Histological case–control study of peeling-induced skin changes by different peeling agents in surgically subcutaneous undermined skin flaps in facelift patients

A histological evaluation of peeling-induced skin changes in subcutaneous undermined preauricular facial skin flaps of nine patients was performed. There were three treatment groups: Trichloroacetic acid (TCA) 25%, TCA 40% and phenol/croton oil; one group served as control. Two independent evaluator...

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Bibliographic Details
Published in:Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2017-11, Vol.70 (11), p.1660-1665
Main Authors: Gonser, P., Kaestner, S., Jaminet, P., Kaye, K.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Caustics - adverse effects
Croton Oil - adverse effects
Dermatologic Agents - adverse effects
Facelift
Female
Histology
Humans
Middle Aged
Peeling
Phenol/croton oil
Rhytidoplasty - methods
Skin - drug effects
Skin - pathology
Skin Aging
Skin changes
Skin Diseases - chemically induced
Skin Diseases - pathology
Skin Diseases - surgery
Skin Transplantation - methods
Surgical Flaps
Trichloroacetic acid
Trichloroacetic Acid - adverse effects
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Summary:A histological evaluation of peeling-induced skin changes in subcutaneous undermined preauricular facial skin flaps of nine patients was performed. There were three treatment groups: Trichloroacetic acid (TCA) 25%, TCA 40% and phenol/croton oil; one group served as control. Two independent evaluators determined the epidermal and dermal thickness and the depth of necrosis (micrometre). The percentual tissue damage due to the peeling was calculated, and a one-sample t-test for statistical significance was performed. On the basis of the histomorphological changes, peeling depth was classified as superficial, superficial-partial, deep-partial and full thickness chemical burn. The histological results revealed a progression of wound depth for different peeling agents without full thickness necrosis. TCA peels of up to 40% can be safely applied on subcutaneous undermined facial skin flaps without impairing the vascular patency, producing a predictable chemical burn, whereas deep peels such as phenol/croton oil peels should not be applied on subcutaneous undermined skin so as to not produce skin slough or necrosis by impairing vascular patency.
ISSN:1748-6815
1878-0539
DOI:10.1016/j.bjps.2017.06.016