Daily Cosmetic Research Analysis

OBJECTIVE: The benefit of subcutaneous tissue closure during cesarean delivery (CD) has been well established in pregnant individuals with a subcutaneous tissue thickness greater than 2 cm. However, its routine application in all pregnant individuals remains a contentious topic. This meta-analysis aimed to evaluate and quantify the effect of subcutaneous tissue closure compared to nonclosure on postoperative wound complications in all patients undergoing CD. DATA SOURCES: We searched PubMed, EMBASE, Web of Science, Medline, Scopus, Cochrane Central Register of Clinical Trials, and ClinicalTrials.gov from their inception to October 2024 for randomized controlled trials (RCTs). STUDY ELIGIBILITY CRITERIA: Eligible studies included RCTs comparing subcutaneous tissue closure vs nonclosure in patients undergoing CD. Studies were excluded if they focused solely on selected subpopulations, such as pregnant individuals with subcutaneous fat >2 cm or those classified as obese. Primary outcomes were seroma formation, hematoma, surgical site infection (SSI), and wound dehiscence. Secondary outcomes included postoperative pain and cosmetic results. STUDY APPRAISAL AND SYNTHESIS METHODS: Random-effects models were used to calculate relative risks (RR) for each outcome. Heterogeneity across studies was assessed using the I² statistic. RESULTS: Eight trials comprising 1854 participants (918 closure, 936 nonclosure) met inclusion criteria. There were no significant differences between groups for SSI (RR 0.95, 95% CI: [0.69-1.31]), dehiscence (RR 0.64, 95% CI: [0.21-1.98]), seroma (RR 0.87, 95% CI: [0.05-14.81]), hematoma (RR 0.54, 95% CI: [0.02-15.90]), or composite wound outcomes (RR 1.05, 95% CI: [0.80-1.38]). Study heterogeneity was low (I²<45%). CONCLUSIONS: Subcutaneous tissue closure during CD does not significantly reduce the risk of wound complications when applied universally. These findings do not support its routine implementation for all patients with subcutaneous thickness less than 2 cm. Further research should focus on refining patient selection criteria and evaluating other potential benefits, including long-term cosmetic outcomes. El resumen está disponible en Español al final del artículo.

INTRODUCTION: This randomized trial evaluated the efficacy and safety of the prophylactic use of a hyaluronic acid (HA) 0.2 %-containing cream to reduce acute radiodermatitis in breast cancer patients undergoing adjuvant radiotherapy (RT). METHODS: Candidates for conventionally-fractionated or hypofractionated adjuvant RT for unilateral stage I-III breast cancer were randomized 1:1 to the HA cream or neutral comparator applied twice daily from 14 days before starting until 14 days after completing local RT. The primary endpoint was the development of acute skin dermatitis of grade ≥2 according to RTOG scale at the end of RT. RESULTS: The study closed early after 86 of the planned 120 patients were enrolled because of an unexpectedly low frequency of acute skin toxicity. Cumulative acute grade ≥2 radiodermatitis was lower with the HA cream (21.1 %) than the comparator group (35.3 %) but did not reach statistical significance in the primary endpoint (p = 0.3). At the end of RT, acute dermatitis grade ≥1 occurred in 92 % of patients undergoing conventionally-fractionated RT and 50 % in the hypofractionation subgroup. Physician-based RTOG grading scale and quantitative assessment with skin reflectance spectrophotometry (SRS) measures were comparable in detecting skin toxicity. However, an increase in SRS values was detectable a week before the first signs of radiodermatitis were depicted using RTOG scores. CONCLUSION: Compared to physician-based grading, SRS enabled earlier detection of skin toxicity and may be used as a valid and effective tool for assessing radiodermatitis. Prophylactic topical HA may help mitigate this toxicity; however adequately powered prospective trials are needed.

BACKGROUND: Microneedling (MN) has risen in popularity as a non-surgical treatment option for facial skin aging. We aimed to evaluate patient-reported outcomes (PROMs) and safety profiles associated with MN. METHODS: A systematic review was conducted adhering to PRISMA guidelines. Articles were screened for relevance in a two-stage process. Descriptive statistics and a proportion meta-analysis was utilized for patient satisfaction using Stata statistical software. RESULTS: Of 346 studies identified, a total of 21 articles reporting outcomes of 723 patients undergoing MN for facial rejuvenation were included for review and meta-analysis. The patient cohort was majority female (72%), and the average age was 48 years. The most common esthetic study endpoints were wrinkling (71%, 15/21), skin texture (33%, 7/21), photoaging (29%, 6/21), and skin laxity (14%, 3/21). The majority of trials (90%, 19/21) treated patients with multiple MN sessions, and these studies' treatment schedules also varied by number and timing of sessions. Pooled meta-analysis revealed that 83% of patients reported satisfaction with their treatment (95% CI [0.76; 0.88]). The most common reported adverse effects were transient erythema (6.8%), scaling (1.7%), burning sensation (1.5%), and pruritus (0.4%). CONCLUSION: Our meta-analysis revealed that MN is associated with high patient satisfaction and low rates of adverse events. High patient satisfaction coupled with a low incidence of adverse events supports MN as a viable non-surgical treatment option for facial rejuvenation. However, the lack of standardized measures for esthetic outcomes warrants continued research to better determine its efficacy in treating signs of facial aging. 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.