Chen Se-Yi, Chen Szu-Ting, Lin Jui-Yu, Lin Chuan-Yuan
Department of Neurosurgery, Chung-Shan Medical University Hospital, Taichung, Taiwan, Republic of China.
School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, Republic of China.
Plast Reconstr Surg Glob Open. 2020 May 18;8(5):e2829. doi: 10.1097/GOX.0000000000002829. eCollection 2020 May.
Injectable poly-d,l-lactic acid (PDLLA) is a new collagen-stimulating filler containing PDLLA microspheres and carboxymethyl cellulose. It is available as a lyophilized powder that must be reconstituted with a diluent before administration. The aims of this study were to investigate the efficacy of different diluents and a new accelerating "back-and-forth" method.
Six different diluents, sodium bicarbonate, sterile water for injection (SWFI), normal saline, lidocaine, lidocaine with epinephrine (lidocaine + E), and mannitol, were tested. The recommended "vortex" method for preparation of thin suspensions and a new back-and-forth method suitable for both thin and thick suspensions were compared. Gross and microscopic views of the prepared suspensions were examined.
Using the vortex method, only mannitol and SWFI are found to be effective reconstitution diluents for injectable PDLLA. Using the back-and-forth method, all six diluents can be used for reconstitution of injectable PDLLA. Moreover, the time needed for reconstitution of injectable PDLLA by this back-and-forth method is very short, regardless of the thickness of the suspension.
Clinically, only SWFI can be used for reconstitution of injectable PDLLA by "hand-shaking" or vortex method. To accelerate the reconstitution time especially when using small amount of SWFI, back-and-forth is the method of choice. Besides, when SWFI is not available, other diluents such as normal saline, lidocaine, or lidocaine + E can be used by this novel back-and-forth reconstitution method.
可注射聚-d，l-乳酸（PDLLA）是一种新型的胶原蛋白刺激填充剂，含有PDLLA微球和羧甲基纤维素。它以冻干粉末形式提供，给药前必须用稀释剂复溶。本研究的目的是研究不同稀释剂的效果以及一种新的加速“来回”方法。
测试了六种不同的稀释剂，碳酸氢钠、注射用无菌水（SWFI）、生理盐水、利多卡因、含肾上腺素的利多卡因（利多卡因+E）和甘露醇。比较了制备稀悬浮液推荐的“涡旋”方法和适用于稀悬浮液和浓悬浮液的新来回方法。检查制备的悬浮液的大体和显微镜视图。
使用涡旋方法，仅发现甘露醇和SWFI是可注射PDLLA有效的复溶稀释剂。使用来回方法，所有六种稀释剂均可用于可注射PDLLA的复溶。此外，无论悬浮液的浓度如何，通过这种来回方法复溶可注射PDLLA所需的时间都非常短。
临床上，仅SWFI可通过“手摇”或涡旋方法用于可注射PDLLA的复溶。为了加快复溶时间，特别是在使用少量SWFI时，来回法是首选方法。此外，当没有SWFI时，其他稀释剂如生理盐水、利多卡因或利多卡因+E可通过这种新型来回复溶方法使用。
