Clinical validation of an elastin-derived trifunctional peptide for skin regeneration.

Aging is associated with progressive skin fragility, characterized in part by extracellular matrix (ECM) fragmentation. This degradation produces matrikines which have an impact on ECM rremodeling. Our group previously designed and characterized a trifunctional peptide (TFP), constituted of i) an elastokine motif (VGVAPG)3, able to increase the expression of matrix constituent through the stimulation of the elastin-binding protein receptor, ii) a tripeptide inhibiting matrix metalloproteinase-1 activity (GIL), and iii) a linker domain acting as a competitive substrate for urokinase (RVRL). TFP was shown to activate the production of matrix constituents while inhibiting Matrix MetalloProtease MMP-1 in vitro on fibroblasts and ex vivo on skin explants. OBJECTIVE: In the present study, TFP properties were evaluated in a clinical assay. METHODS: Twenty-two volunteers applied a TFP-based cream on one hemi-face and a placebo-based cream on the other hemi-face, twice a day during 28 days, before undergoing a surgical lifting. Cutometry and skin relief measurements were performed at days 0 and 28, and skin explants from lifting surgery were used for histological analyses. RESULTS: Cutometry and skin relief measurements reveal TFP firming properties and wrinkle depth decrease in 28 days on TFP- as compared to placebo-treated hemi-faces. These results are confirmed by histological analyses showing an increase of the ratio between basal lamina and stratum corneum. Furthermore, immunostaining of collagen reveals a modification of the ratio between type I and III collagens. CONCLUSION: The combined analysis of phenotypic and histologic parameters demonstrates a reorganization of the ECM towards a regenerative profile upon TFP treatment.

Post-operative orbital haematomas over a 12-year period. A description of three cases among 280 orbital procedures.

PURPOSE: To evaluate the incidence of orbital haematoma requiring surgical treatment following procedures including fracture repairs and orbital osteotomies over a 12-year period and to discuss their management. METHODS: The records of all the patients who underwent a procedure involving the orbits from 1998 to 2011 were reviewed for evidence of post-operative haematomas. Medical data including clinical presentation, time between diagnosis and treatment, management and subsequent outcome were collected. RESULTS: 280 patients were included, 257 procedures for orbital or zygomato orbital fractures and 23 osteotomies for dysthyroid orbitopathy or malunited orbital fractures. Three cases (1.07%) of post-operative haematomas were observed as follows: 2/257 orbital fractures (0.77%) and 1/23 osteotomies (4.34%). All cases occurred in the early post-operative period of less than 6 h. No spontaneous loss of vision or pain was described by patients. All could be operated on as soon as the diagnosis was established; no CT-scans were required. Orbital drainage was successfully performed in all cases. CONCLUSION: Post-operative orbital haematomas are uncommon complications. Diagnosis is based on a clinical examination, including pain, proptosis and alteration in visual acuity. Surgical treatment should be undertaken immediately following diagnosis.

[Mondor's disease: about two cases]. / La maladie de Mondor: à propos de deux cas.

The authors report two cases of Mondor's disease after mammoplasty reduction's surgery. This pathology rare and benign should be known by all surgeons, because it could be a postoperative discord, especially in these lithigious times. If the evolution is favourable in one or two months, the therapeutic urgency is to reassure the patient.