Histological case–control study of peeling-induced skin changes by different peeling agents in surgically subcutaneous undermined skin flaps in facelift patients. Issue 11 (November 2017)

• Record Type: Journal Article
• Authors: Gonser, P.; Kaestner, S.; Jaminet, P.; Kaye, K.
• Is Part Of: Journal of plastic, reconstructive & aesthetic surgery. Volume 70:Issue 11(2017:Nov.)
• Page Start: 1660
• Page End: 1665
• Publication Date: 2017-11
• Subjects: Peeling -- Phenol/croton oil -- Trichloroacetic acid -- Histology -- Skin changes -- Facelift; Surgery, Plastic -- Great Britain -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.bjps.2017.06.016
• Languages: English
• ISSNs: 1748-6815

Abstract

Summary: A histological evaluation of peeling-induced skin changes in subcutaneous undermined preauricular facial skin flaps of nine patients was performed. There were three treatment groups: Trichloroacetic acid (TCA) 25%, TCA 40% and phenol/croton oil; one group served as control. Two independent evaluators determined the epidermal and dermal thickness and the depth of necrosis (micrometre). The percentual tissue damage due to the peeling was calculated, and a one-sample t -test for statistical significance was performed. On the basis of the histomorphological changes, peeling depth was classified as superficial, superficial-partial, deep-partial and full thickness chemical burn. The histological results revealed a progression of wound depth for different peeling agents without full thickness necrosis. TCA peels of up to 40% can be safely applied on subcutaneous undermined facial skin flaps without impairing the vascular patency, producing a predictable chemical burn, whereas deep peels such as phenol/croton oil peels should not be applied on subcutaneous undermined skin so as to not produce skin slough or necrosis by impairing vascular patency.