Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic review
INTRODUCTION: We performed a retrospective systematic review of studies reporting the use of Picibanil for treatment of lymphatic malformations (LMs). METHODS: We searched the PubMed database for available studies, including those published between January 1990 and April 14, 2013. The se...
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Thieme Revinter Publicações Ltda.
2016-09-01
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| Series: | Revista Brasileira de Cirurgia Plástica |
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| Online Access: | http://www.rbcp.org.br/export-pdf/1772/en_v31n3a19.pdf |
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| author | Olívia Helena Gomes Patatas Dov Goldenberg Rolf Gemperli |
| author_facet | Olívia Helena Gomes Patatas Dov Goldenberg Rolf Gemperli |
| author_sort | Olívia Helena Gomes Patatas |
| collection | DOAJ |
| description | INTRODUCTION: We performed a retrospective systematic review of studies reporting the use of Picibanil for treatment of lymphatic malformations (LMs).
METHODS: We searched the PubMed database for available studies, including those published between January 1990 and April 14, 2013. The search strategy involved the use of the keywords "OK-432" or "Picibanil" and "lymphatic malformation." Information was compiled regarding the reported mechanism of action, indications, contraindications, efficacy, administration, side effects, complications, and advantages and disadvantages compared to those of other modalities.
RESULTS: Forty-four studies were found, of which 27 fulfilled the inclusion criteria. Picibanil is a lyophilized preparation of a low-virulence strain of Streptococcus pyogenes inactivated with penicillin G. Its mechanism of action is unclear, but it has been speculated that it causes a controlled inflammatory response with adhesion of cyst walls. Picibanil is almost unanimously indicated for the treatment of macrocystic LMs, which show a greater effectiveness response compared to that shown by microcystic or mixed LMs. Picibanil is usually administered by puncturing, either with direct visualization or guided by ultrasound, with the patient under general anesthesia. The most widely used preparation comprises 0.1 mg of Picibanil in 10 mL of saline. Side effects are mostly mild, with pain, swelling, and fever being the most frequently reported.
CONCLUSION: The studies had low scientific evidence. A systematic review found that Picibanil is useful against any LM, with better results in macrocystic lesions. Efficacy was comparable to that of other therapies. No specific contraindication was presented. Although the mechanism of action has not been established, the inclusion of Picibanil as a treatment option is warranted. |
| format | Article |
| id | doaj-art-97adc9f4b38e45d7af244272daba9924 |
| institution | Kabale University |
| issn | 1983-5175 2177-1235 |
| language | English |
| publishDate | 2016-09-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Revista Brasileira de Cirurgia Plástica |
| spelling | doaj-art-97adc9f4b38e45d7af244272daba99242025-08-20T03:34:57ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352016-09-01310340541610.5935/2177-1235.2016RBCP0067Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic reviewOlívia Helena Gomes Patatas0Dov Goldenberg1Rolf Gemperli2Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, BrazilINTRODUCTION: We performed a retrospective systematic review of studies reporting the use of Picibanil for treatment of lymphatic malformations (LMs). METHODS: We searched the PubMed database for available studies, including those published between January 1990 and April 14, 2013. The search strategy involved the use of the keywords "OK-432" or "Picibanil" and "lymphatic malformation." Information was compiled regarding the reported mechanism of action, indications, contraindications, efficacy, administration, side effects, complications, and advantages and disadvantages compared to those of other modalities. RESULTS: Forty-four studies were found, of which 27 fulfilled the inclusion criteria. Picibanil is a lyophilized preparation of a low-virulence strain of Streptococcus pyogenes inactivated with penicillin G. Its mechanism of action is unclear, but it has been speculated that it causes a controlled inflammatory response with adhesion of cyst walls. Picibanil is almost unanimously indicated for the treatment of macrocystic LMs, which show a greater effectiveness response compared to that shown by microcystic or mixed LMs. Picibanil is usually administered by puncturing, either with direct visualization or guided by ultrasound, with the patient under general anesthesia. The most widely used preparation comprises 0.1 mg of Picibanil in 10 mL of saline. Side effects are mostly mild, with pain, swelling, and fever being the most frequently reported. CONCLUSION: The studies had low scientific evidence. A systematic review found that Picibanil is useful against any LM, with better results in macrocystic lesions. Efficacy was comparable to that of other therapies. No specific contraindication was presented. Although the mechanism of action has not been established, the inclusion of Picibanil as a treatment option is warranted.http://www.rbcp.org.br/export-pdf/1772/en_v31n3a19.pdf lymphatic abnormalitiestherapeuticssclerotherapypicibanilstreptococcus pyogenes |
| spellingShingle | Olívia Helena Gomes Patatas Dov Goldenberg Rolf Gemperli Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic review Revista Brasileira de Cirurgia Plástica lymphatic abnormalities therapeutics sclerotherapy picibanil streptococcus pyogenes |
| title | Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic review |
| title_full | Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic review |
| title_fullStr | Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic review |
| title_full_unstemmed | Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic review |
| title_short | Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic review |
| title_sort | intralesional treatment of lymphatic malformations with emphasis on picibanil ok 432 sclerotherapy a systematic review |
| topic | lymphatic abnormalities therapeutics sclerotherapy picibanil streptococcus pyogenes |
| url | http://www.rbcp.org.br/export-pdf/1772/en_v31n3a19.pdf |
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