The role of subcutaneous dimethyl-sulfoxide in morphological study of random skin flaps in rats

A isquemia tecidual acompanha a confeccao de retalhos cutaneos randomicos, em que pese os cuidados tecnicos de sua confeccao.0 dimetil-sulfoxido (DMSO) e uma droga com reconhecida capacidade de varredor de radicais toxicos de oxigenio em tecidos expostos aos fenomenos de isquemia. Devido suas caracteristicas de solvente organico pode ser administrado por diversas vias. A via subcutanea, I de citacao incomum na literatura biomedica, foi escolhida como um modo de colocar a droga em concentracao e tempo habil no sitio operatorio, uma vez que o estresse oxidativo tem expressao ja a partir de cinco minutos de pos-operatorio. O objetivo foi avaliar atraves do estudo morfologico (macro e microscopico) a eficacia do DMSO na genese da necrose distal de retalhos randomicos isquemicos em ratos. Foram utilizados 30 ratos machos, linhagem Wistar, peso entre 220 e 363g e idade media de 3 meses.0 retalho cutaneo dorsal (8x2cm) com pediculo cranial foi descolado, reposto em seu leito e suturado com poliamida 4.0. O grupo controle-CT (n=10)nao recebeu nenhuma medicacao, o grupo simulado-SM (n=10) recebeu o volume de 1mL de solucao salina subcutanea, dividida em dez aplicacoes ao longo do retalho, o grupo experimento-EX (n=10) recebeu a injecao de 1m1 de DMS05 por cento. Apos sete dias foram avaliadas as areas de necrose distal e colhido material para o estudo histologico. As medidas das areas de necrose (CT=47,99, SM=58,78, EX=41,57) e as porcentagens das areas de necrose (CT=29,98, SM=36,73, EX =23,99) mostraram-se menores no grupo Ex (p< 0,05). O estudo histologico qualitativo mostrou, no grupo Ex, maior presenca de neovascularizacao, menor desestruturacao dos anexos e do estroma conjuntivo e presenca de fibroblastos en~ periodo mais precoce que nos dois outros grupos. A analise dos dados coletados pode inferir que o DMSO teve acao benefica sobre os retalhos cutaneos randomicos em ratos, expressos pela menor area de necrose distal e pelo aspecto histologico de reparacao tecidual mais precoceThe tissue ischemia is a current event in a random skin flap, in spite of the surgical technical cares .The dimethyl-sulfoxide (DMSO) is a drug with abilities to scavenge oxygenfree radicals implied to the tissue, before, during and several hours after the tissue insult. Due their characteristics of organic solvent can be administered by enteral and parenteral via. The subcutaneous injections, of uncommon citation in the biomedical literature, it was chosen as a way of offering the drug in concentration and skilled time in the operative site, once the oxidative stress has expression already starting from five minutes of postoperative procedure. The objective was to evaluate through the morphologic study (macro and microscopic) the effectiveness of DMSO in the genesis of the distal necrosis of random skin flaps in rats. 30 male rats were used, lineage Wistar, weight between 220 and 363g and 3 months medium age .The skin flap (8x2cm) with cranial remained vessels it was unstuck, restored at his bed and sutured with polyamide 4.0. The control-group CT (n=10) don’t received any medication, the simulated group -SM (n=10) it received the volume of 1mL of subcutaneous saline solution, divided in ten applications along the skin flap, the experiment group (n=10) it received the injection of 1ml of DMSO5%. After seven days they were appraised the areas of distal necrosis and picked material for the histology study. The measures of the necrosis areas (CT=47.99, SM=58.78, EX=41.57) and the percentages of the necrosis areas (CT=29.98, SM=36.73, EX =23.99) they were shown smaller in the EX group (p < 0,05). The qualitative histology study showed, in the group EX, larger angiogenic presence, smaller destruction of the enclosures and of the conjunctive stroma and presence of fibroblasts in more precocious period than in the two other groups. The analysis of the collected data can infer that DMSO had beneficial action on the random skin flaps, expressed by the smallest area of distal necrosis and for the histology aspect of repairing tissue more precocious.BV UNIFESP: Teses e dissertaçõe