Update in Wound Healing in Facial Plastic Surgery

Hershcovitch, Meir D.; Hom, David B.

doi:10.1001/2013.jamafacial.33

Cited by 9 publications

(14 citation statements)

References 50 publications

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“…Once recognised, the offending conditions could be removed through debridement of the necrotic burden, management of exudate with dressings, and resolution of bacterial imbalance with topical and systemic antibiotics. These and other basic wound management tenets such as tissue oxygenation and adequate nutrition remain crucial components to aiding a proper healing response [70]. Obviously, a comprehensive assessment to address the underlying aetiology is also necessary [47].…”

Section: Current Treatmentsmentioning

confidence: 99%

“…Hence, dressings and devices have remained the mainstay of wound care, despite many lacking clinical evidence [71]. Early interest in the therapeutic roles of exogenous growth factors and cytokines has diminished after lacklustre performances in clinical trials [70]. Nevertheless, there is great potential in this area as scientific knowledge advances and techniques become more sophisticated.…”

Section: Current Treatmentsmentioning

confidence: 99%

“…PGDF is chemotactic for neutrophils and macrophages, and hence plays an important role in the inflammatory response. Clinically, however, becaplermin has demonstrated only modest improvements in healing diabetic and pressure ulcers, but it and other growth factors have been used off-label in various acute and chronic wounds to some degree of success [70]. Recently, an angiotensin receptor agonist called aclerastide—also for the treatment of diabetic foot ulcers—advanced to phase III clinical trials, where, unfortunately, the study was terminated after conducting futility determinations [73].…”

Section: Current Treatmentsmentioning

confidence: 99%

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Inflammation in Chronic Wounds

Zhao

Liang

Clarke

et al. 2016

IJMS

725

589

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Non-healing chronic wounds present a major biological, psychological, social, and financial burden on both individual patients and the broader health system. Pathologically extensive inflammation plays a major role in the disruption of the normal healing cascade. The causes of chronic wounds (venous, arterial, pressure, and diabetic ulcers) can be examined through a juxtaposition of normal healing and the rogue inflammatory response created by the common components within chronic wounds (ageing, hypoxia, ischaemia-reperfusion injury, and bacterial colonisation). Wound bed care through debridement, dressings, and antibiotics currently form the basic mode of treatment. Despite recent setbacks, pharmaceutical adjuncts form an interesting area of research.

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Section: Current Treatmentsmentioning

confidence: 99%

Section: Current Treatmentsmentioning

confidence: 99%

Section: Current Treatmentsmentioning

confidence: 99%

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Inflammation in Chronic Wounds

Zhao

Liang

Clarke

et al. 2016

IJMS

725

589

View full text Add to dashboard Cite

show abstract

“…Multiple biological, synthetic, and genetically derived factors; bioengineered tissue substitutes; vacuum-assisted closure devices; and hyperbaric oxygen therapies allow clinicians to proactively treat facial wounds and reduce wound-healing complications, such as infection and scar formation. 128 Growth factors are one adjunctive product to enhance healing of wounds. Examples of growth factors include recombinant human platelet-derived growth factor, anti-deltalike ligand 4, and recombinant human transforming growth factor β-3.…”

Section: Wound Healingmentioning

confidence: 99%

“…The irradiation of wounds may alter growth factor presence and create higher levels of growth factor inhibitor. 128 Anti-deltalike ligand 4 is a growth factor that increases tissue vascularity and thereby increases the rate of wound healing. 130 Intradermal injection of recombinant human transforming growth factor β-3 has been shown to reduce scarring.…”

Section: Wound Healingmentioning

confidence: 99%

Overview of Facial Plastic Surgery and Current Developments

Chuang

Barnes

Wong

2016

Surg J

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Facial plastic surgery is a multidisciplinary specialty largely driven by otolaryngology but includes oral maxillary surgery, dermatology, ophthalmology, and plastic surgery. It encompasses both reconstructive and cosmetic components. The scope of practice for facial plastic surgeons in the United States may include rhinoplasty, browlifts, blepharoplasty, facelifts, microvascular reconstruction of the head and neck, craniomaxillofacial trauma reconstruction, and correction of defects in the face after skin cancer resection. Facial plastic surgery also encompasses the use of injectable fillers, neural modulators (e.g., BOTOX Cosmetic, Allergan Pharmaceuticals, Westport, Ireland), lasers, and other devices aimed at rejuvenating skin. Facial plastic surgery is a constantly evolving field with continuing innovative advances in surgical techniques and cosmetic adjunctive technologies. This article aims to give an overview of the various procedures that encompass the field of facial plastic surgery and to highlight the recent advances and trends in procedures and surgical techniques.

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Negative Pressure Wound Therapy in Head and Neck Surgery

Asher

White

Golden

et al. 2014

JAMA Facial Plast Surg

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IMPORTANCE Negative pressure wound therapy has been shown to accelerate healing. There is a paucity of literature reporting its use as a tool to promote wound healing in head and neck reconstruction. OBJECTIVE To review 1 institution's experience with negative pressure dressings to further describe the indications, safety, and efficacy of this technique in the head and neck. DESIGN, SETTING, AND PARTICIPANTS Retrospective case series at a tertiary care academic hospital. One hundred fifteen patients had negative pressure dressings applied between April 2005 and December 2011. Data were gathered, including indications, details of negative pressure dressing use, adverse events, wound healing results, potential risk factors for compromised wound healing (defined as previous radiation therapy, hypothyroidism, or diabetes mellitus), and wound characteristics (complex wounds included those with salivary contamination, bone exposure, great vessel exposure, in the field of previous microvascular free tissue transfer, or in the case of peristomal application in laryngectomy). EXPOSURE Negative pressure wound therapy utilized after head and neck reconstruction. MAIN OUTCOMES AND MEASURES Indications for therapy, length and number of dressing applications, identification of wound healing risk factors, classification of wound complexity, wound healing results, and adverse events related to the use of the device. RESULTS Negative pressure wound therapy was used primarily for wounds of the neck (94 of 115 patients [81.7%]) in addition to other head and neck locations (14 of 115 patients [12.2%]), and free tissue transfer donor sites (7 of 115 patients [6.1%]). The mean (SD) wound size was 5.6 (5.0) cm. The mean number of negative pressure dressing applications was 1.7 (1.2), with an application length of 3.7 (1.4) days. Potential risk factors for compromised wound healing were present in 82 of 115 patients (71.3%). Ninety-one of 115 patients (79.1%) had complex wounds. Negative pressure dressings were used in wounds with salivary contamination (n = 64), bone exposure (n = 40), great vessel exposure (n = 25), previous free tissue transfer (n = 55), and peristomal application after laryngectomy (n = 32). Adverse events occurred in 4 of 115 patients (3.5%). CONCLUSIONS AND RELEVANCE Negative pressure wound therapy in head and neck surgery is safe and has potential to be a useful tool for complex wounds in patients with a compromised ability to heal. LEVEL OF EVIDENCE 4

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Update in Wound Healing in Facial Plastic Surgery

Cited by 9 publications

References 50 publications

Inflammation in Chronic Wounds

Inflammation in Chronic Wounds

Overview of Facial Plastic Surgery and Current Developments

Negative Pressure Wound Therapy in Head and Neck Surgery

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