Long-Term Cicatrization Analysis in Periocular Incisions for Oculoplastic Surgery Performed With Cold Blade and Colorado Needle

González-López, Julio J.; González-García, Francisco; Sales‐Sanz, Marco; Alonso, Nieves; Albandea, Ana Rosa; Mateos, E

doi:10.1097/iop.0000000000000054

Cited by 9 publications

(11 citation statements)

References 6 publications

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“… 1 With eyelid incisions usually healing well, and scar hypertrophy and keloids being common on the chest wall, we chose to use paired eyelid and presternal tissues for our study to represent opposite ends of the clinical spectrum of cutaneous scarring. 2 , 3 , 5 Because fibroblasts are the primary drivers of scarring 15 and their biological properties are known to vary with their anatomical origin, 14 , 16 – 18 , 23 we surmised that the strikingly different scarring behavior observed in eyelid and chest skin could reflect different properties of the local cutaneous fibroblasts. We used our well-characterized in vitro 3D model of tissue contraction 21 , 26 – 29 to assess the contractile properties of the tissue-derived fibroblasts in classical free-floating collagen gels and further analyzed the intrinsic mechanical properties of the cells within engineered tissues mimicking physiological environments.…”

Section: Discussionmentioning

confidence: 97%

“…Differences in the resting tensions within, and rigidity of, engineered tissue matrices derived from eyelid and presternal fibroblasts might also belie the traditional belief that differences in clinical scarring are solely related to tissue tension and skin thickness. Indeed, dermal fibroblasts populations are extremely heterogeneous, 14 , 16 – 18 , 23 and the overall mixed populations that we have isolated may comprise various subsets of fibroblasts and fibroblast-like cells, including mesenchymal stem cells. 33 – 36 Furthermore, as dermal fibroblasts from the face originate from the neural crest, whereas fibroblasts from the ventral skin are derived from the lateral plate mesoderm, 34 , 35 and we cannot exclude the possibility that the differences we observed between the 2 populations are linked to the different anatomical origins of the cells analyzed.…”

Section: Discussionmentioning

confidence: 99%

“…Patients were reviewed after 3 months, and the scars were assessed using the Vancouver scar scale 22 to clinically quantify the eyelid and the presternal scar formation. 23 , 24 …”

Section: Methodsmentioning

confidence: 99%

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Eyelid and Sternum Fibroblasts Differ in Their Contraction Potential and Responses to Inflammatory Cytokines

Li¹,

Roos²,

Rose³

et al. 2015

Plastic and Reconstructive Surgery - Global Open

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Background:Adverse skin scarring varies by anatomical site with, for example, presternal skin showing a greater hypertrophic response when compared with eyelid; such differences have traditionally been attributed to regional variations in skin tension, thickness, and Langer’s lines. Fibroblasts are the main cell implicated in fibrosis, and they too are known to show anatomical variation in their expression, differentiation, and intercellular interactions. We, therefore, investigated whether intrinsic differences in skin fibroblasts derived from separate locations might contribute to the observed discrepancies in clinical scarring.Methods:Primary in vitro cultures were established using matched eyelid and presternal skin from 3 healthy donors undergoing blepharoplasty surgery. We used an in vitro collagen gel model of fibroblast-mediated tissue contraction to compare the properties of the dermal fibroblasts from each site. Cell contractile force and matrix stiffness were assessed in 3-dimensional tissue constructs using an automated high-throughput device.Results:Dermal fibroblasts isolated from eyelid and sternum differ both in their ability to contract a gel matrix and in their response to cytokine stimulation; despite having lower intrinsic contractile force (P < 0.01) and resting stiffness (P < 0.02), the presternal cells were more contractile (P < 0.001) following stimulation with serum, or inflammatory cytokines transforming growth factor-β (P < 0.01) and interleukin-1β (P < 0.05).Conclusions:The propensity to cutaneous scarring may, at least in part, result from intrinsic differences in the local fibroblasts’ ability to contract and their sensitivity to inflammatory cytokines. Improved understanding of the underlying molecular pathways should prove useful in identifying new therapeutic targets for altering surgical and other scarring.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Eyelid and Sternum Fibroblasts Differ in Their Contraction Potential and Responses to Inflammatory Cytokines

Li¹,

Roos²,

Rose³

et al. 2015

Plastic and Reconstructive Surgery - Global Open

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“…We observed that in later operations, surgeons could incise with electrocautery quicker than during prior operations and sometimes quicker than when using the scalpel. In a systematic review, the authors found five previous studies [17][18][19][20][21] on Colorado needle electrocautery for upper eyelid skin incision; however, among these articles, they did not have an RCT study to compare Colorado needle electrocautery and a scalpel in upper blepharoplasty incision with respect to bleeding during skin incision and scarring using standard evaluation. Moreover, there were no previous studies on Asian people with poor scar outcomes compared with White people.…”

Section: Prs Global Open • 2023mentioning

confidence: 99%

Comparison of Colorado Needle Electrocautery and Traditional Scalpel for Upper Eyelid Blepharoplasty Incision: A Randomized Controlled Trial and Systematic Review

Pruksapong,

Jankajorn,

Burusapat

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Upper eyelid blepharoplasty is a popular aesthetic surgery. Electrocautery provides a hemostatic benefit for skin incision; however, its effect on scar cosmesis remains unclear, especially in Asian skin types. We aimed to compare the Colorado needle electrocautery pure cutting mode and the traditional scalpel to determine their efficacy, complications, and cosmetic outcomes. Methods: A systematic review was performed to review the outcome with the conventional method (scalpel) and other methods in upper blepharoplasty procedures. Further, a prospective intraindividual randomized controlled trial was conducted to compare the efficacy of Colorado needle electrocautery and the scalpel in upper blepharoplasty. Study outcomes included scar quality at different times until 1-year postoperation, bleeding during incision, and postoperative ecchymosis. Results: Five articles met the inclusion criteria for this systematic review. The prospective randomized controlled trial study included 30 patients; the average incisional time on the electrocautery side was significantly longer than that on the scalpel side, and the electrocautery side had less blood loss during incision than the scalpel side (2.4 versus 3.27 using average cotton bud sticks, respectively) (P < 0.001). Hypopigmented scarring occurred more frequently on the scalpel side; however, the difference was not statistically significant. Conclusions: Colorado needle electrocautery pure cutting mode can be an alternative to traditional scalpel for upper eyelid blepharoplasty skin incision because of long-term scar quality. Electrocautery use has hemostatic benefits, leading to a decrease in bleeding that can obscure the incision site. However, the incision time on the electrocautery side was significantly longer than the scalpel side, which may be owing to an adaptation of surgical technique.

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“…Incision scars of the lower eyelid and medial canthus were evaluated by 3 plastic surgeons using the Vancouver scar scale (VSS). 12 The surgeons were blinded to the surgical treatment of each patient and were not participants of this study.…”

Section: Studymentioning

confidence: 99%

Modified Hotz Procedure Combined With Modified Z-Epicanthoplasty Versus Modified Hotz Procedure Alone for Epiblepharon Repair

Jian-xin

Shao²,

Wang³

et al. 2017

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Long-Term Cicatrization Analysis in Periocular Incisions for Oculoplastic Surgery Performed With Cold Blade and Colorado Needle

Abstract: Esthetic results of periocular scars secondary to skin incisions performed with cold blade or Colorado needle are clinically similar in Spanish patients. Esthetic result of dacryocystorhinostomy scars showed lower scores in OSAS and VSS.

Cited by 9 publications

References 6 publications

Eyelid and Sternum Fibroblasts Differ in Their Contraction Potential and Responses to Inflammatory Cytokines

Eyelid and Sternum Fibroblasts Differ in Their Contraction Potential and Responses to Inflammatory Cytokines

Comparison of Colorado Needle Electrocautery and Traditional Scalpel for Upper Eyelid Blepharoplasty Incision: A Randomized Controlled Trial and Systematic Review

Modified Hotz Procedure Combined With Modified Z-Epicanthoplasty Versus Modified Hotz Procedure Alone for Epiblepharon Repair

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