Use of autologous fibrin glue in dermatologic surgery: application of skin graft and second intention healing

OBJECTIVE: To evaluate the efficiency of biological sealant, an autologous fibrin glue, in dermatological surgery. DESIGN: Randomized clinical trial. SETTING: The Dermatology Service of Hospital das Clínicas, Universidade de Campinas (UNICAMP), referral center. PATIENTS: 14 patients with malign epithelial cutaneoos tumors participated in the evaluation, each having two tumors, generally facial and symmetrical, in order to perform a comparative evaluation on the same individual. PROCEDURES: The glue was prepared beforehand with a sample of autologous blood. Surgical extirpation of the tumor was followed by grafts or second intention healing. OUTCOMES: The efficiency of the sealant was then evaluated in relation to hemostasis, adhesion, surgical time and evolution of the granulation tissue, clinically and histologically. RESULTS: Immediate hemostasis and graft adhesion, with a significant reduction of surgical time, and in the open wounds there was immediate hemostasis and a clinical increase in granulation tissue, but with no histological differences among the groups on the 7th day. CONCLUSION: It is an adjuvant resource in skin cancer surgery.OBJETIVO: Avaliar a eficácia de um selante biológico, a cola de fibrina autóloga, na cirurgia dermatológica. TIPO DE ESTUDO: Estudo prospectivo, randomizado. PARTICIPANTES: 14 doentes com dois tumores cutâneos epiteliais malignos, principalmente faciais e simétricos, para avaliação comparativa no mesmo indivíduo. LOCAL: Serviço de Dermatologia do Hospital de Clínicas da UNICAMP. PROCEDIMENTOS: A cola foi preparada, previamente, com amostra de 50 ml de sangue autólogo. Após a exérese do tumor, seguiu-se a colocação de enxertos ou cicatrização por segunda intensão. VARIÁVEIS: Hemostasia, adesão, tempo cirúrgico e evolução do tecido de granulação, clínica e histologicamente. RESULTADOS: Os resultados com a cola mostraram hemostasia e adesão imediata dos enxertos, com redução significativa do tempo cirúrgico e nas feridas abertas houve hemostasia imediata e maior tecido de granulação clinicamente mas sem diferenças histológicas, no 7º dia, entre os grupos. CONCLUSÃO: Concluiu-se que é recurso adjuvante na cirurgia do câncer de pele.1747175

Lipodistrofia ginoide : aspectos epidemiologicos clinicos histopatologicos e terapeuticos

Orientador: Andre Luiz VergananiniDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Com os objetivos de estudar os aspectos clínicos, epidemiológicos e histopatológicos (derme) da lipodistrofia ginóide (L.D.G.) e avaliar a eficácia da terapêutica tópica, foi realizado um estudo observacional descritivo de um grupo de 75 mulheres, que participaram de um ensaio clínico duplo cego - placebo com um produto tópico. Como princípios ativos, foram empregados um vaso ativo (ginkgo biloba), um lipolítico (cafeína) e um trófico do tecido conjuntivo (centella asiática), além do silício orgânico (com atuação a nível do tecido conjuntivo, adipócitos e microcirculação). Os principais fatores agravantes citados foram o sedentarismo, a gravidez e o aumento de peso, e o sintoma associado mais freqüente foi a sensação de peso nas pernas. O estudo histopatológico da derme revelou mucoidose e proliferação de fibras colágenas. No ensaio clínico os métodos utilizados para avaliação objetiva foram as medidas antropométricas e da espessura da epiderme e derme (através da análise de imagem). Não houve diferença, estatisticamente significante das medidas objetivas, antes e depois da utilização dos produtos, contrastando com diferenças importantes na avaliação subjetiva das pacientesAbstract: This study shows the clinical, epidemiologic and histophatologic aspects of the so called cellulitis (lipodistrofia ginóide - L.D.G.), and evaluate the effectiveness of the topical therapy, through a descriptive study in 75 women. They had participated in a double blind clinical evaluation - placebo and a topical product. It have been used, as active agents, a vasoactive (ginkgo biloba), a lipolytic one (caffeine), and a trophic of the conjunctive tissue (asiatic centella) as well as the organic silicon, acting on a leveI of adipose and conjunctive tissue and microcirculation. The main named worsening agents were physical inactivity, pregnancy and over-weight, and the most frequent associated syntom was the feeling of heavy legs. The dermal histophatologic study has shown mucinose and bundles of collagenous fibers proliferation. The methods used in the clinical study, for an objective evaluation, were the anthropometric measurements and the epidermal and dermal thickness (through the image analysis). There was no statistical significant difference betwen the objective measurements before and after the utilization of the products, in contrast to the signifficant differences found in the subjective evaluation of the patientsMestradoClinica MedicaMestre em Clinica Medic

Use of autologous fibrin glue in dermatologic surgery: application of skin graft and second intention healing

OBJECTIVE: To evaluate the efficiency of biological sealant, an autologous fibrin glue, in dermatological surgery. DESIGN: Randomized clinical trial. SETTING: The Dermatology Service of Hospital das Clínicas, Universidade de Campinas (UNICAMP), referral center. PATIENTS: 14 patients with malign epithelial cutaneoos tumors participated in the evaluation, each having two tumors, generally facial and symmetrical, in order to perform a comparative evaluation on the same individual. PROCEDURES: The glue was prepared beforehand with a sample of autologous blood. Surgical extirpation of the tumor was followed by grafts or second intention healing. OUTCOMES: The efficiency of the sealant was then evaluated in relation to hemostasis, adhesion, surgical time and evolution of the granulation tissue, clinically and histologically. RESULTS: Immediate hemostasis and graft adhesion, with a significant reduction of surgical time, and in the open wounds there was immediate hemostasis and a clinical increase in granulation tissue, but with no histological differences among the groups on the 7th day. CONCLUSION: It is an adjuvant resource in skin cancer surgery