Department of Plastic and Reconstructive Surgery, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy,
Aesthetic Plast Surg. 2013 Dec;37(6):1220-4. doi: 10.1007/s00266-013-0212-3. Epub 2013 Sep 18.
Despite scientific literature replete with stories of disastrous results and disfigurement, illicit subcutaneous injections of highly viscous fluids in massive quantities still are performed, often by unqualified persons. The authors present a devastating long-term outcome from a massive volume of silicone oil injected subcutaneously into the buttocks of a 48-year-old transsexual patient and its ulceration treated only through regular medications.
The therapeutic protocol consisted of wound disinfection with iodopovidone, washing with saline solution, disinfection with sodium hypochlorite 0.05 %, and application of ointment containing Vibrio alginolyticus collagenase and hyaluronan. The follow-up evaluation was at 1 and 2 weeks and then at 1, 2, and 3 months. Weekly photographs were taken, and measurements of the lesion and evolution were estimated every 7 days.
After 3 months of regular medications, the authors succeeded in closing the ulcer, avoiding invasive therapeutic options.
In the presence of the cutaneous ulceration above a massively infiltrated area, if the removal of all the injected oil is surgically definitely impossible, other conservative procedures should be considered. Our experience demonstrated how it is possible to manage a so prickly a case with a noninvasive approach such as periodic medications.
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尽管科学文献中充斥着大量灾难性结果和毁容的故事，但仍有大量未经授权的人大量非法将高粘性液体皮下注射到体内。作者报告了一名 48 岁跨性别患者臀部大量注射硅油后出现严重的长期后果，仅通过常规药物治疗导致溃疡。
治疗方案包括用聚维酮碘消毒伤口、用生理盐水冲洗、用 0.05%次氯酸钠消毒，以及涂抹含有溶藻弧菌胶原酶和透明质酸的软膏。随访评估在第 1 天、第 2 天和第 1 个月、第 2 个月、第 3 个月进行。每周拍摄照片，每 7 天评估病变和进展情况。
经过 3 个月的常规治疗，作者成功地封闭了溃疡，避免了侵入性治疗选择。
在大面积浸润区域上方出现皮肤溃疡，如果手术清除所有注射的油是不可能的，则应考虑其他保守治疗方法。我们的经验表明，对于如此棘手的病例，可以通过非侵入性的方法如定期药物治疗来进行处理。
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