Necrotizing metachronous facial ulcerations after 'stem cell face lift'
| Autor: | Salim C. Saba, Marek Dobke, Brian Mailey, Jason R. Bailey, Dhaval Bhavsar |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Erythema medicine.medical_treatment Abdominal wall Necrosis Skin Ulcer medicine Humans Dexamethasone Mycobacterium Infections business.industry Middle Aged Cannula Surgery medicine.anatomical_structure Adipose Tissue Liposuction Etiology Rhytidoplasty Female Differential diagnosis medicine.symptom Stem cell business Facial Dermatoses medicine.drug |
| Zdroj: | Annals of plastic surgery. 70(4) |
| ISSN: | 1536-3708 |
| Popis: | Introduction A 63-year-old woman underwent face and neck lift with autologous fat transfer-called by her physician a "stem cell face lift." Methods Fatty aspirate from her abdominal wall was enriched by hyaluronic acid, triiodothyronine, thyroxine, insulin, dimethylaminoethanol, estriol, dexamethasone, indomethacin, and fibroblast growth factor before injection into the face. Results At approximately 4-weeks postoperative, the patient developed facial swellings, erythema, necrotizing ulcers, and an orocutaneous fistula. New lesions continued occurring up to 16 weeks after surgery. After multiple surgical debridements and an oral course of rifampin, a decisive reduction in inflammation and healing was observed. Differential diagnosis included (1) mistaken transfer of allogeneic fat (ruled out), (2) toxic impurities in transferred material, (3) microbial contaminant(s) from multiple use liposuction cannula or tissue markers, and (4) endogenous anaerobic orofacial infection (history of previous radiation for tonsillar cancer and dental implants). Conclusions The most probable etiology was mycobacterial infection. This is based on a single colony of mycobacterium isolated, histologic finding revealing granulomatous inflammation, and the favorable response to rifampin. The patient underwent subsequent autologous fat transfers, which successfully reduced some disfigurement and scarring. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|