Bezrukov G.S.

Crimea state medical university named after S. I. Georgievsky, Simferopol.

The efficiency of different methodological approaches to the elimination of deformations of the soft tissues of the face by injection method.

One of the most complicate and rapidly developing directions in maxillo-facial surgery and plastic surgery is contouring, which is designed to eliminate the both : congenital and acquired appearance flaws. According to some authors the contouring is the subject of permanent study and continues to be one of the most actual problems in medicine. Last years in form of the face and neck correction are involved remedy, administered by injection. To this group refer the polymers of class of hydrogels. Drug of choice for these purposes are hydrophilic polyacrylamide gels “Aqualift”

and “Esteform” , which have important properties such as biocompatibility, elasticity, shape stability and general stability. But results of it use for defects elimination of soft tissue of face and neck not always satisfy the professionals. It is due to the development of local inflammatory reactions, the material migration from the area of administration with area of congestion(lumpiness) formation , or asymmetry.

The purpose of our investigation is to increase the efficiency of treatment the patients with defects of soft tissues of the face by development the method of stratified injection of polyacrylamide gel in tissues, and also the including in treatment the preparation with immunocorrective and adaptogenic effect.

Materials and methods.

For study the efficiency of polyacrylamide gel use during the stratified injection were formed control and main groups of patients. The control group included 30 patients , which had injected the preparation “ Esteform” by single layer by the traditional method.The I and II main groups included 46 and 57 patients, which had injected the polyacrylamide gel according to our methodology. In second group used immunocorrector and adaptogen, preparation Traumel-C. The material implantation in face tissues used in age changes (interebrow and nasolabial folds) and also in hereditary and age of lipodystrophy of the lips.

The polyacrylamide gel administered by injection method. The averange amount of the drug , injected in the face , variated from 1,0 to 20, ml and depended from the severity of deformation and defect.

The results of clinical observations

The comparative study of received results has showed the development of short , not significant or moderate edema in area of administration of polyacrylamide gel; quickly passing pain; uncomplicated healing of puncture canal in terms of 2-4 days with total disappearance of carried out punction marks in patients of main and control group. The observations the postoperative period progressing in dynamics allowed to clarify, that infiltration at the site of injection are totally resorbed in terms 1-3 months. During the palpation the patients of main group cease to be determined the boundaries of implants location and tuberosity of the tissues in its projection surface. At the same time is saved increased volume of tissues, but less than than in the dau of implantation.

The long-term results observed in 46 patients of main groups in terms of 6-12 months. The complicantions, caused by polyacrylamide gel injection in tissues and the cases of rejection of the implant we have not observed.

In control groups of observations identified 12 cases ( %) of uneven tuberous of implant location in tissues, that due to , in our opinion, the increased density of used gel and no effect from infiltration of tissues.

The conclusions

1. Hydrophilic implant “Aqualift” by it single layer injection in tissues of the face in small dose ( to 2 ml per area) for defects and deformation elimination gives positive and persistent therapeutic effect .

2. The material does not undergo the resorption, fragmentation and exclusion, does not change the consistency of tissues , does not lead to clearly defined boundaries formation. He is not demand the additional fixation in the implantation area and constantly present in the its location.

3. The administration of the drug in soft tissues does not demand additional equipment, easily tolerated by the patient, leaves no residue on skin after performed injection, gives the possibility to rapidly get the aesthetic effect, can be used in ambulator conditions.

4. Our development method use of stratified injection of polyacrylamide gel with combination with use as adaptogen - the preparation Traumel-C reduces the terms of attenuation of the inflammatory response and accelerates the processes of reparation of tissues, that testifies the indexes of antitrypsin activity of mixed saliva.