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首页> 外文期刊>The Internet Journal of Plastic Surgery >Injectable Poly-L-Lactic Acid (PLLA): Practical Approaches to Optimize Outcomes
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Injectable Poly-L-Lactic Acid (PLLA): Practical Approaches to Optimize Outcomes

机译：可注射的聚-L-乳酸（PLLA）：优化结果的实用方法

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The use of injectable devices for soft-tissue augmentation has been associated with the occurrence of adverse events. The present case report discusses the successful treatment and resolution of painful nodules that were histologically shown to be foreign body granulomas in a patient who had previously received injectable poly-L-lactic acid for the correction of nasolabial folds, the neck, and zygomatic area. Incorrect injection placement and method may have led to the formation of granulomatous nodules. Properly trained professionals can minimize or avoid the occurrence of many of these types of adverse events for their patients by employing proper reconstitution and injection techniques and injecting appropriate/indicated areas. If granulomas do occur, full resolution may be expected following a course of triamcinolone injections. Introduction Injectable poly-L-lactic acid (injectable PLLA; Sculptra and Sculptra Aesthetic, Dermik Laboratories, Bridgewater, NJ, a business of sanofi-aventis U.S. LLC) is a biocompatible, biodegradable polymeric device. In the United States, injectable PLLA is approved for use in immune-competent people as a single regimen for the correction of shallow to deep nasolabial fold contour deficiencies and other facial wrinkles in which deep dermal grid pattern injection technique is appropriate.1 Injectable PLLA is also approved in the United States for the restoration and/or correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus (HIV).2 Injectable PLLA has been shown to have a sustained duration of effect for up to 25 months in immune-competent people3 and for up to 24 months in patients with HIV-associated facial lipoatrophy.4-9 The use of injectable devices for soft-tissue augmentation can be associated with injection- or product-related adverse events. This report describes an approach to optimizing treatment in a patient who received injectable PLLA for aesthetic correction and developed painful subcutaneous nodules. Improper injection technique/placement may have contributed to the occurrence of this adverse effect. Case report In October 2004, a 52-year-old woman presented with painful subcutaneous nodules. Medical history revealed that she had received aesthetic treatment with injectable PLLA from 2 different physicians; posttreatment visits had been completed in December 2003. The patient had received a total of 3 treatment sessions at 8-week intervals; areas treated included the nasolabial folds, neck, and zygomatic area. The dilution volume used for the first injection was 4 mL of sterile water; the second and third injections were administered using a 6-mL dilution. Further details of injection technique were not available from the treating physicians. The patient reported that a favorable aesthetic result had been achieved 6 weeks after treatment with injectable PLLA (Figure 1).
机译：可注射装置用于软组织增强与不良事件的发生有关。本病例报告讨论了在组织学上已证明是异物肉芽肿的疼痛结节的成功治疗和解决方法，该患者先前曾接受可注射的聚-L-乳酸矫正鼻唇沟，颈部和骨区域。错误的注射位置和方法可能导致肉芽肿结节的形成。经过适当培训的专业人员可以通过采用适当的重构和注射技术并注射适当的/指定的区域，将对患者造成的许多这类不良事件减至最少或避免发生。如果确实发生肉芽肿，则在注射曲安西龙的疗程后可能会期望完全解决。简介可注射的聚L-乳酸（可注射的PLLA; Sculptra和Sculptra美学技术，新泽西州布里奇沃特市Dermik实验室，由sanofi-aventis U.S. LLC经营）是一种生物相容性，可生物降解的聚合物装置。在美国，可注射的PLLA被批准用于免疫能力强的人，作为纠正浅至深的鼻唇沟轮廓缺损和其他面部皱纹的单一疗法，其中深部的皮肤网格图案注射技术是合适的。1在美国也获得批准，可用于恢复和/或矫正人类免疫缺陷病毒（HIV）患者的面部脂肪减少（脂肪萎缩）迹象。2注射用PLLA已显示出持续有效的作用持续时间长达25年具有免疫能力的人3个月，与HIV相关的面部脂肪萎缩症患者长达24个月。4-9使用注射装置进行软组织增强可能与注射或产品相关的不良事件有关。该报告描述了一种在接受注射PLLA进行美学矫正并出现了皮下结节疼痛的患者中优化治疗的方法。注射技术/放置不当可能是造成这种不良影响的原因。病例报告2004年10月，一名52岁的女性出现了痛苦的皮下结节。病史表明，她接受了两位不同医生的注射PLLA美容治疗;治疗后访视已于2003年12月完成。该患者以8周为间隔共接受了3次治疗。治疗区域包括鼻唇沟，颈部和骨区域。第一次注射的稀释体积为4 mL无菌水;第二次和第三次注射使用6 mL稀释液进行。不能从治疗医生那里获得注射技术的更多细节。该患者报告说，用可注射的PLLA治疗6周后取得了良好的美学效果（图1）。

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