the use of poly lactic acid to improve projection of reconstructed nipple

Abstract Purpose Nipple-areola reconstruction represents an important step for final mammary reconstruction. Many techniques have been described. The drawback is the progressive nipple projection loss with time from 50% to over 70% of the initial projection. In this report, we evaluated the effect of injectable poly-lactic acid (PLLA) to improve projection of reconstructed nipples. Results We selected 12 patients with a residual nipple projection between 0.1 and 2 mm. The patients were injected locally inside the nipple with 0.5 ml of PLLA (dilution 1:4) every 4 weeks for 4 times. At the study end, patients were satisfied with results. No adverse effects were observed. After one year, an increase of nipple projection ranging from 0.5 to 3.5 mm was obtained with an average increase of 2.3 mm (282%) and this variation was statistically significant ( p Conclusion The use of injectable PLLA is a simple and effective procedure to improve projection of reconstructed nipple

Applicazioni cliniche di una crema lidocaina/prilocaina (EMLA„µ) nel prelievo di innesti cutanei a tutto spessore

EMLA® is a cream containing an eutectic mixture of local anaesthetics for topical use. Its anaesthetic action is maximal about two hours after application and is evident even beyond the cutaneous layer, as proved by several prior studies. Such features have induced the Authors to theorize its possible use in anaesthesia of the donor area of full thickness skin grafts. The aim of our study was to ascertain 'in vivo' the truthfullness of our proposition and to observe the possibility of a different response according to dosage, site and length of application. The trial was conducted on 24 patients who all required excision of skin lesions and subsequent repair with full thickness grafts. Most of the patients were elderly with medical problems, mainly of cardiovascular origin, and therefore at risk if given large doses of local anaesthetics. For donor areas we used the postauricular, supraclavicular and the inner arm. Application lasted between 90 and 120 minutes. Patients were asked to report pain on a 0-10 scale during the whole procedure. The donor area was closed by direct suture. In all 24 patients surgery was completed and in 17 of them EMLA® cream provided adequate anaesthesia during the whole procedure. Differences in pain control were reported for the different donor areas only

Phase 2 cross-over multicenter trial on the efficacy and safety of topical cyanoacrylates compared with topical silicone gel in the prevention of pathologic scars

Many clinical studies on scar therapy are reported in the literature, but only silicone gel sheeting and corticosteroid injections are supported by accurate prospective controlled studies. This prospective multicenter cross-over phase 2 study tested the effectiveness of a topical cyanoacrylate compared with silicone gel in improving postsurgical scars. Patients presenting with symmetric breast scars after augmentation or reduction mammaplasty were enrolled in the study. From the same day as stitch removal, the cyanoacrylate was applied on one side every 3 to 5 days and the silicone gel on the other side twice a day for 3 months. Assessments of patients and external observers using a visual analog scale were recorded at scheduled visits during 1 year, and scars were photographed. Objective evaluations included measurements of scar width, length, and elevation. The statistical significance of objective parameter modifications was analyzed using the Wilcoxon test. Positive effects of both tested products were observed during the scar maturation process, and final scars of good quality were achieved without any major adverse effect. The topical cyanoacrylate proved to be more efficacious in preventing scar widening, and this result was statistically significant. The tested topical cyanoacrylate had a positive effect on the scar maturation process at least comparable with that of topical silicone gel

Phase 2 cross-over multicenter trial on the efficacy and safety of topical cyanoacrylates compared with topical silicone gel in the prevention of pathologic scars

Many clinical studies on scar therapy are reported in the literature, but only silicone gel sheeting and corticosteroid injections are supported by accurate prospective controlled studies. This prospective multicenter cross-over phase 2 study tested the effectiveness of a topical cyanoacrylate compared with silicone gel in improving postsurgical scars Patients presenting with symmetric breast scars after augmentation or reduction mammaplasty were enrolled in the study. From the same day as stitch removal, the cyanoacrylate was applied on one side every 3 to 5 days and the silicone gel on the other side twice a day for 3 months. Assessments of patients and external observers using a visual analog scale were recorded at scheduled visits during 1 year, and scars were photographed. Objective evaluations included measurements of scar width, length, and elevation. The statistical significance of objective parameter modifications was analyzed using the Wilcoxon test Positive effects of both tested products were observed during the scar maturation process, and final scars of good quality were achieved without any major adverse effect. The topical cyanoacrylate proved to be more efficacious in preventing scar widening, and this result was statistically significant The tested topical cyanoacrylate had a positive effect on the scar maturation process at least comparable with that of topical silicone gel