Blood transfer: the use of autologous blood as a chromophore and tissue augmentation agent

Autologous platelet-poor plasma gel for injection laryngoplasty

PURPOSE

To overcome the potential disadvantages of the use of foreign materials and autologous fat or collagen, we introduce here an autologous plasma gel for injection laryngoplasty. The purpose of this study was to present a new injection material, a plasma gel, and to discuss its clinical effectiveness.

MATERIALS AND METHODS

From 2 mL of blood, the platelet poor serum layer was collected and heated at 100°C for 12 min to form a plasma gel. The plasma gel was then injected into a targeted site; the safety and efficacy thereof were evaluated in 30 rats. We also conducted a phase I/II clinical study of plasma gel injection laryngoplasty in 11 unilateral vocal fold paralysis patients.

RESULTS

The plasma gel was semi-solid and an easily injectable material. Of note, plasma gel maintains the same consistency for up to 1 year in a sealed bottle. However, exposure to room air causes the plasma gel to disappear within 1 month. In our animal study, the autologous plasma gel remained in situ for 6 months in animals with minimal inflammation. Clinical study showed that vocal cord palsy was well compensated for with the plasma gel in all patients at two months after injection with no significant complications. Jitter, shimmer, maximum, maximum phonation time (MPT) and mean voice handicap index (VHI) also improved significantly after plasma gel injection. However, because the injected plasma gel was gradually absorbed, 6 patients needed another injection, while the gel remained in place in 2 patients.

CONCLUSION

Injection laryngoplasty with autologous plasma gel may be a useful and safe treatment option for temporary vocal cord palsy.

Postacne Scarring: A Qualitative Global Scarring Grading System

BACKGROUND

There is no global qualitative grading system for assessing the disease load and global severity of disease in a patient with postacne scarring.

OBJECTIVE

The purpose of this article is to provide a simple qualitative grading system that would allow better communication between practitioners of a patient's global disease severity and the most appropriate corresponding therapy for that degree of acne scarring.

METHODS

Four grades of postacne scarring are described, and appropriate therapeutic interventions are presented for each. Grade assignment is made by lesion morphologies and disease load as indicated by patient perception of severity (i.e., whether or not an individual can easily disguise his or her disease at social distances).

RESULTS

A simple qualitative global acne scarring grading system is presented.

LIMITATIONS

The determination of disease load in terms of patient perception of severity is intrinsically imperfect due to varying subjectivity among individuals.

CONCLUSION

A global acne scarring grading system is presented that is simple to use and may optimize therapeutic intervention. This system would also allow investigators, educators, and proceduralists to compare their cases more accurately and to have a more objective discussion of the efficacy of operative interventions or therapies.

Liquid injectable silicone: history, mechanism of action, indications, technique, and complications

Medical grade liquid injectable silicone can be used for soft tissue augmentation to correct and replace lost volumes of the subcutaneous tissue. It is potentially a permanent tissue augmentation agent and is the most effective filler for certain indications. This article presents the history, mechanism of action, indications and contraindications, technique, and the possible complications of silicone and their treatment.