Does Platelet-Rich Plasma Promote Facial Rejuvenation? Revising the Latest Evidence in a Narrative Review.

Facial aging is characterized by progressive macroscopic, histological, and molecular changes. Due to its regenerative and rejuvenating properties, the use of platelet-rich plasma (PRP) as a facial antiaging agent has gained popularity over the last decade. In order to gather and evaluate the latest evidence focusing on the effect of PRP on facial skin rejuvenating, a search through MEDLINE (PubMed) using relevant keywords, inclusion, and exclusion criteria was performed. A total of 539 articles were initially retrieved, and from those, 16 were included in the review. Treatment protocols comprised the use of PRP both in monotherapy and in combination with other substances and by means of direct injection or topical application following skin permeation. The selected studies presented high variability regarding PRP preparation methods, administration protocols, and results assessment. In most studies, PRP seemed to improve to some degree the signs of facial aging, such has wrinkles, skin quality, and pigmentation, accompanied by significant histological and molecular responses. Optimizing treatment protocols should be the next step in assessing the full potential of PRP.

1-Year of covid-19 pandemic: changes in the epidemiology of maxillofacial trauma / 1 año de pandemia de COVID-19: cambios en la epidemiología del trauma maxilofacial

Objectives: Due to COVID-19 pandemic, social distancing policies were enacted worldwide, including by the Portuguese official authorities. However, the impact of these measures on maxillofacial trauma and fracture surgical repair remains poorly understood. The aim of this study was to evaluate and compare the incidence and aetiology of facial fractures submitted to surgical repair during 1-year of COVID-19 pandemic versus the previous 4 years, in a level III Trauma Centre located in Lisbon, Portugal. Materials and methods: All emergency episodes registered in our hospital between March 2016 and February 2021 that resulted in patient admittance for surgical treatment of facial fracture were included. Comparative analysis was performed for variables such as fracture type and aetiology. Results: Analysis showed that surgeries performed during the 1st year of COVID-19 were reduced by 37.5 %. Considering only the 75-day lockdown period at the beginning of the pandemic, reduction was even more pronounced and reached -66.7 %. Significant diffe­rences in the aetiology were also found, with physical assault and sport accidents relative frequency decreasing. Moreover, despite being systematically the second most common cause of fracture, during lockdown, fall ranked first, over physical assault. The relative frequency of nasal fractures, the most common facial fracture treated in our hospital, decreased during both the 1st year of COVID-19 and the lockdown period, while mandible fractures ranked first during lockdown. (AU)

Objetivos: Debido a la pandemia por COVID-19, se establecieron políticas de confinamiento social mundial, incluso por parte de las autoridades oficiales portuguesas. Sin embargo, el impacto de estas medidas sobre la cirugía originada por traumatismo maxilofacial sigue siendo poco conocida. El objetivo del presente estudio ha sido evaluar y comparar la incidencia sobre la etiología de las fracturas faciales quirúrgicas, durante 1 año de pandemia de COVID-19 versus los 4 años anteriores, en un Centro de Traumatología (nivel III) ubicado en Lisboa, Portugal. Materiales y métodos: Se incluyeron todos los registros de urgencia en nuestro hospital, entre marzo de 2016 y febrero de 2021, que cursaron con el ingreso de pacientes diagnosticados de fractura facial y su correspondiente tratamiento quirúrgico. Se realizó un análisis comparativo de variables cualitativas como el tipo de fractura y la etiología de las mismas. Resultados: El análisis mostró que las cirugías realizadas durante el primer año por COVID-19 se redujeron en un 37,5 %. Teniendo en cuenta solo el periodo de confinamiento de 75 días al comienzo de la pandemia, la reducción fue aún más pronunciada y alcanzó el 66,7 %. Se encontraron diferencias significativas en la etiología_ disminuyendo la frecuencia relativa de agresiones físicas y accidentes deportivos. A pesar de ser sistemáticamente la segunda causa más frecuente de fractura durante el confinamiento, la caída ocupó el primer lugar, por encima de las agresiones físicas. La frecuencia relativa de las fracturas nasales, fractura facial tratada con mayor incidencia en nuestro hospital, disminuyó tanto durante el primer año por COVID-19 así como durante el periodo de confinamiento, mientras que las fracturas maxilares ocuparon el primer lugar durante el confinamiento. (AU)

Intra- and interreader variability of orbital volume quantification using 3D computed tomography for reconstructed orbital fractures.

PURPOSE: Management of orbital fractures continues to present some difficulties, particularly regarding the prediction of late complications. Radiographic assessment provides a detailed evaluation, but the results lack consistency to be considered a standard factor in the decision-making process. Studies focusing on reliability of post-operative imaging are lacking. MATERIALS AND METHODS: We performed a retrospective study using patients from a major trauma center with unilateral orbital floor fracture who underwent surgery. Using three-dimensional volume assessment software, we performed a volume calculation and determined the intra- and interreader variation by intraclass correlation coefficient analysis. RESULTS: Twenty-four orbits were assessed. Mean orbital volume (SD) was 24.02 (2,43) cm3 for reader 1 and 24.08 (2,51) cm3 for reader 2. The intraclass correlation coefficient (95% CI) was 0.95 (0.91-0.98) between readers and 0.96 (0.91-0.98) for intra-reader variability. Normal and reconstructed orbits assessed separately also showed very high correlation coefficient for both intra- and inter-subject variability. CONCLUSION: Results show an almost perfect agreement of volume assessment between readers. The presence of reconstruction material does not seem to add variability. Although reproducible and reliable, radiological volume assessments have not yet shown a clear correlation with clinical outcomes and post-operative management decisions should be based mainly on clinical findings.