incisional hernias occur with some frequency in adult population, however they are rare in children. It is hypothesized that the most efficient process of healing in pediatric population is the answer to this important difference in incidence. Therefore, certain elements of healing such as neovascularization, degree of inflammation, percentage of mature and immature collagen, proliferation of fibroblasts and expression of certain genes can explain why healing in children is more efficient when compared to the adult and elderly population. Materials and methods: Seventy-one rats of 3 different age groups (weaning, adult and old) underwent surgery in 3 different incisions (vertical, oblique and horizontal). In the procedure, skin and abdominal wall of the animal were sectioned and only skin was sutured, in order to mimic incisional hernia in the animals. After 4 weeks of surgery, the rats were sacrificed, their skin removed, and the extent of scar tissue formed in the muscle opening was measured. In addition, samples of scar tissue were collected and histological, immunohistochemical and molecular analyzes were performed. Results: Shorter length hernias were formed in weaning rats when compared to old ones in surgery with horizontal incision (p=0.03). There was greater proliferation of fibroblasts in rats of the younger age groups, regardless of the type of incision made. The Lox gene was more expressed in weaning-aged rats in vertical and oblique incision surgeries. Conclusions: The contraction of scar tissue formed in wounds appears to be more intense in horizontal cuts than vertical ones. The greater proliferation of fibroblasts in scar tissue of weaning rats may explain the better healing and lower incidence of hernias in pediatric population. The Lox gene seems to be more expressed in weaning groups and may also explain better healing in children, but more studies need to be done