Secondary complications in Wassel II & IV thumb duplication: a comprehensive review of preventive measures.

Objectives: Thumb duplication is one of the most challenging pediatric reconstructive hand surgeries. Wassel types II and IV are the most frequent, but also the most complex reconstructions as the duplication arises at the joint level. Ablation and reconstruction, the most widely used technique, aims at achieving a stable, well-aligned, mobile and esthetically acceptable thumb.

Blue light induces DNA damage in normal human skin keratinocytes.

Background: The generation of DNA damage by ultra-violet radiations (UV) is well established, and both the nature of the DNA lesions and their respective DNA repair pathways have largely been described. Besides UV rays, visible light constitutes a very important part of the sun spectrum where blue light is considered a significant contributor to premature aging. However, blue light-induced DNA damage has not been deeply explored yet.

Thiel-embalmed porcine placenta: A valid and reusable microsurgical practice model.

Background: Simulation models are increasingly important for skill acquisition during microsurgery training. Prosthetics, living and non-living biological models have been proposed in the literature in the optics of recreating real-life scenarios in a controlled environment. This study aims to validate and prove the reusability of a novel non-living biological model: the porcine placenta.

Immediate breast reconstruction surgery with expander/direct implant and use of acellular dermal matrix: Does hormone therapy increases the risk of infection?

Background: The use of hormone therapy (tamoxifen and aromatase inhibitors) has been shown to increase venous thromboembolism. However, while estrogens play a crucial role in wound healing, no study has assessed the impact of tamoxifen or aromatase inhibitors on other postoperative breast reconstruction complications, including infections, necrosis, capsular contracture and seroma. As breast cancer patients undergoing Implants-ADMs breast reconstruction are often receiving hormone therapy, it is unclear whether this increased infection risk is associated with increased infections cases.

Preliminary Results Supporting the Bacterial Hypothesis in Red Breast Syndrome following Postmastectomy Acellular Dermal Matrix- and Implant-Based Reconstructions.

Acellular dermal matrices have become a mandatory tool in reconstructive breast surgery. Since their introduction, they have been considered to be nonreactive and nonimmunogenic scaffolds. However, some patients who undergo implant-based breast reconstruction with acellular dermal matrices develop postoperative cutaneous erythema overlying their matrices, a condition commonly referred to as red breast syndrome.

The social integration of healthcare agency workers in long-term care facilities: A cross-sectional study.

Background: Patient care quality is a key concern for long-term care facilities and is directly related to effective collaboration between healthcare professionals. The use of agency staff in long-term care facilities creates important challenges in terms of coordination and communication within work units.

Objectives: The purpose of this study is to assess the mediating effect of common in-group identity in the relationship between permanent employees' perceptions regarding the use of agency workers -namely distributive justice, perceptions of threat, perceived similarities with agency workers, and leader inclusiveness toward agency staff- and the permanent employees' adoption of collaborative behaviours.

Laser Scanning Microscopic Investigations of the Decontamination of Soot Nanoparticles from the Skin.

Background/aims: Airborne pollutants, such as nano-sized soot particles, are increasingly being released into the environment as a result of growing population densities and industrialization. They can absorb organic and metal compounds with potential biological activity, such as polycyclic aromatic hydrocarbons and airborne pollen allergens. Local and systemic toxicities may be induced in the skin if the particulates release their harmful components upon dermal contact.

The perplexing dilemma of measuring sun protection factors.

Truth, like knowledge, is surprisingly difficult to define. Indeed, every definition of truth that philosophers have developed falls prey to the question, 'Is it true?' In this essay, we consider what is the true SPF of a sunscreen product and whether it can ever be realizable.

Influence of Topical, Systemic and Combined Application of Antioxidants on the Barrier Properties of the Human Skin.

Background: The formation of free radicals in human skin by solar ultraviolet radiation is considered to be the main reason for extrinsic skin aging. The antioxidants in human tissue represent an efficient protection system against the destructive action of these reactive free radicals. In this study, the parameters of the skin, epidermal thickness, stratum corneum moisture, elasticity and wrinkle volume, were determined before and after the treatment with antioxidant- or placebo-containing tablets and creams.

Free Radical Threshold Value: A New Universal Body Constant.

Three evolutionary sources create 'primary' reactive oxygen species (ROS) and 'secondary' lipid oxygen species (LOS), forming the human body's 'free radical ground state'. We present evidence for the existence of a universal free radical threshold value (FRTV), defining the borderline between advantageous and adverse effects of free radicals observed above the free radical ground state. Based on standard vitamin D doses, the calculated amount of ∼3.

Low to moderate doses of infrared A irradiation impair extracellular matrix homeostasis of the skin and contribute to skin photodamage.

Human skin is daily exposed to sun rays, which include not only ultraviolet radiation, but also an important quantity of infrared (IR) radiation. In the past few years, many publications have underlined the negative impact of IR radiation on the human skin, particularly when the skin and/or the cells are exposed to high sun irradiance and significant doses of IR. In the present study, we demonstrate, in vitro on normal human fibroblasts, that even under low irradiance with single or very few repeated doses, infrared A irradiation (IRA) produces free radicals, triggers major changes in the expression of the type I collagen and elastin network, impairs the dermal-epidermal junction, upregulates several matrix metalloproteinases and has an impact on the expression of key genes of the extracellular matrix.

Influence of sun exposure on the cutaneous collagen/elastin fibers and carotenoids: negative effects can be reduced by application of sunscreen.

Resonance Raman spectroscopy and multi-photon tomography were used in vivo to analyse the influence of sun exposure on the cutaneous carotenoids and collagen/elastin fibers. Comparing Berlin (low sun exposure) and Monegasque (high sun exposure) volunteers, it could be demonstrated that extended sun exposure significantly reduces the cutaneous carotenoids and collagen/elastin concentration (p < 0.05).

A novel proposal for labelling sunscreens based on compliance and performance.

Objective: To propose a new way of classifying sunscreens, which combines the labelled SPF with an objective measure of compliance.

Methods: The in vitro determination of uniformity of sunscreen application was combined with an in vivo measure of applied thickness to derive a Compliance Factor for each of 10 sunscreens.

Results: The predicted SPF resulting from real-life application of each sunscreen product, which is termed the SPF(in vivo veritas), was calculated from the Compliance Factor and the labelled SPF.

A new chemical approach to optimize the in vitro SPF method on the HD6 PMMA plate.

In a previous study, we demonstrated that control of the roughness of molded PMMA plates improves in vitro SPF reproducibility. However, in vitro/vivo deviations are still observed. Sunscreens show different behavior during spreading on the HD6 surface according to the formulation, resulting in a more or less homogenous distribution.

Transfer of ultraviolet photon energy into fluorescent light in the visible path represents a new and efficient protection mechanism of sunscreens.

The development of sunscreens with high sun protection factor (SPF) values but low filter concentrations is the ultimate goal. The purpose of the present study was to investigate why a sunscreen spray and cream with different concentrations of the same UV-filters provided the same SPF. Therefore, the homogeneity of the distribution of both sunscreens was investigated by laser scanning microscopy (LSM) and tape stripping (TS).

Predicting the efficacy of sunscreens in vivo veritas.

A novel in vitro technique for measuring the efficacy of sunscreens over the skin surface is described. It is demonstrated that those products that spread easily are associated with both a low variance in delivered SPF and a subjective assessment of a product that is pleasing to use, which in turn results in a higher application thicknesses and greater delivered photoprotection leading to improved health benefits of sunscreen use.

Dermal carotenoid level and kinetics after topical and systemic administration of antioxidants: enrichment strategies in a controlled in vivo study.

Background: High doses of sun-emitted UV-radiation induce reactive oxygen species (ROS) as major pro-oxidants thus inducing premature skin aging. The best prevention of the destructive action of free radicals in human skin is textile coverings, topical sunscreens and the development of a high antioxidative protective network.

Objective: The effects of topical, systemic and combined application of antioxidants (AO) were investigated on human skin in vivo.

Uptake of antioxidants by natural nutrition and supplementation: pros and cons from the dermatological point of view.

The pros and cons of the systemic and topical application of antioxidant substances are a subject of intense discussion among experts, with resulting confusion for consumers and producers. The objective of the present article is to clarify the various uncertainties relating to the use of antioxidant substances in dermatology. Whereas inappropriate application of antioxidant substances (concerning their concentration and composition) might induce harmful effects, the consumer will definitively benefit from physiological concentrations and compositions of antioxidants.

Validation of HPLC method for the simultaneous and quantitative determination of 12 UV-filters in cosmetics.

The aim of the study was the validation of a high-performance liquid chromatography (HPLC) method for the simultaneous and quantitative determination of twelve commonly used organic UV-filters (phenylbenzimidazole sulfonic acid, benzophenone-3, isoamyl p-methoxycinnamate, diethylamino hydroxybenzoyl hexyl benzoate, octocrylene, ethylhexyl methoxycinnamate, ethylhexyl salicylate, butyl methoxydibenzoylmethane, diethylhexyl butamido triazone, ethylhexyl triazone, methylene bis-benzotriazolyl tetramethylbutylphenol and bis-ethylhexyloxyphenol methoxyphenyl triazine) contained in suncare products. The separation and quantitative determination was performed in <30 min, using a Symmetry Shield(R) C18 (5 microm) column from Waters and a mobile phase (gradient mode) consisting of ethanol and acidified water. UV measurements were carried out at multi-wavelengths, according to the absorption of the analytes.

How a calculated model of sunscreen film geometry can explain in vitro and in vivo SPF variation.

Spectroscopic in vitro assay has recently gained importance for UVA protection, or even for SPF assessment, as manufacturers are increasingly keen to replace in vivo by in vitro tests. These assays are based on transmission UV spectroscopy of a known amount of sunscreen product spread onto an ultraviolet-transparent substrate. In the most recent European publications or methods, the preferred substrate is a roughened PMMA plate.

A catch-up validation study on reconstructed human epidermis (SkinEthic RHE) for full replacement of the Draize skin irritation test.

Efforts to fully replace the in vivo Draize skin irritation test, according to the Directive 67/548/ECC or OECD TG 404, were reinforced with the seventh Amendment of the Cosmetic Directive and the REACh regulation. In 2007, the EpiSkin test method was scientifically validated and recognized as the stand alone method to discriminate skin irritants (R38) from non-irritants (no label) according to the definition of the EU risk phrases. An ECVAM performance standards (PS) document was defined to evaluate the accuracy and reliability of other analogous test methods (ECVAM SIVS, May 2007).

O/W emulsion and W/O/W multiple emulsion: physical characterization and skin pharmacokinetic comparison in the delivery process of caffeine.

The aim of this study was to compare the characteristics of an O/W emulsion and a W/O/W emulsion, formulated with similar ingredients. The physical properties of these two types of vehicles were characterized first. Using three types of in vitro models, human skin biopsies, nitrate acetate cellulose membranes and human reconstituted epidermis, the delivery potential of each vehicle for one hydrophilic drug, caffeine, was compared.

Formulation and interest of a decorative emulsifier-free O/W emulsion with a positive zeta potential.

The aim of this study was to formulate an emulsifier-free foundation with a positive zeta potential. This formulation was achieved through a comparative study carried out on 16 cationic hydrogels. Measurements of the cationic activity of those gels were undertaken.