Avaliação bioquímica e histológica da resposta inflamatória, com fio farpado de polidioxanona e poliglactina 910, em sutura de cúpula vaginal e aponeurose abdominal, em suínas submetidas a histerectomia

Abstract

Each year in Brazil, about 300,000 women receive the indication to undergo hysterectomy, which should only be performed after all possibilities of noninvasive treatments are exhausted. In order to perform this procedure, there are several techniques, such as the access route, type of suture, and which wires can be used, as this surgical time (suture) is extremely important, and should favor tissue restoration and restore sutured site function as early as possible. Suture threads are fundamental in surgical practice and there is a great diversity of materials with which they are produced, providing the practice of different techniques for suturing, minimizing the tissue reaction and reducing the time of its accomplishment. The aim of this research is to compare the inflammatory response, healing stability, presence or absence of suture adhesions or dehiscence between the two wires used. For suturing with polydioxanone thread, there is no need to knot the suture, unlike when using polyglactin 910 thread which needs knotting for suture stabilization. Sixteen abdominal pig hysterectomies were performed, divided into two groups, 08 using polydioxanone thread and 08 using polyglactin 910 thread, in the vaginal dome suture and abdominal aponeurosis. Blood samples were collected preoperatively, hysterectomy (D1) and samples taken from aponeurosis and vaginal dome (D9). Blood samples were performed with complete blood count, fibrinogen and C-reactive protein levels to evaluate the systemic inflammatory reaction. When the samples of aponeuroses and vaginal domes were collected, the presence or absence of local adhesions or abscesses was observed, and later the material was sent for histological analysis, for evaluation of fibrosis and fat encapsulation, classification and assignment of indices to histological findings. for further characterization of the inflammatory process phase. After this study, no significant differences were found between the two evaluated wires, and we conclude that when the time to suture is relevant, as in laparoscopic video hysterectomy, the use of polydioxanone suture for vaginal dome suture is the most suitable.