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Park S, Huang L, Ao X, Elbendary A, Li G, Xian H, Du M, Xue R, Wang C. Micronized acellular dermal matrix combined with platelet rich plasma in the treatment of atrophic acne scars: A self-controlled split face study. J Cosmet Dermatol 2024; 23:2386-2391. [PMID: 38558364 DOI: 10.1111/jocd.16293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/20/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Micronized acellular dermal matrix (mADM) can induce tissue regeneration and repair, and filling. OBJECTIVES The efficacy and safety of (mADM) were evaluated in the treatment of atrophic acne scar. METHODS In this single-blinded, self-controlled, split-face study, 16 patients (48 scar sites) were divided into treatment group (24 scar sites) and control group (24 scar sites). One side of the affected area was treated with mADM combined with platelet rich plasma (PRP) injection as the treatment group; the other side of the affected area was treated with PRP injection as the control group. The efficacy was evaluated by the Acne scar assessment scale (ASAS) and Acne Scar Weight Rating Scale (ECCA) 3 months after treatment. RESULTS After 3-month treatment in 16 patients, the atrophic acne scars in both groups were all improved. The ASAS score and ECCA weight score in the treatment group was significantly lower than that in the control group (2.50 ± 0.51 vs. 3.62 ± 0.77 and 14.17 ± 10.18 vs. 31.88 ± 13.25; p < 0.001). LIMITATIONS Short-term 3-month treatment period. Small sample size limits generalizability of results. CONCLUSION The curative effect of mADM combined with PRP is significantly better than that of PRP alone.
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Affiliation(s)
- Sunwoo Park
- Aesthetic Plastic Surgery Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Lining Huang
- Aesthetic Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Xian Ao
- Aesthetic Plastic Surgery Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Amira Elbendary
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
| | - Guomin Li
- Dermatology Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Hua Xian
- Aesthetic Plastic Surgery Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Meiyi Du
- Aesthetic Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Ruzeng Xue
- Dermatology Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Chunmei Wang
- Aesthetic Plastic Surgery Department, Dermatology Hospital, Southern Medical University, Guangzhou, China
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An Update on the Clinical Efficacy and Safety of Collagen Injectables for Aesthetic and Regenerative Medicine Applications. Polymers (Basel) 2023; 15:polym15041020. [PMID: 36850304 PMCID: PMC9963981 DOI: 10.3390/polym15041020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/19/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
Soft tissues diseases significantly affect patients quality of life and usually require targeted, costly and sometimes constant interventions. With the average lifetime increase, a proportional increase of age-related soft tissues diseases has been witnessed. Due to this, the last two decades have seen a tremendous demand for minimally invasive one-step resolutive procedures. Intensive scientific and industrial research has led to the recognition of injectable formulations as a new advantageous approach in the management of complex diseases that are challenging to treat with conventional strategies. Among them, collagen-based products are revealed to be one of the most promising among bioactive biomaterials-based formulations. Collagen is the most abundant structural protein of vertebrate connective tissues and, because of its structural and non-structural role, is one of the most widely used multifunctional biomaterials in the health-related sectors, including medical care and cosmetics. Indeed, collagen-based formulations are historically considered as the "gold standard" and from 1981 have been paving the way for the development of a new generation of fillers. A huge number of collagen-based injectable products have been approved worldwide for clinical use and have routinely been introduced in many clinical settings for both aesthetic and regenerative surgery. In this context, this review article aims to be an update on the clinical outcomes of approved collagen-based injectables for both aesthetic and regenerative medicine of the last 20 years with an in-depth focus on their safety and effectiveness for the treatment of diseases of the integumental, gastrointestinal, musculoskeletal, and urogenital apparatus.
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Reconstitution of Injectable Poly-d,l-lactic Acid: Efficacy of Different Diluents and a New Accelerating Method. Plast Reconstr Surg Glob Open 2020; 8:e2829. [PMID: 33154871 PMCID: PMC7605845 DOI: 10.1097/gox.0000000000002829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/06/2020] [Indexed: 11/26/2022]
Abstract
Injectable poly-d,l-lactic acid (PDLLA) is a new collagen-stimulating filler containing PDLLA microspheres and carboxymethyl cellulose. It is available as a lyophilized powder that must be reconstituted with a diluent before administration. The aims of this study were to investigate the efficacy of different diluents and a new accelerating “back-and-forth” method.
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Ahn SK, Choi HJ, Lee JB, Kim JH. A Clinical Study of Micronized Acellular Dermal Matrix Collagen Paste Application with Negative Pressure Wound Therapy. ACTA ACUST UNITED AC 2019. [DOI: 10.22467/jwmr.2018.00535] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Osteoinductivity depends on the ratio of demineralized bone matrix to acellular dermal matrix in defects in rat skulls. Tissue Eng Regen Med 2013. [DOI: 10.1007/s13770-012-1083-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Glattauer V, White JF, Tsai WB, Tsai CC, Tebb TA, Danon SJ, Werkmeister JA, Ramshaw JAM. Preparation of resorbable collagen-based beads for direct use in tissue engineering and cell therapy applications. J Biomed Mater Res A 2010; 92:1301-9. [PMID: 19343777 DOI: 10.1002/jbm.a.32468] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
For tissue engineering and cell therapy applications, expansion of cells such as chondrocytes on beads in spinner culture can provide advantages compared with monolayer culture. The use of resorbable beads that can be included as an integral part of the construct provides the advantage of minimizing the extent of cell handling and eliminating a final trypsin treatment to detach cells from the bead. In this study, we have made various types of beads based on native collagen and denatured collagen (gelatin). The beads have been stabilized by different extents of glutaraldehyde cross-linking, and characterized by a combination of chemical analysis, thermal stability, and microscopy. In vitro examination in the presence and absence of chondrocytes showed that stability increased with the extent of crosslinking and could also be influenced by the manner of fabrication. On the basis of the in vitro stability studies, gelatin beads of a defined stability were shown to resorb over time in subcutaneous implants in nude mice compared with more stable demineralized bone particle (DMB) carriers. These data indicate that for direct use in tissue engineering or cell therapy applications, where resorbable beads can be used for cell expansion and then direct delivery of cells, it is possible to design suitable carrier beads with a range of stabilities that match the implant requirements.
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Yoo G, Lim JS. Tissue engineering of injectable soft tissue filler: using adipose stem cells and micronized acellular dermal matrix. J Korean Med Sci 2009; 24:104-9. [PMID: 19270821 PMCID: PMC2650983 DOI: 10.3346/jkms.2009.24.1.104] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Accepted: 04/29/2008] [Indexed: 11/29/2022] Open
Abstract
In this study of a developed soft tissue filler, adipose tissue equivalents were constructed using adipose stem cells (ASCs) and micronized acellular dermal matrix (Alloderm). After labeling cultured human ASCs with fluorescent green protein and attaching them to micronized Alloderm (5 x 10(5) cells/1 mg), ASC-Alloderm complexes were cultured in adipogenic differentiation media for 14 days and then injected into the dorsal cranial region of nude male mice. The viabilities of ASCs in micronized Alloderm were determined at 1, 4, 7, and 14 days, and complexes, which had been cultured for 14 days and implanted in vivo for 2 months, were histologically evaluated by light, confocal, and scanning electron microscopy. The viabilities represented that ASCs in micronized Alloderm were alive during the culture period. ASC-Alloderm complexes cultured for 14 days contained round cells with large lipid vesicles by light microscopy and many spherical cells by SEM. ASCs in implanted ASC-Alloderm complexes harvested from mice at 2 months postinjection were histologically found to have differentiated into adipocytes which had green fluorescence dye. Micronized Alloderm may be found useful as scaffold for human ASCs when constructing fat tissue for three-dimensional soft tissue filling. The present study suggests that ASC-Alloderm complexes can be used as injectable three-dimensional soft tissue fillers.
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Affiliation(s)
- Gyeol Yoo
- Department of Plastic Surgery, the Catholic University of Korea, Seoul, Korea
| | - Jin Soo Lim
- Department of Plastic Surgery, the Catholic University of Korea, Seoul, Korea
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Acne scarring: A review and current treatment modalities. J Am Acad Dermatol 2008; 59:659-76. [DOI: 10.1016/j.jaad.2008.05.029] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 05/28/2008] [Accepted: 05/31/2008] [Indexed: 11/23/2022]
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Dadzie OE, Mahalingam M, Parada M, El Helou T, Philips T, Bhawan J. Adverse cutaneous reactions to soft tissue fillers – a review of the histological features. J Cutan Pathol 2008; 35:536-48. [DOI: 10.1111/j.1600-0560.2007.00853.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pietramaggiori G, Scherer SS, Mathews JC, Alperovich M, Yang HJ, Neuwalder J, Czeczuga JM, Chan RK, Wagner CT, Orgill DP. Healing modulation induced by freeze-dried platelet-rich plasma and micronized allogenic dermis in a diabetic wound model. Wound Repair Regen 2008; 16:218-25. [DOI: 10.1111/j.1524-475x.2008.00362.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Qiu QQ, Mendenhall HV, Garlick DS, Connor J. Evaluation of bone regeneration at critical-sized calvarial defect by DBM/AM composite. J Biomed Mater Res B Appl Biomater 2007; 81:516-23. [PMID: 17034012 DOI: 10.1002/jbm.b.30692] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study investigated the bone-regenerative potential of a demineralized bone and acellular matrix (DBM/AM) composite (AlloCraft DBM) in comparison with autologous bone using an in vivo model. Critical-sized calvarial defects (5 mm) were created in athymic rats. The defects were grafted with either the DBM/AM composite or the acellular human dermal matrix (AM), and compared with the defects filled with autologous bone (positive control) and the empty defect (negative control). Histological and radiographic assessments were carried out at 4 and 8 weeks after surgery to determine the biological healing, the amount and type of new bone formation and the percentage of new bone filled in the critical defects. At 4 weeks, DBM/AM composite group had the highest percentage of the defect filled with new bone (84%), which was significantly greater than autologous bone (62%), AM (41%), and untreated control (32%) groups. At 8 weeks, the DBM/AM continued to have the highest percentage of the defect filled with new bone (91%). The autologous bone group increased the percentage of bone fill to 83%. The defects either filled with AM or left untreated still had less of the defect filled with new bone, 57% and 33%, respectively. The total healing of defects grafted with DBM/AM was comparable with autologous bone group at 8 weeks. The results demonstrated that the DBM/AM composite promoted new bone formation more rapidly than autologous bone at calvarial defect in athymic rats. The study supports that DBM/AM is a potential substitute of autologous bone for bone repair.
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Affiliation(s)
- Qing-Qing Qiu
- Department of Development, LifeCell Corporation, One Millennium Way, Branchburg, New Jersey 08876, USA
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Abstract
LEARNING OBJECTIVES After studying this article, the participant should be able to: 1. Know the composition and biology of injectable fillers. 2. Understand the advantages and disadvantages of each injectable filler. 3. Understand the U.S. Food and Drug Administration regulatory status of each type of injectable filler, including their indications. BACKGROUND The use of injectable filling agents for soft-tissue facial defects has a long history of successful use based on xenogeneic collagen materials. New materials of differing compositions for injection treatments either are now available or will soon be available for clinical use. METHODS A review of the medical literature was performed to provide chemical compositions, methods of preparation, biological behavior, and clinical outcomes for every known injectable filler material that is either currently used or being evaluated in clinical trials. RESULTS Hyaluronic acid-based materials have now replaced animal or human-derived collagen as the standard injection materials. Synthetic alternatives offer the potential of longer lasting results, but the long-term outcome with their use in large numbers of patients is not yet known. CONCLUSIONS As there is no single injectable filler that has all of the desired characteristics, understanding the advantages and disadvantages of one filler over another is extremely helpful in guiding the patient to an informed decision. Although all of the reviewed injectable fillers are safe, the concepts of their long-term volume persistence and how they compare with each other remain largely anecdotal, with few prospective controlled clinical trials.
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Affiliation(s)
- Barry L Eppley
- Indianapolis, Ind. From the Division of Plastic Surgery, Indiana University School of Medicine
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Abstract
Thirteen breast reconstructions in 11 patients, averaging 58 years of age, underwent mastectomies. The technique uses a saline implant either totally or partially covered with a human acellular dermal matrix. The mean postoperative follow-up time was 14 months. Ninety percent of the patients were considered high risk; the thickness of the human acellular dermal matrix was an average of 1.3 mm, with an average area per breast of 121 cm. There were 12 successful breast reconstructions (92%) that provided stability, increased soft tissue padding, which allowed a greater resemblance to normal breast shape and decreased rippling and implant visibility. The graft was used in an onlay fashion or as an extension of the pectoralis major muscle that covers the implant. A representative histologic cross-section of well-integrated human acellular dermal matrix is presented. The use of a human acellular dermal matrix in breast reconstruction is an alternative protocol in high-risk patients, resulting in a minimal increase in operative time and a decrease in morbidity compared with more extensive procedures.
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Affiliation(s)
- G Mabel Gamboa-Bobadilla
- Section of Plastic Surgery, Department of Surgery, Medical College of Georgia, Augusta, GA 30901-4080, USA.
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Amen F, Roy D. Percutaneous Injection of Vocal Fold With Synthetic Dermal Filler. Laryngoscope 2006; 116:846; author reply 846-7. [PMID: 16652106 DOI: 10.1097/01.mlg.0000209101.21347.ff] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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