Síntese de grandes feridas da parede corpórea com fita elástica de borracha em coelhos

Abstract

Background: The healing of a large wound is a surgical challenge, not always successful. The purpose of this study is to evaluate the efficiency of the closure of large wounds of the body wall of rabbits by means of the traction of their edges using rubber bands and to compare the efficiency of this technique with the synthesis of large wounds by second intention and with the use of autologous skin grafts. Method: 30 male, White New Zeland rabbits were submitted to a removal of a skin segment from their dorsum. The animals were treated according to their following procedures and divided into three groups (n = 10): Group 1 Healing of a wound by second intention, without any treatment. Group 2 Treatment of wound by means of autogenous orthotopic skin graft. Group 3 Treatment of skin wound injury using traction with rubber bands sutured to the wounds edges in consecutive X. Blood samples were collected from all animals to perform hemogram immediately before the operation, on the 7th and 21st post-operative days. The rabbits were weighed in the post-operative phase, on the 10th and 21st post-operative days. All animals were followed-up over a 21-day period. At the end of the 21 days postoperative period, the closure of the wound was studied and samples of the skin were removed to verify the resistance of the scar and the histological aspect. Results: Two animals from groups 1 and 2 and one from Group 3 died. Two animals from Groups 1 and 2 presented an abscess in the wound. In Group 2, total or partial necrosis of the graft was observed in 90% of the animals. The complete closure of the wounds occurred in four animals from Group 1, in six from Group 2, and in eight from Group 3. In the seventh POD, the values of leukocytes were lower in Group 3. The scar tensile strength values in Group 3 were not different from those from Group 2, and both of them were greater than those of Group 1. The histological findings in the three groups were characterized by the presence of fibrosis consisting of mature conjunctive tissue interspersed with a small quantity of blood vessels and inflammatory infiltrate, predominantly composed of polymorphonuclears. Conclusion: The closure of large wounds of the rabbit body wall by the traction of its borders using a rubber band constitutes a method that is efficacious, simple, easily feasible, and of low cost, proving to be more efficient than second intention healing, and as efficacious as closure by grafting, with less complications.