Background:The craniotomy performed with minimal hair removal and closure with intradermal suture alone is an option in neurosurgical procedures, which can help faster psychological recovery of the patient, as it allows a better cosmetic result. This study is aimed at evaluating if such method is safe and effective, compared with continuous skin sutures with 2-0 nylon.Methods:We analyzed the sutures in 117 patients undergoing craniotomies for cerebral aneurysm clipping. In the case group (n = 49), closure of the scalp was performed only with intradermal absorbable sutures using wire Monocryl® 2-0. In the control group (n = 68), closure was performed with continuous suture using 2-0 nylon.Results:The case group was composed of 49 patients in whom just intradermal suture was performed. One (2.2%) patient developed wound infection and was given proper medical treatment. No cases of dehiscence or cerebrospinal fluid leaks were observed. The control group was composed of 68 patients in whom the skin was closed with 2-0 nylon continuous suture. Three (5.3%) patients developed wound infection and were given proper medical treatment. There were no cases of wound dehiscence. The overall infection rate in the control group was 4%. There was no statistically significant difference in the number of wound infections between the two groups (P = 0.73).Conclusion:The closure with intradermal suture alone in craniotomies is as safe as the traditional skin closure with nylon sutures, besides eliminating the need for suture removal and providing a cosmetic advantage.
Pneumoperitônio é a técnica de insuflação com gás da cavidade peritoneal necessária para que haja uma boa visualização das estruturas anatômicas na cirurgia videolaparoscópica. Todavia, diversas alterações fisiológicas são relatadas em decorrência do pneumoperitônio, quais sejam por deslocamento e compressão de estruturas como o diafragma, alterando a fisiologia respiratória, e a veia cava caudal, comprometendo o pré-carga e o débito cardíaco, ou por efeitos sistêmicos decorrentes da absorção de CO2, por exemplo. O presente estudo teve como objetivo avaliar as alterações hemodinâmicas do pneumoperitônio com CO2 em gatas anestesiadas. Foram utilizadas 10 gatas sadias, adultas, premedicadas com cloridrato de cetamina e midazolam e anestesiadas com isoflurano e submetidas a OSH por cirurgia laparoscópica com insuflação abdominal por CO2. As pressões diastólica, sistólica e média foram avaliadas de maneira invasiva por cateterização da artéria femoral e mensurada por um monitor multiparamétrico antes e depois do estabelecimento do pneumoperitônio. Os resultados foram formatados e submetidos à análise de variância e posteriormente analisados pelo teste t de Student e teste Tukey. As alterações em PAS, PAD e PAM observadas no decorrer dos procedimentos, entretanto, não configuraram diferenças estatísticas conforme as análises realizadas. Conclui-se, então, que a realização do pneumoperitônio com CO2 não provoque alterações relevantes na pressão arterial em gatas anestesiadas ou que estas alterações sejam fisiologicamente corrigidas por mecanismos compensatórios.
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