in patients with favorable clinical conditions, the definitive treatment with flaps was adequate for cases of wounds due to extravasation of drugs in the subcutaneous tissue when there was exposure of noble structures.

Background Facial nerve injury after facelift is rare; hence, its treatment is poorly established. Botulinum toxin type A (BTXA) can be used to resolve the asymmetry. There is no protocol in the literature about the best timing for this treatment, injection sites or recommended dose. Objectives Propose a protocol to guide the management of asymmetries post-facelifts. Methods Fifteen patients with post-rhytidectomy facial palsies were treated in the non-paralyzed side with BTXA. After analysis of the smile deviation vectors, it is possible to identify the muscles that should be treated. The dose varied from 1-2 Uv/point. Patients were examined after 15 days for outcomes evaluation, and “touch-up” if needed. Patients were re-treated after 5-6 months in case of asymmetry recurrence. Results Symmetry was achieved in all cases. Six patients had definitive nerve lesions and needed to be treated every 6 months after the first session. Five patients had lesions affecting the upper third of the face, four of them were definitive nerve lesions. Two of the four patients who were treated less than 2 weeks after surgery recovered early from the post-facelift paralysis and developed reversed asymmetry due to the BTXA. In seven patients, the post-facelift asymmetry was due to neuropraxis: the recovery from the nerve injury and BTXA treatment occurred symmetrically on both sides of the face in the following months, after one single session. Conclusions Asymmetries post-facelifts were successfully managed with the proposed protocol. Best time for injection was 2-4 weeks after surgery.

Introduction Facial burns are extremely important biological dressings have been developed as temporary substitutes for human skin to avoid infection and accelerate tissue repair, with comfort to the patient. The biocellulose film is produced by the bacterium Acetobacter xylinium. After dehydration process, the obtained product turns into a film. We also use the celluloses film hydrated. Aim: To show the experience of the use of a biocellulose membrane in our hospital, for facial superficial second degree burns.x’x’ Methods This study took place from January 2009 till December 2017. We selected forty five patients with facial superficial second degree burns treated with a biocellulose film since day one post burn. It remained on the face until the complete epithelialization and spontaneous detachment. We studied 45 patients (25 children and 20 adults). We evaluated the final healing time, the pain, the dressing changes and the facility of application (notes from 0 to 10). Results The evaluation note for the ease of application varied from 7 and 8 (40%) and 9 to 10 (60%). We saw spontaneous detachment of the dressing in all cases till day 10. The grade of pain varied from 0 to 2. After day 4 no one referred pain. The full epithelization occurred in 8 days in 90% of children and in 10 days in the other 10% of the children. The restoration in the adults followed t the same pattern. Conclusions The biocellulose dressing seems to be a good option for superficial facial burns. It is painless, easy to apply and has a good cost benefit relation. The authors suggest longer randomized studies. Applicability of Research to Practice New technologies that are cheape, less painfull and efective can be of a great value not only for us but for everyone who work with burn patients.

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