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Cosmetics

Extracorporeal shock waves as curative therapy for varicose veins? - (Fiorenzo Angehrn, Christoph Kuhn, Ortrud Sonnabend, Axel Voss) - In this prospective design study the effects of low-energy partially focused extracorporeal generated shock waves (ESW) onto a subcutaneous located varicose vein – left vena saphena magna (VSM) – are investigated. The treatment consisted of 4 ESW applications within 21 days. The varicose VSM of both sides were removed by surgery, and samples analyzed comparing the treated and untreated by means of histopathology.

Effects of the extracorporeal shock wave therapy on the skin: an experimental study -(Thayná Melo de Lima Morais, Patrícia Froes Meyer, Liliane Santos de Vasconcellos, Julio Costa e Silva, Ito Ferreira e Andrade, Vinicius Alves Freire de Farias, Igor Candido da Silva, Roberta Marinho Falcão Gondim Araújo, Rodrigo Marcel Valentim da Silva, Esteban Fortuny Pacheco, Ciro Dantas Soares) - Extracorporeal shock wave therapy (ESWT) has been extensively studied for its multiple biological properties, and although it iswidely applied in esthetical procedures, little is known about its effects on the epidermis and dermis. In this study, a histological and immunohistochemical study of the effects of ESWT was performed on rat skin. Forty-five female rats were treated with one or two sessions of ESWT and sacrificed on days 1, 7, 14, and 21 after treatment.

Response of Post-Mastectomy Lymphedema to Extracorporeal Shockwave Therapy -(Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt ?Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt) - Post-mastectomy lymphedema is a chronic, debilitating disorder that is frequently misdiagnosed, treated too late or not treated at all, Lymphedema (LE) is an abnormal accumulation of protein-rich fluid in the interstitium leading to limb swelling, chronic inflammation and reactive fibrosis of the affected tissues resulting from damage to lymphatic circulation following surgery, chemotherapy and/or radiation therapy. The aim was to investigate the effect of shockwave therapy on the post-mastectomy lymphedema.

Extracorporeal shock wave treatment of capsular fibrosis after mammary augmentation –Preliminary results - (Caritas-Krankenhaus St. Josef, Klinik f ü r Plastische und Ä sthetische, Hand- und Wiederherstellungs-Chirurgie, Regensburg, Germany and Universit ä tsklinikum Regensburg, Funktionsbereich Plastische- Hand- und Wiederherstellungschirurgie, Regensburg, Germany) - Extracorporeal shock wave therapy has undergone continuous development and has become a well-established therapy option both in urology and in orthopaedics/trauma surgery. Experimental and clinical studies have proved the effectiveness of extracorporeal shock wave therapy in the treatment of connective tissue diseases such as fibromatosis.

Cellulite and Focused Extracorporeal Shockwave Therapy for Non-Invasive Body Contouring: a Randomized Trial -(Karsten Knobloch • Beatrice Joest • Robert Kra ̈mer • Peter M. Vogt​) - Focused extracorporeal shockwave
therapy (ESWT) has been demonstrated to improve wound healing and skin regeneration such as in burn wounds and scars. We hypothesized that the combination of focused ESWT and a daily gluteal muscle strength program is superior to SHAM-ESWT and gluteal muscle strength training in moderate to severe cellulite.

Extracorporeal shock wave therapy (ESWT) for the treatment of cellulite e A current metaanalysis​ -(Plastic, Hand and Burn Surgery, University of Schlewig Holstein, Lubeck, Germany​) - The aim of this metaanalysis was to investigate the effectiveness of extracorporeal shock wave therapy (ESWT) in cellulite.
Methods: Electronic databases (such as Ovid MEDLINE, Scopus and Ovid) as well as reference lists of the
available studies were evaluated in June 2015 by two expert examiners. Assessment of each study's
methodological quality was performed with the help of the published quality index tool by Downs and
Black.

Extracorporeal shockwave: mechanisms of action and physiological aspects for cellulite, body shaping, and localized fat—Systematic review - Extracorporeal Shockwave Therapy – ESWT has had a wide use in rehabilitation, and has presented positive effects in the treatment of unaesthetic affections. The objective of the present study was to search, in the literature, the mechanisms of action and the physiological aspects of shockwaves acting on the biological tissue to improve the condition of cellulite and localized fat. A systematic review of the literature was carried out in the period from September 2016 to February 2017 based on the bibliographic databases Lilacs, MedLine, PubMed and Scielo. Fifteen articles were identified in that systematic review, three of which were excluded because they did not make the complete access to the article available or the theme investigated did not encompass the objective of the study. The revision demonstrated that extracorporeal shockwaves present relevant effects on the biological tissue, which leads to the restructuring of skin properties and subcutaneous tissue, clinically improving the aspects of cellulite and localized fat.

Prospective Randomized Trial of Accelerated Re-epithelization of Skin Graft Donor Sites Using Extracorporeal Shock Wave Therapy -(Christian Ottomann, MD, Bernd Hartmann, MD, Josh Tyler, MD, Heike Maier, MD, Richard Thiele, MD,Wolfgang Schaden, MD, Alexander Stojadinovic, MD, FACS) - Between January 2006, and September 2007, 28 patients with acute traumatic wounds and burns requiring skin grafting were randomly assigned in a 1:1 fashion to receive standard topical therapy (nonadherent silicone mesh [Mepitel, Mölnlycke Health Care] and antiseptic gel [polyhexanide/octenidine]) to graft donor sites with (n  13) or without (n  15) defocused
extracorporeal shock wave therapy (ESWT, 100 impulses/cm2 at 0.1 mJ/mm2) applied once to
the donor site, immediately after skin harvest. The randomization sequence was computer generated, and the patients were blinded to treatment allocation. The primary endpoint was time to complete donor site epithelialization and was determined by an independent blinded observer.​

Prospective Randomized Phase II Trial of Accelerated Reepithelialization of Superficial Second-Degree Burn Wounds Using Extracorporeal Shock Wave Therapy -(Christian Ottomann, MD,∗ Alexander Stojadinovic, MD, FACS, Philip T. Lavin, PhD, Francis H. Gannon, MD, Michael H. Heggeness, MD, Richard Thiele, MD, Wolfgang Schaden, MD, and Bernd Hartmann, MD) - As extracorporeal shock wave therapy (ESWT) can enhance
healing of skin graft donor sites, this study focused on shock wave effects in burn wounds.

Anti-fibrosclerotic effects of shock wave therapy in lipedema and cellulite -(Research Institute of Environmental Medicine at Heinrich-Heine University, D-40021 Duesseldorf,Germany) - In vivo measurements in 26 female patients with lipedema and cellulite parameters were carried out before and after therapy by means of complex physical decongestive therapy (CPDT) including manual lymph drainage and compressionas main components and/or shock wave therapy (SWT). Oxidative stress parameters of blood serum and biomechanic skin properties/smoothening of dermis and hypodermis surface were evaluated.

Extracorporeal shockwave therapy for treatment of keloid scars - (Center for Shockwave Medicine and Tissue Engineering, Department of Orthopedic Surgery/Sports Medicine, Kaohsiung Chang Gung
Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, and Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan) - The purpose of this investigation was to study the effectiveness of extracorporeal shockwave therapy (ESWT) for the treatment of keloid scars, and compared the results with intralesional steroid injection. Thirty-nine patients were randomly divided into 22 in ESWT group and 17 in steroid group. The ESWT group received 3 ESWT treatments in 6 weeks. The steroid group received three intra-lesional triamcinolone injections in 6 weeks. The evaluations included gross morphology, functional outcome, local blood flow perfusion, biopsy for histopathological examination, and immunohistochemical analysis. 

MTS Spark Waves®– an effective therapy option for aesthetic indications Cellulite / Scars / Stretch marks / Lymphoedema / Alopecia -(MTS Science) - Cellulite is a multifactorial condition that is present in 80-90 % of post-pubertal women, commonly found on the posterolateral thighs, buttocks, and abdomen. It is described by an orange peel appearance of the skin surface and classified into four grades. Despite its high prevalence, it remains a major concern for women. Cellulite is a multifactor condition that requires a multidisciplinary approach for the treatment. Factors include, among others, connective tissue architecture, estrogen action, microvascular alterations, and certain genetic and hormonal characteristics. Inadequate nutrition and poor lifestyle tend to worsen the appearance of cellulite. Body fat, stress, fatty, sugary and salty food, inactivity, alcohol and smoking favour cellulite.

Acoustic wave therapy for cellulite, body shaping and fat reduction. - (Hexsel D, Camozzato FO, Silva AF, Siega) - In this open-label, single-centre trial, 30 women presenting moderate or severe cellulite underwent 12 sessions of AWT on the gluteus and back of the thighs, over six weeks. The following assessments were performed at baseline, and up to 12 weeks after treatment: Cellulite Severity Scale (CSS), body circumference measurements, subcutaneous fat thickness by magnetic resonance imaging (MRI), quality of life related by Celluqol® and a satisfaction questionnaire.

Extracorporeal Acoustic Wave Therapy and Multiple Symmetric Lipomatosis - (Carlotta Scarpa, MD, PhD, Vincenzo Vindigni, MD, PhD, and Franco Bassetto, MD) - Acoustic waves are mechanical waves recently used to activate tissue metabolism by exploiting the cell permeabilization caused by their passage. We report a case of a retroauricular lipoma in a 44-year-old woman affected by multiple symmetric lipomatosis and treated with extracorporeal acoustic wave therapy. The adipose thickness of the lipoma was reduced from 35.8 to 21 mm, with increased softness at palpatory examination.

A randomized, controlled clinical study to investigate the safety and efficacy of acoustic wavetherapy in body contouring. - The objective of this study was to determine the safety and efficacy of noninvasive lipolysis of excess adiposities overlying the lateral thigh region using acoustic wave therapy (AWT). This study incorporates 2 mechanical waves with varying properties in the same session: radial and planar AWT.

Cellulite and focused extracorporeal shockwave therapy for non-invasive body contouring: a randomized trial. - Focused extracorporeal shockwave therapy (ESWT) has been demonstrated to improve wound healing and skin regeneration such as in burn wounds and scars. We hypothesized that the combination of focused ESWT and a daily gluteal muscle strength program is superior to SHAM-ESWT and gluteal muscle strength training in moderate to severe cellulite.

Placebo controlled, prospectively randomized, double-blinded study for the investigation of the effectiveness and safety of the acoustic wave therapy (AWT(®)) for cellulite treatment. - Placebo controlled double-blinded, prospectively randomized clinical trial with 17 patients (11 verum, 5 placebo) for evaluation of cellulitetreatment with Acoustic Wave Therapy, (AWT(®)) was performed. The patients were treated once a week for 7 weeks, a total of 8 treatments with the D-ACTOR(®) 200 by Storz Medical AG. Data were collected at baseline, before 8th treatment, at 1 month (follow-up 1) and at 3 months (follow-up 2) after the last treatment with a patients' questionnaire, weight control, measurement of circumference and standardized photography. Treatment progress was further documented using a specially designed 3D imaging system (SkinSCAN(3D), 3D-Shape GmbH) providing an objective measure of cellulite (primary efficacy criteria). Patient's questionnaire in the verum group revealed an improvement in number and depth of dimples, skin firmness and texture, in shape and in reduction of circumference. The overall result (of skin waviness, Sq and Sz, surface and volume of depressions and elevations, Vvv and Vmp) at two follow-up visits indicates a more than medium sized superiority (MW = 0.6706) and is statistically significant (pWei-Lachin = 0.0106). The placebo group revealed no statistical significance. No side effects were seen. This indicates the efficacy and safety of AWT(®) for patients with cellulite.

Body shaping with acoustic wave therapy AWT(®)/EPAT(®): randomized, controlled study on 14 subjects. - The objective of this study is to demonstrate the efficacy and safety of AWT(®), combining two different mechanical waves, planar AWT and radial AWT during the same session, in volume reduction of saddle bags in women.

Improvement in skin elasticity in the treatment of cellulite and connective tissue weakness by means of extracorporeal pulse activation therapy. - Extracorporeal pulse activation therapy (EPAT), also called extracorporeal acoustic wave therapy, seeks to achieve effective and long-lasting improvement of age-related connective tissue weakness in the extremities, especially in the treatment of unsightly cosmetic skin defects referred to as cellulite.

Extracorporeal Shock Wave Therapy (ESWT) Minimizes Ischemic Tissue Necrosis Irrespective of Application Time and Promotes Tissue Revascularization by Stimulating Angiogenesis - (Rainer Mittermayr, MD, Joachim Hartinger, Vlado Antonic, MS, Alexandra Meinl, PhD, Sabine Pfeifer, Alexander Stojadinovic, MD, Wolfgang Schaden, MD, and Heinz Redl, PhD) - ESWT has been shown to accelerate tissue repair in acute and chronic wounds and improve graft survival, but the mechanism remains incompletely understood.

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