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QMP's Plastic Surgery Pulse News
Authors: Diane Irvine Duncan, MD, FACS
For many years, medical practitioners have thought that cells die in one of only two ways: Either necrotic cells die violently when their outer membrane ruptures, or cells undergo programmed silent cell death through a mechanism called apoptosis. In 2001 Cookson and Brennan1 published an article in Trends in Microbiology describing a new means of cell death that occurs usually within the context of an infectious process called pyroptosis.
An investigation for a device that causes an intermediate reaction—a fractional response, permanent adipocyte demise, and a ild to moderate inflammatory response in the treatment region
The best responders to this RFbased tissue treatment type are older patients with little fibrous content in their fatty layer. A thick fibroseptal network can act as insulation, creating a protective covering for the adipocytes, which are then less affected by the heat and electroporation effect.
Although early evidence shows that irreversible electroporation causes a pyroptotictype response in treated adipocytes, the mechanism of action seen with SEM varies somewhat from the process seen with infectioncaused pyroptosis. The recent emergence of similar but distinct mechanisms of cell death such as anoikis, pyronecrosis, paraptosis, and entosis shows that there are probably many undiscovered cell death pathways, each with unique characteristics.12 More study is needed to better define the stepbystep mechanism of action of irreversible electroporation on adipocytes. As the nuances of response to increases and decreases in power, duration, optimal treatment temperature, wave oscillation patterns, and subject tissue type are studied, we will be better able to predict and control treatment outcomes.