Introduction: Avascular necrosis of the sesamoid bones in the hand is a very rare and painful condition that is often associated to overuse or circulatory disturbances. The literature on its etiology, cause, and frequency remains sparse. This condition is more commonly observed in the femoral head or metacarpal head, while sesamoid necrosis of the hand is less frequently to not at all discussed. This study explores the causes, symptoms, diagnosis, and treatment options for this rare condition, presenting a case of a 76-year-old woman diagnosed with avascular necrosis of the sesamoid bone in the index finger. Material and methods: An extensive literature review was conducted using PubMed and Google Scholar, yielding 82 publications from 1990 to 2024. Of these, 80 were excluded due to being related to the foot. A retrospective analysis of the remaining two articles focused on the conservative and surgical treatments for sesamoid necrosis in the hand. The data include demographic information, diagnosis, and treatment outcomes. Results: Over the past 35 years, only two cases of avascular necrosis of the sesamoid bones in the hand have been documented. Both previous reports involved female patients presenting with symptoms of grip weakness and progressive pain at the metacarpophalangeal (MCP) joint. In the two reported cases, conservative treatments such as Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and physical therapy were initially applied but ultimately proved ineffective. Surgical intervention, including sesamoidectomy, was required to alleviate symptoms, with all diagnoses confirmed through pathological examination. Conclusion: Avascular necrosis of the sesamoid bones in the hand, though rare, can lead to significant pain and functional impairment. Conservative treatments can provide short-term symptom relief, but they have been insufficient for long-term pain management or functional restoration in the few cases reported worldwide. Surgical intervention, specifically sesamoidectomy, remains the definitive treatment for achieving lasting relief. Early intervention is recommended to prevent long-term disability, chronic pain and resulting infection.
Background: Microvascular tissue transfer is the method of choice for oncological and trauma reconstruction. Successful free tissue transfer requires technical expertise and management of patients and surgery related factors. However, whether systemic blood pressure (SBP) affects perfusion of free flaps remains unclear. Methods: Photoplethysmography (PPG) is a relatively new technology used in many wearable medical devices to measure blood pressure and heart rate. It is a simple optical technique that detects changes in blood volume within the underlying microvascular bed of tissue. This study aimed to evaluate the relationship between systemic blood pressure (SBP) and free flap perfusion using PPG. Results: Twenty-five patients who underwent free flap reconstruction for head-neck cancers or traumatic soft tissue defects were enrolled in this study. All patients were clinically normotensive without needing postoperative vasopressors. The study did not find a statistically significant correlation between systolic or mean blood pressure and free flap perfusion. Conclusion: Beyond a critical threshold of mean arterial pressure (MAP), free flap perfusion is not directly correlated with blood pressure. In clinically normovolemic patients, elevations of BP above MAP ~65 mm Hg did not enhance flap perfusion.
Objective:As the number of elective hand surgeries has increased across the board, this systematic review aims to elucidate the effectiveness of extracorporeal shockwave therapy (ESWT) in hand surgery. Of interest are Dupuytren's disease (DD), trigger finger (TF), De Quervain's tenosynovitis, osteonecrosis of the lunate (ONL), and carpal tunnel syndrome (CTS). Methods:Qualitative analysis of the current evidence according to the Cochrane Handbook for systematic reviews of interventions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using electronic databases, and quality assessment of the included studies using the Cochrane risk of bias in non-randomized Studies - of Interventions assessment tool, the Cochrane risk-of-bias tool for randomized trials and the measurement tool to assess systematic reviews 2 were performed. Results:ESWT with ≥5 sessions in DD improved functional status and symptom severity significantly and consistently, especially pain, in the short- and mid-term. In TF ESWT alleviated pain in the short-, mid- and long-term. Also, functional status and severity of triggering improved consistently in the mid- and long-term. Three sessions of ESWT are the optimal number in TF patients. In DQT ESWT improved pain and functional status in the short- and mid-term. One study showed LCI and ESWT to be equally effective in DQT patients. Another study showed ESWT as an effective treatment of the pain and progression of ONL. ESWT improved pain and functional status in CTS in the short- and mid-term, especially if ≥4 sessions of ESWT are performed. The long-term effectiveness of ESWT has been suggested but not sufficiently proven. Conclusions:ESWT is an effective and recommended treatment in DD, TF, and CTS to improve pain and functional status, especially, rESWT regarding CTS and likely also TF. It represents an equally effective option as local corticosteroid injections in TF, DD and CTS with fewer and less severe adverse effects. In the treatment of DQT, ESWT should be considered an option in the clinical setting. Further research is necessary to develop normed protocols and expand its scope of application. Trial registration:The review and search protocol were registered at PROSPERO (National Institute for Health and Care Research) - CRD42024598627.
Background: The authors report a case of a 42-year-old male patient who presented with a relapse of penile acne inversa five years after a split-thickness skin graft without use of collagen-elastin-matrix (CEM). After unsatisfactory pharmacological treatment, resection of the affected skin, negative pressure wound therapy (NPWT), CEM application, and split-thickness skin graft (STSG) were performed in several steps. Methods: We performed initial debridement and consecutive NPWT. After achieving a clean wound bed, a CEM (1 mm MatriDerm®; MedSkin Solutions Dr. Suwelack AG, Germany) was applied, followed by split-thickness skin grafting. Results: During a 19-month follow-up, the patient presented with a very good functional and cosmetic outcome. Under intravenous antibiotic therapy and intensive wound care, we achieved complete recurrence-free status in the genital area at the 19-month follow-up. The subjective quality of life almost tripled from 3.2 to 9.3 on the numeric analog scale (NAS). Conclusion: Complex reconstruction procedures of penile defects in acne inversa can be avoided if there is a well-perfused wound bed. Coverage of the defect with MatriDerm® and split-thickness skin grafting may lead to long-term aesthetically satisfactory results with high patient satisfaction. We have monitored one patient over 19 months, who presented with stable penile soft tissue coverage and no signs of relapse. We anticipate that coverage of penile defects using MatriDerm® and split-thickness skin grafts may prevent or at least delay the need for complex reconstruction in cases of recurrence.
Arthroplasty in managing tumors of the extremities is a challenging surgery. Careful planning and the expertise of the surgical team are of utmost importance, especially when managing unpredictable intraoperative complications. In this study, we report on the surgical management of a pathological femoral neck fracture with multiple metastases with carcinoma of an unknown primary origin. Primary total hip replacement was planned. However, due to the presence of multiple metastases in the lower limb with intraoperative fracture of the distal femur, a total femoral replacement with a push-through endoprosthesis was carried out primarily. The duration for the surgical intervention was three hours and 56 minutes. Following surgery, initial intensive care was necessary due to the multimorbidity of the patient. Two days after surgery, the patient could be mobilized with full weight bearing and no restriction of range of motion of the entire left lower limb supervised by physiotherapists at ward level, which she tolerated well. The pain was significantly relieved during hospital stay. Mega-endoprostheses with push-through stems are a reliable option in cases with multiple metastases.
Oral squamous cell carcinoma (OSCC) is one of the most common malignant tumors worldwide with an increasing incidence. The surgical treatment is challenging and often requires the entire repertoire of plastic surgery. Diagnostically only a few crucial parameters are in use and even less for an individual and specific drug targeting. An individualised prognostic calculation is unavoidable to be able to adapt very complex surgical processes to an acceptable level. Unfortunately, the classic TNM system and grading are no longer sufficient, especially for individualized prognosis. Moreover, despite advances in treatment, studies have shown that the prognosis of patients with OSCC in terms of survival rate has not improved significantly, which is mainly due to the presence of treatment-resistant OSCC. Therefore, the identification of new, reliable biomarkers for early diagnosis and drug targets of OSCC is urgently needed. Meanwhile, the abundance of potential biomarkers for OSCC is difficult to keep track of. Therefore, the aim of the article was to provide an overview of articles listed in Pubmed® that deal with the topic of biomarkers in oral squamous cell carcinoma, focusing in particular on the topic metabolism. Another question of this study was to set the focus on essential additive metabolic biomarkers, which can also be easily used in clinical routine.
Background:Significant osseous defects or osteonecrosis, precipitated by open fractures, infections, or neoplastic conditions, represent infrequent yet critical medical conditions. The free vascularized fibular graft (FVFG) is a challenging but straightforward, reliable surgical intervention for the reconstruction of defects across various anatomical regions. This study aims to compare, quantify, and demonstrate the FVFG's versatility. The utilization of a single- or double-barrel approach, contingent on the defect's characteristics, optimizes length conservation or enhances the stability of extensive defects. Methods:We retrospectively evaluated patients who underwent the FVFG procedure, employing either a single- or double-barrel technique, at our medical center during the period from August 2017 to May 2023. The inclusion criterion was the presence of substantial osseous defects (bone loss in straight bone over 8-10 cm or multi-level spine resection), precipitated by trauma, neoplasms, non-union fractures or infections. Results:Our study encompassed eight male patients, with an average age of 31 years, ranging from 10 to 56. Each patient underwent osseous resection due to osteomyelitis (n=2), tumor excision (n=4), or pseudarthrosis (n=2) resulting from previous trauma, followed by a free fibula flap as part of the FVFG procedure. When fibula was simultaneously prepared already during tumor resection (n=2), there was a significant reduction in the overall operation time. Postoperative assessment revealed that full osseous integrity without any graft failure was restored in all patients, and the same number of patients regained independent ambulatory ability. Surgical complications were observed in one patient, who exhibited wound healing post-reconstruction, all of which were rectified through subsequent surgical intervention. Conclusion:Diverse osseous defects in complex cases can be reconstructed by using the FVFG, thereby restoring maximal reconstructive capacity, expedited union compared to non-vascularized bone, and acceptable donor site morbidity. FVFG remain a reliable solution for diverse defects. Moreover, in cases requiring complex tumor defects, careful preoperative planning and an interdisciplinary treatment are essential for successful treatment.
Hyperhidrosis, with a prevalence of 1 to 2% of the population, primarily affects young people under 40 years of age. The individually perceived burden of odor and amount of sweat leads to a reduced quality of life. In recent years, conservative and surgical measures have been used to treat hyperhidrosis. The miraDry (R) (R) method based on microwave technology is a non-invasive treatment that enables comparable results in terms of effectiveness while at the same time reducing the burden. In the Park-Klinik Birkenwerder, 282 hyperhidrosis patients were treated with the miraDry (R) (R) method between 2017 and 2024. An online survey was conducted in May and June 2024. 220 patients were contacted, the results of 80 patients are available (response rate: 36.4%). Changes in the restrictions caused by increased sweating in various areas of life were asked before and after the treatment. In addition, the assessment of general quality of life before and after the treatment was compared. There is a significant reduction in restrictions and a corresponding increase in quality of life after treatment with miraDry (R). (R) . Satisfaction with the method is high, which is reflected in a high recommendation rate of over 80%.
Introduction: Scalp defect reconstruction requires interdisciplinary cooperation to restore soft tissue and osseous defects. While wound closure and form restoration, often a short-term treatment goal, ensures patient survival, the long-term preservation of the head and neck's integrity and aesthetics is crucial for maintaining quality of life. This study aims to compare, quantify, and establish a safe and reproducible approach to various reconstruction options and the postoperative complication profile for individual scalp defect areas. Materials and methods: We retrospectively evaluated patients who underwent scalp reconstruction at our institution between March 2017 and April 2022. The inclusion criterion was the presence of a soft tissue defect at the cranium level. Results: We included 31 patients in the study (17 males, 14 females), with an average age of 61 years (range 17-92 years). Eight patients had received radiotherapy in the affected region. The mean defect size was 72.5 +/- 116 cm(2) (range 20-441 cm(2)), and an average of 3 +/- 2 surgeries had been performed before the plastic surgical treatment was initiated. Eleven patients had only a soft tissue defect, while 20 patients had an associated bone defect. Fifteen of these patients received a cranioplasty. The rotation flap was the most frequently used (n=23), with or without split-thickness skin grafting, followed by the free latissimus dorsi muscle flap with split-thickness skin grafting (n=5), and the free lateral arm flap (n=2). Revision surgeries were necessary in 38.7% of cases due to wound healing disorders (n=9), bleeding (n=2), and cerebrospinal fluid leaks (n=1). Eventually, all wounds were successfully closed. Conclusion: Complex scalp defects can be closed using local flaps, thereby restoring aesthetics and tissue integrity. Free flaps remain a reliable solution for extensive defects. Moreover, in cases requiring cranioplasty, careful preoperative planning and an uncontaminated wound are essential for successful treatment.
The use of silicone breast implants has a history of over 60 years. In recent years, specific health issues among implant wearers have repeatedly come into focus. The term "breast implant illness" has been circulating in scientific literature and on social media for several years. It describes a cluster of up to 60 different symptoms. The present results of an online survey conducted within a clinic's patient population of the last 8 years show, among other things, the evolution of 8 reported symptoms before and after breast implant removal. In the comparison before and after, there is a significant reduction in the intensity of symptoms after implant removal. A causal relationship with the removal of the implants is to be presumed.
Arthrodesis of the knee joint has proven effective in the treatment of chronic periprosthetic infections as well as in cases of previous multiple revision surgery after total knee replacement with insufficiency of the extensor apparatus. In this case report, we report on the use of a custom-made intramedullary arthrodesis nail of the knee joint following multiple revisions due to aseptic loosening after total knee replacement. Surgery was performed according to preoperative computerized planning. Microbiological and histological samples obtained intraoperatively showed no evidence of infection. Yet, the patient presented postoperatively with complete loss of active dorsiflexion of the ipsilateral foot. On one-year follow-up, the patient did not complain of any pain. The radiological findings one year after surgery showed no sign of loosening or any other pathological findings. The neurological lesion has completely recovered. The Harris Hip Score HHS improved from 24 (prior to implantation of the arthrodesis) to 75 on one-year follow-up, the Western Ontario and McMaster Universities Osteoarthritis Index WOMAC improved from 86 to 20. The particularity of this case lies in the fact that an additional femoral neck screw was brought in to prevent periprosthetic fracture of the proximal femur. Careful preoperative planning as well as surgical performance were necessary to adjust the rotation of the femoral nail to allow adequate positioning of the femoral neck screw.Intramedullary arthrodesis of the knee is a suitable management option following multiple revision surgery after total knee replacement with insufficiency of the extensor apparatus. In many cases, an individual therapeutic plan is necessary ranging up to the use of custom-made implants.
Background: The clinical appearance of acral melanoma is diverse and can cause diagnostic difficulties in individual cases.Case description: We present a clinical case of an 83-year-old patient with a melanoma in the heel area that was initially interpreted as a pressure ulcer, resulting in delayed and more complicated treatment.Conclusions: Melanomas should be included in the differential diagnosis even in “typical” pressure ulcer areas. Against the background of increasingly poor healthcare in rural areas, an increase in such cases can be expected.
Mega-endoprostheses enable wide management options in the treatment of primary and periprosthetic fracture of the lower extremities. In this study, we report on the use of custom-made subtotal diaphyseal endoprosthetic replacement in treatment of interprosthetic femoral fracture. This procedure is off-label, but in this particular case, it was the safest and most stress-stable treatment option. The implant was delivered within three weeks. The surgical procedure for subtotal replacement of the femoral diaphysis was performed without any intra- or postoperative complication. The duration for the surgical intervention was one hour and 40 minutes. The patient was then mobilized with full weight bearing. At one-year follow-up, the patient did not complain of any pain. The Harris Hip Score HHS improved from 26 to 83 at one-year follow-up, the Western Ontario and McMaster Universities Osteoarthritis Index WOMAC improved from 88 to 16. Mega-endoprostheses enable a wide range of management options in the treatment of primary, peri- and interprosthetic fractures of the lower extremities. In many cases, an individual therapeutic plan is necessary ranging up to the use of custom-made implants.
Objective: Lipomas are common, benign tumors usually located in the subcutaneous tissue. The “one-inch method” is a minimally invasive technique for resecting large subcutaneous lipomas through a one-inch incision after blunt dissection of the lipoma from its peripheral retaining ligaments. The limitations of this method are currently unclear. Materials and methods: We assessed twenty-five patients with large lipomas, defined as a tumor diameter greater than 5 cm. The location of the lipoma was at the shoulder in fifteen patients, the extremity in six patients, and the torso in four patients. Results: The mean operative time for all lesions was 28.3 minutes, with a mean time of 25.9 minutes for lipomas at the shoulder, 21.8 minutes for the extremities, and 47.0 minutes for the torso. We classified patients into three groups according to operative time: the short group (10–29 min), middle group (30–49 min), and long group (50–70 min). For lipomas of the shoulder, there were eleven patients (73%) in the short group, three patients (20%) in the middle group, and one patient (7%) in the long group. For lipomas of the extremity, the groups contained five patients (83%), one patient (17%), and no patients (0%), respectively. For lipomas of the torso, the groups contained one patient (25%), no patients (0%), and three patients (75%), respectively. Conclusions: Lipomas of the torso require a longer operative time than those of the shoulder or extremity; this difference could be due to the number of retaining ligaments present, which is reportedly higher in the back than in the anterior or side body. Lipomas of the back are less amenable to the one-inch method, and posterior shoulder lipomas may take more time than those at other parts of the shoulder or at the extremities.
Objective:To analyze the effects of Argireline on skin surface wrinkles using the Visia® camera system developed by Canfield Scientific Inc., U.S.A., for facial image capture.Method:Nineteen female participants were recruited from a plastic surgery clinic. Initial facial images captured the left, front, and right sides of the participants' faces, which were documented as timepoint one. Following this, the participants immediately began to apply a facial skin serum containing triple hyaluronic acids produced by CNC cosmetic GmbH, Philippsburg, Germany. The serum was applied once in the morning and once in the evening. Participants received two identical containers labeled L for left and R for right, with each container to be used on the corresponding facial side, particularly around the eye area. One container contained Argireline, a synthetic hexapeptide, which previously was deemed to be a biosafe alternative to botulinum neurotoxin. The study was conducted as double-blind; neither the participants nor researchers knew which of the two containers contained Argireline. Participants were allowed to use their own cosmetic products throughout the study. After four weeks, the participants returned to have their faces recaptured using the Visia® camera, which was documented as timepoint two. The absolute scores of the wrinkles were noted, and results on both sides of the face were calculated and compared. The "TruSkinAge®" measurement provided by the Visia® camera was reviewed for each face side. Results between both time points and both sides of the face were compared. After the data analysis was complete, the company was contacted to determine which container contained Argireline.Results:Nineteen participants returned for facial image capture. There were no significant adverse events, allergic reactions, or skin irritations. The investigation revealed that the wrinkle score slightly decreased for the right and left side of the face following four weeks of serum application. However, this decrease was not significant (p>0.05) based on the Wilcoxon matched pairs tests for the wrinkle scores (right side p=0.060 and left side p=0.176) and Truskin Ages® results (right side p=0.096 and left side p=0.489).Comparing the data from the right side with that from the left side of the face revealed that neither demonstrated a significant reduction in wrinkle score (p=0.829) or Truskin Ages® results (p=0.804). Argireline was included in the serum applied to the right side of the face. However, no statistical significance was seen in the results on this side of the face indicating any possible effects.Conclusion:Wrinkle scores and Truskin Ages® results were observed to decrease non-significantly following the application of a skin serum involving hyaluronic acid. The Visia® imaging method was used to analyze the data objectively. Differences between both sides of the face that were treated with and without Argireline were not statistically significant. Therefore, the effect of Argireline was not proven. While Argireline presented with low toxicity, its efficacy was found not to be significant. Therefore, it is not deemed to be an alternative treatment to botulinum toxin.
Introduction:Neurofibromatosis type 1 (NF1) is an is an autosomal dominant heritable tumor predisposition syndrome.. Peripheral nerve sheath tumors (PNST) are a hallmark of NF1. Plexiform neurofibromas (PNF) are neoplasms that are characteristic of NF1, often causing disfiguring effects (e.g., on the face), and are considered precancerous lesions. Previous studies have shown that facial PNF (FPNF) have an impact on the shape of facial bones. This study examines deviations of mandibular symmetry from cephalometric reference planes considering the topography of FPNF. Material and methods:The posterior-anterior (PA) cephalograms of 168 patients with NF1 were examined. We compared three groups: patients with FPNF (n=74), with disseminated cutaneous neurofibroma (DNF (n=94)), and control subjects without NF1 (n=23). The PNF group was subtyped with respect to facial PNST type and location. Typical mandibular cephalometric reference points were determined (condyle, antegonion, and menton). Results:The skeletal measurement points of the mandible in FPNF patients often differ significantly from those of the DNF group. It has been proven that typical asymmetries of the median-sagittal measurement points are indicators of PNF. Differences within the trigeminal tumor spread patterns are indicated in the measured values. A local tumor effect (PNF) on the relation of the measurement points to the reference planes is made plausible by the study results. The investigations prove that tumor type (FPNF) and the number of FPNF affected branches of the trigeminal nerve may correlate with significant deviations of mandible from symmetry on PA projections. Conclusion:The presented study shows that characteristic patterns of mandibular deformity can be measured on standardized radiographs in NF1 patients with FPNF. Mandibular deformities imaged on standardized radiographs may be initial indicators of a previously unrecognized NF1. Tumor-associated alterations of the mandible should be considered in the classification systems of pathognomonic, diagnostically pioneering osseous findings in NF1. The radiological findings provide clues for planning mandibular osteotomies in NF1 patients, especially for assessing facial regions typically highly vascularized by tumor spread. Furthermore, the radiological findings are an indication of a tumor potentially invading and destroying adjacent masticatory and mimic muscle, findings that may have an influence on surgical measures (function, aesthetics, and wound healing).
Fournier gangrene is a disease characterized by necrotizing fasciitis of the perineal and genital region, resulting from synergistic polymicrobiotic infection. Most infections can be localized to a cutaneous, urethral, or rectal source and can culminate in a fulminant sepsis. Current state of the art is systemic broad-spectrum antibiotics and serial aggressive debridement which result in superficial perineal defect of wide dimensions. We compiled all the cases of Fournier gangrene that required reconstruction after debridement in Centro Hospitalar Universitário Lisboa Central from 2018 to 2022. Inclusion criteria were reconstruction for Fournier defects and patients' age 18 to 90 years old. Exclusion criteria were patients who didn't require reconstruction or didn't complete it due to death or transfer to another healthcare institution. Reconstructive procedures and complication rates are reported as whole numbers and percentages of total. The initial search yielded 32 patients. There were 2 (6.2%) patients with defects that healed by secondary intention, 6 (18.7%) with delayed primary closure, 4 (12.5%) with implantation of the testicle in a medial thigh pocket, 12 (37.5%) with skin grafts, 4 (12.5%) with scrotal advancement flaps, 2 (6.2%) with flaps, and 2 (6.2%) with flaps and skin grafts in combination. Four outcomes were evaluated: number of patients, defect size, method of reconstruction, and wound-healing complications. Most reconstructive techniques provide reliable coverage and protection of testicular function with an acceptable cosmetic result. The reconstructive options need to be patient tailored in order to achieve long lasting results with a minimum of postoperative morbidity.
The article Subcutaneous lipomas: A minimally invasivemethod for resection of subcutaneous lipomas preserving retaining ligaments, written by Akio Sakamoto, Takeshi Okamoto, Shuichi Matsuda, was originally published electronically on the publisher’s internet portal (currently SpringerLink).
The German guideline for oral squamous cell carcinoma (OSCC) de-scribes the recommended diagnosis and treatment procedures for OSCC and ensures the highest quality patient care. However, the current German guideline for OSCC is indistinct and therapy planning is not standardized in detail between centers. To address this, the current diagnostic and therapeutic strategies in different oral and maxillofacial surgery departments in Germany were summarized using a uniform questionnaire. The results revealed high standards in oncologic maxil-lofacial care, but non-uniform standards exist between centers. More-over, an increasing use of diagnostic and treatment methods that are not included in the German guideline for OSCC, such as positron emis-sion tomography computed tomography (PET-CT) and tumor biomarkers, were used by different centers. These results support the updated German guideline for OSCC but highlight the need to consider other additive methods to improve patient care and outcomes. Furthermore, a recommendation to introduce tumor passports to simplify OSCC dia-gnosis and treatment should be discussed. These changes will improve the prognosis and quality of life of patients with OSCC.
Objective:This study aimed to investigate the reproducibility and accuracy of the Visia® Complexion Analysis Camera System by Canfield Scientific for objective skin analysis.Methods:Nineteen participants underwent facial capture with the Visia® camera following a standardised protocol. During the first session, the participants sat down and positioned their faces in a capture rig, closed their eyes and had their faces captured from the left, front and right sides, with threefold repetition of the captures from the front side. After 4 weeks, the participants underwent recapture in a similar manner. Based on the frontal views, data for two measurement methods of the Visia® camera system, the absolute scores and the percentiles, were obtained with regard to the skin criterion wrinkles via automated software calculation. Means and standard deviations were evaluated. Based on the side views, the data for the Truskin Ages® were calculated by the Visia® camera system and compared with the calendrical ages, which served as the gold standard for comparison.Results:In the assessment of the reproducibility of the data of the capture system the standard deviation from the frontal captures among all participants was about 3% when the absolute scores of the wrinkles were compared with each other; specifically, the average deviation was 3.36% during the first capture session and 3.4% during the second capture session. Meanwhile, the standard deviation of the measurements was about 9% when the percentiles were compared; specifically, the average deviation was 8.2% during the first capture session and 10.7% during the second capture session. In the assessment of the accuracy the correlation between the calendrical age and the calculated Truskin Age® for both facial sides was very high at a correlation coefficient rho value of >0.8 (right side: r=0.896; left side: r=0.827) and statistically significant at a p-value of <0.001. The average calendrical age and Truskin Age® deviated only slightly from each other and did not differ significantly (right side: p=0.174; left side: p=0.190). The Truskin Age® was slightly higher than the calendrical age by a mean value of 1.37 years for both facial sides. The analysis of the absolute differences revealed that in 50% of the cases, there was a maximum difference of 3 years, and in 75% of the cases, there were maximum differences of 4.5 years for the right side and 5.5 years for the left side.Conclusion:The assessment of the reproducibility and accuracy of the objective measurement method, the Visia® camera system, contributed to the validation of the system. The evaluation of the reproducibility revealed a satisfactory precision of the repeated captures when investigating facial wrinkles. Absolute scores should be preferred over percentiles owing to their better precision. The calculation of the accuracy of the Truskin Age® data from the Visia® camera system revealed only a slight deviation from the true calendrical ages. The correlation between both data groups was highly significant.
