Comportamento das variáveis da dimensão fractal em tecido cutâneo cicatricial submetidos a diferentes métodos de indução de ferida e tratamentos: revisão sistemática de escopo

Abstract

Fractal dimension has proven to be a tool capable of interpreting diagnostic areas of biological tissue in order to understand therapeutic responses and their mechanisms in the process of wound induction and healing. However, understanding the behavior of fractal dimension variables is still inconclusive regarding the treatment of skin lesions, since different types of intervention seem to influence different patterns of inflammatory aspects and cell permeability. The present study aimed to systematically search databases and select preclinical studies regarding fractal analysis in the healing process of skin wounds. The search strategy included the Medline databases via OVID, EMBASE, Web of Science and CINAHL, considering the following terms: healing, wounds, collagen, rats, rabbits, burn, morphometry, histology and immunohistochemistry. The study selection process consisted of selecting the title, then the abstract and, finally, reading the full text. To control and standardize the study selection processes, the Rayyan platform and an Excel form were used so that the process would be blinded and standardized among the authors for subsequent double checking. A total of 407 articles were extracted from the databases. Of these, 69 were duplicates and were therefore excluded. After reading the titles and abstracts, 8 studies were included for full reading. Seven preclinical studies were included in this review because they met all the inclusion criteria, such as fractal analysis performed on tissues of rats, mice or rabbits, through induction of burn or dermoscopic cut wounds or emission of X-rays. Among the 7 studies found, the behavior of the fractal analysis was shown to be variable and dependent on the wound induction process, with the burn procedure being the one that presented the most differentiated results, due to the loss of tissue fractality related to thermal denaturation.