Hong Ji Yeon, Seok Joon, Ahn Ga Ram, Jang Yu-Jin, Li Kapsok, Kim Beom Joon
Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
Dermatol Ther. 2017 Mar;30(2). doi: 10.1111/dth.12440. Epub 2016 Nov 28.
Vascular compromise with impending skin necrosis is one of the most serious potential complications. Early recognition of vascular occlusion and swift and aggressive treatment are required to avoid any irreversible changes. However, initial symptoms of a vascular event are often dismissed as simple post-procedural discomfort. If more than 3 days pass after filler injection, crust formation is initiated over the erythematous base along with a rim of fibrous tissue. Due to the replacement of normal tissues by fibrous material, the healing process may result in scar formation in spite of debridement and aggressive dressing changes. Scars often cause contracture and subsequent cosmetic disfigurement, which results in a traumatic burden to the patient. By sharing our experience of the patients with filler induced skin necrosis, we suggest that treatment should be initiated no later than 3 days after the procedure.
伴有即将发生皮肤坏死的血管受损是最严重的潜在并发症之一。需要早期识别血管阻塞并迅速采取积极治疗，以避免任何不可逆的变化。然而，血管事件的初始症状通常被视为简单的术后不适而被忽视。如果在填充剂注射后超过3天，在红斑基底上会开始形成结痂，并伴有一圈纤维组织。由于正常组织被纤维材料替代，尽管进行了清创和积极更换敷料，愈合过程仍可能导致瘢痕形成。瘢痕常导致挛缩和随后的美容缺陷，给患者带来创伤负担。通过分享我们在填充剂诱导皮肤坏死患者中的经验，我们建议治疗应在术后不迟于3天开始。
