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Laryngoscope Investigative... Jun 2024During the COVID-19 pandemic, elective surgeries faced cancelations due to quarantine measures. The objective of this study was to assess facial plastic and...
OBJECTIVE
During the COVID-19 pandemic, elective surgeries faced cancelations due to quarantine measures. The objective of this study was to assess facial plastic and reconstructive surgery (FPRS) volume before, during, and after the height of the pandemic on a national scale.
METHODS
The TriNetX Research Network identified 68,101,098 individuals aged 18+ with healthcare interactions from 2017 to 2022. Rates of common FPRS surgeries and procedures were compared during March-August of each year, aligning with the pandemic lockdown.
RESULTS
Compared to immediately before the pandemic in 2019, the 2020 pandemic peak saw an overall surgical volume reduction of -36.8%, with specific surgeries decreasing significantly: rhinoplasty (-28.6%), septoplasty (-34.0%), rhytidectomy (-54.9%), blepharoplasty (-40.7%), brow lift (-43.8%), ectropion/entropion repair (-35.6%), repair of blepharoptosis (-45.6%), correction of lagophthalmos (-29.9%), correction of lid retraction (-36.8%), and lipectomy (-41.8%) ( < .001). The procedural volume also decreased by 28.6%, encompassing reductions in various procedures: botulinum toxin A (-18.7%), facial filler (-40.7%), dermabrasion (-62.3%), chemical peel (-36.6%), and intralesional injection (-33.3%) ( < .001). In contrast to 2020, 2021 witnessed an increase of +75.0% in total surgical and +61.3% procedural volume: rhinoplasty (+81.0%), septoplasty (+74.7%), rhytidectomy (+143.4%), blepharoplasty (+81.7%), brow lift (+64.5%), ectropion/entropion repair (+55.2%), repair of blepharoptosis (+62.7%), correction of lagophthalmos (+39.0%), correction of lid retraction (+73.0%), lipectomy (+121.2%), botulinum toxin A (+52.4%), filler (+59.6%), dermabrasion (+91.8%), chemical peel (+78.8%), and intralesional injection (+67.3%) ( < .001). In 2022, rates of total surgeries (+8.5%) and procedures (+12.8%) surpassed pre-pandemic levels from 2019 ( < .001).
CONCLUSIONS
FPRS experienced significant pandemic-induced decreases, followed by a notable recovery in subsequent years, with certain surgeries and procedures surpassing pre-pandemic levels.
LEVEL OF EVIDENCE
4.
PubMed: 38864000
DOI: 10.1002/lio2.1292 -
Children (Basel, Switzerland) Jan 2023The lingual frenulum is a submucosal component significantly involved in the mobility of the tongue. In the case of short lingual frenulum, different surgical approaches...
The lingual frenulum is a submucosal component significantly involved in the mobility of the tongue. In the case of short lingual frenulum, different surgical approaches have been proposed. Atmospheric plasma is a thermal technique of vaporization or sublimation of the superficial tissues, without going deep, and the resulting fine carbonized layer avoids bleeding. The aim of the present investigation was to evaluate the effectiveness of atmospheric plasma (voltaic arc dermabrasion) for the frenectomy of a short lingual frenulum. A total of 30 patients with an age range between 6−11 years old and a class III/IV Kotlow’s ankyloglossia classification were included in the study. The Kotlow’s free-tongue, maximal interincisal mouth opening (MIO, mm) and interincisal mouth opening with tongue tip to maxillary incisive papillae at roof of mouth (MOTTIP, mm) were calculated at the baseline, immediately postoperatively (T0), at one week (T1), one month (T2) and two months (T3). A significant increase of Kotlow’s measurements, MOTTIP and MIO were detected when comparing the baseline and the T0 (p < 0.05). No significant difference was detected between the T0, T1 and T2 (p > 0.05). The atmospheric plasma demonstrated a very minimal invasive approach for frenectomy, without important or fibrotic complications and with very low recurrence rates.
PubMed: 36670655
DOI: 10.3390/children10010105 -
Archives of Dermatological Research Jan 2020Non-melanoma skin cancer primarily affects geriatric patients as evidenced by the fact that only 20% of these cancers are diagnosed in patients under the age of...
Non-melanoma skin cancer primarily affects geriatric patients as evidenced by the fact that only 20% of these cancers are diagnosed in patients under the age of 60 years. Of importance, geriatric skin responds to procarcinogenic ultraviolet B radiation (UVB) in a manner that permits the establishment of tumor cells. Recent studies have indicated that wounding of geriatric skin with fractionated resurfacing lasers and dermabrasion upregulates fibroblast production of insulin-like growth factor-1 (IGF-1) and normalizes the procarcinogenic acute UVB response consisting of basal keratinocytes proliferating while still harboring unrepaired DNA damage. The present studies tested the ability of wounding with a commercially available microneedling device to upregulate IGF-1 levels and normalize the geriatric UVB response. Geriatric volunteers were treated with a microneedling device on buttock skin and 3 months later the IGF-1 levels and UVB responses tested in wounded vs control skin. Wounding via microneedling upregulated IGF-1 and resulted in lower levels of basal keratinocytes proliferating with unrepaired DNA damage. The ability of microneedling to protect against the formation of UVB-damaged proliferating keratinocytes indicates the potential of this wounding modality to reduce aging-associated non-melanoma skin cancer.
Topics: Aged; Aging; Cellular Senescence; Female; Humans; Insulin-Like Growth Factor I; Keratinocytes; Male; RNA, Messenger; Skin; Ultraviolet Rays
PubMed: 31659432
DOI: 10.1007/s00403-019-02001-z -
Regenerative Therapy Dec 2021Curettage and dermabrasion are effective in the treatment of giant congenital melanocytic nevi (GCMN); however, local infection and hypertrophic scar formation are major...
INTRODUCTION
Curettage and dermabrasion are effective in the treatment of giant congenital melanocytic nevi (GCMN); however, local infection and hypertrophic scar formation are major issues. Thus, we applied cultured epithelial autografts (CEA) on skin defects after curettage or abrasion of GCMN and assessed the postoperative outcomes.
METHODS
Seven nevi lesions of five patients (aged 3 months to 24 years) were treated with CEA after curettage or abrasion with a dermatome or a surgical bar, respectively. We assessed the postoperative outcomes, including CEA take ratio, erosion and/or ulcer formation in the acute phase, hospitalization days, Vancouver scar scale, and color improvement one year after the operation. In addition, a histological evaluation of a skin biopsy was performed over one year after the operation.
RESULTS
The CEAs took well on the wound, and the wound surface was mostly epithelized by postoperative day 7 in all cases. While hypertrophic scar formation and slight pigmentation were observed in some lesions, the color was improved in all of the treated lesions. Histopathological examination revealed that the regenerated epidermis had stratified keratinocytes with rete ridges, and the dermal layer without nevus cells regenerated above the remaining dermis layer.
CONCLUSIONS
In this study, we found that early epithelialization and regeneration of the dermal layer was achieved after the application of CEA, suggesting that CEA could be an effective option after curettage or abrasion of GCMN.
PubMed: 33778134
DOI: 10.1016/j.reth.2021.02.003 -
Annals of Burns and Fire Disasters Jun 2023Post-burn leucoderma patients remain the most challenging to treat because they have two distinct issues: textural changes and hypopigmentation that must be managed...
Post-burn leucoderma patients remain the most challenging to treat because they have two distinct issues: textural changes and hypopigmentation that must be managed simultaneously. A variety of surgical techniques have been used with variable outcome. This prospective study evaluated the efficacy of superficial dermabrasion followed by suction blister epidermal grafting (SBEG) in post-burn leucoderma treatment. Twenty patients, 15 females and 5 males, ages ranging from 18 to 52 years, all having post-burn leucoderma ranging from 10 to 36 months, were included. The recipient sites were prepared by superficial dermabrasion. The Chinese cupping device was used for blister induction. Blister formation times, as well as the number of blisters, were noted. Complications, extent of the repigmentation, treatment efficacy and color matching were recorded. The mean time taken for blister formation was 91.75±10.29 min. The number of blisters harvested for each case ranged from 2 to 9. Regarding complications, 1 had partial graft loss, 3 developed perigraft halo at the recipient site, and all patients had temporary hyperpigmented circular macules at the donor sites. After a mean follow up period of 8.5±1.73 months, repigmentation percentage ranged from 40 to 100% with good color matching. Treatment efficacy was excellent in 3 cases (15%), good in 12 cases (60%), fair in 4 cases (20%), and poor in 1 case (5%). As regards patient satisfaction, 15 patients (75%) were satisfied, while 5 patients (25%) weren't. Combined superficial dermabrasion and SBEG appears to be a simple and cost-effective surgical treatment modality for localized post-burn leucoderma.
PubMed: 38681944
DOI: No ID Found -
Journal of Cutaneous and Aesthetic... 2021Medical therapies for rhinophyma have been described but these only delay progression. Therefore, surgery is the method of choice. Plenty of modalities have been...
UNLABELLED
Medical therapies for rhinophyma have been described but these only delay progression. Therefore, surgery is the method of choice. Plenty of modalities have been described including cold-knife surgery, electrosurgery, hydrosurgery, laser-assisted treatments, and dermabrasion.
SETTINGS AND DESIGN
In this two-center study, patients' charts and photodocumentation were analyzed retrospectively.
MATERIALS AND METHODS
Surgery was performed under general anesthesia with an additional local anesthesia of the affected areas of the nose. We removed the hypertrophic tissue in thin layers with a sterile disposable razor blade under constant visual control of the underlying cartilage and adnexal structures. A dressing with Mepithel and gauzes was applied. Patients presented weekly to monitor the wounds. Follow-up was 1 year.
RESULTS
From 2016 to 2019, nine male patients with rhinophyma underwent surgical therapy at AGAPLESION Markus Hospital, Frankfurt am Main, Germany and at the Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Austria. The mean age of the patients was 66 years. Mean time to complete re-epithelization equaled 31.5 days. No recurrences were noted within the follow-up period of 1 year. Patients' satisfaction was very high. Only one patient had hypertrophic scars at the wing of the nose and another one developed a superficial fistula without connection to the nasal cavity.
CONCLUSION
To the best of our knowledge, this is the first case series describing the use of a disposable razor blade for rhinophyma treatment supporting its efficiency described in previous anecdotal publications. We can highly recommend the technique, as it is cost-efficient and simple and provides excellent aesthetic results.
PubMed: 34084011
DOI: 10.4103/JCAS.JCAS_139_20 -
Lasers in Surgery and Medicine Jan 2020Actinic keratoses (AK) are common pre-cancerous lesions, which are associated with ultraviolet light exposure and aging. Wounding therapies such as fractionated laser...
Single Ablative Fractional Resurfacing Laser Treatment For Forearm Actinic Keratoses: 6-Month Follow-Up Data From An Intrapatient Comparison Between Treated and Untreated Sites.
BACKGROUND AND OBJECTIVES
Actinic keratoses (AK) are common pre-cancerous lesions, which are associated with ultraviolet light exposure and aging. Wounding therapies such as fractionated laser resurfacing (FLR) have been previously demonstrated to effectively treat facial AK. However, the effectiveness of FLR on other sites commonly afflicted with AK has not been studied in detail. Previously, our group has reported that treatment of aged skin with wounding therapies including dermabrasion and ablative fractionated resurfacing results in the removal of senescent fibroblasts and normalizing the pro-carcinogenic acute ultraviolet B radiation responses associated with aged skin. The current studies were designed to test the effectiveness of FLR of the forearm skin of subjects aged 60 and older to remove AKs.
STUDY DESIGN/MATERIALS AND METHODS
Between February 2018 and March 2019, 30 subjects were enrolled in a study, in which they underwent a single FLR treatment of one extremity including the dorsal forearm, wrist, and dorsal hand. The number of AKs was recorded on both extremities at baseline, 3 and 6 months in a blinded fashion. Side effects of the FLR were documented.
RESULTS
A single FLR treatment resulted in a 62% reduction in the absolute number of AK in the treated arm at 6 months post-treatment. The laser treatment was well-tolerated without major complications.
CONCLUSIONS
These studies demonstrate that FLR using settings, which have demonstrated to remove senescent fibroblasts and normalize the pro-carcinogenic UVB-response of aged skin is a potentially effective and safe field therapy treatment that should be studied for long-term efficacy for use in treating upper extremity AKs. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
Topics: Age Factors; Aged; Follow-Up Studies; Forearm; Humans; Keratosis, Actinic; Low-Level Light Therapy; Male; Middle Aged; Time Factors; Treatment Outcome
PubMed: 31736123
DOI: 10.1002/lsm.23175 -
International Journal of Surgery Case... Apr 2023Nevus comedonicus (NC) is a rare cutaneous disorder thought to be caused by hamartomatous pilosebaceous tissue proliferation that was first described in 1895. Clinically...
INTRODUCTION
Nevus comedonicus (NC) is a rare cutaneous disorder thought to be caused by hamartomatous pilosebaceous tissue proliferation that was first described in 1895. Clinically NC appears as a group of elevated follicular openings often linearly arrayed, giving the appearance of comedones. NC usually manifests at birth but can also present later during adolescence and rarely in adulthood.
CASE PRESENTATION
A 21-year-old medically healthy single male presented with right-sided chest black papules in comedo distribution with areas of superficial ulcerations and suppurations in periareolar distribution since the age of 16. Histopathological examination showed dilated follicular ostia filled with keratin plug, devoid of the hair shaft, and lined by stratified squamous epithelium with compact hyperkeratosis, focal parakeratosis, and patchy atrophy and acanthosis.
CLINICAL DISCUSSION
Nevus comedonicus often responds effectively to conservative treatment, however some cases need surgery intervention. The patient failed conservative medical and topical treatment, and he was treated by surgical-wide local excision and primary closure of the affected skin with free nipple grafting.
CONCLUSION
Nevus comedonicus (NC) is a rare cutaneous pathology secondary to pilosebaceous apparatus developmental defect that usually manifests at birth and can affect any area of skin; they typically manifest as black papules in comedo distribution. They can present as an isolated cutaneous pathology or as a component of nevus comedonicus syndrome. Different therapeutic approaches were described, including topical retinoids, keratolytic agents, oral retinoids, antibiotic therapy, manual extraction of comedos, dermabrasion, and surgical resection of the lesion.
PubMed: 37001367
DOI: 10.1016/j.ijscr.2023.108021 -
Craniomaxillofacial Trauma &... Dec 2020This is a prospective observational study of 60 consecutive cases with facial scars and contour deformity who underwent structural fat grafting.
STUDY DESIGN
This is a prospective observational study of 60 consecutive cases with facial scars and contour deformity who underwent structural fat grafting.
OBJECTIVES
The aim of the present article is to highlight how fat grafting helps to improve aesthetic and functional outcome in facial scars and contour deformities. It also highlights the factors that need to be considered while planning autologous fat grafting to get better aesthetic results.
METHODS
This is a prospective observational study of 60 consecutive cases with facial scars and contour deformity. The study was conducted from May 2014 to April 2019 in a tertiary care hospital. All the patients were followed up for a minimum period of 1 year from the date of surgery. Assessment of post-operative aesthetic outcome, in terms of satisfaction, was done using the Visual Analogue Scale (VAS), which ranges from 1 to 10 by the patient and operative surgeon.
RESULTS
The mean age was 30.8 9.8 years. Out of 60 patients, 20 patients underwent additional procedure like dermabrasion and collagen dressing to improve aesthetic outcome. Among 60 patients, 24 patients had transient edema and 10 patients had bruising at the recipient site. There were no major donor site complications except pain which was managed conservatively. Mean patient satisfaction score is 7 and mean surgeon satisfaction score is 7.25.
CONCLUSION
Despite the ongoing concerns about survival and longevity of fat grafts and also unpredictability of long-term outcomes, fat grafting has become a very useful surgical tool to improve the quality of facial scars and correct contour deformity. Our series shows excellent outcome both clinically as well as from the patient satisfaction. Future research is warranted in the fields of the adipocyte derived stem cells and to expand the clinical application of fat grafting.
PubMed: 33456702
DOI: 10.1177/1943387520948709 -
Frontiers in Pediatrics 2023To investigate the therapeutic effect of clitoris exposure + episioplasty + dermabrasion + platelet-rich plasma (PRP) injection + chemexfoliation on vulvar lichen...
INTRODUCTION
To investigate the therapeutic effect of clitoris exposure + episioplasty + dermabrasion + platelet-rich plasma (PRP) injection + chemexfoliation on vulvar lichen sclerosus (VLS).
METHODS
Twenty children with VLS (under 14 years old) at our hospital from July 2020 to November 2022 were enrolled and treated with clitoris exposure + episioplasty + dermabrasion + PRP injection + chemexfoliation. Additionally, symptomatic changes and improvements in signs were recorded.
RESULTS
Significant therapeutic effects were achieved in all children enrolled in this study. The Cattanco score was 8.02 ± 1.22 points before surgery, 2.21 ± 0.70 points 3 months after surgery, and 2.61 ± 0.59 points 6 months after surgery, demonstrating that the score after surgery was significantly lower than that before surgery ( < 0.05). Mild complications (one case of mild vulvar swelling, one case of minor bleeding, and one case of superficial ulcer) were observed in three children after surgery, with an overall complication incidence of 15%; all complications were improved after the intervention, and no severe adverse reactions were observed. Recurrence was observed in one child (5%) 6 months after surgery.
CONCLUSION
Clitoris exposure + episioplasty + dermabrasion + PRP injection + chemexfoliation is an effective approach for the treatment of VLS.
SYSTEMATIC REVIEW REGISTRATION
https://www.chictr.org.cn/searchproj.html, identifier: ChiCTR2100054787.
PubMed: 38111623
DOI: 10.3389/fped.2023.1276786