The Objective Buttocks Assessment Scale (OBAS): a new and complete method to assess the gluteal region

Introduction: New treatment methods to improve and enhance buttocks appearance require globally accepted scales for aesthetic research and patient evaluation. The purpose of our study was to develop a set of grading scales for objective assessment of the gluteal region and assess their reliability and validity. Materials and methods: Twelve photonumeric grading scales were created. Eleven aesthetic experts rated photographs of 650 women in 2 validation sessions. Responses were analyzed to assess inter-rater and intra-rater reliability. The Rasch model was used as part of the validation process. Results: All the scales exceeded criteria for acceptability, reliability and validity. Overall inter-rater reliability and intra-rater reliability were both “almost perfect” (p=0.15 and p=0.16 respectively). Conclusion: Consistent outcomes between raters and by individual raters at 2 time points confirm the reliability of the Objective Buttocks Assessment Scale in female patients and suggest it will be a valuable tool for use in research and clinical practice

Synergistic Effects of Autologous Platelet-Rich Plasma and Hyaluronic Acid Injections on Facial Skin Rejuvenation

Background: Many therapeutic options are currently available for facial skin rejuvenation, but little evidence exists about the efficacy of combining such procedures. Objectives: The aim of this study was to assess and investigate the synergistic effect of hyaluronic acid (HA) and autologous platelet-rich plasma (a-PRP) injections on facial skin rejuvenation. Methods: For this randomized controlled prospective study, 93 eligible patients were enrolled and randomized into 3 intervention groups to undergo a series of 3 treatment sessions with either a-PRP, HA, or a mixture of a-PRP and HA (Cellular Matrix; Regen Lab) injected into facial cheeks. Results: A total of 93 patients were included. Treatment with Cellular Matrix led to a very significant improvement in the overall facial appearance compared with treatment with a-PRP or HA alone (P < 0.0001). Participants treated with Cellular Matrix showed a 20%, 24%, and 17% increase in FACE-Q score at 1, 3, and 6 months posttreatment, respectively. For the HA group, the improvement in FACE-Q score was 12%, 11%, and 6% at 1, 3, and 6 months posttreatment, respectively, whereas for the a-PRP group the improvement was 9%, 11%, and 8% at 1, 3, and 6 months posttreatment, respectively. Biophysical measurements showed significantly improved skin elasticity for the Cellular Matrix group compared with the groups receiving a-PRP or HA alone. No serious adverse events were reported. Conclusions: Combining a-PRP and HA seems to be a promising treatment for facial rejuvenation with a highly significant improvement in facial appearance and skin elasticity compared with a-PRP or HA alone

Necrotizing Fasciitis of the Upper Limb: Optimizing Management to Reduce Complications

Background: Necrotizing fasciitis (NF) is a severe, potentially life-threatening condition. The aim of this study is to identify strategies aimed at reducing complications in patients with NF of the upper limb. Methods: We conducted a retrospective study on patients admitted to our Unit for suspected NF of the upper limb. The analyzed data included patient characteristics, delay before primary care, clinical and biological signs upon arrival, pathogens involved, and the rate of amputations and mortality. Results: A total of 21 patients presented with confirmed necrotizing bacterial dermohypodermitis-NBDH with NF (NBDH-NF) affecting the upper limb. The mean delay between the onset of symptoms and the clinical examination in the Emergency Dermatology Unit was 48 h (range: 6 to 72 h). The mean delay between admission and primary surgery was 150 min (range: 60 min to 280 min). No amputations were performed. All patients were alive one year after the first surgical procedure. Conclusions: Our study demonstrated that it is possible to reduce mortality and morbidity rates in NF of the upper limb. Timely diagnosis and early treatment and a multidisciplinary medico-surgical dedicated team providing care can significantly modify the outcomes. Early surgical debridement is the most important factor affecting the prognosis of these infections

Tissue Induction in Plastic and Maxillo-facial Surgery

Tissue induction is defined as the activation of cell regeneration to restore damaged tissue, which involves stimulating cell signaling and modifying the microenvironment. Tissue inducers therefore have the advantage of acting quickly and durably on treated tissues, alone or in combination with surgical procedures, in order to reduce iatrogeny and potentiate surgical results. The aim of this review was to detail the various current techniques for tissue regeneration in the field of plastic and maxillo-facial surgery. We conducted a systematic search on Pubmed, Google Scholar and Science Direct. Articles in English and French, published after 2012 and focusing on facial tissue induction were searched. Only prospective comparative studies assessing as many cases as possible were analyzed. The following keywords were used: “skin rejuvenation”, “skin regeneration”, “collagen induction”, “skin enhancer”, “aging rejuvenation”, “oral mucosa rejuvenation”, “oral mucosa regeneration”, “buccal mucosa rejuvenation”, “buccal mucosa regeneration”, “oral bone regeneration”, “alveolar bone regeneration”. Fifty innovative articles published since 2012 dealing with tissue induction techniques with an interest in plastic and maxillo-facial surgery were identified and then selected. The most effective tissue inducers for skin and mucosal regeneration were lasers, radiofrequency, pulsed light, hyaluronic acid and PRP. Tissue induction allows collagen self-production leading to tissue regeneration. Many techniques can be used for tissue induction that represent an additional tool in the therapeutic arsenal available to plastic and maxillofacial surgeons to improve patient management.These inducers can be used alone or in combination to achieve synergistic effects and better clinical outcomes

Parental occupations at birth and risk of adult testicular germ cell tumors in offspring: a French nationwide case-control study

BACKGROUND: Testicular germ cell tumors (TGCT) are the most frequent cancer in young men in developed countries. Parental occupational exposures during early-life periods are suspected to increase TGCT risk. The objective was to estimate the association between parental occupations at birth and adult TGCT. METHODS: A case-control study was conducted, including 454 TGCT cases aged 18-45 from 20 French university hospitals, matched to 670 controls based on region and year of birth. Data collected from participants included parental jobs at birth coded according to the International Standard Classification of Occupation-1968 and the French nomenclature of activities-1999. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors. RESULTS: Paternal jobs at birth as service workers (OR = 1.98, CI 1.18-3.30), protective service workers (OR = 2.40, CI 1.20-4.81), transport equipment operators (OR = 1.96, CI 1.14-3.37), specialized farmers (OR = 2.66, CI 1.03-6.90), and maternal jobs as secondary education teachers (OR = 2.27, CI 1.09-4.76) or in secondary education (OR = 2.35, CI 1.13-4.88) were significantly associated with adult TGCT. The risk of seminoma was increased for the above-mentioned paternal jobs and that of non-seminomas for public administration and defence; compulsory social security (OR = 1.99, CI 1.09-3.65); general, economic, and social administration (OR = 3.21, CI 1.23-8.39) for fathers; and secondary education teacher (OR = 4.67, CI 1.87-11.67) and secondary education (OR = 3.50, CI 1.36-9.01) for mothers. CONCLUSION: Some paternal jobs, such as service workers, transport equipment operators, or specialized farmers, and maternal jobs in secondary education seem to be associated with an increased risk of TGCT with specific features depending on the histological type. These data allow hypotheses to be put forward for further studies as to the involvement of occupational exposures in the risk of developing TGCT, such as exposure to pesticides, solvents, or heavy metals

Combinaison of PRP with cell therapy in the field of plastic surgery

De nombreuses pathologies sont à l’origine de perte de substance des parties molles à la fois cutanée représentant un enjeu de santé publique.Egalement de nombreux mécanismes lésionnels sont à l’origine du stress oxydatif pouvant altérer ces parties molles. L’avenir de la chirurgie reconstructrice sera de promouvoir des thérapies cellulaires autologues permettant la régénération tissulaire cutanée, musculaire et nerveuse tout en luttant contre le stress oxydatif.Les cellules souches mésenchymateuses d’origine adipeuse (ASC) représentent une source de cellules multipotentes plus faciles à isoler que celles de la moelle osseuse. En effet, les cellules souches localisées dans le tissu en cours de cicatrisation ont un rôle immunomodulateur, et améliore la trophicité par un effet pro-angiogénique, chimio-attractant, anti-fibrotique et anti-inflammatoire.Nos travaux précédents tendaient à montrer que l’association du plasma riche en plaquettes aux ASC en injection sous cutanée semblait améliorer la cicatrisation cutanée dans le modèle murin par un effet potentialisateur du PRP sur les ASC en stimulant leurs sécrétions de facteurs pro-angiogéniques (VEGF) et pro-inflammatoires (IL6) tout en augmentant leur survie.Notre hypothèse est que le plasma riche en plaquettes potentialise les CSM en milieu lésé ou en cas de stress en améliorant leur survie, le pourvoir angiogénique et chémoattractant.Nous objectif est d’évaluer l’association des ASC et du plasma riche en plaquette dans la régénération cutanée.Dans un premier temps, nous étudierons cette interaction en in vitro. Puis, nous développerons des modèles murins de perte de subtance cutanée pour étudier cette nouvelle association en injection locale pour la régénération tissulaire.Many diseases are the cause of soft tissue loss involving the skin.Also many injuries are the cause of oxidative stress that can lead to lesions of soft tissues. The future of the reconstructive surgery will promote autologous cell therapy for skin, muscular and nervous regeneration.The adipose derived stem cells (ASC) are a source of multipotent cells, which are easier to isolate than the bone marrow. Indeed, ASCs have an immunomodulatory role, and improve the trophism by a pro-angiogenic, chemoattractant, anti-fibrotic and anti-inflammatory effect.Our previous studies tended to show that the sub cutaneous injection of a combination of platelet-rich plasma with the ASCs seemed to improve wound healing in a mouse model, thank to a potentiating effect of PRP on ASC which stimulates the secretion of pro-angiogenic factors (VEGF ) and pro-inflammatory (IL-6) while increasing the survival of ASCs.Our hypothesis is that PRP potentialize the CSM in stressed condition or in skin wound and allows the improvement of the CSM survival, the angiogenic and chemoattraction power.Our aim is to assess the association of ASCs with PRP for skin regeneration.First, we will study this in vitro interaction. Then we will develop an animal model of oxidative stress skin to study this new local injection of association of ASCs with PRP for tissue regeneration

Multi-recurrent invasive ameloblastoma: A surgical challenge

Introduction: Ameloblastomas are rare head and neck tumors, and yet the most common odontogenic neoplasms. They account for 1% and 11% of all head and neck and odontogenic tumors respectively. Embryologically, they originate from remnants of odontogenic epithelium. Their aggressive, destructive nature, as well as their anticipated high rate of recurrence, even after en bloc resection, poses a surgical predicament. Presentation: We present a case of a 56 year-old Asian female with a multi-recurrent invasive ameloblastoma. Initially, the lesion was mandibular in location for which she underwent a mandiblectomy. Later on, she presented with a maxillary ameloblastoma with invasion of both the anterior wall of the maxillary sinus and the floor of the orbit. The patient was operated twice and histopathology confirmed a cystic type recurrent ameloblastoma. A year later, she came with recurrent maxillary ameloblastoma and a maxillectomy was done. However, histopathology revealed a follicular ameloblastoma. Three years later, she presented with a retro-orbital ameloblastoma with infiltration to the temporal muscles. The patient was operated and the histopathologic examination revealed a partially cystic lesion with no malignant transformation. Conclusion: This case discusses available treatment options and emphasizes on the importance of long-term patient follow-up due to the biological behavior of ameloblastoma

Improving Abdominal Plastic Scars with a Dietary Supplement—A Comparative Study

Introduction:. Massive weight loss following bariatric surgery has a major functional and aesthetic impact on patients. Many patients are nonetheless reluctant to undergo plastic surgery in connection with their former obesity because they fear potentially large scars, even though such scars are not visible (ie, they are covered by undergarments). Purpose:. The aim of this study was to evaluate the quality of wound healing in patients receiving Celergen supplementation following abdominoplasty, compared with a control group. The hypothesis was that supplementation would speed up wound healing and improve scar quality. Materials and Methods:. We conducted a prospective, monocentric, controlled study of patients undergoing abdominoplasty. A group of patients received Celergen, a food supplement, for 3 months and were monitored for 1 year after their surgery. Results:. Of 33 patients who underwent abdominoplasty, 25 received Celergen supplements. There was no significant difference between the 2 groups. The mean time to wound healing was significantly better in the group receiving supplementation compared with the control group [respectively, 24.6 ± 9.31 days and 34 ± 13.48 days (P = 0.03)]. The Patient and Observer Scar Assessment Scale (POSAS) observer score was significantly better at 1 year in the group receiving supplementation compared with the control group [12.68 ± 6.6 and 17.38 ± 5.24 (P = 0.01), respectively]. There was no significant difference in the total POSAS score at 1 year (P = 0.166). Conclusion:. Celergen supplementation significantly improved the time to healing and the POSAS observer score at 1 year for patients undergoing abdominoplasty