A Successful Collagenase and Hyaluronic Acid Topical Use Combined with Antibiotic Therapy in the Treatment of Ulcerative Lesions Arising on Tattoo

Fioramonti, Paolo; Fino, Pasquale; Ruggieri, M; Scuderi, Nicolò; Onesti, Maria Giuseppina

doi:10.1155/2012/253492

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Standard treatment uses a collagenase derived from Clostridium histolyticum (3,4). In our hospital, we experimented a combined use of hyaluronic acid (HA) and a new collagenase bacterial fermented sodium hyalunorate (0·2% w/w) salt obtained from non-pathogenic V. alginolyticus (>2·0 nkat1/g) (5,6).…”

Section: Key Messagesmentioning

confidence: 99%

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Non‐surgical treatment of deep wounds triggered by harmful physical and chemical agents: a successful combined use of collagenase and hyaluronic acid

Onesti

Fino

Ponzo

et al. 2014

International Wound Journal

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Some chronic ulcers often occur with slough, not progressing through the normal stages of wound healing. Treatment is long and other therapies need to be performed in addition to surgery. Patients not eligible for surgery because of ASA class (American Society of Anesthesiologists class) appear to benefit from chemical therapy with collagenase or hydrocolloids in order to prepare the wound bed, promoting the healing process. We describe four cases of traumatic, upper limb deep wounds caused by different physical and chemical agents, emphasising the effectiveness of treatment based on topical application of collagenase and hyaluronic acid (HA) before standardised surgical procedures. We performed careful disinfection of lesions combined with application of topical cream containing hyaluronic acid, bacterial fermented sodium hyaluronate (0·2%w/w) salt, and bacterial collagenase obtained from non-pathogenic Vibrio alginolyticus (>2·0 nkat1/g). In one patient a dermo-epidermal graft was used to cover the wide loss of substance. In two patients application of a HA-based dermal substitute was done. We obtained successful results in terms of wound healing, with satisfactory aesthetic result and optimal recovery of the affected limb functionality. Topical application of collagenase and HA, alone or before standardised surgical procedures allows faster wound healing.

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Section: Key Messagesmentioning

confidence: 99%

“…Topical administration of collagenase has been shown to increase the effects of macrophage collagenase . This allows wound debridement by breaking down proteins that hold the eschar (dead and devitalised material) over the wound .…”

Section: Introductionmentioning

confidence: 99%

Non‐surgical treatment of deep wounds triggered by harmful physical and chemical agents: a successful combined use of collagenase and hyaluronic acid

Onesti

Fino

Ponzo

et al. 2014

International Wound Journal

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“…In our case, a young man with a leg ulcer produced by a stingray puncture has been periodically treated with detersion, disinfection, and debridement—obtained by the use of collagenase and hyaluronic acid and administration of antibiotic therapy. 11-14 This case report highlights how sometimes successful wound healing is possible even without surgery.…”

Section: Resultsmentioning

confidence: 91%

Clinical Examination and Treatment of a Leg Ulcer Caused by a Stingray Puncture

Fino

Onesti

Felli

et al. 2014

The International Journal of Lower Extremity Wounds

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The most frequent causes of leg ulcers include venous incompetency (superficial and deep), arterial insufficiency, trauma, vasculitis, and neoplasm. Leg ulcers from injury by stingrays are quite rare. In this case report, we describe a leg ulcer caused by a stingray sting complicated by infection, which healed completely without surgery. In addition, since there few cases in the literature describing such traumas, we performed a comprehensive review of the literature. Important is the fact that the wound healing was complete without resorting to surgery, but only with a correct targeted antibiotic therapy and the use of a collagenase, which has the particularity of having hyaluronic acid as a component.

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“…In 2012, Fioramonti et al used a collagenase product to preserve a colorful tattoo following onset of ulcerative lesions. 11 Use of collagenase increased wound debridement and facilitated the natural healing process. When topical therapy is not enough to solve the problem, an incision is often needed.…”

Section: Literature Searchmentioning

confidence: 99%

Tattoo preservation during surgical procedures

Tenna¹,

Femmine²,

Pendolino³

et al. 2014

OAS

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In recent years, the number of people getting tattoos has continued to increase. Tattoos are much more than cultural fads and cosmetic complements, and nowadays often represent events that express the patient's personality without words. The presence of a tattoo in the surgical field may be a problem for both the patient and the surgeon. However, the relevant literature is mostly based on complications related to application of tattoos or methods used to remove them. To date, few reports have focused on the importance of preserving a tattoo during a surgical procedure, and no organized studies could be found. The aim of this paper is to provide an overview of the range of solutions that surgeons can use to preserve tattoos during surgery. A PubMed database search was done to assess other surgeons' experience. The terms "tattoo" in combination with "incision", "surgery", "surgical", or "operative" were used as key words. Following a review of the literature, photographs of patients presenting with a tattoo in the last 5 years at University Campus Bio-Medico of Rome were identified in order to determine the frequency of patients presenting with tattoos in our department. The patients were classified according to sex, age, type of surgery, number of tattoos, and tattoo location. Specific requests to preserve tattoos were recorded. Finally, an algorithm of treatment according to tattoo dimension and location is proposed. Knowledge of all the strategies available for saving tattoos is important for plastic and cosmetic surgeons. If a tattooed area needs to be operated on, surgeons should attempt, when possible, to avoid altering the tattoo in order to maximize the final cosmetic result.

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A Successful Collagenase and Hyaluronic Acid Topical Use Combined with Antibiotic Therapy in the Treatment of Ulcerative Lesions Arising on Tattoo

Cited by 5 publications

References 5 publications

Non‐surgical treatment of deep wounds triggered by harmful physical and chemical agents: a successful combined use of collagenase and hyaluronic acid

Non‐surgical treatment of deep wounds triggered by harmful physical and chemical agents: a successful combined use of collagenase and hyaluronic acid

Clinical Examination and Treatment of a Leg Ulcer Caused by a Stingray Puncture

Tattoo preservation during surgical procedures

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