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Dermal filler complications and management
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The Tyndall effect is a phenomenon which happens when light is scattered by particles in a colloid solution. As this isn’t a physics textbook we shan’t dwell on the science behind it too much, just note that in colloid solutions blue light is scattered more greatly than red. This means that clear colloid solutions such as dermal fillers can appear blue. The relevance of this to your cosmetic practice is that dermal fillers are a colloid solution and therefore can develop a bluish hue and discolour the surrounding skin. In the acute phase, the Tyndall effect is often mistaken for a deep bruise; however, the primary discerning feature is that unlike a bruise this will not resolve spontaneously over the next few weeks (Figure 13.4).
Colloid versus Crystalloids
Published in Stephen M. Cohn, Alan Lisbon, Stephen Heard, 50 Landmark Papers, 2021
For the patient with hypotension due to hypovolemia, one of the first therapeutic interventions is fluid replacement. The options for replacement include crystalloids or colloids. The three main crystalloids are hypertonic saline, normal (0.9%) saline (NS), and balanced (buffered) salt solutions. The most commonly used balanced salt solution in the United States is lactated Ringer's (LR). The colloids include albumin, starch, and gelatin solutions.
No Blood … What to Do?
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Avi Benov, Roy Nadler, Avishai M. Tsur, Ori Yaslowitz, Andrew P. Cap, Mark H. Yazer, Elon Glassberg
Colloids are aqueous solutions that also contain electrolytes and organic macromolecules. These macromolecule constituents are unable to cross the endothelial membrane of the blood vessels, remaining within the intravascular space, exerting higher oncotic pressure than the electrolytes contained in crystalloids. Several types of colloids are in use, differing in the type of macromolecules contained in each. The most common options include albumin, hydroxyethyl starch (HES), gelatins, and dextrans. Despite the presumed rationale for colloid, compared with crystalloid use, the expected greater intravascular volume expansion was not shown to improve the prognosis of patients suffering from haemorrhagic shock. Furthermore, colloids were shown to increase kidney injury, impair immune function, and worsen coagulopathy.
Nanophyto-gel against multi-drug resistant Pseudomonas aeruginosa burn wound infection
Published in Drug Delivery, 2021
Ming Ming Wen, Ibrahim A. Abdelwahab, Rania G. Aly, Sally A. El-Zahaby
Figure 9 shows that the skin specimen from the normal control group presented typical cellular integrity with an intact surface epithelium, normal dermis, and subcutaneous tissue lacking any inflammatory infiltrate. The skin specimens from group 1 (without any treatment) showed a third-degree burn with wide ulceration of the surface epithelium covered by fibroid inflammatory exudate. The dermis part contained an inflammatory infiltrate formed of mixed acute and chronic inflammatory cells of neutrophils, lymphocytes, plasma cells, and histiocytes. The second group treated with cinnamon oil gel showed a smaller skin ulcer, compared to the first group, covered by fibrinoid material. The dermis and subcutaneous tissue showed mixed acute and chronic inflammatory cells. Group 3 (NLC-cinnamon colloid) showed a wide area of granulation tissue and fibrosis denoting the healing process with minor inflammatory infiltrate. The fourth group (NLC blank gel) showed skin ulceration covered by the fibrinoid material. Area of granulation tissue and fibrosis appeared in the dermis and subcutaneous tissue; however, less than group 3, while the inflammatory infiltrates were more than that of group 3. The fifth group (NLC-cinnamon gel) showed the most remarkable amount of fibrosis of the dermis and subcutaneous tissue with only a few inflammatory cells toward completion of healing.
Evaluation of two different fluids regimens on central venous-to-arterial Carbon Dioxide difference (pCO2 gap) - a randomized controlled trial
Published in Egyptian Journal of Anaesthesia, 2021
Rabab S. S. Mahrous, Tarek I. Ismail
These results could be attributed to the unique and better pharmacological characters of colloids. Inadequate fluid therapy is a leading cause of diminished oxygen transport with subsequent organ failure and death. Colloids are strongly expanding the intravascular volume with increase of CO with higher persistence result in better regional blood flow when compared to crystalloids [33]. Moreover, colloids have better expansion of micro vascular volume with minimal leakage from capillaries associated with higher blood viscosity which result in adequate capillaries recruitment and micro vascular flow adjustment [34]. More stability of hemodynamics with colloids is also believed to have a great influence on regional microcirculation [35]. Last important aspect of enhancement of microcirculatory perfusion is the efficacy of colloids to enhance tissue oxygenation with subsequent improvement of cellular O2 utilization to avoid cellular hypoxia [36]. Conversely, crystalloids are distributed within the entire extracellular space leaving the intravascular space and thus expanding the extravascular space with gradual accumulation of interstitial fluids and subsequent decrease of microcirculatory perfusion [37]. The efficacy of colloid solution over crystalloid solution in the current study has been proved from different clinical trials.
Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients
Published in Current Medical Research and Opinion, 2020
Beyond the type of fluid, an important question is the amount of fluid to administer, in particular, whether restrictive fluid strategies benefit critically ill and surgical patients. Fluid infusion must be carefully titrated and individualized, as too much or too little fluid can worsen outcomes1. Both crystalloids and colloids can cause edema, though the pathophysiological mechanisms differ9. Hypotonic HSA solution should be avoided as a resuscitation fluid in patients with traumatic brain injury, based on results from the Saline versus Albumin Fluid Evaluation (SAFE) study17. Crystalloids and colloids can be used together to balance the risk of fluid-induced adverse effects, especially in patients who would need large volumes1. For example, in surgical patients, switching to a colloid may be necessary when more than 3–4 L of crystalloid have been infused but the patient still requires plasma volume support and blood product transfusion is not indicated9.