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Romo T, Graf AE, Ferzli G, Kim SH, Kim IS. Appropriate Use of Implants in the Nose. Facial Plast Surg Clin North Am 2024; 32:641-652. [PMID: 39341678 DOI: 10.1016/j.fsc.2024.06.007] [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] [Indexed: 10/01/2024]
Abstract
Alloplastic materials are well suited for use in rhinoplasty in the right clinical scenarios, specifically in patients with platyrrhine noses and in challenging revision cases. The most commonly used materials today are silicone and high-density porous polyethylene. Both implant materials carry a unique set of properties and offer various advantages and disadvantages for use. Complications can be minimized with appropriate utilization of implants and using proper technique.
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Affiliation(s)
- Thomas Romo
- Lenox Hill Hospital and Manhattan Eye, Ear & Throat Hospital (MEETH)-Northwell Health Systems, New York, NY, USA.
| | - Alexander E Graf
- Department of Otolaryngology-Head and Neck Surgery, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Sun Hong Kim
- Be and Young Aesthetic Surgery Clinic, Seoul, Korea
| | - In-Sang Kim
- Department of Otolaryngology and Fascial Plastic Surgery, Labom Plastic Surgery Clinic, Korea
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2
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Hong DW, Oh JH, Wang J, Kim TH, Kim YC, Choi JW. A Grading System-Guided Approach to the Severely Contracted Nose. Aesthetic Plast Surg 2024; 48:3596-3603. [PMID: 38536430 DOI: 10.1007/s00266-024-03957-8] [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: 12/14/2023] [Accepted: 02/16/2024] [Indexed: 10/07/2024]
Abstract
PURPOSE Capsular contracture is a rare but serious complication of silicone implant-based augmentation rhinoplasty. When severe, the contracture can affect all layers of the nose, causing significant scarring and disfigurement. There is currently no standardized method of evaluating contracted noses and a paucity of literature on the treatment of severe contracture. Therefore, this study aimed to establish a comprehensive grading system and treatment approach for patients with nasal contracture secondary to silicone implant-based rhinoplasty. METHODS We conducted a retrospective analysis on patients who presented with nasal contracture from 2012 to 2021. All preoperative photographs were evaluated by two plastic surgeons, twice at 1-month intervals. The proposed grading system comprised: normal (grade I), mild contracture with detectable implant (grade II), moderate contracture with skin thinning (grade III), severe contracture with short nose deformity (grade IV), and destructive contracture with scarring of the dorsal skin (grade Va), or columella deficiency (grade Vb). Inter- and intraobserver agreement was assessed using the kappa value to determine the reliability of the system. RESULTS Based on 87 patients, interobserver agreement was substantial for both evaluation time points (k = 0.701 and 0.723). Intraobserver agreement was excellent for evaluator 1 (k = 0.822) and substantial for evaluator 2 (k = 0.699). CONCLUSIONS Using this grading system, we propose a graduated treatment algorithm for contracted noses. Most notable is our use of radial forearm free or forehead flaps to reconstruct the columella in grade Vb patients. By combining reconstructive and aesthetic principles, this treatment approach provides an effective and elegant solution for the management of the severely contracted nose. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Dae Won Hong
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Ji Hye Oh
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Jessica Wang
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Tae Hyung Kim
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Young Chul Kim
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Jong Woo Choi
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
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Li D, Yin Z, Liu Y, Li X, Dong W, Zhang C, Ma J, Zhou G, Zhang Y, Cao Y. Injectable Cartilage Microtissue Regenerated by Autologous Chondrocytes for Nasal Augmentation: A 5-Year Follow-Up Study. Plast Reconstr Surg 2024; 153:1259-1268. [PMID: 38810156 DOI: 10.1097/prs.0000000000010604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND A lack of ideal filling materials is a critical limitation in current rhinoplasty. Cartilage sheet regeneration by autologous chondrocytes is expected to provide an ideal source of material. However, the inability to perform minimally invasive transplantation of cartilage sheets has greatly limited the clinical application of this material. In this article, the authors propose the concept of injectable cartilage microtissue (ICM) based on cartilage sheet technology, with the aim of achieving minimally invasive augmentation rhinoplasty in clinical practice. METHODS Approximately 1.0 cm2 of posterior auricular cartilage was collected from 28 patients. Isolated chondrocytes were expanded, then used to construct autologous cartilage sheets by high-density seeding and in vitro culture in chondrogenic medium with cytokines (eg, transforming growth factor beta-1 and insulin-like growth factor-1) for 3 weeks. Next, ICM was prepared by granulation of the cartilage sheets; it was then injected into a subcutaneous pocket for rhinoplasty. RESULTS ICM was successfully prepared in all patients, and its implantation efficiently raised the nasal dorsum. Magnetic resonance imaging confirmed that regenerative tissue was present at the injection site; histologic examinations demonstrated mature cartilage formation with typical cartilage lacunae and abundant cartilage-specific deposition of extracellular matrix. Excellent or good postoperative patient satisfaction results were achieved in 83.3% of patients over 5 years of follow-up. Obvious absorption of grafts occurred in only two patients (8.3%). CONCLUSIONS These results demonstrated that ICM could facilitate stable cartilage regeneration and long-term maintenance in the human body; the implantation of ICM enabled natural augmentation of the depressed nasal dorsum. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Dan Li
- From the Department of Plastic and Reconstructive Surgery
- Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Zongqi Yin
- Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine
- Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | | | - Xin Li
- No. 17 Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Wei Dong
- Department of Orthopedic Trauma Skin Beauty, Baotou Eighth Hospital
| | - Chen Zhang
- Department of Plastic Surgery, Xinhua Hospital of Dalian University
| | - Jiguang Ma
- No. 17 Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Guangdong Zhou
- From the Department of Plastic and Reconstructive Surgery
- Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine
- Shanghai Resthetic Bio
| | - Yixin Zhang
- From the Department of Plastic and Reconstructive Surgery
| | - Yilin Cao
- From the Department of Plastic and Reconstructive Surgery
- Shanghai Key Laboratory of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine
- Shanghai Resthetic Bio
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Wang X, Zeng W, Sun Y, Xiong X, Meng X, Li W, Yi Z, Fang B, Tian Y, Qiao Z, Deng Y, Zhao H. New classification system of contracted nose and its treatment algorithm. J Plast Reconstr Aesthet Surg 2023; 85:414-422. [PMID: 37579651 DOI: 10.1016/j.bjps.2023.07.046] [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: 04/11/2023] [Revised: 07/12/2023] [Accepted: 07/22/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND The nasal contracture after rhinoplasty is one of the most severe complications in East Asian patients. The classification and treatment algorithm of nasal contracture have not yet been established. This study aimed to develop a new classification system and treatment algorithm of contracted noses in East Asian patients to improve treatment outcomes. METHODS A retrospective study was conducted with 62 patients with nasal contracture who underwent a revision rhinoplasty between March 2017 and March 2021. The authors classified the 62 patients into 3 groups based on the classification system. All patients underwent rhinoplasty designed according to the corresponding classification. The patients were followed up after surgery, and the rhinoplasty outcomes evaluation (ROE) was used to evaluate their satisfaction rate. RESULTS A total of 59 female patients and 3 male patients (mean age, 29.45 ± 7.73 years) were included in this study. Forty-five cases presented mild nasal contracture (72.58%), 11 presented moderate nasal contracture (17.74%), and 6 presented severe nasal contracture (9.68%). There were statistically significant differences in the number of prior rhinoplasty procedures, infection history, and preoperative ROE scores among the three groups, with no differences in sex ratio, age, kinds of initial implant materials, and postoperative ROE scores. Almost all patients achieved satisfactory outcomes after the revision surgery designed by different classifications. CONCLUSION The authors have established a new classification system and treatment algorithm for contracted noses based on the change in pathological anatomy of nose, which is effective for guiding the treatment of contracted noses with good results.
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Affiliation(s)
- Xiancheng Wang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China.
| | - Weiliang Zeng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Yang Sun
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Xiang Xiong
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Xianxi Meng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Wenbo Li
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Zhongjie Yi
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Bairong Fang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Yi Tian
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Zhihua Qiao
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Yiwen Deng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Hongli Zhao
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
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An Y, Wang G, Shang Y, Zhen Y, Li X, Shu F, Li D, Zhao Z, Li H. Autologous Shuffling Lipo-Aspirated Fat Combined Mechanical Stretch in Revision Rhinoplasty for Severe Contractures in Asian Patients. Aesthetic Plast Surg 2023; 47:282-291. [PMID: 35606536 DOI: 10.1007/s00266-022-02920-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/14/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND A severely contracted nose is a common occurrence. Intraoperative expansion is not sufficient to soften the severely constricted nasal envelope, which poses challenges in revision rhinoplasty. In recent years, adjuvant therapies, including nasal fat grafting and cell component injection, are applied before revision rhinoplasty to soften the nasal envelope. Herein, autologous shuffling lipo-aspirated fat and manual mechanical stretch were combined as adjuvant therapy before revision rhinoplasty. METHODS A total of 24 patients with severe nasal contracture were included in this study. Of these, 8 received autologous shuffling lipo-aspirated fat and manual mechanical stretch before revision rhinoplasty (comprehensive therapy), 8 underwent mechanical stretch and revision rhinoplasty, and 8 patients underwent only revision rhinoplasty. The objective and subjective outcome assessment was processed in the follow-up period of 6 months. Nasal length, nasal tip projection, nasofrontal angle, and nasolabial angle were measured, and potential complications were assessed. RESULTS All 24 patients underwent a successful revision rhinoplasty. In the comprehensive therapy group, no patient had postoperative wound infection and defect of the nasal column mucous. The comprehensive treatment group had the most significant improvement in nasal length and nasal tip projection, and the nasolabial angle was the closest to 90°, which indicated the most effective nasal revision and aesthetic contour. CONCLUSIONS The adjuvant therapy combines autologous shuffling lipo-aspirated fat and manual mechanical stretch before revision rhinoplasty could effectively improve the surgical outcome and decrease the postoperative complications regarding severe nasal contractures. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yang An
- Department of Plastic Surgery, Peking University 3rd Hospital, NO.49 of North Huayuan Road, Haidian District, Beijing, 100191, China.
| | - Guanhuier Wang
- Department of Plastic Surgery, Peking University 3rd Hospital, NO.49 of North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Yujia Shang
- Department of Plastic Surgery, Peking University 3rd Hospital, NO.49 of North Huayuan Road, Haidian District, Beijing, 100191, China
- Department of Natural Products Chemistry, School of Traditional Chinese Materia Medica, Key Laboratory of Structure-Based Drug Design & Discovery, Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University 3rd Hospital, NO.49 of North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Xiao Li
- Department of Plastic Surgery, Peking University 3rd Hospital, NO.49 of North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Fan Shu
- Department of Plastic Surgery, Peking University 3rd Hospital, NO.49 of North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Dong Li
- Department of Plastic Surgery, Peking University 3rd Hospital, NO.49 of North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Zhenmin Zhao
- Department of Plastic Surgery, Peking University 3rd Hospital, NO.49 of North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Hua Li
- Department of Natural Products Chemistry, School of Traditional Chinese Materia Medica, Key Laboratory of Structure-Based Drug Design & Discovery, Ministry of Education, Shenyang Pharmaceutical University, Shenyang, 110016, China.
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Jiang F, Su X, Dai Y, Shen H, Hu J, Wu L, Wu Y, Zhan S. Analysis of pathogen distribution and antimicrobial resistance at infected sites in plastic surgery. J Cosmet Dermatol 2023; 22:1575-1584. [PMID: 36606385 DOI: 10.1111/jocd.15600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/28/2022] [Accepted: 12/11/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE By analyzing the distribution and drug resistance of common pathogen in different sites in plastic surgery to provide reference for clinicians to choose the best antibacterial treatment plan. METHODS Pathogens of postoperative infection in plastic surgery from January 2011 to December 2021 were retrospectively analyzed to determine the species and quantity, and to access the trend of each pathogen's detection rate. The antibiotic sensitivity and distribution characteristics of common pathogens were studied in conjunction with the site of infection. RESULTS A total of 1709 bacterial strains were detected, including 1244 gram-positive bacterial strains and 465 gram-negative bacterial strains. The main pathogen of perineum was Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa), while Staphylococcus aureus (S. aureus) was the most common pathogen in the other infected sites. The detection rate of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative staphylococcus (MRCNS) was on the rise from 2011 to 2021. No S. aureus and coagulase-negative staphylococcus (CoNS) strains were resistant to vancomycin. The sensitive rate of S. aureus from all parts and CoNS from all sites except lower limbs and mandible was higher than 80% to linezolid. The resistance rate of S. aureus and CoNS in all parts to penicillin, clindamycin, and erythromycin was high. The susceptibility rate of CoNS in lower mandible was high to gentamicin. CONCLUSIONS Staphylococcus aureus was the primary pathogen of gram-positive bacteria in all site of plastic surgery except perineum, followed by CoNS. The distribution and drug resistance of pathogen in different infection sites were different. We should formulate more accurate and reasonable antibacterial programs according to drug resistance results of various parts to reduce the emergence of resistant strains and effectively prevent and control infection.
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Affiliation(s)
- Fengli Jiang
- Department of Medical Laboratory, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueshang Su
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuduo Dai
- Department of Hair, Branch of National Clinical Research Center for Skin and Immune Disease, The Fifth People's Hospital of Hainan Province, Haikou, China
| | - Hang Shen
- Outpatient Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jintian Hu
- Department of Cicatrix Minimally Invasive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lingsong Wu
- Department of Medical Laboratory, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanyuan Wu
- Department of Medical Laboratory, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sien Zhan
- Department of Medical Laboratory, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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An Y, Wang G, Li X, Zhen Y, Zhao J, Li D. Rhinoplasty with Simultaneous Autologous Full-Face Fat Transfer for Asian Facial Contouring Balance: A Retrospective Study. Aesthetic Plast Surg 2022; 47:746-756. [PMID: 36042025 DOI: 10.1007/s00266-022-03064-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aesthetic facial contouring procedures have gained an increasing popularity in the Asian population. Nevertheless, currently, there are few specific literature assessments and studies on the outcomes of rhinoplasty combined with full-face fat graft contouring. To conduct an objective evaluation of the efficacy of Asian rhinoplasty combined with autologous facial fat transfer in terms of 3-dimensional measurement and patient-reported outcomes. METHODS Patients who underwent rhinoplasty combined with full-face fat transfer for facial contouring between January 2016 and July 2019 were recruited in the study. The preoperative and postoperative clinical variables and 3-dimensional measurement of patients were also collected. The satisfaction outcome of surgeons and patients was assessed. RESULTS Twenty patients completed rhinoplasty with full-face fat transfer. The average postoperative follow-up was 10.2 months (range 6-24 months). The nasal length, and the nasal protrusion rate were significantly increased (p < 0.05) after surgery, and the median number of nasolabial angles decreased from 106° to 101°, which was closer to the aesthetic standard of 90°-100°. The topographical projection images of whole face indicated that the volume of frontal, temporal, inner cheek and chin regions were increased obviously. All cases received satisfaction outcome based on surgeons' satisfaction scale, ROE scale, FACE-Q overall facial satisfaction scale, and FACE-Q Rhinoplasty scale. Additionally, no patients had intraoperative or postoperative complications. CONCLUSIONS Rhinoplasty combined with full-face fat transfer is a reliable and effective method of augmenting and contouring the facial convexity in the Asian populations. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yang An
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
| | - Guanhuier Wang
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Xiao Li
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Jianfang Zhao
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Dong Li
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
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Moris V, Lam M, Amoureux L, Magallon A, Guilloteau A, Maldiney T, Zwetyenga N, Falentin-Daudre C, Neuwirth C. What is the best technic to dislodge Staphylococcus epidermidis biofilm on medical implants? BMC Microbiol 2022; 22:192. [PMID: 35933363 PMCID: PMC9356421 DOI: 10.1186/s12866-022-02606-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Bacterial biofilm can occur on all medical implanted devices and lead to infection and/or dysfunction of the device. In this study, artificial biofilm was formed on four different medical implants (silicone, piccline, peripheral venous catheter and endotracheal tube) of interest for our daily clinical and/or research practice. We investigated the best conventional technic to dislodge the biofilm on the implants and quantified the number of bacteria. Staphylococcus epidermidis previously isolated from a breast implant capsular contracture on a patient in the university hospital of Dijon was selected for its ability to produce biofilm on the implants. Different technics (sonication, Digest-EUR®, mechanized bead mill, combination of sonication plus Digest-EUR®) were tested and compared to detach the biofilm before quantifying viable bacteria by colony counting. Results For all treatments, the optical and scanning electron microscope images showed substantial less biofilm biomass remaining on the silicone implant compared to non-treated implant. This study demonstrated that the US procedure was statistically superior to the other physical treatment: beads, Digest-EUR® alone and Digest-EUR® + US (p < 0.001) for the flexible materials (picc-line, PIV, and silicone). The number of bacteria released by the US is significantly higher with a difference of 1 log on each material. The result for a rigid endotracheal tube were different with superiority for the chemical treatment dithiothreitol: Digest-EUR®. Surprisingly the combination of the US plus Digest-EUR® treatment was consistently inferior for the four materials. Conclusions Depending on the materials used, the biofilm dislodging technique must be adapted. The US procedure was the best technic to dislodge S. epidermidis biofilm on silicone, piccline, peripheral venous catheter but not endotracheal tube. This suggested that scientists should compare themselves different methods before designing a protocol of biofilm study on a given material. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-022-02606-x.
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Affiliation(s)
- Vivien Moris
- Department of Maxillo-Facial Surgery, Plastic, Reconstructive and Aesthetic Surgery and Hand Surgery, University Hospital of Dijon, boulevard de Maréchal-de-Lattre-de-Tassigny, 21000, Dijon, France. .,Lipids Nutrition Cancer Team NuTox, UMR866, Université de Bourgogne Franche-Comté, 17 rue Paul Gaffarel, Dijon, 21000, France.
| | - Mylan Lam
- LBPS/CSPBAT, UMR CNRS 7244, Galilee Institute, Paris 13 University Sorbonne Paris Cité, 99 avenue JB, 93430, Clément, Villetaneuse, France
| | - Lucie Amoureux
- Department of Bacteriology, University Hospital of Dijon, Dijon Cedex, France.,UMR/CNRS 6249 Chrono-Environnement, University of Bourgogne Franche-Comté, Besançon, France
| | - Arnaud Magallon
- Department of Bacteriology, University Hospital of Dijon, Dijon Cedex, France.,UMR/CNRS 6249 Chrono-Environnement, University of Bourgogne Franche-Comté, Besançon, France
| | - Adrien Guilloteau
- Hospital Epidemiology and Hygiene Department, University of Franche-Comté, 11 Rue Claude Goudimel, Besançon, 25000, France
| | - Thomas Maldiney
- Lipids Nutrition Cancer Team NuTox, UMR866, Université de Bourgogne Franche-Comté, 17 rue Paul Gaffarel, Dijon, 21000, France.,Department of Intensive Care Medicine, William Morey General Hospital, Chalon-sur-Saône, France
| | - Narcisse Zwetyenga
- Department of Maxillo-Facial Surgery, Plastic, Reconstructive and Aesthetic Surgery and Hand Surgery, University Hospital of Dijon, boulevard de Maréchal-de-Lattre-de-Tassigny, 21000, Dijon, France.,Lipids Nutrition Cancer Team NuTox, UMR866, Université de Bourgogne Franche-Comté, 17 rue Paul Gaffarel, Dijon, 21000, France
| | - Céline Falentin-Daudre
- LBPS/CSPBAT, UMR CNRS 7244, Galilee Institute, Paris 13 University Sorbonne Paris Cité, 99 avenue JB, 93430, Clément, Villetaneuse, France
| | - Catherine Neuwirth
- Department of Bacteriology, University Hospital of Dijon, Dijon Cedex, France.,UMR/CNRS 6249 Chrono-Environnement, University of Bourgogne Franche-Comté, Besançon, France
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Kao WK, Faddis B, Chole RA, Davis RE. Evidence of Biofilm and Persister Cell Formation in Revision Rhinoplasty. Facial Plast Surg Aesthet Med 2022; 24:233-238. [DOI: 10.1089/fpsam.2021.0378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- W. Katherine Kao
- Department of Otolaryngology, University of Texas Health Science Center in Houston, McGovern Medical School, Houston, Texas, USA
| | - Brian Faddis
- Department of Otolaryngology, Washington University in St. Louis School of Medicine, St Louis, Missouri, USA
| | - Richard A. Chole
- Department of Otolaryngology, Washington University in St. Louis School of Medicine, St Louis, Missouri, USA
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Wang K, Nakano K, Naderi N, Bajaj-Elliott M, Mosahebi A. Is the skin microbiota a modifiable risk factor for breast disease?: A systematic review. Breast 2021; 59:279-285. [PMID: 34329949 PMCID: PMC8335652 DOI: 10.1016/j.breast.2021.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/07/2021] [Accepted: 07/16/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE High prevalence, unreliable risk discrimination and poor clinical outcomes are observed in malignant and benign breast diseases (BD). The involvement of microbial communities in the development of BD has become topical, and distal influences of microbial dysregulation in the breast have been well established. Despite advances, the role of the breast skin microbiota in BD remains unclear. Interactions between the skin microbiota and the underlying mucosal immune system are complex. In homeostasis, the skin offers a physical barrier protecting underlying breast tissue from skin commensals and noxious environmental triggers. Our review aims to illuminate the role of the skin microbiota in the development of BD. METHODS Adhering to the PRISMA protocol, a systematic review was conducted utilising the Medline and Embase search engines. RESULTS Through a comprehensive search of the last ten years, twenty-two studies satisfied the inclusion criteria. Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes were identified as the most prevalent phyla of both breast tissue and skin in healthy controls and BD. High abundance of skin commensals, specifically some species of Staphylococcus, have been linked in breast cancer and metastases. Similarly, dysregulated microbial abundance is also seen in inflammatory and implant-associated BD. These findings raise the hypothesis that the skin microbiota plays a role in tissue homeostasis and may contribute to a range of breast pathologies. Several mechanisms of microbial transfer to underlying tissue have been proposed, including retrograde transfer through ductal systems, breakdown of the skin barrier, and migration through nipple-aspirate fluid. CONCLUSION Our review provides preliminary insights into the skin microbiota as a modifiable risk factor for BD. This raises opportunities for future studies in antimicrobials/probiotics as an adjunct to, or replacement of surgery; a diagnostic and/or prognostic tool for BD; and the possibility of conditioning the microbiota to manage BD.
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Affiliation(s)
- Katie Wang
- Royal Perth Hospital, Western Australia, Australia.
| | - Kento Nakano
- University of Western Australia, Western Australia, Australia
| | - Naghmeh Naderi
- Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK
| | - Mona Bajaj-Elliott
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Afshin Mosahebi
- Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK
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Li M, Wu M, Xie HJ, Liu HW. Identification of transcriptomic characteristics during nasal capsular contracture progression using RNA deep sequencing. Wound Repair Regen 2021; 29:393-405. [PMID: 33608978 DOI: 10.1111/wrr.12900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/10/2020] [Accepted: 11/25/2020] [Indexed: 11/30/2022]
Abstract
Nasal capsular contracture is a prevalent complication commonly observed after rhinoplasty. However, the mechanism underlying the pathogenesis of nasal capsular contracture is largely unclear compared to that of breast capsular contracture. This study aimed to identify the key genes implicated in nasal capsular contracture progression using RNA deep sequencing (RNA-seq). Biopsy samples were taken from Grade II to Grade IV nasal fibrous capsular tissues. The former is regarded as the relatively normal tissues and thus was set as control group, while the latter was treated as pathological group. Results from RNA-seq underwent GO enrichment and KEGG pathway analysis and subsequent verification by quantitative reverse transcriptase polymerase chain reaction and western blot assays. RNA-seq analysis showed that 3149 genes were up-regulated and 3131 genes in pathological groups compared with controls. The top 30 up-regulated genes included many chemokines (e.g., CCL18, CCL13, CCL17 and CCL8), matrix metallopeptidases (e.g., MMP9 and MMP12) and integrin proteins (e.g., ITGAM and ITGB2). GO enrichment analysis demonstrated that the up-regulated genes affected various immune functions, including immune system process, cell activation, leukocyte activation, defence response and positive regulation of immune. The down-regulated gene primary influenced muscle development and functions as well as metabolic processes. In summary, this study reveal that abnormal changes of immune functions, muscle develop and metabolic processes are probably implicated in the pathogenesis of nasal capsular contracture.
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Affiliation(s)
- Ming Li
- Laser Center of Plastic Surgery and Cosmetology, The First Affiliated Hospital of Jinan University, Guangzhou City, China
| | - Meng Wu
- Laser Center of Plastic Surgery and Cosmetology, The First Affiliated Hospital of Jinan University, Guangzhou City, China
| | - Hong-Ju Xie
- Department of Plastic Surgery, Second Affiliated Hospital of Hainan Medical College, Haikou City, China
| | - Hong-Wei Liu
- Laser Center of Plastic Surgery and Cosmetology, The First Affiliated Hospital of Jinan University, Guangzhou City, China
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Yoon ES. Current status of breast implant-associated anaplastic large cell lymphoma in South Korea. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.1.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a unique type of lymphoma caused by breast implants. Concerns about BIA-ALCL have increased worldwide, and three domestic cases have been reported in South Korea. However, the incidence of the disease is not clear, and the risk probability has been reported to be up to 1/3,000. The most important factor in BIA-ALCL is the texturing of the implanted devices. Since the type of texturing is heterogeneous among products and companies, it is important for physicians to be aware of the spectrum of products and their implied risk. The pathophysiology of BIA-ALCL is presumed to be a combination of chronic inflammation related to the microenvironment and genetic predisposition. Further studies will allow accurate diagnosis and prognosis of the disease. The prognosis of BIA-ALCL is favorable if patients with late seroma or pericapsular masses are diagnosed early and complete surgical removal is achieved. Accurate diagnosis includes cytology or pathology with immunohistochemistry, including the CD30 protein and anaplastic lymphoma kinase. An essential factor in surgical success is radical excision with total capsulectomy. However, there is no evidence for prophylactic removal of a textured implant without symptoms. Careful examination and consultation should precede the implant removal, which can lead to deformity or complications. Domestic collaboration among healthcare providers for diagnosis and treatment is needed along with active reporting and registration of suspected patients. Finally, worldwide cooperation and improved awareness leading to regular surveillance are crucial in the era of BIA-ALCL.
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