enconlram as alterac;6es IDtermedlanas da desnatura~ao da flbra colagena com
ncoforma~ao da<;mesmas, provocando a contra~ao da pele ap6s a aphca~ao do laser
(T ANG ct aI, 1997) Estes achado<; foram ~Imllares aos encontrado<; por
RODRIGUES (2000), embora a zona de fibroplasia fOl maiS espessa com
0laser de
CO
2,plOvavelmente devldo a mal or nccro<;e coagulatlva do tecldo provocada pOI este
ultimo
0que leva a lmedlata e vl<;fvel contra~ao tecldual pOl daoo tCImlco do
colageno (ALSTER. 1999)
Neste estudo fOl observado um espe<;5amento da derme papllar a<; cu<;ta<;de neoforma<;ao colagena que aumenlou progresslvamente ate 0 fmal do expenmento quando a neocolagenese alcan~ou 0 ~eu maximo No mfclO 0 colageno e llnatUlo, com grande quanudade de fIblOblastos Jovens e flbl as colagena<; menos densas, devldo a grande quantldade de agua que p055uem (HUGHES. 1998) A partlr daf 0 teCido conJuntlvo val amadurecendo plOgre<;5lvamenle com malOr depo"l~ao de col<lgeno mauuro, que e le<;pon<,avel pelo e5pes<;amenlo das areas lesadas pelo la<;er no perfodo de clcalnLa<;ao (NANN I e ALSTER, 1998) No dla
56
Ja fOI observado malor quanudade de colageno maduro, que e meno<; celular e com menor quantldade de agua, que ~e manteve ate 0 dla 112 Estes achados dlferem do<; encontrad05 por GRAF (2000) e RODRIGUES (2000), onde na pele normal a fibroplasIa a1cmwou 0 <;eu maxImo no dla 28 e56,
re5peCtIvdmente, e decam progre~slvamente ate 0 dla 1120
retardo da [lbroplasJa nC5te e<,tudo com a sua manutenC(ao elevdda provavelmcnte <;cna cau5ada pela lsquemla caracterhllca d05 retalhos cutaneo<; ate a reconstltUl<;ao dos va<;o<;sangufneos secclOnado<;A celula lespon<>avel pela deposl<;ao de colageno nd denne em ploce<;<;o de Clcatnza<;do e 0 flblOb1asto (SINGER e CLARK, 1999) O~ fIbroblastos nece<;<;ano5 a Clcatnza<;uo cutanea <;e acumulam no tecldo
a
partIr de dlferencla<;ao de ftbr6cltos plesente~ na denne re<;tante vIJ.vel e da mlgra<;ao de lecluos vlzmhos atrave<; de contlgUlddde tecldual ou aporte vasculal atl ave~ da dlferencla<;3.0 dos mon6clto<; Na derme. os f1brobla<;to5 prontamente se mull1pl1cam e come<;am a ploduzlr colageno novo No plesentc e5tudo [01 nOlado que a area de fIbroplasia dermlca apresenla-se bem dlfelencJada a partIr do dw 14 com aumento proglesslvo na <;ua espessura ate 0dIU 112. representando esle dJa 0 plCO da deposl~ao de colageno Esles resultados dlfelem dos observados por GRAF (2000), que observou 0 plCO da fIbroplasIa no dw 28 c SECKEL, YOUNAI e WANG (1998) e por RODRIGUES (2000). no dw
56
No trabalho de ROSS et al (1999) fOl observado urn aumento da fIbroplasIa do dla 21 para 0 dla 42 do expenmento•
6 CONCLUSOES
Ba~ead05 nos resultados obtldo,> ne~te e~tudo pode-se conclulr que 0 la"er de ErblUm-Y AG
nao alterou a vlablhdade do retalho quando comparado com 0 glUpO contro1c, apresentando area" vHlvels dos retalhos semelhante,> com p=O,OOI5,
2 promoveu, atraves da planIlnetna digital a contra<;ao cutiinea lInedJata de 22,05%
(p<O,OOOI) e e5ta 5e manteve ate t1l1al do e5tudo com p=0,0090,
3 provocou 0 estfmulo do colageno, com neoforma<;ao de flbla" colagenas que ,>e dep051taram na derme de forma regular. dlspostas paralela5
a
eplderme. ob~ervadohlsrologlcamente, e que refletcm 0 grau de fibroplasIa presente durante todo 0 estudo,
4 atrave5 da mOl fomctna par Imagem apre,>entou uma zona de fibroplasia acentuadd, que se manteve ate 0 [1I1aldo expenmento,
5
0
laser de Er Y AG alterou os lesultado~ da tenslometna em todas as fa5cs do expenmento e a malOr carga de rllptura ocorrell no dla 56 0 alongamento de ruptura 5C manteve mcnor em todas as fases do cstlldo. ~endo estatIstlcamente slgl11flcante nos dla~ ] 4, 28 c 56 do estudo (p=O,0090)REFERENCIAS
..
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