Correction of Cicatricial Upper Eyelid Ectropion Using a Dermofat Graft and an Anti-Adhesive Agent

Ectropion is characterized by eversion of the eyelid margin and exposure of the cornea and conjunctiva. This leaves the inner eyelid surface exposed and prone to irritation, and in severe cases, poor eye closure. Ectropion can occur for several reasons including congenital malformations, trauma, burns, anti-cancer medications, allergies, and inappropriate eyelid surgery. Surgical treatments usually include local flaps or skin grafts, depending on the severity of the defect. We present a case of successful cicatricial upper eyelid ectropion correction using a dermofat graft and an anti-adhesive agent (Guardix-Sol) after the wide release of tethering scar tissue.

Effectiveness of the Anti-adhesive Agent Protescal after Arthroscopic Rotator Cuff Repair: A Retrospective Study

BACKGROUND: Many hyaluronic acid (HA)-based anti-adhesive agents have been commercialized for clinical use in the pharmaceutical market. But their efficacy in arthroscopic rotator cuff repairs remains elusive. To determine their efficacy, we performed a comparative analysis of the effects of two hyaluronate/carboxymethylcellulose (CMC)-based anti-adhesive agents, Protescal and Guardix. METHODS: We recruited a total of 256 patients who had received an arthroscopic rotator cuff repair at our hospital between January 2014 and March 2015. Among them, 96 patients fulfilled the study's selection criteria and were enrolled as the final population sample. Thirty patients who had received a postoperative injection of Protescal were allocated into Group A. Another 30 patients who had received a postoperative injection of Guardix were allocated into Group B. As controls, 36 patients who did not receive any injection were allocated into Group C. The patients included in this study were aged between 19 and 75 years. For the clinical assessment, we measured the following clinical parameters—the visual analogue scale for pain (PVAS), the American Shoulder and Elbow Surgeons (ASES) score, and the constant score, as well as passive range of motions (ROMs)—at three time-points (preoperatively, 2-month postoperatively, and 6-month postoperatively). RESULTS: We found that Group A compared to Group B tended to show a swifter recovery in passive anterior elevation and in internal rotation by the 2-month postoperative follow-up, but the differences were not statistically significant. CONCLUSIONS: We found that the effects of HA/CMC-based injections were minimal after arthroscopic rotator cuff repairs.

Effectiveness of the Anti-adhesive Agent Protescal after Arthroscopic Rotator Cuff Repair: A Retrospective Study

BACKGROUND: Many hyaluronic acid (HA)-based anti-adhesive agents have been commercialized for clinical use in the pharmaceutical market. But their efficacy in arthroscopic rotator cuff repairs remains elusive. To determine their efficacy, we performed a comparative analysis of the effects of two hyaluronate/carboxymethylcellulose (CMC)-based anti-adhesive agents, Protescal and Guardix. METHODS: We recruited a total of 256 patients who had received an arthroscopic rotator cuff repair at our hospital between January 2014 and March 2015. Among them, 96 patients fulfilled the study's selection criteria and were enrolled as the final population sample. Thirty patients who had received a postoperative injection of Protescal were allocated into Group A. Another 30 patients who had received a postoperative injection of Guardix were allocated into Group B. As controls, 36 patients who did not receive any injection were allocated into Group C. The patients included in this study were aged between 19 and 75 years. For the clinical assessment, we measured the following clinical parameters—the visual analogue scale for pain (PVAS), the American Shoulder and Elbow Surgeons (ASES) score, and the constant score, as well as passive range of motions (ROMs)—at three time-points (preoperatively, 2-month postoperatively, and 6-month postoperatively). RESULTS: We found that Group A compared to Group B tended to show a swifter recovery in passive anterior elevation and in internal rotation by the 2-month postoperative follow-up, but the differences were not statistically significant. CONCLUSIONS: We found that the effects of HA/CMC-based injections were minimal after arthroscopic rotator cuff repairs.

GnRH Agonists: Are They Ready for Clinical Use as an Anti-adhesive Agent? A Review of the Literature.

GnRH agonists have been shown to intervene in the mechanism of adhesion formation in a variety of ways. Influence on the hormonal state, the inflammatory and coagulation processes contribute to the reduction of adhesion formation postoperatively. Most studies on this topic have been conducted in animal models and have indicated the possible clinical use of GnRH agonists for this purpose. The aim of this study is to investigate the literature review of the mechanisms and the possible advantages of GnRH agonists therapy in the prevention of postoperative adhesions.

Microleakage of bonded amalgam restorations using different adhesive agents with dye under vacuum: An in vitro study.

Aim: In an effort to minimize tooth preparation, yet provide additional retention to compromised tooth structure, bonded amalgam restorations were introduced. Various resin-based adhesives have been tried earlier under bonded amalgam restorations. Still there are controversies regarding the outcome of bonded amalgam restorations regarding their adaptability to the tooth structure and microleakage. Therefore, this study was undertaken to compare the microleakage of bonded amalgam restorations using different adhesive materials. Materials and Methods: Standard Class I cavities were prepared on occlusal surfaces of 60 human molars. Teeth (n=60) were divided into three groups according to the material employed, as follows: group I: amalgam with glass ionomer cement (GIC) (type I); group II: amalgam with resin cement (Panavia F 2.0) and group III: amalgam with Copalex varnish as a control. Following restoration, the teeth were submitted to thermal cycling. The teeth were subsequently immersed in 2% rhodamine B dye under vacuum for 48 hours and sectioned to allow the assessment of microleakage under stereomicroscope. Results: The values were tabulated and the results were statistically analyzed using analysis of variance (ANOVA), Tukey's post hoc test and Kruskal-Wallis test. Amalgam with type I GIC showed the least leakage with no statistically significant difference (P value 0.226) when compared to amalgam with Panavia F 2.0 and amalgam with varnish (P value 0.107). Conclusion: It can be concluded that bonded amalgam with type I GIC is a good alternative to amalgam with resin cement (Panavia F 2.0) and amalgam with varnish for large restorations, with the added advantages of GICs. Clinical Significance: Bonded amalgam restorations prevent over-preparation and reduce the tooth flexure. GIC type I under amalgam provides chemical bonding in between amalgam and tooth structure and thus reduces the microleakage.