Bezrukov G.S.
Crimea state medical university named after S. I.
Georgievsky, Simferopol.
The
complex justification of using the
injection therapy for elimination
of face soft tissues deformations.
The injection method of elimination defects and deformations of soft tissues of the face is the most
actively developing and perspective directions in plastic and reconstructive
maxillofacial surgery.This contributes lesser trauma, high efficiency and availability of method. But not always the
positive results of treatment have stable character. The complications observed
in in 5- 40 %. This contributes the tendency of hydrophilic gels(HP) to
migration from the area of injection with formation of clusters as “gelioma”,
developing of secondary deformations and local inflammotory reactions in
long-term of observation.
That is why the purpose of
our investigation was the increase the efficiency of treatment the patients
with defects and deformations of soft tissues of the face by development and
implementation of method of stratified injection of HP against the background
of adaptive and immunocorrective therapy.
For investigation were
formed 3 clinical groups (1st main group
- 46 patients, 2nd main – 57, control – 30), comparable by 3
basic comparable criteria( the character and localization of patological
process, sex and age).
All female patients
carried out the course of treatment and examination in outpatient regimen. The
basic complex of conservative treatment did not has significant difference.
Just in second main group the treatment
was supplemented by preparation Traumel-C with purpose to strengthening
the adaptive and immunocorrective direction of therapeutic manipulations.
The groups of investigation
included the female patients with 3 typical
versions of defects and deformations of soft tissues: interbrow(42)
and nasolabial folds(42) (as a
deformation), hypoplasia of the lip (49)(defect).
In control group for
interbrown and nasolabial folds smoothing were injected HP gel (AquaLift) subfascially single layer under the fold
along its entire length using 1-2 ml of material. For the patients of main
groups performed stratified placement of HP gel in
tissues for defects elimination. The
patients of 2 group had used
preparation Traumel – C(as immunomodulator, antioxidant and
adaptogen).The preparation was injected one time 2,2 ml in the day of
implantation, and the it was administreted in tablets.(2-3 times a day , sublingual,
course for 10 days).
Results of implantation
estimated by study of the patient's complaints, palpation, and the indexes of
additional methods of investigation, and also learning of snapshots. Firs
results estimated on 14-15 day. The final results estimated in terms 5-6 and
11-12 months.
The analysis of character
of changes the clinical symptoms in early postimplantation period allowed to notice following items. By
all analyzed indexes (hyperaemia, local edema, pain) in all groups of
investigation identifed significant differences, that point out to the less and
expressive and continuous inflammotory reactions in the implantation
area in first and second groups. The
positive dynamics of deformation
elimination was the most expressive in 2nd and 1st
main groups.
It should be noted, that
the largest number of gelioms (22,72%)
were revealed in patients of control group. The local inflammotory reactions,
related with placement of implant in soft
tissues;it was registated in 13,64 %
patients of control group (2,44% - in 2nd group). The number of
positive treatment outcome was the most high in 2nd main group
(92,68%, 68,18 % in control).The recovery of initial level of biopotentials of
the skin noticed in
2nd main group on 7 day after implantation, in 1st
group – on 10 day and in control – on 14 day with expressive intergroup
differences(p<0,05)
Conclusions
1.
The analysis
of character of changes of clinical indexes in groups of comparation in early
postimplantation period point out to the efficiency of the method of stratified injection of HP gel ( AquaLift)
in tissues, in the area of defect or deformation. With it use the inflammotory reactions (hyperaemia, edema and
pain) proceed less expressive.
2.
The long-term
results of clinical observation showed , that
stratified injection of HP gel in soft tissues of the face with general
adaptogenic and immunocorrective therapy by preparation Traumel-C promotes the
optimization of conditions of inflammatory processes, increase the number of
positive outcome of treatment, decrease the frequency of development and
severity of local inflammatory reactions.
3.
The main
rheographic indexes point out to the most early and complite recovery of
circulation in area of damage in patients of 2nd main group (7 day) and 1st main
group (10 day) (in control 14-21 day)
This all testify about highefficiency of developing by us method