Polydioxanone Bioactive Sutures-Acetyl Hexapeptide-8 (Argireline): An Intelligent System for Controlled Release in Facial Harmonization.

Introduction: We propose a new facial lifting protocol using polydioxanone (PDO) threads embedded in acetyl hexapeptide-8 (Argireline [Arg]). We assume that Arg reinforces the effects of PDO threads, as it is a mimetic of botulinum toxin. Because the PDO suture is hydrolyzable, this assumption is analyzed by instrumental analysis. Objective: To demonstrate the capacity of the PDO suture as a system for the controlled release of acetyl hexapeptide-8 to apply in deep wrinkles of the upper third. Materials and Methods: Three segments of 1-cm long 21G PDO threads immersed in 1 mL of Arg. PDO threads were observed under an optical, electron microscope at 24, 48, and 72 h later. They were also weighed before and after being soaked in Arg, and employing ultraviolet (UV)-visible spectroscopy, the release rate of Arg from the PDO suture was measured. Finally, was insert the thread PDO-Arg following a protocol designed especially for deep static wrinkles in the upper third. Results: The electronic weighing revealed that the PDO thread enjoys capillarity by the peptide, doubling its weight every 24 h. UV spectra revealed that PDO thread is a well-controlled release system for Arg, allowing its sustained release for 1 h. Optical and electronic photomicrographs confirm the swelling of the PDO thread by absorbing Arg by its capillarity, but this hydrophilicity does not lead to its premature physical degradation. Conclusions: The PDO thread system with Arg is an intelligent bioactive system useful in facial harmonization. It recommend conduct clinical trial to verify his superior lifting effect.

Epidermal Growth Factor in Aesthetics and Regenerative Medicine: Systematic Review.

INTRODUCTION: Epidermal Growth Factor (rhEGF) is a promising skin antiaging agent that successfully promotes skin wound repair, and it has been investigated in the past decade for these purposes. However, there are no updated systematic reviews, in English or English, that support the efficacy of rhEGF as a regenerative skin treatment or systematic reviews that compile the uses of rhEGF as facial aesthetic therapy and regenerative medicine. AIM: To describe the current state of facial aesthetic and regenerative medicine treatments in which rhEGF has been effectively used. MATERIALS AND METHODS: An exhaustive search was carried out in "Medline" (via "PubMed"), "Cochrane," "Bireme" through the Virtual Health Library (VHL), "Elsevier" via "Science Direct," "Springer," "SciELo," "ResearchGate," and Google Scholar. Studies related to the use of rhEGF in addressing skin disorders or skin aging are included. RESULTS: Overall, 49 articles were found, which described the use of rhEGF for skin regeneration and restructuring. Efficacy in the regeneration of skin wounds was verified through the intradermal and topical application of formulations with rhEGF. Most clinical trials in aesthetics point to an effective inversion of skin aging. However, uncontrolled or randomized trials abound, so that does not represent enough evidence to establish its efficiency. There are transient adverse effects for both cases. CONCLUSION: The rhEGF considers an effective therapeutic alternative for patients with recalcitrant skin wounds and skin aging, as it is a potent and specific mitogenic factor for the skin.

Innovative Paradigm in Aesthetics Medicine: Proposal for Diagnostic Morphological Geometric by Thirds, Semiology in Clinical Applied to Aging Facial.

The diagnosis of aging based on the morphogeometric changes experienced by the face, measured by the application of facial stratigraphic semiology by thirds, could become a novel approach that guarantees an efficient replacement of aged tissues through minimally invasive aesthetic medicine strategies. Facial aging should be analyzed by thirds, because not all thirds grow old at the same time. Owing to this is necessary go giving solve the aging problems each one of them, by means of therapies of the facial restructuring into sequential treatment appointments, with the purpose of being go giving time to the tissues rearrangement of the face, so that it is perceived as a subtle progressive reversal of aging and so generate a comfortable social acceptance of the resulting changes of said facial rejuvenation. This article intends to present the practical approach of the concepts and guidelines illustrated in the routine aesthetic diagnosis, the anatomical changes in the various tissue layers that are externally appreciated, but detailing them under a regional approach (upper, middle, and lower thirds). Our paradigm seeks that as professionals of aesthetic and regenerative medicine we identify facial aging not only as the obvious wrinkles and other changes in the skin, but that we diagnose according to the proposed parameters, so that when considering the rejuvenation treatment, we identify which are facial tissues that have changed due to aging and must therefore be restored to harmonize the face according to the ideal forms and proportions that must prevail (morphometry).

In Vitro Degradation of Polydioxanone Lifting Threads in Hyaluronic Acid.

Recently, some clinicians have proposed implanting polydioxanone (PDO) threads imbibed in hyaluronic acid (HA), arguing that this may reinforce the lifting effects. However, this is controversial because PDO sutures are hydrophilic and the presence of HA could increase the rate of hydrolysis. The aim of this study was to demonstrate the degradation of PDO lifting threads in HA through ultramicroscopy. It was a qualitative research and preclinical trial. Three, 1-cm-long, segments of 23-G PDO threads were immersed in 1.5-mL non-crosslinked HA in previously labeled, sterile microcentrifuge tubes. These were observed by ultramicroscopy at 4× and 10× after 24, 48, and 72 h. Microphotographs taken after 24 h show structural changes in the fibers, presenting an increase in interlaminar spaces and dilution of violet pigmentation. At 48 h, degradation continues. PDO hygroscopy is observed as aqueous content between the peripheral layers and the central core of the thread. At 72 h, as the pigment is released, larger empty spaces are observed in the central column of the thread, and there is disorganization of the peripheral fibrils with fraying all along the fiber. HA induces rapid biodegradation of the PDO thread by hydrolysis beginning 24 h after contact of the thread with the biomaterial. The non-crosslinked HA is a powerful catalyzing agent for hydrolytic degradation of the PDO thread, because this thread is highly hydrophilic. Clinically, embedding PDO threads in HA accelerates biodegradation of the suture.

Microscopic and clinical evidence of the degradation of polydioxanone lifting threads in the presence of hyaluronic acid: a case report. / Evidencia clínica y microscópica de la degradación de hilos de dermosustentación de polidioxanona en presencia de ácido hialurónico: reporte de caso.

We present the case of a female patient with complications from superficial implantation of polydioxanone spiculated threads in the facial middle third. The manifestations were edema, ecchymosis, superficial palpation of the thread and skin plication. For the treatment we propose a novel protocol of clinical degradation of polydioxanone threads, using hyaluronic acid injecting it into the implantation area of the polydioxanone threads. Non-cross linked hyaluronic acid was infiltrated along the path of the thread. The follow-up at seven, 21 and 45 days showed decreased edema, folds and skin irregularities due to wire traction and attenuation of secondary rhytides. A sample of the thread in hyaluronic acid was observed in a laminar flow campaign evidencing degradation at 72 hours. Administering hyaluronic acid was effective in inducing clinical biodegradation of the thread suggesting that non-crosslinked hyaluronic acid is a powerful catalyst for the hydrolytic degradation of polydioxanone.

Se expone el caso de una paciente remitida por complicaciones posteriores a la implantación superficial en el tercio medio facial de hilos de polidioxanona espiculados. Presentaba edema, equimosis, palpación superficial del hilo y plicación dérmica. Para el tratamiento planteamos un novedoso protocolo de degradación clínica de hilos de polidioxanona, empleando ácido hialurónico inyectándolo en el área de su implantación. Se infiltró ácido hialurónico no reticulado en el trayecto a lo largo del recorrido del hilo. El seguimiento a los siete, 21 y 45 días evidenció disminución del edema, de los pliegues e irregularidades dérmicas por la tracción del hilo y atenuación de rítides secundarias. Una muestra del hilo en ácido hialurónico fue observado en campana de flujo laminar evidenciándose degradación a las 72 horas. Administrar ácido hialurónico fue efectivo para inducir la biodegradación clínica del hilo. La hipótesis derivada sugiere que el ácido hialurónico no reticulado es un poderoso catalizador de la degradación hidrolítica de la polidioxanona.

Histomorfometría de la regeneración ósea obtenida con sistema liposoma-membrana de quitosano en un modelo experimental

RESUMEN Introducción: desarrollamos un andamiaje a base de quitosano en dos formas físicas, membrana y liposoma como biomateriales para Regeneración ósea guiada no estudiado histológicamente en modelo experimental. Objetivo: determinar histológicamente la eficiencia del quitosano para la regeneración ósea guida en defectos óseos creados en tibias de ratas del linaje Wistar. Materiales y Métodos: esta investigación fue realizada en 25 ratas Wistar machos, adultas con peso entre 350 g - 500 g, a los cuales se les creó un defecto longitudinal en ambas tibias (control y experimental). Los animales fueron divididos al azar en 3 grupos: 9 ratas que fueron evaluadas a las 3 semanas, 8 que fueron valoradas a las 6 semanas y 8 a las 9 semanas. Resultados: los hallazgos histológicos confirmaron que existía mayor actividad osteoinductiva y mayor nivel de madurez ósea en las tibias experimentales a diferencia del grupo control. Conclusiones: el liposoma de quitosano fue eficiente para la regeneración ósea guiada promoviendo mayor regeneración ósea en menor tiempo que en el grupo control.

ABSTRACT Introduction: We developed a chitosan scaffold in two physical forms, membrane and liposome as biomaterials for guided bone regeneration, which has not been studied histologically in an experimental model. Objective: To determine histologically the efficiency of chitosan in the guided bone regeneration in bone defects created in tibias of Wistar rats. This study was performed in 25 male adult Wistar rats with weight between 350 g - 500 g. A longitudinal defect was created in both tibias (control and experimental). The animals were randomly divided into 3 groups: 9 rats were evaluated at 3 weeks, 8 at 6 weeks and 8 at 9 weeks. Results: The histological findings confirmed that there was more osteoinductive activity and a higher level of bone maturity in the experimental tibias than in the control group. Conclusions: The chitosan liposome was efficient in the guided bone regeneration promoting more bone regeneration in less time in the experimental group than in the control group.