Publications by Murillo Fraga
Revista Brasileira de …, Jan 1, 2012
A técnica de anastomose microcirúrgica é desafiadora e requer treinamento extenso, dedicação e te... more A técnica de anastomose microcirúrgica é desafiadora e requer treinamento extenso, dedicação e tempo. Os autores descrevem um modelo de treinamento acessível, prático e fácil, que utiliza retalho abdominal proveniente de abdominoplastias. O calibre dos vasos epigástricos superficiais encontrados nos retalhos abdominais excisados variou de 1,2 mm a 2 mm, dependendo do índice de massa corporal da paciente no pré-operatório. Esse retalho permitiu o treinamento de anastomoses microcirúrgicas em vasos de diferentes calibres. Esses vasos permaneciam com pequena quantidade de sangue em seu lúmen, o que permitia testar a qualidade e a patência das anastomoses. Esse modelo de treinamento em vasos abdominais humanos, quando comparado aos modelos animais ou inanimados, permite transição mais rápida e real aos pacientes. A prática de dissecção e de anastomoses terminoterminais e terminolaterais de uma maneira efetiva e prática aperfeiçoa a destreza cirúrgica.
Papers by Murillo Fraga
Hemangiomas of infancy are unique, benign tumors of endothelial cells characterized by an initial... more Hemangiomas of infancy are unique, benign tumors of endothelial cells characterized by an initial phase of rapid proliferation, followed by slow involution, often leading to complete regression. The aim of this case report is to present the natural evolution of a nasolabial hemangioma based on the progression of the disease, since birth until adult life. Many therapeutic options are available. The appropriate moment to proceed should be identified by the physician taking into account the natural course of the disease.
Lymphology
This unusually rare case of giant primary lymphedema of the left upper extremity in a 21-year old... more This unusually rare case of giant primary lymphedema of the left upper extremity in a 21-year old woman, who had undergone five surgical procedures (two Charles' procedures and three partial resections) without lasting clinical improvement, demonstrates the difficulty in achieving satisfactory long-term results in patients with grotesquely huge extremities secondary to primary lymphedema. Disarticulation of the left upper extremity was felt to be the most appropriate surgical option in this severe congenital lymphedema patient.
Acta Cirurgica Brasileira, 2013
To describe an experimental model of cutaneous radiation injury in rabbits. On this study eight s... more To describe an experimental model of cutaneous radiation injury in rabbits. On this study eight six-month-old New Zealand male rabbits, with an average weight of 2.5 kg were used. They were distributed in four groups (n=2 per group). The control group did not receive radiotherapy and the others received one radiotherapy session of 2000, 3000 and 4500 cGy, respectively. Photographic analysis and histopathological evaluation of the irradiated areas were carried out. After 30 days, the animals from the control group had all their hair grown. In spite of that, the animals from group 2000 cGy had a 60-day alopecia and from group 3000 cGy, a 90-day alopecia. After the 30th day, the 3000 cGy group demonstrated 90-day cutaneous radiation injuries, graded 3 and 4. One of the animals from group 4500 cGy died on the 7th day with visceral necrosis. The other from the same group had total skin necrosis. A progressive reduction of glands and blood vessels count and an increase on collagen deposition was observed. The proposed experimental model is reproductable. This study suggests that the dosage 4500 cGy is excessive and the 3000 cGy is the most effective for this experimental model of cutaneous radiation injury in rabbits.
Revista do Colégio Brasileiro de Cirurgiões, 2013
Plastic and Reconstructive Surgery, 2009
To avoid harming the physical integrity of the human being, it is necessary to practice surgical ... more To avoid harming the physical integrity of the human being, it is necessary to practice surgical procedures in synthetic, devitalized, or animal material before attempting them in patients. The continuous training has the goal of improving the experienced surgeon's skills, to serve ...
Revista Brasileira de Cirurgia Plástica (Impresso), 2010
Plastic and Reconstructive Surgery, 2013
Journal of Plastic, Reconstructive & Aesthetic Surgery, 2010
Numerous applications of autogenous platelet-rich plasma (PRP) have been studied so far; however,... more Numerous applications of autogenous platelet-rich plasma (PRP) have been studied so far; however, its property of enhancing the survival of free fat grafts has not been defined yet. In the literature, many reports are anecdotal and few include controls to definitely determine the role played by PRP in these grafts. PRP was investigated to study its effect in free fat grafts' survival in a rabbit model. A total of 30 New Zealand male rabbits aged 6 months received 0.8 g fat tissue (harvested by scissors dissection from the scapular area of the own animal) in the ears and were randomised into two groups. Group 1 (PRP group) was given the combination of 0.8 g of free fat graft and 1 ml of PRP. Group 2 (control group) received 0.8 g of free fat graft and 1 ml of saline solution. The rabbits were followed up for a period of 6 months after the procedure and then euthanised. The grafted tissue was stained with haematoxylin-eosin and submitted to microscopical evaluation. Graft histopathology was investigated for adipocyte viability, number of blood vessels and the presence of necrosis and fibrosis. All data were statistically analysed by the differences between the study groups. Three major effects of the addition of PRP in the free fat graft were observed. Group 1 showed a significantly higher fat survival weight as compared with the control group (P<0.05). Histopathological investigations revealed that the number of viable adipocytes and blood vessels was higher in group 1, and still, a larger number of necrotic areas and fibrosis were detected between group 2 (P<0.05). Application of autogenous PRP can enhance free fat graft survival in rabbits.
Journal of Plastic, Reconstructive & Aesthetic Surgery, 2008
The free transplant of fatty tissue has gone through several phases of interest over the last 100... more The free transplant of fatty tissue has gone through several phases of interest over the last 100 years of medical history, having undergone cycles of use and disuse. In the present study we aimed to create, through a delaying process, an improvement in the integration and lower resorption rates of autologous fat grafts. Similar research has not been found in the literature, and this was the motivating factor for the present study. Twenty-three New Zealand male rabbits were used. The study consisted of two different modalities of autologous fatty tissue transplants [autonomised graft (A) vs nonautonomised grafts (NA)]. In order to characterise the histological differences that could contribute to the different macroscopic aspects in the samples of the autonomised and nonautonomised groups, three anatomic-pathological criteria were considered: steatonecrosis, viable adipocytes, and fibrous proliferation. For this analysis, the 'point-counting' technique proposed by Gundersen et al. was used, with a reticulum of 100 points and 50 lines. Statistically significant differences were found between the autonomised (A) and nonautonomised (NA) groups in both the macroscopic and microscopic aspects after the 6 month study period (P<0.05). We conclude that autonomisation of the fatty tissue and its transfer as an autologous implant, in rabbits, is capable of promoting lower rates of resorption and greater integration of the transplanted tissue, characterised by a greater number of viable adipocytes, lower rates of fibrosis and steatonecrosis in comparison with the nonautonomised graft.
Aesthetic Surgery Journal, 2009
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Publications by Murillo Fraga
Papers by Murillo Fraga