JOHNNY LEANDRO CONDUTA BORDA ALDUNATE

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PAHC, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina

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  • article
    Uso de matriz dérmica associado ao curativo por pressão negativa na abordagem da contratura em pacientes queimados
    (2012) ALDUNATE, Johnny Leandro Conduta Borda; VANA, Luiz Philipe Molina; FONTANA, Carlos; FERREIRA, Marcus Castro
    BACKGROUND: Burn patients are initially treated with volume replacement and, importantly, subsequent excision and early grafting of their injuries. These first aid measures improve the progress and survival rates of burned individuals. However, this treatment creates a new challenge in reparative surgery with regard to the management of burn sequelae, which mainly include contractures. In this study, we aimed to assess the effect of artificial dermal matrix application and negative pressure therapy on the treatment of burn sequelae. METHODS: Ten patients with burn contractures were selected for this study and underwent scar contracture release, wound coverage with an artificial dermal matrix (Integra®), and negative pressure dressing according to the standard procedures. Dressing changes were performed every 5 days for 3-4 weeks. A skin graft was then laid on the wound bed. In the pre- and postoperative period, the patients were asked to rate their satisfaction with the aesthetic and functional aspects of the treated region. RESULTS: In the areas in which the contractures were resected, integration of almost 98% of the dermal regeneration matrix was observed. Also integration was observed in 85% of the grafts used. All the patients reported a significant aesthetic and, in particular, functional improvement of the treated region. CONCLUSIONS: The use of dermal regeneration matrix and negative pressure therapy for the treatment of scar contractures improves the success rate and the aesthetic and functional outcomes of patients with severe burn sequelae.
  • article
    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 Castro
    BACKGROUND: 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.