da S Neto Manoel P, de S Almeida Élia C, da C C Tiveron Luciana R, da Cunha Marco T R, Medeiros Aluísio G, Etchebehere Renata M
Plastic Surgery Department, Triângulo Mineiro Federal University, Uberaba, Minas Gerais, Brazil.
Plast Reconstr Surg Glob Open. 2020 Aug 20;8(8):e3056. doi: 10.1097/GOX.0000000000003056. eCollection 2020 Aug.
Rhinoplasty is one of the most challenging procedures in plastic surgery because the surgical modifications should attend to patient expectations and to the need for functional correction allied to aesthetics. Composed of leukocytes and platelet-rich fibrin, an autologous membrane has great potential for tissue repair. The purpose of this study was to assess the use of this membrane (associated or not associated with diced cartilage) as an alternative to techniques such as the camouflage and filling; correction of irregularities of the dorsum, nose tip, soft triangle, and K zone; filling in of dead space; skin camouflage; and an improvement in the healing process in primary or secondary rhinoplasties.
The membranes were obtained by centrifuging patients' peripheral blood before the rhinoplasty. At the time of use, the membrane was removed from the tube, separated from the clot, and used in the camouflage and filling process in patients operated on due to various indications: 19 associated with diced cartilage, and 4 sole. The authors present the clinical and photographic impressions of the immediate and late postoperative period, as well as the patients' opinions using a specific questionnaire.
No patient had immediate or late postoperative complications. The use of leukocyte- and platelet-rich fibrin (L-PRF) was sufficient to carry out the camouflage and filling in all patients, and the patient declared satisfaction.
This membrane was shown to be an excellent surgical alternative to the camouflage and filling in rhinoplasty. In addition, it is rich in factors that can improve and accelerate regeneration of tissues.
隆鼻术是整形外科中最具挑战性的手术之一，因为手术改良既要符合患者期望，又要满足与美学相关的功能矫正需求。由白细胞和富含血小板的纤维蛋白组成的自体膜在组织修复方面具有巨大潜力。本研究的目的是评估这种膜（与切碎的软骨联合或不联合）作为伪装和填充等技术的替代方法的应用；用于矫正鼻背、鼻尖、软三角和K区的不规则；填充死腔；皮肤伪装；以及改善一期或二期隆鼻术中的愈合过程。
在隆鼻术前通过离心患者外周血获取膜。使用时，将膜从管中取出，与血凝块分离，并用于因各种适应证接受手术的患者的伪装和填充过程：19例与切碎的软骨联合使用，4例单独使用。作者展示了术后即刻和晚期的临床及照片记录，以及使用特定问卷收集的患者意见。
没有患者出现术后即刻或晚期并发症。使用富含白细胞和血小板的纤维蛋白（L-PRF）足以对所有患者进行伪装和填充，患者表示满意。
这种膜被证明是隆鼻术中伪装和填充的一种优秀手术替代方法。此外，它富含可改善和加速组织再生的因子。
