ABSTRACT Purpose The aim of this work was to analyze the effect of fibrin biopolymer sealant (FS) associated or not to aquatic exercise (AE) on the calcaneal tendon repair. Methods Forty-four female Wistar rats were randomly divided into four experimental groups: Lesion control (L), Lesion and FS (LS), Lesion and AE (LE) and Lesion and FS associated to AE (LSE). The edema volume (EV), collagen ratio, and histopathological analysis were evaluated after 7, 14, and 21 days of partial tendon transection. Results The EV was statistically reduced for all treatment groups after 7 and 21 days when compared to L group. The LS and LSE had the highest EV reduction after 21 days of treatment. The FS group didn’t induce tissue necrosis or infections on the histopathological analysis. It was observed tenocytes proliferation, granulation tissue and collagen formation in the tendon partial transection area in the FS group. The LSE demonstrated higher amount of granulation tissue and increased the collagen deposition at the injury site. Conclusions Our data suggests that the therapeutic potential of the association of heterologous fibrin biopolymer sealant with aquatic exercise program should be further explored as it may stimulate the regeneration phase and optimize calcaneal tendon recovery.

Abstract Purpose To synthesize and characterize poly(hydroxybutyrate) (PHB) and norbixin membranes to evaluate them for genotoxicity in rats and wound healing in mice by histological staining. Methods For the evaluation of genotoxicity, male rats ( Rattus novegicus ) were divided into three groups (n= 5): 5% PHB/Norbixin membrane introduced into the peritoneum by laparotomy; B – negative control; C – positive control (intraperitoneal dose of cyclophosphamide 50 mg/kg). For the evaluation of biocompatibilty, a cutaneous wound was induced on the back of males mice ( Mus musculus ) divided into two experimental treatment groups: control and membrane that underwent euthanasia after 7 and 14 days treatment. Statistical analysis ware made by One Way Anova post hoc Tukey Test (p<0.05). Results Regarding the incidence of polychromatic erythrocytes, there was no difference between negative control and 5% PHB/Norbixin membrane; however, when compared to the positive control represented by cyclophosphamide, there was a significant difference (p <0.001). As for DNA damage, the changes induced in the first 4h were repaired in 24h. In addition, the membrane was effective in abbreviating the inflammatory process and served as a scaffold due to the stimulus to reepithelialization mainly on the 7 days of treatment. Conclusion The non-genotoxic PHB/Norbixin 5% membrane presented promising results that suggest its effectiveness as a guide for tissue regeneration given its biocompatibility.

Abstract Purpose: To evaluate the in vivo response of photobiomodulation therapy associated with norbixin-based poly(hydroxybutyrate) membrane (PHB) in tenotomized calcaneal tendon. Methods: Thirty rats were randomly allocated to six groups (n=5 each): LED groups (L1, L2 and L3) and membrane + LED groups (ML1, ML2 and ML3). The right calcaneal tendons of all animals were sectioned transversely and were irradiated with LED daily, one hour after surgery every 24 hours, until the day of euthanasia. At the end of the experiments the tendons were removed for histological analysis. Results: The histological analysis showed a significant reduction in inflammatory cells in the ML1, ML2 and ML3 groups (p=0.0056, p=0.0018 and p<0.0001, respectively) compared to those in the LED group. There was greater proliferation of fibroblasts in the ML1 (p<0.0001) and L3 (p<0.0001) groups. A higher concentration of type I collagen was also observed in the ML1 group (p=0.0043) replacing type III collagen. Conclusion: Photobiomodulation in association with norbixin-based PHB membrane led to control of the inflammatory process. However, it did not favor fibroblast proliferation and did not optimize type I collagen formation in the expected stage of the repair process.

Abstract Purpose: To determine the efficacy of norbixin-based poly(hydroxybutyrate) (PHB) membranes for Achilles tendon repair. Methods: Thirty rats were submitted to total tenotomy surgery of the right Achilles tendon and divided into two groups (control and membrane; n = 15 each), which were further subdivided into three subgroups (days 7, 14, and 21; n = 5 each). Samples were analyzed histologically. Results: Histological analysis showed a significant reduction in inflammatory infiltrates on days 7, 14 (p < 0.0001 for both), and 21 (p = 0.0004) in the membrane group compared to that in the control group. There was also a significant decrease in the number of fibroblasts in the control group on days 7, 14 (p < 0.0001), and 21 (p = 0.0032). Further, an increase in type I collagen deposition was observed in the membrane group compared to that in the control group on days 7 (p = 0.0133) and 14 (p = 0.0107). Conclusion: Treatment with norbixin-based PHB membranes reduces the inflammatory response, increases fibroblast proliferation, and improves collagen production in the tendon repair region, especially between days 7 and 14.

RESUMO Introdução: Diversos recursos terapêuticos, como laser e ultrassom isolado, combinados com fármacos e fonoforese têm sido utilizados em casos de inflamação e reparo de tendão, sendo o ultrassom pulsado bastante eficaz em tendinites crônicas. Objetivo: Analisar a eficácia do uso da fonoforese com o extrato etanólico das cascas do caule da Ximenia americana L. na resolução do processo inflamatório crônico em Rattus norvegicus. Métodos: A amostra consistiu em 120 animais para análise da resposta inflamatória, utilizando-se como variáveis edema, força biomecânica, número de fibroblastos e análise histológica. Resultados: Nos 7° e no 14° dia, verificou-se diferença significativa entre o grupo ultrassom com gel do caule de Ximenia americana L. e o grupo ultrassom com placebo (p < 0,05) quanto à redução de edema, aumento da força máxima de ruptura, redução extremamente significativa da deformação máxima (p < 0,001), além de aumento dos fibroblastos. Na análise histológica, houve melhora do processo inflamatório inicial e aceleração do reparo tendíneo, com redução de células inflamatórias e com deposição de colágeno organizado com matriz extracelular densa. Conclusão: O ultrassom pulsado combinado com o gel do caule de Ximenia americana L. é uma forma terapêutica eficaz para a resolução do processo inflamatório crônico.

ABSTRACT Introduction: Several therapeutic resources such as laser and isolated ultrasound combined with drugs and phonophoresis have been used in cases of inflammation and tendon repair, and the pulsed ultrasound is quite effective in chronic tendinitis. Objective: To analyze the efficacy of phonophoresis with the ethanol extract of the stem bark of Ximenia americana L. to manage the chronic inflammatory process in Rattus norvegicus. Methods: The sample consisted of 120 animals for analysis of the inflammatory response using edema, biomechanical strength, number of fibroblasts and histological analysis as variables. Results: On the 7th and 14th day, there was a significant difference between the group ultrasound with Ximenia americana L. gel and the ultrasound with placebo group (p<0.05) for edema reduction, increased maximum rupture strength, highly significant reduction of the maximum deformation (p<0.001), in addition to an increase in fibroblasts. In the histological analysis, there was improvement in the inflammatory process and acceleration of tendon repair with reduction of inflammatory cells and deposition of organized collagen with dense extracellular matrix. Conclusion: The pulsed ultrasound combined with gel of Ximenia americana L. is an effective therapy to manage the chronic inflammatory process.

RESUMEN Introducción: Varios recursos terapéuticos, tales como láser y ultrasonido aislado, en combinación con fármacos y la fonoforesis se han utilizado en casos de inflamación y reparación del tendón, y el ultrasonido pulsado ha sido muy eficaz en la tendinitis crónica. Objetivo: Analizar la eficacia de la fonoforesis con el extracto de etanol de la corteza del tallo de Ximenia americana L. en la resolución del proceso inflamatorio crónico en Rattus norvegicus. Métodos: La muestra fue de 120 animales para analizar la respuesta inflamatoria, utilizando como variables el edema, la resistencia biomecánica, el número de fibroblastos y el análisis histológico. Resultados: En el 7° y en el 14° día, se observó una diferencia significativa entre el grupo de ultrasonido con gel de Ximenia americana L. y el grupo ultrasonido con placebo (p < 0,05) en la reducción del edema, el aumento de la resistencia máxima a la rotura, la reducción altamente significativa de la deformación máxima (p < 0,001), además del aumento de los fibroblastos. En el análisis histológico hubo una mejoría en el proceso inflamatorio y la aceleración de la reparación del tendón, con reducción de células inflamatorias y deposición de colágeno organizado con matriz extracelular densa. Conclusión: La eficacia del ultrasonido pulsado combinado con gel de Ximenia americana L. es una forma eficaz para la resolución del proceso inflamatorio crónico.

ABSTRACT PURPOSE: To evaluate in a macroscopic, histological and histomorphometric manner the healing process of cutaneous wounds in mice. METHODS: The sample consisted of 40 male mice and was divided in four groups: 1st group (control, n=10), 2nd group (High Frequency Generator - HF, the maximum amplitude range, 120s, n=10), 3rd group (AlGaInP Laser 660 nm, 30mW power, 5 J/cm2, applying scan mode, 120s, n=10) and 4thgroup (AlGaInP Laser 660 nm, 30 mW power, 8 J/cm2, applying scan mode, n=10). The surgical incision was made with an 8 mm diameter punch perpendicularly to the back of the animal. The statistical analysis was achieved by the statistical test One Way Anova post hoc Tukey Test and significance at p<0.05 in GraphPad Prism program. RESULTS: It was observed that in the acute phase the AlGaInP Laser at 5 J/cm2 provided a greater stimulus to healing, and both lasers were effective in the remodeling phase. CONCLUSION: The AlGaInP lasers from 5 J/cm2 to 8 J/cm2 showed better biomodulatory results in the acute and remodeling phases respectively, however, the HF was less effective than the laser, providing significant benefits only in the acute phase of tissue repair.