Department of Plastic & Laser Cosmetic, Hunan Provincial People's Hospital, Changsha, China.
Gold Skin Care Center, Nashville, Tennessee.
J Cosmet Dermatol. 2019 Jun;18(3):747-754. doi: 10.1111/jocd.12968. Epub 2019 May 10.
The purpose of this manuscript is to investigate the treatment of skin soft tissue embolization or vascular occlusion after the injection of hyaluronic acid (HA) for Injection Rhinoplasty (IR) in Asians with a special interest in the time occurrence of the occlusion.
A total of 35 cases were evaluated after receiving HA injections for IR who presented with a vascular occlusive event. They were divided into three stages based on the time to embolization. Immediate, ≤5 hours; early, ≤3 days; and late, >3 days. There were two cases of immediate, 28 deemed early, and five late. Methods to prevent tissue necrosis are reviewed in the manuscript based on these stages.
Skin color gradually recovered to normal after 11 treatments in 11 patients with mild embolization. No ischemic aggravation or skin necrosis was observed in 19 patients with moderate embolization; red scarring was seen in two and hypertrophic scar with uneven skin color in one patient. The five patients in the severe category had longer healing, more red scars, and more hypertrophic scarring.
The treatment of skin soft tissue embolization or vascular occlusion after HA IR in Asians can be effected by identifying the stage and degree of embolization and treating appropriately with the outlines presented in this manuscript.
本手稿的目的是研究亚洲人接受注射用透明质酸（HA）隆鼻（IR）注射后发生皮肤软组织栓塞或血管阻塞的治疗方法，特别关注阻塞的发生时间。
共评估了 35 例因 HA 注射后出现血管阻塞事件而接受治疗的病例。根据栓塞时间将其分为三个阶段：即刻，≤5 小时；早期，≤3 天；晚期，>3 天。其中有 2 例即刻，28 例早期，5 例晚期。根据这些阶段，本文回顾了预防组织坏死的方法。
11 例轻度栓塞患者经过 11 次治疗后皮肤颜色逐渐恢复正常。19 例中度栓塞患者未观察到缺血加重或皮肤坏死；2 例出现红色瘢痕，1 例出现不均匀肤色的肥厚性瘢痕。5 例严重患者的愈合时间更长，红色瘢痕更多，肥厚性瘢痕更严重。
通过识别栓塞的阶段和程度，并根据本文提供的治疗方案进行适当治疗，可以对亚洲人接受 HA-IR 后皮肤软组织栓塞或血管阻塞进行治疗。
