JULIO MORAIS BESTEIRO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
bookPart 0 Citação(ões) na Scopus Mandible reconstruction with fibula microvascular transfer(2012) BESTEIRO, J. M.- Mandible Reconstruction with Fibula Microvascular Transfer(2012) BESTEIRO, Julio Morais
- A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients(2012) ALVES, Helio R. N.; ISHIDA, Luis C.; ISHIDA, Luis H.; BESTEIRO, Julio M.; GEMPERLI, Rolf; FARIA, Jose C. M.; FERREIRA, Marcus C.The supraclavicular island flap has been widely used in head and neck reconstruction, providing an alternative to the traditional techniques like regional or free flaps, mainly because of its thin skin island tissue and reliable vascularity. Head and neck patients who require large reconstructions usually present poor clinical and healing conditions. An early experience using this flap for late-stage head and neck tumour treatment is reported. Forty-seven supraclavicular artery flaps were used to treat head and neck oncologic defects after cutaneous, intraoral and pharyngeal tumour resections. Dissection time, complications, donor and reconstructed area outcomes were assessed. The mean time for harvesting the flaps was 50 min by the senior author. All donor sites were closed primarily. Three cases of laryngopharyngectomy reconstruction developed a small controlled (salivary) leak that was resolved with conservative measures. Small or no strictures were detected on radiologic swallowing examinations and all patients regained normal swallowing function. Five patients developed donor site dehiscence. These wounds were treated with regular dressing until healing was complete. There were four distal flap necroses in this series. These necroses were debrided and closed primarily. The supraclavicular flap is pliable for head and neck oncologic reconstruction in late-stage patients. High-risk patients and modified radical neck dissection are not contraindications for its use. The absence of the need to isolate the pedicle offers quick and reliable harvesting. The arc of rotation on the base of the neck provides adequate length for pharyngeal, oral lining and to reconstruct the middle and superior third of the face.
- How to Perform a Supraclavicular Fasciocutaneous Flap for Head and Neck Reconstruction(2012) ALVES, Helio R. N.; BESTEIRO, Julio M.; CERNEA, Claudio C.
- Light-emitting diode stimulates radiodermatitis recovery(2021) CAMARGO, Cristina Pires; CARVALHO, Heloisa Andrade; MALUF, Feres Camargo; SOUSA, Alexandre Agostinho da Cruz; PERIN, Paulo Otavio Maluf; PERIN, Marcela Maluf; MORAIS-BESTEIRO, Julio; GEMPERLI, RolfPurpose: To evaluate the effect of light-emitting diode (LED) in an experimental mod& of radiodermatitis. Methods: Ten male Wistar rats weighing 200-250 g were analyzed. Radiation was delivered in a single dose (20 Gy with Strontium-90 dermatological plaques), two areas per animal. After 15 days, they were divided into two groups: control group (n =5) and LED group (n =5), which was treated during 21 days later (LED 660 nm, 10 min in alternate days). The endpoints were radiodermatitis scale, histological analysis HE, Picrius Sirius and the gene expression of interleukin-10 (IL-10) and matrix metalloproteinase-9 (MMP-9). Results: The LED group showed a higher number of dermal appendages (p = 0.04) and angiogenesis (p = 0.007), a tendency towards higher IL-10 (p = 0.06) and an increase in MMP-9 (p = 0.004) when compared to the control group. Conclusion: This study suggested that the use of LED for radiodermatitis increased skin regeneration.
- Hyaluronic acid in tobacco-exposed rats. Inflammatory reaction, and duration of effects(2019) CAMARGO, Cristina Pires; FRASSEI, Renan Dias; SILVA, Daniel Imbassahy de Sa Bittencourt Camara e; PFANN, Robert Zawadzki; SILVA, Luiza de Campos Moreira da; MORAIS-BESTEIRO, Julio; GEMPERLI, RolfPurpose: To evaluate the hyaluronic acid (HA) inflammatory reaction, fibroblasts, fibrosis and duration of effect in the dorsal region of tobacco-exposed rats. Methods: Ten Wistar rats were divided into two groups: tobacco-exposed-group (TEG;n=5) and air-control-group (CG;n=5). The TEG animals were tobacco-exposed twice a day, 30-minutes/session, during 60 days. After this period, all animals received 0.1 mL HA subcutaneous injection in the dorsal area. The volume of HA was measured immediately after HA injection and weekly using a hand-caliper in nine weeks. After this period, all the animals were euthanized, and a specimen of was collected to evaluate inflammatory cells, fibroblasts, and fibrosis by HE. Results: This study showed a higher inflammatory reaction in TEG than CG: inflammatory cell-count (CG: 1.07 +/- 0.9; TEG: 8.61 +/- 0.36, p<0.001); fibroblast count (CG: 2.92 +/- 0.17; TEG: 19.14 +/- 0.62, p<0.001), and fibrosis quantification (CG: 2.0; TEG: 3.75, p<0.001). The analysis of the HA volume in nine weeks in the dorsal region did not show a difference between groups (p=0.39). Conclusions: This study suggested that the HA injection in the TEG caused an increase in inflammatory cell count, fibroblast, and fibrosis quantification when compared to the CG. There was no difference in the duration of effect of HA between the groups.
- Prelaminated Supraclavicular Island Flap for Total Ear Reconstruction: A New Technique(2020) ALVES, Helio R. N.; RODRIGUEZ, Juan Felippe G. U. M. de; FERNANDES, Thadeu R. R.; BUSNARDO, Fabio F.; BESTEIRO, Julio M.; CERNEA, Claudio Roberto; GEMPERLI, RolfMajor ear reconstruction has progressed over the past years with the emergence of new techniques directed mainly to patients without available or usable local skin. However, microsurgical transfer requires specific training and eligible patients. The authors report a successful ear reconstruction with a prelaminated supraclavicular island flap in 3 stages, which may be a valuable resource for selected patients or when microsurgery is not available. Advantages and disadvantages of this new technique are discussed, and a possible solution to achieve a more satisfactory result is suggested.
- Rectus Abdominis Flap(2012) BESTEIRO, Julio Morais
- The influence of adipocyte-derived stem cells (ASCs) on the ischemic epigastric flap survival in diabetic rats(2021) CAMARGO, Cristina Pires; KUBRUSLY, Marcia Saldanha; MORAIS-BESTEIRO, Julio; HARMSEN, Martim Conrad; GEMPERLI, RolfPurpose: To assess the effects of adipocyte-derived stem cell (ASC)-injection on the survival of surgical flaps under ischemia in diabetic rats. Methods: Diabetes was induced in 30 male Wistar rats using streptozotocin (55 mg/kg). After eight weeks, epigastric flap (EF) surgery was performed. The animals were divided into control (CG), medium-solution (MG), and ASC groups. The outcomes were: the survival area (SA), the survival/total area rate (S/TR), and expression levels (EL) of genes: C5ar1, Icam1, Nos2, Vegf-a. Results: In the ASC group, compared to CG, we observed improved flap SA (CG-420 mm(2) vs. ASC-720 mm(2); p=0.003) was observed. The S/TR analysis was larger in the ASC group (78%) than the CG (45%). This study showed an increase in the Vegf-a EL in the ASC group (2.3) vs. CG (0.93, p=0.0008). The Nos2 EL increased four-fold in the ASC group compared to CG, and C5ar1 EL decreased almost two-fold in the ASC group vs. the CG (p=0.02). There was no difference among the groups regarding Icam1 EL. Compared to the MG, the ASC group had a bigger flap SA (720 mm(2) vs. 301 mm(2), respectively), a bigger S/TR (78% vs. 32%, p=0.06, respectively) and increased EL of Vegf-a (2.3 vs. 1.3, respectively). No difference between ASC-group and MG was seen regarding Nos2 (p=0.08) and C5ar1 (p=0.05). Conclusion: This study suggests that ASCs increase the survival of EF under IR in diabetic rats.
- A non-living, effective model for microvascular training(2017) CAMARGO, Cristina Pires; SILVA, Daniel Imbassahy de Sa Bittencourt de Camara e; MALUF, Fauze Camargo; MORAIS-BESTEIRO, Julio; GEMPERLI, RolfPurpose: To introduce a nonliving microvascular training model based on vessels diameter and feasibility. Methods: We dissected ten oxen tongues, and divided the pedicles into three-thirds: proximal, middle and distal. We measured the external vessels diameter in all regions. We performed a descriptive statistical analysis. Three students (two beginner level and one intermediate level) performed this training. We evaluated the confidence, according Likert scale. Results: We dissected all oxen tongues, each tongue showed two parallel pedicles. Each pedicle was located at 1.5 - 2.0 cm from the midline. Proximal median artery and vein diameter were 3.9 +/- 0.7, and 5.04 +/- 1.44mm, respectively. In the middle third, the mean artery diameter was 3.3 +/- 0.4mm, and the vein diameter was 3.5 +/- 0.9mm. The distal third showed a mean artery diameter of 2.0 +/- 0.42mm, and a vein diameter of 2.4 +/- 0.82mm. The students performed ten anastomoses. This study showed a higher confidence level (CL) (p=0.03) than the pre training CL assessment. Conclusion: This study suggested a feasible non-animal model for microsurgical training process for beginners and intermediate trainees.