Efeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinos

Detalhes bibliográficos
Autor(a) principal: Pereira, Roberta Carneiro da Fontoura
Data de Publicação: 2016
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações do UFSM
Texto Completo: http://repositorio.ufsm.br/handle/1/11647
Resumo: Platelet rich plasma (PRP) is a product obtained from whole blood through one or two centrifugations, resulting in small volume of plasma containing high number of platelets and growth factors. The growth factors from the α-granules are platelet components that are important in the homeostasis of injured tissues beginning and regulating some stages of tissue healing, promoting chemotaxis, cell proliferation and differentiation, neovascularization and deposition of extracellular matrix. Wound healing of skin lesions distal to the carpus or tarsus of horses, usually are complicated by the reduced blood supply, low oxygen tension and increased risk of bacterial contamination. In many cases when wounds are not treated properly, they can become chronic with excessive formation of granulation tissue. Tendinitis and desmites are pathologies characterized by degeneration of tendons and ligaments. The tissue degeneration mechanism of these structures is attributed to mechanical factors, vascular and inflammatory. Tendinitis and desmitis are common pathologies of equine athletes, these diseases tend to have long recovery periods, due to histological, anatomic and biomechanical features of tendons and ligaments. This thesis presents studies of 8 horses, in order to evaluate the clinical effect and the presence of recurrence lesions, of use of PRP and exercise controlled in the treatment of tendon and ligament injuries, through the clinical and ultrasonographic evaluation (CHAPTER 1), review by clinical and histopathological evolution the healing process of surgical wounds located at the distal region of forelimbs treated by three different methods of application of PRP (CHAPTER 2), and also determine the best form to PRP application to equine skin wounds ( CHAPTER 2.) In Chapter 1, it included eight horses, with an average age of 5 years (± 2.6) diagnosed with injuries in tendons and ligaments, through clinical and ultrasonographic evaluation. These animals underwent treatment with intralesional PRP, guided by ultrasound. The animals μL diagnosed with tendonitis (4/8) had lesion scores of 2.3 (± 0.57) (score 1 to 3), mean platelet concentration of 512.250 / uL (± 144.965) and average healing time of 262 days (± 82) (Table 2). In contrast, animals with desmitis (4/8) in the suspensory ligament injuries had a score of 2.6 (± 0.57) (score 1 to 3), mean platelet concentration of 566.500 / uL (± 97.722) and average healing time 120 days (± 42) (table 3). In this study no correlation was found between the number of platelets in the PRP, and the time for healing of tendonitis and desmitis. Clinical and ultrasonographic monitoring of intralesional injections of PRP, followed by gradual increase of exercise program, allowed the horses to return to his previous athletic activity without recurrence of the lesions. In Chapter 2 we used eight healthy horses, with an average age of 8 years (± 3.76), which were created four wounds of 4 cm2 area in the dorsolateral aspect of the third cannon bone, two on the left forelimb (A1 and A2) and two on the right forelimb (A3 and A4) (figure 1). The cutaneous lesions were treated according to the established treatment group. In the same animal, each of the four wounds were assigned to one of four treatment groups at random, for each treatment group obtained eight replicates in different regions in the forelimbs (Figure 1). In the group (G) I, the skin lesions were treated with PRP infiltration of the wound edges, the GII PRP was used in gel form, the GIII was used homologous PRP and GIV as a control group (without PRP application). In the wounds treated with the GII was reduced to a fortnight in healing time compared the wounds treated with the GIV. Histopathology GII presented a higher frequency of mild inflammation and neovascularization mild to moderate in biopsies 1 and 2. The GIV had the highest intensity of granulating wounds between the groups. PRP in gel form, both in the clinical evaluation as the histopathology showed the best result in the application on wounds in the distal member of horses. The homologous PRP can also be used as adjuvant in equine wound healing.
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spelling 2017-09-12T13:20:47Z2017-09-12T13:20:47Z2016-03-11http://repositorio.ufsm.br/handle/1/11647Platelet rich plasma (PRP) is a product obtained from whole blood through one or two centrifugations, resulting in small volume of plasma containing high number of platelets and growth factors. The growth factors from the α-granules are platelet components that are important in the homeostasis of injured tissues beginning and regulating some stages of tissue healing, promoting chemotaxis, cell proliferation and differentiation, neovascularization and deposition of extracellular matrix. Wound healing of skin lesions distal to the carpus or tarsus of horses, usually are complicated by the reduced blood supply, low oxygen tension and increased risk of bacterial contamination. In many cases when wounds are not treated properly, they can become chronic with excessive formation of granulation tissue. Tendinitis and desmites are pathologies characterized by degeneration of tendons and ligaments. The tissue degeneration mechanism of these structures is attributed to mechanical factors, vascular and inflammatory. Tendinitis and desmitis are common pathologies of equine athletes, these diseases tend to have long recovery periods, due to histological, anatomic and biomechanical features of tendons and ligaments. This thesis presents studies of 8 horses, in order to evaluate the clinical effect and the presence of recurrence lesions, of use of PRP and exercise controlled in the treatment of tendon and ligament injuries, through the clinical and ultrasonographic evaluation (CHAPTER 1), review by clinical and histopathological evolution the healing process of surgical wounds located at the distal region of forelimbs treated by three different methods of application of PRP (CHAPTER 2), and also determine the best form to PRP application to equine skin wounds ( CHAPTER 2.) In Chapter 1, it included eight horses, with an average age of 5 years (± 2.6) diagnosed with injuries in tendons and ligaments, through clinical and ultrasonographic evaluation. These animals underwent treatment with intralesional PRP, guided by ultrasound. The animals μL diagnosed with tendonitis (4/8) had lesion scores of 2.3 (± 0.57) (score 1 to 3), mean platelet concentration of 512.250 / uL (± 144.965) and average healing time of 262 days (± 82) (Table 2). In contrast, animals with desmitis (4/8) in the suspensory ligament injuries had a score of 2.6 (± 0.57) (score 1 to 3), mean platelet concentration of 566.500 / uL (± 97.722) and average healing time 120 days (± 42) (table 3). In this study no correlation was found between the number of platelets in the PRP, and the time for healing of tendonitis and desmitis. Clinical and ultrasonographic monitoring of intralesional injections of PRP, followed by gradual increase of exercise program, allowed the horses to return to his previous athletic activity without recurrence of the lesions. In Chapter 2 we used eight healthy horses, with an average age of 8 years (± 3.76), which were created four wounds of 4 cm2 area in the dorsolateral aspect of the third cannon bone, two on the left forelimb (A1 and A2) and two on the right forelimb (A3 and A4) (figure 1). The cutaneous lesions were treated according to the established treatment group. In the same animal, each of the four wounds were assigned to one of four treatment groups at random, for each treatment group obtained eight replicates in different regions in the forelimbs (Figure 1). In the group (G) I, the skin lesions were treated with PRP infiltration of the wound edges, the GII PRP was used in gel form, the GIII was used homologous PRP and GIV as a control group (without PRP application). In the wounds treated with the GII was reduced to a fortnight in healing time compared the wounds treated with the GIV. Histopathology GII presented a higher frequency of mild inflammation and neovascularization mild to moderate in biopsies 1 and 2. The GIV had the highest intensity of granulating wounds between the groups. PRP in gel form, both in the clinical evaluation as the histopathology showed the best result in the application on wounds in the distal member of horses. The homologous PRP can also be used as adjuvant in equine wound healing.O plasma rico em plaquetas (PRP) é um produto obtido do sangue total, através de uma ou duas centrifugações, resultando em um pequeno volume deste plasma contendo elevado número de plaquetas e fatores de crescimento. Estes fatores de crescimento, provenientes dos α-grânulos plaquetários, são componentes importantes na homeostase de tecidos lesados, iniciando e regulando alguns estágios da cicatrização tecidual, por promover quimiotaxia, proliferação e diferenciação celular, neovascularização e deposição de matriz extracelular. As tendinites e desmites são patologias caracterizadas pela degeneração de tendões e ligamentos. O mecanismo de degeneração tecidual destas estruturas é atribuído a fatores mecânicos, vasculares e inflamatórios. As lesões tendíneas e ligamentares comprometem a performance atlética de equinos e cursam com longos períodos de cicatrização, devido às características de composição histológica, anatômica e biomecânica destas estruturas. A cicatrização das feridas localizadas distais ao carpo ou tarso de equinos é geralmente complicada pela falta de tecido de revestimento, menor suprimento sanguíneo, baixa concentração de oxigênio nos tecidos e maior risco de contaminação bacteriana. Em muitos casos quando não tratadas adequadamente, as feridas poderão tornar-se crônicas, com crescimento exacerbado do tecido de granulação. Na presente tese, são apresentados estudos com equinos com a finalidade de avaliar o efeito clínico, do número de plaquetas em relação ao tempo de cicatrização e índice de recidivas da utilização do PRP associado à exercícios controlados no tratamento de lesões tendíneas e ligamentares, avalidos por meio do exame clínico e ultrassonográfico (CAPÍTULO 1). Neste estudo também foi avaliado o processo de cicatrização de feridas cirúrgicas experimentais, localizadas na região distal dos membros locomotores, tratadas com três métodos distintos de aplicação do PRP e avaliada através da evolução clínica e histopatológica. Objetivou-se determinar a melhor forma de aplicação do PRP em feridas cutâneas de equinos (CAPÍTULO 2). No capítulo 1, foram incluídos oito equinos, com idade média de 5 anos (±2,6), diagnosticados com lesões em tendões e ligamentos, através da avaliação clínica e ultrassonográfica. Esses animais foram submetidos ao tratamento intralesional com PRP, guiado por ultrassonografia. Os animais diagnosticados com tendinite (4/8) tiveram escore das lesões de 2,3 (±0.57)(escala 1 a 3), média da concentração plaquetária de 512.250 /μl (± 144.965) e tempo médio de cicatrização de 262 dias (±82) (tabela 2). Em contrapartida, os animais com desmite (4/8) no ligamento suspensório apresentaram escore das lesões de 2,6 (± 0,57)( escala 0 a 3), média da concentração plaquetária de 566.500 /μl (± 97.722) e tempo médio de cicatrização de 120 dias (± 42) (tabela 3). Não foi observada correlação entre o número de plaquetas do PRP e o tempo de cicatrização das tendinites e desmites. A monitoração clínica e ultrassonográfica da resposta às injeções intralesionais de PRP, seguidas de programa de incremento gradual de exercício, permitiu que os cavalos retornassem à sua atividade atlética prévia sem recidiva das lesões. No capítulo 2 foram utilizados oito equinos hígidos, com idade média de 8 anos (± 3,76), onde foram criadas quatro feridas cutâneas de 4 cm2 de área, no aspecto dorsolateral do terceiro osso metarcapiano, duas no membro torácico esquerdo (A1 e A2) e duas no membro torácico direito (A3 e A4). As lesões cutâneas foram tratadas com três aplicações de PRP de acordo com o grupo estabelecido aleatoriamente. No grupo (G) I, as lesões cutâneas foram tratadas com infiltração de PRP nas bordas da ferida, no GII o PRP foi utilizado na forma gel sobre a área total da ferida, no GIII foi usado PRP homólogo e o GIV serviu como grupo controle (apenas aplicação de solução fisiológica) com infiltração nas bordas da ferida. Desta maneira, os quatro tratamento foram aplicados nas 4 feridas de um mesmo animal. Para cada grupo de tratamento obtivemos oito repetições em regiões distintas nos membros torácicos, nos oito cavalos avaliados. No GII houve redução de 15 dias no tempo de cicatrização quando comparada às feridas do GIV. Na análise histopatológica o GII apresentou maior frequência de inflamação leve e neovascularização leve a moderada, nas biópsias 1 e 2. O GIV apresentou a maior intensidade de granulação das feridas entre os grupos avaliados. O PRP na forma gel, tanto na avaliação clínica como na histopatológica apresentou o melhor resultado na aplicação em feridas cutâneas no membro distal de equinos. O PRP homólogo também pode ser utilizado como terapia celular adjuvante na cicatrização cutânea de equinos.porUniversidade Federal de Santa MariaCentro de Ciências RuraisPrograma de Pós-Graduação em Medicina VeterináriaUFSMBrasilMedicina VeterináriaAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessPRPLesões cutâneasTendõesLigamentosUltrassonografiaSkin lesionsTendonsLigamentsUltrasoundCNPQ::CIENCIAS AGRARIAS::MEDICINA VETERINARIAEfeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinosClinical effect of platelet-rich plasma on cutaneous, tendinous and ligament lesions in horsesinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisDe La Côrte, Flávio Desessardshttp://lattes.cnpq.br/4040388452531898Krause, Alexandrehttp://lattes.cnpq.br/7760558908777387Muller, Daniel Curvello de Mendonçahttp://lattes.cnpq.br/9457849435452537Castro Junior, Jarbas Francisco da Costahttp://lattes.cnpq.br/8240530443510245Inkelmann, Maria Andréiahttp://lattes.cnpq.br/4522716316684753http://lattes.cnpq.br/7043973472257026Pereira, Roberta Carneiro da Fontoura5005000000076007d696fdf-546c-4c47-9f54-d36a1cf7e6b11287df12-987e-4c4e-a179-c1264690529b48b1731f-9fa9-4553-ab4a-18302b9fc514c2fbc457-3292-4bfd-bda0-950752de1a58c9332065-928d-4b64-a7a0-a2784a44e55d933a74a2-5a19-4412-90c7-52da1a176e8creponame:Biblioteca Digital de Teses e Dissertações do UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALPereira, Roberta Carneiro da Fontoura.pdfPereira, Roberta Carneiro da Fontoura.pdfTese de Doutoradoapplication/pdf1274910http://repositorio.ufsm.br/bitstream/1/11647/1/Pereira%2c%20Roberta%20Carneiro%20da%20Fontoura.pdf7edd1d28e66d4108879d699884a97dd3MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; 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dc.title.por.fl_str_mv Efeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinos
dc.title.alternative.eng.fl_str_mv Clinical effect of platelet-rich plasma on cutaneous, tendinous and ligament lesions in horses
title Efeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinos
spellingShingle Efeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinos
Pereira, Roberta Carneiro da Fontoura
PRP
Lesões cutâneas
Tendões
Ligamentos
Ultrassonografia
Skin lesions
Tendons
Ligaments
Ultrasound
CNPQ::CIENCIAS AGRARIAS::MEDICINA VETERINARIA
title_short Efeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinos
title_full Efeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinos
title_fullStr Efeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinos
title_full_unstemmed Efeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinos
title_sort Efeito clínico do plasma rico em plaquetas em lesões cutâneas, tendíneas e ligamentares de equinos
author Pereira, Roberta Carneiro da Fontoura
author_facet Pereira, Roberta Carneiro da Fontoura
author_role author
dc.contributor.advisor1.fl_str_mv De La Côrte, Flávio Desessards
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/4040388452531898
dc.contributor.referee1.fl_str_mv Krause, Alexandre
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/7760558908777387
dc.contributor.referee2.fl_str_mv Muller, Daniel Curvello de Mendonça
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/9457849435452537
dc.contributor.referee3.fl_str_mv Castro Junior, Jarbas Francisco da Costa
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/8240530443510245
dc.contributor.referee4.fl_str_mv Inkelmann, Maria Andréia
dc.contributor.referee4Lattes.fl_str_mv http://lattes.cnpq.br/4522716316684753
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/7043973472257026
dc.contributor.author.fl_str_mv Pereira, Roberta Carneiro da Fontoura
contributor_str_mv De La Côrte, Flávio Desessards
Krause, Alexandre
Muller, Daniel Curvello de Mendonça
Castro Junior, Jarbas Francisco da Costa
Inkelmann, Maria Andréia
dc.subject.por.fl_str_mv PRP
Lesões cutâneas
Tendões
Ligamentos
Ultrassonografia
topic PRP
Lesões cutâneas
Tendões
Ligamentos
Ultrassonografia
Skin lesions
Tendons
Ligaments
Ultrasound
CNPQ::CIENCIAS AGRARIAS::MEDICINA VETERINARIA
dc.subject.eng.fl_str_mv Skin lesions
Tendons
Ligaments
Ultrasound
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS AGRARIAS::MEDICINA VETERINARIA
description Platelet rich plasma (PRP) is a product obtained from whole blood through one or two centrifugations, resulting in small volume of plasma containing high number of platelets and growth factors. The growth factors from the α-granules are platelet components that are important in the homeostasis of injured tissues beginning and regulating some stages of tissue healing, promoting chemotaxis, cell proliferation and differentiation, neovascularization and deposition of extracellular matrix. Wound healing of skin lesions distal to the carpus or tarsus of horses, usually are complicated by the reduced blood supply, low oxygen tension and increased risk of bacterial contamination. In many cases when wounds are not treated properly, they can become chronic with excessive formation of granulation tissue. Tendinitis and desmites are pathologies characterized by degeneration of tendons and ligaments. The tissue degeneration mechanism of these structures is attributed to mechanical factors, vascular and inflammatory. Tendinitis and desmitis are common pathologies of equine athletes, these diseases tend to have long recovery periods, due to histological, anatomic and biomechanical features of tendons and ligaments. This thesis presents studies of 8 horses, in order to evaluate the clinical effect and the presence of recurrence lesions, of use of PRP and exercise controlled in the treatment of tendon and ligament injuries, through the clinical and ultrasonographic evaluation (CHAPTER 1), review by clinical and histopathological evolution the healing process of surgical wounds located at the distal region of forelimbs treated by three different methods of application of PRP (CHAPTER 2), and also determine the best form to PRP application to equine skin wounds ( CHAPTER 2.) In Chapter 1, it included eight horses, with an average age of 5 years (± 2.6) diagnosed with injuries in tendons and ligaments, through clinical and ultrasonographic evaluation. These animals underwent treatment with intralesional PRP, guided by ultrasound. The animals μL diagnosed with tendonitis (4/8) had lesion scores of 2.3 (± 0.57) (score 1 to 3), mean platelet concentration of 512.250 / uL (± 144.965) and average healing time of 262 days (± 82) (Table 2). In contrast, animals with desmitis (4/8) in the suspensory ligament injuries had a score of 2.6 (± 0.57) (score 1 to 3), mean platelet concentration of 566.500 / uL (± 97.722) and average healing time 120 days (± 42) (table 3). In this study no correlation was found between the number of platelets in the PRP, and the time for healing of tendonitis and desmitis. Clinical and ultrasonographic monitoring of intralesional injections of PRP, followed by gradual increase of exercise program, allowed the horses to return to his previous athletic activity without recurrence of the lesions. In Chapter 2 we used eight healthy horses, with an average age of 8 years (± 3.76), which were created four wounds of 4 cm2 area in the dorsolateral aspect of the third cannon bone, two on the left forelimb (A1 and A2) and two on the right forelimb (A3 and A4) (figure 1). The cutaneous lesions were treated according to the established treatment group. In the same animal, each of the four wounds were assigned to one of four treatment groups at random, for each treatment group obtained eight replicates in different regions in the forelimbs (Figure 1). In the group (G) I, the skin lesions were treated with PRP infiltration of the wound edges, the GII PRP was used in gel form, the GIII was used homologous PRP and GIV as a control group (without PRP application). In the wounds treated with the GII was reduced to a fortnight in healing time compared the wounds treated with the GIV. Histopathology GII presented a higher frequency of mild inflammation and neovascularization mild to moderate in biopsies 1 and 2. The GIV had the highest intensity of granulating wounds between the groups. PRP in gel form, both in the clinical evaluation as the histopathology showed the best result in the application on wounds in the distal member of horses. The homologous PRP can also be used as adjuvant in equine wound healing.
publishDate 2016
dc.date.issued.fl_str_mv 2016-03-11
dc.date.accessioned.fl_str_mv 2017-09-12T13:20:47Z
dc.date.available.fl_str_mv 2017-09-12T13:20:47Z
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dc.identifier.uri.fl_str_mv http://repositorio.ufsm.br/handle/1/11647
url http://repositorio.ufsm.br/handle/1/11647
dc.language.iso.fl_str_mv por
language por
dc.relation.cnpq.fl_str_mv 500500000007
dc.relation.confidence.fl_str_mv 600
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dc.rights.driver.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Universidade Federal de Santa Maria
Centro de Ciências Rurais
dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Medicina Veterinária
dc.publisher.initials.fl_str_mv UFSM
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Medicina Veterinária
publisher.none.fl_str_mv Universidade Federal de Santa Maria
Centro de Ciências Rurais
dc.source.none.fl_str_mv reponame:Biblioteca Digital de Teses e Dissertações do UFSM
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reponame_str Biblioteca Digital de Teses e Dissertações do UFSM
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