A 2-year follow-up of irradiated homologous costal cartilage used as a septal extension graft for the correction of contracted nose in Asians.

BACKGROUND: Septal extension graft is a useful method for the correction of contracted nose. When septal or costal cartilage is not available, irradiated homologous costal cartilage (IHCC) may be an alternative choice. This preliminary study is focused on noninfective absorption and other complications and postoperative changes of nasal length after septal extension graft using IHCC. METHODS: Thirty patients who could be observed for more than 2 years postoperatively were assessed. All patients had contracted nose deformities with a history of an inflammatory contracture after previous aesthetic surgical procedures. The IHCC was used only as a septal extension graft in each patient. Nasal length was analyzed by comparing preoperative and 2-year postoperative photographs. RESULTS: There was no noticeable graft warping or infective IHCC absorption. However, 3 patients underwent revision: 2 cases of graft avulsion fracture and 1 case of minimal nasal obstruction. Nasal length, which had increased an average of 8.5% after the procedure, was maintained at follow-up 2 years postoperatively. CONCLUSIONS: The IHCC has the advantages of avoiding donor-site scars, and also provides the same benefits as autogenous costal cartilage. It can therefore be a reliable alternative material for rhinoplasty. A longer follow-up may be necessary to confirm the structural stability of the IHCC graft in the lengthened caudal septum.

Is topical vitamin C an effective post-Fraxel laser regimen for asians?

UNLABELLED: The Fraxel laser has been a useful method for skin resurfacing. According to recent reports, vitamin C has beneficial effects for the skin. However, there is a paucity of data about the effect of vitamin C associated with the Fraxel laser. This study aimed to assess the effect of topical vitamin C as a post-Fraxel regimen. The study involved 44 Koreans, who wished to improve their facial skin aesthetics. All the patients were treated by Fraxel laser twice, with a 4-week interval between treatments. Beginning on day 1, the treatment group used a topical vitamin C agent as a post-Fraxel regimen for 12 weeks. The control group was told not to apply any topical agents. At every visit (0, 4, 8, and 12 weeks after the first Fraxel), colorimetric status, stratum corneum hydration, skin surface lipids, skin pH, and transepidermal water loss (TEWL) were measured. The parameters showing significant differences were TEWL and pH. Stratum corneum hydration, skin surface lipids, and colorimetric status showed no statistically significant differences between the two groups. Topical vitamin C application reduces the injury of the skin's surface barrier after Fraxel laser and promotes restoration of skin pH. However, there is a limit with increasing skin lightness or decreasing skin redness. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article.

Effect of percutaneous transluminal angioplasty on tissue oxygenation in ischemic diabetic feet.

Percutaneous transluminal angioplasty (PTA) has been performed as an alternative to bypass surgery for improving tissue oxygenation in ischemic diabetic feet because the former is less invasive than the latter. The purpose of this study was to evaluate the effect of PTA on tissue oxygenation in ischemic diabetic feet. This study included 29 ischemic diabetic feet, as determined by a transcutaneous oxygen pressure (TcPO(2) )<30 mmHg. The PTA was carried out in 29 limbs. The PTA procedure was considered successful, acceptable, and failed when residual stenosis was<30%, between 30 and 50%, and>50%, respectively. For evaluation of tissue oxygenation, the foot TcPO(2) was measured before PTA and weekly for 6 weeks after PTA. Immediately after PTA, 26 feet were evaluated as being successful and the remaining three as acceptable. Before PTA, the average foot TcPO(2) was 12.7 ± 8.9 mmHg. The TcPO(2) values were increased to 43.6 ± 24.1, 51.0 ± 22.6, 58.3 ± 23.0, 61.3 ± 24.2, 59.0 ± 22.2, and 53.8 ± 21.0 mmHg 1, 2, 3, 4, 5, and 6 weeks after PTA, respectively (p<0.01). The PTA procedure significantly increases tissue oxygenation in ischemic diabetic feet. The maximal level of tissue oxygenation was measured on the fourth week following PTA.

The treatment of diabetic foot ulcers with uncultured, processed lipoaspirate cells: a pilot study.

Human processed lipoaspirate (PLA) cells are relatively easy to obtain in large quantities without cell culture. The purpose of this study was to present the possibility of using uncultured PLA cell autografts for the treatment of diabetic ulcers. An in vitro study was designed initially to determine the effect of PLA cell autografts on the proliferation and collagen synthesis of diabetic fibroblasts (n=4). In a subsequent clinical study, 26 patients with diabetic foot ulcers were treated using PLA cell autografts. Control treatment was also performed in 26 patients. Eight weeks after treatment, the percentages of complete healing and mean healing times were compared. Cell proliferation and collagen synthesis in the PLA cell treatment group were 28 and 44% higher than that in the control group in vitro, respectively. Our clinical study showed that 100% of the PLA cell-treated group and 62% of the control group achieved complete healing. The PLA cell treatment was also superior to the conventional method in terms of the healing time. No adverse events related to the study treatment occurred. Uncultured PLA cell autografts stimulate the activity of diabetic fibroblasts and may offer a simple and effective treatment for diabetic ulcers.