silicon and Skin-Ulcer

The injection of fluid silicone was formerly an acceptable therapy for recontouring post-traumatic or age-related changes of the face and neck. About 20 years after the use of silicone injections, the number of patients presenting with late complications is increasing. Such complications include migration of the silicone, granuloma formation, chronic cellulitis, skin ulcers and and scarring, all of which are difficult to treat medically or surgically. Recent data in the literature support the notion that fluid silicon is a potential carcinogen. These patients require a careful approach combining the limited surgical possibilities with the support needed to live with such a problem. Using a case report as an example, we discuss the diagnostic and therapeutic problems associated with this phenomenon which is relatively uncommon in Europe.

Topics: Cellulitis; Cicatrix; Female; Foreign-Body Migration; Humans; Injections; Middle Aged; Plastic Surgery Procedures; Risk Assessment; Silicon; Skin Ulcer

Topics: Adult; Bandages; Becaplermin; Chronic Disease; Epidermolysis Bullosa, Junctional; Female; Gels; Humans; Paraffin; Platelet-Rich Plasma; Re-Epithelialization; Silicon; Silver; Skin Ulcer; Surgical Sponges; Viscoelastic Substances; Wound Healing

Acellular dermal matrix (ADM) products are adopted in the management of injuries to soft tissues. ADMs have been increasingly employed for their clinical advantages, and they are acquiring relevance in the future of plastic surgery. The aim of our study is to evaluate the application of ADMs in our patients who could not undergo fast reconstruction.. We performed a retrospective study on 12 patients who underwent ADM placement for scalp and limb surgical reconstructions at the Humanitas Research Hospital, Rozzano (Milano), Italy. Wounds resulted from 9 tumor resections and 3 chronic ulcers. The ADM substrate used to treat these lesions was PELNAC™ (Gunze, Japan), a double-layered matrix composed of atelocollagen porcine tendon and silicon reinforcement. All patients underwent a second surgical operation to complete the treatment with a full-thickness skin graft to cover the lesion.. In this study, 12 patients were treated with PELNAC™: 11 out of 12 patients showed a good attachment over a median time of 21.3 days (range 14-27). After almost 23 days, all patients were ready to undergo a full-thickness skin grafting.. This study assesses the benefits of PELNAC™ and proposes this method as an alternative to traditional approaches, especially in situations where the latter techniques cannot be applied.

Topics: Acellular Dermis; Adult; Aged; Aged, 80 and over; Animals; Collagen; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Plastic Surgery Procedures; Retrospective Studies; Scalp; Silicon; Skin; Skin Transplantation; Skin Ulcer; Skin, Artificial; Swine; Tendons; Wound Healing

A case is described in which a ring ulcerated into a finger, until only the setting could be seen. The patient reported when the finger began to swell. The injury recovered after removal of the ring. Previous reports of ring and rubber band constriction are reviewed.

Topics: Erythromycin; Fingers; Humans; Male; Middle Aged; Silicon; Skin Ulcer