Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
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Randomized Controlled Trial
Controlled, randomized study of pain levels in subjects treated with calcium hydroxylapatite premixed with lidocaine for correction of nasolabial folds.
Calcium hydroxylapatite (CaHA) has been administered after nerve block injection of anesthetic agents. ⋯ Investigators concluded that CaHA premixed with lidocaine results in significant pain reduction during dermal filler injection while maintaining the aesthetic improvement of CaHA without lidocaine and demonstrating comparable local transient adverse events for treatment and control. BioForm Medical (San Mateo, CA) provided the soft tissue filler, lidocaine, and other necessary supplies used in this study. All authors are members of the Bioform Medical Education Faculty.
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Dermicol-P35 27G, an advanced collagen dermal filler, is effective for nasolabial fold (NLF) correction. ⋯ Dermicol-P35 27G/0.3% lidocaine resulted in less pain than Dermicol-P35 27G/topical anesthesia, with no observed reduction in efficacy.
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Pressure ulcers are one of the most frequently registered complications in general surgery. ⋯ The incidence of pressure ulcers is strongly correlated to sex, age, and indication of admittance. Most ulcers were classified as mild and had no consequences. The insight obtained into incidence, cause, and consequences of pressure ulcers can be used as an indicator of quality of provided care if adjusted for case mix and indication of operation.
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A constantly increasing number of gel fillers for aesthetic and reconstructive purposes have been introduced during the last 20 years. Most of the new ones are modified versions of the original collagen and hyaluronic acid gels. They have been reconstructed, often by adding cross-bindings to the polymer in order to obtain a more dense molecular structure, which will prolong degradation and filling effect of the gel. Other gel fillers contain particles of organic (poly-lactic acid) or inorganic (calcium hydroxylapatite) material, which have been used in human tissue for other purposes (degradable suture material and bone cement, respectively). The permanent fillers (silicone oil and polyacrylamide gel) have been used for many years, silicone mainly in the US and polyacrylamide gel in most countries outside the US and Canada. ⋯ Complications following homogenous hydrogels are caused by infection with bacteria, which have been inserted into the gel during injection. If not treated with relevant antibiotics (but instead steroids or large doses of NSAIDs) the bacteria form a biofilm, which gives rise to a low-grade chronic infection that is resistant to antibiotics. Complications following particulated gels and silicone oil are not known, but bacteria in a biofilm and/or endotoxins released by these is a possibility which deserves further investigations, primarily by using the fluorescence in situ hybridization (FISH) technique.