Daily Cosmetic Research Analysis

BACKGROUND: Chlorhexidine gluconate (CHG) (0.05%) has recently been suggested as a dip and irrigation solution at time of inflatable penile prosthesis (IPP) surgery. AIM: This study evaluated infection rates before and after implementing CHG protocol while investigating concurrent risk factors contributing to post operative infections. METHODS: A retrospective, consecutive cohort study was performed that included patients who underwent insertion of a Coloplast Titan IPP including both virgin and revision cases between 2021 and 2024. Cases performed from January 2021 to August 2022 utilized rifampin/gentamicin for dip and vancomycin/gentamicin for irrigation (ABX), whereas those from October 2022 to May 2024 utilized CHG for both dip and irrigation. Perioperative risk factors including dip and irrigation solution used at time of surgery were compared between groups. OUTCOMES: We defined the incidence of postoperative infection and risk factors associated with infection in each group. RESULTS: The incidence of infection was significantly higher in the 0.05% CHG group (13/377) compared to the ABX group (0/320) (P < .001). When analyzed separately by subgroup, virgin cases treated with CHG for dip and irrigation demonstrated a significantly higher infection rate (7/315) compared to those in the ABX group (0/280) (P = .012). Similarly, in revision cases, the CHG group also exhibited a significantly higher infection rate (0/40) than the ABX group (6/62) (P = .043).Univariable analysis of the CHG cohort identified three significant risk factors for infection: diabetes mellitus (DM), extended operative time (OP), and revision surgery (P = .003, .001, and < .001, respectively). Multivariable regression analysis revealed that patients with DM had a 5.7-fold increased risk of infection (OR: 5.70, P = .004), while those undergoing revision surgery faced a 5.3-fold higher risk (OR: 5.26, P = .004). Additionally, each minute increase in OP was associated with a 1% higher infection risk (OR: 1.01 per minute, P = .007). These associations remained significant after adjusting for all variables in the model. CLINICAL IMPLICATIONS: Prosthetic surgeons should be cautious about adopting 0.05% CHG for both dip and irrigation in the absence of strong clinical evidence demonstrating its non-inferiority to antibiotic solutions. STRENGTHS AND LIMITATIONS: This is the first clinical study reporting infection rates after IPP surgery using 0.05% CHG for both dip and irrigation. While retrospective and non-randomized, we present a relatively large sample size of patients. CONCLUSIONS: Our findings identify four risk factors for penile prosthesis infection: usage of the 0.05% CHG solution for dip and irrigation solution of Coloplast hydrophilic-coated devices, DM, revision surgery, and extended OP.

Radiofrequency microneedling (RFMN) is a commonly used fractional device to treat skin laxity and rhytids. Several studies investigated its histological and clinical effects. However, the role of the applied energy per needle (EPN) and total energy in the outcome remains unclear. The aim of the present study is to analyze the correlation between applied energy and resulting histological and clinical volume effects of RFMN treatment for skin rejuvenation. Ex vivo porcine skin was treated with a RFMN system equipped with insulated needles. Histological measurements of coagulation volumes were correlated with the delivered EPN, ranging from 20 mJ to 100 mJ. For the clinical investigation, a cohort of patients received treatment on the lower face and submental area. Absolute volume changes were calculated using computer-aided three-dimensional analysis. Pearson's and Spearman's correlation coefficients r were determined. Histologic analysis revealed a strong positive correlation between EPN and coagulation volume (r = 0.976; p < 0.005). A total of 30 patients, with a mean age of 55.9 ± 8.7 years, were recruited and received 1.7 ± 0.8 sessions (1-3) with a total energy of 1518.2 ± 784.1 J. Three-dimensional imaging revealed a strong logistic correlation with the total energy applied across all sessions (r = 0.676; p < 0.001). Analysis showed a positive association between the number of sessions and volume change. Study findings indicate a very strong and strong correlation between the applied energy and the resulting histological and clinical outcome in RFMN treatment, respectively. The introduction of coagulation volume as a matrix in RFMN treatments enables medical doctors to tailor and adjust treatment plan to the individual patient.

BACKGROUND: Plasma gel, also known as plasma-rich in growth factors (PRGF) gel or platelet-rich gel, is a novel application of platelet-rich plasma (PRP), created by heating platelet-poor plasma (PPP) to induce denaturation, forming a gel-like substance. This gel is then combined with PRP to create a new injectable biomaterial that offers both the regenerative benefits of PRP and structural support due to its gel-like consistency. Plasma gel has been increasingly used not only for its biological regenerative properties but also as a cosmetic filler to enhance tissue volume and improve skin aesthetics. It shows promise in facial rejuvenation by improving skin texture and elasticity, and reducing the appearance of wrinkles. However, the detailed in vivo behavior of plasma gel, particularly its absorption rate and regenerative efficacy, remains underexplored. AIMS: This study aims to investigate the in vivo behavior of plasma gel, focusing on its absorption rate and its ability to stimulate tissue regeneration. Specifically, we aim to assess how quickly plasma gel is absorbed after subcutaneous injection and to evaluate its effects on collagen production and neovascularization using a nude mouse model. METHODS: Plasma gel was prepared by heating PPP to create a gel-like substance, which was then mixed with PRP. This mixture was injected subcutaneously into nude mice. The absorption of the gel was monitored over time by measuring the remaining volume at different time points. Tissue samples were analyzed using Masson's trichrome staining to detect collagen and CD31 immunohistochemical staining to assess neovascularization to understand the regenerative effects induced by plasma gel. RESULTS: The study found that plasma gel is absorbed rapidly, with approximately 50% of the volume disappearing within the first week and almost complete absorption by eight weeks. Despite this rapid absorption, significant increases in collagen deposition and new blood vessel formation were observed, indicating strong regenerative properties even after the gel had been largely absorbed. CONCLUSIONS: The main findings of this study suggest that while plasma gel is quickly absorbed and may not be suitable for long-term volumizing effects, it shows significant potential for temporary volume enhancement and as a biostimulatory agent. Plasma gel's ability to promote collagen production and neovascularization makes it valuable in clinical applications where temporary support and long-term tissue regeneration are desired. Future research should focus on ways to extend the retention time of plasma gel and enhance its regenerative effects, potentially through modifications to its formulation or combination with other bioactive substances.