CESAR ISAAC
Projetos de Pesquisa
Unidades Organizacionais
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina - Líder
5 resultados
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- Estabelecimento de protocolo para armazenamento de pele autógena refrigerada(2017) CONCEIÇÃO, RENATA OLIVEIRA DA; PAGGIARO, ANDRÉ OLIVEIRA; POLO, EUGÊNIO FERRAMUNDO; MARTINES, KARINA; ISAAC, CESAR; CARVALHO, VIVIANE FERNANDES DE; GOMEZ, DAVID DE SOUZA; GEMPERLI, ROLFABSTRACT Introduction: Autologous skin grafts are used for treatment of burn patients. These grafts can be stored and preserved, as long as the storage process is performed with strict quality control to reduce the risk of infection. Methods: A retrospective cohort study was conducted in the Burn Unit of the Hospital das Clínicas de São Paulo from February 2015 to July 2016. During this period, a protocol was established to store refrigerated skin, with control of collection, preservation, and packaging, and recording of all processes. To ensure quality, graft biopsies were collected for preand poststorage microbiology testing and a cross-sectional study for contamination was performed. Results: Critical deficiencies included inadequate packaging, lack of processing records, lack of biopsies for microbiology testing, and failure to discard specimens. Most of the samples were contaminated before and after storage (84.2%). Only two samples were sterile before storage but became contaminated after storage, with growth of Gram-positive skin bacteria. Conclusion: A promising method for the storage of refrigerated skin was established, but requires minor adjustments in quality control.
- Sistematização de curativos para o tratamento clínico das feridas(2012) SMANIOTTO, Pedro Henrique de Souza; FERREIRA, Marcus Castro; ISAAC, Cesar; GALLI, RafaelThe treatment of cutaneous wounds includes both medical and surgical methods; dressing is one of the most commonly used clinical treatments. An extensive therapeutic toolkit comprising passive dressings or dressings with active principles can help repair wounds in various situations. Dressings are used to improve the conditions of the wound bed and may occasionally be considered the definitive treatment, whereas in some cases, they may be considered an intermediate step to surgical treatment. Intelligent and biological wound dressings are currently classified as dermal substitutes and will not be discussed in this article. Dressings should be selected on the basis of knowledge of the pathophysiology of wound healing and tissue repair while keeping the systemic problems of the patient in mind.
- Construção de substituto da pele composto por matriz de colágeno porcino povoada por fibroblastos dérmicos e queratinócitos humanos: avaliação histológica(2012) ISAAC, Cesar; REGO, Francinni M. P.; LADEIR, Pedro Ribeiro Soares de; ALTRAM, Silvana C.; OLIVEIRA, Renata C. de; ALDUNATE, Johnny L. C. B.; PAGGIARO, André O.; FERREIRA, Marcus CastroBACKGROUND: In the case of extensive lesions, the use of autologous grafts is limited by the extent of the donor area and the clinical condition of patients. Allografts collected from cadavers or volunteers are usually rejected after 1 to 2 weeks, thus serving only as temporary cover for these lesions. Treating major cutaneous lesions with reconstructed autologous skin is an attractive alternative, because it is possible to obtain cultures of cells that multiply rapidly and can be cryopreserved from a small fragment of the patient's skin, thereby facilitating its indefinite use in new treatments. This study evaluated the histological behavior of cultured human keratinocytes and fibroblasts on a collagen matrix derived from porcine small intestinal submucosa. METHODS: Cells from human epidermis and dermis were grown separately and seeded on porcine collagen matrix, which was maintained in a controlled environment for 21 days before being subjected to histological analysis. RESULTS: Fibroblasts invaded and colonized the collagen matrix, whereas keratinocytes were organized in laminated and stratified layers on the surface on which they were seeded. CONCLUSIONS: The use of porcine collagen matrix as a support for human skin cells is feasible, and the organization of these cells resembles the architecture of human skin.
- Análise do atendimento clínico de portadores de úlceras crônicas em membros inferiores(2015) AGUIAR JR, ARMANDO COSTA; ISAAC, CESAR; NICOLOSI, JULIA TEIXEIRA; MEDEIROS, MARIO MUCIO MAIA DE; PAGGIARO, ANDRÉ OLIVEIRA; GEMPERLI, ROLFABSTRACT Introduction: Chronic ulcers of the lower limbs may have different etiologies, with the most frequent being venous, arterial, traumatic, infectious, and diabetic. The treatment of these wounds is dynamic and depends on the evolution of tissue repair. This treatment includes clinical and surgical methods, and dressings are the most frequently used. Dressings can range from inert covers to vehicles for actuation of active substances in the wound bed. The main indication for these substances is related to the effects of debridement and control of the bacterial population, enabling the preparation of wound beds for surgical or spontaneous resolution. Methods: This study is an observational, cross-sectional, retrospective study, with random sampling, aimed at assessing the care provided to patients with chronic ulcers of the lower limbs in the Outpatient Clinic for chronic wounds of the Plastic Surgery Division, HCFMUSP, between 2011 and 2013. Results: The clinical charts of 481 patients of both sexes, with a mean age 60 years, were analyzed; all had chronic ulcers in different stages of evolution. Comorbidities, underlying disease, size of the lesion, treatments, and evolution of wounds were evaluated. A predominance of vascular disease (69.2%) was the underlying cause. All patients were initially treated with dressings containing active agents, for preparation of the wound bed. Of these, 84% were referred for surgical management of wounds. There was no spontaneous closure in 1.5% of cases. The remaining patients (14.5%) showed worsening of lesions with topical treatment, and required other forms of preparation of the wound bed. Conclusion: Topical agents may be an effective outpatient/home method to prepare the wound bed of chronic ulcers for surgical management.
- Terapias compressivas no tratamento de úlcera venosa: estudo bibliométrico(2015) TEIXEIRA NICOLOSI, Júlia; CEREIJIDO ALTRAN, Silvana; PIRO BARRAGAM, Jéssica; FERNANDES DE CARVALHO, Viviane; ISSAC, CésarIntroduction: Venous ulcers are skin lesions, which usually affect the lower third of the legs. The treatment of these wounds is dynamic and depends on the tissue repair process. Clinical and surgical procedures are included among those therapies, and the therapeutic compressive most often used non-surgical method. Inelastic and elastic bandages, elastic stockings and intermittent pneumatic pressure are the most common compressive therapy used. Objective: This study aimed to identify the national and international scientific literature profile describing compression therapy and venous ulcers and classify that profile according to: chronology of publication, country, periodicals that are published review of 'Qualis' - CAPES, distribution of the methodological approach, analysis of the publications content and compare, where possible, the data presented. Method: bibliometric study conducted in the Medline, Lilacs and CINAHL databases using the keywords ""Varicose Ulcer / therapy"", ""Compression Bandages"", ""Wound Healing"" and boleyn word AND between the years 2009-2013. Results: 47 articles were selected, the major part was published in 2012 (n = 12, 25.53 %), the United States (n = 14, 29.78 %) and the United Kingdom (n = 14, 29.78%), in vascular surgery specialized magazines (n = 19, 40.42%), Qualis A2 (n = 13, 27.65 %) and B1 (n = 13, 27.65 %). Much of the methodology used in the selected studies was ""clinical studies"" type (n = 30, 63.82 %). Only 30 % ( n = 14 ) had as main objective assessment of compressive therapy and intended study compared the effectiveness of elastic bandages, inelastic, elastic stockings , intermittent pneumatic pressure and absence compression therapy for the treatment of venous ulcers. Conclusions: There is a concern, in the scientific community, about the research for effective treatment for venous ulcers. However, the worldwide distribution of publications is uneven. It was evident that compression therapy is not the main object in the majority of selected studies emerging interest in adjuvant or complementary to such therapies. It is evident the compressive therapy need, but there is no consensus on which pressure should be used for best results in healing and more studies must be performed to evaluate the interference of different pressures levels on the tissue repair process . There is also a lack of studies demonstrating the action of intermittent pneumatic pressure or not associations with elastic bandages