Use of cross-linked carboxymethyl cellulose for soft-tissue augmentation: preliminary clinical studies

Abstract

Purpose:The continual search for new products for soft-tissue augmentation has in recent years led to the introduction of long lasting alternatives to hyaluronic acids and collagen that are composed of other polymers able to improve clinical persistence over time. This is the first report in which sodium carboxymethyl cellulose (CMC) has been chemically treated by the cross-linking process and thus used as a hydrogel for soft-tissue augmentation through injection with thin needles. The study evaluates, from a clinical point of view, the behavior of cross-linked carboxymethyl cellulose hydrogel used in the aesthetic field and its side effects so as to check the safety and performance of the polymer following intradermal injections.Patients and methods:This work shows the preliminary results of an ongoing clinical study conducted between 2006 and 2009, performed on 84 healthy volunteers (62 females, 22 males) aged between 18 and 72 years, for the treatment of 168 nasolabial folds, 45 perioral wrinkles, and 39 lip volume.Results:Study results show an excellent correction of facial defects. Tolerance and aesthetic quality of the correction obtained indicate considerable safety features and absence of side effects. From a clinical point of view, hydrogel is gradually absorbed into the injection site without migration issues.Conclusion:Cross-linked CMC hydrogel proves to be an ideal agent for soft tissue augmentation with regard to safety and ease of application. It did not cause infection, extrusion, migration, or adverse reactions in the patients who have been followed for two years. Delayed aesthetic results on facial wrinkles were very satisfactory.

Facile fabrication of self-healing carboxymethyl cellulose hydrogels

“…Due to the merits of non-toxicity, water solubility, low-cost and environmental friendliness [25], CMC has been widely used as a natural ingredient for hydrogels, and has been developed for various applications including tissue engineering, drug delivery, wound dressing and plant breeding [24][25][26][27][28][29]. All these applications expect self-healing performance of CMC hydrogels to enhance their service life and applicability.…”

“…All these applications expect self-healing performance of CMC hydrogels to enhance their service life and applicability. Currently, the preparation methods of CMC hydrogels are largely based on chemical cross-linking [24][25][26][27][28][29]. However, breaking the chemically cross-linked CMC networks results in irreversibly damaged polymer networks, and the chemical agents involved are generally toxic.…”

Sericin–carboxymethyl cellulose porous matrices as cellular wound dressing material

“…[23][24][25] Carboxymethyl cellulose (CMC) is water-soluble cellulose ether, and an acid derivative of cellulose. Due to their low cost, biodegradability, and nontoxicity, cellulose and its derivatives are highly attractive biopolymers for biomedical applications as an antioxidant, 26,27 as exudates absorber near wounds, for control drug release, 28 and as cell carriers. 29 It finds applications in preventing postoperative adherences and epidural scarring.…”

Characterization of porous polymethylmethacrylate space maintainers for craniofacial reconstruction

“…To fabricate porous PMMA, an aqueous gel of carboxymethylcellulose (CMC) can be used in a phase separation strategy due to the hydrophobicity of PMMA and its monomer, MMA. Similar to PMMA, CMC also has been extensively used in clinical applications such as the treatment of glottic insufficiency,19 postoperative laparoscopic adhesion,20 and the augmentation of soft‐tissue 21. Fabrication of porous PMMA with CMC has been investigated for bone substitution 22–25.…”

“…Similar to PMMA, CMC also has been extensively used in clinical applications such as the treatment of glottic insufficiency, 19 postoperative laparoscopic adhesion, 20 and the augmentation of soft-tissue. 21 Fabrication of porous PMMA with CMC has been investigated for bone substitution. [22][23][24][25] A 20-year follow-up clinical study 25 revealed good implant fixation due to bone ingrowth into pores and no side effects ascribed to the porous PMMA bone substitute.…”