New-generation filler based on cross-linked carboxymethylcellulose: study of 350 patients with 3-year follow-up.

PURPOSE: In recent years there has been a growing interest in nonsurgical procedures for facial rejuvenation. Hyaluronic acid is currently the most widely used dermal filler for the treatment of facial wrinkles. However, new products with interesting features are being introduced into the market. Cross-linked carboxymethylcellulose is one of these and represents a new alternative for the correction of wrinkles and facial defects. PATIENTS AND METHODS: The retrospective, multicenter, open-label study on nasolabial folds reported here was carried out between January 2010 and April 2014 on 350 subjects between 22 and 67 years of age for a 36-month follow-up period in order to consistently and extensively assess the safety and performance of this treatment. RESULTS: The study revealed effective and durable correction of nasolabial wrinkles for periods of 9-12 months. Product reapplication over a 36-month period did not lead to an increase in adverse effects, which always remained rare and of little clinical significance, usually consisting of bruising and redness. CONCLUSION: Cross-linked carboxymethyl cellulose has been shown to be a safe and effective alternative to the resorbable products currently on the market.

Use of cross-linked carboxymethyl cellulose for soft-tissue augmentation: preliminary clinical studies.

PURPOSE: The continual search for new products for soft-tissue augmentation has in recent years led to the introduction of long lasting alternatives to hyaluronic acids and collagen that are composed of other polymers able to improve clinical persistence over time. This is the first report in which sodium carboxymethyl cellulose (CMC) has been chemically treated by the cross-linking process and thus used as a hydrogel for soft-tissue augmentation through injection with thin needles. The study evaluates, from a clinical point of view, the behavior of cross-linked carboxymethyl cellulose hydrogel used in the aesthetic field and its side effects so as to check the safety and performance of the polymer following intradermal injections. PATIENTS AND METHODS: This work shows the preliminary results of an ongoing clinical study conducted between 2006 and 2009, performed on 84 healthy volunteers (62 females, 22 males) aged between 18 and 72 years, for the treatment of 168 nasolabial folds, 45 perioral wrinkles, and 39 lip volume. RESULTS: Study results show an excellent correction of facial defects. Tolerance and aesthetic quality of the correction obtained indicate considerable safety features and absence of side effects. From a clinical point of view, hydrogel is gradually absorbed into the injection site without migration issues. CONCLUSION: Cross-linked CMC hydrogel proves to be an ideal agent for soft tissue augmentation with regard to safety and ease of application. It did not cause infection, extrusion, migration, or adverse reactions in the patients who have been followed for two years. Delayed aesthetic results on facial wrinkles were very satisfactory.

Pharyngoesophageal reconstruction: using microsurgical jejunum and pectoralis major flaps / Reconstrução faringoesofágica: utilização do retalho peitoral maior e jejuno microcirúrgico

Pharyngoesophageal reconstruction is one of the majorchallenges of neck surgery. Many treatment options have been described. All of them involve procedures of greater or lesser technical complexity and high ratesof complications and mortality. The present study describes the techniques performed at the Service of Plastic Surgery of the PUC-RS São Lucas Hospital in 10 reconstructions: myocutaneous pectoralis major flap and microsurgical jejunal flap. Indications, complications, advantages and disadvantages of each method are discussed.

Reconstruction of fingertip pulp loss / Reconstrução de perdas de substância digitais distais

loss of valor fingertip pulp is frequent in hand trauma. Eighty-six homodigital flaps (22 Tranquilli; 20 Hueston; 40 Single Pedicle Island and 4 Kutter) were performed from Jannuary 1994 to July 1998, to repair volar fingertip substance loss, except for the thumb. The mean age was 28 years (ranging from 18-58) and the average post-operative follow-up period was 12 months. We analyzed advancements, sensitivity and cold intolerance for each flap used: Tranquilli (0.4cm/8mm/6); Kuttler (0.3cm/10mm/3); Hueston (1.0cm/9mm/5); Single Pedicle Island (1.5cm/8mm/6). The single pedicle island flap was demonstrated to be clearly better in all aspects analyzed. We consider the utilization of homodigital flaps the first choice alternative for reconstruction fingertips. (AU)#TRA