Adverse Reactions to Injectable Soft Tissue Permanent Fillers

Christensen, Lise; Breiting, Vibeke; Janssen, Martin; Vuust, Jens; Høgdall, Estrid

doi:10.1007/s00266-004-0113-6

Cited by 289 publications

(360 citation statements)

References 72 publications

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“…Due to their high water content, mechanical properties of hydrogels often closely match those of biological tissues. Hydrogels have been traditionally used for a range of soft tissue replacement applications such as contact lenses, drug delivery vehicles, separation membranes and adhesives [29][30][31][32]. Table 1 lists representative natural and synthetic polymers used in medical devices.…”

Section: Introductionmentioning

confidence: 99%

Conducting polymer-hydrogels for medical electrode applications

Green

Baek

Poole-Warren

et al. 2010

Science and Technology of Advanced Materials

241

182

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Conducting polymers hold significant promise as electrode coatings; however, they are characterized by inherently poor mechanical properties. Blending or producing layered conducting polymers with other polymer forms, such as hydrogels, has been proposed as an approach to improving these properties. There are many challenges to producing hybrid polymers incorporating conducting polymers and hydrogels, including the fabrication of structures based on two such dissimilar materials and evaluation of the properties of the resulting structures. Although both fabrication and evaluation of structure-property relationships remain challenges, materials comprised of conducting polymers and hydrogels are promising for the next generation of bioactive electrode coatings.

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Section: Introductionmentioning

confidence: 99%

Conducting polymer-hydrogels for medical electrode applications

Green

Baek

Poole-Warren

et al. 2010

Science and Technology of Advanced Materials

241

182

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“…This is in accordance with previous studies that demonstrated pathological changes in the retina in vivo, primarily in parts more likely to have been in direct contact with the gel [37], suggesting at least in part a toxic or immunological response. Recently, clinical use of Bio-Alcamid® in reconstructive surgery has become increasingly controversial due to late complications such as inflammation, infection and excessive capsule formation [45][46][47][48].…”

Section: Our Previous Results and Our Hypothesismentioning

confidence: 99%

A new model for in vitro testing of vitreous substitute candidates

Barth

Crafoord

O’Shea

et al. 2014

Graefes Arch Clin Exp Ophthalmol

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Purpose To describe a new model for in vitro assessment of novel vitreous substitute candidates. Methods The biological impact of three vitreous substitute candidates was explored in a retinal explant culture model; a polyalkylimide hydrogel (Bio-Alcamid®), a two component hydrogel of 20 wt.% poly (ethylene glycol) in phosphate buffered saline (PEG) and a cross-linked sodium hyaluronic acid hydrogel (Healaflow®). The gels where applied to explanted adult rat retinas and then kept in culture for 2, 5 and 10 days. Gel-exposed explants were compared with explants incubated under standard tissue culture conditions. Cryosections of the specimens were stained with hematoxylin and eosin, immunohistochemical markers (GFAP, Vimentin, Neurofilament 160, PKC, Rhodopsin) and TUNEL. Results Explants kept under standard conditions as well as PEG-exposed explants displayed disruption of retinal layers with moderate pyknosis of all neurons. They also displayed moderate labeling of apoptotic cells. Bio-Alcamid®-exposed explants displayed severe thinning and disruption of retinal layers with massive cell death. Healaflow®-treated explants displayed normal retinal lamination with significantly better preservation of retinal neurons compared with control specimens, and almost no signs of apoptosis. Retinas exposed to Healaflow® and retinas kept under standard conditions showed variable labeling of GFAP with generally low expression and some areas of upregulation. PEG-exposed retinas showed increased GFAP labeling and Bio-Alcamid®-exposed retinas showed sparse labeling of GFAP. Conclusions Research into novel vitreous substitutes has important implications for both medical and surgical vitreoretinal disease. The in vitro model presented here provides a method of biocompatibility testing prior to more costly and cumbersome in vivo experiments. The explant culture system imposes reactions within the retina including disruption of layers, cell death and gliosis, and the progression of these reactions can be used for comparison of vitreous substitute candidates. Bio-Alcamid® had strong adverse effects on the retina which is consistent with results of prior in vivo trials. PEG gel elicits reactions similar to the control retinas whereas Healaflow® shows protection from culture-induced trauma indicating favorable biocompatibility.

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“…Complications included five instances of ecchymosis, which resolved after 10 days, and no patient's ability to work was hampered as the average down time was less than 1 day. Even though there were only a few complications in our study, they must be kept in mind by all operators [22]. There are indeed two types of exogenous stabilized HA: that of animal origin obtained by extraction and the nonanimal type that we used, obtained by fermentation.…”

Section: Discussionmentioning

confidence: 99%

Nonanimal Stabilized Hyaluronic Acid for Tissue Augmentation of the Dorsal Hands: A Prospective Study on 38 Patients

et al. 2012

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Background Often ignored, hands are one of the most telltale signs of aging. This prospective study was initiated to evaluate the effect of subcutaneous hyaluronic acid (HA) injections in aging hands, with special attention to complications and long-term outcomes. Methods Between January 2010 and December 2010, a total of 38 patients with skin phototypes II-IV and between 58 and 76 years old were treated with HA injection for aging hands. The quantity of injection never exceeded 1.0-1.5 ml HA per hand. A clinical follow-up was performed at 2 weeks, 4 weeks, 3 months, and 6 months after injection. Complications were reviewed for the whole series. At the first follow-up, 2 weeks after the procedure, ultrasound was carried out to determine if additional filling material was required. At each follow-up, patients were asked to fill out a satisfaction questionnaire. Results Nine patients developed slight ecchymosis that disappeared after 1 week. No other complications were seen in the series. Pain during the injection and discomfort after the procedure were minimal. At the 2-week follow-up, after ultrasound control, nine patients received a complementary injection. At each follow-up, overall patient satisfaction was high and was validated by clearance of rhytids, veins, bony prominences, and dermal and subcutaneous atrophy. Conclusion Skin revitalization with injectable HA can improve the clinical appearance of the back of the hands. However, this therapy requires knowledge of the possible complications and their remediation as well as knowledge and respect of injected doses. Moreover, despite excellent results at each follow-up, the results of our series are not as good after 6 months, and a longer follow-up would be needed to determine if this procedure provides long-lasting benefit.

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Adverse Reactions to Injectable Soft Tissue Permanent Fillers

Cited by 289 publications

References 72 publications

Conducting polymer-hydrogels for medical electrode applications

Conducting polymer-hydrogels for medical electrode applications

A new model for in vitro testing of vitreous substitute candidates

Nonanimal Stabilized Hyaluronic Acid for Tissue Augmentation of the Dorsal Hands: A Prospective Study on 38 Patients

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