Giese S Y, McKinney P, Roth S I, Zukowski M
Department of Functional Restoration (Plastic Surgery), Stanford University Medical School, Palo Alto, Calif. USA.
Plast Reconstr Surg. 1997 Aug;100(2):489-98; discussion 499-500. doi: 10.1097/00006534-199708000-00035.
Chemosurgical peel is a technique that has been used widely by plastic surgeons and dermatologists to remove fine and deep wrinkles of the skin. However, the reaction of elastic tissue to the cutaneous application of commonly used chemical peeling agents has not been defined. This study comparatively assessed the alteration in dermal histology and mechanical properties of skin following treatment with 25% and 50% trichloroacetic acid, Baker's phenol solution, and dermabrasion. Yucatan minipigs served as the animal model. The skin was analyzed at five intervals over 6 months after treatment using histologic, quantitative, and mechanical analysis (hematoxylin and eosin, elastic tissue, and Sirius red stains, computerized digital morphometry, and a tensiometer). At 6 months we found no change in the quality, structure, or arrangement of elastic fibers in skin treated with a single application of 25% and 50% trichloroacetic acid or dermabrasion when compared with untreated skin. Skin treated with Baker's phenol solution showed a marked morphologic change in the elastic fibers. The fibers within the regenerated zone of dermis were sparse, wispy, and immature at 6 months after treatment. Preliminary tensiometric analysis of phenol-treated skin at 6 months indicated that the skin was stiffer and weaker. This study questions the possibility of long-term change to the skin by the deep penetration of caustic chemicals to remove wrinkles and rejuvenate the skin.
化学外科去皮术是整形外科医生和皮肤科医生广泛使用的一种技术,用于去除皮肤的细纹和深层皱纹。然而,弹性组织对常用化学去皮剂皮肤应用的反应尚未明确。本研究比较评估了用25%和50%三氯乙酸、贝克苯酚溶液和磨皮术治疗后皮肤的真皮组织学和力学性能的变化。尤卡坦小型猪作为动物模型。在治疗后的6个月内,每隔一段时间使用组织学、定量和力学分析(苏木精和伊红染色、弹性组织染色和天狼星红染色、计算机数字形态测量和张力计)对皮肤进行分析。在6个月时,我们发现与未治疗的皮肤相比,单次应用25%和50%三氯乙酸或磨皮术治疗的皮肤中弹性纤维的质量、结构或排列没有变化。用贝克苯酚溶液治疗的皮肤在弹性纤维上显示出明显的形态学变化。治疗后6个月,真皮再生区内的纤维稀疏、纤细且不成熟。对6个月时苯酚处理的皮肤进行的初步张力分析表明,皮肤更硬且更脆弱。本研究对苛性化学物质深度渗透以去除皱纹和使皮肤恢复活力从而对皮肤产生长期变化的可能性提出了质疑。