Volumetric Approach to the Lips
Neil S. Sadick in Illustrated Manual of Injectable Fillers, 2020
Necrosis is a rare but real complication of any dermal filler, including HA fillers. There are two main etiologies of necrosis: first, compression of the vessel either by the product itself or by intradermal bleeding, and second by intra-arterial injection and occlusion of the artery (33). Knowing the signs and symptoms of necrosis is vitally important, as much tissue can be saved if the vascular compromise is caught prior to the death of the cutaneous tissue. Typical signs and symptoms of impending necrosis are a blanching or grey discoloration of the skin, a reticulate or lacy erythema, increasing pain or unusual sensation, or loss of sensation (33). If a patient describes any strange or unusual symptom, it is wise of the physician to insist the patient return to clinic for further evaluation. If impending necrosis is suspected or if necrosis has started, the treatment is with vigorous massage, nitroglycerin ointment, aspirin, warm compresses, and flooding the area of necrosis with two vials of hyaluronidase (33). There are numerous strategies one can employ while injecting to decrease the risk of necrosis; these include refluxing prior to each injection, monitoring the skin’s response with each injection—immediate blanching is a sign of intra-arterial injection, injecting in a retrograde fashion, injecting small amounts with each stroke of the needle, and injecting slowly. Additionally, knowing your vascular anatomy and staying away from danger zones is highly recommended with any facial rejuvenation.
Complications of Reconstructive Surgery
Stephen M. Cohn, Matthew O. Dolich in Complications in Surgery and Trauma, 2014
The large mass (area) of the latissimus dorsi muscle makes this muscle ideal for covering very large defects in any region of the body. Like the rectus abdominis flap, the latissimus dorsi flap is hardy and can be easily harvested with a skin paddle. Skin necrosis is unusual. Seromas at the donor site are a common problem when latissimus dorsi flaps are used, but reports indicate that using sharp dissection instead of electrocautery can reduce the incidence of this complication by half. More muscle mass can be harvested by including the serra-tus anterior muscle in the dissection. This procedure, however, increases the likelihood of injury to the long thoracic nerve and the debilitating “winged scapula.”
Drugs causing cutaneous necrosis
Biju Vasudevan, Rajesh Verma in Dermatological Emergencies, 2019
A thorough history to elucidate the possible causes of the necrosis of skin has to be taken. This should include history of recent travel and history of underlying illnesses such as diabetes, renal disease, AIDS, autoimmune diseases, inflammatory bowel disease, and malignancies. History of recent surgeries and prolonged bedridden states may also be contributory [4]. A thorough history would generally be able to identify the cause of the symptoms and the causative drug if implicated. The Naranjo adverse drug reaction probability score may be employed to assess the temporal association of the drug with the symptoms of the patients [14].
Effect of pulsed electromagnetic fields stimulation on ischemic skin model
Published in Electromagnetic Biology and Medicine, 2022
Ja-Woo Lee, Jun-Young Kim, Na-Ra Lee, Yong-Heum Lee
The skin is the outer skin of the body, which protects the body, feels the touch, regulates temperature. Skin can lead to necrosis due to disorders such as peripheral tissues, nerves, blood vessels, etc.(Hidalgo et al. 2016; Khanolkar et al. 2008; Laing 1998; Macedo and Santos 2007; Yarkony 1994), which can cause various secondary diseases such as inflammation and pain. Various blood circulation disorders such as ischemia can cause skin necrosis over time, which causes various side effects (Kerrigan 1983). Various methods are being studied as methods for treating skin necrosis, but there are typically pharmacological methods (da Silva Duarte et al. 1998; Davis et al. 1999; Gherardini et al. 1999; Kamada and Kenzaka 2019; Karimi et al. 2017) and low-level laser treatment methods (Junior et al. 2012; Prado et al. 2006), and both methods mainly use improvement of blood circulation to solve problems. However, in the case of the pharmacological method, there is a high probability of side effects, and in the case of the low-level laser treatment method, there is a limitation in that it is difficult to stimulate deep tissue due to the light scattering property.
In vivo evaluation of the biocompatibility and biodegradation of a new denatured plasma membrane combined with liquid PRF (Alb-PRF)
Published in Platelets, 2021
Ezio Gheno, Carlos Fernando de Almeida Barros Mourão, Rafael Coutinho de Mello-Machado, Emanuele Stellet Lourenço, Richard J Miron, Karoline Ferreira Farias Catarino, Adriana Terezinha Alves, Gutemberg Gomes Alves, Mônica D. Calasans-Maia
All aspects of animal care and accommodation were performed in accordance with ISO 10993–2 and ISO 10993–6. Several biological response parameters were assessed and recorded, included the following: The extent of the fibrosis capsule layer and inflammation, measured semiquantitatively (see Table I).The degeneration, determined by assessing changes in tissue morphology.the number and distribution of inflammatory cells, namely, polymorphonuclear cells, lymphocytes, plasma cells, eosinophils, macrophages, and multinucleated cells, as a function of distance from the material–tissue interface.The presence and extent of necrosis.Other tissue alterations, such as vascularization, fatty infiltration, granuloma formation, mineralization, and bone formation.Material parameters, such as fragmentation or the presence of debris, including the form and location of the degraded material.The quality and quantity of tissue ingrowth for porous and absorbable implant materials.
Metformin induces myeloma cells necrosis and apoptosis and it is considered for therapeutic use
Published in Journal of Chemotherapy, 2023
Zhentian Wu, Lianghua Wu, Liangliang Zou, Muqing Wang, Xin Liu
In our study, cellular and molecular mechanisms responsible for the actions of metformin differed from cell line to cell line. For U266 cells, it induced necrosis. For H929, RPMI8226, and MM.1s cells, it induced apoptosis. Cell cycle analysis showed that the cycle arrest also varied from cell to cell following metformin treatment. We found no change in U266 cells, in H929 and MM.1s cells, it induced at the G0/G1 phase, and in RPMI8226, it induced at the G2/M phase. Cell cycle arrest is controlled by some cyclin-dependent kinases (CDKs), such as cyclin-D1 in the G1/S transition and cyclin-B1 in the G2/M transition. We hypothesize that metformin acts powerfully on the cell cycle via different pathways in different MM cells. For H929 and MM.1s cells, the down-regulation of CyclinD1 leads to G1/G0 arrest and suppresses the cell proliferation. Cyclin-B1 is a key regulator of the cell cycle, it is involved in regulating the events of mitosis. It increased in the early G2 phase, and it is necessary for transition from G2 to M. Here we show that RPMI8226 cells arrested in G2/M with down-regulation of cyclin-B1 while metformin treated. It suggests that this reduction leads to accumulation of MM cells in the G2 phase and inhibits transition to the M phase. Necrosis is an unordered and accidental form of cellular dying, and usually with no changes in cell cycle arrest. For U266, we found necrosis related protein iNOS increasingly expressed and no apoptosis-associated protein was detected. It further confirmed that metformin might induce U266 necrosis.