A modified nonsurgical treatment of keloids: Cocktail therapy.

BACKGROUND: The high recurrence rate after nonsurgical treatment of keloid is a major challenge for clinicians. Although there are many existing treatment options, how to optimize and upgrade the existing options and make a reasonable combination of utilization is our concern. The aim of this study is to provide a comprehensive non-surgical treatment for keloid-cocktail therapy. METHODS: According to the different changes of keloid with treatment, the treatment was divided into four stages, and different treatment schemes were adopted for each stage. The incidence of side effects of keloid at each stage and the effective rate and cure rate 16 months after the end of treatment were analyzed. RESULTS: All patients completed this study on time, and were followed up 16 months after the end of treatment, the treatment effective rate was 100%, and the cure rate was up to 92.8%. CONCLUSION: Cocktail therapy can achieve a higher cure rate of keloid, and is worthy of clinical promotion.

High-Frequency Ultrasound Imaging Findings of Different Mental Injectable Soft Tissue Fillers.

BACKGROUND: In recent years, the use of mental injectable soft tissue fillers is popular. However, some fillers are difficult to distinguish from pathological tissue, and some non-absorbable fillers need to be removed in time. Therefore, identification of different fillers is important. In this study, we summarized the ultrasonic manifestations of different mental injectable soft tissue fillers to provide references for clinical practice. METHODS: We screened the mental ultrasound images from November 2014 to November 2021 in the Plastic Surgery Hospital of Chinese Academy of Medical Sciences, identified different filling injection materials, and summarized and classified the ultrasonic characteristics of each filling material. RESULTS: A total of 244 cases were included, involving 62 cases of hyaluronic acid, 126 cases of polyacrylamide hydrogel, 19 cases of growth factor, 16 cases of calcium hydroxyapatite, 15 cases of silicone oil and 6 cases of fat. The ultrasonic manifestation of hyaluronic acid was anechoic area, which could be divided into six types according to the distribution characteristics. The ultrasonography of polyacrylamide hydrogel showed fine punctate echo, which could be divided into nine types. The ultrasonographic appearance of growth factor was similar to the echo of the surrounding tissue, and the boundary was not clear. Calcium hydroxyapatite was characterized by uneven hyperechoic area, which was spread in the tissue space, with unclear boundary with surrounding tissues. Sonographic patterns of silicone oil were hyperechoic and cloudy on high-frequency ultrasound. The deep tissue and periosteum layer were not clear. Transplanted fat showed isoechoic area or uneven low-echo area, with clear boundary and peripheral adipose tissue acoustic enhancement. CONCLUSIONS: High-frequency ultrasound is safe and reliable for identification and typing of chin filling injection materials, which can be applied in clinical practice. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Application of high-frequency ultrasound in detection and identification of nasal filling injection materials.

OBJECTIVE: To access and determine the ultrasound images of different nasal filling injection materials. METHODS: From November 2014 to November 2021, facial ultrasound images of Plastic Surgery Hospital of Chinese Academy of Medical Science were analyzed and judged. RESULTS: A total of 337 cases were enrolled, including 203 cases of hyaluronic acid, 102 cases of polyacrylamide hydrogel, 16 cases of calcium hydroxyapatite-based fillers, 10 cases of silicone oil, and 6 cases of growth factor. According to ultrasound images, hyaluronic acid is characterized by anechoic area with a clear boundary, which seems like a capsule, and the internal echo is uniform, there is no obvious blood flow signal in it. It is possible to see a stratified appearance if hyaluronic acid diffused into surrounding tissues, and it is mainly exhibited as hypoechoic area, with anechoic or hypoechoic areas in it. Polyacrylamide hydrogel showed irregular flocculent hypoechoic or fine punctured hypoechoic under ultrasound, which could aggregate into cystic hypoechoic area or disperse in tissue space, and echo floating or dislocation flow could be seen under probe pressure. Under ultrasound, calcium hydroxyapatite-based filler is characterized by heterogeneous hyperechoic or hypoechoic area, which spreads in the tissue space with unclear boundary with surrounding tissue, and no obvious liquid flow could be observed. Silicone oil is commonly found in the dermis, it is characterized by cloud-like high echo, the deep tissue is not clear. Growth factor is characterized by heterogeneous echo, which is similar to the echo of peripheral tissue, and the boundary is not clear. Plenty of blood flow signals suggest infection. If the image is characterized with posterior echogenic shadow, it suggests calcification. CONCLUSIONS: High-frequency ultrasound can identify the types of nasal filling injection materials and can guide the selection of clinical treatment plan according to the classification of imaging features.