Vascular complications of hyaluronic acid fillers and the role of hyaluronidase in management
Summary Skin necrosis following the inadvertent arterial injection of hyaluronic acid (HA) is a serious complication. It is not clear whether or not subcutaneous injections of hyaluronidase decrease skin necrosis in HA-induced vascular complications. We had four cases of HA-induced vascular complica...
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| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2011-12, Vol.64 (12), p.1590-1595 |
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| container_title | Journal of plastic, reconstructive & aesthetic surgery |
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| creator | Kim, Deok-Woo Yoon, Eul-Sik Ji, Yi-Hwa Park, Seung-Ha Lee, Byung-Il Dhong, Eun-Sang |
| description | Summary Skin necrosis following the inadvertent arterial injection of hyaluronic acid (HA) is a serious complication. It is not clear whether or not subcutaneous injections of hyaluronidase decrease skin necrosis in HA-induced vascular complications. We had four cases of HA-induced vascular complications, two of which were treated with hyaluronidase the next day. All of the patients had skin necrosis and scarring. We performed an animal study with rabbit ears in which HA filler was injected into the auricular arteries of both ears. Five rabbits each received a subcutaneous injection of 750 IU of hyaluronidase 4 and 24 h after the filler injection. The hyaluronidase-treated ears in the 4-h intervention group had significantly smaller necrotic areas ( p |
| doi_str_mv | 10.1016/j.bjps.2011.07.013 |
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It is not clear whether or not subcutaneous injections of hyaluronidase decrease skin necrosis in HA-induced vascular complications. We had four cases of HA-induced vascular complications, two of which were treated with hyaluronidase the next day. All of the patients had skin necrosis and scarring. We performed an animal study with rabbit ears in which HA filler was injected into the auricular arteries of both ears. Five rabbits each received a subcutaneous injection of 750 IU of hyaluronidase 4 and 24 h after the filler injection. The hyaluronidase-treated ears in the 4-h intervention group had significantly smaller necrotic areas ( p < 0.05), while the 24-h intervention group had no differences in the area of necrosis. Hyaluronidase reduced the vascular complications of HA fillers when used early, but there was no benefit to hyaluronidase injection after 24 h.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2011.07.013</identifier><identifier>PMID: 21807574</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Adult ; Animals ; Biocompatible Materials - therapeutic use ; Biological and medical sciences ; Bones, joints and connective tissue. Antiinflammatory agents ; Complication ; Cosmetic Techniques - adverse effects ; Ear, External - blood supply ; Female ; Humans ; Hyaluronic acid ; Hyaluronic Acid - administration & dosage ; Hyaluronic Acid - adverse effects ; Hyaluronic Acid - analogs & derivatives ; Hyaluronidase ; Hyaluronoglucosaminidase - therapeutic use ; Inflammation - chemically induced ; Injections, Intra-Arterial ; Injections, Subcutaneous ; Medical sciences ; Necrosis ; Pharmacology. Drug treatments ; Plastic Surgery ; Rabbits ; Rejuvenation ; Retrospective Studies ; Rhinoplasty - adverse effects ; Skin - pathology ; Skin necrosis ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2011-12, Vol.64 (12), p.1590-1595</ispartof><rights>British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-cea8f44f3ff07a7b0f4bf31a1b772899b96cee48604a418268b9b950715674953</citedby><cites>FETCH-LOGICAL-c440t-cea8f44f3ff07a7b0f4bf31a1b772899b96cee48604a418268b9b950715674953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.bjps.2011.07.013$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25245907$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21807574$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Deok-Woo</creatorcontrib><creatorcontrib>Yoon, Eul-Sik</creatorcontrib><creatorcontrib>Ji, Yi-Hwa</creatorcontrib><creatorcontrib>Park, Seung-Ha</creatorcontrib><creatorcontrib>Lee, Byung-Il</creatorcontrib><creatorcontrib>Dhong, Eun-Sang</creatorcontrib><title>Vascular complications of hyaluronic acid fillers and the role of hyaluronidase in management</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Summary Skin necrosis following the inadvertent arterial injection of hyaluronic acid (HA) is a serious complication. It is not clear whether or not subcutaneous injections of hyaluronidase decrease skin necrosis in HA-induced vascular complications. We had four cases of HA-induced vascular complications, two of which were treated with hyaluronidase the next day. All of the patients had skin necrosis and scarring. We performed an animal study with rabbit ears in which HA filler was injected into the auricular arteries of both ears. Five rabbits each received a subcutaneous injection of 750 IU of hyaluronidase 4 and 24 h after the filler injection. The hyaluronidase-treated ears in the 4-h intervention group had significantly smaller necrotic areas ( p < 0.05), while the 24-h intervention group had no differences in the area of necrosis. Hyaluronidase reduced the vascular complications of HA fillers when used early, but there was no benefit to hyaluronidase injection after 24 h.</description><subject>Adult</subject><subject>Animals</subject><subject>Biocompatible Materials - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>Complication</subject><subject>Cosmetic Techniques - adverse effects</subject><subject>Ear, External - blood supply</subject><subject>Female</subject><subject>Humans</subject><subject>Hyaluronic acid</subject><subject>Hyaluronic Acid - administration & dosage</subject><subject>Hyaluronic Acid - adverse effects</subject><subject>Hyaluronic Acid - analogs & derivatives</subject><subject>Hyaluronidase</subject><subject>Hyaluronoglucosaminidase - therapeutic use</subject><subject>Inflammation - chemically induced</subject><subject>Injections, Intra-Arterial</subject><subject>Injections, Subcutaneous</subject><subject>Medical sciences</subject><subject>Necrosis</subject><subject>Pharmacology. Drug treatments</subject><subject>Plastic Surgery</subject><subject>Rabbits</subject><subject>Rejuvenation</subject><subject>Retrospective Studies</subject><subject>Rhinoplasty - adverse effects</subject><subject>Skin - pathology</subject><subject>Skin necrosis</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2L1TAYhYsozof-AReSjbjq9U2bNCmIMAw6CgMu_NhJSNM3TmqaXJNWuP_elHtVdOEqITznEJ5TVU8o7CjQ7sW0G6Z93jVA6Q7EDmh7rzqnUsgaeNvfL3fBZN1Jys-qi5wnANZSxh9WZw2VILhg59WXzzqb1etETJz33hm9uBgyiZbcHbRfUwzOEG3cSKzzHlMmOoxkuUOSose_uFFnJC6QWQf9FWcMy6PqgdU-4-PTeVl9evP64_Xb-vb9zbvrq9vaMAZLbVBLy5htrQWhxQCWDbalmg5CNLLvh74ziEx2wDSjsunkUN44CMo7wXreXlbPj737FL-vmBc1u2zQex0wrln1wAB6zjeyOZImxZwTWrVPbtbpoCiozaqa1GZVbVYVCFWsltDTU_06zDj-jvzSWIBnJ6DY1N4mHYzLfzjeMN6DKNzLI4dFxg-HSWXjMBgcXUKzqDG6___j1T9x413ZR_tveMA8xTWFollRlRsF6sO2_zY_pQBtXxp-At5sqro</recordid><startdate>20111201</startdate><enddate>20111201</enddate><creator>Kim, Deok-Woo</creator><creator>Yoon, Eul-Sik</creator><creator>Ji, Yi-Hwa</creator><creator>Park, Seung-Ha</creator><creator>Lee, Byung-Il</creator><creator>Dhong, Eun-Sang</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20111201</creationdate><title>Vascular complications of hyaluronic acid fillers and the role of hyaluronidase in management</title><author>Kim, Deok-Woo ; Yoon, Eul-Sik ; Ji, Yi-Hwa ; Park, Seung-Ha ; Lee, Byung-Il ; Dhong, Eun-Sang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-cea8f44f3ff07a7b0f4bf31a1b772899b96cee48604a418268b9b950715674953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Animals</topic><topic>Biocompatible Materials - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>Complication</topic><topic>Cosmetic Techniques - adverse effects</topic><topic>Ear, External - blood supply</topic><topic>Female</topic><topic>Humans</topic><topic>Hyaluronic acid</topic><topic>Hyaluronic Acid - administration & dosage</topic><topic>Hyaluronic Acid - adverse effects</topic><topic>Hyaluronic Acid - analogs & derivatives</topic><topic>Hyaluronidase</topic><topic>Hyaluronoglucosaminidase - therapeutic use</topic><topic>Inflammation - chemically induced</topic><topic>Injections, Intra-Arterial</topic><topic>Injections, Subcutaneous</topic><topic>Medical sciences</topic><topic>Necrosis</topic><topic>Pharmacology. Drug treatments</topic><topic>Plastic Surgery</topic><topic>Rabbits</topic><topic>Rejuvenation</topic><topic>Retrospective Studies</topic><topic>Rhinoplasty - adverse effects</topic><topic>Skin - pathology</topic><topic>Skin necrosis</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Deok-Woo</creatorcontrib><creatorcontrib>Yoon, Eul-Sik</creatorcontrib><creatorcontrib>Ji, Yi-Hwa</creatorcontrib><creatorcontrib>Park, Seung-Ha</creatorcontrib><creatorcontrib>Lee, Byung-Il</creatorcontrib><creatorcontrib>Dhong, Eun-Sang</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Deok-Woo</au><au>Yoon, Eul-Sik</au><au>Ji, Yi-Hwa</au><au>Park, Seung-Ha</au><au>Lee, Byung-Il</au><au>Dhong, Eun-Sang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vascular complications of hyaluronic acid fillers and the role of hyaluronidase in management</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2011-12-01</date><risdate>2011</risdate><volume>64</volume><issue>12</issue><spage>1590</spage><epage>1595</epage><pages>1590-1595</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Summary Skin necrosis following the inadvertent arterial injection of hyaluronic acid (HA) is a serious complication. It is not clear whether or not subcutaneous injections of hyaluronidase decrease skin necrosis in HA-induced vascular complications. We had four cases of HA-induced vascular complications, two of which were treated with hyaluronidase the next day. All of the patients had skin necrosis and scarring. We performed an animal study with rabbit ears in which HA filler was injected into the auricular arteries of both ears. Five rabbits each received a subcutaneous injection of 750 IU of hyaluronidase 4 and 24 h after the filler injection. The hyaluronidase-treated ears in the 4-h intervention group had significantly smaller necrotic areas ( p < 0.05), while the 24-h intervention group had no differences in the area of necrosis. Hyaluronidase reduced the vascular complications of HA fillers when used early, but there was no benefit to hyaluronidase injection after 24 h.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>21807574</pmid><doi>10.1016/j.bjps.2011.07.013</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Animals Biocompatible Materials - therapeutic use Biological and medical sciences Bones, joints and connective tissue. Antiinflammatory agents Complication Cosmetic Techniques - adverse effects Ear, External - blood supply Female Humans Hyaluronic acid Hyaluronic Acid - administration & dosage Hyaluronic Acid - adverse effects Hyaluronic Acid - analogs & derivatives Hyaluronidase Hyaluronoglucosaminidase - therapeutic use Inflammation - chemically induced Injections, Intra-Arterial Injections, Subcutaneous Medical sciences Necrosis Pharmacology. Drug treatments Plastic Surgery Rabbits Rejuvenation Retrospective Studies Rhinoplasty - adverse effects Skin - pathology Skin necrosis Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases |
| title | Vascular complications of hyaluronic acid fillers and the role of hyaluronidase in management |
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