Italian recommendations on enzymatic debridement in burn surgery.

Abstract Introduction Nexobrid®, a bromelain-based type of enzymatic debridement, has become more prevalent in recent years. We present the recommendations on enzymatic debridement (Nexobrid®)'s role based on the practice knowledge of expert Italian users. Methods The Italian recommendations, endorsed by SIUST (Italian Society of Burn Surgery), on using enzymatic debridement to remove eschars for burn treatment were defined. The definition followed a process to evaluate the level of agreement (a measure of consensus) among selected experts, representing Italian burn centers, concerning defined clinical aspects of enzymatic debridement. The consensus involved a multi-phase process based on the Delphi method. Results The consensus panel included experts from Italy with a combined experience of 1068 burn patients treated with enzymatic debridement. At the end of round 3 of the Delphi method, the panel reached 100% consensus on 26 out of 27 statements. The panel achieved full, strong consensus (all respondents strongly agreed on the statement) on 24 out of 27 statements. Discussion The statements provided by the Italian consensus panel represent a "ready to use" set of recommendations for enzymatic debridement in burn surgery that both draw from and complete the existing scientific literature on the topic. These recommendations are specific to the Italian experience and are neither static nor definitive. As such, they will be updated periodically as further quality evidence becomes available

Cellulite treatment: a comprehensive literature review

8noAn effective and long-term treatment of cellulite has not been well established. To our knowledge, no review has analyzed the whole range of treatments for this condition. We conducted a review of in vivo studies on humans adopting the key words "cellulite" and "treatment." The studies were included according to eligibility criteria. We performed an analysis to estimate the overall effect of cellulite treatments from clinical studies. Medline library was screened up to December 2014 to identify eligible studies. We included 73 original studies in the present review. All of them were clinical studies, in most of them, only women were recruited. Above the studies searched up, 66 tested the effectiveness of an exclusive treatment performed without the association to other procedures: 11 topical agents, 10 shock-wave therapy, 10 radio frequency, eight laser therapy, five oral therapy, four manual massage therapy, three carbon dioxide therapy, two compressive therapy, two infrared therapy, one dermabrasion, and 11 devices that use an association of multiple treatments. Seven papers tested a combination of two or more treatments. The mean difference of clinical morphologic features and ultrastructural changes between the treated group and the controlled showed significant heterogeneity between studies. It is still difficult to indicate an exclusive and effective single treatment for this condition. Our analysis purposed to obtain a complete overview of the available treatments in cellulite reduction. © 2015 Wiley Periodicals, Inc.reservedmixedZerini, Irene; Sisti, Andrea; Cuomo, Roberto; Ciappi, Serena; Russo, Francesco; Brandi, Cesare; D'Aniello, Carlo; Nisi, GiuseppeZerini, Irene; Sisti, Andrea; Cuomo, Roberto; Ciappi, Serena; Russo, Francesco; Brandi, Cesare; D'Aniello, Carlo; Nisi, Giusepp

Il ruolo della carbossiterapia nel trattamento sintomatico delle acrosindromi vascolari

12nonenoneCAMPANA M; VACCARO M; PERELLO R; ROSATO L; CECCACCIO L; CIAPPI S; BRAFA A; CALABRÒ M; G. NISI; BRANDI C; GRIMALDI L; DANIELLO CCampana, Matteo; Vaccaro, Marina; Perello, R; Rosato, Luca; Ceccaccio, Lavinia; Ciappi, Serena; Brafa, Anna; Calabro', Massimiliano; Nisi, Giuseppe; Brandi, Cesare; Grimaldi, Luca; D'Aniello, Carl

The role of carbon dioxide in the treatment of symptomatic vascular acrosyndromes[Il ruolo della carbossiterapia nel trattamento sintomatico delle acrosindromi vascolari]

Vascular acrosyndromes constitute a common reason for physician visits. From March 2006 to March 2008 we treated Carbomed CDT evolution device 40 patients (20 with Acrocyanosis and 20 with Raynaud phenomenon), with 1 session for week for a total of 5 weeks with a maintenance every 4 weeks. Treated patients showed benefit from the first session in the 80% of cases (court fine), In 10% of patients said they were partially satisfied with the treatment (court fine), in the remaining 10% sufficiently met (adequate trial). None reported a worsening of symptoms or the occurrence of adverse phenomena. In conclusion we can say that carbossiterapia is useful in the treatment of symptomatic vascular acrosindromi