RESUMO
BACKGROUND: After abdominoplasty, patients experience decreased ventilatory function and increased intra-abdominal pressure (IAP). Breathing exercises are used during the pre- and postoperative periods of several abdominal surgeries to prevent or minimize postoperative complications. OBJECTIVES: The aim of this study was to assess the effect of preoperative respiratory physiotherapy on the outcome of abdominoplasty patients. METHODS: Thirty-three patients were divided into 2 groups. The control group (n = 18) received no preoperative intervention. The intervention group (n = 15) performed breathing exercises during the preoperative period, including incentive spirometry, diaphragmatic breathing, shortened expiration, and sustained maximal inspiration. Respiratory physiotherapy started one week before surgery. Breathing exercises were performed daily. They were performed 3 times weekly in the presence of a physiotherapist and patients were instructed to carry on the exercises at home on days without physiotherapy sessions for three sets of 20 repetitions each. Patients were assessed by spirometry and IAP measurements. RESULTS: No significant difference in spirometry was found between groups. However, patients in the intervention group had lower IAP at the start of surgery and at all time points (P = 0.010) compared with controls. CONCLUSIONS: Preoperative respiratory physiotherapy had no impact on spirometry, but may have contributed to reduce IAP intraoperatively.
Assuntos
Abdominoplastia/efeitos adversos , Exercícios Respiratórios/métodos , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/métodos , Adulto , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: It has been demonstrated that there is an increase of intra-abdominal pressure (IAP) after correction of rectus diastasis. OBJECTIVE: To evaluate the correlation between the diastasis width and IAP variation after the plication of the anterior rectus sheath. METHODS: Seventeen patients met the inclusion criteria and were selected. The diastasis width was measured at three levels: 3 cm above the umbilicus, 2 cm above the umbilicus, and 2 cm below the umbilicus. Rectus sheath plication was performed in two layers: the first layer with separate stitches, and the second with continuous suture. The IAP was measured at two stages: before and after the correction of rectus diastasis. The distance between the iliac spines (IS) and that between the xiphoid process and pubic symphysis (XP) were measured. The abdominal surface index (ASI) was calculated using the formula: ASI = (IS × XP)/2. This index was used to determine the individual abdominal surface. The relative diastasis coefficient (RDC) was calculated using the formula: RDC = diastasis/ASI. These measurements were correlated to the IAP variation. The results of the IAP measurements obtained in each stage and the RDC values were compared, using the Pearson's linear correlation coefficient. RESULTS: There was no statistically significant correlation between the IAP variation and the RDC values at the three levels studied. CONCLUSIONS: The diastasis width does not interfere with the increase of the IAP when a plication of the anterior aponeurosis is performed. LEVEL OF EVIDENCE: 3 Diagnostic.
Assuntos
Músculos Abdominais/cirurgia , Abdominoplastia , Complicações na Gravidez/cirurgia , Músculos Abdominais/fisiopatologia , Abdominoplastia/efeitos adversos , Adolescente , Adulto , Pontos de Referência Anatômicos , Brasil , Estética , Feminino , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/fisiopatologia , Pressão , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
A atividade de glicose-6-fosfato desidrogenase em células in vitro foi determinada através de método espectrofotométrico. Foi estabelecida a densidade populacional adequada e padronizaram-se as condiçöes para extraçäo da enzima e para o desenvolvimento da reaçäo