Open AccessLocal Cooling as a Step of Treatment for Tissue Ischemia Caused by Hyaluronic Acid Injection-induced Embolism—A Report of 9 Cases
Author(s) -
Chen Zhang,
Chunying Ge,
Chunxiao Du,
Jieqi Li
Publication year - 2018
Publication title -
plastic and reconstructive surgery. global open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.759
H-Index - 28
ISSN - 2169-7574
DOI - 10.1097/gox.0000000000001824
Subject(s) - hyaluronic acid , hyaluronidase , medicine , massage , saline , bench to bedside , ischemia , embolism , anesthesia , air embolism , surgery , chemistry , pathology , complication , biochemistry , alternative medicine , medical physics , anatomy , enzyme
Summary: Hyaluronic acid injection is 1 of the most popular procedures in facial rejuvenation and augmentation. It is widely popular in the cosmetic surgery due to several advantages, which include rapid effect, minimal injury, and a short postoperative recovery period. With continuous increase in hyaluronic acid injections, many cases of hyaluronic acid injection-induced embolism have been reported. At present, methods for early treatment of hyaluronic acid injection–induced embolism include local injection of hyaluronidase, topical application of nitroglycerin ointment, massage, hot compression, and intravenous injections of antibiotics and hormones. Although early warm massage may facilitate hyaluronic acid degradation by hyaluronidase, local application of heat will also increase metabolic rate in the tissue, thereby reducing the ischemic tolerance of the tissue. Therefore, in this study, warm massage was limited to the first 30 minutes after hyaluronidase injection and was followed by local cooling using a gauze pad soaked with antibiotic saline solution. Excellent therapeutic effects were achieved with this approach. The methods of treatment for tissue ischemia caused by hyaluronic acid injection–induced embolism and clinical cases are introduced in the article.