Epidermal nerve findings may predict outcomes in rhytidectomy

Results from a recent pilot study indicated that histological findings may be useful in predicting wound healing in patients undergoing rhytidectomy.

The study was conducted to determine quantitative and qualitative differences in epidermal nerve fibers (ENFs), neurotransmitters, vasculature and mast cells in facial skin in a cohort of five patients who underwent primary rhytidectomy and three patients who underwent revision rhytidectomy.

Eligible participants were treated at a single center between July 2010 and March 2014. Researchers collected data on demographic characteristics of patients, including smoking status, along with scales for facial outcomes.

Patients undergoing primary procedures had a mean of 54.4 ENFs per mm (range, 14.2-99.2; SD = 31.6) was reported. For the revision group, the mean was 18.6 ENFs per mm (range, 13.8-25; SD = 5.8).

The patient with the lowest ENF per mm rate (14.2) was a patient in the primary rhytidectomy group who was a 25 pack-year smoker.

Qualitative changes in normal neural antigen prevalence — including substance P, calcitonin gene-related peptide, and vasoactive intestinal peptide — were reported for the revision rhytidectomy group.

In both groups, capillary loops seemed less robust and were observed less frequently in dermal papilla. Also in both groups, mast cells were more derangulated, according to the findings.

Self-reported subjective facial sensation-related outcomes were similar between the two arms. – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.

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Source:

Ardeshirpour F, et al. JAMA Facial Plast Surg. 2017;doi:10.1001/jamafacial.2017.0007.