Dermatologic Surgery最新文献

Background: Autologous and allogeneic platelet-rich plasma (PRP) in addition to its derivatives, such as platelet-rich fibrin (PRF), are broadly accepted therapeutic approaches in orthopedics, otolaryngology, sports medicine, plastic surgery, and oral and maxillofacial surgery. However, the absence of expert consensus, standardized protocols, and varying outcomes pose challenges to their broader acceptance in cosmetic dermatology and dermatologic surgery.

Objective: To offer a contemporary literature overview of PRP and PRF, focusing on fundamental aspects of the technology, diversity of commercially accessible systems, and shed light on present-day controversies within the field.

Methods: A systemic review of PRP and PRF literature was conducted, utilizing search engine databases: Cochrane Database of Systematic Reviews, Embase, Ovid MEDLINE, and PubMed. Emphasis was placed on scrutinizing higher level-of-evidence articles, specifically randomized control trials, systematic reviews, and meta-analyses (Level 1A-2A), with particular emphasis on recent data that have not been well reviewed in other publications from January 2022 to May 2024.

Results: An increasing body of literature affirms advantages of PRP products in dermatology, spanning wound care, facial rejuvenation, scar revision, and hair growth.

Conclusion: A foundational understanding of variation in preparation protocol, outcomes, and timing of administration is needed to better comprehend market dynamics, patient demand, and strategies for integrating PRP into dermatologic practice.

Background: The superior auricular artery (SAA)-retroauricular flap is commonly used for the repair of defects of the superior auricle. There are few studies about the anatomy of the SAA.

Objective: This study mainly analyzed the anatomical pattern of SAA.

Materials and methods: Computed tomography (CT) was performed on 26 cadaver heads infused with lead oxide. The anatomical pattern of the SAA was statistically analyzed by 3-dimensional CT images.

Results: The SAA was classified into 3 types according to whether it gave off the helix branch or the auricular dorsal branch. The SAA was located mainly in an area 2 cm above and below the horizontal line at the midpoint of the 2 base points (the otobasion superius and the apex of the external auditory canal). The origin of each branch of the SAA was mainly located in Areas 2, 3, and 4 within a circular area that had the otobasion superius as the center of the circle and a radius of 2 cm.

Conclusion: In this study, the 3 anatomical types and anatomical patterns of the SAA were identified. These findings can provide a reference for the design of SAA-retroauricular flaps and for surgical planning.

Background: Lower extremity reticular and telangiectatic veins are of common cosmetic concern.

Objective: To retrospectively evaluate results of lower extremity sclerotherapy using a combination of foam and liquid sclerosing agents.

Methods: A retrospective chart review of sclerotherapy patients at a dermatology practice (January 2014 to April 2023) was performed.

Results: Eight hundred and nine patients (775 women and 34 men) with a mean age of 49.6 ± 12.2 (18-84) years underwent a mean 1.4 ± 0.7 (1-7) sessions. Multiple different sclerosing agents were used, with 0.2% sodium tetradecyl sulfate foam/liquid predominating, although 72% glycerin liquid and 0.25% to 0.5% polidocanol foam/liquid were also used. Coagula occurred in 61.0% of patients at 2 weeks and 6.4% at 3 months, whereas postsclerotherapy hyperpigmentation was seen in 5.0% and 19.1% of patients at the same time points. Both were more common after first-round treatment, each with a trend toward decreased frequency with increasing session number. Telangiectatic matting was found in 2.3% of 3-month follow-up patients. Edema, superficial venous thrombophlebitis, migraines, and ulceration were rarely seen. Significant clinical improvement was noted in 72.0% of treatments.

Conclusion: This retrospective chart review, the largest to date of its kind, confirms the safety and efficacy of cosmetic lower extremity sclerotherapy with a combination of foam and liquid sclerosing agents.

Background: The surgical management of leg wounds following skin cancer extirpation is challenging. Pinch grafting (PG) is a technique that has been rarely described in the reconstruction of acute surgical wounds.

Objective: The purpose of this study was to evaluate whether PG resulted in faster healing times for below the knee wounds following Mohs micrographic surgery (MMS) when compared with second intention healing (SIH).

Materials and methods: This was a prospective randomized trial of patients with post-Mohs micrographic surgical wounds of the lower extremity who were randomized either to receive pinch grafts or to heal by second intention. Patients were followed through a combination of in-person and virtual visits until their wounds were completely reepithelialized.

Results: Median time to wound healing was 36 days in the PG group versus 56 days for the SIH group, representing a 56% improvement in healing time. There were no differences in complications between the 2 groups with trends toward decreased rates of pain and infection in the PG group.

Conclusion: PG is an effective simple method to hasten the healing of lower extremity wounds following MMS.