No abstract

Quality of care is a critical requirement for wound healing and 'good' care of wounds has been synonymous with topical prevention and management of microbial contamination. Topical antiseptics are antimicrobial agents that kill, inhibit or reduce the number of microorganisms and are thought to be essential for wounds infection control. However, they have long and commonly been used on wounds to prevent or treat infection, the merits of antiseptic fluid irrigation have received little scientific study. Unlike antibiotics that act selectively on a specific target, antiseptics have multiple targets and a broader spectrum of activity, which include bacteria, fungi, viruses, protozoa and even prions. Although certain skin and wound cleansers are designed as topical solutions with varying degrees of antimicrobial activity, concerns have been raised. Wound cleansers may affect normal human cells and may be antimitotic adversely affecting normal tissue repair. Repeated and excessive treatment of wounds with antiseptics without proper indications may have negative outcomes or promote a microenvironment similar to those found in chronic wounds. However, when applied at the proper times and concentrations, some classes of antiseptics may provide a tool for the clinician to drive the wound bed in desired directions. The present review summarises the various antiseptics in use and their negative impact on the wound healing mechanisms. It is clear that the role of antiseptics on wounds and their role in wound care management need to be reconsidered.

The gold standard treatment for the many aesthetic aspects of aging has for many years been surgery in its many forms. However, with increasing patient demand for cosmetic rejuvenation and with the strong desire and drive by patients to attain aesthetic enhancement with minimal risk and rapid recovery, there has been a strong surge inspiring the field of nonsurgical skin rejuvenation. Traditionally, most of the nonsurgical methods have centered around those that destroy the epidermis and cause a dermal wound, with resultant dermal collagen remodeling and secondary skin tightening and rhytid improvement. Currently, there is growing interest in a wide range of nonablative interventions that, predictably, are claimed to rejuvenate skin and subcutaneous tissue "safely and effectively." Although several nonablative systems have been cleared by the U.S. Food and Drug Administration (FDA) for the purpose of skin rejuvenation and despite significant reported improvement in the appearance of signs and symptoms of photoaging by relatively noninvasive means, the clinical results have been generally less than impressive, with most subjects showing only mild improvement. The current review aims at summarizing the various nonablative methods currently in use for skin rejuvenation and to evaluate the evidence-based efficacy of a particular nonablative radiofrequency (NARF) method: monopolar radiofrequency.

Many issues remain unanswered. Unfortunately, the present state of our knowledge does not allow the formulation of clear-cut guidelines. Only general trends can be outlined, and these will certainly have some practical applications but above all will dictate future research in the field.

There is a growing trend nowadays for patients to seek the least invasive treatments possible with less risk of complications and downtime to correct rhytides and ptosis characteristic of aging. Nonsurgical face and neck rejuvenation has been attempted with various types of interventions. Suture suspension of the face, although not a new idea, has gained prominence with the advent of the so called "lunch-time" face-lift. Although some have embraced this technique, many more express doubts about its safety and efficacy limiting its widespread adoption. The present review aims to evaluate several clinical parameters pertaining to thread suspensions such as longevity of results of various types of polypropylene barbed sutures, their clinical efficacy and safety, and the risk of serious adverse events associated with such sutures. Early results of barbed suture suspension remain inconclusive. Adverse events do occur though mostly minor, self-limited, and of short duration. Less clear are the data on the extent of the peak correction and the longevity of effect, and the long-term effects of the sutures themselves. The popularity of barbed suture lifting has waned for the time being. Certainly, it should not be presented as an alternative to a face-lift.