Xanthelasma palpebrarum removed with Atmospheric Plasma technique: 11-year follow up.

Xanthelasma palpebrarum is a subcutaneous lesion of the lid and cause a cosmetical issue. The aim of the present study was to evaluate the atmospheric plasma treatment for the treatment of xanthelasma with an 11-year follow up. Seventy-two patients with bilateral xanthelasma and 26 patients with unilateral xanthelasma by atmospheric plasma technique known also as voltaic arc dermabrasion (VAD, Europe Medical s.r.l. Montesilvano (PE), Italy). Photographs were obtained at the baseline and after the procedure and analyzed by an independent observer. The evaluation of the results was made 2 months after this single treatment with 11 years of follow up. The subjects average age was 48.5 years (range 41-63 years). All subjects were elected for a single session for the lesion removal. The erosion is epithelialized from the lesion margins and the dermal basal cells. After 2 months from the treatment, the result was scored as 4 (clearing of lesions > 75%, complete resolution) in 66 patients for a total of 104 lesions treated; scored as 3 in 24 patients for a total of 48 lesions, and as 2 in nine patients for a total of 18 lesions. No subjects scored 0 or 1. A total of 8 lesions showed mild erythema in the treated areas for 1 month. Numerous approaches were proposed for xanthelasma exeresis such as a surgical treatment especially in case of excessively large lesions or lesions involving the medial canthus that could produce a more limited skin laxity rapidly induces a risk of ectropion. In conclusion, the effectiveness of the present investigation suggest that the atmospheric plasma is a useful therapeutic option for the treatment of xanthelasma palpebrarum.

Bacterial adherence to silk and expanded polytatrafluorethilene sutures: an in vivo human study.

After oral surgery, bacterial adhesion to suture can cause surgical site infections and delay wound healing. Microbial adherence to the suture is influenced by its physical configuration and chemical structure. The aim of this study was to compare in vivo the bacterial adhesion to two suture materials used in oral surgery: silk and monofilament expanded polytetrafluoethilene (e-PTFE). After sinus lift surgery, 15 flaps were sutured with silk (nonabsorbable, organic, braided, 4.0) and 15 were sutured with e-PTFE (nonabsorbable, synthetic, monofilament, 4.0). Seven days after surgery, bacterial adherence, in terms of percentage of the surface covered, was evaluated for each suture material by scanning electron microscope (SEM). Onto silk suture, plaque consisted of a few cocci and a higher proportion of rods and filamentous-shaped bacteria, with some mineralized plaque. Onto e-PTFE speciments, only small colonies of a few cocci or no bacteria were observed, with empty spaces between the colonies and no plaque mineralization. The surface covered by bacteria on e-PTFE specimens was significantly lower than that of silk sutures. (22.1% ±4.96% vs 54.3% ± 7.9%; P =0.0001). The results of the present study suggest that multifilament structure of silk favours a greater bacterial adherence, proliferation, and persistence, so monofilament and e- PTFE suture should be preferred in oral surgery.