Fanous Nabil, Zari Shadi
Division of Facial Plastic, Reconstructive and Esthetic Surgery, Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Department of Dermatology, McGill University, Montreal, Quebec, Canada.
JAMA Facial Plast Surg. 2017 May 1;19(3):212-219. doi: 10.1001/jamafacial.2016.1666.
Despite their great potential, medium and deep trichloroacetic acid peels are underused in light-skinned patients and are rarely used in darker-skinned patients because of the widespread fear of pigmentary complications and scarring. This concern has led many physicians to opt for the use of lighter types of peels (glycolic acid peel, Jessner peel, etc) and different lasers and intense light technologies. Trichloroacetic acid peels have been described in numerous publications. However, no study to date has described the precise technique and the practical pearls of a successful trichloroacetic acid peel approach in a clear, detailed, and reproducible manner.
To clarify a practical approach to a universal trichloroacetic acid peel and to offer novice and experienced facial plastic surgeons an organized, easy, and safe technique for medium and deep trichloroacetic acid peels.
DESIGN, SETTING, AND PARTICIPANTS: This study was a case series of universal trichloroacetic acid peels in an academic setting. The study dates were January 1, 1996, to November 1, 2015.
This article discusses the preoperative evaluation for a chemical peel, a previously published genetico-racial skin classification, and the trichloroacetic acid peel technique, which aims at standardizing and controlling the application of the acid to improve results and lessen complications. The "strip" technique is described, which increases the physician's control over the peel depth.
A total of 923 trichloroacetic acid peels in 803 female patients (87.0%) and 120 male patients (13.0%) were reviewed (mean age, 41.59 years). The follow-up period ranged from 6 months to 13 years (mean, 13 months). This case series revealed a low incidence of complications, including 54 patients (5.9%) with persistent hyperpigmentation, 3 patients (0.3%) with mild telangiectasia, 2 patients (0.2%) with acute herpesvirus infection, 2 patients (0.2%) with bacterial Staphylococcus infection, and 1 patient (0.1%) with hypopigmentation.
When properly applied, trichloroacetic acid peels are efficient and safe for light and dark skin. The technique can be an easily implementable addition to a physician's cosmetic practice.
尽管中深度三氯乙酸化学剥脱术潜力巨大，但在浅肤色患者中未得到充分利用，而在深肤色患者中则很少使用，这是因为人们普遍担心会出现色素沉着并发症和瘢痕形成。这种担忧使得许多医生选择使用较浅类型的剥脱术（乙醇酸剥脱术、杰斯纳剥脱术等）以及不同的激光和强光技术。众多出版物中都有关于三氯乙酸化学剥脱术的描述。然而，迄今为止，尚无研究以清晰、详细且可重复的方式描述成功的三氯乙酸化学剥脱术的精确技术和实用技巧。
阐明一种通用的三氯乙酸化学剥脱术的实用方法，并为新手和经验丰富的面部整形外科医生提供一种用于中深度三氯乙酸化学剥脱术的有条理、简便且安全的技术。
设计、地点和参与者：本研究是在学术环境中进行的一系列通用三氯乙酸化学剥脱术的病例系列研究。研究时间为1996年1月1日至2015年11月1日。
本文讨论了化学剥脱术的术前评估、先前发表的遗传 - 种族皮肤分类以及三氯乙酸化学剥脱术技术，该技术旨在规范和控制酸的应用以改善效果并减少并发症。文中描述了“条带”技术，该技术可增强医生对剥脱深度的控制。
共回顾了803例女性患者（87.0%）和120例男性患者（13.0%）的923次三氯乙酸化学剥脱术（平均年龄41.59岁）。随访期为6个月至13年（平均13个月）。该病例系列显示并发症发生率较低，包括54例患者（5.9%）出现持续性色素沉着、3例患者（0.3%）出现轻度毛细血管扩张、2例患者（0.2%）出现急性疱疹病毒感染、2例患者（0.2%）出现金黄色葡萄球菌细菌感染以及1例患者（0.1%）出现色素减退。
正确应用时，三氯乙酸化学剥脱术对浅肤色和深肤色皮肤均有效且安全。该技术可轻松添加到医生的美容实践中。
4级。
