Safety and efficacy of autologous noncultured dermal cell suspension transplantation in the treatment of localized facial volume loss: A pilot study.

BACKGROUND: Available options for correction of facial volume loss, such as synthetic fillers, autologous fat and cultured fibroblasts, have limitations viz. temporary effect and high cost. AIM: To assess the use of a novel technique, autologous non-cultured dermal cell suspension transplantation, for correction of localized facial volume loss due to inflammatory pathologies. METHODS: It was a pilot study conducted in the Dermatology Outpatient Department, All India Institute of Medical Sciences (AIIMS), New Delhi, India. Autologous non-cultured dermal cell suspension was transplanted in a total of 10 patients, out of which 5 had predominantly dermal loss and the rest had predominantly lipoatrophy. The donor tissue from the gluteal region was digested into a single cell suspension using collagenase-1 and injected into the recipient area. The outcome was assessed subjectively by patients and investigators and objectively using ultrasonography. Cell count, viability testing and measurement of mesenchymal stem cells were also done. RESULTS: On assessment of patients, the median improvement in the predominantly dermal atrophy group at 3 and 6 months was 70% (range: 10-90%) and 80% (range: 0-90%), respectively, and in the predominantly lipoatrophy group, 0% (range: 0-40) and 0% (range: 0-50), respectively. Mean thickness of dermis + subcutis at the baseline was 1.835 mm (range: 0.89-6.04 mm), which increased to 2.912 mm (range: 0.88-7.07 mm, P = 0.03) at 6 months. LIMITATIONS: Our pilot study has some limitations such as small sample size and heterogeneity of the recruited patients. CONCLUSIONS: Autologous non-cultured dermal cell suspension transplantation appears to be safe and effective in localized facial dermal defects because of inflammatory pathologies, but not effective in deeper defects.

Reconstruction of facial deformities in leprosy patients.

Almost all the parts of the face may be involved in deformities caused by leprosy. Reconstructive surgery can be undertaken after the disease is arrested by medical treatment. Reconstruction of nose can be done by augmentation with autogenous bone graft, retronasal inlay graft, etc. Loss of eyebrows can be reconstructed with hair bearing skin with hair follicles. Sagging face can be corrected by nasolabial face-lift with correction of glabellar folds. Blepharoplasty is done for correction of some conditions. The temporal muscle sling is a dynamic procedure to reconstruct facial nerve palsy.

An analysis into the trends of reconstructive surgery in Gudiyatham Taluk, a leprosy control area.

The trends in Reconstructive Surgery in Gudiyatham Taluk, an area where an effective Leprosy Control Programme has been in progress since 1963, were analysed. Over the years 1962-79, it is shown that there is a decline in the number of Reconstructive surgical operations in Karigiri, on patients from the Control area, even though the new case detection rate and the total number of operations from both control and non-control areas remained high. The decline in the number of Reconstructive Surgery on patients from a Control area, provides a reliable index to judge the efficacy of a Leprosy Control Programme.

The surgical management of Hansens disease: a survey updated

Hansen's disease, leprosy, is one of the ildest known diseases, yet it continues to be shrouded in mystery and superstititon, not only among the public but also within the medical profession. Unwarranted fear is due to a lack of knowledge of the disease and dread of acquiring the same fate as Hansen's disease victims.

Chirurgie plastique du visage lépreux / Plastic surgery of the face in leprosy

Notre récente mission dans une léproserie iranienne nous a permis de constater que les indications à la chirurgie réparatrice du visage lépreux sont fréquentes. Cette chirurgie se propose d'effacer les stigmates de la maladie hansénienne au niveau du visage et par diverses techniques, elle doit permettre la réintégration sociale des anciens malades, jusqu'alors objets de répulsion.