Imaging in dermal fillers

Steeds meer mensen kiezen om cosmetische redenen voor rimpelvullers, producten die de weke delen van de huid versterken. Deze verschillen onderling in samenstelling en duurzaamheid. Wanneer er complicaties optreden, zoals bijvoorbeeld migratie van het materiaal, infecties of acute en terugkerende zwellingen, is het voor het behandelplan van groot belang dat er een goede diagnose gesteld wordt. Francesca Grippaudo onderzocht hoe hoge-frequentie-echografie kan helpen bij de diagnostiek. Grippaudo concludeert dat het bij complicaties allereerst van belang is aan te tonen dat er inderdaad rimpelvullers gebruikt zijn in de weke delen. De volgende stap is nagaan welke vuller er gebruikt is. De promovenda stelt dat dat belangrijk is, omdat het gebruik van verschillende vullers tot complicaties kan leiden. Zij ontdekte dat verschillende beeldvormingstechnieken, zoals MRI en WBC Scintigrafie, het mogelijk maken om de vullers af te beelden in relatie tot de anatomische structuur van het gezicht. WBC Scintigrafie maakt het bovendien mogelijk om infecties en ontstekingen op te sporen. Deze informatie maakt het vaststellen van het meest geschikte behandelplan gemakkelijker

Procutase (R) versus 1% silver sulphadiazine in the treatment of minor burns

The purpose of this randomised comparative study was to evaluate the use of silver sulphadiazine (SSD) 1% cream (Group A) with the use of Procutase (R) (Group B) in treating burns with a TBSA <10% and a depth not greater than 2nd degree burns and thus suitable for outpatient management. The two groups were similar in age, gender, race, and extent of burn. Procutase (R) is an ionic hydrogel composed of natural hydrophilic polymers in an active ionic solution with an inhibitor of matrix metalloproteinases MMP-1, -3 and -9 (collagenase/gelatinase). Subjects were seen in follow-up biweekly, and wounds of patients in SSD group were compared with those of Procutase (R) group for healing time, pain score at dressing change, compliance with therapy and complication rate. The result of this study showed that Procutase (R) treated patients had statistically significantly less pain and shorter wound healing time. Procutase (R) can be used successfully in patients with burns that do not require hospital admission. (C) 2009 Elsevier Ltd and ISBI. All rights reserved

Management of craniofacial development in the Parry-Romberg syndrome: Report of two patients

Objective: The aim of this article is to describe the orthodontic therapy for Parry-Romberg syndrome. The therapeutic goal is to minimize the wasting effects of progressive atrophy on facial development of a part of the face. Design: To correct problems affecting craniofacial development of these patients, occurring during puberty, an orthodontic appliance was employed, which helps maintain parallelism of the facial planes, in particular the mandibular plane. Setting: Orthodontic care was carried out in the Dental Clinic of the Catholic University of the Sacred Heart of Rome. Intervention: Two patients underwent orthodontic therapy for 6 years. Appliances were checked every month and modified periodically so as to adapt to facial bone growth. Results: At the end of craniofacial growth, the mandible was almost symmetric and the problem relating to atrophy remained confined to the initial area. Cephalometric analyses demonstrated that the occlusal plane and the mandibular plane maintained a straight orientation in relation to the bizygomatic plane. The ratio between the left and right side of the ramus and condyle, in the mandible, improved. Conclusions: The use of orthodontic therapy allows patients affected by hemifacial progressive atrophy to present a more harmonic face at the end of puberty when final reconstruction can be planned. These results provide for a limitation of surgical intervention to the sclerodermic area alone

Osservazioni sul nevo sebaceo di Jadassohn

Scopo del lavoro è illustrare la clinica, l'istologia e l'innovativa terapia ricostruttiva mediante skin expander del nevo di Jadassoh

Mammary implants: laboratory simulation of recreational diving conditions

To ascertain whether mammary implants are prone to changes in conformation or structure if they are submitted to recreational dives, eight mammary implants were submitted to 40 simulated dives to imitate an average recreational diving schedule. Matching implants were used as a control group. Photographs were taken before and after completion of the protocol. All implants were observed for changes in volume and checked for integrity. Variations in density were evaluated using a Tc scan. No changes in volume occurred after each dive. None of the implants showed ruptures, and Tc scanning failed to reveal any differences in density between tested and control implants. Cohesive-gel implants submitted to the simulated dives showed some morphological alterations. This study indicates that the mammary implants tested could be implanted in a sports diver, but raises concern about whether the increased exposure to stress could negatively affect their durability. (C) 2002 The British Association of Plastic Surgeons

Foot Reconstruction

Since the conquest of the upright position, the foot has gained more importance as an organ that supports both the lower limb and the whole body weight and that allows humans to stand up, walk, run, jump, and climb. Human evolution determined progressive changes in both the skeleton architecture and the soft tissue of the foot to cope with the new environmental requirements. From the orangutan to the chimpanzee, from the gorilla to the human, the most important modifications of the skeleton included the progressive reduction of the distal area of the phalanxes with the loss of the grasping function and the enlargement of the proximal bones (astragalus, calcaneum) to obtain a resistant yet flexible structure. See the image below

The effects of COVID-19 pandemic on elective post-bariatric surgery waiting list. A single plastic surgery center investigation

Objective: After massive weight loss, patients that meet specific criteria can be inserted in an ad-hoc post-bariatric surgery list in order to be subjected to body contouring procedures. During COVID-19 pandemic, the Italian National Health System has been overwhelmed by the continue load of life-threatening patients that needed medical assistance. Plastic surgery practice enormously scaled back during this period and this fact greatly affected elective procedures waiting lists. The aim of our study is to analyze how the lockdown and its related sanitary policies affected post-bariatric patients' behaviors towards the delay of their procedure. Patients and methods: A 7-item questionnaire was administered to all patients. Change in the desire to be subjected to body contouring procedures was recorded. Smoking status, level of training during quarantine and psychological co-morbidities were also evaluated. Results: 124 patients completed the questionnaire. Data analysis showed that none of them encountered a decrease of the desire to be subjected to post-bariatric plastic surgery procedures. Conclusions: The present study showed that all the patients in the waiting list did not modify their interest in being subjected to post-bariatric surgery procedures, even though the waiting time increased

Acral Lentiginous Melanoma of the Thumb: Dermoscopy and Treatment

Melanoma affecting glabrous skin is a challenging entity that needs to be managed by an interdisciplinary team of dermatologists, oncologists, and surgeons. The thin subcutaneous layer of glabrous skin, which speeds up its metastatic spread, is one of the key elements that contributes to the aggressiveness of this form of cutaneous cancer when identified in this anatomical region. Acral lentiginous melanoma is a rare melanocytic malignancy that is usually associated with ominous outcomes, especially in those with dark skin. Moreover, more extensive research is needed to elucidate the puzzle of molecular drivers and their relationship with thermal injury. We reported our experience in order to highlight the value of timely diagnosis and treatment