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soft contact lenses, opthalmic surgery, packaging agent in food, clarification agent for sugar juices , in water purification
Has been used in plastic and aesthetic surgery in the former Soviet Union for more than 15 years and in Europe for 7 years Excellent plasticity, widely atoxic and non-immunogenic
response in cheek
tissue after 2 months No granulocytes
No clinical symptoms
Adverse reactions
It is common to see some swelling about 10 days after Aquamid injection. This swelling is probably due to a tissue response to the gel in order to reach a steady-state. This swelling disappears spontaneously after 12-13 days Classical signs of infection are not present (warmth, pulsation, pain and redness)
Inflammatory nodule
Characterised by polymorphnuclear granulocytes and microorganisms (bacteria) which may be difficult to detect As well as the foreign-body reaction which is seen in all tissues injected with a foreign material.
1. Gloves, mask, hut 2. Skin disinfection of injection site 3. Retraction of injection needle as prescribed 4. Tell patient to refrain from activities increasing
Cultures taken from breast tissue far away from the papilla and not previously operated upon have shown a 53% positivity for coagulase-negative staphylococci. Propionibacterium acne was the most frequently found anaerobic bacterium (Thornton, 88).
Cultures from 389 periprosthetic breast tissues with no clinical signs of infection have shown 23.5 % microorganisms including aerobic and anaerobic bacteria as well as fungi and other organisms (Netscher, 95),
We all harbour bacteria within out tissues. Our immune system take care of them. Patients with long-term antibiotic treatment for different diseases (colitis ulcerosa, Mb. Crohn, DM) may grow antibiotic-resistant bacterial strains Patients on long-term steroid or NSAID treatment (collagenoses) have a reduced immune system.
1. Aquamid should be treated like any other implant (heart valves, artificial blood vessels, breast silicone prostheses and hip replacement prostheses). The local immune defence is reduced
2. In case of sepsis (e.g. tooth extraction, pneumonia, abdominal surgery) antibiotic treatment should be given
Report on 56 cases of adverse events out of 40.000 patients injected with Aquamid (1.4 )
Information from treating physicists and patients on filled-in pre-printed forms distributed by and sent to the manufacturer
Number of patients:
56
Study period:
Contributing countries: Australia (9 pt.s), Austria (4 pt.s), Belgium (1 pt.), Brazil (5 pt.s), Equador (1 pt.), France (7 pt.s), Germany (7 pt.s), Holland (3 pt.s), Israel (1 pt), Italy (7 pt.s), New Zealand (1 pt), Spain (6 pt.s), Sweden (1 pt), Switzerland (2 pt.s), USA (1 pt.)
Injection sites:
Lip 32 Naso-labial folds 24 Glabella 5 Cheekbone 4 Cheek 2 Chin 2 Forearm, allergy test 2 Nosetip 1
Type of physician:
Plastic surgeon Dermatologist Aesthetic/cosmetic doctor Unknown 23 12 20 1
Symptom delay (Time from last injection to first symptom of adverse reaction: median 12 days.
Herpes labialis
5 cases Too superficially injected 2 cases Palsy 1 case
Known contraindications: Several previous injections at the same site: 9 patients Mb. Crohn and Colitis Ulcerosa: 2 patients Pemphigus: 1 patient Insulin dependent Diabetes Mellitus: 1 patient Dentistry at the injection site: 1 patient Face-lift just prior to injection: 1 patient Oral sex right after injection: 1 patient Make-up during injection: 1 patient
Antibiotic alone:
Antibiotic+steroid: Antibiotic+steroid+NSAID: Steroid: NSAID:
10 patients
13 patients 7 patients 6 patients 6 patients
Anti-histamine:
Drainage only: Total
4 patients
4 patients 56 patients
32 patients
29 patients 3 patients
Third line treatment 8 patients Antibiotic: 8 patients ___________________________________________________ Primary treatment . Steroid + weak antibiotic: 2 patients Steroid alone: 2 patients Steroid + NSAID and/or antihistamine 3 patients Antihistamine 1 patient
They all received antibiotics the third time with improvement or complete recovery.
Fastest recovery was obtained for those patients treated with antibiotics from the start - in spite of negative findings on culture and/or microscopy.
A prolonged course resulted if primary (antibiotic) treatment was delayed/weak or if it included steroids or NSAIDs.
1. Fluoroquinolon (Ciproxin) 500 mg x 2 for up to 7 days 2. Vancomycin/Teicomycin, i.m. 1 g x 2 , or Lincomycin 300 mg x 2 for 2 days followed by dosis for the next 10-20 days.
*Tell patient to go to injecting doctor for treatment and show patience