Scar and Scarring in the Elderly

Colboc, Hester; Meaume, Sylvie

doi:10.1007/978-3-030-44766-3_44

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…A critical role of hypothalamic D 2 -type receptor signaling per se in thermoregulation has been well established. For example, intrahypothalamic injections of dopamine have been shown to induce hypothermia in rats 63,64 , an effect that was antagonized by treatment with D 2 -type antagonists 63 and was paralleled by deficits in locomotion 64 similar to the pattern observed after PDE4 inhibitor treatment (Fig. 6).…”

Section: Blockade Of Central D 2/3 -Dopamine Receptors Alleviates Pde4 Inhibitor-induced Hypothermiamentioning

confidence: 64%

Inhibition of type 4 cAMP-phosphodiesterases (PDE4s) in mice induces hypothermia via effects on behavioral and central autonomous thermoregulation

McDonough

Rich

Aragon

et al. 2020

Biochemical Pharmacology

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Inhibitors of Type 4 cAMP-phosphodiesterases (PDE4s) exert a number of promising therapeutic benefits, including potent anti-inflammatory, memory-and cognition-enhancing, metabolic, and antineoplastic effects. We report here that treatment with a number of distinct PDE4 inhibitors, including Rolipram, Piclamilast, Roflumilast and RS25344, but not treatment with the PDE3selective inhibitor Cilostamide, induces a rapid (10-30 min), substantial (−5°C) and long-lasting (up to 5 h) decrease in core body temperature of C57BL/6 mice; thus, identifying a critical role of PDE4 also in the regulation of body temperature. As little as 0.04 mg/kg of the archetypal PDE4 inhibitor Rolipram induces hypothermia. As similar or higher doses of Rolipram were used in a majority of published animal studies, most of the reported findings are likely paralleled by, or potentially impacted by hypothermia induced by these drugs. We further show that PDE4 inhibition affects central body temperature regulation and acts by lowering the cold-defense balance point of behavioral (including posture and locomotion) and autonomous (including cutaneous tail vasodilation) cold-defense mechanisms. In line with the idea of an effect on central body temperature regulation, hypothermia is induced by moderate doses of various brain-penetrant PDE4 inhibitors, but not by similar doses of YM976, a PDE4 inhibitor that does not efficiently cross the blood-brain barrier. Finally, to begin delineating the mechanism of drug-induced

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Section: Blockade Of Central D 2/3 -Dopamine Receptors Alleviates Pde4 Inhibitor-induced Hypothermiamentioning

confidence: 64%

Inhibition of type 4 cAMP-phosphodiesterases (PDE4s) in mice induces hypothermia via effects on behavioral and central autonomous thermoregulation

McDonough

Rich

Aragon

et al. 2020

Biochemical Pharmacology

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“…Elderly patients, owing to their increased skin laxity, afford greater flexibility in the use of technically simpler flaps, leading to a reduction in surgical time, quicker functional recovery, and a reduction in surgical risks, as supported by the scientific literature [18]. This patient population often exhibits less efficient wound healing compared to their younger counterparts, resulting in the general tendency of having less exuberant scarring and better overall scar outcomes, offering a superior aesthetic result with equivalent surgical techniques [19,20]. On the other hand, it is essential to emphasize that elderly patients frequently exhibit significant comorbidities which make it imperative to perform procedures under local anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Lower Lip Reconstruction after Skin Cancer Excision: A Tailored Algorithm for Elderly Patients

Russo,

Pentangelo,

Ceccaroni

et al. 2024

JCM

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Background: Lower lip reconstruction is crucial to restore oral integrity post-cancer excision. A perfect balance between form and function should be achieved. With an aging demographic, adapting surgical methods to meet the unique needs of the elderly becomes imperative. Our study aims to introduce a specialized algorithm for lower lip reconstruction; it was tailored to geriatric patients and emphasized the use of “simpler flaps”. Additionally, “Pearls and Pitfalls” were provided for surgeons approaching lower lip reconstruction. Methods: Between January 2018 and June 2021, a retrospective study was carried out. Data collection included patient demographics, defect attributes, reconstructive approaches, flap viability assessment, wound healing, and complications. The follow-up was carried out for a period of a minimum of 6 months. Results: Among 78 patients, squamous cell carcinoma predominated with a mean defect area of 3308 cm2. Postoperative complications were recorded in two patients. All patients reported sensory restoration and overall satisfaction at the 6-month follow-up; secondary procedures were not necessary. Conclusion: Our reconstructive algorithm, focused on elderly patients, prioritizes less invasive reconstructive techniques and introduces innovative modifications to the established methods to achieve both aesthetic and functional outcomes with a low complication rate. In patients undergoing lower lip reconstruction, the subjective microstomia was found to be less relevant than the objective microstomia.

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“…This can be attributed to the fact that older patients are less concerned about the scars of the donor area. 20 Although none of the treatments was delivered to the philtrum, Figures 3 and 5 show that the philtrum was enhanced after the treatment. The authors believe that this enhancement is related to the increase in lip projection.…”

Section: Discussionmentioning

confidence: 99%

A Comparison Between Hyaluronic Acid Filler and Dermofat Grafts With or Without Tie-Over Dressing for Lip Augmentation

Ince,

Zuhour,

Kadiyoran

et al. 2023

Dermatol Surg

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BACKGROUND There are many different autologous grafts used for lip augmentation, such as fat, fascia, or dermofat grafts (DFG). However, filling with synthetic materials such as hyaluronic acid (HA) fillers is the most preferred method. OBJECTIVE The authors aimed to compare DFG with HA fillers regarding cost, permanence, complication rate, gained volume, and satisfaction rate. The authors investigated the effect of tie-over dressings on the viability of DFG. PATIENTS AND METHODS Patients who received hyaluronic acid fillers were referred to as Group H. Patients who received grafts without tie-over and with tie-over dressings formed Groups D1 and D2, respectively. The lip index (LI) was used for volume comparisons. The viable area of the grafts was measured using ultrasound imaging. RESULTS At postoperative month 6, the only significant difference was found between Group D1 and Group D2 (p < .05). At the postoperative first year, Groups D1 and D2 had a statistically higher LI value compared with Group H. Group D2 had a higher viable area than Group D2 (p < .05). Group H and Group D2 showed higher satisfaction scores than Group D1 (p < .05). CONCLUSION Dermofat grafts with or without tie-over dressings can be considered a reliable and inexpensive choice for patients who seek a more permanent procedure. Tie-over dressings increase the predictability of DFG and reduce the need for overcorrection.

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Scar and Scarring in the Elderly

Cited by 6 publications

References 11 publications

Inhibition of type 4 cAMP-phosphodiesterases (PDE4s) in mice induces hypothermia via effects on behavioral and central autonomous thermoregulation

Inhibition of type 4 cAMP-phosphodiesterases (PDE4s) in mice induces hypothermia via effects on behavioral and central autonomous thermoregulation

Lower Lip Reconstruction after Skin Cancer Excision: A Tailored Algorithm for Elderly Patients

A Comparison Between Hyaluronic Acid Filler and Dermofat Grafts With or Without Tie-Over Dressing for Lip Augmentation

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